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

Section: PASTMEDICALHX
Patient Information: Significant for hypertension, type 2 diabetes mellitus, asthma, and high cholesterol.

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.

assistant: Can you tell me what are the diseases you have been diagnosed with in the past?

user: Sure, I have had hypertension, diabetes, asthma and cholesterol problem.

assistant: Ok, is there anything else?

user: Nope.
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: PASTMEDICALHX
Patient Information: Status post right orchiectomy secondary to his testicular cancer 18 years ago approximately 1989, GERD, irritable bowel syndrome, seasonal asthma (fall and spring) triggered by postnasal drip, history of bilateral carpal tunnel syndrome, and status post excision of abdominal teratoma and incisional hernia.

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.

assistant: Good afternoon, sir. Do you remember the details of your surgery?

user: No, can you remind me?

assistant: Well, um, we did a right orchiectomy due to your testicular cancer, when did you have that?

user: Um, it was about eighteen years ago now, so that was about nineteen eighty nine.

assistant: Good, while you're here, do you have any other conditions that I should be aware of?

user: Sure, I have G E R D, and um, I B S.

assistant: Thank you, what about allergies, do those bother you?

user: Yeah, unfortunately I have those.

assistant: Do you have them in the spring, or in the fall?

user: Actually, I have them in both. It's really annoying.

assistant: What allergy symptoms do you have usually?

user: Um, another doctor called it a postnasal drip.

assistant: Okay, yes, I'm familiar with that. Have you ever had any other surgeries?

user: Yeah, um, I had a hernia removed and repaired some time ago.

assistant: I see, what about any other major medical conditions?

user: I've had carpal tunnel before.

assistant: Which hands did you have it in?

user: I've had it in both.
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: PASTMEDICALHX
Patient Information: Status post right orchiectomy secondary to his testicular cancer 18 years ago approximately 1989, GERD, irritable bowel syndrome, seasonal asthma (fall and spring) triggered by postnasal drip, history of bilateral carpal tunnel syndrome, and status post excision of abdominal teratoma and incisional hernia.

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, can you remind me?

assistant: Well, um, we did a right orchiectomy due to your testicular cancer, when did you have that?

user: Um, it was about eighteen years ago now, so that was about nineteen eighty nine.

assistant: Good, while you're here, do you have any other conditions that I should be aware of?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: PASTMEDICALHX
Patient Information: Status post right orchiectomy secondary to his testicular cancer 18 years ago approximately 1989, GERD, irritable bowel syndrome, seasonal asthma (fall and spring) triggered by postnasal drip, history of bilateral carpal tunnel syndrome, and status post excision of abdominal teratoma and incisional hernia.

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, it was about eighteen years ago now, so that was about nineteen eighty nine.

assistant: Good, while you're here, do you have any other conditions that I should be aware of?

user: Sure, I have G E R D, and um, I B S.

assistant: Thank you, what about allergies, do those bother you?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: PASTMEDICALHX
Patient Information: Status post right orchiectomy secondary to his testicular cancer 18 years ago approximately 1989, GERD, irritable bowel syndrome, seasonal asthma (fall and spring) triggered by postnasal drip, history of bilateral carpal tunnel syndrome, and status post excision of abdominal teratoma and incisional hernia.

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: Sure, I have G E R D, and um, I B S.

assistant: Thank you, what about allergies, do those bother you?

user: Yeah, unfortunately I have those.

assistant: Do you have them in the spring, or in the fall?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: PASTMEDICALHX
Patient Information: Status post right orchiectomy secondary to his testicular cancer 18 years ago approximately 1989, GERD, irritable bowel syndrome, seasonal asthma (fall and spring) triggered by postnasal drip, history of bilateral carpal tunnel syndrome, and status post excision of abdominal teratoma and incisional hernia.

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, unfortunately I have those.

assistant: Do you have them in the spring, or in the fall?

user: Actually, I have them in both. It's really annoying.

assistant: What allergy symptoms do you have usually?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: PASTMEDICALHX
Patient Information: Status post right orchiectomy secondary to his testicular cancer 18 years ago approximately 1989, GERD, irritable bowel syndrome, seasonal asthma (fall and spring) triggered by postnasal drip, history of bilateral carpal tunnel syndrome, and status post excision of abdominal teratoma and incisional hernia.

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, I have them in both. It's really annoying.

assistant: What allergy symptoms do you have usually?

user: Um, another doctor called it a postnasal drip.

assistant: Okay, yes, I'm familiar with that. Have you ever had any other surgeries?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: PASTMEDICALHX
Patient Information: Status post right orchiectomy secondary to his testicular cancer 18 years ago approximately 1989, GERD, irritable bowel syndrome, seasonal asthma (fall and spring) triggered by postnasal drip, history of bilateral carpal tunnel syndrome, and status post excision of abdominal teratoma and incisional hernia.

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, another doctor called it a postnasal drip.

assistant: Okay, yes, I'm familiar with that. Have you ever had any other surgeries?

user: Yeah, um, I had a hernia removed and repaired some time ago.

assistant: I see, what about any other major medical conditions?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: PASTMEDICALHX
Patient Information: Status post right orchiectomy secondary to his testicular cancer 18 years ago approximately 1989, GERD, irritable bowel syndrome, seasonal asthma (fall and spring) triggered by postnasal drip, history of bilateral carpal tunnel syndrome, and status post excision of abdominal teratoma and incisional hernia.

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, um, I had a hernia removed and repaired some time ago.

assistant: I see, what about any other major medical conditions?

user: I've had carpal tunnel before.

assistant: Which hands did you have it in?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: PASTMEDICALHX
Patient Information: Status post right orchiectomy secondary to his testicular cancer 18 years ago approximately 1989, GERD, irritable bowel syndrome, seasonal asthma (fall and spring) triggered by postnasal drip, history of bilateral carpal tunnel syndrome, and status post excision of abdominal teratoma and incisional hernia.

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 had carpal tunnel before.

assistant: Which hands did you have it in?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: PASTMEDICALHX
Patient Information: Status post right orchiectomy secondary to his testicular cancer 18 years ago approximately 1989, GERD, irritable bowel syndrome, seasonal asthma (fall and spring) triggered by postnasal drip, history of bilateral carpal tunnel syndrome, and status post excision of abdominal teratoma and incisional hernia.

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.

assistant: Good afternoon, sir. Do you remember the details of your surgery?

user: No, can you remind me?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: PASTMEDICALHX
Patient Information: Status post right orchiectomy secondary to his testicular cancer 18 years ago approximately 1989, GERD, irritable bowel syndrome, seasonal asthma (fall and spring) triggered by postnasal drip, history of bilateral carpal tunnel syndrome, and status post excision of abdominal teratoma and incisional hernia.

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.

assistant: Good afternoon, sir. Do you remember the details of your surgery?

user: No, can you remind me?

assistant: Well, um, we did a right orchiectomy due to your testicular cancer, when did you have that?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: PASTMEDICALHX
Patient Information: Status post right orchiectomy secondary to his testicular cancer 18 years ago approximately 1989, GERD, irritable bowel syndrome, seasonal asthma (fall and spring) triggered by postnasal drip, history of bilateral carpal tunnel syndrome, and status post excision of abdominal teratoma and incisional hernia.

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.

assistant: Good afternoon, sir. Do you remember the details of your surgery?

user: No, can you remind me?

assistant: Well, um, we did a right orchiectomy due to your testicular cancer, when did you have that?

user: Um, it was about eighteen years ago now, so that was about nineteen eighty nine.
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, that's me, good morning doctor.

assistant: Before we begin, I just need a few pieces of information. How old are you?

user: I'm forty four years young, doctor.

assistant: Good, thank you. Next, which hand do you write with?
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'm forty four years young, doctor.

assistant: Good, thank you. Next, which hand do you write with?

user: I write with my right hand.

assistant: Finally, what do you do for a living?
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 write with my right hand.

assistant: Finally, what do you do for a living?

user: I'm an aircraft mechanic.

assistant: Very nice, so, how did you get hurt?
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'm an aircraft mechanic.

assistant: Very nice, so, how did you get hurt?

user: Um, I was working on repairing an airplane at work when I fell between the plane and one of the stands.

assistant: How big was the gap that you stepped in?
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, I was working on repairing an airplane at work when I fell between the plane and one of the stands.

assistant: How big was the gap that you stepped in?

user: Um, it was about a foot and a half.

assistant: Which knee did you hurt?
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, it was about a foot and a half.

assistant: Which knee did you hurt?

user: It was my left knee.

assistant: Did you have surgery after the accident?
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: It was my left knee.

assistant: Did you have surgery after the accident?

user: Yes I did, I had two arthroscopies, and an, um, patellar replacement after those.

assistant: Okay, yes, I see.
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 I did, I had two arthroscopies, and an, um, patellar replacement after those.

assistant: Okay, yes, I see.

user: Then, I had a left knee replacement on Month D D, Y Y Y Y.

assistant: Do you have any imaging of this 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: Then, I had a left knee replacement on Month D D, Y Y Y Y.

assistant: Do you have any imaging of this knee?

user: I didn't have any x rays done, but I have an MRI report and notes from Doctor A B C D.

assistant: Can I see that report?
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 didn't have any x rays done, but I have an MRI report and notes from Doctor A B C D.

assistant: Can I see that report?

user: Yes absolutely, here.

assistant: Okay, so this M R I from September two thousand six shows some nonspecific edema anterior to the patellar tendon, but thankfully there's no evidence of fracture of ligamentous avulsion or abnormality.
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 absolutely, here.

assistant: Okay, so this M R I from September two thousand six shows some nonspecific edema anterior to the patellar tendon, but thankfully there's no evidence of fracture of ligamentous avulsion or abnormality.

user: What does that mean?

assistant: There's some bleeding in the bone there, but nothing is broken or out of alignment.
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: What does that mean?

assistant: There's some bleeding in the bone there, but nothing is broken or out of alignment.

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

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