vania-janet/multiturn-rag-retrieval-data huggingface dataset:
Anemia
Anemia goes undetected in many people and symptoms can be minor . The symptoms can be related to an underlying cause or the anemia itself . Most commonly , people with anemia report feelings of weakness or fatigue , and sometimes poor concentration . They may also report shortness of breath on exertion . In very severe anemia , the body may compensate for the lack of oxygen - carrying capability of the blood by increasing cardiac output . The patient may have symptoms related to this , such as palpitations , angina ( if pre-existing heart disease is present ) , intermittent claudication of the legs , and symptoms of heart failure . On examination , the signs exhibited may include pallor ( pale skin , lining mucosa , conjunctiva and nail beds ) , but this is not a reliable sign . There may be signs of specific causes of anemia , e.g. , koilonychia ( in iron deficiency ) , jaundice ( when anemia results from abnormal break down of red blood cells -- in hemolytic anemia ) , bone deformities ( found in thalassemia major ) or leg ulcers ( seen in sickle - cell disease ) . In severe anemia , there may be signs of a hyperdynamic circulation : tachycardia ( a fast heart rate ) , bounding pulse , flow murmurs , and cardiac ventricular hypertrophy ( enlargement ) . There may be signs of heart failure . Pica , the consumption of non-food items such as ice , but also paper , wax , or grass , and even hair or dirt , may be a symptom of iron deficiency , although it occurs often in those who have normal levels of hemoglobin . Chronic anemia may result in behavioral disturbances in children as a direct result of impaired neurological development in infants , and reduced academic performance in children of school age . Restless legs syndrome is more common in those with iron - deficiency anemia .
Sickle cell disease
The loss of red blood cell elasticity is central to the pathophysiology of sickle cell disease . Normal red blood cells are quite elastic , which allows the cells to deform to pass through capillaries . In sickle cell disease , low oxygen tension promotes red blood cell sickling and repeated episodes of sickling damage the cell membrane and decrease the cell 's elasticity . These cells fail to return to normal shape when normal oxygen tension is restored . As a consequence , these rigid blood cells are unable to deform as they pass through narrow capillaries , leading to vessel occlusion and ischaemia .
White blood cell
Another way to categorize disorders of white blood cells is qualitatively . There are various disorders in which the number of white blood cells is normal but the cells do not function normally .
Anemia
Intrinsic ( intracorpuscular ) abnormalities cause premature destruction . All of these , except paroxysmal nocturnal hemoglobinuria , are hereditary genetic disorders . Hereditary spherocytosis is a hereditary defect that results in defects in the RBC cell membrane , causing the erythrocytes to be sequestered and destroyed by the spleen . Hereditary elliptocytosis is another defect in membrane skeleton proteins . Abetalipoproteinemia , causing defects in membrane lipids Enzyme deficiencies Pyruvate kinase and hexokinase deficiencies , causing defect glycolysis Glucose - 6 - phosphate dehydrogenase deficiency and glutathione synthetase deficiency , causing increased oxidative stress Hemoglobinopathies Sickle cell anemia Hemoglobinopathies causing unstable hemoglobins Paroxysmal nocturnal hemoglobinuria Extrinsic ( extracorpuscular ) abnormalities Antibody - mediated Warm autoimmune hemolytic anemia is caused by autoimmune attack against red blood cells , primarily by IgG . It is the most common of the autoimmune hemolytic diseases . It can be idiopathic , that is , without any known cause , drug - associated or secondary to another disease such as systemic lupus erythematosus , or a malignancy , such as chronic lymphocytic leukemia . Cold agglutinin hemolytic anemia is primarily mediated by IgM . It can be idiopathic or result from an underlying condition . Rh disease , one of the causes of hemolytic disease of the newborn Transfusion reaction to blood transfusions Mechanical trauma to red blood cells Microangiopathic hemolytic anemias , including thrombotic thrombocytopenic purpura and disseminated intravascular coagulation Infections , including malaria Heart surgery Haemodialysis
Diphtheria
In cases that progress beyond a throat infection , diphtheria toxin spreads through the blood and can lead to potentially life - threatening complications that affect other organs , such as the heart and kidneys . Damage to the heart caused by the toxin affects the heart 's ability to pump blood or the kidneys ' ability to clear wastes . It can also cause nerve damage , eventually leading to paralysis . About 40 % to 50 % of those left untreated can die .
Anemia
Anemia is a decrease in the total amount of red blood cells ( RBCs ) or hemoglobin in the blood , or a lowered ability of the blood to carry oxygen . When anemia comes on slowly , the symptoms are often vague and may include feeling tired , weakness , shortness of breath or a poor ability to exercise . Anemia that comes on quickly often has greater symptoms , which may include confusion , feeling like one is going to pass out , loss of consciousness , or increased thirst . Anemia must be significant before a person becomes noticeably pale . Additional symptoms may occur depending on the underlying cause .
Anemia
Anemia Reticulocyte production index shows inadequate production response to anemia . Reticulocyte production index shows appropriate response to anemia = ongoing hemolysis or blood loss without RBC production problem . No clinical findings consistent with hemolysis or blood loss : pure disorder of production . Clinical findings and abnormal MCV : hemolysis or loss and chronic disorder of production * . Clinical findings and normal MCV = acute hemolysis or loss without adequate time for bone marrow production to compensate * * . Macrocytic anemia ( MCV > 100 ) Normocytic anemia ( 80 < MCV < 100 ) Microcytic anemia ( MCV < 80 )
Nervous system
Physical damage to the spinal cord may result in loss of sensation or movement . If an injury to the spine produces nothing worse than swelling , the symptoms may be transient , but if nerve fibers in the spine are actually destroyed , the loss of function is usually permanent . Experimental studies have shown that spinal nerve fibers attempt to regrow in the same way as nerve fibers , but in the spinal cord , tissue destruction usually produces scar tissue that can not be penetrated by the regrowing nerves .
Sickle cell disease
While umbilical cord blood transplant can potentially cure the condition , a suitable donor is available in only 10 % of people . About 7 % of people also die as a result of the procedure and graft versus host disease may occur .
Lead poisoning
Lead has no known physiologically relevant role in the body , and its harmful effects are myriad . Lead and other heavy metals create reactive radicals which damage cell structures including DNA and cell membranes . Lead also interferes with DNA transcription , enzymes that help in the synthesis of vitamin D , and enzymes that maintain the integrity of the cell membrane . Anemia may result when the cell membranes of red blood cells become more fragile as the result of damage to their membranes . Lead interferes with metabolism of bones and teeth and alters the permeability of blood vessels and collagen synthesis . Lead may also be harmful to the developing immune system , causing production of excessive inflammatory proteins ; this mechanism may mean that lead exposure is a risk factor for asthma in children . Lead exposure has also been associated with a decrease in activity of immune cells such as polymorphonuclear leukocytes . Lead also interferes with the normal metabolism of calcium in cells and causes it to build up within them .
Red blood cell distribution width
A false high RDW reading can occur if EDTA anticoagulated blood is used instead of citrated blood . See Pseudothrombocytopenia .
Huntington's disease
Several pathways by which mHTT may cause cell death have been identified . These include : effects on chaperone proteins , which help fold proteins and remove misfolded ones ; interactions with caspases , which play a role in the process of removing cells ; the toxic effects of glutamine on nerve cells ; impairment of energy production within cells ; and effects on the expression of genes .
Polycythemia
Relative polycythemia is an apparent rise of the erythrocyte level in the blood ; however , the underlying cause is reduced blood plasma ( hypovolemia , cf . dehydration ) . Relative polycythemia is often caused by loss of body fluids , such as through burns , dehydration , and stress . A specific type of relative polycythemia is Gaisböck syndrome . In this syndrome , primarily occurring in obese men , hypertension causes a reduction in plasma volume , resulting in ( amongst other changes ) a relative increase in red blood cell count .
Anemia
Certain gastrointestinal disorders can cause anemia . The mechanisms involved are multifactorial and not limited to malabsorption but mainly related to chronic intestinal inflammation , which causes dysregulation of hepcidin that leads to decreased access of iron to the circulation .
Lead poisoning
Blood film examination may reveal basophilic stippling of red blood cells ( dots in red blood cells visible through a microscope ) , as well as the changes normally associated with iron - deficiency anemia ( microcytosis and hypochromasia ) . However , basophilic stippling is also seen in unrelated conditions , such as megaloblastic anemia caused by vitamin B12 ( colbalamin ) and folate deficiencies .
Water fluoridation
Fluoridation has little effect on risk of bone fracture ( broken bones ) ; it may result in slightly lower fracture risk than either excessively high levels of fluoridation or no fluoridation . There is no clear association between fluoridation and cancer or deaths due to cancer , both for cancer in general and also specifically for bone cancer and osteosarcoma . Other adverse effects lack sufficient evidence to reach a confident conclusion .
Anemia
Heme synthesis defect Iron deficiency anemia ( microcytosis is not always present ) Anemia of chronic disease ( more commonly presenting as normocytic anemia ) Globin synthesis defect Alpha - , and beta - thalassemia HbE syndrome HbC syndrome Various other unstable hemoglobin diseases Sideroblastic defect Hereditary sideroblastic anemia Acquired sideroblastic anemia , including lead toxicity Reversible sideroblastic anemia
Megaloblastic anemia
Megaloblastic anemia ( or megaloblastic anaemia ) is an anemia ( of macrocytic classification ) that results from inhibition of DNA synthesis during red blood cell production . When DNA synthesis is impaired , the cell cycle can not progress from the G2 growth stage to the mitosis ( M ) stage . This leads to continuing cell growth without division , which presents as macrocytosis . Megaloblastic anemia has a rather slow onset , especially when compared to that of other anemias . The defect in red cell DNA synthesis is most often due to hypovitaminosis , specifically a deficiency of vitamin B and / or folic acid . Vitamin B deficiency alone will not cause the syndrome in the presence of sufficient folate , as the mechanism is loss of B dependent folate recycling , followed by folate - deficiency loss of nucleic acid synthesis ( specifically thymine ) , leading to defects in DNA synthesis . Folic acid supplementation in the absence of vitamin B prevents this type of anemia ( although other vitamin B - specific pathologies may be present ) . Loss of micronutrients may also be a cause . Copper deficiency resulting from an excess of zinc from unusually high oral consumption of zinc - containing denture - fixation creams has been found to be a cause .
Stem cell
Hepatotoxicity and drug - induced liver injury account for a substantial number of failures of new drugs in development and market withdrawal , highlighting the need for screening assays such as stem cell - derived hepatocyte - like cells , that are capable of detecting toxicity early in the drug development process .
White blood cell
Neutrophilia is an increase in the absolute neutrophil count in the peripheral circulation . Normal blood values vary by age . Neutrophilia can be caused by a direct problem with blood cells ( primary disease ) . It can also occur as a consequence of an underlying disease ( secondary ) . Most cases of neutrophilia are secondary to inflammation .
Cavalier King Charles Spaniel
As many as half of all Cavalier King Charles Spaniels may have a congenital blood disorder called idiopathic asymptomatic thrombocytopenia , an abnormally low number of platelets in the blood , according to recent studies in Denmark and the United States . Platelets , or thrombocytes , are disk - shaped blood elements which aid in blood clotting . Excessively low numbers are the most common cause of bleeding disorders in dogs . The platelets in the blood of many Cavalier King Charles Spaniels are a combination of those of normal size for dogs and others that are abnormally oversized , or macrothrombocytes . Macrothrombocytosis also is a congenital abnormality found in at least a third of CKCSs . These large platelets function normally , and the typical Cavalier does not appear to experience any health problems due to either the size or fewer numbers of its platelets .
Eating disorder
Anorexia Nervosa symptoms include the increasing chance of getting osteoporosis . This disease causes the bones of an individual to become brittle , weak , and low in density . Thinning of the hair as well as dry hair and skin is also very common . The muscles of the heart will also start to change if no treatment is inflicted on the patient . This causes the heart to have an abnormally slow heart rate along with low blood pressure . Heart failure becomes a major consideration when this begins to occur . Muscles throughout the body begin to lose their strength . This will cause the individual to begin feeling faint , drowsy , and weak . Along with these symptoms , the body will begin to grow a layer of hair called lanugo . The human body does this in response to the lack of heat and insulation due to the low percentage of body fat .
Nutrition and cognition
Mild to moderate cases of pernicious anemia may show poor concentration . In severe cases of pernicious anemia , individuals may present with various cognitive problems such as dementia , and memory loss . It is not always easy to determine whether B deficiency is present , especially within older adults . Patients may present with violent behavior or more subtle personality changes . They may also present with vague complaints , such as fatigue or memory loss , that may be attributed to normative aging processes . Cognitive symptoms may mimic behavior in Alzheimer 's and other dementias as well .
Anemia
The causes of anemia may be classified as impaired red blood cell ( RBC ) production , increased RBC destruction ( hemolytic anemias ) , blood loss and fluid overload ( hypervolemia ) . Several of these may interplay to cause anemia eventually . Indeed , the most common cause of anemia is blood loss , but this usually does not cause any lasting symptoms unless a relatively impaired RBC production develops , in turn most commonly by iron deficiency . ( See Iron deficiency anemia )
Anemia
The three main types of anemia are due to blood loss , decreased red blood cell production , and increased red blood cell breakdown . Causes of blood loss include trauma and gastrointestinal bleeding , among others . Causes of decreased production include iron deficiency , a lack of vitamin B12 , thalassemia , and a number of neoplasms of the bone marrow . Causes of increased breakdown include a number of genetic conditions such as sickle cell anemia , infections like malaria , and certain autoimmune diseases . It can also be classified based on the size of red blood cells and amount of hemoglobin in each cell . If the cells are small , it is microcytic anemia . If they are large , it is macrocytic anemia while if they are normal sized , it is normocytic anemia . Diagnosis in men is based on a hemoglobin of less than 130 to 140 g / L ( 13 to 14 g / dL ) , while in women , it must be less than 120 to 130 g / L ( 12 to 13 g / dL ) . Further testing is then required to determine the cause .
Myocardial infarction
Tissue death and myocardial scarring alter the normal conduction pathways of the heart , and weaken affected areas . The size and location puts a person at risk of abnormal heart rhythms ( arrhythmias ) or heart block , aneurysm of the heart ventricles , inflammation of the heart wall following infarction , and rupture of the heart wall that can have catastrophic consequences .
Cremation
An unavoidable consequence of cremation is that a tiny residue of bodily remains is left in the chamber after cremation and mixes with subsequent cremations .
Bubonic plague
Y. pestis bacilli can resist phagocytosis and even reproduce inside phagocytes and kill them . As the disease progresses , the lymph nodes can haemorrhage and become swollen and necrotic . Bubonic plague can progress to lethal septicemic plague in some cases . The plague is also known to spread to the lungs and become the disease known as the pneumonic plague .
Radioactive decay
However , the biological effects of radiation due to radioactive substances were less easy to gauge . This gave the opportunity for many physicians and corporations to market radioactive substances as patent medicines . Examples were radium enema treatments , and radium - containing waters to be drunk as tonics . Marie Curie protested against this sort of treatment , warning that the effects of radiation on the human body were not well understood . Curie later died from aplastic anaemia , likely caused by exposure to ionizing radiation . By the 1930s , after a number of cases of bone necrosis and death of radium treatment enthusiasts , radium - containing medicinal products had been largely removed from the market ( radioactive quackery ) .
Red blood cell distribution width
An elevation in the RDW is not characteristic of all anemias . Anemia of chronic disease , hereditary spherocytosis , acute blood loss , aplastic anemia ( anemia resulting from an inability of the bone marrow to produce red blood cells ) , and certain hereditary hemoglobinopathies ( including some cases of thalassemia minor ) may all present with a normal RDW .
Sickle cell disease
Sickle cell disease ( SCD ) is a group of blood disorders typically inherited from a person 's parents . The most common type is known as sickle cell anaemia ( SCA ) . It results in an abnormality in the oxygen - carrying protein haemoglobin found in red blood cells . This leads to a rigid , sickle - like shape under certain circumstances . Problems in sickle cell disease typically begin around 5 to 6 months of age . A number of health problems may develop , such as attacks of pain ( `` sickle cell crisis '' ) , anemia , swelling in the hands and feet , bacterial infections and stroke . Long - term pain may develop as people get older . The average life expectancy in the developed world is 40 to 60 years .
Human brain
Brain damage , or disease of the brain can manifest in a wide variety of ways . Traumatic brain injury , for example in contact sport , after a fall , or in traffic or work accidents , can be associated with both immediate and longer - term problems . Immediate problems that develop may include bleeding within the skull , compressing the brain tissue or damaging its blood supply , skull fractures , injury to a particular area , deafness , and concussion . In addition to the site of injury , the opposite side of the brain may be affected , termed a contrecoup injury . Longer - term issues that may develop include post-traumatic stress , hydrocephalus , and chronic traumatic encephalopathy .
Sickle cell disease
Signs of sickle cell disease usually begin in early childhood . The severity of symptoms can vary from person to person . Sickle cell disease may lead to various acute and chronic complications , several of which have a high mortality rate .
T cell
Causes of T cell deficiency include lymphocytopenia of T cells and / or defects on function of individual T cells . Complete insufficiency of T cell function can result from hereditary conditions such as severe combined immunodeficiency ( SCID ) , Omenn syndrome , and cartilage -- hair hypoplasia . Causes of partial insufficiencies of T cell function include acquired immune deficiency syndrome ( AIDS ) , and hereditary conditions such as DiGeorge syndrome ( DGS ) , chromosomal breakage syndromes ( CBSs ) , and B - cell and T - cell combined disorders such as ataxia - telangiectasia ( AT ) and Wiskott -- Aldrich syndrome ( WAS ) .
Anemia
The `` kinetic '' approach to anemia yields arguably the most clinically relevant classification of anemia . This classification depends on evaluation of several hematological parameters , particularly the blood reticulocyte ( precursor of mature RBCs ) count . This then yields the classification of defects by decreased RBC production versus increased RBC destruction or loss . Clinical signs of loss or destruction include abnormal peripheral blood smear with signs of hemolysis ; elevated LDH suggesting cell destruction ; or clinical signs of bleeding , such as guaiac - positive stool , radiographic findings , or frank bleeding . The following is a simplified schematic of this approach :
Sickle cell disease
The protective effect of sickle cell trait does not apply to people with sickle cell disease ; in fact , they are more vulnerable to malaria , since the most common cause of painful crises in malarial countries is infection with malaria . It has therefore been recommended that people with sickle cell disease living in malarial countries should receive anti-malarial chemoprophylaxis for life .
Medical diagnosis
A failure to respond to treatments that would normally work may indicate a need for review of the diagnosis .
Sickle cell disease
The terms `` sickle cell crisis '' or `` sickling crisis '' may be used to describe several independent acute conditions occurring in patients with SCD . SCD results in anaemia and crises that could be of many types including the vaso - occlusive crisis , aplastic crisis , sequestration crisis , haemolytic crisis , and others . Most episodes of sickle cell crises last between five and seven days . `` Although infection , dehydration , and acidosis ( all of which favor sickling ) can act as triggers , in most instances , no predisposing cause is identified . ''
Sickle cell disease
Blood transfusions are often used in the management of sickle cell disease in acute cases and to prevent complications by decreasing the number of red blood cells ( RBC ) that can sickle by adding normal red blood cells . In children preventative red blood cell ( RBC ) transfusion therapy has been shown to reduce the risk of first stroke or silent stroke when transcranial Doppler ( TCD ) ultrasonography shows abnormal cerebral blood flow . In those who have sustained a prior stroke event it also reduces the risk of recurrent stroke and additional silent strokes .