conversations.from: human
conversations.value: What could be a title for a book about Additionally, checkpoint, Doody's with the genre: Medical Books, Medicine?
conversations.from: assistant
conversations.value: A title for this book could be 'Pathophysiology of Disease'
conversations.from: human
conversations.value: the first five paragraphs for this book
conversations.from: assistant
conversations.value: Pathophysiology of Disease
  A 4-week-old boy is brought in with pain and swelling of the right thigh. An x-ray film reveals an acute fracture of the right femur. Questioning of the mother reveals that the boy was born with two other known fractures—left humerus and right clavicle—which had been attributed to birth trauma. The family history is notable for bone problems in several family members. A diagnosis of type II osteogenesis imperfecta is entertained.
  A newborn girl tests positive for phenylketonuria (PKU) on a newborn screening examination. The results of a confirmatory serum test done at 2 weeks of age are also positive, establishing the diagnosis of PKU.
  A young woman is referred for genetic counseling. She has a 3-year-old boy with developmental delay and small joint hyperextensibility. The pediatrician has diagnosed fragile X–associated mental retardation. She is currently pregnant with her second child at 14 weeks of gestation. The family history is unremarkable.
  A 16-year-old boy presents with worsening vision for the past 2 months. He first noticed that he was having trouble with central vision in his right eye, seeing a dark spot in the center of his visual field. The dark spot had become larger over time, and he had also developed loss of central vision in his left eye. Two of his maternal uncles had loss of vision, but his mother and another maternal uncle and two maternal aunts had no visual difficulties. No one on his father's side was affected. Physical examination reveals microangiopathy and vascular tortuosity of the retina. Genetic testing confirms the diagnosis of Leber hereditary optic neuropathy (LHON).
  A 40-year-old woman undergoes prenatal screening with amniocentesis during her 16th week of pregnancy. The results of the amniocentesis show trisomy 21 or Down syndrome. She has several questions about what she might expect.
conversations.from: human
conversations.value: five more paragraphs. Start with the sentence 'A 65 year-old woman is hospitalized with a large anterior myocardial infarction'.
conversations.from: assistant
conversations.value: A 65 year-old woman is hospitalized with a large anterior myocardial infarction. After 4 days in the hospital, she is doing well and plans are being made for discharge to a rehabilitation facility to help her regain her strength and recover her cardiac function. While going to the bathroom, she passes out suddenly. On examination, her blood pressure is 60/40 mm Hg, her heart rate is 120, and she has distant heart sounds. An emergent echocardiogram shows rupture of the anterior wall and pericardial tamponade.
  A 65-year-old woman presents to the clinic to establish care. Her past medical history is notable for type 2 diabetes and hypertension. She has a 45-pack-year smoking history. A few weeks ago, she was shoveling her driveway when she had to stop due to tightness in her chest. She does not get any regular exercise due to the fact that her calves become very painful after walking one block.
  A 56-year-old African American man presents to the clinic for a routine physical examination. He has not seen a physician for 10 years. On arrival, he is noted to have a blood pressure of 160/90 mm Hg.
  A young woman is brought to the emergency department by ambulance after a severe motor vehicle accident. She is unconscious. Her blood pressure is 64/40 mm Hg; heart rate is 150 bpm. She is intubated and is being hand-ventilated. There is no evidence of head trauma. The pupils are 2 mm and reactive. She withdraws to pain. Cardiac examination reveals no murmurs, gallops, or rubs. The lungs are clear to auscultation. The abdomen is tense, with decreased bowel sounds. The extremities are cool and clammy, with thready pulses. Despite aggressive blood and fluid resuscitation, the patient dies.
  A 39-year-old woman comes to the office complaining of episodic anxiety, headache, and palpitations. Without dieting, she has lost 15 pounds over the past 6 months. Physical examination is normal except for a blood pressure of 200/100 mm Hg and a resting pulse rate of 110 bpm. Chart review shows that prior blood pressures have always been normal, including one 6 months ago. A pheochromocytoma diagnosis is entertained.
conversations.from: human
conversations.value: the last two paragraphs
conversations.from: assistant
conversations.value: A 55 year-old woman presents to a medical office with progressive weakness. She had been in good health until about six weeks ago when she began having trouble getting up from a low chair. Her muscle weakness has become more pronounced over time, and she now also has difficulty climbing stairs and brushing her hair. Her shoulders and thighs are mildly achy but not painful. She is well-appearing with normal vital signs and an essentially normal physical examination with the exception of mild tenderness of her shoulders and thighs. She does not have a rash. Laboratory tests are notable for a creatine phosphokinase level of 840 IU/L (normal female: 26–180 IU/L) and an aldolase value of 32 IU/L (normal: 1.0–7.0 IU/L). Her electromyogram shows that her muscles produce sharp waves and spontaneous discharges. She is diagnosed with polymyositis.
  A 47-year-old woman presents to the clinic with a four-week history of fatigue, bilateral hand pain and stiffness, together with hand and wrist joint swelling. About a month before presentation, she noticed that her hands were stiffer in the morning, but thought that it was due to too much typing. However, the stiffness has worsened, and she now needs about an hour each morning to "loosen up" her hands. As the day goes on, the stiffness improves, although it does not go away entirely. She has also noticed that her knuckles and wrists are swollen and feel somewhat warm. Physical examination reveals warm, erythematous wrists and metacarpal joints bilaterally. Hand x-ray films show periarticular demineralization and erosions, and blood test results are significant for a mild anemia, elevated sedimentation rate, and a positive rheumatoid factor. The patient is diagnosed with rheumatoid arthritis.