diff --git "a/data_dev.csv" "b/data_dev.csv" --- "a/data_dev.csv" +++ "b/data_dev.csv" @@ -1,10 +1,17 @@ -,text +,prompt,response,text 0,"Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Increased velocity of conduction in a nerve is oured by, with the following options: A: Increased capacitance, B: Decreased capacitance, C: Increased resistance, D: Increased velocity +### Response: +","In unmyelinated fibers, electrical impulses (action potentials) travel as continuous waves, but, in myelinated fibers, they ""hop"" or propagate by saltatory conduction. ... Myelin decreases capacitance and increases electrical resistance across the axonal membrane (the axolemma) Ref: guyton and hall textbook of medical physiology 12 edition page number:57,58,59","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Increased velocity of conduction in a nerve is oured by, with the following options: A: Increased capacitance, B: Decreased capacitance, C: Increased resistance, D: Increased velocity + ### Response: In unmyelinated fibers, electrical impulses (action potentials) travel as continuous waves, but, in myelinated fibers, they ""hop"" or propagate by saltatory conduction. ... Myelin decreases capacitance and increases electrical resistance across the axonal membrane (the axolemma) Ref: guyton and hall textbook of medical physiology 12 edition page number:57,58,59 ### End" @@ -14,6 +21,13 @@ In unmyelinated fibers, electrical impulses (action potentials) travel as contin Answer the following medical question: All regarding HSP is true except, with the following options: A: Hematuria resolve without treatment, B: Steroids best treat skin lesions, C: Self limiting ahralgia, D: Excellent prognosis +### Response: +","B i.e. Steroids best treat skin lesions Presence of palpable (non-blanching) purpura, mainly involving dependent areas such as buttocks & lower extremities in children & adolescents (along with ahralgia; gastrointestinal bleedin colic abdominal pain, hematuriaQ, and histo pathological demonstration of extra /peri- vascular neutrophil (granulocyte) infiltrates (leukocytoclastic vasculitis)Q with IgA (mostly IgAl subtype) and C3 deposition about small blood vessels in skin, intestine and kidneyQ by immunofluorescence is diagnostic of - Henoch - Schonlein purpura. Meningiococcernia presents with sho lived UI, nausea, headache muscle soreness followed by --+ fever, obtundation, meningitis --> vomiting, stupor, hemorrhagic rash & hypotension. Skin findings include transient macular & papular lesions (resembling viral exanthema) f/b characteristic small, irregular, smudged appearance, asymmetrical petechiae most often on extremities & trunk but can also be on head, palm, sole & mucous membrane Extensive maplike hemorrhagic lesions with central necrosis (suggilations) & bullae can develop. Purpura Fulminans is extensive hemorrhagic necrosis of skin d/ t DIC (disseminated intravascular coagulation). It may be idiopathic (with in 10 days of Scarlet fever or varicella), secondary (in acute sepsis with gram +ve or -ye organism most commonly meningococcemia) or associated with homozygous protein C deficiency.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All regarding HSP is true except, with the following options: A: Hematuria resolve without treatment, B: Steroids best treat skin lesions, C: Self limiting ahralgia, D: Excellent prognosis + ### Response: B i.e. Steroids best treat skin lesions Presence of palpable (non-blanching) purpura, mainly involving dependent areas such as buttocks & lower extremities in children & adolescents (along with ahralgia; gastrointestinal bleedin colic abdominal pain, hematuriaQ, and histo pathological demonstration of extra /peri- vascular neutrophil (granulocyte) infiltrates (leukocytoclastic vasculitis)Q with IgA (mostly IgAl subtype) and C3 deposition about small blood vessels in skin, intestine and kidneyQ by immunofluorescence is diagnostic of - Henoch - Schonlein purpura. Meningiococcernia presents with sho lived UI, nausea, headache muscle soreness followed by --+ fever, obtundation, meningitis --> vomiting, stupor, hemorrhagic rash & hypotension. Skin findings include transient macular & papular lesions (resembling viral exanthema) f/b characteristic small, irregular, smudged appearance, asymmetrical petechiae most often on extremities & trunk but can also be on head, palm, sole & mucous membrane Extensive maplike hemorrhagic lesions with central necrosis (suggilations) & bullae can develop. Purpura Fulminans is extensive hemorrhagic necrosis of skin d/ t DIC (disseminated intravascular coagulation). It may be idiopathic (with in 10 days of Scarlet fever or varicella), secondary (in acute sepsis with gram +ve or -ye organism most commonly meningococcemia) or associated with homozygous protein C deficiency. ### End" @@ -23,6 +37,13 @@ B i.e. Steroids best treat skin lesions Presence of palpable (non-blanching) pur Answer the following medical question: In positively skewed detion ?, with the following options: A: Mean = Median = Mode, B: Mean > Medians > Mode, C: Mode > Median > Mean, D: None of the above +### Response: +","Ans. is 'b' i.e., Mean > Medians > Mode","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In positively skewed detion ?, with the following options: A: Mean = Median = Mode, B: Mean > Medians > Mode, C: Mode > Median > Mean, D: None of the above + ### Response: Ans. is 'b' i.e., Mean > Medians > Mode ### End" @@ -32,6 +53,13 @@ Ans. is 'b' i.e., Mean > Medians > Mode Answer the following medical question: 20 year old male presented with eczema, recurrent skin abscesses, recurrent lung infections. There is eosinophilia and high serum levels of IgE. Diagnosis is, with the following options: A: Job's syndrome, B: Shwachwan's disease, C: Wiskott-Aldrich syndrome, D: Nezelof Syndrome +### Response: +","Job's syndrome or Hyper-IgE Syndrome Characterized by eczema, Staphylococcal skin abscesses, pneumatocele.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: 20 year old male presented with eczema, recurrent skin abscesses, recurrent lung infections. There is eosinophilia and high serum levels of IgE. Diagnosis is, with the following options: A: Job's syndrome, B: Shwachwan's disease, C: Wiskott-Aldrich syndrome, D: Nezelof Syndrome + ### Response: Job's syndrome or Hyper-IgE Syndrome Characterized by eczema, Staphylococcal skin abscesses, pneumatocele. ### End" @@ -41,6 +69,16 @@ Job's syndrome or Hyper-IgE Syndrome Characterized by eczema, Staphylococcal ski Answer the following medical question: As per the most common classification of Triage system that is internationally accepted, the colour code that indicates high priority treatment or transfer is, with the following options: A: Black, B: Red, C: Yellow, D: Blue +### Response: +","Red - High +Yellow - Medium +Green - Low +Black - Least","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: As per the most common classification of Triage system that is internationally accepted, the colour code that indicates high priority treatment or transfer is, with the following options: A: Black, B: Red, C: Yellow, D: Blue + ### Response: Red - High Yellow - Medium @@ -53,6 +91,13 @@ Black - Least Answer the following medical question: Majority of bladder cancers are:, with the following options: A: Adenocarcinoma, B: Adenosquamous carcinoma, C: Squamous carcinoma, D: Transitional cell carcinoma +### Response: +","Ans: D (Transitional cell carcinoma) Ref: Bailey & Love's Short Practice of Surgery,25th Edition 1334Explanation:Types of Bladder CancerTransitional Carcinoma - 90%Squomous cell carcinoma -5 (Associated with hilharzias)Adenocarcinoma -1-2% ( Arises either from the urachal remnant or from areas of glandular metaplasia)NoteMost common type of Prostrate cancer - AdenocarcinomaMost common type of Renal cell Carcinoma - Adenocarcinoma","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Majority of bladder cancers are:, with the following options: A: Adenocarcinoma, B: Adenosquamous carcinoma, C: Squamous carcinoma, D: Transitional cell carcinoma + ### Response: Ans: D (Transitional cell carcinoma) Ref: Bailey & Love's Short Practice of Surgery,25th Edition 1334Explanation:Types of Bladder CancerTransitional Carcinoma - 90%Squomous cell carcinoma -5 (Associated with hilharzias)Adenocarcinoma -1-2% ( Arises either from the urachal remnant or from areas of glandular metaplasia)NoteMost common type of Prostrate cancer - AdenocarcinomaMost common type of Renal cell Carcinoma - Adenocarcinoma ### End" @@ -62,6 +107,21 @@ Ans: D (Transitional cell carcinoma) Ref: Bailey & Love's Short Practice of Surg Answer the following medical question: Sucralfate does not interfere with the absorption of:, with the following options: A: Ciprooxacin, B: Phenytoin, C: Phenoxy methyl penicillin, D: Digoxin +### Response: +","Sucralfate forms a viscous layer in the stomach that prevents the absorption of other drugs such as digoxin, phenytoin, quinolone antibiotics, ketoconazole, and cimetidine. +Sucralfate comprises of sucrose octasulfate bound to aluminum hydroxide. In the presence of an acidic environment, sucralfate produces a sticky polymer which gets attached to the ulcer crater for at least 6 hours. +Other indications for sucralfate besides acid peptic disease: +Oral mucositis (Radiation and aphthous ulcers) +Bile reflux gastropathy +Side Effects +A most common side effect of sucralfate is constipation. +Bezoar formation can occur with consumption of sucralfate due to the sticky nature of the drug. +Bezoar formation is more prone to occur in patients with gastroparesis.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Sucralfate does not interfere with the absorption of:, with the following options: A: Ciprooxacin, B: Phenytoin, C: Phenoxy methyl penicillin, D: Digoxin + ### Response: Sucralfate forms a viscous layer in the stomach that prevents the absorption of other drugs such as digoxin, phenytoin, quinolone antibiotics, ketoconazole, and cimetidine. Sucralfate comprises of sucrose octasulfate bound to aluminum hydroxide. In the presence of an acidic environment, sucralfate produces a sticky polymer which gets attached to the ulcer crater for at least 6 hours. @@ -79,6 +139,13 @@ Bezoar formation is more prone to occur in patients with gastroparesis. Answer the following medical question: The following test is not used for diagnosis of leprosy –, with the following options: A: Lepromin test, B: Slit skin smear, C: Fine needle aspiration cytology, D: Skin biopsy +### Response: +","Lepromin Test is not used to diagnose leprosy, nor does it indicate prior contact with lepra bacilli. Healthy persons in nonendemic areas with no chance of contact with the bacillus may give a positive lepromin test.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The following test is not used for diagnosis of leprosy –, with the following options: A: Lepromin test, B: Slit skin smear, C: Fine needle aspiration cytology, D: Skin biopsy + ### Response: Lepromin Test is not used to diagnose leprosy, nor does it indicate prior contact with lepra bacilli. Healthy persons in nonendemic areas with no chance of contact with the bacillus may give a positive lepromin test. ### End" @@ -88,6 +155,14 @@ Lepromin Test is not used to diagnose leprosy, nor does it indicate prior conta Answer the following medical question: Arrange the following steps in order of the events occurring first to lastA. MarginationB. Rolling C. StasisD. Pavementing, with the following options: A: ABCD, B: DCAB, C: CABD, D: DABC +### Response: +","The correct order is  +Stasis - Margination - Rolling - Pavementing.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Arrange the following steps in order of the events occurring first to lastA. MarginationB. Rolling C. StasisD. Pavementing, with the following options: A: ABCD, B: DCAB, C: CABD, D: DABC + ### Response: The correct order is  Stasis - Margination - Rolling - Pavementing. @@ -98,6 +173,13 @@ Stasis - Margination - Rolling - Pavementing. Answer the following medical question: Indicator of efficacy of hospital services and health programs, with the following options: A: Case fatality rate, B: Prevalence, C: Incidence, D: Secondary attack rate +### Response: +",Case fatality rate - propoion of deaths within a designated population of cases Incidence- It is rate of new cases of diseases occuring with in a period of time Prevalance - It is actual number of cases alive with disease during a period of time. Hence it shows the efficicacy of hospital services and health programs Secondary Attack Rate - It is defined as probability of infection occuring in the susceptible individuals with in a reasonable incubation period following known contact with infected person/source,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Indicator of efficacy of hospital services and health programs, with the following options: A: Case fatality rate, B: Prevalence, C: Incidence, D: Secondary attack rate + ### Response: Case fatality rate - propoion of deaths within a designated population of cases Incidence- It is rate of new cases of diseases occuring with in a period of time Prevalance - It is actual number of cases alive with disease during a period of time. Hence it shows the efficicacy of hospital services and health programs Secondary Attack Rate - It is defined as probability of infection occuring in the susceptible individuals with in a reasonable incubation period following known contact with infected person/source ### End" @@ -107,6 +189,13 @@ Case fatality rate - propoion of deaths within a designated population of cases Answer the following medical question: Fundal myomas commonly present as :, with the following options: A: Inversion of uterus, B: Dysmenorrhoea, C: Urinary retention, D: Menorrhagia +### Response: +",Ans. is d i.e. Menorrhagia I know many of you might be thinking - Inversion of uterus is the correct option. It is correct that. Inversion of uterus occurs in a fundal submucous fibroid polyp when it is being extruded. But chronic inversion of the uterus as such is a rare entity. Most common symptom of fundal fibroid like other fibroids is menstrual irregularitymenorrhagia. The Bottom line is : Most common fibroid causing inversion of uterus is fundal submucous firboid.deg But most common symptom of fundal submucous fibroid is menorrhagia.deg,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Fundal myomas commonly present as :, with the following options: A: Inversion of uterus, B: Dysmenorrhoea, C: Urinary retention, D: Menorrhagia + ### Response: Ans. is d i.e. Menorrhagia I know many of you might be thinking - Inversion of uterus is the correct option. It is correct that. Inversion of uterus occurs in a fundal submucous fibroid polyp when it is being extruded. But chronic inversion of the uterus as such is a rare entity. Most common symptom of fundal fibroid like other fibroids is menstrual irregularitymenorrhagia. The Bottom line is : Most common fibroid causing inversion of uterus is fundal submucous firboid.deg But most common symptom of fundal submucous fibroid is menorrhagia.deg ### End" @@ -116,6 +205,13 @@ Ans. is d i.e. Menorrhagia I know many of you might be thinking - Inversion of u Answer the following medical question: As per 'Deadly dozen of chest injuries, which of the following is not immediately life-threatening, with the following options: A: Pericardial tamponade, B: Open pneumothorax, C: Flail chest, D: Myocardial contusion +### Response: +",The 'deadly dozen' threats to life from chestinjury. Immediately life threatening Airway obstruction Tension pneumothorax Pericardial tamponade Open pneumothorax Massive haemothorax Flail chest Potentially life threatening Aoic injuries Tracheobronchial injuries Myocardial contusion Rupture of diaphragm Oesophageal injuries Pulmonary contusion Bailey and love 27e pg: 367,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: As per 'Deadly dozen of chest injuries, which of the following is not immediately life-threatening, with the following options: A: Pericardial tamponade, B: Open pneumothorax, C: Flail chest, D: Myocardial contusion + ### Response: The 'deadly dozen' threats to life from chestinjury. Immediately life threatening Airway obstruction Tension pneumothorax Pericardial tamponade Open pneumothorax Massive haemothorax Flail chest Potentially life threatening Aoic injuries Tracheobronchial injuries Myocardial contusion Rupture of diaphragm Oesophageal injuries Pulmonary contusion Bailey and love 27e pg: 367 ### End" @@ -125,6 +221,14 @@ The 'deadly dozen' threats to life from chestinjury. Immediately life threatenin Answer the following medical question: The extraction of upper first molars may be indicated:, with the following options: A: When the removal of 4/4 provides insufficient space, B: Where they are rotated, C: When their prognosis is poor, D: When 5/5 are palatally placed +### Response: +","Key concept: +Any teeth which is having poor prognosis is indicated for extraction.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The extraction of upper first molars may be indicated:, with the following options: A: When the removal of 4/4 provides insufficient space, B: Where they are rotated, C: When their prognosis is poor, D: When 5/5 are palatally placed + ### Response: Key concept: Any teeth which is having poor prognosis is indicated for extraction. @@ -135,6 +239,13 @@ Any teeth which is having poor prognosis is indicated for extraction. Answer the following medical question: A child was exposed to excess fluoride in drinking water for a long time. What will be the earliest manifestation of fluorosis in this child?, with the following options: A: ARDS, B: Delayed speech development, C: Mottled enamel, D: Osteoporosis +### Response: +","In humans, the major manifestations of chronic ingestion of excessive fluoride are osteosclerosis and mottled enamel. Mottling is one of the first visible signs of excess fluoride intake during childhood. Continuous use of water containing ~1 ppm of fluoride may result in very mild mottling in 10% of children; at 4-6 ppm the incidence approaches 100%, with a marked increase in severity. Osteosclerosis is characterized by increased bone density secondary both to elevated osteoblastic activity and to the replacement of hydroxyapatite by the denser fluorapatite. Ref: Friedman P.A. (2011). Chapter 44. Agents Affecting Mineral Ion Homeostasis and Bone Turnover. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A child was exposed to excess fluoride in drinking water for a long time. What will be the earliest manifestation of fluorosis in this child?, with the following options: A: ARDS, B: Delayed speech development, C: Mottled enamel, D: Osteoporosis + ### Response: In humans, the major manifestations of chronic ingestion of excessive fluoride are osteosclerosis and mottled enamel. Mottling is one of the first visible signs of excess fluoride intake during childhood. Continuous use of water containing ~1 ppm of fluoride may result in very mild mottling in 10% of children; at 4-6 ppm the incidence approaches 100%, with a marked increase in severity. Osteosclerosis is characterized by increased bone density secondary both to elevated osteoblastic activity and to the replacement of hydroxyapatite by the denser fluorapatite. Ref: Friedman P.A. (2011). Chapter 44. Agents Affecting Mineral Ion Homeostasis and Bone Turnover. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e. ### End" @@ -144,6 +255,13 @@ In humans, the major manifestations of chronic ingestion of excessive fluoride a Answer the following medical question: All of the following are strategies to prevent contrast nephropathy, except:, with the following options: A: Intravenous Hydration, B: Use of High Osmolar Contrast Agents, C: Theophylline administration, D: Hemodialysis +### Response: +","Answer is B (Use of High Osmolar Contrast Agents): Low Osmolar Contrast Media (LOCM) results in substantially less Contrast Induced Nephropathy (CIN) than High Osmolar Contrast Media (HOCM) in patients with preexisting renal dysfunction. The type of contrast medium used is an impoant risk factor for the development of contrast medium induced nephropathy with iso-osmolar contrast media (I0CM) and low-osmolar contrast media (LOCM) being less nephrotoxic than high-osmolar contrast agents in patients with pre-existing renal impairment. Therefore low-osmolar or iso-osmolar nonionic contrast media are recommended in high-risk patients to reduce the risk of contrast medium-induced nephropathy. Note: No benefit has been demonstrated in those without renal dysfunction. Although there is no proven decrease in CIN in normal populations, better tolerability and fewer side effects of LOCM have largely resulted in their supplanting HOCM in routine clinical practice.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following are strategies to prevent contrast nephropathy, except:, with the following options: A: Intravenous Hydration, B: Use of High Osmolar Contrast Agents, C: Theophylline administration, D: Hemodialysis + ### Response: Answer is B (Use of High Osmolar Contrast Agents): Low Osmolar Contrast Media (LOCM) results in substantially less Contrast Induced Nephropathy (CIN) than High Osmolar Contrast Media (HOCM) in patients with preexisting renal dysfunction. The type of contrast medium used is an impoant risk factor for the development of contrast medium induced nephropathy with iso-osmolar contrast media (I0CM) and low-osmolar contrast media (LOCM) being less nephrotoxic than high-osmolar contrast agents in patients with pre-existing renal impairment. Therefore low-osmolar or iso-osmolar nonionic contrast media are recommended in high-risk patients to reduce the risk of contrast medium-induced nephropathy. Note: No benefit has been demonstrated in those without renal dysfunction. Although there is no proven decrease in CIN in normal populations, better tolerability and fewer side effects of LOCM have largely resulted in their supplanting HOCM in routine clinical practice. ### End" @@ -153,6 +271,13 @@ Answer is B (Use of High Osmolar Contrast Agents): Low Osmolar Contrast Media (L Answer the following medical question: Auditory neurotherapy is an effective modality of treatment for which of the following abnormalities of hearing?, with the following options: A: CSOM, B: Meniere's disease, C: Malignant otitis externa, D: Otosclerosis +### Response: +","Ans. b. Meniere's disease (Ref Dhingra 6th/100-104. 5/e pg 112-113; Lagan- Turner 10th/335; Scott-Brown 7/e p3570).Among the given options, only Meniere's disease involves the vestibular system of inner ear. Hence, a neurotherapv. Le. direct nerve stimulation, is going to be useful only in Meniere 's disease.Meniere's DiseaseMeniere's disease is also known as endolymphatic hydropsQDisorder of the inner ear where the endolymphatic system is distended due to increased volume of endolymphQ.Cardinal symptoms of Meniere's Disease* Episodic vertigoQ* Fluctuating hearing lossQ* TinnitusQ * Sense of fullness or pressureQ in the involved earTullio phenomenonLoud sounds or noise produce vertigoQDue to distended saccule lying against the stapes footplate.Some cases of Meniere's Disease show Tullio phenomenonQAlso seen when there are three functioning windows in the ear, e.g. fenestration of horizontal canal in the presence of mobile stapes.Displacusis may be seen in Meniere's disease.Displacusis: Condition in which the pitch of single tone is heard as two different pitches by the two earsQ.This causes distortion of soundQ.Patients with Meniere's disease cannot tolerate loud sounds due to recruitment phenomenonQ, they are thus poor candidates for hearing aids.Investigations for Meniere's DiseasePure tone audiometrySpeech audiometrySpecial audiometry testsElectrocochleog raphy* In early stages, lower frequencies are affected and the curve is of rising type.* When higher frequencies are involved curve becomes flat or falling type.* Discrimination score is usually 55-85% between the attacks but discrimination ability is much impaired during & immediately following an attack.* They indicate cochlear nature of disease and thus help to differentiate from retro- cochlear lesions e.g. acoustic neuroma.* Electrocochleog raphy is diagnostic* Ratio of Sum mating Potential (SP) to Action Potential (AP) is >30%. Management of Meniere's DiseaseMedicalSurgicalOthers* Medical management is the mainstay of treatment:- Vestibular sedatives to relieve vertigo (Promethazine, Diazepam)- Vasodilators: Carbogen, histamine drip, nicotinic acid (in chronic phase)- Intratympanic Gentamicin therapy: Gentamicin is vestibulotoxic.* Surgical treatment when medical management fails:- Decompression of endolymphatic Sac- Shunt between endolymphatic sac & subarachnoid space- Sacculotomy (Fick's operation)* Intermittent low pressure pulse therapy (Meniett device) using a myringotomy and a ventilation tube.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Auditory neurotherapy is an effective modality of treatment for which of the following abnormalities of hearing?, with the following options: A: CSOM, B: Meniere's disease, C: Malignant otitis externa, D: Otosclerosis + ### Response: Ans. b. Meniere's disease (Ref Dhingra 6th/100-104. 5/e pg 112-113; Lagan- Turner 10th/335; Scott-Brown 7/e p3570).Among the given options, only Meniere's disease involves the vestibular system of inner ear. Hence, a neurotherapv. Le. direct nerve stimulation, is going to be useful only in Meniere 's disease.Meniere's DiseaseMeniere's disease is also known as endolymphatic hydropsQDisorder of the inner ear where the endolymphatic system is distended due to increased volume of endolymphQ.Cardinal symptoms of Meniere's Disease* Episodic vertigoQ* Fluctuating hearing lossQ* TinnitusQ * Sense of fullness or pressureQ in the involved earTullio phenomenonLoud sounds or noise produce vertigoQDue to distended saccule lying against the stapes footplate.Some cases of Meniere's Disease show Tullio phenomenonQAlso seen when there are three functioning windows in the ear, e.g. fenestration of horizontal canal in the presence of mobile stapes.Displacusis may be seen in Meniere's disease.Displacusis: Condition in which the pitch of single tone is heard as two different pitches by the two earsQ.This causes distortion of soundQ.Patients with Meniere's disease cannot tolerate loud sounds due to recruitment phenomenonQ, they are thus poor candidates for hearing aids.Investigations for Meniere's DiseasePure tone audiometrySpeech audiometrySpecial audiometry testsElectrocochleog raphy* In early stages, lower frequencies are affected and the curve is of rising type.* When higher frequencies are involved curve becomes flat or falling type.* Discrimination score is usually 55-85% between the attacks but discrimination ability is much impaired during & immediately following an attack.* They indicate cochlear nature of disease and thus help to differentiate from retro- cochlear lesions e.g. acoustic neuroma.* Electrocochleog raphy is diagnostic* Ratio of Sum mating Potential (SP) to Action Potential (AP) is >30%. Management of Meniere's DiseaseMedicalSurgicalOthers* Medical management is the mainstay of treatment:- Vestibular sedatives to relieve vertigo (Promethazine, Diazepam)- Vasodilators: Carbogen, histamine drip, nicotinic acid (in chronic phase)- Intratympanic Gentamicin therapy: Gentamicin is vestibulotoxic.* Surgical treatment when medical management fails:- Decompression of endolymphatic Sac- Shunt between endolymphatic sac & subarachnoid space- Sacculotomy (Fick's operation)* Intermittent low pressure pulse therapy (Meniett device) using a myringotomy and a ventilation tube. ### End" @@ -162,6 +287,13 @@ Ans. b. Meniere's disease (Ref Dhingra 6th/100-104. 5/e pg 112-113; Lagan- Turne Answer the following medical question: Not true about vancomycin is -, with the following options: A: 95% oral bioavailability, B: Inhibits cells wall synthesis, C: Can be used parenterally as well as orally, D: Indicated for MRSA infections +### Response: +","Ans. is 'a' i.e., 95% oral bioavailability o Vancomycin is not absorbed orally (zero bioavailibility).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Not true about vancomycin is -, with the following options: A: 95% oral bioavailability, B: Inhibits cells wall synthesis, C: Can be used parenterally as well as orally, D: Indicated for MRSA infections + ### Response: Ans. is 'a' i.e., 95% oral bioavailability o Vancomycin is not absorbed orally (zero bioavailibility). ### End" @@ -171,6 +303,13 @@ Ans. is 'a' i.e., 95% oral bioavailability o Vancomycin is not absorbed orally ( Answer the following medical question: Which of the following is the most effective intravesical therapy for superficial bladder cancer-, with the following options: A: Mitomycin, B: Adriamycin, C: Thiotepa, D: BCG +### Response: +","Ans. is 'd' i.e., BCG Management of bladder cancerCystoscopy and transurethral resection or biopsy initially, any pt. with hematuria is examined by cystoscopy and any tumor seen is removed by transurethral resection (if possible) or biopsied.Further treatment decisions are made after tumor staging on histology. Such decisions are based on tumor stage (TNM), grade, size, multiplicity, and recurrence pattern.First see the staging (TNM)Tis - Ca in situTa - Ca confined to mucosa T1 - Ca confined to submucosa T2 -- Muscle invasion T3 - perivesical fat invasionT4 - invasion of adjacent structures (prostate, uterus, vagina, pelvic wall, abd. wall)Now the histological grading.There are 3 histological grades - grade 1, II & IIIThere is a strong correlation between tumor grading and tumor recurrence progression and survival.Cancer Stage Initial Treatment OptionsTis. Complete TUR followed by intravesical BCGTa (single, low-to-moderate grade, not recurrent)Complete. TURTa (large, multiple high-grade, or} recurrent T1 }. Complete TUR followed by intravesical chemo- or immunotherapyT2-T4Radical cystectomy .Neoadjuvant chemotherapy followed by radical cystectomy Radical cystectomy followed by adjuvant chemotherapy Neoadjuvant chemotherapy followed by concomitant chemotherapy and irradiationAny T, N+, M+Systemic chemotherapy followed by selective surgery or irradiationIntravesical therapy: Common agents used for intravesical therapy are Mitomycin C Thiotepa - BCG * Among these agents, BCG is the most effective.Treatment options for bladder cancers.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is the most effective intravesical therapy for superficial bladder cancer-, with the following options: A: Mitomycin, B: Adriamycin, C: Thiotepa, D: BCG + ### Response: Ans. is 'd' i.e., BCG Management of bladder cancerCystoscopy and transurethral resection or biopsy initially, any pt. with hematuria is examined by cystoscopy and any tumor seen is removed by transurethral resection (if possible) or biopsied.Further treatment decisions are made after tumor staging on histology. Such decisions are based on tumor stage (TNM), grade, size, multiplicity, and recurrence pattern.First see the staging (TNM)Tis - Ca in situTa - Ca confined to mucosa T1 - Ca confined to submucosa T2 -- Muscle invasion T3 - perivesical fat invasionT4 - invasion of adjacent structures (prostate, uterus, vagina, pelvic wall, abd. wall)Now the histological grading.There are 3 histological grades - grade 1, II & IIIThere is a strong correlation between tumor grading and tumor recurrence progression and survival.Cancer Stage Initial Treatment OptionsTis. Complete TUR followed by intravesical BCGTa (single, low-to-moderate grade, not recurrent)Complete. TURTa (large, multiple high-grade, or} recurrent T1 }. Complete TUR followed by intravesical chemo- or immunotherapyT2-T4Radical cystectomy .Neoadjuvant chemotherapy followed by radical cystectomy Radical cystectomy followed by adjuvant chemotherapy Neoadjuvant chemotherapy followed by concomitant chemotherapy and irradiationAny T, N+, M+Systemic chemotherapy followed by selective surgery or irradiationIntravesical therapy: Common agents used for intravesical therapy are Mitomycin C Thiotepa - BCG * Among these agents, BCG is the most effective.Treatment options for bladder cancers. ### End" @@ -180,6 +319,13 @@ Ans. is 'd' i.e., BCG Management of bladder cancerCystoscopy and transurethral r Answer the following medical question: Which of the following is a characteristic feature of borderline leprosy, with the following options: A: Extensive glove and stocking anesthesia, B: Inveed saucer shaped lesions, C: Erythema nodosum leprosum, D: Facial lesions +### Response: +",Ans. b. Inveed saucer shaped lesions Often a single lesion is present surrounded by several smaller ones. Skin and nerves are the only directly affected tissues in BL (Borderline Lepromatous). The skin lesions consist of erythematous macules or plaques. Inveed saucer-shaped annular lesions are characteristic,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is a characteristic feature of borderline leprosy, with the following options: A: Extensive glove and stocking anesthesia, B: Inveed saucer shaped lesions, C: Erythema nodosum leprosum, D: Facial lesions + ### Response: Ans. b. Inveed saucer shaped lesions Often a single lesion is present surrounded by several smaller ones. Skin and nerves are the only directly affected tissues in BL (Borderline Lepromatous). The skin lesions consist of erythematous macules or plaques. Inveed saucer-shaped annular lesions are characteristic ### End" @@ -189,6 +335,13 @@ Ans. b. Inveed saucer shaped lesions Often a single lesion is present surrounded Answer the following medical question: All of the following statements about the vagus nerve are true except that it, with the following options: A: Supplies hea & lung, B: Carries postganglionic parasympathetic fibers, C: Innervates right two third of transverse colon, D: Stimulates peristalsis & relaxes sphincters +### Response: +","It carries preganglionic secretomotor fibres to the submandibular ganglion for supply of the submandibular and sublingual salivary glands. REF:BDC VOL.3,FIFTH EDITION.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following statements about the vagus nerve are true except that it, with the following options: A: Supplies hea & lung, B: Carries postganglionic parasympathetic fibers, C: Innervates right two third of transverse colon, D: Stimulates peristalsis & relaxes sphincters + ### Response: It carries preganglionic secretomotor fibres to the submandibular ganglion for supply of the submandibular and sublingual salivary glands. REF:BDC VOL.3,FIFTH EDITION. ### End" @@ -198,6 +351,13 @@ It carries preganglionic secretomotor fibres to the submandibular ganglion for s Answer the following medical question: Most specific marker for neural tube defects is, with the following options: A: Alpha-fetoprotein, B: Unconjugated estriol, C: Acetylcholinesterase, D: Pseudocholinesterase +### Response: +",Both alpha-fetoprotein and acetylcholinesterase in amniotic fluid are markers for neural tube defects. But acetylcholinesterase is the most specific marker. Ref : Dutta book of obstetrics 8th Ed,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most specific marker for neural tube defects is, with the following options: A: Alpha-fetoprotein, B: Unconjugated estriol, C: Acetylcholinesterase, D: Pseudocholinesterase + ### Response: Both alpha-fetoprotein and acetylcholinesterase in amniotic fluid are markers for neural tube defects. But acetylcholinesterase is the most specific marker. Ref : Dutta book of obstetrics 8th Ed ### End" @@ -207,6 +367,13 @@ Both alpha-fetoprotein and acetylcholinesterase in amniotic fluid are markers fo Answer the following medical question: Which type of gout is seen in a patient who is on treatment of CML?, with the following options: A: Secondary gout, B: Pseudogout, C: Acute gout, D: Primary gout +### Response: +","Secondary gout is related to medications or conditions that cause hyperuricemia, such as the Myeloproliferative diseases or their treatment. Causes of secondary gout: Lymphoproliferative/myeloproliferative disorders Chronic hemolytic anemias Secondary polycythemia Severe exfoliative psoriasis Gaucher's disease Cytotoxic drug High purine diet","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which type of gout is seen in a patient who is on treatment of CML?, with the following options: A: Secondary gout, B: Pseudogout, C: Acute gout, D: Primary gout + ### Response: Secondary gout is related to medications or conditions that cause hyperuricemia, such as the Myeloproliferative diseases or their treatment. Causes of secondary gout: Lymphoproliferative/myeloproliferative disorders Chronic hemolytic anemias Secondary polycythemia Severe exfoliative psoriasis Gaucher's disease Cytotoxic drug High purine diet ### End" @@ -216,6 +383,13 @@ Secondary gout is related to medications or conditions that cause hyperuricemia, Answer the following medical question: The tensile strength of the wound stas and increases after, with the following options: A: Immediately after suturing, B: 3-4 days, C: 7-10 days, D: 1 month +### Response: +","Wounds do not begin to gain tensile strength from collagen until 5 - 7 days. Wound achieves around 20 % by 3 weeks, and around 60 % by four months. Scar tissue continues to remodel for at least 6 - 12 months after an injury.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The tensile strength of the wound stas and increases after, with the following options: A: Immediately after suturing, B: 3-4 days, C: 7-10 days, D: 1 month + ### Response: Wounds do not begin to gain tensile strength from collagen until 5 - 7 days. Wound achieves around 20 % by 3 weeks, and around 60 % by four months. Scar tissue continues to remodel for at least 6 - 12 months after an injury. ### End" @@ -225,6 +399,13 @@ Wounds do not begin to gain tensile strength from collagen until 5 - 7 days. Wou Answer the following medical question: In neonatal cholestasis, if the serum gamma glutamyl- transpeptidase (GGT) is more than 600 IU/L the most likely diagnosis is:, with the following options: A: Neonatal hepatitis, B: Choledochal cyst, C: Sclerosing cholangitis, D: Biliary atresia +### Response: +","D. Biliary atresia(Ref: Nelson's 20/e p 1933)3 Enzymes reflect cholestasis: Alkaline phosphatase, 5'nucleotidase & Gamma glutamyl transpeptidase.About GGT in Cholestasis: (Normal value of GGT is 5-40IU/L)""GGT levels are commonly elevated to values more than 10 times normal in biliary atresia while in hepatic causes it is raised to about three times normal""Thus a value of 600IU/L in the patient in question reflects an elevation of more than ten times the normal value. The patient is thus likely suffering from 'biliary atresia'.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In neonatal cholestasis, if the serum gamma glutamyl- transpeptidase (GGT) is more than 600 IU/L the most likely diagnosis is:, with the following options: A: Neonatal hepatitis, B: Choledochal cyst, C: Sclerosing cholangitis, D: Biliary atresia + ### Response: D. Biliary atresia(Ref: Nelson's 20/e p 1933)3 Enzymes reflect cholestasis: Alkaline phosphatase, 5'nucleotidase & Gamma glutamyl transpeptidase.About GGT in Cholestasis: (Normal value of GGT is 5-40IU/L)""GGT levels are commonly elevated to values more than 10 times normal in biliary atresia while in hepatic causes it is raised to about three times normal""Thus a value of 600IU/L in the patient in question reflects an elevation of more than ten times the normal value. The patient is thus likely suffering from 'biliary atresia'. ### End" @@ -234,6 +415,13 @@ D. Biliary atresia(Ref: Nelson's 20/e p 1933)3 Enzymes reflect cholestasis: Alka Answer the following medical question: Breast examination is done yearly in patients with?, with the following options: A: Multiple fibroadenoma, B: Family history of ca. breast, C: Carcinoma cervix, D: Endometrial carcinoma +### Response: +",Ans. is 'b' i.e. Family history of ca. breast,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Breast examination is done yearly in patients with?, with the following options: A: Multiple fibroadenoma, B: Family history of ca. breast, C: Carcinoma cervix, D: Endometrial carcinoma + ### Response: Ans. is 'b' i.e. Family history of ca. breast ### End" @@ -243,6 +431,13 @@ Ans. is 'b' i.e. Family history of ca. breast Answer the following medical question: Gaseous necrosis is seen in -, with the following options: A: CMV infection, B: Staphylococcal infection, C: Treponemal infection, D: HSV infection +### Response: +","Ans. is 'c' i.e., Treponemal infection Caseous necrosis is a feature of syphilis which is caused by tremonemal infection.Gaseous necrosisIt is a variant of coagulative necrosis. It is most commonly encountered when cell death is attributable to eain organismse.g., mycobacterium tuberculosis (TB), syphilis and fungi (Histoplasma, Coccidioidomycosis).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Gaseous necrosis is seen in -, with the following options: A: CMV infection, B: Staphylococcal infection, C: Treponemal infection, D: HSV infection + ### Response: Ans. is 'c' i.e., Treponemal infection Caseous necrosis is a feature of syphilis which is caused by tremonemal infection.Gaseous necrosisIt is a variant of coagulative necrosis. It is most commonly encountered when cell death is attributable to eain organismse.g., mycobacterium tuberculosis (TB), syphilis and fungi (Histoplasma, Coccidioidomycosis). ### End" @@ -252,6 +447,13 @@ Ans. is 'c' i.e., Treponemal infection Caseous necrosis is a feature of syphilis Answer the following medical question: The disease with known association with malignant hyperthermia is, with the following options: A: Huntington chorea, B: Fabry disease, C: Burns, D: Denborough syndrome +### Response: +","KDS-King Denborough syndrome, Muscular dystrophy (DMD),myotonia are musculoskeletal disease associated with malignant hyperthermia.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The disease with known association with malignant hyperthermia is, with the following options: A: Huntington chorea, B: Fabry disease, C: Burns, D: Denborough syndrome + ### Response: KDS-King Denborough syndrome, Muscular dystrophy (DMD),myotonia are musculoskeletal disease associated with malignant hyperthermia. ### End" @@ -261,6 +463,13 @@ KDS-King Denborough syndrome, Muscular dystrophy (DMD),myotonia are musculoskel Answer the following medical question: Which is a nonabsorbable suture, with the following options: A: Vicryl, B: Polypropylene, C: Catgut, D: PDS +### Response: +","Absorbable suture materials are: plain catgut, chromic catgut, vicryl ( polyglactic acid),dexon(polyglycolic acid), maxon(polyglyconate), PDS( poly dioxanone suture material ), monocryl, biosyn.Non absorbable suture materials are silk, polypropylene (prolene), polyethylene, cotton, linen, steel, polyester, polyamide, nylon.Reference : page 1172 SRB's manual of surgery 5th edition","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which is a nonabsorbable suture, with the following options: A: Vicryl, B: Polypropylene, C: Catgut, D: PDS + ### Response: Absorbable suture materials are: plain catgut, chromic catgut, vicryl ( polyglactic acid),dexon(polyglycolic acid), maxon(polyglyconate), PDS( poly dioxanone suture material ), monocryl, biosyn.Non absorbable suture materials are silk, polypropylene (prolene), polyethylene, cotton, linen, steel, polyester, polyamide, nylon.Reference : page 1172 SRB's manual of surgery 5th edition ### End" @@ -270,6 +479,16 @@ Absorbable suture materials are: plain catgut, chromic catgut, vicryl ( polyglac Answer the following medical question: In slow sand filters, the percentage of waters that is bacteria-free:, with the following options: A: 100%, B: 99.90%, C: 99%, D: 90% +### Response: +","The total bacterial count is reduced by 99.9 to 99.99%. +Essentials of preventive and community dentistry  +Soben Peter  +5th edition","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In slow sand filters, the percentage of waters that is bacteria-free:, with the following options: A: 100%, B: 99.90%, C: 99%, D: 90% + ### Response: The total bacterial count is reduced by 99.9 to 99.99%. Essentials of preventive and community dentistry  @@ -282,6 +501,14 @@ Soben Peter  Answer the following medical question: Which is true regarding shoulder dislocation -, with the following options: A: Posterior dislocation is often over-looked, B: Pain is severe in anterior dislocation, C: Radiography may be misleading in posterior dislocation, D: All of the above +### Response: +","The features of posterior dislocation of the shoulder are not very striking, and for that reason the injury is often overlooked. An important sign is fixed medial (internal) rotation of the arm, which cannot be rotated outward (externally), even to neutral position. +Radiography may be misleading if only the ordinary anteroposterior film is available, because the dislocation may not be apparent or at least not obvious on this projection.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which is true regarding shoulder dislocation -, with the following options: A: Posterior dislocation is often over-looked, B: Pain is severe in anterior dislocation, C: Radiography may be misleading in posterior dislocation, D: All of the above + ### Response: The features of posterior dislocation of the shoulder are not very striking, and for that reason the injury is often overlooked. An important sign is fixed medial (internal) rotation of the arm, which cannot be rotated outward (externally), even to neutral position. Radiography may be misleading if only the ordinary anteroposterior film is available, because the dislocation may not be apparent or at least not obvious on this projection. @@ -292,6 +519,13 @@ Radiography may be misleading if only the ordinary anteroposterior film is avail Answer the following medical question: Which of the following ECG changes is least likely in a patient with left pneumothorax-(/i//MS, with the following options: A: Inversion of Twave, B: Left axis detion, C: Small R wave, D: Electrical altemans +### Response: +",Abnormal left axis detion was found with left-sided was pneumothorax .Relevant QRS abnormalities (incomplete RBBB and T-wave inversion)in (10%). QRS amplitude in V2-V6 leads was significantly decreased in left-sided pneumothorax. Ref Harrison 20th edition pg 1536,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following ECG changes is least likely in a patient with left pneumothorax-(/i//MS, with the following options: A: Inversion of Twave, B: Left axis detion, C: Small R wave, D: Electrical altemans + ### Response: Abnormal left axis detion was found with left-sided was pneumothorax .Relevant QRS abnormalities (incomplete RBBB and T-wave inversion)in (10%). QRS amplitude in V2-V6 leads was significantly decreased in left-sided pneumothorax. Ref Harrison 20th edition pg 1536 ### End" @@ -301,6 +535,13 @@ Abnormal left axis detion was found with left-sided was pneumothorax .Relevant Q Answer the following medical question: Plasminogen domain resembles, with the following options: A: Fibrinogen, B: LDL receptor, C: Apolipoprotein a, D: Prothrombin +### Response: +","REF: ROBBINS pathology 10th edition Phylogeny of the serine proteinase domains and analysis of intron-exon boundaries and Kringle sequences indicate that hepatocyte growth factor/scatter factor (HGF/SF), hepatocyte growth factor-like/macrophage stimulating protein (HGFVMSP), plasminogen, and apolipoprotein (a) have evolved from a common ancestral gene. The name Kringle comes from the Scandinan pastry that these structures resemble them","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Plasminogen domain resembles, with the following options: A: Fibrinogen, B: LDL receptor, C: Apolipoprotein a, D: Prothrombin + ### Response: REF: ROBBINS pathology 10th edition Phylogeny of the serine proteinase domains and analysis of intron-exon boundaries and Kringle sequences indicate that hepatocyte growth factor/scatter factor (HGF/SF), hepatocyte growth factor-like/macrophage stimulating protein (HGFVMSP), plasminogen, and apolipoprotein (a) have evolved from a common ancestral gene. The name Kringle comes from the Scandinan pastry that these structures resemble them ### End" @@ -310,6 +551,14 @@ REF: ROBBINS pathology 10th edition Phylogeny of the serine proteinase domains a Answer the following medical question: Vibration sensation (low frequency) is mediated by:, with the following options: A: Merkel’s disc, B: Ruffini’s end organ, C: Pacinian corpuscle, D: Meissner’s corpuscle +### Response: +","Merkel’s disc is the only touch receptor located in epidermis.  +Touch and pressure are sensed by four types of mechanoreceptors. Meissner corpuscles are dendrites encapsulated in connective tissue and respond to changes in texture and slow vibrations. Merkel cells are expanded dendritic endings, and they respond to sustained pressure and touch. Ruffini corpuscles are enlarged dendritic endings with elongated capsules, and they respond to sustained pressure. Pacinian corpuscles consist of unmyelinated dendritic endings of a sensory nerve fiber, 2 μm in diameter, encapsulated by concentric lamellae of connective tissue that give the organ the appearance of a cocktail onion. These receptors respond to deep pressure and fast vibration. The sensory nerves from these mechanoreceptors are large myelinated Aα and Aβ fibers whose conduction velocities range from ~70–120 to ~40–75 m/s, respectively.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Vibration sensation (low frequency) is mediated by:, with the following options: A: Merkel’s disc, B: Ruffini’s end organ, C: Pacinian corpuscle, D: Meissner’s corpuscle + ### Response: Merkel’s disc is the only touch receptor located in epidermis.  Touch and pressure are sensed by four types of mechanoreceptors. Meissner corpuscles are dendrites encapsulated in connective tissue and respond to changes in texture and slow vibrations. Merkel cells are expanded dendritic endings, and they respond to sustained pressure and touch. Ruffini corpuscles are enlarged dendritic endings with elongated capsules, and they respond to sustained pressure. Pacinian corpuscles consist of unmyelinated dendritic endings of a sensory nerve fiber, 2 μm in diameter, encapsulated by concentric lamellae of connective tissue that give the organ the appearance of a cocktail onion. These receptors respond to deep pressure and fast vibration. The sensory nerves from these mechanoreceptors are large myelinated Aα and Aβ fibers whose conduction velocities range from ~70–120 to ~40–75 m/s, respectively. @@ -320,6 +569,13 @@ Touch and pressure are sensed by four types of mechanoreceptors. Meissner corpus Answer the following medical question: What is Ogive?, with the following options: A: Bar chart, B: Histogram, C: Cumulative frequency curve, D: Frequency polygon +### Response: +","Ans. is 'c' i.e., Cumulative frequency curveCumulative frequency diagram (OGIVE)o Cumulative relative frequency or cumulative percentage, gives the percentage of persons having a measurement less than or equal to the upper boundary of the class interval.Weight interval (lb)FrequencyRelative frequencyCumulative relatives frequency10-1958.88.820-291933.342.130-391017.559.640-491322.882.450-5947.089.460-6947.096.470-7923.599.9 ~ 100%Total57100 o The last column of above table shows the cumulative relative frequency or cumulative percentage. This column is easy to form, you do it by successively accumulating the relative frequencies of each of the various intervals. In the above table the cumulative percentage for the first three intervals is 8.8 + 33.3 + 17.5 = 59.6 and we can say that 59.6% of the children in the data set have a weight of 39.5 lb or less. Or, as another example, 96.4% of children weight 69.5 lb or less.o The cumulative relative frequency can be presented graphically. This type of curve is called a cumulative frequency graph or OGIVE. To construct such a graph, we place a point representing the cumulative relative frequency and the points are connected with straight lines.Weight (lb)o The cumulative frequency graph provides a class of important statistics known as percentiles or percentile scores. For example, the 90th percentile is the numerical value that exceeds 90% of the values in the data set and is exceeded by only 10% of them. As another example, the 80th percentile is that numerical value that exceeds 80% of the values contained in the data set and is exceeded by 20% of them, and so on. The 50th percentile is commonly called the median.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What is Ogive?, with the following options: A: Bar chart, B: Histogram, C: Cumulative frequency curve, D: Frequency polygon + ### Response: Ans. is 'c' i.e., Cumulative frequency curveCumulative frequency diagram (OGIVE)o Cumulative relative frequency or cumulative percentage, gives the percentage of persons having a measurement less than or equal to the upper boundary of the class interval.Weight interval (lb)FrequencyRelative frequencyCumulative relatives frequency10-1958.88.820-291933.342.130-391017.559.640-491322.882.450-5947.089.460-6947.096.470-7923.599.9 ~ 100%Total57100 o The last column of above table shows the cumulative relative frequency or cumulative percentage. This column is easy to form, you do it by successively accumulating the relative frequencies of each of the various intervals. In the above table the cumulative percentage for the first three intervals is 8.8 + 33.3 + 17.5 = 59.6 and we can say that 59.6% of the children in the data set have a weight of 39.5 lb or less. Or, as another example, 96.4% of children weight 69.5 lb or less.o The cumulative relative frequency can be presented graphically. This type of curve is called a cumulative frequency graph or OGIVE. To construct such a graph, we place a point representing the cumulative relative frequency and the points are connected with straight lines.Weight (lb)o The cumulative frequency graph provides a class of important statistics known as percentiles or percentile scores. For example, the 90th percentile is the numerical value that exceeds 90% of the values in the data set and is exceeded by only 10% of them. As another example, the 80th percentile is that numerical value that exceeds 80% of the values contained in the data set and is exceeded by 20% of them, and so on. The 50th percentile is commonly called the median. ### End" @@ -329,6 +585,13 @@ Ans. is 'c' i.e., Cumulative frequency curveCumulative frequency diagram (OGIVE) Answer the following medical question: Anti leprosy drug causing ichthyoses is ?, with the following options: A: Dapsone, B: Clofazamine, C: Rifampicin, D: Clarithromycin +### Response: +","Ans. is 'd' i.e., Clofazamine Acquired ichthyosis (Ichthyosis acquista) Acquired ichthyosis is seen in : ? Deficiency :- Protein, Vitamin A, Kwashiorkor, Marasmus. Infection :- Leprosy, AIDS Senile ichthyosis :- Elderly Systemic diseases :- SLE, DM, hypothyroidism, Sarcoidosis, liver & kidney diseases. Malignancy, especially Hodgkin's lymphoma. Drugs :- Clofazimine, Statins, triparanol.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Anti leprosy drug causing ichthyoses is ?, with the following options: A: Dapsone, B: Clofazamine, C: Rifampicin, D: Clarithromycin + ### Response: Ans. is 'd' i.e., Clofazamine Acquired ichthyosis (Ichthyosis acquista) Acquired ichthyosis is seen in : ? Deficiency :- Protein, Vitamin A, Kwashiorkor, Marasmus. Infection :- Leprosy, AIDS Senile ichthyosis :- Elderly Systemic diseases :- SLE, DM, hypothyroidism, Sarcoidosis, liver & kidney diseases. Malignancy, especially Hodgkin's lymphoma. Drugs :- Clofazimine, Statins, triparanol. ### End" @@ -338,6 +601,13 @@ Ans. is 'd' i.e., Clofazamine Acquired ichthyosis (Ichthyosis acquista) Acquired Answer the following medical question: Changes in blood passing through the systemic capillaries are all except, with the following options: A: Increase in hemotocrit, B: pH decreases, C: Shift of oxygen dissociation curve to the left, D: Increase in protein content +### Response: +","In systemic capillaries pO2 while normal germinal centers contain numerous B cells undergoing apoptosis, follicular lymphoma is characteristically devoid of apoptotic cells","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are true about follicular lymphoma except:, with the following options: A: CD 20+, B: CD 5+, C: Bc1-1 positive in follicular lumphoma where as Bel-2 positive in mantle cell lymphoma, D: Translocation of (14:18) + ### Response: Ans. is 'b' i.e.CD 5+ Follicular lymphoma o Follicular lymphoma is the most common form of indolent non-Hodgkin's lymphomas and the second most common form of non-Hodgkin's lymphoma overall. o It is the tumor of germinal center (follicular center), B cells, and is strongly associated with chromosomal translocation involving Bcl 2 o Growth pattern is nodular (follicular) or nodular (follicular) and diffuse. o Two principal cell types are present in varying propoion: (i) Small cleared cells (centrocytes) (ii) Centroblasts o In most follicular lymphomas, centrocytes predominate. Immunophenotype The neoplastic cells closely resemble normal germinal center B cells, expressing CD19, CD 20, CD 10, surface Ig, and Bel 6. o Unlike CLL/SLL and mantel cell lymphoma, CD 5 is not expressed. o Bcl 2 is expressed in more than 90% of cases, in distinction to normal follicular center B cells, which are Bcl 2 negative, and mantel cell lymphoma cells which express BCL 1 (cyclin D1). Molecular pathogenesis o The hallmark of follicular lymphoma is (14:18) translocation that juxtaposes the IgH locus on chromosome 14 and the Bel 2 locus on chromosome 18. Bcl 2 antagonizes the apoptosis and promotes the survival of follicular lymphoma cells --> while normal germinal centers contain numerous B cells undergoing apoptosis, follicular lymphoma is characteristically devoid of apoptotic cells ### End" @@ -410,6 +729,13 @@ Ans. is 'b' i.e.CD 5+ Follicular lymphoma o Follicular lymphoma is the most comm Answer the following medical question: During the delivery, it is necessary to do an episiotomy. The tear extends through sphincter of the rectum, but the rectal mucosa is intact. How would you classify this type of episiotomy?, with the following options: A: First-degree, B: Second-degree, C: Third-degree, D: Fourth-degree +### Response: +","Ans. C. Third-degreeA first-degree tear involves the vaginal mucosa or perineal skin, but not the underlying tissue. In a second-degree episiotomy, the underlying subcutaneous tissue is also involved, but not the rectal sphincter or rectal mucosa. In a third-degree tear, the rectal sphincter is affected. A fourth-degree episiotomy involves a tear that extends into the rectal mucosa.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: During the delivery, it is necessary to do an episiotomy. The tear extends through sphincter of the rectum, but the rectal mucosa is intact. How would you classify this type of episiotomy?, with the following options: A: First-degree, B: Second-degree, C: Third-degree, D: Fourth-degree + ### Response: Ans. C. Third-degreeA first-degree tear involves the vaginal mucosa or perineal skin, but not the underlying tissue. In a second-degree episiotomy, the underlying subcutaneous tissue is also involved, but not the rectal sphincter or rectal mucosa. In a third-degree tear, the rectal sphincter is affected. A fourth-degree episiotomy involves a tear that extends into the rectal mucosa. ### End" @@ -419,6 +745,13 @@ Ans. C. Third-degreeA first-degree tear involves the vaginal mucosa or perineal Answer the following medical question: which of the following is not the use of fluoxetine, with the following options: A: treatment of delayed ejaculation, B: treatment of premature ejaculation, C: treatment of impulse control disorder, D: treatment of paraphlia +### Response: +","SSRI * IMPOANCE Most widely prescribed antidepressant * MECHANISM Specifically acts on serotonin transpoers and increases serotonin in synapse. DRUGS FLUOXETINE FLUVOXAMINE DAPOXETINE CITALOPRAM ESCITALOPRAM ESCITALOPRAM SERALINE PAROXETINE USE FLUOXETINE=============CHILDHOOD DEPRESSION FLUVOXAMINE===========OCD DAPOXETINE==============PME ESCITALOPRAM===========HEA SAFE, PATHOLOGICAL EMOTIONS PAROXETINE=========SEDATING, PANIC DISORDER IMPULSE CONTROL DISORDERS PME PARAPHILIA Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, 966","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: which of the following is not the use of fluoxetine, with the following options: A: treatment of delayed ejaculation, B: treatment of premature ejaculation, C: treatment of impulse control disorder, D: treatment of paraphlia + ### Response: SSRI * IMPOANCE Most widely prescribed antidepressant * MECHANISM Specifically acts on serotonin transpoers and increases serotonin in synapse. DRUGS FLUOXETINE FLUVOXAMINE DAPOXETINE CITALOPRAM ESCITALOPRAM ESCITALOPRAM SERALINE PAROXETINE USE FLUOXETINE=============CHILDHOOD DEPRESSION FLUVOXAMINE===========OCD DAPOXETINE==============PME ESCITALOPRAM===========HEA SAFE, PATHOLOGICAL EMOTIONS PAROXETINE=========SEDATING, PANIC DISORDER IMPULSE CONTROL DISORDERS PME PARAPHILIA Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, 966 ### End" @@ -428,6 +761,13 @@ SSRI * IMPOANCE Most widely prescribed antidepressant * MECHANISM Specifically a Answer the following medical question: The most common underlying aetiology of primary hyperparathyroidism is, with the following options: A: Parathyroid adenoma, B: MEN-1, C: MEN-2A, D: Parathyroid adenocarcinoma +### Response: +","The underlying aetiology of PHPT is usually a solitary parathyroid adenoma, however, in a small number of patient (2-4%), there are double adenomas. It may occur in a sporadic fashion or it can be familial (MEN type 1 or type 2A, hyperparathyroidism-jaw tumour syndrome (HPT-JT)Ref: Bailey and Love 27e pg: 826","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The most common underlying aetiology of primary hyperparathyroidism is, with the following options: A: Parathyroid adenoma, B: MEN-1, C: MEN-2A, D: Parathyroid adenocarcinoma + ### Response: The underlying aetiology of PHPT is usually a solitary parathyroid adenoma, however, in a small number of patient (2-4%), there are double adenomas. It may occur in a sporadic fashion or it can be familial (MEN type 1 or type 2A, hyperparathyroidism-jaw tumour syndrome (HPT-JT)Ref: Bailey and Love 27e pg: 826 ### End" @@ -437,6 +777,13 @@ The underlying aetiology of PHPT is usually a solitary parathyroid adenoma, howe Answer the following medical question: Which of the following is not seen in subacute thyroiditis?, with the following options: A: Raised T4 levels, B: Raised ESR, C: Pain, D: High Radio iodine uptake +### Response: +","The patient usually presents with a painful and enlarged thyroid, sometimes accompanied by fever. There may be features of thyrotoxicosis or hypothyroidism, depending on the phase of the illness. The patient characteristically evolves through three distinct phases over about 6 months: Thyrotoxic phase, Hypothyroid phase, and Recovery phase. In the thyrotoxic phase, T4 and T3 levels are increased; reflecting their discharge from the damaged thyroid cells, and TSH is suppressed. The diagnosis is confirmed by a high ESR and low radioiodine uptake.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is not seen in subacute thyroiditis?, with the following options: A: Raised T4 levels, B: Raised ESR, C: Pain, D: High Radio iodine uptake + ### Response: The patient usually presents with a painful and enlarged thyroid, sometimes accompanied by fever. There may be features of thyrotoxicosis or hypothyroidism, depending on the phase of the illness. The patient characteristically evolves through three distinct phases over about 6 months: Thyrotoxic phase, Hypothyroid phase, and Recovery phase. In the thyrotoxic phase, T4 and T3 levels are increased; reflecting their discharge from the damaged thyroid cells, and TSH is suppressed. The diagnosis is confirmed by a high ESR and low radioiodine uptake. ### End" @@ -446,6 +793,13 @@ The patient usually presents with a painful and enlarged thyroid, sometimes acco Answer the following medical question: Negri bodies are located in -, with the following options: A: Astrocytes, B: Oligodendroglia, C: Neurons, D: Microglia +### Response: +",Negrie bodies are abundant in brai cells(cerebellum&hippocampus) REF:p> ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.531,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Negri bodies are located in -, with the following options: A: Astrocytes, B: Oligodendroglia, C: Neurons, D: Microglia + ### Response: Negrie bodies are abundant in brai cells(cerebellum&hippocampus) REF:p> ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.531 ### End" @@ -455,6 +809,13 @@ Negrie bodies are abundant in brai cells(cerebellum&hippocampus) REF:p> ANATHANA Answer the following medical question: Heparin acts as an anticoagulant by:-, with the following options: A: Activating antithrombin III, B: Inactivating antithrombin III, C: Activating thrombin, D: Activating factor Xa +### Response: +",Heparin acts an anticoagulant by activating antithrombin III and thus inactivating thrombin and factor Xa. Heparin displaces lipoprotein lipase enzyme from the endothelial wall. Other glycosaminoglycans uses are: Danaparoid is an anticoagulant.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Heparin acts as an anticoagulant by:-, with the following options: A: Activating antithrombin III, B: Inactivating antithrombin III, C: Activating thrombin, D: Activating factor Xa + ### Response: Heparin acts an anticoagulant by activating antithrombin III and thus inactivating thrombin and factor Xa. Heparin displaces lipoprotein lipase enzyme from the endothelial wall. Other glycosaminoglycans uses are: Danaparoid is an anticoagulant. ### End" @@ -464,6 +825,25 @@ Heparin acts an anticoagulant by activating antithrombin III and thus inactivati Answer the following medical question: % of children with simple febrile seizures developing epilepsy is –, with the following options: A: 1–2%, B: 2–5%, C: 5–10%, D: 10–20% +### Response: +","Children with febrile seizures have an increased risk of developing epilepsy. +Between 2% to 7% of all children with febrile seizures develop epilepsy if followed up to the age of 25 years. Risk depends on type of febrile seizure : + +i) Simple febrile seizures →2% of all children with simple febrile seizures. +ii) Complex febrile seizures → 6-8% of all children with complex febrile seizures. + + +Three major risk factors increase the risk of epilepsy :- + + +Complex febrile seizures. +Pre-existing neurodevelopment abnormality. +Epilepsy in first degree relatives.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: % of children with simple febrile seizures developing epilepsy is –, with the following options: A: 1–2%, B: 2–5%, C: 5–10%, D: 10–20% + ### Response: Children with febrile seizures have an increased risk of developing epilepsy. Between 2% to 7% of all children with febrile seizures develop epilepsy if followed up to the age of 25 years. Risk depends on type of febrile seizure : @@ -485,6 +865,13 @@ Epilepsy in first degree relatives. Answer the following medical question: Nipple confusion means?, with the following options: A: Baby fed with a bottle finding it difficult and confusing to suckle at breast, B: Baby not able to suckle with bottle, C: Baby not able to feed with spoon, D: Baby not able to feed with paladin +### Response: +","Ans. (a) Baby fed with a bottle finding it difficult and confusing to suckle at breastRef: OP Ghai 8th ed./153* A problem that may beset a bottlefed baby in which it forgets how to nurse on mother' nipple* Breastfeeding requires far more vigorous mouth and tongue motions and greater muscle coordination than bottlefeeding.* On bottle nipples or even pacifiers, a newborn can forget how to nurse properly.* This confusion can lead to diminished or discontinued nursing. Nipple confusion is usually not a concern after the early weeks, once the baby is nursing well.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Nipple confusion means?, with the following options: A: Baby fed with a bottle finding it difficult and confusing to suckle at breast, B: Baby not able to suckle with bottle, C: Baby not able to feed with spoon, D: Baby not able to feed with paladin + ### Response: Ans. (a) Baby fed with a bottle finding it difficult and confusing to suckle at breastRef: OP Ghai 8th ed./153* A problem that may beset a bottlefed baby in which it forgets how to nurse on mother' nipple* Breastfeeding requires far more vigorous mouth and tongue motions and greater muscle coordination than bottlefeeding.* On bottle nipples or even pacifiers, a newborn can forget how to nurse properly.* This confusion can lead to diminished or discontinued nursing. Nipple confusion is usually not a concern after the early weeks, once the baby is nursing well. ### End" @@ -494,6 +881,13 @@ Ans. (a) Baby fed with a bottle finding it difficult and confusing to suckle at Answer the following medical question: A four-fold increase in the titre obtained in Weil- Felix reaction is diagnostic of -, with the following options: A: Rickettsial infection, B: Fungal infection, C: Spirochetal infection, D: Viral infection +### Response: +","In weil-felix test, host antibodies to various rickettsial species cause agglutination of Proteus bacteria because they cross-react with bacterial cell surface antigens. Reference: Harrison20th edition pg 1011","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A four-fold increase in the titre obtained in Weil- Felix reaction is diagnostic of -, with the following options: A: Rickettsial infection, B: Fungal infection, C: Spirochetal infection, D: Viral infection + ### Response: In weil-felix test, host antibodies to various rickettsial species cause agglutination of Proteus bacteria because they cross-react with bacterial cell surface antigens. Reference: Harrison20th edition pg 1011 ### End" @@ -503,6 +897,13 @@ In weil-felix test, host antibodies to various rickettsial species cause aggluti Answer the following medical question: Prostate Specific Antigen is specific to, with the following options: A: BPH, B: Prostatitis, C: Prostatic cancer, D: All of the above +### Response: +","(D) All of the above# PSA is secreted by the epithelial cells of the prostate gland.> PSA is not a unique indicator of prostate cancer, but may also detect prostatitis or benign prostatic hyperplasia. Only 30 percent of patients with high PSA have prostate cancer diagnosed after biopsy.> PSA is used for Prostate cancer screening and levels between 4 and 10 ng/mL (nanograms per milliliter) are considered to be suspicious and confirm the abnormal PSA with a repeat test.> PSA levels are monitored periodically every 6-36 months after treatment for prostate cancer.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Prostate Specific Antigen is specific to, with the following options: A: BPH, B: Prostatitis, C: Prostatic cancer, D: All of the above + ### Response: (D) All of the above# PSA is secreted by the epithelial cells of the prostate gland.> PSA is not a unique indicator of prostate cancer, but may also detect prostatitis or benign prostatic hyperplasia. Only 30 percent of patients with high PSA have prostate cancer diagnosed after biopsy.> PSA is used for Prostate cancer screening and levels between 4 and 10 ng/mL (nanograms per milliliter) are considered to be suspicious and confirm the abnormal PSA with a repeat test.> PSA levels are monitored periodically every 6-36 months after treatment for prostate cancer. ### End" @@ -512,6 +913,13 @@ Answer the following medical question: Prostate Specific Antigen is specific to, Answer the following medical question: Which of the following is the most common cause of first trimester aboion?, with the following options: A: Syphilis, B: Chromosomal abnormalities, C: Rhesus isoimmunization, D: Cervical incompetence +### Response: +","Majority (50%) of early miscarriges are due to chromosomal abnormalities in the conceptus. Autosomal trisomy is the commonest cytogenetic abnormality. The most common trisomy is trisomy 16. Polyploidy is seen in 22% of abouses and monosomy constitutes 20% of abouses. Ref: Textbook of Obstetrics By D.C.Dutta, 6th Edition, Page 160","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is the most common cause of first trimester aboion?, with the following options: A: Syphilis, B: Chromosomal abnormalities, C: Rhesus isoimmunization, D: Cervical incompetence + ### Response: Majority (50%) of early miscarriges are due to chromosomal abnormalities in the conceptus. Autosomal trisomy is the commonest cytogenetic abnormality. The most common trisomy is trisomy 16. Polyploidy is seen in 22% of abouses and monosomy constitutes 20% of abouses. Ref: Textbook of Obstetrics By D.C.Dutta, 6th Edition, Page 160 ### End" @@ -521,6 +929,13 @@ Majority (50%) of early miscarriges are due to chromosomal abnormalities in the Answer the following medical question: TRUE/FALSE about Barrett's esophagus is/are: 1. Metaplasia 2. Peptic ulcer 3. Paraesophageal hernia 4. Leads to adenocarcinoma 5. Long esophageal segment involved, with the following options: A: 1,2,3 true & 4,5 false, B: 1,2,4,5 true & 3 false, C: 1,2,4 True & 3,5 false, D: 1,2 true & 3,4,5 false +### Response: +","Barrett's esophagus refers to the metaplastic change of distal esophageal mucosa from normal squamous epithelium to columnar epithelium, in response to chronic gastroesophageal reflux. The most common type of metaplasia is intestinal type of metaplasia and presence of intestinal goblet cell is the hallmark of intestinal metaplasia. Stricture formation and peptic ulceration of columnar lined epithelium of esophagus is common complication of barrett's esophagus. Barrett's esophagus can be classified into long segment( involvement of >3 cm of esophagus) and sho segment disease ( involvement of < 3 cm of esophagus). Long segment disease carries more risk for adenocarcinoma. Barrett's esophagus is associated with sliding hernia not with paraesophageal hernia. Ref: Robbins 8/e, Page 770; Bailey & Love 25/e, Page 1022.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: TRUE/FALSE about Barrett's esophagus is/are: 1. Metaplasia 2. Peptic ulcer 3. Paraesophageal hernia 4. Leads to adenocarcinoma 5. Long esophageal segment involved, with the following options: A: 1,2,3 true & 4,5 false, B: 1,2,4,5 true & 3 false, C: 1,2,4 True & 3,5 false, D: 1,2 true & 3,4,5 false + ### Response: Barrett's esophagus refers to the metaplastic change of distal esophageal mucosa from normal squamous epithelium to columnar epithelium, in response to chronic gastroesophageal reflux. The most common type of metaplasia is intestinal type of metaplasia and presence of intestinal goblet cell is the hallmark of intestinal metaplasia. Stricture formation and peptic ulceration of columnar lined epithelium of esophagus is common complication of barrett's esophagus. Barrett's esophagus can be classified into long segment( involvement of >3 cm of esophagus) and sho segment disease ( involvement of < 3 cm of esophagus). Long segment disease carries more risk for adenocarcinoma. Barrett's esophagus is associated with sliding hernia not with paraesophageal hernia. Ref: Robbins 8/e, Page 770; Bailey & Love 25/e, Page 1022. ### End" @@ -530,6 +945,13 @@ Barrett's esophagus refers to the metaplastic change of distal esophageal mucosa Answer the following medical question: Side effects of magnesium sulfate includes, with the following options: A: Hypotonia, B: Anuria, C: Coma, D: Pulmonary edema +### Response: +","Side effects flushing perspiration headache muscle weakness rarely pulmonary edema neonatal side effects lethargy hypotonia respiratory depression D.C.DUTTA&;S TEXTBOOK OF OBSTETRICS,Pg no:508,7th edition","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Side effects of magnesium sulfate includes, with the following options: A: Hypotonia, B: Anuria, C: Coma, D: Pulmonary edema + ### Response: Side effects flushing perspiration headache muscle weakness rarely pulmonary edema neonatal side effects lethargy hypotonia respiratory depression D.C.DUTTA&;S TEXTBOOK OF OBSTETRICS,Pg no:508,7th edition ### End" @@ -539,6 +961,13 @@ Side effects flushing perspiration headache muscle weakness rarely pulmonary ede Answer the following medical question: Child with B.P. 190/110, pedal edema ++ ; facial edema ascites-absent. Gross hematuria diagnosis is -, with the following options: A: Acute G.N., B: Nephrotic syndrome, C: Renal thrombosis, D: Renal amyloidosis +### Response: +","Ans. is 'a' i.e., Acute GN. o Hematuria, hypeension and edema suggest the diagnosis of nephritic syndrome caused by acute glomerulonephritis. Causes of acute nephritic syndrome in children Primary glomerulonephritis Acute GN i) Post-streptococcal ii) Non-streptococcal Rapidly progressive GN Membranoproliferative GN Focal GN IgA nephropathy Systemic disease SLE PAN Wegener's granulomatosis Henoch-Schonlein purpura Cryoglobulinemia","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Child with B.P. 190/110, pedal edema ++ ; facial edema ascites-absent. Gross hematuria diagnosis is -, with the following options: A: Acute G.N., B: Nephrotic syndrome, C: Renal thrombosis, D: Renal amyloidosis + ### Response: Ans. is 'a' i.e., Acute GN. o Hematuria, hypeension and edema suggest the diagnosis of nephritic syndrome caused by acute glomerulonephritis. Causes of acute nephritic syndrome in children Primary glomerulonephritis Acute GN i) Post-streptococcal ii) Non-streptococcal Rapidly progressive GN Membranoproliferative GN Focal GN IgA nephropathy Systemic disease SLE PAN Wegener's granulomatosis Henoch-Schonlein purpura Cryoglobulinemia ### End" @@ -548,6 +977,13 @@ Ans. is 'a' i.e., Acute GN. o Hematuria, hypeension and edema suggest the diagno Answer the following medical question: Phobia is a type of, with the following options: A: Psychosis, B: Neurosis, C: Mania, D: Depression +### Response: +","In ICD-10, neurosis, stress-related and somatoform disorders have been classified into the following types: Phobic anxiety disorders Other anxiety disorders Obsessive-compulsive disorders (Ref: a sho textbook of psychiatry, Niraj Ahuja,7th edition, pg no 89)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Phobia is a type of, with the following options: A: Psychosis, B: Neurosis, C: Mania, D: Depression + ### Response: In ICD-10, neurosis, stress-related and somatoform disorders have been classified into the following types: Phobic anxiety disorders Other anxiety disorders Obsessive-compulsive disorders (Ref: a sho textbook of psychiatry, Niraj Ahuja,7th edition, pg no 89) ### End" @@ -557,6 +993,13 @@ In ICD-10, neurosis, stress-related and somatoform disorders have been classifie Answer the following medical question: Allopurinol potentiates the action of:, with the following options: A: Coicosteroids, B: Probenecid, C: 6-Mercaptopurine, D: Ampicilin +### Response: +",Allopurinol: used for chronic gout Reduces uric acid synthesis by competitively inhibiting xanthine oxidase Allopurinola Alloxanthine a noncompetitive inhibitor of xanthine oxidase ESSENTIALS OF MEDICAL PHARMACOLOGY;7TH EDITION;KD TRIPATHI;PAGE NO 216,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Allopurinol potentiates the action of:, with the following options: A: Coicosteroids, B: Probenecid, C: 6-Mercaptopurine, D: Ampicilin + ### Response: Allopurinol: used for chronic gout Reduces uric acid synthesis by competitively inhibiting xanthine oxidase Allopurinola Alloxanthine a noncompetitive inhibitor of xanthine oxidase ESSENTIALS OF MEDICAL PHARMACOLOGY;7TH EDITION;KD TRIPATHI;PAGE NO 216 ### End" @@ -566,6 +1009,13 @@ Allopurinol: used for chronic gout Reduces uric acid synthesis by competitively Answer the following medical question: The Predominant source of blood supply to the organ whose histological slide is shown in?, with the following options: A: Hepatic aery, B: Hepatic Vein, C: Poal vein, D: Cystic aery +### Response: +",Poal Vein,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The Predominant source of blood supply to the organ whose histological slide is shown in?, with the following options: A: Hepatic aery, B: Hepatic Vein, C: Poal vein, D: Cystic aery + ### Response: Poal Vein ### End" @@ -575,6 +1025,13 @@ Poal Vein Answer the following medical question: Antibody shown to be useful for Crohn's Disease is:, with the following options: A: Omalizumab, B: Palivizumab, C: Natalizumab, D: None of the above +### Response: +","Answer is C (Natalizumab) Natalizumab is a monoclonal antibody shown to be useful .far Crohn's Disease. Natalizumab is a recombinant humanized immunoglobulin G4 Antibody (IgG4 Monoclonal Antibody) against alpha 4 integrins that is effective in the induction and maintenance of remission in Crohn's Disease patients. It has been approved for the treatment of patients with Crohn's disease refractory to intolerant to anti-TNF Therapy. Omalizumab is used for Bronchial Asthma (Allergic Bronchial Asthma) Palivizuntab is used in infection with Respiratory Syncytial Virus (RSV) Note Natalizumab therapy has been associated with the development of multifocal leukoencephalopathy, a predominantly fatal infection of the central nervous system by the JC polyomavius. This risk appears to be I in 1,000 patients, paicularly those receiving treatment with several immunosuppressive agents.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Antibody shown to be useful for Crohn's Disease is:, with the following options: A: Omalizumab, B: Palivizumab, C: Natalizumab, D: None of the above + ### Response: Answer is C (Natalizumab) Natalizumab is a monoclonal antibody shown to be useful .far Crohn's Disease. Natalizumab is a recombinant humanized immunoglobulin G4 Antibody (IgG4 Monoclonal Antibody) against alpha 4 integrins that is effective in the induction and maintenance of remission in Crohn's Disease patients. It has been approved for the treatment of patients with Crohn's disease refractory to intolerant to anti-TNF Therapy. Omalizumab is used for Bronchial Asthma (Allergic Bronchial Asthma) Palivizuntab is used in infection with Respiratory Syncytial Virus (RSV) Note Natalizumab therapy has been associated with the development of multifocal leukoencephalopathy, a predominantly fatal infection of the central nervous system by the JC polyomavius. This risk appears to be I in 1,000 patients, paicularly those receiving treatment with several immunosuppressive agents. ### End" @@ -584,6 +1041,13 @@ Answer is C (Natalizumab) Natalizumab is a monoclonal antibody shown to be usefu Answer the following medical question: Maxillary sinus opens into which meatus?, with the following options: A: Inferior, B: Superior, C: Middle, D: All +### Response: +","Ans. c (Middle meatus). (Ref. Bhargaw, 5th ed.151)THE LATERAL NASAL WALL# It consists anteriorly of the nasal bone, frontal process of maxilla & the lacrimal bone.# Posterior to lacrimal bone, the lateral wall of nasal cavity is formed by ethmoid labyrinth, maxillary & inferior concha.# Perpendicular plate of palatine bone & the medial pterygoid plate form the most posterior portion.# Within the nasal cavity, scrolls of bone on the lateral walls, the conchae, projected medially to divide the cavity into meatuses.# Superior & middle conchae are part of ethmoid bone, but the inferior conchae are separate pair of bones.# A turbinate is a concha, meaning a soft tissue bone complex.# Superior, middle & inferior meatuses that are formed under & lateral to respective conchae, have increased contact with nasal surface to permit effective warming & moistening of inspired air.Superior turbinate meatus- Post ethmoidal air cells drain into it & sphenoid sinus drain via sphenoethmoidal recess.Middle turbinate meatus- Most important area, forms OMC where anterior-middle ethmoid air cells, maxillary & frontal sinuses drain into it.- Anterior to frontal recess & anterior end of middle turbinate is the bony prominence of frontal process of maxilla known as agger nasi, cells in it drains into ethmoid infundibulumInferior turbinate meatus- Largest turbinate. Nasolacrimal duct drains into its anterior part.Osteomeatal unit/complex (OMC)- OMC is the normal aerated channel which provides airflow & mucocilliary clearance for sinuses.- It is the key area for pathogenesis of chronic sinus diseases.- It is the cross road (confluence) for drainage of most paranasal sinuses.- It is the center of interest due to functional endoscopic sinus surgery (FESS).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Maxillary sinus opens into which meatus?, with the following options: A: Inferior, B: Superior, C: Middle, D: All + ### Response: Ans. c (Middle meatus). (Ref. Bhargaw, 5th ed.151)THE LATERAL NASAL WALL# It consists anteriorly of the nasal bone, frontal process of maxilla & the lacrimal bone.# Posterior to lacrimal bone, the lateral wall of nasal cavity is formed by ethmoid labyrinth, maxillary & inferior concha.# Perpendicular plate of palatine bone & the medial pterygoid plate form the most posterior portion.# Within the nasal cavity, scrolls of bone on the lateral walls, the conchae, projected medially to divide the cavity into meatuses.# Superior & middle conchae are part of ethmoid bone, but the inferior conchae are separate pair of bones.# A turbinate is a concha, meaning a soft tissue bone complex.# Superior, middle & inferior meatuses that are formed under & lateral to respective conchae, have increased contact with nasal surface to permit effective warming & moistening of inspired air.Superior turbinate meatus- Post ethmoidal air cells drain into it & sphenoid sinus drain via sphenoethmoidal recess.Middle turbinate meatus- Most important area, forms OMC where anterior-middle ethmoid air cells, maxillary & frontal sinuses drain into it.- Anterior to frontal recess & anterior end of middle turbinate is the bony prominence of frontal process of maxilla known as agger nasi, cells in it drains into ethmoid infundibulumInferior turbinate meatus- Largest turbinate. Nasolacrimal duct drains into its anterior part.Osteomeatal unit/complex (OMC)- OMC is the normal aerated channel which provides airflow & mucocilliary clearance for sinuses.- It is the key area for pathogenesis of chronic sinus diseases.- It is the cross road (confluence) for drainage of most paranasal sinuses.- It is the center of interest due to functional endoscopic sinus surgery (FESS). ### End" @@ -593,6 +1057,16 @@ Ans. c (Middle meatus). (Ref. Bhargaw, 5th ed.151)THE LATERAL NASAL WALL# It con Answer the following medical question: In the perspective of the busy life schedule in the modern society, the accepted minimum period of sexual cohabilitation resulting in no offspring for a couple to be declared infertile is:, with the following options: A: One year, B: One and a half - year, C: Two years, D: Three years +### Response: +","If a couple fails to achieve pregnancy after one year of “unprotected” and regular intercourse, it is an indication to investigate the couple for infertility. +• Infertility: +– Primary : When no previous pregnancies have occurred. +– Secondary : When a prior pregnancy although not necessary although not necessary a live birth, has occurred.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In the perspective of the busy life schedule in the modern society, the accepted minimum period of sexual cohabilitation resulting in no offspring for a couple to be declared infertile is:, with the following options: A: One year, B: One and a half - year, C: Two years, D: Three years + ### Response: If a couple fails to achieve pregnancy after one year of “unprotected” and regular intercourse, it is an indication to investigate the couple for infertility. • Infertility: @@ -605,6 +1079,13 @@ If a couple fails to achieve pregnancy after one year of “unprotected” and r Answer the following medical question: Telogen phase of hair growth lasts for ?, with the following options: A: 1 day, B: 10 days, C: 100 days, D: 1000 days +### Response: +","Ans. is 'c' i.e., 100 days The most impoant feature of hair follicle is that their activity is cyclic. Hair grows at 0.4 mm per day and as it reaches a definitive length, it is shed to be replaced by a new hair. Hair undergoes through 3 different phases of hair cycle :? 1) Anagen phase (Phase of activity and growth) This is the phase in which growth of hair takes place -4 Cells in the root of hair are dividing rapidly. Melanogenesis also occurs during anagen phase. This phase lasts for 3 years (2-6 years). Most of the hair (75-80%) are in anagen phase at a given time. 2) Catagen phase (Transition phase) It is the transition phase between anagen and telogen. 3% of hair are in this phase. During this phase growth stops and outer root sheat shrinks and attaches to root of hair known as club hair. This phase lasts for 2-3 weeks. 3) Telogen phase (Resting or degenerative phase) This phase is the resting phase and lasts for 100 days (3 months). About 25-100 telogen hair are shed normally each day. 10-15% of hair are in this phase. After telogen phase the cycle is complete and the new hair, which stas growing in same follicle, pushes this old hair (who has completed the hair cycle) --> Old hair is lost and new hair stas growing. This hair cycle of one hair is independent of the cycle of neighboring hair, i.e., the neighboring hair follicles are not synchronized in growth, this is called Mosaic. The propoion of hair in each phase can be estimated by looking at the plucked hair called as trichogram.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Telogen phase of hair growth lasts for ?, with the following options: A: 1 day, B: 10 days, C: 100 days, D: 1000 days + ### Response: Ans. is 'c' i.e., 100 days The most impoant feature of hair follicle is that their activity is cyclic. Hair grows at 0.4 mm per day and as it reaches a definitive length, it is shed to be replaced by a new hair. Hair undergoes through 3 different phases of hair cycle :? 1) Anagen phase (Phase of activity and growth) This is the phase in which growth of hair takes place -4 Cells in the root of hair are dividing rapidly. Melanogenesis also occurs during anagen phase. This phase lasts for 3 years (2-6 years). Most of the hair (75-80%) are in anagen phase at a given time. 2) Catagen phase (Transition phase) It is the transition phase between anagen and telogen. 3% of hair are in this phase. During this phase growth stops and outer root sheat shrinks and attaches to root of hair known as club hair. This phase lasts for 2-3 weeks. 3) Telogen phase (Resting or degenerative phase) This phase is the resting phase and lasts for 100 days (3 months). About 25-100 telogen hair are shed normally each day. 10-15% of hair are in this phase. After telogen phase the cycle is complete and the new hair, which stas growing in same follicle, pushes this old hair (who has completed the hair cycle) --> Old hair is lost and new hair stas growing. This hair cycle of one hair is independent of the cycle of neighboring hair, i.e., the neighboring hair follicles are not synchronized in growth, this is called Mosaic. The propoion of hair in each phase can be estimated by looking at the plucked hair called as trichogram. ### End" @@ -614,6 +1095,13 @@ Ans. is 'c' i.e., 100 days The most impoant feature of hair follicle is that the Answer the following medical question: The amino acid that lacks chirality, with the following options: A: Lysine, B: Leucine, C: Histidine, D: Glycine +### Response: +","Ans. is 'd' i.e. Glycine ""The Alpha carbon of each amino acid is attached to four different chemical groups and is therefore a chiral or optically active carbon atom. Glycine is the exception because its alpha carbon has two hydrogens substituents (2 H atoms attached to alpha carbon) and is therefore optically inactive (lacks chirality). ""All amino acids except glycine exists as two stereoisomers (or optical isomers or enantiomers), designated asD (dextro) &L (levo) forms.All the amino acids found in proteins are of the L-configuration*Also rememberSmallest and simplest amino acid - Glycine*Amino acid responsible for flexibility of proteins is - Glycine*","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The amino acid that lacks chirality, with the following options: A: Lysine, B: Leucine, C: Histidine, D: Glycine + ### Response: Ans. is 'd' i.e. Glycine ""The Alpha carbon of each amino acid is attached to four different chemical groups and is therefore a chiral or optically active carbon atom. Glycine is the exception because its alpha carbon has two hydrogens substituents (2 H atoms attached to alpha carbon) and is therefore optically inactive (lacks chirality). ""All amino acids except glycine exists as two stereoisomers (or optical isomers or enantiomers), designated asD (dextro) &L (levo) forms.All the amino acids found in proteins are of the L-configuration*Also rememberSmallest and simplest amino acid - Glycine*Amino acid responsible for flexibility of proteins is - Glycine* ### End" @@ -623,6 +1111,13 @@ Ans. is 'd' i.e. Glycine ""The Alpha carbon of each amino acid is attached to fo Answer the following medical question: All are true about precocious puberty except -, with the following options: A: Secondary sexual characters before the age of 8 years, B: Secondary sexual characters before the age of 6 years, C: Menstruation before the age of 10 years, D: Most common cause is constitutional +### Response: +","Ans. is 'b' i.e., Secondary sexual characters before the age of 6 years o Precocious puberty is the appearance of appropriate secondary sexual characters before the age of 8 years and occurrence of menstruation before 10 years of chronological age.o It is divided into the following types:A) Gonadotropin dependent precocious puberty/ Central precocious puberty / True precocious puberty:# Most common cause is constitutional, due to early maturation and activation of the hypothalamic - pituitary - gonadal axis.# Both breast and pubic hair development in girls# Pubic hair development and testicular enlargement in boys# Early developing sexual characteristics are ""isosexual"", meaning they are consistent with the child's gender.# Initial spurt in the height followed by premature closure of epiphysis with the result the ultimate height remains stunted.B) Gonadotropin - independent precocious puberty/ Peripheral precocious puberty/Pseudo - precocious puberty:# Exposure to sex steroid hormones that derive from the gonads, the adrenals or the environment.# Further subclassified as isosexual when sexual characters are consistent with gender, and as contrasexual when inconsistent with gender (virilization in girls, or feminization in boys).# Autonomous functional ovarian follicular cysts are the most common cause of gonadotropin - independent precocious puberty in girls.C) Incomplete precocious puberty':# Children with isolated premature thelarche or premature adrenarche. Both usually represent variants of normal pubertal development, but some will progress to complete precocious puberty that may be gonadotropin - dependent or independent.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are true about precocious puberty except -, with the following options: A: Secondary sexual characters before the age of 8 years, B: Secondary sexual characters before the age of 6 years, C: Menstruation before the age of 10 years, D: Most common cause is constitutional + ### Response: Ans. is 'b' i.e., Secondary sexual characters before the age of 6 years o Precocious puberty is the appearance of appropriate secondary sexual characters before the age of 8 years and occurrence of menstruation before 10 years of chronological age.o It is divided into the following types:A) Gonadotropin dependent precocious puberty/ Central precocious puberty / True precocious puberty:# Most common cause is constitutional, due to early maturation and activation of the hypothalamic - pituitary - gonadal axis.# Both breast and pubic hair development in girls# Pubic hair development and testicular enlargement in boys# Early developing sexual characteristics are ""isosexual"", meaning they are consistent with the child's gender.# Initial spurt in the height followed by premature closure of epiphysis with the result the ultimate height remains stunted.B) Gonadotropin - independent precocious puberty/ Peripheral precocious puberty/Pseudo - precocious puberty:# Exposure to sex steroid hormones that derive from the gonads, the adrenals or the environment.# Further subclassified as isosexual when sexual characters are consistent with gender, and as contrasexual when inconsistent with gender (virilization in girls, or feminization in boys).# Autonomous functional ovarian follicular cysts are the most common cause of gonadotropin - independent precocious puberty in girls.C) Incomplete precocious puberty':# Children with isolated premature thelarche or premature adrenarche. Both usually represent variants of normal pubertal development, but some will progress to complete precocious puberty that may be gonadotropin - dependent or independent. ### End" @@ -632,6 +1127,13 @@ Ans. is 'b' i.e., Secondary sexual characters before the age of 6 years o Precoc Answer the following medical question: Which of the following is the commonest site of intestinal tuberculosis?, with the following options: A: Stomach, B: Jejunum, C: Ileum, D: Colon +### Response: +","Although any poion of gastrointestinal tract may be affected in tuberculosis , terminal ileum & cecum are most common sites of intestinal TB","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is the commonest site of intestinal tuberculosis?, with the following options: A: Stomach, B: Jejunum, C: Ileum, D: Colon + ### Response: Although any poion of gastrointestinal tract may be affected in tuberculosis , terminal ileum & cecum are most common sites of intestinal TB ### End" @@ -641,6 +1143,13 @@ Although any poion of gastrointestinal tract may be affected in tuberculosis , t Answer the following medical question: Fine touch and rapidly adapting receptor is, with the following options: A: Meissners corpuscle, B: Merkel' s disc, C: Pacinian corpuscle, D: Ruffini's nerve ending +### Response: +","Tactile corpuscles (or Meissner&;s corpuscles) are a type of mechanoreceptor. They are a type of nerve ending in the skin that is responsible for sensitivity to light touch. In paicular, they have highest sensitivity (lowest threshold) when sensing vibrations between 10 and 50 Hez. They are rapidly adaptive receptors. They are most concentrated in thick hairless skin, especially at the finger pads.Ref: Ganong&;s review of medical physiology 23rd edition Page no: 150","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Fine touch and rapidly adapting receptor is, with the following options: A: Meissners corpuscle, B: Merkel' s disc, C: Pacinian corpuscle, D: Ruffini's nerve ending + ### Response: Tactile corpuscles (or Meissner&;s corpuscles) are a type of mechanoreceptor. They are a type of nerve ending in the skin that is responsible for sensitivity to light touch. In paicular, they have highest sensitivity (lowest threshold) when sensing vibrations between 10 and 50 Hez. They are rapidly adaptive receptors. They are most concentrated in thick hairless skin, especially at the finger pads.Ref: Ganong&;s review of medical physiology 23rd edition Page no: 150 ### End" @@ -650,6 +1159,13 @@ Tactile corpuscles (or Meissner&;s corpuscles) are a type of mechanoreceptor. Th Answer the following medical question: Commonest sign of intrabronchial foreign body in children is -, with the following options: A: Cough, B: Wheeze, C: Dyspnoea, D: Stridor +### Response: +","Ans. is 'a' i.e., Cough","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Commonest sign of intrabronchial foreign body in children is -, with the following options: A: Cough, B: Wheeze, C: Dyspnoea, D: Stridor + ### Response: Ans. is 'a' i.e., Cough ### End" @@ -659,6 +1175,13 @@ Ans. is 'a' i.e., Cough Answer the following medical question: A child on b2 agonists for treatment of bronchial asthma may exhibit all of the following features except:, with the following options: A: Tremors, B: Hypoglycemia, C: Hypokalemia, D: Bronchodilation +### Response: +",Ans. (B) Hypoglycemia(Ref: KDT 8th/e p149)b2 agonists are the inhaled bronchodilators used for the management of bronchial asthma.Tremor is the dose related adverse effect of these drugs.Brief hyperkalemia followed by hypokalemia is an important adverse effect of these agents.b2 agonists do not cause hypoglycemia.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A child on b2 agonists for treatment of bronchial asthma may exhibit all of the following features except:, with the following options: A: Tremors, B: Hypoglycemia, C: Hypokalemia, D: Bronchodilation + ### Response: Ans. (B) Hypoglycemia(Ref: KDT 8th/e p149)b2 agonists are the inhaled bronchodilators used for the management of bronchial asthma.Tremor is the dose related adverse effect of these drugs.Brief hyperkalemia followed by hypokalemia is an important adverse effect of these agents.b2 agonists do not cause hypoglycemia. ### End" @@ -668,6 +1191,13 @@ Ans. (B) Hypoglycemia(Ref: KDT 8th/e p149)b2 agonists are the inhaled bronchodil Answer the following medical question: Most common histological type of the thyroid carcinoma is, with the following options: A: Medullary type, B: Follicular type, C: Papillary type, D: Anaplastic type +### Response: +","Papillary thyroid cancer is the most common cancer. Occurs in 70-80% of patients diagnosed with thyroid cancer. Common in females and younger age group. According to Woolner's Classification there are 3 types. 1)Occult primary(less than 1.5cm) 2) Intrathyroidal 3) Extrathyroidal Reference: SRB's Manual of Surgery, 6th Edition, page no = 468.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common histological type of the thyroid carcinoma is, with the following options: A: Medullary type, B: Follicular type, C: Papillary type, D: Anaplastic type + ### Response: Papillary thyroid cancer is the most common cancer. Occurs in 70-80% of patients diagnosed with thyroid cancer. Common in females and younger age group. According to Woolner's Classification there are 3 types. 1)Occult primary(less than 1.5cm) 2) Intrathyroidal 3) Extrathyroidal Reference: SRB's Manual of Surgery, 6th Edition, page no = 468. ### End" @@ -677,6 +1207,13 @@ Papillary thyroid cancer is the most common cancer. Occurs in 70-80% of patients Answer the following medical question: Which of the following heavy metal poisoning may cause colitis that resembles diptheritic colitis?, with the following options: A: Lead, B: Arsenic, C: Mercury, D: Copper +### Response: +",C i.e. Mercury,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following heavy metal poisoning may cause colitis that resembles diptheritic colitis?, with the following options: A: Lead, B: Arsenic, C: Mercury, D: Copper + ### Response: C i.e. Mercury ### End" @@ -686,6 +1223,13 @@ C i.e. Mercury Answer the following medical question: The unique propey of SERMs is that they:, with the following options: A: Have both estrogenic and progestational agonistic activity, B: Inhibits the aromatase enzyme that is required for estrogen synthesis, C: Produces estrogenic effect without binding to estrogen receptors, D: Act as agonist in some tissues and antagonist in other tissues +### Response: +","SERM: 1. Raloxifene- Agonist at bone - Agonist in blood : Increase HDL level- Antagonist at breast: Decrease breast carcinoma risk- Antagonist at endometrium: Decrease endometrium carcinoma- Agonist at liver: Increase thromboembolism risk 2. Tamoxifen- Agonist at bone - Agonist in blood : Increase HDL level- Antagonist at breast: Decrease breast carcinoma risk- Agonist at endometrium: Increase endometrium carcinoma- Agonist at liver: Increase thromboembolism risk Tamoxifen, Doloxifen and toremifene are beneficial on: - Bone - Blood - Breast 3. Clomifene Antagonist at pituataryHypothalamus - GnRHPituatary - LH/FSHOvary - E/P","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The unique propey of SERMs is that they:, with the following options: A: Have both estrogenic and progestational agonistic activity, B: Inhibits the aromatase enzyme that is required for estrogen synthesis, C: Produces estrogenic effect without binding to estrogen receptors, D: Act as agonist in some tissues and antagonist in other tissues + ### Response: SERM: 1. Raloxifene- Agonist at bone - Agonist in blood : Increase HDL level- Antagonist at breast: Decrease breast carcinoma risk- Antagonist at endometrium: Decrease endometrium carcinoma- Agonist at liver: Increase thromboembolism risk 2. Tamoxifen- Agonist at bone - Agonist in blood : Increase HDL level- Antagonist at breast: Decrease breast carcinoma risk- Agonist at endometrium: Increase endometrium carcinoma- Agonist at liver: Increase thromboembolism risk Tamoxifen, Doloxifen and toremifene are beneficial on: - Bone - Blood - Breast 3. Clomifene Antagonist at pituataryHypothalamus - GnRHPituatary - LH/FSHOvary - E/P ### End" @@ -695,6 +1239,13 @@ SERM: 1. Raloxifene- Agonist at bone - Agonist in blood : Increase HDL level- An Answer the following medical question: In erect posture commonest siteof foreign body in bronchus, with the following options: A: Right lower lobe, B: Right upper lobe, C: Carina, D: Left lower lobe +### Response: +","Foreign bodies like pins,coins entering the trachea pass into the right bronchus,which is wider,more veical & is in line with trachea.Most of the human beings want to take the path of least resistance,so the foreign bodies in the trachea travel down into right bronchus and then into posterior basal segments of the lower lobe of the lung. Reference:B D Chaurasia's Human anatomy-Volume 1,5th edition,page no:288","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In erect posture commonest siteof foreign body in bronchus, with the following options: A: Right lower lobe, B: Right upper lobe, C: Carina, D: Left lower lobe + ### Response: Foreign bodies like pins,coins entering the trachea pass into the right bronchus,which is wider,more veical & is in line with trachea.Most of the human beings want to take the path of least resistance,so the foreign bodies in the trachea travel down into right bronchus and then into posterior basal segments of the lower lobe of the lung. Reference:B D Chaurasia's Human anatomy-Volume 1,5th edition,page no:288 ### End" @@ -704,6 +1255,13 @@ Foreign bodies like pins,coins entering the trachea pass into the right bronchus Answer the following medical question: Which of the following is not associated with stuporous catatonia?, with the following options: A: Echolalia, B: Echopraxia, C: Rigidity, D: Increased speech production +### Response: +",Increased speech production is seen in excited catatonia.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is not associated with stuporous catatonia?, with the following options: A: Echolalia, B: Echopraxia, C: Rigidity, D: Increased speech production + ### Response: Increased speech production is seen in excited catatonia. ### End" @@ -713,6 +1271,13 @@ Increased speech production is seen in excited catatonia. Answer the following medical question: All of the following are B cell markers, EXCEPT:, with the following options: A: CD 10, B: CD 19, C: CD 20, D: CD 34 +### Response: +","CD34 is a stem cell marker. Surface markers expressed by myeloid and lymphoid cells (can be used to analyze origin of neoplastic cell): B-cell markers: CD10, CD19, and CD20 T-cell markers: CD2, CD3, CD4, CD7, and CD8 Lymphoblast: TdT Myeloid markers: CD13, CD14, CD15, and CD64 Stem cell marker: CD34 Ref: Wyatt C., Kemp W.L., Moos P.J., Burns D.K., Brown T.G. (2008). Chapter 12. Hematopathology. In C. Wyatt, W.L. Kemp, P.J. Moos, D.K. Burns, T.G. Brown (Eds), Pathology: The Big Picture.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following are B cell markers, EXCEPT:, with the following options: A: CD 10, B: CD 19, C: CD 20, D: CD 34 + ### Response: CD34 is a stem cell marker. Surface markers expressed by myeloid and lymphoid cells (can be used to analyze origin of neoplastic cell): B-cell markers: CD10, CD19, and CD20 T-cell markers: CD2, CD3, CD4, CD7, and CD8 Lymphoblast: TdT Myeloid markers: CD13, CD14, CD15, and CD64 Stem cell marker: CD34 Ref: Wyatt C., Kemp W.L., Moos P.J., Burns D.K., Brown T.G. (2008). Chapter 12. Hematopathology. In C. Wyatt, W.L. Kemp, P.J. Moos, D.K. Burns, T.G. Brown (Eds), Pathology: The Big Picture. ### End" @@ -722,6 +1287,13 @@ CD34 is a stem cell marker. Surface markers expressed by myeloid and lymphoid ce Answer the following medical question: In lag screw technique, what is the function of counter-sink?, with the following options: A: Assures appropriate receptacle for screw head, B: It is the hole made in the distal fragment that engages the screw threads, C: It is the hole made in the proximal segment that does not engage the screw threads, D: It is non functional +### Response: +","To flush the obliquely place screw head with the rest of the proximal cortex, countersink is made that acts as a receptacle for engaging the end of screw head.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In lag screw technique, what is the function of counter-sink?, with the following options: A: Assures appropriate receptacle for screw head, B: It is the hole made in the distal fragment that engages the screw threads, C: It is the hole made in the proximal segment that does not engage the screw threads, D: It is non functional + ### Response: To flush the obliquely place screw head with the rest of the proximal cortex, countersink is made that acts as a receptacle for engaging the end of screw head. ### End" @@ -731,6 +1303,13 @@ To flush the obliquely place screw head with the rest of the proximal cortex, co Answer the following medical question: Enteric fever on fourth day is best diagnosed by:, with the following options: A: Stool test, B: Widal test, C: Urine test, D: Blood culture +### Response: +","Ans. (d) Blood cultureRef.:Harrison 18th edition, Chapter 153* The definitive diagnosis of enteric fever requires the isolation of S. typhi or S. paratyphi from blood, bone marrow, other sterile sites, rose spots, stool, or intestinal secretions.For diagnosis in the first week* Sensitivity of blood culture is only 40-80%, probably because of high rates of antibiotic use in endemic areas and the small quantities of S. typhi (i.e., <15 organisms/ mL).* Bone marrow culture is 55-90% sensitive, and, unlike that of blood culture, its yield is not reduced by up to 5 days of prior antibiotic therapy.* Culture of intestinal secretions (best obtained by a noninvasive duodenal string test) can be positive despite a negative bone marrow culture.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Enteric fever on fourth day is best diagnosed by:, with the following options: A: Stool test, B: Widal test, C: Urine test, D: Blood culture + ### Response: Ans. (d) Blood cultureRef.:Harrison 18th edition, Chapter 153* The definitive diagnosis of enteric fever requires the isolation of S. typhi or S. paratyphi from blood, bone marrow, other sterile sites, rose spots, stool, or intestinal secretions.For diagnosis in the first week* Sensitivity of blood culture is only 40-80%, probably because of high rates of antibiotic use in endemic areas and the small quantities of S. typhi (i.e., <15 organisms/ mL).* Bone marrow culture is 55-90% sensitive, and, unlike that of blood culture, its yield is not reduced by up to 5 days of prior antibiotic therapy.* Culture of intestinal secretions (best obtained by a noninvasive duodenal string test) can be positive despite a negative bone marrow culture. ### End" @@ -740,6 +1319,13 @@ Ans. (d) Blood cultureRef.:Harrison 18th edition, Chapter 153* The definitive di Answer the following medical question: A patient who underwent surgery for stage IA grade 3 Ca endometrium was brought to you for postoperative adjuvant therapy. What is the preferred mode of treatment in the above mentioned case?, with the following options: A: External pelvic radiation, B: External field radiation, C: Vaginal brachytherapy, D: Observation +### Response: +","The postoperative adjuvant therapy for different stages of Ca endometrium is given below Stages Adjuvant therapy Stage IA, G1, G2 Observation Stage IA, G3 Vaginal brachytherapy Stage IB, G1, G2, G3 & Stage II, Stage III A ,B, C1, G1, G2, G3 External pelvic radiation + vaginal brachytherapy Stage III ,C2, G1, G2, G3 Extended field radiation + Vaginal brachytherapy Stage IV Whole abdominal radiation + pelvic radiation + Vaginal brachytherapy Ref: Essentials of Gynaecology by Lakshmi Seshadri, Edition 1, page - 414.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A patient who underwent surgery for stage IA grade 3 Ca endometrium was brought to you for postoperative adjuvant therapy. What is the preferred mode of treatment in the above mentioned case?, with the following options: A: External pelvic radiation, B: External field radiation, C: Vaginal brachytherapy, D: Observation + ### Response: The postoperative adjuvant therapy for different stages of Ca endometrium is given below Stages Adjuvant therapy Stage IA, G1, G2 Observation Stage IA, G3 Vaginal brachytherapy Stage IB, G1, G2, G3 & Stage II, Stage III A ,B, C1, G1, G2, G3 External pelvic radiation + vaginal brachytherapy Stage III ,C2, G1, G2, G3 Extended field radiation + Vaginal brachytherapy Stage IV Whole abdominal radiation + pelvic radiation + Vaginal brachytherapy Ref: Essentials of Gynaecology by Lakshmi Seshadri, Edition 1, page - 414. ### End" @@ -749,6 +1335,13 @@ The postoperative adjuvant therapy for different stages of Ca endometrium is giv Answer the following medical question: A child developed methemoglobinemia after receiving local anaesthesia during a surgical procedure which was treated by the intravenous administration of methylene blue. Which of the following anaesthetic must have given in this child?, with the following options: A: Procaine, B: Bupivacaine, C: Prilocaine, D: Lignocaine +### Response: +","Prilocaine is an intermediate-acting amino amide. Prilocaine has the highest clearance of the amino-amide anesthetics, impaing reduced risk of systemic toxicity. It has propensity to induce methemoglobinemia, which results from accumulation of one its metabolites, oho-toluidine, an oxidizing agent. Development of methemoglobinemia is dependent on the total dose administered, usually appearing after a dose of 8 mg/kg. If necessary, it can be treated by the intravenous administration of methylene blue (1-2 mg/kg). Ref: Drasner K. (2012). Chapter 26. Local Anesthetics. In B.G. Katzung, S.B. Masters, A.J. Trevor (Eds), Basic & Clinical Pharmacology, 12e.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A child developed methemoglobinemia after receiving local anaesthesia during a surgical procedure which was treated by the intravenous administration of methylene blue. Which of the following anaesthetic must have given in this child?, with the following options: A: Procaine, B: Bupivacaine, C: Prilocaine, D: Lignocaine + ### Response: Prilocaine is an intermediate-acting amino amide. Prilocaine has the highest clearance of the amino-amide anesthetics, impaing reduced risk of systemic toxicity. It has propensity to induce methemoglobinemia, which results from accumulation of one its metabolites, oho-toluidine, an oxidizing agent. Development of methemoglobinemia is dependent on the total dose administered, usually appearing after a dose of 8 mg/kg. If necessary, it can be treated by the intravenous administration of methylene blue (1-2 mg/kg). Ref: Drasner K. (2012). Chapter 26. Local Anesthetics. In B.G. Katzung, S.B. Masters, A.J. Trevor (Eds), Basic & Clinical Pharmacology, 12e. ### End" @@ -758,6 +1351,13 @@ Prilocaine is an intermediate-acting amino amide. Prilocaine has the highest cle Answer the following medical question: Enophthalmos is an uncommon feature of Horner's syndrome. Enophthalmos is due to palsy of:, with the following options: A: Levator palpebrae superioris, B: Superior tarsal muscle, C: Orbitalis muscle, D: Inferior tarsal muscle +### Response: +","Enophthalmos (sinking of the eye) is the inward displacement of the eyeball. It results from paralysis of the orbitalis muscle (a smooth muscle that spans the inferior orbital fissure and may contribute to maintaining the normal position of the eyeball). Ref: Gray's Basic Anatomy By Richard Drake, A. Wayne Vogl, Adam W. M. Mitchell, 2012, Page 467.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Enophthalmos is an uncommon feature of Horner's syndrome. Enophthalmos is due to palsy of:, with the following options: A: Levator palpebrae superioris, B: Superior tarsal muscle, C: Orbitalis muscle, D: Inferior tarsal muscle + ### Response: Enophthalmos (sinking of the eye) is the inward displacement of the eyeball. It results from paralysis of the orbitalis muscle (a smooth muscle that spans the inferior orbital fissure and may contribute to maintaining the normal position of the eyeball). Ref: Gray's Basic Anatomy By Richard Drake, A. Wayne Vogl, Adam W. M. Mitchell, 2012, Page 467. ### End" @@ -767,6 +1367,13 @@ Enophthalmos (sinking of the eye) is the inward displacement of the eyeball. It Answer the following medical question: A person has given 0.175 gm oral digoxin with bioavailabilty 70%. The amount of drug reaching in systemic circulation is:, with the following options: A: 0.175, B: 0.175 x 0.7, C: 0.175/7, D: 0.175 + 0.7 +### Response: +",Ans. (B) 0.175 x 0.7Amount of drug reaching in systemic circulation= drug dose given x bioavailability= 0.175 gm x 70/100= 0.175 gm x 0.7,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A person has given 0.175 gm oral digoxin with bioavailabilty 70%. The amount of drug reaching in systemic circulation is:, with the following options: A: 0.175, B: 0.175 x 0.7, C: 0.175/7, D: 0.175 + 0.7 + ### Response: Ans. (B) 0.175 x 0.7Amount of drug reaching in systemic circulation= drug dose given x bioavailability= 0.175 gm x 70/100= 0.175 gm x 0.7 ### End" @@ -776,6 +1383,13 @@ Ans. (B) 0.175 x 0.7Amount of drug reaching in systemic circulation= drug dose g Answer the following medical question: True about carriers -, with the following options: A: Infection with clinical symptoms, B: Serves as source of infection, C: More infectious than cases, D: Less dangerous than cases +### Response: +","Ans. is 'b' i.e., Serves as source of infection o A carrier is defined as 41an infected person or animal that harbours a specific infectious agent in the absence of clinical disease and serves as a potential source of infection "".o As a rule carriers are less infectious than cases, but epidemiologically they are more dangerous than cases because they escape recognition, and continuing as they do to live a normal life among the population or comunity, they readily infect the susceptible individuals over a wider area and longer period of time.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about carriers -, with the following options: A: Infection with clinical symptoms, B: Serves as source of infection, C: More infectious than cases, D: Less dangerous than cases + ### Response: Ans. is 'b' i.e., Serves as source of infection o A carrier is defined as 41an infected person or animal that harbours a specific infectious agent in the absence of clinical disease and serves as a potential source of infection "".o As a rule carriers are less infectious than cases, but epidemiologically they are more dangerous than cases because they escape recognition, and continuing as they do to live a normal life among the population or comunity, they readily infect the susceptible individuals over a wider area and longer period of time. ### End" @@ -785,6 +1399,13 @@ Ans. is 'b' i.e., Serves as source of infection o A carrier is defined as 41an i Answer the following medical question: A patient ingested some unknown substance and presented with myoclonic jerks, seizures, tachycardia and hypotension. ECG shows a heart rate of 120/min. The arterial blood revealed a pH of 7.25, pCO2 of 30 mm Hg and bicarbonate ions are 15 mmol/L. The most likely poisonous agent is:, with the following options: A: Amanita phylloids, B: Ethylene glycol, C: Imipramine, D: Phencyclidine +### Response: +","Ans. (C) Imipramine(Ref: KDT 8/e p486, 487)Features are typical of tricyclic antidepressant poisoning. TCAs possess anticholinergic activity that can result in tachycardia. These agents can lead to metabolic acidosis (pH < 7 4, HCO3- < 24 mmol/L). Seizures and myoclonic jerks are other features of TCA poisoning.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A patient ingested some unknown substance and presented with myoclonic jerks, seizures, tachycardia and hypotension. ECG shows a heart rate of 120/min. The arterial blood revealed a pH of 7.25, pCO2 of 30 mm Hg and bicarbonate ions are 15 mmol/L. The most likely poisonous agent is:, with the following options: A: Amanita phylloids, B: Ethylene glycol, C: Imipramine, D: Phencyclidine + ### Response: Ans. (C) Imipramine(Ref: KDT 8/e p486, 487)Features are typical of tricyclic antidepressant poisoning. TCAs possess anticholinergic activity that can result in tachycardia. These agents can lead to metabolic acidosis (pH < 7 4, HCO3- < 24 mmol/L). Seizures and myoclonic jerks are other features of TCA poisoning. ### End" @@ -794,6 +1415,13 @@ Ans. (C) Imipramine(Ref: KDT 8/e p486, 487)Features are typical of tricyclic ant Answer the following medical question: Bias is defined as?, with the following options: A: purious association between two variables, B: A quantified relationship between exposure and disease, C: Systemic error in determination of association between exposure and disease, D: Statistical technique used to evaluate the effect of a treatment by comparing treated and non-treated. +### Response: +","ANSWER: (C) Systemic error in determination of association between exposure and diseaseREF: Park 20th edition page 68, 69, http://jech. bmj.com/content/58/8/635.fiill, http://ocw. jhsph.edu/courses/fundepiii/PDFs/Lecturel8. pdf, http://carcin. oxfordjournals. org/ con tent /19/12/2063. full.pdfIndirect repeat December 2010Bias is any systematic error in the determination of the association between the exposure and disease.A statistic is biased if it is calculated in such a way that it is systematically different from the population parameter of interest. The following lists some types of, or aspects of, bias which should not be considered mutually exclusive:CONFOUNDINGNON CONFOUNDINGCigarette Smoking - Pre Cancerous Lung Cells - Lung CancerConfounding bias: In statistics, a confounding variable (also confounding factor, lurking variable, a confound,or confounder) is an extraneous variable in a statistical model that correlates (positively or negatively) with boththe dependent variable and the independent variable. This bias is removed by matching in case control studies.Selection bias: The error introduced when the study population does not represent the target population.Examples of selection bias areSampling bias is systematic error due to a non-random sample of a population. It is mostly classified as a subtype of selection bias, sometimes specifically termed sample selection bias, but some classify it as a separate type of bias.Healthcare access bias: when the patients admitted to an institution do not represent the cases originated in the communityBerkesonian bias: first described by Berkson in 1946 for case-control studies. It is produced when the probability of hospitalisation of cases and controls differ.Neyman bias (synonyms: incidence-prevalence bias, selective survival bias): This type of bias can occur in cross-selectional and case-control studies when asymptomatic, mild, clinically resolved, or fatal cases are inadvertently excluded from the case group because the selected cases are examined some time after the disease process has already begun (i.e. looking at prevalent versus incident cases).Healthy worker effect:Volunteer bias is another type of selection bias. It is due to the fact that those individuals who take part in epidemiologic studies tend to be systematically different from those who do not.Loss to follow-up bias is a form of selection bias that may occur when there are significant losses to follow-up in ongoing cohort and experimental studies. If the final sample is systematically different from the original or target population with regard to exposure frequency or outcome susceptibility, then spurious associations can result.III. Information/Observation bias/ Measurement Bias: occurs when information is collected differently between two groups, leading to an error in the conclusion of the association. When information is incorrect, there is misclassification. Examples of Information Bias areMemory/Recall bias: When cases and control are asked questions about their past history, it may be more likely for the cases to recall the existence of certain event or factors than the control who are healthy persons. Recall bias is a type of measurement bias that is very common in case-control studies. It can be reduced using blindingInterviewer bias: Interviewer knows the status of the subjects before the interview process. Interviewer may probe differently about exposures in the past if he or she knovrs the subjects as cases. Interviewer bias is a type of measurement bias that can arise in all types of epidemiologic studies. It can be reduced using blindingLead time bias is the bias that occurs when two tests for a disease are compared, and one test (the new, experimental one) diagnoses the disease earlier, but there is no effect on the outcome of the disease--it may appear that the test prolonged survival, when in fact it only resulted in earlier diagnosis when compared to traditional methods.Hawthorne effect: described in the 192 Os in the Hawthorne plant of the Western Electric Company (Chicago, IL). It is an increase in productivity--or other outcome under study--in participants who are aware of being observedSurveillance bias/Detection bias: The group with the known exposure or outcome may be followed more closely or longer than the comparison group.Misclassification bias: When subjects are erroneously classified with respect to either exposure or disease status.Differential misclassification occurs when the level of misclassification differs between the two groups.Random or Non-differential misclassification occurs when the level of misclassification does not differ between the two groups.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Bias is defined as?, with the following options: A: purious association between two variables, B: A quantified relationship between exposure and disease, C: Systemic error in determination of association between exposure and disease, D: Statistical technique used to evaluate the effect of a treatment by comparing treated and non-treated. + ### Response: ANSWER: (C) Systemic error in determination of association between exposure and diseaseREF: Park 20th edition page 68, 69, http://jech. bmj.com/content/58/8/635.fiill, http://ocw. jhsph.edu/courses/fundepiii/PDFs/Lecturel8. pdf, http://carcin. oxfordjournals. org/ con tent /19/12/2063. full.pdfIndirect repeat December 2010Bias is any systematic error in the determination of the association between the exposure and disease.A statistic is biased if it is calculated in such a way that it is systematically different from the population parameter of interest. The following lists some types of, or aspects of, bias which should not be considered mutually exclusive:CONFOUNDINGNON CONFOUNDINGCigarette Smoking - Pre Cancerous Lung Cells - Lung CancerConfounding bias: In statistics, a confounding variable (also confounding factor, lurking variable, a confound,or confounder) is an extraneous variable in a statistical model that correlates (positively or negatively) with boththe dependent variable and the independent variable. This bias is removed by matching in case control studies.Selection bias: The error introduced when the study population does not represent the target population.Examples of selection bias areSampling bias is systematic error due to a non-random sample of a population. It is mostly classified as a subtype of selection bias, sometimes specifically termed sample selection bias, but some classify it as a separate type of bias.Healthcare access bias: when the patients admitted to an institution do not represent the cases originated in the communityBerkesonian bias: first described by Berkson in 1946 for case-control studies. It is produced when the probability of hospitalisation of cases and controls differ.Neyman bias (synonyms: incidence-prevalence bias, selective survival bias): This type of bias can occur in cross-selectional and case-control studies when asymptomatic, mild, clinically resolved, or fatal cases are inadvertently excluded from the case group because the selected cases are examined some time after the disease process has already begun (i.e. looking at prevalent versus incident cases).Healthy worker effect:Volunteer bias is another type of selection bias. It is due to the fact that those individuals who take part in epidemiologic studies tend to be systematically different from those who do not.Loss to follow-up bias is a form of selection bias that may occur when there are significant losses to follow-up in ongoing cohort and experimental studies. If the final sample is systematically different from the original or target population with regard to exposure frequency or outcome susceptibility, then spurious associations can result.III. Information/Observation bias/ Measurement Bias: occurs when information is collected differently between two groups, leading to an error in the conclusion of the association. When information is incorrect, there is misclassification. Examples of Information Bias areMemory/Recall bias: When cases and control are asked questions about their past history, it may be more likely for the cases to recall the existence of certain event or factors than the control who are healthy persons. Recall bias is a type of measurement bias that is very common in case-control studies. It can be reduced using blindingInterviewer bias: Interviewer knows the status of the subjects before the interview process. Interviewer may probe differently about exposures in the past if he or she knovrs the subjects as cases. Interviewer bias is a type of measurement bias that can arise in all types of epidemiologic studies. It can be reduced using blindingLead time bias is the bias that occurs when two tests for a disease are compared, and one test (the new, experimental one) diagnoses the disease earlier, but there is no effect on the outcome of the disease--it may appear that the test prolonged survival, when in fact it only resulted in earlier diagnosis when compared to traditional methods.Hawthorne effect: described in the 192 Os in the Hawthorne plant of the Western Electric Company (Chicago, IL). It is an increase in productivity--or other outcome under study--in participants who are aware of being observedSurveillance bias/Detection bias: The group with the known exposure or outcome may be followed more closely or longer than the comparison group.Misclassification bias: When subjects are erroneously classified with respect to either exposure or disease status.Differential misclassification occurs when the level of misclassification differs between the two groups.Random or Non-differential misclassification occurs when the level of misclassification does not differ between the two groups. ### End" @@ -803,6 +1431,13 @@ ANSWER: (C) Systemic error in determination of association between exposure and Answer the following medical question: Secondary hyperparathyroidism due to Vit D deficiency shows :, with the following options: A: Hypocalcemia, B: Hypercalcemia, C: Hypophosphatemia, D: Hyperphosphatemia +### Response: +","C i.e. Hypophosphatemia PTH increases phosphate excretion in urineQ. This phosphaturic action is due to decreased reapsorption of phosphate in distal tubules. Secondary Hyperparathyroidism d/t -Vit D deficiency - This results from decreased serum Ca2+. - The released parathyroid hormone directs its activity to increase serum Ca2+ at the cost of of loss of phosphate from the body - hypophosphatemiaQ. - PTH mobilizes both Ca2+ & phosphate from the bone to increased level of both in blood initially, while it reabsorbs the filtered Ca2+ from renal tubules, it fails to reabsorb phosphate which is lost in urine.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Secondary hyperparathyroidism due to Vit D deficiency shows :, with the following options: A: Hypocalcemia, B: Hypercalcemia, C: Hypophosphatemia, D: Hyperphosphatemia + ### Response: C i.e. Hypophosphatemia PTH increases phosphate excretion in urineQ. This phosphaturic action is due to decreased reapsorption of phosphate in distal tubules. Secondary Hyperparathyroidism d/t -Vit D deficiency - This results from decreased serum Ca2+. - The released parathyroid hormone directs its activity to increase serum Ca2+ at the cost of of loss of phosphate from the body - hypophosphatemiaQ. - PTH mobilizes both Ca2+ & phosphate from the bone to increased level of both in blood initially, while it reabsorbs the filtered Ca2+ from renal tubules, it fails to reabsorb phosphate which is lost in urine. ### End" @@ -812,6 +1447,13 @@ C i.e. Hypophosphatemia PTH increases phosphate excretion in urineQ. This phosph Answer the following medical question: Triple test includes:, with the following options: A: Maternal AFP + HCG + Estradiol, B: Maternal AFP + HCG + PAPPA, C: Maternal AFP + PAPPA + Estradiol, D: TSH + HCG + Estradiol +### Response: +","Ans. is a, i.e. Maternal AFP + hCG + EstradiolThis is a repeat question and doesn't need explanation- actually it is estriol levels and not estradiol levels which are checked but since in options only estradiol is mentioned so we go with it.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Triple test includes:, with the following options: A: Maternal AFP + HCG + Estradiol, B: Maternal AFP + HCG + PAPPA, C: Maternal AFP + PAPPA + Estradiol, D: TSH + HCG + Estradiol + ### Response: Ans. is a, i.e. Maternal AFP + hCG + EstradiolThis is a repeat question and doesn't need explanation- actually it is estriol levels and not estradiol levels which are checked but since in options only estradiol is mentioned so we go with it. ### End" @@ -821,6 +1463,13 @@ Ans. is a, i.e. Maternal AFP + hCG + EstradiolThis is a repeat question and does Answer the following medical question: Involution of uterus occurs at the rate of: September 2009, with the following options: A: 1.0 cm/day, B: 1.25 cm/day, C: 1.5 cm/day, D: 2.0 cm/day +### Response: +","Ans. B: 1.25 cm/day Immediately after the delivery, the upper margin of the uterus lies about 5 inches above the pubic symphysis. In an average sized woman, this will be at the level of the umbilicus. But, by the 7th day, the uterus becomes much smaller and only its upper border can just be felt at the level of the symphysis. The size of the uterus decreases at the rate of 1.25 cm (1/2 inches) per 24 hours in the first 14 days of the postpaum period. It regains its pre-pregnancy size at the end of 6 weeks. By the end of 2 weeks uterus becomes a pelvic organ.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Involution of uterus occurs at the rate of: September 2009, with the following options: A: 1.0 cm/day, B: 1.25 cm/day, C: 1.5 cm/day, D: 2.0 cm/day + ### Response: Ans. B: 1.25 cm/day Immediately after the delivery, the upper margin of the uterus lies about 5 inches above the pubic symphysis. In an average sized woman, this will be at the level of the umbilicus. But, by the 7th day, the uterus becomes much smaller and only its upper border can just be felt at the level of the symphysis. The size of the uterus decreases at the rate of 1.25 cm (1/2 inches) per 24 hours in the first 14 days of the postpaum period. It regains its pre-pregnancy size at the end of 6 weeks. By the end of 2 weeks uterus becomes a pelvic organ. ### End" @@ -830,6 +1479,13 @@ Ans. B: 1.25 cm/day Immediately after the delivery, the upper margin of the uter Answer the following medical question: IV administration of which drug is most painful among the following, with the following options: A: Methohexitol, B: Propofol, C: Etomidate, D: Ketamine +### Response: +","* Pain on injection is the most commonly repoed adverse event during propofol administration. Not seen with etomidate due to use of etomidate in lipid emulsion vehicle. Ref:- Stoelting's Pharmacology and Physiology in Anesthetic Practice 5th edition Pg num:- 168,170","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: IV administration of which drug is most painful among the following, with the following options: A: Methohexitol, B: Propofol, C: Etomidate, D: Ketamine + ### Response: * Pain on injection is the most commonly repoed adverse event during propofol administration. Not seen with etomidate due to use of etomidate in lipid emulsion vehicle. Ref:- Stoelting's Pharmacology and Physiology in Anesthetic Practice 5th edition Pg num:- 168,170 ### End" @@ -839,6 +1495,13 @@ Answer the following medical question: IV administration of which drug is most p Answer the following medical question: A patient presented with a history of fall on outstretched hand. There is pain & swelling over the radial aspect of the wrist without any obvious deformity. Radial styloid process is at a lower level than the ulnar styloid process. Tenderness can be elicited in anatomical snuff box. Findings are consistent with the diagnosis of: March 2013 (e), with the following options: A: Fracture scaphoid, B: Fracture Colle's, C: Fracture pisiform, D: Wrist osteoahritis +### Response: +",Ans. A i.e. Fracture scaphoid Scaphoid Only carpal bone to undergo fracture as well as AVN: Scaphoid Fragment undergoing necrosis in fracture scaphoid: Proximal MC site of fracture scaphoid: Waist,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A patient presented with a history of fall on outstretched hand. There is pain & swelling over the radial aspect of the wrist without any obvious deformity. Radial styloid process is at a lower level than the ulnar styloid process. Tenderness can be elicited in anatomical snuff box. Findings are consistent with the diagnosis of: March 2013 (e), with the following options: A: Fracture scaphoid, B: Fracture Colle's, C: Fracture pisiform, D: Wrist osteoahritis + ### Response: Ans. A i.e. Fracture scaphoid Scaphoid Only carpal bone to undergo fracture as well as AVN: Scaphoid Fragment undergoing necrosis in fracture scaphoid: Proximal MC site of fracture scaphoid: Waist ### End" @@ -848,6 +1511,13 @@ Ans. A i.e. Fracture scaphoid Scaphoid Only carpal bone to undergo fracture as w Answer the following medical question: In myocardial infarction, the infarct acquires hyperemic rim with a yellow center at, with the following options: A: 1-2 hours, B: 3-7 days, C: 7-14 days, D: 10-20 days +### Response: +",Findings of infarct at 3 - 7 days: Gross examinationHyperemia borderSoftening yellow-tan center Histopathology (light microscopy)The beginning of the disintegration of dead muscle fibersNecrosis of neutrophilsThe beginning of macrophage removal of dead cells at the border,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In myocardial infarction, the infarct acquires hyperemic rim with a yellow center at, with the following options: A: 1-2 hours, B: 3-7 days, C: 7-14 days, D: 10-20 days + ### Response: Findings of infarct at 3 - 7 days: Gross examinationHyperemia borderSoftening yellow-tan center Histopathology (light microscopy)The beginning of the disintegration of dead muscle fibersNecrosis of neutrophilsThe beginning of macrophage removal of dead cells at the border ### End" @@ -857,6 +1527,13 @@ Findings of infarct at 3 - 7 days: Gross examinationHyperemia borderSoftening ye Answer the following medical question: A 28-year-old primi presented with true labor pain. The resident doctor examines the patient and notices multiple painful tiny vesicular ulcers over the vulva and vaginal walls. On examination, there are painful, enlarged lymph nodes, and microscopic examination shows multinucleated giant cells. What is the best step in the management of delivery in this patient?, with the following options: A: Vaginal delivery, B: Local application of antibiotic, C: Give tocolytics and treat the infection, D: Cesarean section +### Response: +","Painful genital ulcers and painful inguinal lymph adenopathy is suggestive of herpes virus infection. The best step in the management of delivery in this patient is Cesarean section. Herpes infection in the newborn may occur during bih, paicularly if the mother has genital lesions due to HSV-2. In such cases, Cesarean section may prevent infection Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 28-year-old primi presented with true labor pain. The resident doctor examines the patient and notices multiple painful tiny vesicular ulcers over the vulva and vaginal walls. On examination, there are painful, enlarged lymph nodes, and microscopic examination shows multinucleated giant cells. What is the best step in the management of delivery in this patient?, with the following options: A: Vaginal delivery, B: Local application of antibiotic, C: Give tocolytics and treat the infection, D: Cesarean section + ### Response: Painful genital ulcers and painful inguinal lymph adenopathy is suggestive of herpes virus infection. The best step in the management of delivery in this patient is Cesarean section. Herpes infection in the newborn may occur during bih, paicularly if the mother has genital lesions due to HSV-2. In such cases, Cesarean section may prevent infection Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition ### End" @@ -866,6 +1543,13 @@ Painful genital ulcers and painful inguinal lymph adenopathy is suggestive of he Answer the following medical question: What is the treatment for a newborn child with CTEV?, with the following options: A: Jess fixation, B: Manipulation and strapping or serial cast, C: Posteromedial soft tissue release, D: Triple arthrodesis +### Response: +","Ans. is 'b' i.e., Manipulation and strapping or serial cast Treatment of CTEV in new born:o Treatment should begin early, preferably within a day or two of birth (as early as possible or when the newborn presents to the surgeon).o This consists of repeated manipula- tion and adhesive strapping that maintains the correction; the manipulations are taught to the child's mother, who is then able to carry out gentle stretches on a regular basis with the strapping still in place.o Treatment is supervised by a physiotherapist, who alters the strapping as correction is gradually obtained,o If this level of care is not available, it may be better to hold position by applying a light plaster cast (over a protective layer of strapping), which is soaked off and changed every week.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What is the treatment for a newborn child with CTEV?, with the following options: A: Jess fixation, B: Manipulation and strapping or serial cast, C: Posteromedial soft tissue release, D: Triple arthrodesis + ### Response: Ans. is 'b' i.e., Manipulation and strapping or serial cast Treatment of CTEV in new born:o Treatment should begin early, preferably within a day or two of birth (as early as possible or when the newborn presents to the surgeon).o This consists of repeated manipula- tion and adhesive strapping that maintains the correction; the manipulations are taught to the child's mother, who is then able to carry out gentle stretches on a regular basis with the strapping still in place.o Treatment is supervised by a physiotherapist, who alters the strapping as correction is gradually obtained,o If this level of care is not available, it may be better to hold position by applying a light plaster cast (over a protective layer of strapping), which is soaked off and changed every week. ### End" @@ -875,6 +1559,13 @@ Ans. is 'b' i.e., Manipulation and strapping or serial cast Treatment of CTEV in Answer the following medical question: Structure formed from Mesonephric duct is?, with the following options: A: Ovary, B: Ureter, C: Uterus, D: Uterine tubes +### Response: +","A diveiculum called Ureteric bud which arises From the lower pa of the mesonephric duct(wolffian duct) Ureter develops from pa of the Ureteric bud that lies between the pelvis of the kydney and the vesico urethral canal HUMAN EMBRYOLOGY-INDERBIR SINGH TENTH EDITION-PAGE NO:285,290","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Structure formed from Mesonephric duct is?, with the following options: A: Ovary, B: Ureter, C: Uterus, D: Uterine tubes + ### Response: A diveiculum called Ureteric bud which arises From the lower pa of the mesonephric duct(wolffian duct) Ureter develops from pa of the Ureteric bud that lies between the pelvis of the kydney and the vesico urethral canal HUMAN EMBRYOLOGY-INDERBIR SINGH TENTH EDITION-PAGE NO:285,290 ### End" @@ -884,6 +1575,13 @@ A diveiculum called Ureteric bud which arises From the lower pa of the mesonephr Answer the following medical question: Not seen in fecal pollution is, with the following options: A: Staphylococcus, B: Streptococcus, C: E.coli, D: Clostridium perfringens +### Response: +",The primary bacterial indicator recommended for faecal contamination is the coliform group of organisms as a whole (E.Coli)Supplementary indicator organisms are faecal streptococci and sulphite-reducing clostridia.Park 23e pg: 720,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Not seen in fecal pollution is, with the following options: A: Staphylococcus, B: Streptococcus, C: E.coli, D: Clostridium perfringens + ### Response: The primary bacterial indicator recommended for faecal contamination is the coliform group of organisms as a whole (E.Coli)Supplementary indicator organisms are faecal streptococci and sulphite-reducing clostridia.Park 23e pg: 720 ### End" @@ -893,6 +1591,13 @@ The primary bacterial indicator recommended for faecal contamination is the coli Answer the following medical question: Which of the following is not true about PTEN gene?, with the following options: A: It is the membrane associated phosphatase, B: Encoded by gene located on chromosome 10q23, C: It is mutated in endometrial, breast, thyroid carcinoma, D: It acts as a proto-oncogene +### Response: +","PTEN (phosphatase and tensin homologue) Membrane-associated phosphatase encoded by a gene on chromosome 10q23 that is mutated in Cowden syndrome Autosomal dominant disorder C/F:- Marked by frequent benign growths, such as skin appendage tumors Increased incidence of epithelial cancers, paicularly of the breast, endometrium, and thyroid. PTEN acts as a tumor suppressor by serving as a brake on the PI3K/AKT arm of the receptor tyrosine kinase pathway. PTEN gene function is lost in many cancers through deletion, deleterious point mutations, or epigenetic silencing.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is not true about PTEN gene?, with the following options: A: It is the membrane associated phosphatase, B: Encoded by gene located on chromosome 10q23, C: It is mutated in endometrial, breast, thyroid carcinoma, D: It acts as a proto-oncogene + ### Response: PTEN (phosphatase and tensin homologue) Membrane-associated phosphatase encoded by a gene on chromosome 10q23 that is mutated in Cowden syndrome Autosomal dominant disorder C/F:- Marked by frequent benign growths, such as skin appendage tumors Increased incidence of epithelial cancers, paicularly of the breast, endometrium, and thyroid. PTEN acts as a tumor suppressor by serving as a brake on the PI3K/AKT arm of the receptor tyrosine kinase pathway. PTEN gene function is lost in many cancers through deletion, deleterious point mutations, or epigenetic silencing. ### End" @@ -902,6 +1607,13 @@ PTEN (phosphatase and tensin homologue) Membrane-associated phosphatase encoded Answer the following medical question: The amino acid that acts as a precursor in the production of urea is, with the following options: A: Arginine, B: Aspaic acid, C: Ornithine, D: Glutamate +### Response: +","(Refer: Harper's Illustrated Biochemistry, 26th edition, pg no: 265)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The amino acid that acts as a precursor in the production of urea is, with the following options: A: Arginine, B: Aspaic acid, C: Ornithine, D: Glutamate + ### Response: (Refer: Harper's Illustrated Biochemistry, 26th edition, pg no: 265) ### End" @@ -911,6 +1623,13 @@ Answer the following medical question: The amino acid that acts as a precursor i Answer the following medical question: When used for emergency contraception, What is the dose of ulipristal acetate?, with the following options: A: 300mg, B: 30mg, C: 300ug, D: 30ug +### Response: +","Emergency Contraceptives Drug Dose Levonorgestrel (POP) 1 dose 1.5 mg within 72 hrs Copper IUDs ( NOT THE DOC ! ) Inseion within 5 days Ulipristal acetate (SPRM) 30 mg orally within 120 hours Ethinyl estradiol 50 ug + Norgestrel 0.25 mg (COC) 2 tab stat and 2 after 12 hour Mifepristone RU 486 (PA) 25 to 100 mg single dose ICUDs are the most effective methods, no doubt, but they can never be the DOC. Thats because they require seeing a gynecologist take a prescription and then a specialist to inse the device. Emergency contraception is based on the principle of 'over the counter' easy to use medication to prevent a pregnancy and when there is unplanned intercourse, which can happen many times in a year, a person cannot be expected to take an IUCD every time! However, a LNG tablet can be easily, and effectively, be taken whenever there is unplanned intercourse * Please note: We are in the early pa of year 2020 now. Mifepristone or Ullipristal may be soon termed as the best drugs for EC. Please be on the look out for recent updates.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: When used for emergency contraception, What is the dose of ulipristal acetate?, with the following options: A: 300mg, B: 30mg, C: 300ug, D: 30ug + ### Response: Emergency Contraceptives Drug Dose Levonorgestrel (POP) 1 dose 1.5 mg within 72 hrs Copper IUDs ( NOT THE DOC ! ) Inseion within 5 days Ulipristal acetate (SPRM) 30 mg orally within 120 hours Ethinyl estradiol 50 ug + Norgestrel 0.25 mg (COC) 2 tab stat and 2 after 12 hour Mifepristone RU 486 (PA) 25 to 100 mg single dose ICUDs are the most effective methods, no doubt, but they can never be the DOC. Thats because they require seeing a gynecologist take a prescription and then a specialist to inse the device. Emergency contraception is based on the principle of 'over the counter' easy to use medication to prevent a pregnancy and when there is unplanned intercourse, which can happen many times in a year, a person cannot be expected to take an IUCD every time! However, a LNG tablet can be easily, and effectively, be taken whenever there is unplanned intercourse * Please note: We are in the early pa of year 2020 now. Mifepristone or Ullipristal may be soon termed as the best drugs for EC. Please be on the look out for recent updates. ### End" @@ -920,6 +1639,34 @@ Emergency Contraceptives Drug Dose Levonorgestrel (POP) 1 dose 1.5 mg within 72 Answer the following medical question: Injury to radial nerve in the lower part of spiral groove -, with the following options: A: Spares nerve supply to extensor carpi radialis longus, B: Results in paralysis of anconeus muscle, C: Leaves extensions at elbow joint intact, D: Weakens pronation movement +### Response: +","Radial nerve injury + +Radial nerve injury may be high or low. + +1) High radial nerve palsy + +The injury is before the spiral groove +All muscles supplied by radial nerve are paralysed. + +2) Low radial nerve palsy + +The injury is after the spiral groove. +Low radial nerve palsy may be of two types. + +i) Type I: - Injury occurs between the spiral groove and elbows joint. Muscles involvement is : - +a)Elbow extensors (Triceps, anconeus) are spared. +b)Wrist, elbow and finger extensors are paralysed. +c) Sensory loss in first web space (on dorsal side) +ii) Type II: - Injury occurs below the elbow joint. +a) Elbow extensors (triceps, anconeus), Brachioradialis and wrist extensors (ECRL) are spared. +b) Finger extensors (extensor digitorum, extensor digit minimi, extensor indices) and thumb extensors (extensor pollicis longus & brevis) are paralysed. +c) Sensory loss in first web space ( on dorsal side).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Injury to radial nerve in the lower part of spiral groove -, with the following options: A: Spares nerve supply to extensor carpi radialis longus, B: Results in paralysis of anconeus muscle, C: Leaves extensions at elbow joint intact, D: Weakens pronation movement + ### Response: Radial nerve injury @@ -950,6 +1697,13 @@ c) Sensory loss in first web space ( on dorsal side). Answer the following medical question: Coin shaped eczema is –, with the following options: A: Nummular eczema, B: Atopic acema, C: Infantile eczema, D: Endogenous eczema +### Response: +","Nummular eczema (discoid eczema) is characterized by multiple, itchy, scaly, coin shaped exudative plaques on extremities in middle-aged men.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Coin shaped eczema is –, with the following options: A: Nummular eczema, B: Atopic acema, C: Infantile eczema, D: Endogenous eczema + ### Response: Nummular eczema (discoid eczema) is characterized by multiple, itchy, scaly, coin shaped exudative plaques on extremities in middle-aged men. ### End" @@ -959,6 +1713,13 @@ Nummular eczema (discoid eczema) is characterized by multiple, itchy, scaly, coi Answer the following medical question: Lead pipe appearance is seen in, with the following options: A: Chron's disease, B: Ulcerative colitis, C: Schistosomiasis, D: Carcinoma colon +### Response: +",B i.e. Ulcerative colitis,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Lead pipe appearance is seen in, with the following options: A: Chron's disease, B: Ulcerative colitis, C: Schistosomiasis, D: Carcinoma colon + ### Response: B i.e. Ulcerative colitis ### End" @@ -968,6 +1729,13 @@ B i.e. Ulcerative colitis Answer the following medical question: Deficiency of enzyme a-keto acid decarboxylase leading to a block in the metabolism of branch chain amino acids is observed in -, with the following options: A: Maple syrup urine disease, B: Hanup's disease, C: Alkaptonuria, D: Phenylketonuria +### Response: +","Ans. is 'a' i.e., Maple Syrup urine diseaseMAPLE SYRUP URINE DISEASE In this disorder, the branched-chain keto acids derived from isoleucine, leucine, and valine appear in the urine, giving it a maple syrup-like odor.This condition results from a deficiency in the branched-chain -keto acid dehydrogenase.It is a mitochondrial, enzyme complex consisting of a-ketoacid decarboxylase , Dihydrolipoyl dehydrogenase and Transacylase The early steps in the metabolism of these three amino-acids are similar. One of the steps - decarboxylation is accomplished by a complex enzyme system i.e. branched chain oc-keto acid dehydrogenase using thiamine pyrophosphate (vitamin B1) as a coenzyme.The elevated keto acids cause severe brain damage, with death in the first year of life.The disease is characterized by feeding problems,vomiting, dehydration, severe metabolic acidosis, and a characteristic maple syrup odor to the urine. If untreated, the disease leads to mental retardation, physical disabilities, and even death.Treatment. A few cases respond to megadoses of thiamine (vitamin B1). Otherwise, synthetic diets low in branched-chain amino acids are given.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Deficiency of enzyme a-keto acid decarboxylase leading to a block in the metabolism of branch chain amino acids is observed in -, with the following options: A: Maple syrup urine disease, B: Hanup's disease, C: Alkaptonuria, D: Phenylketonuria + ### Response: Ans. is 'a' i.e., Maple Syrup urine diseaseMAPLE SYRUP URINE DISEASE In this disorder, the branched-chain keto acids derived from isoleucine, leucine, and valine appear in the urine, giving it a maple syrup-like odor.This condition results from a deficiency in the branched-chain -keto acid dehydrogenase.It is a mitochondrial, enzyme complex consisting of a-ketoacid decarboxylase , Dihydrolipoyl dehydrogenase and Transacylase The early steps in the metabolism of these three amino-acids are similar. One of the steps - decarboxylation is accomplished by a complex enzyme system i.e. branched chain oc-keto acid dehydrogenase using thiamine pyrophosphate (vitamin B1) as a coenzyme.The elevated keto acids cause severe brain damage, with death in the first year of life.The disease is characterized by feeding problems,vomiting, dehydration, severe metabolic acidosis, and a characteristic maple syrup odor to the urine. If untreated, the disease leads to mental retardation, physical disabilities, and even death.Treatment. A few cases respond to megadoses of thiamine (vitamin B1). Otherwise, synthetic diets low in branched-chain amino acids are given. ### End" @@ -977,6 +1745,13 @@ Ans. is 'a' i.e., Maple Syrup urine diseaseMAPLE SYRUP URINE DISEASE In this dis Answer the following medical question: Ophthalmoplegic migraine is characterized by, with the following options: A: Transient diplopia, B: Headache with vomiting episodes, C: Headache with benign recurrent 3 rd N. palsy, D: Headache with complete vision loss +### Response: +","Ophthalmoplegic migraine is a rare neurologic syndrome characterized by recurrent bouts of head pain and ophthalmoplegia. The third cranial nerve is most commonly affected, in which case mydriasis and ptosis can also be observed Ophthalmoplegic migraine is a rare neurologic syndrome characterized by recurrent bouts of head pain and ophthalmoplegia. The third cranial nerve is most commonly affected, in which case mydriasis and ptosis can also be observed. Most patients recover completely within days to weeks, but a minority are left with persistent neurologic deficits Ref Harrison20th edition pg 1234","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ophthalmoplegic migraine is characterized by, with the following options: A: Transient diplopia, B: Headache with vomiting episodes, C: Headache with benign recurrent 3 rd N. palsy, D: Headache with complete vision loss + ### Response: Ophthalmoplegic migraine is a rare neurologic syndrome characterized by recurrent bouts of head pain and ophthalmoplegia. The third cranial nerve is most commonly affected, in which case mydriasis and ptosis can also be observed Ophthalmoplegic migraine is a rare neurologic syndrome characterized by recurrent bouts of head pain and ophthalmoplegia. The third cranial nerve is most commonly affected, in which case mydriasis and ptosis can also be observed. Most patients recover completely within days to weeks, but a minority are left with persistent neurologic deficits Ref Harrison20th edition pg 1234 ### End" @@ -986,6 +1761,13 @@ Ophthalmoplegic migraine is a rare neurologic syndrome characterized by recurren Answer the following medical question: Most common cause of sudden death -, with the following options: A: Ventricular fibrillation, B: Atrial fibrillation, C: PSVT, D: A-V block +### Response: +","Ans. is 'a' i.e., Ventricular fibrillation Ventricular fibrillation is the most frequent mechanism of sudden cardiac death : - (accountsfor 60% of sudden death)o It is a rapid disorganized ventricular arryhthmia resulting in no uniform ventricular contraction, no cardiac output, and no recordable blood pressure.o Death from a ventricular tachyarryhthmia in the setting of an acute myocardial infarction has historically been one of the most frequent causes of sudden cardiac death.o 60% of the death associated with acute Ml occured within the first hour and were attributable to a ventricular arrhythmia.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common cause of sudden death -, with the following options: A: Ventricular fibrillation, B: Atrial fibrillation, C: PSVT, D: A-V block + ### Response: Ans. is 'a' i.e., Ventricular fibrillation Ventricular fibrillation is the most frequent mechanism of sudden cardiac death : - (accountsfor 60% of sudden death)o It is a rapid disorganized ventricular arryhthmia resulting in no uniform ventricular contraction, no cardiac output, and no recordable blood pressure.o Death from a ventricular tachyarryhthmia in the setting of an acute myocardial infarction has historically been one of the most frequent causes of sudden cardiac death.o 60% of the death associated with acute Ml occured within the first hour and were attributable to a ventricular arrhythmia. ### End" @@ -995,6 +1777,13 @@ Ans. is 'a' i.e., Ventricular fibrillation Ventricular fibrillation is the most Answer the following medical question: Carpopedal spasm in hyperventilation occurs because, with the following options: A: Increased calcium uptake by sarcoplasmic reticulum of muscles, B: Increased calcium uptake by bones, C: Increased calcium binding to plasma protein, D: Increased urinary excretion of calcium +### Response: +","Answer- C. Increased calcium binding to plasma proteinCarpopedal spasm and tetany is due to hypocalcemia.""The alkalosis that result from hyperventilation may worsen the hypocalcemia by increasing the fraction ionized calcium bound to plasma protein.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Carpopedal spasm in hyperventilation occurs because, with the following options: A: Increased calcium uptake by sarcoplasmic reticulum of muscles, B: Increased calcium uptake by bones, C: Increased calcium binding to plasma protein, D: Increased urinary excretion of calcium + ### Response: Answer- C. Increased calcium binding to plasma proteinCarpopedal spasm and tetany is due to hypocalcemia.""The alkalosis that result from hyperventilation may worsen the hypocalcemia by increasing the fraction ionized calcium bound to plasma protein. ### End" @@ -1004,6 +1793,13 @@ Answer- C. Increased calcium binding to plasma proteinCarpopedal spasm and tetan Answer the following medical question: Which is not true regarding Insulinoma ?, with the following options: A: Hypoglycemic attacks, B: Weight loss, C: Usually Solitary tumour, D: Mostly benign tumour +### Response: +",Ans is 'b' ie Weight loss As already discussed : Hypoglycemic attacks are pa of Whipple's triad Insulinoma is usually solitary (-90%) Only 5 to 15% are malignant,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which is not true regarding Insulinoma ?, with the following options: A: Hypoglycemic attacks, B: Weight loss, C: Usually Solitary tumour, D: Mostly benign tumour + ### Response: Ans is 'b' ie Weight loss As already discussed : Hypoglycemic attacks are pa of Whipple's triad Insulinoma is usually solitary (-90%) Only 5 to 15% are malignant ### End" @@ -1013,6 +1809,13 @@ Ans is 'b' ie Weight loss As already discussed : Hypoglycemic attacks are pa of Answer the following medical question: Most common extra-intestinal malignancy in HNPCC:, with the following options: A: Pancreatic carcinoma, B: Ca stomach, C: Small bowel carcinoma, D: Transitional cell carcinoma +### Response: +","EXTRA - INTESTINAL MALIGNANCIES IN HNPCC Endometrial (39-60%)>gastric (13-19)>ovarian (6-12%) Rare Malignancies: Small intestine, pancreatic, thyroid, transitional cell epithelium in the urinary tract (renal pelvic, ureter, bladder); brain cancers.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common extra-intestinal malignancy in HNPCC:, with the following options: A: Pancreatic carcinoma, B: Ca stomach, C: Small bowel carcinoma, D: Transitional cell carcinoma + ### Response: EXTRA - INTESTINAL MALIGNANCIES IN HNPCC Endometrial (39-60%)>gastric (13-19)>ovarian (6-12%) Rare Malignancies: Small intestine, pancreatic, thyroid, transitional cell epithelium in the urinary tract (renal pelvic, ureter, bladder); brain cancers. ### End" @@ -1022,6 +1825,13 @@ EXTRA - INTESTINAL MALIGNANCIES IN HNPCC Endometrial (39-60%)>gastric (13-19)>ov Answer the following medical question: Siblings of the diagnosed patient with Wilson disease will be having what risk of Wilson disease?, with the following options: A: 25%, B: 50%, C: 75%, D: 100% +### Response: +","The frequency of Wilson's disease in most populations is about 1 in 30,000. Siblings of a diagnosed patient have a 1 in 4 risk of Wilson's disease. Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 3188","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Siblings of the diagnosed patient with Wilson disease will be having what risk of Wilson disease?, with the following options: A: 25%, B: 50%, C: 75%, D: 100% + ### Response: The frequency of Wilson's disease in most populations is about 1 in 30,000. Siblings of a diagnosed patient have a 1 in 4 risk of Wilson's disease. Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 3188 ### End" @@ -1031,6 +1841,13 @@ The frequency of Wilson's disease in most populations is about 1 in 30,000. Sibl Answer the following medical question: The following tumours commonly metastasis to the ovary, except :, with the following options: A: Malignant melanoma, B: Stomach, C: Oesophagus, D: Lymphoma +### Response: +",Oesophagus,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The following tumours commonly metastasis to the ovary, except :, with the following options: A: Malignant melanoma, B: Stomach, C: Oesophagus, D: Lymphoma + ### Response: Oesophagus ### End" @@ -1040,6 +1857,21 @@ Oesophagus Answer the following medical question: Which of the following is not a clinical criterion to evaluate treatment outcome?, with the following options: A: Absence of a radiolucency, B: No evidence of a sinus tract, C: No swelling present, D: No response to percussion or palpation +### Response: +","Endodontic treatment outcome predictors using PA radiographs and CBCT imaging have been shown to vary and also are influenced by patient inclusion and exclusion criteria. Historically, PA radiographs and physical examinations were used to determine the success of endodontic treatment, and the absence of posttreatment periradicular radiolucencies and symptoms was considered the criterion for success. +The clinical criteria to evaluate treatment outcome may be: + +No evidence of a sinus tract  +No swelling present  +No response to percussion or palpation  +Absence of a radiolucency may be a radiologic feature to evaluate the success of treatment. + +Ref: Cohen pathways of Pulp 11th ed page no 56","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is not a clinical criterion to evaluate treatment outcome?, with the following options: A: Absence of a radiolucency, B: No evidence of a sinus tract, C: No swelling present, D: No response to percussion or palpation + ### Response: Endodontic treatment outcome predictors using PA radiographs and CBCT imaging have been shown to vary and also are influenced by patient inclusion and exclusion criteria. Historically, PA radiographs and physical examinations were used to determine the success of endodontic treatment, and the absence of posttreatment periradicular radiolucencies and symptoms was considered the criterion for success. The clinical criteria to evaluate treatment outcome may be: @@ -1057,6 +1889,13 @@ Ref: Cohen pathways of Pulp 11th ed page no 56 Answer the following medical question: Specimens for toxicological studies are preserved in: DNB 09; Maharashtra 11; AFMC 12, with the following options: A: 10% of formaldehyde, B: Alcohol, C: Saturated solution of common salt, D: Normal saline +### Response: +",Ans. Saturated solution of common salt,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Specimens for toxicological studies are preserved in: DNB 09; Maharashtra 11; AFMC 12, with the following options: A: 10% of formaldehyde, B: Alcohol, C: Saturated solution of common salt, D: Normal saline + ### Response: Ans. Saturated solution of common salt ### End" @@ -1066,6 +1905,13 @@ Ans. Saturated solution of common salt Answer the following medical question: Drug used in the prophylaxis of nicotine addiction: NIMHANS 08; Manipal 09; Maharashtra 10, WB 11, with the following options: A: Diazepam, B: Naloxone, C: Bupropion, D: Acamprosate +### Response: +",Ans. Bupropion,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Drug used in the prophylaxis of nicotine addiction: NIMHANS 08; Manipal 09; Maharashtra 10, WB 11, with the following options: A: Diazepam, B: Naloxone, C: Bupropion, D: Acamprosate + ### Response: Ans. Bupropion ### End" @@ -1075,6 +1921,13 @@ Ans. Bupropion Answer the following medical question: Topical mitomycin-C is used in, with the following options: A: Sturge-Weber syndrome, B: Laryngotracheal stenosis, C: Endoscopic angiofibroma, D: Skull base osteomyelitis +### Response: +","Mitomycin is an anti-tumor antibiotic with alkylating agent like propey. It is used in superficial cancer of urinary bladder. The drug has radiomimetic effects, and also sensitizes hypoxic tumor cells to the effects of hypoxia. Application of topical mitomycin C after endoscopic dilation of laryngotracheal stenosis reduces the rate of restenosis.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Topical mitomycin-C is used in, with the following options: A: Sturge-Weber syndrome, B: Laryngotracheal stenosis, C: Endoscopic angiofibroma, D: Skull base osteomyelitis + ### Response: Mitomycin is an anti-tumor antibiotic with alkylating agent like propey. It is used in superficial cancer of urinary bladder. The drug has radiomimetic effects, and also sensitizes hypoxic tumor cells to the effects of hypoxia. Application of topical mitomycin C after endoscopic dilation of laryngotracheal stenosis reduces the rate of restenosis. ### End" @@ -1084,6 +1937,13 @@ Mitomycin is an anti-tumor antibiotic with alkylating agent like propey. It is u Answer the following medical question: Curschmann spirals are seen in, with the following options: A: TB cavity, B: Asthma, C: Bronchitis, D: Bronchitis +### Response: +",Curschmann spirals refers to finding in sputum of spiral shaped mucus plugs. They are often seen in association with creola bodies and Charcot leyden crystals. Curschmann's spirals are a microscopic finding in the sputum of asthmatics. They are spiral-shaped mucus plugs from subepithelial mucous gland ducts of bronchi. They may occur in several different lung diseases.and may refer to pas of the desquamated epithelium seen in lavages from asthmatic patients. Ref Davidson edition23rd pg 572,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Curschmann spirals are seen in, with the following options: A: TB cavity, B: Asthma, C: Bronchitis, D: Bronchitis + ### Response: Curschmann spirals refers to finding in sputum of spiral shaped mucus plugs. They are often seen in association with creola bodies and Charcot leyden crystals. Curschmann's spirals are a microscopic finding in the sputum of asthmatics. They are spiral-shaped mucus plugs from subepithelial mucous gland ducts of bronchi. They may occur in several different lung diseases.and may refer to pas of the desquamated epithelium seen in lavages from asthmatic patients. Ref Davidson edition23rd pg 572 ### End" @@ -1093,6 +1953,13 @@ Curschmann spirals refers to finding in sputum of spiral shaped mucus plugs. The Answer the following medical question: In Breast cancer following are expressed:, with the following options: A: HER2/neu, B: P53, C: B RCA1, D: All +### Response: +","Ans. is 'a', 'b' & 'c' i.e. HER2/neu, P53 & BRCA1","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In Breast cancer following are expressed:, with the following options: A: HER2/neu, B: P53, C: B RCA1, D: All + ### Response: Ans. is 'a', 'b' & 'c' i.e. HER2/neu, P53 & BRCA1 ### End" @@ -1102,6 +1969,13 @@ Ans. is 'a', 'b' & 'c' i.e. HER2/neu, P53 & BRCA1 Answer the following medical question: For pain control in a patient having history of G I bleeding, which of the following is given?, with the following options: A: Nimesulide, B: Ibuprofen, C: Rofecoxib, D: Pentazocin +### Response: +","SELECTIVE COX-2 INHIBITORS- Rofecoxib,etoricoxib,celecoxib They cause little gastric mucosal damage; the occurrence of peptic ulcer and ulcer bleeds is clearly lower than with traditional NSAIDs. They do not depress TXA2 Production by platelets (COX-I dependent); do not inhibit platelet aggregation or prolong bleeding time but reduce PGI2 production by vascular endothelium. They increase the risk of cardiovascular events ESSENTIALS OF MEDICAL PHARMACOLOGY;7TH EDITION;KD TRIPATHI;PAGE NO 205","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: For pain control in a patient having history of G I bleeding, which of the following is given?, with the following options: A: Nimesulide, B: Ibuprofen, C: Rofecoxib, D: Pentazocin + ### Response: SELECTIVE COX-2 INHIBITORS- Rofecoxib,etoricoxib,celecoxib They cause little gastric mucosal damage; the occurrence of peptic ulcer and ulcer bleeds is clearly lower than with traditional NSAIDs. They do not depress TXA2 Production by platelets (COX-I dependent); do not inhibit platelet aggregation or prolong bleeding time but reduce PGI2 production by vascular endothelium. They increase the risk of cardiovascular events ESSENTIALS OF MEDICAL PHARMACOLOGY;7TH EDITION;KD TRIPATHI;PAGE NO 205 ### End" @@ -1111,6 +1985,13 @@ SELECTIVE COX-2 INHIBITORS- Rofecoxib,etoricoxib,celecoxib They cause little gas Answer the following medical question: Diameter of graafian follicle at the time of ovulation is -, with the following options: A: 10mm, B: 15mm, C: 20mm, D: 25mm +### Response: +",Ans. C. 20mmOvulation is aprocessby which a secondary oocyte is released from the ovaryfollowingrupture of a mature Graafian follicle and becomes available for conception.There is a pre - ovulatory enlargement in the Graafian follicle and it measures about 20 mm at the time of ovulation.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Diameter of graafian follicle at the time of ovulation is -, with the following options: A: 10mm, B: 15mm, C: 20mm, D: 25mm + ### Response: Ans. C. 20mmOvulation is aprocessby which a secondary oocyte is released from the ovaryfollowingrupture of a mature Graafian follicle and becomes available for conception.There is a pre - ovulatory enlargement in the Graafian follicle and it measures about 20 mm at the time of ovulation. ### End" @@ -1120,6 +2001,13 @@ Ans. C. 20mmOvulation is aprocessby which a secondary oocyte is released from th Answer the following medical question: True about congenital Rubella syndrome is:-, with the following options: A: Blueberry muffin rash is seen, B: Virus can be isolated only upto 6months after bih, C: Triad of CRS are cataract, cardiac defects, cerebral palsy, D: Infection is most serious after five months of pregnancy +### Response: +","Virus can be isolated up to 12 months after bih. Tired of CRS is cardiac defects, cataract and sensory neural defects. Infection is not serious after 5 months of pregnancy Blueberry muffin rash is seen in congenital rubella syndrome.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about congenital Rubella syndrome is:-, with the following options: A: Blueberry muffin rash is seen, B: Virus can be isolated only upto 6months after bih, C: Triad of CRS are cataract, cardiac defects, cerebral palsy, D: Infection is most serious after five months of pregnancy + ### Response: Virus can be isolated up to 12 months after bih. Tired of CRS is cardiac defects, cataract and sensory neural defects. Infection is not serious after 5 months of pregnancy Blueberry muffin rash is seen in congenital rubella syndrome. ### End" @@ -1130,7 +2018,14 @@ Virus can be isolated up to 12 months after bih. Tired of CRS is cardiac defects Answer the following medical question: Mode of inheritance of Leber hereditary optic neuropathy is?, with the following options: A: Mitochondrial DNA damage disorder, B: Lipid storage disorder, C: Nucleotide Excision Repair disorder, D: Lysosomal storage disorder ### Response: -Ans. is 'a' i.e., Mitochondrial DNA damage disorder * Important mitochondrial disorders are Pearson syndrome, Leigh syndrome, MELAS, Keamssayre syndrome (KSS), Leber hereditary optic neuropathy (LHON), Chronic progressive ophthalmoplegia (CPEO), Neurogenic weakness with ataxia and retinitis pigmentosa (NARP), infantile myopathy and lactic acidosis (IMLA), and myoclonic epilepsy with raggedred fibres (MERRF).* The organ mostly affected are CNS (neurological), myocardium, skeletal muscle, kidney and liver, i.e. organs which have large number of mitochondria. +","Ans. is 'a' i.e., Mitochondrial DNA damage disorder * Important mitochondrial disorders are Pearson syndrome, Leigh syndrome, MELAS, Keamssayre syndrome (KSS), Leber hereditary optic neuropathy (LHON), Chronic progressive ophthalmoplegia (CPEO), Neurogenic weakness with ataxia and retinitis pigmentosa (NARP), infantile myopathy and lactic acidosis (IMLA), and myoclonic epilepsy with raggedred fibres (MERRF).* The organ mostly affected are CNS (neurological), myocardium, skeletal muscle, kidney and liver, i.e. organs which have large number of mitochondria.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mode of inheritance of Leber hereditary optic neuropathy is?, with the following options: A: Mitochondrial DNA damage disorder, B: Lipid storage disorder, C: Nucleotide Excision Repair disorder, D: Lysosomal storage disorder + +### Response: +Ans. is 'a' i.e., Mitochondrial DNA damage disorder * Important mitochondrial disorders are Pearson syndrome, Leigh syndrome, MELAS, Keamssayre syndrome (KSS), Leber hereditary optic neuropathy (LHON), Chronic progressive ophthalmoplegia (CPEO), Neurogenic weakness with ataxia and retinitis pigmentosa (NARP), infantile myopathy and lactic acidosis (IMLA), and myoclonic epilepsy with raggedred fibres (MERRF).* The organ mostly affected are CNS (neurological), myocardium, skeletal muscle, kidney and liver, i.e. organs which have large number of mitochondria. ### End" 119,"Below is an instruction that describes a task. Write a response that appropriately completes the request. @@ -1138,6 +2033,13 @@ Ans. is 'a' i.e., Mitochondrial DNA damage disorder * Important mitochondrial di Answer the following medical question: Newborn baby with regurgitation of feeds and continuous drooling of saliva is:, with the following options: A: Esophageal atresia, B: GERD, C: Diffuse esophageal spasm (DES), D: Zenker's diverticulum +### Response: +","Ans. a. Esophageal atresiaESOPHAGEAL ATRESIA (EA) AND TRACHEOESOPHAGEAL FISTULA (TEF)Three basic types:Isolated EAIsolated (H-type) TEFEA and distal TEFMost common anatomy is upper esophagus ends in blind pouch and TEF connected to distal esophagusH-type--presents chronically and diagnosed later in life with chronic respiratory problemsHalf with associated anomalies--VACTERL associationVACTERL AssociationNonrandom association of birth defects:Vertebra! anomaliesAna! atresiaCardiac defectTracheoEsophageal fistulaRenal anamoliesLimb abnormalitiesClinical presentation in neonate (EA or EA+TEF)Bubbling, Frothing, cyanosis, cough, and respiratory distressWith feedings - immediate regurgitation and aspirationClinical presentation with just TEF--feeding problems and recurrent aspirationDiagnosisInability to pass nasogastric/orogastric tubeIsolated TEF: Esophagram with contrast media (or bronchoscopy or endoscopy with methylene blue)Esophageal atresia: X-ray shows coiled nasogastric tube in blind pouch with no distal gas (gasless abdomen)Esophageal atresia and distal fistula: Coiled nasogastric tube in blind pouch the large amount of air in stomach and intestinesTreatment--surgical ligation of TEF and resection with end-to-end anastomosis of esophageal atresia","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Newborn baby with regurgitation of feeds and continuous drooling of saliva is:, with the following options: A: Esophageal atresia, B: GERD, C: Diffuse esophageal spasm (DES), D: Zenker's diverticulum + ### Response: Ans. a. Esophageal atresiaESOPHAGEAL ATRESIA (EA) AND TRACHEOESOPHAGEAL FISTULA (TEF)Three basic types:Isolated EAIsolated (H-type) TEFEA and distal TEFMost common anatomy is upper esophagus ends in blind pouch and TEF connected to distal esophagusH-type--presents chronically and diagnosed later in life with chronic respiratory problemsHalf with associated anomalies--VACTERL associationVACTERL AssociationNonrandom association of birth defects:Vertebra! anomaliesAna! atresiaCardiac defectTracheoEsophageal fistulaRenal anamoliesLimb abnormalitiesClinical presentation in neonate (EA or EA+TEF)Bubbling, Frothing, cyanosis, cough, and respiratory distressWith feedings - immediate regurgitation and aspirationClinical presentation with just TEF--feeding problems and recurrent aspirationDiagnosisInability to pass nasogastric/orogastric tubeIsolated TEF: Esophagram with contrast media (or bronchoscopy or endoscopy with methylene blue)Esophageal atresia: X-ray shows coiled nasogastric tube in blind pouch with no distal gas (gasless abdomen)Esophageal atresia and distal fistula: Coiled nasogastric tube in blind pouch the large amount of air in stomach and intestinesTreatment--surgical ligation of TEF and resection with end-to-end anastomosis of esophageal atresia ### End" @@ -1147,6 +2049,13 @@ Ans. a. Esophageal atresiaESOPHAGEAL ATRESIA (EA) AND TRACHEOESOPHAGEAL FISTULA Answer the following medical question: The features of neonatal hypothyroidism include all EXCEPT:, with the following options: A: Triangular facies with craniosyntosis, B: Congestive cardiac failure, C: Delayed osseous maturation, D: Goitre is rare +### Response: +","- Craniosynostosis refers to premature fusion of sutures & closure of fontanelle - But in congenital hypothyroidism, there is delayed closure of fontanelle - hence wide open anterior & posterior fontanelle is seen","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The features of neonatal hypothyroidism include all EXCEPT:, with the following options: A: Triangular facies with craniosyntosis, B: Congestive cardiac failure, C: Delayed osseous maturation, D: Goitre is rare + ### Response: - Craniosynostosis refers to premature fusion of sutures & closure of fontanelle - But in congenital hypothyroidism, there is delayed closure of fontanelle - hence wide open anterior & posterior fontanelle is seen ### End" @@ -1156,6 +2065,13 @@ Answer the following medical question: The features of neonatal hypothyroidism i Answer the following medical question: Steroid is injurious to wound when given, with the following options: A: On 1st day, B: < 2 weeks, C: 2-4 weeks, D: >4 weeks +### Response: +","Wound healing is delayed in patients who are malnourished, or have vitamin A and C deficiency. Steroids also inhibit the adequate healing of wounds as they inhibit protein synthesis and fibroblast proliferation. Poorly-controlled diabetes delays wound healing and increases the risk of infection at the surgical site. Wound Healing This is variously described as taking place in three or four phases, the most commonly agreed being: the inflammatory phase; the proliferative phase; the remodelling phase (maturing phase). Occasionally, a haemostatic phase is referred to as occurring before the inflammatory phase, or a destructive phase following inflammation consisting of the cellular cleansing of the wound by macrophages The inflammatory phase begins immediately after wounding and lasts 2-3 days. Bleeding is followed by vasoconstriction and thrombus formation to limit blood loss. Platelets stick to the damaged endothelial lining of vessels, releasing adenosine diphosphate (ADP), which causes thrombocytic aggregates to fill the wound. When bleeding stops, the platelets then release several cytokines from their alpha granules. These are platelet-derived growth factor (PDGF), platelet factor IV and transforming growth factor beta (TGFb). These attract inflammatory cells such as polymorphonuclear leukocytes (PMN) and macrophages. Platelets and the local injured tissue release vasoactive amines, such as histamine, serotonin and prostaglandins, which increase vascular permeability, thereby aiding infiltration of these inflammatory cells. Macrophages remove devitalised tissue and microorganisms while regulating fibroblast activity in the proliferative phase of healing. The initial framework for structural suppo of cells is provided by fibrin produced by fibrinogen. A more historical (Latin) description of this phase is described in four words: rubor (redness), tumor (swelling), calor (heat) and dolor (pain). The proliferative phase lasts from the third day to the third week, consisting mainly of fibroblast activity with the production of collagen and ground substance (glycosaminoglycans and proteoglycans), the growth of new blood vessels as capillary loops (angioneogenesis) and the re-epithelialisation of the wound surface. Fibroblasts require vitamin C to produce collagen. The wound tissue formed in the early pa of this phase is called granulation tissue. In the latter pa of this phase, there is an increase in the tensile strength of the wound due to increased collagen, which is at first deposited in a random fashion and consists of type III collagen. This proliferative phase with its increase of collagen deposition is associated with wound contraction, which can considerably reduce the surface area of a wound over the first 3 weeks of healing. The remodelling phase is characterised by maturation of collagen (type I replacing type III until a ratio of 4:1 is achieved). There is a realignment of collagen fibres along the lines of tension, decreased wound vascularity, and wound contraction due to fibroblast and myofibroblast activity. This maturation of collagen leads to increased tensile strength in the wound which is maximal at the 12th week post injury and represents approximately 80% of the uninjured skin strength. Ref: Bailey and love 27th edition Pgno : 24, 299","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Steroid is injurious to wound when given, with the following options: A: On 1st day, B: < 2 weeks, C: 2-4 weeks, D: >4 weeks + ### Response: Wound healing is delayed in patients who are malnourished, or have vitamin A and C deficiency. Steroids also inhibit the adequate healing of wounds as they inhibit protein synthesis and fibroblast proliferation. Poorly-controlled diabetes delays wound healing and increases the risk of infection at the surgical site. Wound Healing This is variously described as taking place in three or four phases, the most commonly agreed being: the inflammatory phase; the proliferative phase; the remodelling phase (maturing phase). Occasionally, a haemostatic phase is referred to as occurring before the inflammatory phase, or a destructive phase following inflammation consisting of the cellular cleansing of the wound by macrophages The inflammatory phase begins immediately after wounding and lasts 2-3 days. Bleeding is followed by vasoconstriction and thrombus formation to limit blood loss. Platelets stick to the damaged endothelial lining of vessels, releasing adenosine diphosphate (ADP), which causes thrombocytic aggregates to fill the wound. When bleeding stops, the platelets then release several cytokines from their alpha granules. These are platelet-derived growth factor (PDGF), platelet factor IV and transforming growth factor beta (TGFb). These attract inflammatory cells such as polymorphonuclear leukocytes (PMN) and macrophages. Platelets and the local injured tissue release vasoactive amines, such as histamine, serotonin and prostaglandins, which increase vascular permeability, thereby aiding infiltration of these inflammatory cells. Macrophages remove devitalised tissue and microorganisms while regulating fibroblast activity in the proliferative phase of healing. The initial framework for structural suppo of cells is provided by fibrin produced by fibrinogen. A more historical (Latin) description of this phase is described in four words: rubor (redness), tumor (swelling), calor (heat) and dolor (pain). The proliferative phase lasts from the third day to the third week, consisting mainly of fibroblast activity with the production of collagen and ground substance (glycosaminoglycans and proteoglycans), the growth of new blood vessels as capillary loops (angioneogenesis) and the re-epithelialisation of the wound surface. Fibroblasts require vitamin C to produce collagen. The wound tissue formed in the early pa of this phase is called granulation tissue. In the latter pa of this phase, there is an increase in the tensile strength of the wound due to increased collagen, which is at first deposited in a random fashion and consists of type III collagen. This proliferative phase with its increase of collagen deposition is associated with wound contraction, which can considerably reduce the surface area of a wound over the first 3 weeks of healing. The remodelling phase is characterised by maturation of collagen (type I replacing type III until a ratio of 4:1 is achieved). There is a realignment of collagen fibres along the lines of tension, decreased wound vascularity, and wound contraction due to fibroblast and myofibroblast activity. This maturation of collagen leads to increased tensile strength in the wound which is maximal at the 12th week post injury and represents approximately 80% of the uninjured skin strength. Ref: Bailey and love 27th edition Pgno : 24, 299 ### End" @@ -1165,6 +2081,13 @@ Wound healing is delayed in patients who are malnourished, or have vitamin A and Answer the following medical question: Anterior resection is done for a patient with rectal cancer. Post operatively he presents with pain. Biopsy shows involvement of muscular wall but no penetration. Out of the 13 lymph nodes, one is involved. But the high tide lymph node is not involved. Modified duke stage, with the following options: A: C1, B: C2, C: D1, D: D2 +### Response: +","Ans. (a) C1Ref Page 1209/ Schwartz 10th editionThough there were lots of named colonic cancer staging used.All are replaced by only TNM staging now.For exam point of view we still read those outdated stagings.DukesACMACDescriptionAAALimited to mucosa, N0 B1B1Penetration into Submucosa, not through Muscularis propria, N0BB2B2Penetration through Muscularis Propria, N0 B3Adherence to adjacent organs, N0CC1C1N+, Limited to bowel wall (B1) C2C2N+, Penetrates through Muscularis propria (B2) C3N+. Adherence to adjacent organs (B3)D Distant Mets* AC -- Astler Coller* MAC -- Modified Astler Coller* N0 -- Node negative* N+-Node positive* Remember Stage C means lymphnode involvement","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Anterior resection is done for a patient with rectal cancer. Post operatively he presents with pain. Biopsy shows involvement of muscular wall but no penetration. Out of the 13 lymph nodes, one is involved. But the high tide lymph node is not involved. Modified duke stage, with the following options: A: C1, B: C2, C: D1, D: D2 + ### Response: Ans. (a) C1Ref Page 1209/ Schwartz 10th editionThough there were lots of named colonic cancer staging used.All are replaced by only TNM staging now.For exam point of view we still read those outdated stagings.DukesACMACDescriptionAAALimited to mucosa, N0 B1B1Penetration into Submucosa, not through Muscularis propria, N0BB2B2Penetration through Muscularis Propria, N0 B3Adherence to adjacent organs, N0CC1C1N+, Limited to bowel wall (B1) C2C2N+, Penetrates through Muscularis propria (B2) C3N+. Adherence to adjacent organs (B3)D Distant Mets* AC -- Astler Coller* MAC -- Modified Astler Coller* N0 -- Node negative* N+-Node positive* Remember Stage C means lymphnode involvement ### End" @@ -1174,6 +2097,13 @@ Ans. (a) C1Ref Page 1209/ Schwartz 10th editionThough there were lots of named c Answer the following medical question: Post gonococcal stricture urethra is most commonly situated in the -, with the following options: A: Bulbar Urethra, B: Penoscrotal Jn., C: Distal pa of spongy urethra, D: Just distal to external meatus +### Response: +","Ans. is 'a' i.e., Bulbar Urethra","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Post gonococcal stricture urethra is most commonly situated in the -, with the following options: A: Bulbar Urethra, B: Penoscrotal Jn., C: Distal pa of spongy urethra, D: Just distal to external meatus + ### Response: Ans. is 'a' i.e., Bulbar Urethra ### End" @@ -1183,6 +2113,13 @@ Ans. is 'a' i.e., Bulbar Urethra Answer the following medical question: A 52 year old male presented with features of purpura, ahralgia, neuropathy and glomerulonephritis. Low hemoglobin and high ESR was noticed in blood routine examination with mild alteration in the LFT with mild transaminase elevation. He has h/o blood transfusion in 1987 following an accident, at district hospital. What will be underlying pathology in this clinical setting?, with the following options: A: Henoch schonlein purpura, B: Amyloidosis, C: Chronic infection with malaria, D: Essential mixed cryoglobulinemia +### Response: +","Palpable purpura, ahralgia, neuropathy and glomerulonephritis are features of essential mixed cryoglobulinemia (EMC). Most cases of EMC are associated with chronic HCV infection. Chronic HCV infection produces asymptomatic transaminase elevation. Proper screening tests for HCV was not available in 1987 and blood transfusion in that period is a risk factor for HCV infection. Ref: Harrisons Principles of Internal Medicine, 18th Edition, Page 2798","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 52 year old male presented with features of purpura, ahralgia, neuropathy and glomerulonephritis. Low hemoglobin and high ESR was noticed in blood routine examination with mild alteration in the LFT with mild transaminase elevation. He has h/o blood transfusion in 1987 following an accident, at district hospital. What will be underlying pathology in this clinical setting?, with the following options: A: Henoch schonlein purpura, B: Amyloidosis, C: Chronic infection with malaria, D: Essential mixed cryoglobulinemia + ### Response: Palpable purpura, ahralgia, neuropathy and glomerulonephritis are features of essential mixed cryoglobulinemia (EMC). Most cases of EMC are associated with chronic HCV infection. Chronic HCV infection produces asymptomatic transaminase elevation. Proper screening tests for HCV was not available in 1987 and blood transfusion in that period is a risk factor for HCV infection. Ref: Harrisons Principles of Internal Medicine, 18th Edition, Page 2798 ### End" @@ -1192,6 +2129,13 @@ Palpable purpura, ahralgia, neuropathy and glomerulonephritis are features of es Answer the following medical question: A 24-year old woman notices increasing shortness of breath after recent treatment for right lower lobe pneumonia. She has no fever, cough, or sputum production. On examination, the pertinent findings are decreased fremitus, dullness on percussion, and absent breath sounds of the right lower lung. In addition, the trachea has shifted to the left.For the above patient with abnormal pulmonary physical findings, select the most likely diagnosis., with the following options: A: acute asthmatic attack, B: complete pneumothorax, C: large pleural effusion, D: atelectasis +### Response: +","Careful physical examination can be very useful in diagnosing many common pulmonary disorders. Atelectasis and large pleural effusions both can present with decreased fremitus, dullness or flatness to percussion, and absent breath sounds. In atelectasis, tracheal shift, if present, is toward the affected side, and the opposite for a large pleural effusion. Asthma's most typical manifestations are prolonged expiration and diffuse wheezing. However, impaired expansion, decreased fremitus, hyperresonance, and low diaphragms can also be found. A complete pneumothorax results in absent fremitus, hyperresonance or tympany, and absent breath sounds. Lobar pneumonia is characterized by consolidation with increased fremitus, dullness, and auscultatory findings of bronchial breathing, bronchophony, pectoriloquy, and crackles.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 24-year old woman notices increasing shortness of breath after recent treatment for right lower lobe pneumonia. She has no fever, cough, or sputum production. On examination, the pertinent findings are decreased fremitus, dullness on percussion, and absent breath sounds of the right lower lung. In addition, the trachea has shifted to the left.For the above patient with abnormal pulmonary physical findings, select the most likely diagnosis., with the following options: A: acute asthmatic attack, B: complete pneumothorax, C: large pleural effusion, D: atelectasis + ### Response: Careful physical examination can be very useful in diagnosing many common pulmonary disorders. Atelectasis and large pleural effusions both can present with decreased fremitus, dullness or flatness to percussion, and absent breath sounds. In atelectasis, tracheal shift, if present, is toward the affected side, and the opposite for a large pleural effusion. Asthma's most typical manifestations are prolonged expiration and diffuse wheezing. However, impaired expansion, decreased fremitus, hyperresonance, and low diaphragms can also be found. A complete pneumothorax results in absent fremitus, hyperresonance or tympany, and absent breath sounds. Lobar pneumonia is characterized by consolidation with increased fremitus, dullness, and auscultatory findings of bronchial breathing, bronchophony, pectoriloquy, and crackles. ### End" @@ -1201,6 +2145,13 @@ Careful physical examination can be very useful in diagnosing many common pulmon Answer the following medical question: Fastest acting agent, with the following options: A: Sevoflurane, B: Desflurane, C: Isoflurane, D: None +### Response: +","Blood-gas paition coefficient, also known as Ostwald coefficient for blood-gas, is a term used in pharmacology to describe the solubility of inhaled general anesthetics in blood. The coefficient is defined as the ratio of the concentration in blood to the concentration in gas that is in contact with that blood when the paial pressure in both compaments is equal. Newer anesthetics (such as desflurane) typically have smaller blood-gas paition coefficients than older ones (such as ether); these are preferred because they lead to faster onset of anesthesia and faster emergence from anesthesia once application of the anesthetic is stopped. If an anesthetic has a high coefficient, then a large amount of it will have to be taken up in the body's blood before being passed on to the fatty (lipid) tissues of the brain where it can exe its effect. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Fastest acting agent, with the following options: A: Sevoflurane, B: Desflurane, C: Isoflurane, D: None + ### Response: Blood-gas paition coefficient, also known as Ostwald coefficient for blood-gas, is a term used in pharmacology to describe the solubility of inhaled general anesthetics in blood. The coefficient is defined as the ratio of the concentration in blood to the concentration in gas that is in contact with that blood when the paial pressure in both compaments is equal. Newer anesthetics (such as desflurane) typically have smaller blood-gas paition coefficients than older ones (such as ether); these are preferred because they lead to faster onset of anesthesia and faster emergence from anesthesia once application of the anesthetic is stopped. If an anesthetic has a high coefficient, then a large amount of it will have to be taken up in the body's blood before being passed on to the fatty (lipid) tissues of the brain where it can exe its effect. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e ### End" @@ -1210,6 +2161,13 @@ Blood-gas paition coefficient, also known as Ostwald coefficient for blood-gas, Answer the following medical question: Most common presenting symptom of thread worm infection amongst the following is -, with the following options: A: Abdominal pain, B: Irritation and pruritus of perianal area, C: Uicaria, D: Vaginitis +### Response: +",Threadworm causes enterobiasis The worm produces intense irritation and pruritus of the perianal and perineal area when it crawls out of anus to lay eggs.This leads to scratching and excoriation of skin around anus. Ref:panikers textbook of Medical parasitology 8th edition page 196,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common presenting symptom of thread worm infection amongst the following is -, with the following options: A: Abdominal pain, B: Irritation and pruritus of perianal area, C: Uicaria, D: Vaginitis + ### Response: Threadworm causes enterobiasis The worm produces intense irritation and pruritus of the perianal and perineal area when it crawls out of anus to lay eggs.This leads to scratching and excoriation of skin around anus. Ref:panikers textbook of Medical parasitology 8th edition page 196 ### End" @@ -1219,6 +2177,16 @@ Threadworm causes enterobiasis The worm produces intense irritation and pruritus Answer the following medical question: Testicular involvement without epididymitis is a feature of -, with the following options: A: Gonorrhoea, B: Syphilis, C: Tuberculosis, D: Granuloma inguinale +### Response: +","Inflammations are distinctly more common in the epididymis than in the testis. +Of the three major specific inflammatory states, gonorrhoea and TB almost invariably arise in the epididymis, whereas syphilis affects the testis first. +In many cases of syphilitic, architis is not accompanied by epididymitis.----- Robbins 1040. +Granuloma inguinale usually affects the external genital organs (not testis or epididymis).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Testicular involvement without epididymitis is a feature of -, with the following options: A: Gonorrhoea, B: Syphilis, C: Tuberculosis, D: Granuloma inguinale + ### Response: Inflammations are distinctly more common in the epididymis than in the testis. Of the three major specific inflammatory states, gonorrhoea and TB almost invariably arise in the epididymis, whereas syphilis affects the testis first. @@ -1231,6 +2199,13 @@ Granuloma inguinale usually affects the external genital organs (not testis or e Answer the following medical question: Characteristic feature of Herpes Simplex Keratitis is-, with the following options: A: Disciform keratits, B: Dendritic Ulcer, C: Haab's Striae, D: Band keratopathy +### Response: +","Ans. is 'b' i.e., Dendritic Ulcer ""The Dendritic ulcer is the most common presentation and is a typical lesion of herpes keratitis""* Most of the ocular infection are caused by HSV-1 except in neonates where eye infection can be caused by HSV-2 through infected genitalia of mother. Ocular involvement by HSV may occur in two forms: -A) Primary herpes: - Typically is a unilateral blepharoconjunctivitis which is characterized by vesicles on the skin of lids, follicular conjunctivitis, preauriculars adenopathy and sometimes punctate keratitis.B) Recurrent ocular herpes: - After primary infection, recurrent disease may involve any or all layers of the cornea. Recurrent herpatic keratitis is divided into: -1) Epithelial keratitis: - Manifestations of epithelial keratitis include: -i) Corneal vesicles: - Vesicles coalesce and erupt to form dendritic or geographic ulcer:ii) Superficial punctate keratitisiii) Dendritic ulcer: - It is the most common presentation and is a typical lesion of herpes keratitis. There is an associated marked diminution of sensation.iv) Geographic ulcer (amoeboid ulcer)2) Stromal keratitis: - Stromal keratitis may be of two types: -i) Disciform keratitis: - This is due to damage to endothelial cells as a result of hypersensitivity reaction to the HSV antigen.ii) Diffuse stromal necrotic keratitis: - Caused by active viral invasion and tissue destruction.3) Metaherpatic keratitis (Epithelial sterile trophic ulceration): - It is not an active disease, but is a mechanical healing problem at the site of previous herpetic ulcer.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Characteristic feature of Herpes Simplex Keratitis is-, with the following options: A: Disciform keratits, B: Dendritic Ulcer, C: Haab's Striae, D: Band keratopathy + ### Response: Ans. is 'b' i.e., Dendritic Ulcer ""The Dendritic ulcer is the most common presentation and is a typical lesion of herpes keratitis""* Most of the ocular infection are caused by HSV-1 except in neonates where eye infection can be caused by HSV-2 through infected genitalia of mother. Ocular involvement by HSV may occur in two forms: -A) Primary herpes: - Typically is a unilateral blepharoconjunctivitis which is characterized by vesicles on the skin of lids, follicular conjunctivitis, preauriculars adenopathy and sometimes punctate keratitis.B) Recurrent ocular herpes: - After primary infection, recurrent disease may involve any or all layers of the cornea. Recurrent herpatic keratitis is divided into: -1) Epithelial keratitis: - Manifestations of epithelial keratitis include: -i) Corneal vesicles: - Vesicles coalesce and erupt to form dendritic or geographic ulcer:ii) Superficial punctate keratitisiii) Dendritic ulcer: - It is the most common presentation and is a typical lesion of herpes keratitis. There is an associated marked diminution of sensation.iv) Geographic ulcer (amoeboid ulcer)2) Stromal keratitis: - Stromal keratitis may be of two types: -i) Disciform keratitis: - This is due to damage to endothelial cells as a result of hypersensitivity reaction to the HSV antigen.ii) Diffuse stromal necrotic keratitis: - Caused by active viral invasion and tissue destruction.3) Metaherpatic keratitis (Epithelial sterile trophic ulceration): - It is not an active disease, but is a mechanical healing problem at the site of previous herpetic ulcer. ### End" @@ -1240,6 +2215,13 @@ Ans. is 'b' i.e., Dendritic Ulcer ""The Dendritic ulcer is the most common prese Answer the following medical question: The Most common cause of embolism causing cerebro vascular disease is, with the following options: A: Prosthetic valves, B: Non rheumatic atrial fibrillation, C: Paradoxical embolus, D: PSVT +### Response: +","(B) Non rheumatic atrial fibrillation # Sources of cardioembolic embolism include the following:> Valvular diseases Rheumatic mitral stenosis Prosthetic valves Calcific aortic stenosis Bicuspid aortic valves Mitral annulus calcification Nonbacterial thrombotic (marantic) endocarditis associated with malignancies and prothrombic states Myxomatous mitral valvulopathy with prolapse> Infective endocarditis Inflammatory valvulitis (ie, Libman-Sacks endocarditis, Behget disease, syphilis) Lambl excrescences and/or strands> Left ventricular thrombi Ischemic heart disease Acute myocardial infarction Left ventricular akinesis or aneurysm Idiopathic hypertrophic subaortic stenosis Trauma (myocardial contusion) Ventricular noncompaction Nonischemic cardiomyopathies (E.g., idiopathic dilating, viral myocarditis-associated, echinococcal, peripartum, amyloid- associated, hypereosinophilia syndrome-associated, rheumatic myocarditis-associated, sarcoidosis-related, neuromuscular disorder-associated, alcoholism-related, catecholamine-induced, Chagas disease-associated, doxorubicin-induced, mitoxantrone-related, crack cocaine-related, cardiac oxalosis-associated) Left ventricular thrombi associated with prothrombotic states Antiphospholipid antibodies Diffuse intravascular coagulation Essential thrombocythemia & myeloproliferative diseases> Left atrial thrombi Arrhythmias A trial fibril la tion (Mos t common) Sick sinus syndrome/atrial asystole Atrial flutter Atrial septal aneurysms Chiari network > Cardiac tumors Atrial myxoma> Cardiac sarcoma Endocardial fibroelastoma Metastatic disease> Paradoxical emboli (major risk) Atrial septal defects> PFO Ventricular septal defects Pulmonary arteriovenous fistulas> Miscellaneous Postcardiac catheterization> Postvalvuloplasty> Esophageal-atrial fistula","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The Most common cause of embolism causing cerebro vascular disease is, with the following options: A: Prosthetic valves, B: Non rheumatic atrial fibrillation, C: Paradoxical embolus, D: PSVT + ### Response: (B) Non rheumatic atrial fibrillation # Sources of cardioembolic embolism include the following:> Valvular diseases Rheumatic mitral stenosis Prosthetic valves Calcific aortic stenosis Bicuspid aortic valves Mitral annulus calcification Nonbacterial thrombotic (marantic) endocarditis associated with malignancies and prothrombic states Myxomatous mitral valvulopathy with prolapse> Infective endocarditis Inflammatory valvulitis (ie, Libman-Sacks endocarditis, Behget disease, syphilis) Lambl excrescences and/or strands> Left ventricular thrombi Ischemic heart disease Acute myocardial infarction Left ventricular akinesis or aneurysm Idiopathic hypertrophic subaortic stenosis Trauma (myocardial contusion) Ventricular noncompaction Nonischemic cardiomyopathies (E.g., idiopathic dilating, viral myocarditis-associated, echinococcal, peripartum, amyloid- associated, hypereosinophilia syndrome-associated, rheumatic myocarditis-associated, sarcoidosis-related, neuromuscular disorder-associated, alcoholism-related, catecholamine-induced, Chagas disease-associated, doxorubicin-induced, mitoxantrone-related, crack cocaine-related, cardiac oxalosis-associated) Left ventricular thrombi associated with prothrombotic states Antiphospholipid antibodies Diffuse intravascular coagulation Essential thrombocythemia & myeloproliferative diseases> Left atrial thrombi Arrhythmias A trial fibril la tion (Mos t common) Sick sinus syndrome/atrial asystole Atrial flutter Atrial septal aneurysms Chiari network > Cardiac tumors Atrial myxoma> Cardiac sarcoma Endocardial fibroelastoma Metastatic disease> Paradoxical emboli (major risk) Atrial septal defects> PFO Ventricular septal defects Pulmonary arteriovenous fistulas> Miscellaneous Postcardiac catheterization> Postvalvuloplasty> Esophageal-atrial fistula ### End" @@ -1249,6 +2231,13 @@ Answer the following medical question: The Most common cause of embolism causing Answer the following medical question: Stain for fat?, with the following options: A: Oil red O, B: Sudan black, C: Sudan III, D: Congo red +### Response: +","Ans. is 'd' i.e., Congo redCongo red is not used in lipid staining. It is used in the staining of amyloid protein.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Stain for fat?, with the following options: A: Oil red O, B: Sudan black, C: Sudan III, D: Congo red + ### Response: Ans. is 'd' i.e., Congo redCongo red is not used in lipid staining. It is used in the staining of amyloid protein. ### End" @@ -1258,6 +2247,13 @@ Ans. is 'd' i.e., Congo redCongo red is not used in lipid staining. It is used i Answer the following medical question: Friedlander Pneumonia refers to Pneumonia caused by-, with the following options: A: Klebsiella, B: Pneumococcus, C: H. Influenzae, D: Staphylococcus +### Response: +","Ans. is 'a' i.e., Klebsiella o Klebsiella Pneumonia is also known as ""Friedlander Pneumonia# Klebsiella initially described in 1882 by Friedlander was also known as Friendlanders bacillus. Community> acquired Pneumonia caused by Friendlanders bacillus (Klebsiella) was termed as Friedlander Pneumonia.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Friedlander Pneumonia refers to Pneumonia caused by-, with the following options: A: Klebsiella, B: Pneumococcus, C: H. Influenzae, D: Staphylococcus + ### Response: Ans. is 'a' i.e., Klebsiella o Klebsiella Pneumonia is also known as ""Friedlander Pneumonia# Klebsiella initially described in 1882 by Friedlander was also known as Friendlanders bacillus. Community> acquired Pneumonia caused by Friendlanders bacillus (Klebsiella) was termed as Friedlander Pneumonia. ### End" @@ -1267,6 +2263,13 @@ Ans. is 'a' i.e., Klebsiella o Klebsiella Pneumonia is also known as ""Friedland Answer the following medical question: All are true about popliteal fossa except, with the following options: A: The popliteal fossa is bounded above by tendons of the hamstring muscles and below by two heads of the gastronemius muscle, B: The deepest structure in the popliteal fossa is the popliteal aery, C: The popliteal and femoral vessels are continuous through the adductor hiatus, D: The common peroneal nerve passes superficially through the central poion of popliteal fossa +### Response: +","POPLITEAL FOSSA:- Diamond shaped depression lying behind the knee joint. Boundaries:-1. Superolaterally- biceps femoris2. Superomedially- semitendinosus,semimembranosus, gracilis, adductor magnus, saorius.3. Inferomedially-medial head of gastrocnemius 4. Inferolaterally-lateral head of gastrocnemius.5. Roof -popliteal fascia.6. Floor- popliteal surface of femur, capsule of knee joint, oblique popliteal ligament and strong popliteal fascia covering the popliteus muscle. Contents:-1. Popliteal aery and its branches.2. Popliteal vein and its tributaries.3. Tibial nerve and its branches.4. Common peroneal nerve and its branches.5. Posterior cutaneous nerve if thigh 6. Genicular branch of obturator nerve.7. Popliteal lymph nodes.8. Fat. Popliteal vessels and tibial nerve crosses the fossa veically.Tibial nerve- most superficial.Popliteal vein- anterior to tibial nerve.Popliteal aery- deepest structure. In upper pa- from medial to lateral-AVN middle- behind forwards-NVA Lower-medial to lateral- NVA Popliteal vessels become continuous through the adductor hiatus. Common peroneal nerve extends from superior angle of fossa to lateral angle. {Reference: BDC 6E. Pg no. 76 chapter-6}","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are true about popliteal fossa except, with the following options: A: The popliteal fossa is bounded above by tendons of the hamstring muscles and below by two heads of the gastronemius muscle, B: The deepest structure in the popliteal fossa is the popliteal aery, C: The popliteal and femoral vessels are continuous through the adductor hiatus, D: The common peroneal nerve passes superficially through the central poion of popliteal fossa + ### Response: POPLITEAL FOSSA:- Diamond shaped depression lying behind the knee joint. Boundaries:-1. Superolaterally- biceps femoris2. Superomedially- semitendinosus,semimembranosus, gracilis, adductor magnus, saorius.3. Inferomedially-medial head of gastrocnemius 4. Inferolaterally-lateral head of gastrocnemius.5. Roof -popliteal fascia.6. Floor- popliteal surface of femur, capsule of knee joint, oblique popliteal ligament and strong popliteal fascia covering the popliteus muscle. Contents:-1. Popliteal aery and its branches.2. Popliteal vein and its tributaries.3. Tibial nerve and its branches.4. Common peroneal nerve and its branches.5. Posterior cutaneous nerve if thigh 6. Genicular branch of obturator nerve.7. Popliteal lymph nodes.8. Fat. Popliteal vessels and tibial nerve crosses the fossa veically.Tibial nerve- most superficial.Popliteal vein- anterior to tibial nerve.Popliteal aery- deepest structure. In upper pa- from medial to lateral-AVN middle- behind forwards-NVA Lower-medial to lateral- NVA Popliteal vessels become continuous through the adductor hiatus. Common peroneal nerve extends from superior angle of fossa to lateral angle. {Reference: BDC 6E. Pg no. 76 chapter-6} ### End" @@ -1276,6 +2279,13 @@ POPLITEAL FOSSA:- Diamond shaped depression lying behind the knee joint. Boundar Answer the following medical question: All of the following host tissue responses can be seen in acute inflammation, EXCEPT:, with the following options: A: Exudation, B: Margination, C: Vasodilation, D: Granuloma formation +### Response: +","Vasodilation, margination and exudation are host tissue responses seen during acute inflammation. Granulomas are seen in chronic inflammation. The three major components of acute inflammation are: ? Alteration in vascular caliber that lead to an increase in blood flow. ? Emigration of the leukocytes from the microcirculation and their accumulation in the focus of injury. ? Structural changes in the microvasculature that permits the plasma proteins and leukocytes to leave the circulation. Ref: Robbins Pathologic Basis of Disease, 6th Edition, Page 83 and 8th Edition, Page 73","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following host tissue responses can be seen in acute inflammation, EXCEPT:, with the following options: A: Exudation, B: Margination, C: Vasodilation, D: Granuloma formation + ### Response: Vasodilation, margination and exudation are host tissue responses seen during acute inflammation. Granulomas are seen in chronic inflammation. The three major components of acute inflammation are: ? Alteration in vascular caliber that lead to an increase in blood flow. ? Emigration of the leukocytes from the microcirculation and their accumulation in the focus of injury. ? Structural changes in the microvasculature that permits the plasma proteins and leukocytes to leave the circulation. Ref: Robbins Pathologic Basis of Disease, 6th Edition, Page 83 and 8th Edition, Page 73 ### End" @@ -1285,6 +2295,13 @@ Vasodilation, margination and exudation are host tissue responses seen during ac Answer the following medical question: Foamy macrophage is formed by -, with the following options: A: LDL, B: HDL, C: Oxidized LDL, D: Oxidized HDL +### Response: +","Ans. is 'c' i.e., Oxidized LDLo Foam cells are lipid laden cells that derive predominantly from macrophages, but smooth muscle cells can also imbibe lipid to become foam cells.o Macrophages and endothelial cells generate oxygen free radicals that induce chemical change in LDL to yield oxidized (modified) LDL.o Oxidized LDL has following effects -Ingested by macrophages through the scavenger receptor, distinct from LDL receptors, thus forming foam cells.Increases monocyte accumulation in lesions.Stimulates release of growth factors and cytokines.Is cytotoxic to smooth muscle cells and endothelial cells,o Oxidized LDL form the core of the atheromatous plaque.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Foamy macrophage is formed by -, with the following options: A: LDL, B: HDL, C: Oxidized LDL, D: Oxidized HDL + ### Response: Ans. is 'c' i.e., Oxidized LDLo Foam cells are lipid laden cells that derive predominantly from macrophages, but smooth muscle cells can also imbibe lipid to become foam cells.o Macrophages and endothelial cells generate oxygen free radicals that induce chemical change in LDL to yield oxidized (modified) LDL.o Oxidized LDL has following effects -Ingested by macrophages through the scavenger receptor, distinct from LDL receptors, thus forming foam cells.Increases monocyte accumulation in lesions.Stimulates release of growth factors and cytokines.Is cytotoxic to smooth muscle cells and endothelial cells,o Oxidized LDL form the core of the atheromatous plaque. ### End" @@ -1294,6 +2311,13 @@ Ans. is 'c' i.e., Oxidized LDLo Foam cells are lipid laden cells that derive pre Answer the following medical question: In Zollinger Ellison syndrome what is raised-, with the following options: A: Insulin, B: VIP, C: Gastrin, D: Glucagon +### Response: +",

Davidson&;s principles and practice of medicine 22nd edition. *Timor secreted gastrin which stimulated gastrin production to its maximum capacity.

,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In Zollinger Ellison syndrome what is raised-, with the following options: A: Insulin, B: VIP, C: Gastrin, D: Glucagon + ### Response:

Davidson&;s principles and practice of medicine 22nd edition. *Timor secreted gastrin which stimulated gastrin production to its maximum capacity.

### End" @@ -1303,6 +2327,13 @@ Answer the following medical question: In Zollinger Ellison syndrome what is rai Answer the following medical question: Presence of islands of undifferentiated mesenchyme, often with cailage, and immature collecting ducts on light microscopy will be seen in which cystic disease of kidney?, with the following options: A: Medullary sponge kidney, B: Autosomal recessive polycystic kidney disease (ARPKD), C: Autosomal dominant polycystic kidney disease (ADPKD), D: Multicystic renal dysplasia +### Response: +","Multicystic renal dysplasia Sporadic disorder that can be unilateral or bilateral and is often cystic. The kidney is usually enlarged, extremely irregular, and multicystic. Although normal nephrons are present, many have immature collecting ducts. The characteristic histologic feature is the presence of islands of undifferentiated mesenchyme, often with cailage, and immature collecting ducts.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Presence of islands of undifferentiated mesenchyme, often with cailage, and immature collecting ducts on light microscopy will be seen in which cystic disease of kidney?, with the following options: A: Medullary sponge kidney, B: Autosomal recessive polycystic kidney disease (ARPKD), C: Autosomal dominant polycystic kidney disease (ADPKD), D: Multicystic renal dysplasia + ### Response: Multicystic renal dysplasia Sporadic disorder that can be unilateral or bilateral and is often cystic. The kidney is usually enlarged, extremely irregular, and multicystic. Although normal nephrons are present, many have immature collecting ducts. The characteristic histologic feature is the presence of islands of undifferentiated mesenchyme, often with cailage, and immature collecting ducts. ### End" @@ -1312,6 +2343,13 @@ Multicystic renal dysplasia Sporadic disorder that can be unilateral or bilatera Answer the following medical question: Which of the following drug is implicated in the causation of osteomalacia of the bone?, with the following options: A: Phenytoin, B: Steroids, C: Heparin, D: Estrogen +### Response: +",Phenytoin inhibit the hepatic production of 25 hydroxy vitamin D and also directly inhibit bone mineralization and thus may result in osteomalacia. Steroids and heparin result in osteoporosis not osteomalacia. Impoant drugs causing osteomalacia are: Phenytoi Carbamazepine Valproate Phenobarbitone Bisphosphonates,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following drug is implicated in the causation of osteomalacia of the bone?, with the following options: A: Phenytoin, B: Steroids, C: Heparin, D: Estrogen + ### Response: Phenytoin inhibit the hepatic production of 25 hydroxy vitamin D and also directly inhibit bone mineralization and thus may result in osteomalacia. Steroids and heparin result in osteoporosis not osteomalacia. Impoant drugs causing osteomalacia are: Phenytoi Carbamazepine Valproate Phenobarbitone Bisphosphonates ### End" @@ -1321,6 +2359,13 @@ Phenytoin inhibit the hepatic production of 25 hydroxy vitamin D and also direct Answer the following medical question: A healthy 21-year-old woman develops a profuse, watery diarrhea 1 day after a meal of raw oysters. On physical examination, her temperature is 37.5deg C. A stool sample is negative for occult blood. There is no abdominal distention or tenderness, and bowel sounds are present. Diarrhea subsides over the next 3 days. Which of the following organisms is most likely to produce these findings?, with the following options: A: Cryptosporidium parvum, B: Entamoeba histolytica, C: Staphylococcus aureus, D: Vibrio parahaemolyticus +### Response: +","Raw or poorly cooked shellfish can be the source of Vibrio parahaemolyticus, which tends to produce milder diarrhea than Vibrio cholerae. Vibrio organisms produce a toxin that increases adenylate cyclase, leading to chloride ion secretion and osmotic diarrhea. Cryptosporidium as a cause of watery diarrhea is most often found in immunocompromised individuals. Entamoeba histolytica produces colonic mucosal invasion along with exudation and ulceration; stools contain blood and mucus. Staphylococcus aureus can produce food poisoning through the elaboration of an enterotoxin that causes explosive vomiting and diarrhea within 2 hours after ingestion. Yersinia enterocolitica is invasive and can produce extraintestinal infection.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A healthy 21-year-old woman develops a profuse, watery diarrhea 1 day after a meal of raw oysters. On physical examination, her temperature is 37.5deg C. A stool sample is negative for occult blood. There is no abdominal distention or tenderness, and bowel sounds are present. Diarrhea subsides over the next 3 days. Which of the following organisms is most likely to produce these findings?, with the following options: A: Cryptosporidium parvum, B: Entamoeba histolytica, C: Staphylococcus aureus, D: Vibrio parahaemolyticus + ### Response: Raw or poorly cooked shellfish can be the source of Vibrio parahaemolyticus, which tends to produce milder diarrhea than Vibrio cholerae. Vibrio organisms produce a toxin that increases adenylate cyclase, leading to chloride ion secretion and osmotic diarrhea. Cryptosporidium as a cause of watery diarrhea is most often found in immunocompromised individuals. Entamoeba histolytica produces colonic mucosal invasion along with exudation and ulceration; stools contain blood and mucus. Staphylococcus aureus can produce food poisoning through the elaboration of an enterotoxin that causes explosive vomiting and diarrhea within 2 hours after ingestion. Yersinia enterocolitica is invasive and can produce extraintestinal infection. ### End" @@ -1330,6 +2375,13 @@ Raw or poorly cooked shellfish can be the source of Vibrio parahaemolyticus, whi Answer the following medical question: Labial bar is indicated when ?, with the following options: A: There is diastema, B: There is labial inclination of teeth, C: There is lingual inclination of teeth, D: There is periodontally weak teeth +### Response: +",Rest all are contraindications for labial bar.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Labial bar is indicated when ?, with the following options: A: There is diastema, B: There is labial inclination of teeth, C: There is lingual inclination of teeth, D: There is periodontally weak teeth + ### Response: Rest all are contraindications for labial bar. ### End" @@ -1339,6 +2391,13 @@ Rest all are contraindications for labial bar. Answer the following medical question: A patient has the following findings -splenomegaly, low RBC count, normal WBC, and platelet count and peripheral blood smear shows target cells. Repeated BM aspiration is unsuccessful. The probable diagnosis is -, with the following options: A: Thalassemia, B: Chronic myeloid leukemia, C: Iron deficiency anaemia, D: Myelofibrosis +### Response: +","Ans. is 'd' i.e., MyelofibrosisRepeated unsuccessful bone marrow aspiration clinches the diagnosis in our of myelofibrosis.o Aspiration of bone marrow is often unsuccessful in myelofibrosis because of extensive fibrosis of bone marrow (characteristic dry tap).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A patient has the following findings -splenomegaly, low RBC count, normal WBC, and platelet count and peripheral blood smear shows target cells. Repeated BM aspiration is unsuccessful. The probable diagnosis is -, with the following options: A: Thalassemia, B: Chronic myeloid leukemia, C: Iron deficiency anaemia, D: Myelofibrosis + ### Response: Ans. is 'd' i.e., MyelofibrosisRepeated unsuccessful bone marrow aspiration clinches the diagnosis in our of myelofibrosis.o Aspiration of bone marrow is often unsuccessful in myelofibrosis because of extensive fibrosis of bone marrow (characteristic dry tap). ### End" @@ -1348,6 +2407,13 @@ Ans. is 'd' i.e., MyelofibrosisRepeated unsuccessful bone marrow aspiration clin Answer the following medical question: A patient on colles cast present after two weeks with the inability to extend his thumb, the most likely reason is:, with the following options: A: Rupture of extensor pollicis longus tendon, B: Compartment syndrome, C: Carpal tunnel syndrome, D: Sudek's osteodystrophy +### Response: +","Ans: A (Rupture of extensor pollicis longus tendon) Ref: Apleys System of Orthopaedics and Fractures, 9th edition, p 774Explanation:Rupture of extensor pollicis longus occasionally occurs a few- weeks after an apparently trivial undisplaced fracture of the lower radius.The patient should be warned of the possibility and told that operative treatment is available.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A patient on colles cast present after two weeks with the inability to extend his thumb, the most likely reason is:, with the following options: A: Rupture of extensor pollicis longus tendon, B: Compartment syndrome, C: Carpal tunnel syndrome, D: Sudek's osteodystrophy + ### Response: Ans: A (Rupture of extensor pollicis longus tendon) Ref: Apleys System of Orthopaedics and Fractures, 9th edition, p 774Explanation:Rupture of extensor pollicis longus occasionally occurs a few- weeks after an apparently trivial undisplaced fracture of the lower radius.The patient should be warned of the possibility and told that operative treatment is available. ### End" @@ -1357,6 +2423,13 @@ Ans: A (Rupture of extensor pollicis longus tendon) Ref: Apleys System of Orthop Answer the following medical question: All are causes of night blindness except:, with the following options: A: Vitamin A deficiency, B: Oguchi disease, C: Myopia, D: Devics disease +### Response: +",Devics disease,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are causes of night blindness except:, with the following options: A: Vitamin A deficiency, B: Oguchi disease, C: Myopia, D: Devics disease + ### Response: Devics disease ### End" @@ -1366,6 +2439,15 @@ Devics disease Answer the following medical question: Broadest neuroretinal rim is seen in –, with the following options: A: Superior pole, B: Inferior pole, C: Nasal pole, D: Temporal pole +### Response: +","The neurorentinal rim is the area of optic disc which contains neural elements and is located between the edge of the optic disc and the physiological cup. +The neuroretinal rin is broadest Inferiorly, followed by Superior, Nasal and Temporal regions in decreasing order of thickness (the ISNT) rule. +The clinical significant of neuroretinal rim is that there is thinning of neuroretinal rim in glaucoma.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Broadest neuroretinal rim is seen in –, with the following options: A: Superior pole, B: Inferior pole, C: Nasal pole, D: Temporal pole + ### Response: The neurorentinal rim is the area of optic disc which contains neural elements and is located between the edge of the optic disc and the physiological cup. The neuroretinal rin is broadest Inferiorly, followed by Superior, Nasal and Temporal regions in decreasing order of thickness (the ISNT) rule. @@ -1377,6 +2459,13 @@ The clinical significant of neuroretinal rim is that there is thinning of neuror Answer the following medical question: All are implicated in etiology of atrophic rhinitis except:, with the following options: A: Chronic sinusitis, B: Nasal deformity, C: DNS, D: Strong hereditary factors +### Response: +",Ans. is c i.e. DNS,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are implicated in etiology of atrophic rhinitis except:, with the following options: A: Chronic sinusitis, B: Nasal deformity, C: DNS, D: Strong hereditary factors + ### Response: Ans. is c i.e. DNS ### End" @@ -1386,6 +2475,13 @@ Ans. is c i.e. DNS Answer the following medical question: Fick's law gives the rate of transpo in case of, with the following options: A: Simple diffusion, B: Facilitated diffusion, C: non-ionic diffusion, D: secondary active transpo +### Response: +","Fick's law is used to calculate the rate of simple diffusionSimple diffusion means that kinetic movement of molecules or ions occurs through a membrane opening or through intermolecular spaces without any interaction with carrier proteins in the membrane. The rate of diffusion is determined by the amount of substance available, the velocity of kinetic motion, and the number and sizes of openings in the membrane through which the molecules or ions can move.Ref: Guyton; 13th edition; Chapter 4; Transpo of Substances Through Cell Membranes","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Fick's law gives the rate of transpo in case of, with the following options: A: Simple diffusion, B: Facilitated diffusion, C: non-ionic diffusion, D: secondary active transpo + ### Response: Fick's law is used to calculate the rate of simple diffusionSimple diffusion means that kinetic movement of molecules or ions occurs through a membrane opening or through intermolecular spaces without any interaction with carrier proteins in the membrane. The rate of diffusion is determined by the amount of substance available, the velocity of kinetic motion, and the number and sizes of openings in the membrane through which the molecules or ions can move.Ref: Guyton; 13th edition; Chapter 4; Transpo of Substances Through Cell Membranes ### End" @@ -1395,6 +2491,13 @@ Fick's law is used to calculate the rate of simple diffusionSimple diffusion mea Answer the following medical question: Prolactin secretion is stimulated by: March 2005, with the following options: A: TRH, B: ACTH, C: GnRH, D: Dopamine +### Response: +","Ans. A: TRH The system of increased production is a positive feedback cycle. This is one of the few instances in the body where positive feedback is normal. Pituitary prolactin secretion is regulated by neuroendocrine neurons in the hypothalamus, the most impoant ones being the neurosecretory tuberoinfundibulum (TIDA) neurons of the arcuate nucleus, which secrete dopamine to act on the dopamine-2 receptors of lactotrophs, causing inhibition of prolactin secretion. Thyrotropin-releasing factor (thyrotropin-releasing hormone) has a stimulatory effect on prolactin release. Vasoactive intestinal peptide and peptide histidine isoleucine also help to regulate prolactin secretion in humans.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Prolactin secretion is stimulated by: March 2005, with the following options: A: TRH, B: ACTH, C: GnRH, D: Dopamine + ### Response: Ans. A: TRH The system of increased production is a positive feedback cycle. This is one of the few instances in the body where positive feedback is normal. Pituitary prolactin secretion is regulated by neuroendocrine neurons in the hypothalamus, the most impoant ones being the neurosecretory tuberoinfundibulum (TIDA) neurons of the arcuate nucleus, which secrete dopamine to act on the dopamine-2 receptors of lactotrophs, causing inhibition of prolactin secretion. Thyrotropin-releasing factor (thyrotropin-releasing hormone) has a stimulatory effect on prolactin release. Vasoactive intestinal peptide and peptide histidine isoleucine also help to regulate prolactin secretion in humans. ### End" @@ -1404,6 +2507,13 @@ Ans. A: TRH The system of increased production is a positive feedback cycle. Thi Answer the following medical question: a-Granules of platelet contains all of the following, EXCEPT:, with the following options: A: Fibrinogen, B: Fibronectin, C: factors V, D: ATP +### Response: +","Platelets play a critical role in normal hemostasis. Their function depends on several glycoprotein receptors, a contractile cytoskeleton, and two types of cytoplasmic granules. a-Granules have the adhesion molecule P-selectin on their membranes and contain fibrinogen, fibronectin, factors V and VIII, platelet factor 4 (a heparin-binding chemokine), platelet-derived growth factor (PDGF), and transforming growth factor-b (TGF-b). Dense (or d) granules contain ADP and ATP, ionized calcium, histamine, serotonin, and epinephrine. Ref: Robbins 8th edition Chapter 4.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: a-Granules of platelet contains all of the following, EXCEPT:, with the following options: A: Fibrinogen, B: Fibronectin, C: factors V, D: ATP + ### Response: Platelets play a critical role in normal hemostasis. Their function depends on several glycoprotein receptors, a contractile cytoskeleton, and two types of cytoplasmic granules. a-Granules have the adhesion molecule P-selectin on their membranes and contain fibrinogen, fibronectin, factors V and VIII, platelet factor 4 (a heparin-binding chemokine), platelet-derived growth factor (PDGF), and transforming growth factor-b (TGF-b). Dense (or d) granules contain ADP and ATP, ionized calcium, histamine, serotonin, and epinephrine. Ref: Robbins 8th edition Chapter 4. ### End" @@ -1413,6 +2523,13 @@ Platelets play a critical role in normal hemostasis. Their function depends on s Answer the following medical question: Some of the E. coli bacteria that were originally isolated from a contaminated salad were tetracycline resistant while the others were susceptible. However, when tetracycline-resistant and -susceptible strains were grown together, all of them became tetracycline resistant. This efficient transfer of resistance depends on which of the following?, with the following options: A: Cell lysis and the release of DNA from donor bacteria, B: Competent cells, C: Conjugative plasmids, D: Recombinase enzymes +### Response: +","Many antibiotic resistance genes in bacteria are carried on conjugative plasmids (c) also known as R factors. These plasmids are transferred from one bacterium to another, of the same or related species, by conjugation. Conjugation is a process by which the donor bacterium (male cell) is brought in direct contact with the recipient bacterium (female cell) through the conjugative pilus. In E. coli, the conjugative pilus is referred to as a sex pilus or F pilus. The conjugative plasmid carries genes necessary for its transfer including the pilus genes. The plasmid is transferred into the recipient cell as a strand of ssDNA, which re-circularizes within the recipient cell. The complementary DNA strand is then synthesized in the recipient cell. The ssDNA in the donor cell is also replicated; thus, both the donor and the recipient now carry a copy of the plasmid. Due to the direct contact between bacteria through the pilus, conjugation is an efficient process of DNA transfer. A transposon (e) is a mobile genetic element that is capable of moving from one replicon (a chromosome or a plasmid) to another but is incapable of initiating DNA transfer. Recombinase enzymes (d) are required for the recombination process that occurs between homologous regions of DNA (as in integration of a DNA in a replicon). Competent cells (b) are part of the bacterial population that is capable of taking up DNA from a solution (naked DNA). This may occur naturally or artificially (in the laboratory). E. coli competent cells are only generated in the laboratory through treatment with certain chemicals. Cell lysis and release of donor DNA (a) may be part of a mechanism through which naturally competent bacteria such as Neisseria take up naked DNA during infection.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Some of the E. coli bacteria that were originally isolated from a contaminated salad were tetracycline resistant while the others were susceptible. However, when tetracycline-resistant and -susceptible strains were grown together, all of them became tetracycline resistant. This efficient transfer of resistance depends on which of the following?, with the following options: A: Cell lysis and the release of DNA from donor bacteria, B: Competent cells, C: Conjugative plasmids, D: Recombinase enzymes + ### Response: Many antibiotic resistance genes in bacteria are carried on conjugative plasmids (c) also known as R factors. These plasmids are transferred from one bacterium to another, of the same or related species, by conjugation. Conjugation is a process by which the donor bacterium (male cell) is brought in direct contact with the recipient bacterium (female cell) through the conjugative pilus. In E. coli, the conjugative pilus is referred to as a sex pilus or F pilus. The conjugative plasmid carries genes necessary for its transfer including the pilus genes. The plasmid is transferred into the recipient cell as a strand of ssDNA, which re-circularizes within the recipient cell. The complementary DNA strand is then synthesized in the recipient cell. The ssDNA in the donor cell is also replicated; thus, both the donor and the recipient now carry a copy of the plasmid. Due to the direct contact between bacteria through the pilus, conjugation is an efficient process of DNA transfer. A transposon (e) is a mobile genetic element that is capable of moving from one replicon (a chromosome or a plasmid) to another but is incapable of initiating DNA transfer. Recombinase enzymes (d) are required for the recombination process that occurs between homologous regions of DNA (as in integration of a DNA in a replicon). Competent cells (b) are part of the bacterial population that is capable of taking up DNA from a solution (naked DNA). This may occur naturally or artificially (in the laboratory). E. coli competent cells are only generated in the laboratory through treatment with certain chemicals. Cell lysis and release of donor DNA (a) may be part of a mechanism through which naturally competent bacteria such as Neisseria take up naked DNA during infection. ### End" @@ -1422,6 +2539,13 @@ Many antibiotic resistance genes in bacteria are carried on conjugative plasmids Answer the following medical question: In acute inflammation the tissue response consists of all except, with the following options: A: Vasodilation, B: Exudation, C: Neutrophilic response, D: Granuloma formation +### Response: +","Ref Robbins9/e p97 Granulomatous inflammation is a distinctive pattern of chronic inflammation characterized by aggregates of acti- vated macrophages with scattered lymphocytes. Granulo- mas are characteristic of ceain specific pathologic states; consequently, recognition of the granulomatous pattern is impoant because of the limited number of conditions (some life-threatening) that cause it (Table 2-8). Granulo- mas can form under three settings: * With persistent T-cell responses to ceain microbes (such as Mycobacterium tuberculosis, T. pallidum, or fungi), in which T cell-derived cytokines are responsible for chronic macrophage activation. Tuberculosis is the proto- type of a granulomatous disease caused by infection and should always be excluded as the cause when granulomas are identified. * Granulomas may also develop in some immune- mediated inflammatory diseases, notably Crohn disease, which is one type of inflammatory bowel disease and an impoant cause of granulomatous inflammation in the United States. * They are also seen in a disease of unknown etiology called sarcoidosis, and they develop in response to rela- tively ine foreign bodies (e.g., suture or splinter), forming so-called foreign body granulomas.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In acute inflammation the tissue response consists of all except, with the following options: A: Vasodilation, B: Exudation, C: Neutrophilic response, D: Granuloma formation + ### Response: Ref Robbins9/e p97 Granulomatous inflammation is a distinctive pattern of chronic inflammation characterized by aggregates of acti- vated macrophages with scattered lymphocytes. Granulo- mas are characteristic of ceain specific pathologic states; consequently, recognition of the granulomatous pattern is impoant because of the limited number of conditions (some life-threatening) that cause it (Table 2-8). Granulo- mas can form under three settings: * With persistent T-cell responses to ceain microbes (such as Mycobacterium tuberculosis, T. pallidum, or fungi), in which T cell-derived cytokines are responsible for chronic macrophage activation. Tuberculosis is the proto- type of a granulomatous disease caused by infection and should always be excluded as the cause when granulomas are identified. * Granulomas may also develop in some immune- mediated inflammatory diseases, notably Crohn disease, which is one type of inflammatory bowel disease and an impoant cause of granulomatous inflammation in the United States. * They are also seen in a disease of unknown etiology called sarcoidosis, and they develop in response to rela- tively ine foreign bodies (e.g., suture or splinter), forming so-called foreign body granulomas. ### End" @@ -1431,6 +2555,13 @@ Ref Robbins9/e p97 Granulomatous inflammation is a distinctive pattern of chroni Answer the following medical question: All of the following are seen with bile duct stone except, with the following options: A: Obstructive jaundice, B: Distended and palpable gallbladder, C: Pruritus, D: Clay coloured stools +### Response: +","Clinical features of CBD stones: CBD stones may be silent and are often discovered incidentally. In these patients, biliary obstruction is transient and laboratory tests may be normal Clinical features suspicious for biliary obstruction due to CBD stones include biliary colic, jaundice, clay coloured stools and darkening of urine Fever and chills may be present in patients with choledocholithiasisand cholangitis Serum bilirubin, aminotransferases and ALP are commonly elevated in patients with biliary obstruction but are neither sensitive nor specific for the presence of CBD stones Ref: Sabiston 20th edition Pgno :1494","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following are seen with bile duct stone except, with the following options: A: Obstructive jaundice, B: Distended and palpable gallbladder, C: Pruritus, D: Clay coloured stools + ### Response: Clinical features of CBD stones: CBD stones may be silent and are often discovered incidentally. In these patients, biliary obstruction is transient and laboratory tests may be normal Clinical features suspicious for biliary obstruction due to CBD stones include biliary colic, jaundice, clay coloured stools and darkening of urine Fever and chills may be present in patients with choledocholithiasisand cholangitis Serum bilirubin, aminotransferases and ALP are commonly elevated in patients with biliary obstruction but are neither sensitive nor specific for the presence of CBD stones Ref: Sabiston 20th edition Pgno :1494 ### End" @@ -1440,6 +2571,13 @@ Clinical features of CBD stones: CBD stones may be silent and are often discover Answer the following medical question: The absolute contraindication for Electro Convulsive Therapy {ECT} is, with the following options: A: Raised Intra Cranial Tension, B: Vascular Dementia, C: Diabetic Retinopathy, D: Peripheral Neuropathy +### Response: +","CONTRA INDICATIONS * NO ABSOLUTE Contra indication RELATIVE CONTRAINDICATION -----------------Brain tumour with midline shift / arrythmia Ref.Kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 1065","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The absolute contraindication for Electro Convulsive Therapy {ECT} is, with the following options: A: Raised Intra Cranial Tension, B: Vascular Dementia, C: Diabetic Retinopathy, D: Peripheral Neuropathy + ### Response: CONTRA INDICATIONS * NO ABSOLUTE Contra indication RELATIVE CONTRAINDICATION -----------------Brain tumour with midline shift / arrythmia Ref.Kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 1065 ### End" @@ -1449,6 +2587,13 @@ CONTRA INDICATIONS * NO ABSOLUTE Contra indication RELATIVE CONTRAINDICATION --- Answer the following medical question: Area that lies immediately lateral to the anterior perforating substance is -, with the following options: A: Orbital gyrus, B: Uncus, C: Optic chiasma, D: Limen Insulae +### Response: +",Limen insula lies immediately lateral to substantia perforate anterior (i.e. anterior perforating substance).,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Area that lies immediately lateral to the anterior perforating substance is -, with the following options: A: Orbital gyrus, B: Uncus, C: Optic chiasma, D: Limen Insulae + ### Response: Limen insula lies immediately lateral to substantia perforate anterior (i.e. anterior perforating substance). ### End" @@ -1458,6 +2603,17 @@ Limen insula lies immediately lateral to substantia perforate anterior (i.e. ant Answer the following medical question: Rest seat of canine should be?, with the following options: A: Flat, B: Triangular, C: V shaped, D: Seat cannot be given on canine +### Response: +","Design for canine rest: +MD width : 2.5-3 mm +FL width : 2 mm +Depth : 1.5 mm +Apex of 'V' shape is directed incisally.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Rest seat of canine should be?, with the following options: A: Flat, B: Triangular, C: V shaped, D: Seat cannot be given on canine + ### Response: Design for canine rest: MD width : 2.5-3 mm @@ -1471,6 +2627,13 @@ Apex of 'V' shape is directed incisally. Answer the following medical question: chemotaxis in response to activation of cells results in, with the following options: A: Random multi directional movement, B: Unidirectional motion, C: Adhesion to endothelium, D: Augmeted oxygen dependent bactericidal effect +### Response: +","Chemotaxis :-After extravasating from the blood, leukocytes move toward sites of infection or injury along a chemical gradient. It is unidirectional or targeted movement of the leukocytes towards antigens/ bacteria. Both exogenous and endogenous substances can be chemotactic for leukocytes, including the following: Exogenous Bacterial products, paicularly peptides with N-formylmethionine termini Endogenous Cytokines, especially those of the chemokine family Components of the complement system, paicularly C5 Products of the lipoxygenase pathway of arachidonic acid (AA) metabolism, paicularly leukotriene B4 (LTB4) ref:- basic pathology, Robbins 9th ed, page 36","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: chemotaxis in response to activation of cells results in, with the following options: A: Random multi directional movement, B: Unidirectional motion, C: Adhesion to endothelium, D: Augmeted oxygen dependent bactericidal effect + ### Response: Chemotaxis :-After extravasating from the blood, leukocytes move toward sites of infection or injury along a chemical gradient. It is unidirectional or targeted movement of the leukocytes towards antigens/ bacteria. Both exogenous and endogenous substances can be chemotactic for leukocytes, including the following: Exogenous Bacterial products, paicularly peptides with N-formylmethionine termini Endogenous Cytokines, especially those of the chemokine family Components of the complement system, paicularly C5 Products of the lipoxygenase pathway of arachidonic acid (AA) metabolism, paicularly leukotriene B4 (LTB4) ref:- basic pathology, Robbins 9th ed, page 36 ### End" @@ -1480,6 +2643,13 @@ Chemotaxis :-After extravasating from the blood, leukocytes move toward sites of Answer the following medical question: If a patient gets an attack of veigo/dizziness by loud noise, he is having ?, with the following options: A: Tullio phenomenon, B: Dysplacusis, C: Hyperacusis, D: Paracusis +### Response: +","Ans. is 'a' i.e., Tullio phenomenon Hyperacusis refers to sensation of discomfo or pain on exposure to normal sounds. It is seen in injury to nerve to stapedius and in case of congenital syphilis (Hennebe sign). Displacusis is a condition where same tone is heard as notes of different pitch in either ear. Paracusis willisii is a condition where patient hears a sound better in presence of background noise. It is seen in otosclerosis. Tullio phenomenon is a condition where the subject gets attack of veigo/dizziness by loud sounds.lt is seen in labyrinthine fistula and after fenestration surgery.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: If a patient gets an attack of veigo/dizziness by loud noise, he is having ?, with the following options: A: Tullio phenomenon, B: Dysplacusis, C: Hyperacusis, D: Paracusis + ### Response: Ans. is 'a' i.e., Tullio phenomenon Hyperacusis refers to sensation of discomfo or pain on exposure to normal sounds. It is seen in injury to nerve to stapedius and in case of congenital syphilis (Hennebe sign). Displacusis is a condition where same tone is heard as notes of different pitch in either ear. Paracusis willisii is a condition where patient hears a sound better in presence of background noise. It is seen in otosclerosis. Tullio phenomenon is a condition where the subject gets attack of veigo/dizziness by loud sounds.lt is seen in labyrinthine fistula and after fenestration surgery. ### End" @@ -1489,6 +2659,13 @@ Ans. is 'a' i.e., Tullio phenomenon Hyperacusis refers to sensation of discomfo Answer the following medical question: Which of the following renal alterations would most likely preserve the GFR?, with the following options: A: Defect in the elimination of hydrogen ions in the distal tubule, B: Luminal obstruction by renal tubular casts, C: Increased interstitial pressure, D: Decreased intrarenal nitric oxide +### Response: +","The renal alteration that would most likely preserve the GRF is type I distal renal tubular acidosis, in which hydrogen ions diffuse back into the distal tubule. This not only retains hydrogen ions, but also reduces the distal tubule reabsorption of bicarbonate. The other choices listed are assocated with acute tubular necrosis and decrease the GFR.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following renal alterations would most likely preserve the GFR?, with the following options: A: Defect in the elimination of hydrogen ions in the distal tubule, B: Luminal obstruction by renal tubular casts, C: Increased interstitial pressure, D: Decreased intrarenal nitric oxide + ### Response: The renal alteration that would most likely preserve the GRF is type I distal renal tubular acidosis, in which hydrogen ions diffuse back into the distal tubule. This not only retains hydrogen ions, but also reduces the distal tubule reabsorption of bicarbonate. The other choices listed are assocated with acute tubular necrosis and decrease the GFR. ### End" @@ -1498,6 +2675,13 @@ The renal alteration that would most likely preserve the GRF is type I distal re Answer the following medical question: Which of the following sensation are transmitted by the Dorsal tract/Posterior column?, with the following options: A: Fine touch, B: Pain, C: Temperature, D: All of the above +### Response: +","Fasciculus gracilis and fasciculus cuneatus occupy the posterior white funiculus of the spinal cord, and are, therefore, often referred to as the posterior column tracts. Functions: -components of sense of touch: Fine-touch Tactile touch Tactile localization Tactile discrimination Stereognosis. - proprioceptive impulses - sense of vibrations. Ref: guyton and hall textbook of medical physiology 12 edition page number: 691,692,693","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following sensation are transmitted by the Dorsal tract/Posterior column?, with the following options: A: Fine touch, B: Pain, C: Temperature, D: All of the above + ### Response: Fasciculus gracilis and fasciculus cuneatus occupy the posterior white funiculus of the spinal cord, and are, therefore, often referred to as the posterior column tracts. Functions: -components of sense of touch: Fine-touch Tactile touch Tactile localization Tactile discrimination Stereognosis. - proprioceptive impulses - sense of vibrations. Ref: guyton and hall textbook of medical physiology 12 edition page number: 691,692,693 ### End" @@ -1508,7 +2692,7 @@ Fasciculus gracilis and fasciculus cuneatus occupy the posterior white funiculus Answer the following medical question: CD4 count refers to, with the following options: A: T helper cells, B: B cells, C: Cytotoxic cells, D: Both B And T Cells ### Response: -Helper T-cells → CD4 positive. o Cytotoxic T-cells and suppressor T-cells → CD 8 positive, +","Helper T-cells → CD4 positive. o Cytotoxic T-cells and suppressor T-cells → CD 8 positive, Based on function CD4 helper T cells are divided into1. Effector CP4 helper T-cells Functions are- A. @@ -1520,14 +2704,40 @@ iv. The killing of intracellular microbes. e.g. tuberculosis and leprosy v. Destruction of target cells by. Activate CDS T cells to become cytotoxic cells. b. Activate NK cells B By TH2 celts i) Activate B cells to develop into anybody producing plasma cells → facilitate the synthesis of antibodies. -2. Memory CD4 helper T cells □ Retain the antigenic affinity of the originally activated T cells and are used to act as later effector cells during a second immune response. -### End" +2. Memory CD4 helper T cells □ Retain the antigenic affinity of the originally activated T cells and are used to act as later effector cells during a second immune response.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: CD4 count refers to, with the following options: A: T helper cells, B: B cells, C: Cytotoxic cells, D: Both B And T Cells + +### Response: +Helper T-cells → CD4 positive. o Cytotoxic T-cells and suppressor T-cells → CD 8 positive, +Based on function CD4 helper T cells are divided into1. Effector CP4 helper T-cells + +Functions are- A. +By TH1 cells +i. Activate macrophages +ii. Delayed hypersensitivity +iii. Cell-mediated immunity +iv. The killing of intracellular microbes. e.g. tuberculosis and leprosy +v. Destruction of target cells by. +Activate CDS T cells to become cytotoxic cells. b. Activate NK cells B By TH2 celts +i) Activate B cells to develop into anybody producing plasma cells → facilitate the synthesis of antibodies. +2. Memory CD4 helper T cells □ Retain the antigenic affinity of the originally activated T cells and are used to act as later effector cells during a second immune response. +### End" 160,"Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Light requirement in watch manufacturing company is -, with the following options: A: 2000-3000 Lux, B: 5000-10000 Lux, C: 10000-20000 Lux, D: 50000 Lux +### Response: +",The recommended illumination (IES Code)in watch manufacturing company is 2000-3000 lux Rule of thumb is that the illumination must be 30 times higher the level at which ask can be just done. Parks textbook of preventive and social medicine.K Park. Edition 23.page no:741.table2.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Light requirement in watch manufacturing company is -, with the following options: A: 2000-3000 Lux, B: 5000-10000 Lux, C: 10000-20000 Lux, D: 50000 Lux + ### Response: The recommended illumination (IES Code)in watch manufacturing company is 2000-3000 lux Rule of thumb is that the illumination must be 30 times higher the level at which ask can be just done. Parks textbook of preventive and social medicine.K Park. Edition 23.page no:741.table2. ### End" @@ -1537,6 +2747,31 @@ The recommended illumination (IES Code)in watch manufacturing company is 2000-30 Answer the following medical question: The most common etiology of short stature is, with the following options: A: Thyroxine deficiency, B: Growth hormone deficiency, C: Constitutional growth delay, D: Systemic diseases +### Response: +","Short Stature +Defined as height below the third centile or more than 2 standard deviations below the median height for age and gender according to the population standard. Children whose statures more than 3 SD below the population mean for age and gender are more likely to be suffering from pathological short stature as compared to those with stature between -2 and -3SD, who are more likely to be affected by familial or constitutional short stature. +CAUSES:- + +The most common cause is constitutional. +Familial +Pathological causes include: + Undernutrition + Chronic systemic illness + Cerebral palsy + Congenital heart disease + Cystic fibrosis, asthma + Malabsorption + Acquired immunodeficiency syndrome +Endocrine causes include: + Psychosocial dwarfism. +Children born small for gestational age. +Skeletal dysplasia; achondroplasia, rickets. +Genetic syndrome; Turner, Down syndrome.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The most common etiology of short stature is, with the following options: A: Thyroxine deficiency, B: Growth hormone deficiency, C: Constitutional growth delay, D: Systemic diseases + ### Response: Short Stature Defined as height below the third centile or more than 2 standard deviations below the median height for age and gender according to the population standard. Children whose statures more than 3 SD below the population mean for age and gender are more likely to be suffering from pathological short stature as compared to those with stature between -2 and -3SD, who are more likely to be affected by familial or constitutional short stature. @@ -1564,6 +2799,13 @@ Genetic syndrome; Turner, Down syndrome. Answer the following medical question: All are true about aneurysmal bone cyst except -, with the following options: A: Eccentric, B: Expansile & lytic, C: Treated by simple curettage, D: Metaphysis of long bones +### Response: +",Aneurysmal bone : Etiology and pathogenesis: 1 Traumatic event result in an area of haemorrhage that maintain connection with the original with the disrupted feeding vessels. Subsequently giant cell granuloma-like can develop after loss of connection with the original vascular source 2. Frequently develops secondary within another lesion of bone as a result of disrupted vascular dynamics in pre-existing intrabony lesion ex. Central giant cell tumors Age : Young adults < 30 Years Location: Shaft of long bones Veebral column 2% Jaw bone; posterior mandibular is more common Sex : No predilection Manifestations: Rapidly growing swelling Painful frequently with parathesia ref : maheswari 9th ed,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are true about aneurysmal bone cyst except -, with the following options: A: Eccentric, B: Expansile & lytic, C: Treated by simple curettage, D: Metaphysis of long bones + ### Response: Aneurysmal bone : Etiology and pathogenesis: 1 Traumatic event result in an area of haemorrhage that maintain connection with the original with the disrupted feeding vessels. Subsequently giant cell granuloma-like can develop after loss of connection with the original vascular source 2. Frequently develops secondary within another lesion of bone as a result of disrupted vascular dynamics in pre-existing intrabony lesion ex. Central giant cell tumors Age : Young adults < 30 Years Location: Shaft of long bones Veebral column 2% Jaw bone; posterior mandibular is more common Sex : No predilection Manifestations: Rapidly growing swelling Painful frequently with parathesia ref : maheswari 9th ed ### End" @@ -1573,6 +2815,13 @@ Aneurysmal bone : Etiology and pathogenesis: 1 Traumatic event result in an area Answer the following medical question: When the same dose of a drug is repeated at half life intervals, the steady-state(plateau)plasma drug concentration is reached after, with the following options: A: 2-3 half lives, B: 4-5 half lives, C: 6-7 half lives, D: 8-10 half lives +### Response: +",Steady state concentration of a drug is achieved after 4-5 half-lives Ref: KDT 6/e pg 30.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: When the same dose of a drug is repeated at half life intervals, the steady-state(plateau)plasma drug concentration is reached after, with the following options: A: 2-3 half lives, B: 4-5 half lives, C: 6-7 half lives, D: 8-10 half lives + ### Response: Steady state concentration of a drug is achieved after 4-5 half-lives Ref: KDT 6/e pg 30. ### End" @@ -1582,6 +2831,13 @@ Steady state concentration of a drug is achieved after 4-5 half-lives Ref: KDT 6 Answer the following medical question: The most common cause of severe obstructive uropathy in neonates is:, with the following options: A: Prune-Belly syndrome, B: Bladder neck obstruction, C: Posterior urethral valves, D: None of these +### Response: +","Ans. C. Posterior urethral valvesPosterior urethral valves are believed to be the most common cause of severe obstructive uropathy in neonates. In this condition, urethral valves are present from before birth which extends from the posterior urethra distally to the external urinary sphincter. Most common site is the prostatic urethra. These neonates commonly have evidence of VUR and reflux nephropathy. Bilateral hydronephrosis and renal damage is common in many of these infants, unless the condition is corrected early. Prune-Belly syndrome and Bladder neck obstruction are also causes of obstructive uropathy in neonates and children, though they appear to be less common cause compared to posterior urethral valves.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The most common cause of severe obstructive uropathy in neonates is:, with the following options: A: Prune-Belly syndrome, B: Bladder neck obstruction, C: Posterior urethral valves, D: None of these + ### Response: Ans. C. Posterior urethral valvesPosterior urethral valves are believed to be the most common cause of severe obstructive uropathy in neonates. In this condition, urethral valves are present from before birth which extends from the posterior urethra distally to the external urinary sphincter. Most common site is the prostatic urethra. These neonates commonly have evidence of VUR and reflux nephropathy. Bilateral hydronephrosis and renal damage is common in many of these infants, unless the condition is corrected early. Prune-Belly syndrome and Bladder neck obstruction are also causes of obstructive uropathy in neonates and children, though they appear to be less common cause compared to posterior urethral valves. ### End" @@ -1591,6 +2847,13 @@ Ans. C. Posterior urethral valvesPosterior urethral valves are believed to be th Answer the following medical question: Hematuria is a feature of snake bite due to, with the following options: A: Cobra, B: Krait, C: viper, D: Sea snake +### Response: +","Viper venom is predominantly hemotoxic. There will be hemolysis , decrease in RBC count and platelet count The bleeding time and clotting time will be prolonged. Disseminated intravascular coagulation(DIC) will occur and there will be bleeding from gums, rectum and site of bite. There will be signs of renal failure. There will be oliguria, albuminuria and hematuria. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 518","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hematuria is a feature of snake bite due to, with the following options: A: Cobra, B: Krait, C: viper, D: Sea snake + ### Response: Viper venom is predominantly hemotoxic. There will be hemolysis , decrease in RBC count and platelet count The bleeding time and clotting time will be prolonged. Disseminated intravascular coagulation(DIC) will occur and there will be bleeding from gums, rectum and site of bite. There will be signs of renal failure. There will be oliguria, albuminuria and hematuria. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 518 ### End" @@ -1600,6 +2863,13 @@ Viper venom is predominantly hemotoxic. There will be hemolysis , decrease in RB Answer the following medical question: On examination of the patient for a hernia, it is useful to realize that:, with the following options: A: An impulse is often much better seen than felt, B: The internal abdominal ring lies 1.25 cm above the midpoint of poupa's ligament, C: The external abdominal ring lies 1.25 cm above and medial to ASIS, D: None of the above +### Response: +","CLINICAL FEATURES Males are 20 times more commonly affected than females. The patient complains of pain in the groin or pain referred to the testicle when performing heavy work or taking strenuous exercise. When asked to cough, a small transient bulging may be seen and felt together with an expansile impulse. Large hernias : Sensation of weight and dragging on the mesentery may produce epigastric pain.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: On examination of the patient for a hernia, it is useful to realize that:, with the following options: A: An impulse is often much better seen than felt, B: The internal abdominal ring lies 1.25 cm above the midpoint of poupa's ligament, C: The external abdominal ring lies 1.25 cm above and medial to ASIS, D: None of the above + ### Response: CLINICAL FEATURES Males are 20 times more commonly affected than females. The patient complains of pain in the groin or pain referred to the testicle when performing heavy work or taking strenuous exercise. When asked to cough, a small transient bulging may be seen and felt together with an expansile impulse. Large hernias : Sensation of weight and dragging on the mesentery may produce epigastric pain. ### End" @@ -1609,6 +2879,13 @@ CLINICAL FEATURES Males are 20 times more commonly affected than females. The pa Answer the following medical question: Time dependent Killing is exhibited by all the following drugs except:, with the following options: A: Ceftriaxone, B: Vancomycin, C: Gentamicin, D: Meropenem +### Response: +","* Time dependent killing(TDK) : Here, the killing activity depends upon the length of time, plasma concentration is above MIC. It is shown by:* Beta Lactams.* Vancomycin Concentration dependent killing(CDK) : Here, killing activity depends upon the ratio of plasma concentration to MIC.It is shown by:* Aminoglycosides.* Flouroquinolone* MetronidazoleSo, Gentamicin is the answer.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Time dependent Killing is exhibited by all the following drugs except:, with the following options: A: Ceftriaxone, B: Vancomycin, C: Gentamicin, D: Meropenem + ### Response: * Time dependent killing(TDK) : Here, the killing activity depends upon the length of time, plasma concentration is above MIC. It is shown by:* Beta Lactams.* Vancomycin Concentration dependent killing(CDK) : Here, killing activity depends upon the ratio of plasma concentration to MIC.It is shown by:* Aminoglycosides.* Flouroquinolone* MetronidazoleSo, Gentamicin is the answer. ### End" @@ -1618,6 +2895,13 @@ Answer the following medical question: Time dependent Killing is exhibited by al Answer the following medical question: Most common secondary tumor with Retinoblastoma is, with the following options: A: Neuroblastoma, B: Pineoblastoma, C: Osteochondroma, D: Osteosarcoma +### Response: +","Most common secondary tumor with Retinoblastoma Osteosarcoma, Soft tissue sarcoma and malignant melanoma.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common secondary tumor with Retinoblastoma is, with the following options: A: Neuroblastoma, B: Pineoblastoma, C: Osteochondroma, D: Osteosarcoma + ### Response: Most common secondary tumor with Retinoblastoma Osteosarcoma, Soft tissue sarcoma and malignant melanoma. ### End" @@ -1627,6 +2911,13 @@ Most common secondary tumor with Retinoblastoma Osteosarcoma, Soft tissue sarco Answer the following medical question: Which of the following antigen is found within the nuclei of infected hepatocytes and NOT usually in the peripheral circulation in Hepatitis B infection?, with the following options: A: HBeAg, B: HBcAg, C: Anti-HBc, D: HBsAg +### Response: +","HBcAg is assembled as the nucleocapsid core paicles. It is not secreted and does not circulate in blood, but can be demonstrated in hepatocytes by immunofluorescence. - HBcAg is not demonstrable in circulation because it is enclosed within the HBsAg coat. But its antibody anti-HBc appears in serum a week or two after the appearance of HBsAg. Reference : Anathanarayan & paniker's 9th edition, pg no: 544,546 <\p>","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following antigen is found within the nuclei of infected hepatocytes and NOT usually in the peripheral circulation in Hepatitis B infection?, with the following options: A: HBeAg, B: HBcAg, C: Anti-HBc, D: HBsAg + ### Response: HBcAg is assembled as the nucleocapsid core paicles. It is not secreted and does not circulate in blood, but can be demonstrated in hepatocytes by immunofluorescence. - HBcAg is not demonstrable in circulation because it is enclosed within the HBsAg coat. But its antibody anti-HBc appears in serum a week or two after the appearance of HBsAg. Reference : Anathanarayan & paniker's 9th edition, pg no: 544,546 <\p> ### End" @@ -1636,6 +2927,13 @@ HBcAg is assembled as the nucleocapsid core paicles. It is not secreted and does Answer the following medical question: A baby with tripod position, bi dexterous approach, recognizes strangers and can spell out mono syllable by what age:, with the following options: A: 7 months, B: 12 months, C: 9 months, D: 10 months +### Response: +",Age of the baby- 7 months Baby can sit in tripod position by 6 months. Bi dexterous approach by 5th month. Monosyllables by 6th month. Stranger anxiety by 7th month,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A baby with tripod position, bi dexterous approach, recognizes strangers and can spell out mono syllable by what age:, with the following options: A: 7 months, B: 12 months, C: 9 months, D: 10 months + ### Response: Age of the baby- 7 months Baby can sit in tripod position by 6 months. Bi dexterous approach by 5th month. Monosyllables by 6th month. Stranger anxiety by 7th month ### End" @@ -1645,6 +2943,20 @@ Age of the baby- 7 months Baby can sit in tripod position by 6 months. Bi dexter Answer the following medical question: The structures passing posterior to diaphragm are all except, with the following options: A: Aorta, B: Azygous vein, C: Thoracic duct, D: Greater splanchnic nerve +### Response: +","Aortic opening +-        Level- T12 +-        At osseoaponeurosis between right and left crus +-        Structures transmitted + +   Aorta +   Thoracic duct +   Azygos vein","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The structures passing posterior to diaphragm are all except, with the following options: A: Aorta, B: Azygous vein, C: Thoracic duct, D: Greater splanchnic nerve + ### Response: Aortic opening -        Level- T12 @@ -1661,6 +2973,13 @@ Aortic opening Answer the following medical question: A 15 year old girl was admitted to the infectious disease hospital with a provisional diagnosis of rabies. The most suitable clinical sample that can confirm the antemortem diagnosis is-, with the following options: A: Serum for anti-rabies IgG antibody, B: Corneal impression smear for immunofluorescence stain, C: CSF sample for viral culture, D: Giemsa stain on smear prepared from salivary secretions +### Response: +","For the antemortem diagnosis of rabies, viral antigens can be demonstrated in the corneal smear, skin biopsy from the face or neck or saliva.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 15 year old girl was admitted to the infectious disease hospital with a provisional diagnosis of rabies. The most suitable clinical sample that can confirm the antemortem diagnosis is-, with the following options: A: Serum for anti-rabies IgG antibody, B: Corneal impression smear for immunofluorescence stain, C: CSF sample for viral culture, D: Giemsa stain on smear prepared from salivary secretions + ### Response: For the antemortem diagnosis of rabies, viral antigens can be demonstrated in the corneal smear, skin biopsy from the face or neck or saliva. ### End" @@ -1670,6 +2989,13 @@ For the antemortem diagnosis of rabies, viral antigens can be demonstrated in th Answer the following medical question: A 6 year old girl is easily distracted in class and exhibits poor scholastic performance. Seizures are precipitated by hyperventilation. What is the probable diagnosis?, with the following options: A: Myoclonic seizures, B: Absence seizures, C: Atonic seizures, D: Myoclonia +### Response: +","Typical absence seizures are characterized by sudden, brief lapses of consciousness without loss of postural control. The seizure typically lasts for only seconds, consciousness returns as suddenly as it was lost, and there is no postictal confusion. Although the brief loss of consciousness may be clinically inapparent or the sole manifestation of the seizure discharge, absence seizures are usually accompanied by subtle, bilateral motor signs such as rapid blinking of the eyelids, chewing movements, or small-amplitude, clonic movements of the hands. Typical absence seizures are associated with a group of genetically determined epilepsies with onset usually in childhood (ages 4-8 years) or early adolescence and are the main seizure type in 15-20% of children with epilepsy. Since the clinical signs of the seizures are subtle, especially to parents who may not have had previous experience with seizures, it is not surprising that the first clue to absence epilepsy is often unexplained ""daydreaming"" and a decline in school performance recognized by a teacher. Hyperventilation tends to provoke these electrographic discharges and even the seizures themselves and is routinely used when recording the EEG. Ref: Lowenstein D.H. (2012). Chapter 369. Seizures and Epilepsy. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 6 year old girl is easily distracted in class and exhibits poor scholastic performance. Seizures are precipitated by hyperventilation. What is the probable diagnosis?, with the following options: A: Myoclonic seizures, B: Absence seizures, C: Atonic seizures, D: Myoclonia + ### Response: Typical absence seizures are characterized by sudden, brief lapses of consciousness without loss of postural control. The seizure typically lasts for only seconds, consciousness returns as suddenly as it was lost, and there is no postictal confusion. Although the brief loss of consciousness may be clinically inapparent or the sole manifestation of the seizure discharge, absence seizures are usually accompanied by subtle, bilateral motor signs such as rapid blinking of the eyelids, chewing movements, or small-amplitude, clonic movements of the hands. Typical absence seizures are associated with a group of genetically determined epilepsies with onset usually in childhood (ages 4-8 years) or early adolescence and are the main seizure type in 15-20% of children with epilepsy. Since the clinical signs of the seizures are subtle, especially to parents who may not have had previous experience with seizures, it is not surprising that the first clue to absence epilepsy is often unexplained ""daydreaming"" and a decline in school performance recognized by a teacher. Hyperventilation tends to provoke these electrographic discharges and even the seizures themselves and is routinely used when recording the EEG. Ref: Lowenstein D.H. (2012). Chapter 369. Seizures and Epilepsy. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e. ### End" @@ -1679,6 +3005,13 @@ Typical absence seizures are characterized by sudden, brief lapses of consciousn Answer the following medical question: Corneal transparency is maintained by all except:, with the following options: A: Relative dehydration, B: Increased mitotic figures in centre of cornea, C: Unmyelinated nerve fibers, D: Uniform spacing of collagen fibrils +### Response: +",Ans. Increased mitotic figures in centre of cornea,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Corneal transparency is maintained by all except:, with the following options: A: Relative dehydration, B: Increased mitotic figures in centre of cornea, C: Unmyelinated nerve fibers, D: Uniform spacing of collagen fibrils + ### Response: Ans. Increased mitotic figures in centre of cornea ### End" @@ -1688,6 +3021,13 @@ Ans. Increased mitotic figures in centre of cornea Answer the following medical question: A 20 year old female presented with vaginal discharge which is non irritating and malodorous. Saline wet preparation reveals clue cells. Clue cells are used to detect which type of vaginitis?, with the following options: A: Bacterial vaginosis, B: Candidal vaginitis, C: Primary syphilis, D: Secondary syphilis +### Response: +","Clue cells are the most reliable indicators of BV. These vaginal epithelial cells contain many attached bacteria, which create a poorly defined stippled cellular border. The positive predictive value of this test for the presence of BV is 95 percent. Must know: Clinical diagnostic criteria for bacterial vaginosis: Microscopic evaluation of a vaginal-secretion saline preparation Release of volatile amines produced by anaerobic metabolism Determination of the vaginal pH Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 3. Gynecologic Infection. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 20 year old female presented with vaginal discharge which is non irritating and malodorous. Saline wet preparation reveals clue cells. Clue cells are used to detect which type of vaginitis?, with the following options: A: Bacterial vaginosis, B: Candidal vaginitis, C: Primary syphilis, D: Secondary syphilis + ### Response: Clue cells are the most reliable indicators of BV. These vaginal epithelial cells contain many attached bacteria, which create a poorly defined stippled cellular border. The positive predictive value of this test for the presence of BV is 95 percent. Must know: Clinical diagnostic criteria for bacterial vaginosis: Microscopic evaluation of a vaginal-secretion saline preparation Release of volatile amines produced by anaerobic metabolism Determination of the vaginal pH Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 3. Gynecologic Infection. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e. ### End" @@ -1697,6 +3037,13 @@ Clue cells are the most reliable indicators of BV. These vaginal epithelial cell Answer the following medical question: Gamma gandy bodies are seen in all except ?, with the following options: A: Cirrhosis with poal hypeension, B: Chronic myeloid leukemia, C: Sickle cell anemia, D: Thalassemia +### Response: +","Ans. is 'd' i.e., Thalassemia","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Gamma gandy bodies are seen in all except ?, with the following options: A: Cirrhosis with poal hypeension, B: Chronic myeloid leukemia, C: Sickle cell anemia, D: Thalassemia + ### Response: Ans. is 'd' i.e., Thalassemia ### End" @@ -1706,6 +3053,13 @@ Ans. is 'd' i.e., Thalassemia Answer the following medical question: Bullous impetigo is caused by -, with the following options: A: Streptococcus, B: Staphylococcus, C: Pseudomonas, D: Y. Pestis +### Response: +","Ans. is 'b' i.e., StaphylococcusImpetigoo Impetigo is a highly contagious, Gram-positive bacterial infection of superficial layer of epidermis. Impetigo occurs in Two forms : -1. Non - bullous impetigo (Impetigo contagiosa)It is the most common bacterial infection of children (occurs mainly in children in contrast to Bullous impetigo which occurs in infants). It is caused by both staphylococcus aureus and hemolytic group A streptococcus (Str. pyogens), though it is mostly caused by staph aureus. Most commonly occurs on face, i.e., around nose & mouth; and exposed parts, i.e., arms, legs. Presents erythematous macule/papule which changes into vesicle which soon ruptures with formation of crusting. Crust has characteristic features : -Honey-yellow colour in streptococcal impetigo.Waxy in staphylococcal impetigo.Lesion heal without scarring. Mucous membrane involvement is rare. Lymphadenopathy is common2. Bullous impetigoIt is caused by staphylococcus aureus most often phage type 71. It usually occurs in infants and manifests as vesicle that develop into bulla and later a pustule without any surrounding erythema. It mainly occurs on face. Mucous membrane may be involved (in contrast to impetigo contigiosa). Lymphadenopathy is rare.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Bullous impetigo is caused by -, with the following options: A: Streptococcus, B: Staphylococcus, C: Pseudomonas, D: Y. Pestis + ### Response: Ans. is 'b' i.e., StaphylococcusImpetigoo Impetigo is a highly contagious, Gram-positive bacterial infection of superficial layer of epidermis. Impetigo occurs in Two forms : -1. Non - bullous impetigo (Impetigo contagiosa)It is the most common bacterial infection of children (occurs mainly in children in contrast to Bullous impetigo which occurs in infants). It is caused by both staphylococcus aureus and hemolytic group A streptococcus (Str. pyogens), though it is mostly caused by staph aureus. Most commonly occurs on face, i.e., around nose & mouth; and exposed parts, i.e., arms, legs. Presents erythematous macule/papule which changes into vesicle which soon ruptures with formation of crusting. Crust has characteristic features : -Honey-yellow colour in streptococcal impetigo.Waxy in staphylococcal impetigo.Lesion heal without scarring. Mucous membrane involvement is rare. Lymphadenopathy is common2. Bullous impetigoIt is caused by staphylococcus aureus most often phage type 71. It usually occurs in infants and manifests as vesicle that develop into bulla and later a pustule without any surrounding erythema. It mainly occurs on face. Mucous membrane may be involved (in contrast to impetigo contigiosa). Lymphadenopathy is rare. ### End" @@ -1715,6 +3069,13 @@ Ans. is 'b' i.e., StaphylococcusImpetigoo Impetigo is a highly contagious, Gram- Answer the following medical question: You decide not to prescribe sildenafil in a patient because the patient told you that he is taking an antianginal drug. Which of the following can it be?, with the following options: A: Calcium channel blockers, B: b adrenergic blockers, C: Organic nitrates, D: Angiotensin conveing enzyme inhibitors +### Response: +",Nitrates act by increasing cGMP and sildenafil inhibits the breakdown of this compound (by inhibiting phosphodiesterase). Marked increase in cGMP levels may result in the profound hypotension and reflex tachycardia.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: You decide not to prescribe sildenafil in a patient because the patient told you that he is taking an antianginal drug. Which of the following can it be?, with the following options: A: Calcium channel blockers, B: b adrenergic blockers, C: Organic nitrates, D: Angiotensin conveing enzyme inhibitors + ### Response: Nitrates act by increasing cGMP and sildenafil inhibits the breakdown of this compound (by inhibiting phosphodiesterase). Marked increase in cGMP levels may result in the profound hypotension and reflex tachycardia. ### End" @@ -1724,6 +3085,13 @@ Nitrates act by increasing cGMP and sildenafil inhibits the breakdown of this co Answer the following medical question: What is the cause for luteal phase defect ?, with the following options: A: Progesterone is inadequately secreted, B: Excess estrogen is secreted, C: Excess progesterone is secreted, D: All +### Response: +","Ans. is a i.e. Progesterone is inadequately secreted Luteal phase Defect is a condition when there is delay in the development of the endometrium of more than 2 days beyond the actual cycle day. This adversely affects the endometrial receptivity to blastocyst implantation. Etiology : Luteal phase defect is due to inadequte progesterone production by corpus luteum. Inadequate progesterone secretion could be due to : Inadequate follicular development Inadequate FSH or LH secretion Hyperprolactinemia Diagnosis : The diagnosis of luteal phase defect can be done by : BBT Cha : slow rise of temperature taking 4 - 5 days following fall in the mid cycle. rise of temperature sustains less than 10 days. Endometrial biopsy: Biopsy done in post ovulatory period reveals endometrium at least 2 days out of phase. Serum progesteronedeg estimated on 5th day following ovulation is less than 10 ng/ml. Management : Adminstration of vaginal or intramuscular progesterone (50 - 100 mg/d) begining 3 days after documentation of an LH surge and continued till : - Either first day of next menstrual cycle. Or - If pregnancy occurs till 8-10 wks of gestation. In unresponsive cases, clomiphene citrate may be tried.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What is the cause for luteal phase defect ?, with the following options: A: Progesterone is inadequately secreted, B: Excess estrogen is secreted, C: Excess progesterone is secreted, D: All + ### Response: Ans. is a i.e. Progesterone is inadequately secreted Luteal phase Defect is a condition when there is delay in the development of the endometrium of more than 2 days beyond the actual cycle day. This adversely affects the endometrial receptivity to blastocyst implantation. Etiology : Luteal phase defect is due to inadequte progesterone production by corpus luteum. Inadequate progesterone secretion could be due to : Inadequate follicular development Inadequate FSH or LH secretion Hyperprolactinemia Diagnosis : The diagnosis of luteal phase defect can be done by : BBT Cha : slow rise of temperature taking 4 - 5 days following fall in the mid cycle. rise of temperature sustains less than 10 days. Endometrial biopsy: Biopsy done in post ovulatory period reveals endometrium at least 2 days out of phase. Serum progesteronedeg estimated on 5th day following ovulation is less than 10 ng/ml. Management : Adminstration of vaginal or intramuscular progesterone (50 - 100 mg/d) begining 3 days after documentation of an LH surge and continued till : - Either first day of next menstrual cycle. Or - If pregnancy occurs till 8-10 wks of gestation. In unresponsive cases, clomiphene citrate may be tried. ### End" @@ -1733,6 +3101,13 @@ Ans. is a i.e. Progesterone is inadequately secreted Luteal phase Defect is a co Answer the following medical question: Crocodile skin appearance is seen in :, with the following options: A: High voltage burns, B: Electric shocks, C: Drowning, D: Mummifications +### Response: +","A i.e. High voltage burn Lightening stroke produce three types of burn - linear burns (in moist creases & folds of skin), surface burns (beneath worn metallic objects) and Filigree or Arborescent or Lichtenberg's flowers burnQ (superficial, thin, irregular touous marking resembling branches of tree or fern(2) Filgree/ Arborescent/ Lichtenberg's Flower's Burn are superficial, thin, irregular toous markings resembling branching of a tree or fere. These are formed d/t rupture of smaller blood vessels, in an injury d/t lightenine","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Crocodile skin appearance is seen in :, with the following options: A: High voltage burns, B: Electric shocks, C: Drowning, D: Mummifications + ### Response: A i.e. High voltage burn Lightening stroke produce three types of burn - linear burns (in moist creases & folds of skin), surface burns (beneath worn metallic objects) and Filigree or Arborescent or Lichtenberg's flowers burnQ (superficial, thin, irregular touous marking resembling branches of tree or fern(2) Filgree/ Arborescent/ Lichtenberg's Flower's Burn are superficial, thin, irregular toous markings resembling branching of a tree or fere. These are formed d/t rupture of smaller blood vessels, in an injury d/t lightenine ### End" @@ -1742,6 +3117,13 @@ A i.e. High voltage burn Lightening stroke produce three types of burn - linear Answer the following medical question: Which of the following is not a cause of microcephaly?, with the following options: A: Angelman syndrome, B: Taysach's disease, C: Rett's syndrome, D: Phenyl ketonuria +### Response: +",Primary causes of microcephaly in children are - Mnemonic - Cannot See PEFR in Children Cri-du-chat Syndrome Smith Lemli Optiz Syndrome Patau syndrome Edward syndrome Familial Rubinstein Taybi syndrome Cornelia de Lange syndrome Also Know Acquired MIcrocephaly Q R - Rett's syndrome A - Angelmann Syndrome S - Seckel syndrome Also know some impoant causes of macrocephaly * Taysach's * MPS * Ganghosidosis * Sotos - Fragile x syndrome - Alexander disease - Canavan disease - Neuro cutaneous syndromes,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is not a cause of microcephaly?, with the following options: A: Angelman syndrome, B: Taysach's disease, C: Rett's syndrome, D: Phenyl ketonuria + ### Response: Primary causes of microcephaly in children are - Mnemonic - Cannot See PEFR in Children Cri-du-chat Syndrome Smith Lemli Optiz Syndrome Patau syndrome Edward syndrome Familial Rubinstein Taybi syndrome Cornelia de Lange syndrome Also Know Acquired MIcrocephaly Q R - Rett's syndrome A - Angelmann Syndrome S - Seckel syndrome Also know some impoant causes of macrocephaly * Taysach's * MPS * Ganghosidosis * Sotos - Fragile x syndrome - Alexander disease - Canavan disease - Neuro cutaneous syndromes ### End" @@ -1751,6 +3133,13 @@ Primary causes of microcephaly in children are - Mnemonic - Cannot See PEFR in C Answer the following medical question: All are true about Antrochoanal polyp EXCEPT:, with the following options: A: Unilateral and single, B: Grows backwards to the choana, C: Avulsion is the treatment of choice, D: Common in children +### Response: +","Avulsion is the treatment of choice TREATMENT OF ANTROCHOANAL POLYP: An antrochoanal polyp is easily removed by avulsion (Avulsion Polypectomy) either through the nasal or oral route. Recurrence is uncommon after complete removal. In cases which do recur, Caldwell-Luc operation may be required to remove the polyp completely from the site of its origin and to deal with co-existent maxillary sinusitis. These days, endoscopic sinus surgery (treatment of choice) has superceded other modes of polyp removal. Caldwell-Luc operation is avoided. DIFFERENCES BETWEEN ANTROCHOANAL AND ETHMOIDAL POLYP: Antrochoanal polyp Ethmoidal polyp Age Common in children Common in adults Aetiology Infection Allergy or multifactorial Number Solitary Multiple T.aterality Unilateral Bilateral Origin Max. sinus near the ostium Ethmoidal sinuses, uncinate process, middle turbinate and middle meatus Growth Grows backwards to the choana; may hang down behind the soft palate Mostly grow anteriorly and may present at the nares Size & shape Trilobed with antral, nasal and choanal pas. Choanal pa may protrude through the choana & fill the nasopharynx obstructing both sides Usually small and grape-like masses Recurrence Uncommon, if removed completely Common Treatment Polypectomy; endoscopic removal or Caldwell- Luc operation if recurrent Polypectomy: Endoscopic surgery or ethmoidectomy (which may be intranasal, extranasal or transantral)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are true about Antrochoanal polyp EXCEPT:, with the following options: A: Unilateral and single, B: Grows backwards to the choana, C: Avulsion is the treatment of choice, D: Common in children + ### Response: Avulsion is the treatment of choice TREATMENT OF ANTROCHOANAL POLYP: An antrochoanal polyp is easily removed by avulsion (Avulsion Polypectomy) either through the nasal or oral route. Recurrence is uncommon after complete removal. In cases which do recur, Caldwell-Luc operation may be required to remove the polyp completely from the site of its origin and to deal with co-existent maxillary sinusitis. These days, endoscopic sinus surgery (treatment of choice) has superceded other modes of polyp removal. Caldwell-Luc operation is avoided. DIFFERENCES BETWEEN ANTROCHOANAL AND ETHMOIDAL POLYP: Antrochoanal polyp Ethmoidal polyp Age Common in children Common in adults Aetiology Infection Allergy or multifactorial Number Solitary Multiple T.aterality Unilateral Bilateral Origin Max. sinus near the ostium Ethmoidal sinuses, uncinate process, middle turbinate and middle meatus Growth Grows backwards to the choana; may hang down behind the soft palate Mostly grow anteriorly and may present at the nares Size & shape Trilobed with antral, nasal and choanal pas. Choanal pa may protrude through the choana & fill the nasopharynx obstructing both sides Usually small and grape-like masses Recurrence Uncommon, if removed completely Common Treatment Polypectomy; endoscopic removal or Caldwell- Luc operation if recurrent Polypectomy: Endoscopic surgery or ethmoidectomy (which may be intranasal, extranasal or transantral) ### End" @@ -1760,6 +3149,13 @@ Avulsion is the treatment of choice TREATMENT OF ANTROCHOANAL POLYP: An antrocho Answer the following medical question: Which of the following inhaled gas is used to decrease pulmonary aery pressure in adults and infants?, with the following options: A: Nitrous oxide, B: Nitrogen dioxide, C: Nitric oxide, D: Nitrogen +### Response: +",C i.e. Nitric oxide Nitric oxide (NO) or endothelium derived relaxing factor (EDRF) is synthesized from L-arginine by nitric oxide synthase (NOS) enzyme in endothelium of blood vesselsQ. Physiologically it causes vasodilation & decreases vascular resistance throughout the bodyQ. It activates guanylyl cyclase producing C-GMP and binds rapidly to Hb & gets inactivatedQ. Whereas inhaled NO is a selective pulmonary-vasodilator decreases pulmonary aery pressure in infants & adults and improves V/P ratioQ. So it is used in treatment of pulmonary aery hypeensionQ. It has no systemic vasodilatory effectQ. Systemic effects of breathing NO includes platetlet & leukocyte inhibition and oxidation of extraerythrocytic hemoglobin. Inhaled NO decreases vascular smooth muscle cell hyperplasia & increases alveolarization in the injured developing limb. This pulmonary vascular & alveolar developmental effect of NO is used to prevent or ameliorate pulmonary hypeension in infants with congenital hea disease and chronic lung disease in premature infants.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following inhaled gas is used to decrease pulmonary aery pressure in adults and infants?, with the following options: A: Nitrous oxide, B: Nitrogen dioxide, C: Nitric oxide, D: Nitrogen + ### Response: C i.e. Nitric oxide Nitric oxide (NO) or endothelium derived relaxing factor (EDRF) is synthesized from L-arginine by nitric oxide synthase (NOS) enzyme in endothelium of blood vesselsQ. Physiologically it causes vasodilation & decreases vascular resistance throughout the bodyQ. It activates guanylyl cyclase producing C-GMP and binds rapidly to Hb & gets inactivatedQ. Whereas inhaled NO is a selective pulmonary-vasodilator decreases pulmonary aery pressure in infants & adults and improves V/P ratioQ. So it is used in treatment of pulmonary aery hypeensionQ. It has no systemic vasodilatory effectQ. Systemic effects of breathing NO includes platetlet & leukocyte inhibition and oxidation of extraerythrocytic hemoglobin. Inhaled NO decreases vascular smooth muscle cell hyperplasia & increases alveolarization in the injured developing limb. This pulmonary vascular & alveolar developmental effect of NO is used to prevent or ameliorate pulmonary hypeension in infants with congenital hea disease and chronic lung disease in premature infants. ### End" @@ -1769,6 +3165,13 @@ C i.e. Nitric oxide Nitric oxide (NO) or endothelium derived relaxing factor (ED Answer the following medical question: Full blown Immunodeficiency syndrome is -, with the following options: A: High viral titres with low CD 4 count, B: Low viral titres with low CD 4 count, C: Low viral titres with high CD 4 count, D: High viral titres with high CD 4 count +### Response: +","HIV infects CD4 T cells. Thus in full blown infection, there will be high viral titres with low CD4 count.Textbook of microbiology REF:Ananthanarayan and Paniker. Page no.:574","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Full blown Immunodeficiency syndrome is -, with the following options: A: High viral titres with low CD 4 count, B: Low viral titres with low CD 4 count, C: Low viral titres with high CD 4 count, D: High viral titres with high CD 4 count + ### Response: HIV infects CD4 T cells. Thus in full blown infection, there will be high viral titres with low CD4 count.Textbook of microbiology REF:Ananthanarayan and Paniker. Page no.:574 ### End" @@ -1778,6 +3181,13 @@ HIV infects CD4 T cells. Thus in full blown infection, there will be high viral Answer the following medical question: Spinnbarkeit refers to?, with the following options: A: Cervical mucus, B: Uterine gland thickness, C: Cervical os appearance, D: Proliferation of breast alveoli +### Response: +","Ans. (a) Cervical mucusRef.-.Ganong25th ed. / 402* The cervical mucus is thinnest at time of ovulation and its elasticity or spinnbarkeit increases such that by mid- cycle one drop can be stretched into a long, thin thread that may be 8-12cm or more in length.* It dries on a slide in an arborizing fern like pattern.* After ovulation it becomes thick and fails to form the fern pattern.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Spinnbarkeit refers to?, with the following options: A: Cervical mucus, B: Uterine gland thickness, C: Cervical os appearance, D: Proliferation of breast alveoli + ### Response: Ans. (a) Cervical mucusRef.-.Ganong25th ed. / 402* The cervical mucus is thinnest at time of ovulation and its elasticity or spinnbarkeit increases such that by mid- cycle one drop can be stretched into a long, thin thread that may be 8-12cm or more in length.* It dries on a slide in an arborizing fern like pattern.* After ovulation it becomes thick and fails to form the fern pattern. ### End" @@ -1787,6 +3197,13 @@ Ans. (a) Cervical mucusRef.-.Ganong25th ed. / 402* The cervical mucus is thinnes Answer the following medical question: Sucralfate, with the following options: A: Reduces gastric acid secretion, B: Neutralises gastric acid, C: Is ulcer protective, D: Isanti H. pylori drug +### Response: +","Ans. is 'c' i.e., Is ulcer protective Sucralfateo Sucralfate is an ulcer protective agent. It preferentially and strongly adheres to the ulcer base, specially duodenal, and acts as a physical barrier preventing acid, pepsin and bile from coming in contact with the ulcer base. However, this protective action is attributed to sucralfate because of certain properties which are achieved only in acidic medium:Acidic medium gives it a viscous consistency, alsoIt polymerises at pH < 4 by cross linkages of molecule assuming sticky gel like consistency,o It is this viscous and gel like properties that are responsible for its action.o When antacids are given concurrently they raise the pH of gastric secretion and this interferes with the very basic mechanism of action of sucralfate (requires pH < 4) and thus makes them ineffective.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Sucralfate, with the following options: A: Reduces gastric acid secretion, B: Neutralises gastric acid, C: Is ulcer protective, D: Isanti H. pylori drug + ### Response: Ans. is 'c' i.e., Is ulcer protective Sucralfateo Sucralfate is an ulcer protective agent. It preferentially and strongly adheres to the ulcer base, specially duodenal, and acts as a physical barrier preventing acid, pepsin and bile from coming in contact with the ulcer base. However, this protective action is attributed to sucralfate because of certain properties which are achieved only in acidic medium:Acidic medium gives it a viscous consistency, alsoIt polymerises at pH < 4 by cross linkages of molecule assuming sticky gel like consistency,o It is this viscous and gel like properties that are responsible for its action.o When antacids are given concurrently they raise the pH of gastric secretion and this interferes with the very basic mechanism of action of sucralfate (requires pH < 4) and thus makes them ineffective. ### End" @@ -1796,6 +3213,13 @@ Ans. is 'c' i.e., Is ulcer protective Sucralfateo Sucralfate is an ulcer protect Answer the following medical question: The theme of World AIDS Day 2019 is:, with the following options: A: Unite for HIV, B: Communities make the difference, C: Right to health, D: Everyone counts +### Response: +","The theme of World AIDS day 2019 is ""Communities make the difference"" World AIDS day- 1st December every year Theme for AIDS day 2017 : Everyone Counts Theme for AIDS day 2018 : Know Your Status","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The theme of World AIDS Day 2019 is:, with the following options: A: Unite for HIV, B: Communities make the difference, C: Right to health, D: Everyone counts + ### Response: The theme of World AIDS day 2019 is ""Communities make the difference"" World AIDS day- 1st December every year Theme for AIDS day 2017 : Everyone Counts Theme for AIDS day 2018 : Know Your Status ### End" @@ -1805,6 +3229,13 @@ The theme of World AIDS day 2019 is ""Communities make the difference"" World AI Answer the following medical question: which of the following SSRI is used only in the management of OCD, with the following options: A: clomipramine, B: seraline, C: miazapine, D: fluvoxamine +### Response: +","SSRI * IMPOANCE Most widely prescribed antidepressant * MECHANISM Specifically acts on serotonin transpoers and increases serotonin in synapse. DRUGS FLUOXETINE FLUVOXAMINE DAPOXETINE CITALOPRAM ESCITALOPRAM ESCITALOPRAM SERALINE PAROXETINE USE FLUOXETINE=============CHILDHOOD DEPRESSION FLUVOXAMINE===========OCD DAPOXETINE==============PME ESCITALOPRAM===========HEA SAFE, PATHOLOGICAL EMOTIONS PAROXETINE=========SEDATING, PANIC DISORDER IMPULSE CONTROL DISORDERS PME PARAPHILIA Ref. kaplon and Sadock, synopsis of psychiatry, 11 th editiom, pg. 955","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: which of the following SSRI is used only in the management of OCD, with the following options: A: clomipramine, B: seraline, C: miazapine, D: fluvoxamine + ### Response: SSRI * IMPOANCE Most widely prescribed antidepressant * MECHANISM Specifically acts on serotonin transpoers and increases serotonin in synapse. DRUGS FLUOXETINE FLUVOXAMINE DAPOXETINE CITALOPRAM ESCITALOPRAM ESCITALOPRAM SERALINE PAROXETINE USE FLUOXETINE=============CHILDHOOD DEPRESSION FLUVOXAMINE===========OCD DAPOXETINE==============PME ESCITALOPRAM===========HEA SAFE, PATHOLOGICAL EMOTIONS PAROXETINE=========SEDATING, PANIC DISORDER IMPULSE CONTROL DISORDERS PME PARAPHILIA Ref. kaplon and Sadock, synopsis of psychiatry, 11 th editiom, pg. 955 ### End" @@ -1814,6 +3245,13 @@ SSRI * IMPOANCE Most widely prescribed antidepressant * MECHANISM Specifically a Answer the following medical question: Incised-like lacerated wound appears at :, with the following options: A: Fore head, B: Hand, C: Thorax, D: Abdomen +### Response: +",A i.e. Forehead,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Incised-like lacerated wound appears at :, with the following options: A: Fore head, B: Hand, C: Thorax, D: Abdomen + ### Response: A i.e. Forehead ### End" @@ -1823,6 +3261,13 @@ A i.e. Forehead Answer the following medical question: Charcot's joint is another name for joint affected by-, with the following options: A: Neuropathy, B: Osteoarthritis, C: Rheumatoid arthritis, D: Ankylosing spondylitis +### Response: +","Ans. is 'a' i.e., Neuropathy o Another name given to joint affected by neuropathic arthropathy is charcot's joint.Neuropathic joint (CharcqaCslomt)o It is a progressive destructive arthritis associated with loss of pain sensation, proprioception or both, in addition normal muscular reflexes that modulate joint movements are decreased,o Without these protective mechanisms, joints are subjected to repeated trauma, resulting in progressive cartilage and bone damage.a It is most commonly caused by diabetes meliitus.Pathophysiologyo At least two underlying mechanisms are believed to be involved in the pathogenesis of neuropathic arthritis.An abnormal autonomic nervous system is thought to be responsible for the increased blood flow to the joint and subsequent resorption of bone.With the loss of deep pain, proprioception and protective neuromuscular reflexes, the joint is subjected to repeated injuries including ligamental tears and bone fractures.Pathologyo The pathological changes seen in charcoal's joints are similar to those found in severe osteoarthritic joint.o There is fragmentation and eventual loss of articular cartilage with ebu motion of the underlying bone.o Osteophytes are found at the joint margins.o With more advanced diseases, erosions are present on the joint surface. Fractures, devitalized bone, and intraarticular loose bodies may be present. Joint effusions are prominent.Clinical manifestationso Usually begins in a single joint and then progresses to involve other joints.o The involved joints progressively becomes enlarged from bony overgrowth and synovial effusion.o Loose bodies may be palpated in the joint cavity.o Joint instability, subluxation and crepitus occur.o The joint pain experienced by the patient is less than that would be anticipated based on the degree of joint involvement.Causes of Neuropathic joint disease (Chareoat's joint)o Diabetes mellitus (most common)o Tabes Dorsaliso Meningomyeloceleo Syringomyeliao Amyloidosiso Leprosyo Congenital indifference to paino Peroneal muscular atrophy","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Charcot's joint is another name for joint affected by-, with the following options: A: Neuropathy, B: Osteoarthritis, C: Rheumatoid arthritis, D: Ankylosing spondylitis + ### Response: Ans. is 'a' i.e., Neuropathy o Another name given to joint affected by neuropathic arthropathy is charcot's joint.Neuropathic joint (CharcqaCslomt)o It is a progressive destructive arthritis associated with loss of pain sensation, proprioception or both, in addition normal muscular reflexes that modulate joint movements are decreased,o Without these protective mechanisms, joints are subjected to repeated trauma, resulting in progressive cartilage and bone damage.a It is most commonly caused by diabetes meliitus.Pathophysiologyo At least two underlying mechanisms are believed to be involved in the pathogenesis of neuropathic arthritis.An abnormal autonomic nervous system is thought to be responsible for the increased blood flow to the joint and subsequent resorption of bone.With the loss of deep pain, proprioception and protective neuromuscular reflexes, the joint is subjected to repeated injuries including ligamental tears and bone fractures.Pathologyo The pathological changes seen in charcoal's joints are similar to those found in severe osteoarthritic joint.o There is fragmentation and eventual loss of articular cartilage with ebu motion of the underlying bone.o Osteophytes are found at the joint margins.o With more advanced diseases, erosions are present on the joint surface. Fractures, devitalized bone, and intraarticular loose bodies may be present. Joint effusions are prominent.Clinical manifestationso Usually begins in a single joint and then progresses to involve other joints.o The involved joints progressively becomes enlarged from bony overgrowth and synovial effusion.o Loose bodies may be palpated in the joint cavity.o Joint instability, subluxation and crepitus occur.o The joint pain experienced by the patient is less than that would be anticipated based on the degree of joint involvement.Causes of Neuropathic joint disease (Chareoat's joint)o Diabetes mellitus (most common)o Tabes Dorsaliso Meningomyeloceleo Syringomyeliao Amyloidosiso Leprosyo Congenital indifference to paino Peroneal muscular atrophy ### End" @@ -1832,6 +3277,13 @@ Ans. is 'a' i.e., Neuropathy o Another name given to joint affected by neuropath Answer the following medical question: All are primary functions of bile acids, EXCEPT:, with the following options: A: To promote bile flow, B: To solubilize cholesterol and phospholipid in the gallbladder, C: To enhance dietary lipid digestion and absorption, D: To promote bile secretion +### Response: +","The primary functions of bile acids are (1) to promote bile flow, (2) to solubilize cholesterol and phospholipid in the gallbladder (3) to enhance dietary lipid digestion and absorption Ref: Harrison, E-18, P-2461","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are primary functions of bile acids, EXCEPT:, with the following options: A: To promote bile flow, B: To solubilize cholesterol and phospholipid in the gallbladder, C: To enhance dietary lipid digestion and absorption, D: To promote bile secretion + ### Response: The primary functions of bile acids are (1) to promote bile flow, (2) to solubilize cholesterol and phospholipid in the gallbladder (3) to enhance dietary lipid digestion and absorption Ref: Harrison, E-18, P-2461 ### End" @@ -1841,6 +3293,13 @@ The primary functions of bile acids are (1) to promote bile flow, (2) to solubil Answer the following medical question: True about Chick-Martin test -, with the following options: A: Phenol is taken as standard, B: Test for efficacy of disinfectant, C: Disinfection in presence of organic matter, D: All of the above +### Response: +","Ans. is 'd' i.e., All of the above o There is no reliable test available to determine the efficacy of a disinfectant,o This is due to the number of parameters which influence disinfectant activity,o Traditionally in such tests phenol is taken as the standard,o Two important tests areRideal-Walker testSuspensions containing equal numbers of typhoid bacilli are submitted to action of varying concentration of phenol and of the disinfectant to be tested.The dilution of test disinfectant which sterilises the suspension in given time, divided by the corresponding dilution of phenol, is stated as the phenol coefficient of disinfectant (phenol-1).In this test disinfectant react directly without any organic matter being present.Chick-Martin testIn this, the disinfectant acts in the presence of organic matter (dried yeast or feces).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about Chick-Martin test -, with the following options: A: Phenol is taken as standard, B: Test for efficacy of disinfectant, C: Disinfection in presence of organic matter, D: All of the above + ### Response: Ans. is 'd' i.e., All of the above o There is no reliable test available to determine the efficacy of a disinfectant,o This is due to the number of parameters which influence disinfectant activity,o Traditionally in such tests phenol is taken as the standard,o Two important tests areRideal-Walker testSuspensions containing equal numbers of typhoid bacilli are submitted to action of varying concentration of phenol and of the disinfectant to be tested.The dilution of test disinfectant which sterilises the suspension in given time, divided by the corresponding dilution of phenol, is stated as the phenol coefficient of disinfectant (phenol-1).In this test disinfectant react directly without any organic matter being present.Chick-Martin testIn this, the disinfectant acts in the presence of organic matter (dried yeast or feces). ### End" @@ -1850,6 +3309,13 @@ Ans. is 'd' i.e., All of the above o There is no reliable test available to dete Answer the following medical question: Which of the following is responsible for the inactive state of Phosphorylase b?, with the following options: A: Insulin, B: cAMP, C: Calcium, D: ATP +### Response: +","Insulin increases the uptake of glucose leading to the increased formation of glucose 6-phosphate which is an inhibitor of phosphorylase kinase, which in-turn is needed for the activation of Phosphorylase b. Ref: Lippincott's Biochemistry, 5th Edition, Pages 132, 133, 311 ; Harper's Textbook of Biochemistry, 27th Edition, Pages 161, 162, 163","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is responsible for the inactive state of Phosphorylase b?, with the following options: A: Insulin, B: cAMP, C: Calcium, D: ATP + ### Response: Insulin increases the uptake of glucose leading to the increased formation of glucose 6-phosphate which is an inhibitor of phosphorylase kinase, which in-turn is needed for the activation of Phosphorylase b. Ref: Lippincott's Biochemistry, 5th Edition, Pages 132, 133, 311 ; Harper's Textbook of Biochemistry, 27th Edition, Pages 161, 162, 163 ### End" @@ -1859,6 +3325,13 @@ Insulin increases the uptake of glucose leading to the increased formation of gl Answer the following medical question: During post mortem period fracture of cervical spine is called?, with the following options: A: Pond fracture, B: Signature fracture, C: Undertakers fracture, D: Hangman's fracture +### Response: +",ANSWER: (C) Undertaker's fractureREF: Principles of Forensic Medicine and Toxicology Rajesh Bardale Page 130Rough handling of dead bodies by undertaker leads to fracture dislocation of C6-C7. This fracture dislocation is called as undertaker's fracture and may resembles antemortem injury.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: During post mortem period fracture of cervical spine is called?, with the following options: A: Pond fracture, B: Signature fracture, C: Undertakers fracture, D: Hangman's fracture + ### Response: ANSWER: (C) Undertaker's fractureREF: Principles of Forensic Medicine and Toxicology Rajesh Bardale Page 130Rough handling of dead bodies by undertaker leads to fracture dislocation of C6-C7. This fracture dislocation is called as undertaker's fracture and may resembles antemortem injury. ### End" @@ -1869,9 +3342,23 @@ ANSWER: (C) Undertaker's fractureREF: Principles of Forensic Medicine and Toxico Answer the following medical question: What is the most common complication of malaria in children, with the following options: A: Cerebral malaria, B: Respiratory distress, C: Severe malarial anemia, D: Hypogylcemia ### Response: -Most common serious complication of malaria is severe anemia. -### End" -196,"Below is an instruction that describes a task. Write a response that appropriately completes the request. +",Most common serious complication of malaria is severe anemia.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What is the most common complication of malaria in children, with the following options: A: Cerebral malaria, B: Respiratory distress, C: Severe malarial anemia, D: Hypogylcemia + +### Response: +Most common serious complication of malaria is severe anemia. +### End" +196,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ideal timing for elective repeat LSCS (ERCS) for a patient of previous 1 LSCS, without any other complicating factor would be?, with the following options: A: 37 weeks, B: 38 weeks, C: 39 weeks, D: At onset of labour + +### Response: +","Risk of perinatal death with ERCS (Elective Repeat Caesarean section) is extremely low but there is a small increase in perinatal respiratory morbidity, when ERCS is performed before 39 weeks. This morbidity can be reduced with pre op steroids.","Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: @@ -1886,6 +3373,13 @@ Risk of perinatal death with ERCS (Elective Repeat Caesarean section) is extreme Answer the following medical question: Pyramidalis is supplied by ?, with the following options: A: Subcostal nerve, B: Ilioinguinal nerve, C: Iliohypogastric nerve, D: Genitofemoral nerve +### Response: +","Ans. is 'a' i.e., Subcostal nerve","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pyramidalis is supplied by ?, with the following options: A: Subcostal nerve, B: Ilioinguinal nerve, C: Iliohypogastric nerve, D: Genitofemoral nerve + ### Response: Ans. is 'a' i.e., Subcostal nerve ### End" @@ -1895,6 +3389,13 @@ Ans. is 'a' i.e., Subcostal nerve Answer the following medical question: Cell shape and physical structure is provided by, with the following options: A: Cell membrane, B: Microtubules, C: Microflaments, D: Golgi apparatus +### Response: +","Microtubules are the largest cytoskeleton component. Cytoskeleton provides a structural framework for the cell. (REF TEXTBOOK OF MEDICAL PHYSIOLOGY GEETHA N 2 EDITION, PAGE NO - 9)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cell shape and physical structure is provided by, with the following options: A: Cell membrane, B: Microtubules, C: Microflaments, D: Golgi apparatus + ### Response: Microtubules are the largest cytoskeleton component. Cytoskeleton provides a structural framework for the cell. (REF TEXTBOOK OF MEDICAL PHYSIOLOGY GEETHA N 2 EDITION, PAGE NO - 9) ### End" @@ -1904,6 +3405,13 @@ Microtubules are the largest cytoskeleton component. Cytoskeleton provides a str Answer the following medical question: A lady wants LASIK surgery for her daughter. All the following are indications for performing LASIK surgery, EXCEPT:, with the following options: A: Age of 15 years, B: Myopia of 4 Diopters, C: Stable refraction for 1 year, D: Corneal thickness of 600 microns +### Response: +","Currently FDA has approved the use of LASIK only in people above 18 years of age. Indications for performing LASIK includes myopia, myopic astigmatism and hyperopia. Hyperopia ranging upto 6 diopters is correctible but at a higher level of attempted correction, predictability is reduced. Ref: Lasik: Fundamentals, Surgical Techniques, and Complications By Dimitri T. Aza, Page 92; Lasik - Principles and Techniques By Lucio Bur a Ho, Page 25.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A lady wants LASIK surgery for her daughter. All the following are indications for performing LASIK surgery, EXCEPT:, with the following options: A: Age of 15 years, B: Myopia of 4 Diopters, C: Stable refraction for 1 year, D: Corneal thickness of 600 microns + ### Response: Currently FDA has approved the use of LASIK only in people above 18 years of age. Indications for performing LASIK includes myopia, myopic astigmatism and hyperopia. Hyperopia ranging upto 6 diopters is correctible but at a higher level of attempted correction, predictability is reduced. Ref: Lasik: Fundamentals, Surgical Techniques, and Complications By Dimitri T. Aza, Page 92; Lasik - Principles and Techniques By Lucio Bur a Ho, Page 25. ### End" @@ -1913,6 +3421,13 @@ Currently FDA has approved the use of LASIK only in people above 18 years of age Answer the following medical question: Tissue of origin of Kaposi sarcoma is:, with the following options: A: Lymphoid, B: Vascular, C: Neural, D: Muscular +### Response: +","Kaposi sarcoma, a vascular tumor ,induced by HHV 8 Incidence of kaposi sarcoma increased dramatically during AIDS epidemic ,now decreased 10 fold with highly active retroviral therapy The lesions of KS are characterized by the proliferation of spindle-shaped cells that express markers of both endothelial cells and smooth muscle cells. There is also a profusion of slit like vascular spaces, suggesting that the lesions may arise from primitive mesenchymal precursors of vascular channels. KS lesions display chronic inflammatory cell infiltrates. Solid organ transplant (SOT) patients are highly susceptible to development of KS Kaposi's sarcoma is 550-1000 times M/C among SOT recipients than in normal population","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Tissue of origin of Kaposi sarcoma is:, with the following options: A: Lymphoid, B: Vascular, C: Neural, D: Muscular + ### Response: Kaposi sarcoma, a vascular tumor ,induced by HHV 8 Incidence of kaposi sarcoma increased dramatically during AIDS epidemic ,now decreased 10 fold with highly active retroviral therapy The lesions of KS are characterized by the proliferation of spindle-shaped cells that express markers of both endothelial cells and smooth muscle cells. There is also a profusion of slit like vascular spaces, suggesting that the lesions may arise from primitive mesenchymal precursors of vascular channels. KS lesions display chronic inflammatory cell infiltrates. Solid organ transplant (SOT) patients are highly susceptible to development of KS Kaposi's sarcoma is 550-1000 times M/C among SOT recipients than in normal population ### End" @@ -1922,6 +3437,13 @@ Kaposi sarcoma, a vascular tumor ,induced by HHV 8 Incidence of kaposi sarcoma i Answer the following medical question: Contribution of employees to ESIS corporation is______ % of wages.(MHPGM CET 2008), with the following options: A: 1.50%, B: 1.75%, C: 1.25%, D: 2% +### Response: +","Ans. b (1.75%) (Ref. Text book of PSM by Park 22nd/ 760; style=""font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif"">)ESI Act -1948: Benefit to both employee and employer.# Employer contributes 4.75% of total wage bill.0# While, the employee contributes 1.75% of wages.0# The state share on medical expenditure is l/8th and ESIC bears 7/8th cost of total medical care.0# Employees getting daily wages below Rs. 50 are exempted from payment of contribution.THE EMPLOYEES STATE INSURANCE ACT SCHEME# The Union Minister for Labour is chairman.# Scope- the ESIS Act extends to whole India.- Includes:* small power using factories with 10-19 persons and non-power using factories with >20 workers,* Service establishments like road transport, cinema houses, shops, restaurants, hotels and newspapers printing are now covered.# Which are the sectors excluded?- Excludes mines, plantation, railways and defence# What is the advantage to employer having ESIS scheme to its workers?- Exemption from the applicability of Workmen's Compensation Act 1923- Exemption from Maternity Benefit Act 1961- Exemption from payment of medical allowance to employees and their dependents or arranging for their medical care- Rebate under the Income Tax Act on contribution deposited in the ESI account- Healthy work-force# What are the benefits to workers?- Medical benefits,- Sickness benefits,- Disablement benefits,- Dependants benefits,- Funeral expenses and- Rehabilitation allowance","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Contribution of employees to ESIS corporation is______ % of wages.(MHPGM CET 2008), with the following options: A: 1.50%, B: 1.75%, C: 1.25%, D: 2% + ### Response: Ans. b (1.75%) (Ref. Text book of PSM by Park 22nd/ 760; style=""font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif"">)ESI Act -1948: Benefit to both employee and employer.# Employer contributes 4.75% of total wage bill.0# While, the employee contributes 1.75% of wages.0# The state share on medical expenditure is l/8th and ESIC bears 7/8th cost of total medical care.0# Employees getting daily wages below Rs. 50 are exempted from payment of contribution.THE EMPLOYEES STATE INSURANCE ACT SCHEME# The Union Minister for Labour is chairman.# Scope- the ESIS Act extends to whole India.- Includes:* small power using factories with 10-19 persons and non-power using factories with >20 workers,* Service establishments like road transport, cinema houses, shops, restaurants, hotels and newspapers printing are now covered.# Which are the sectors excluded?- Excludes mines, plantation, railways and defence# What is the advantage to employer having ESIS scheme to its workers?- Exemption from the applicability of Workmen's Compensation Act 1923- Exemption from Maternity Benefit Act 1961- Exemption from payment of medical allowance to employees and their dependents or arranging for their medical care- Rebate under the Income Tax Act on contribution deposited in the ESI account- Healthy work-force# What are the benefits to workers?- Medical benefits,- Sickness benefits,- Disablement benefits,- Dependants benefits,- Funeral expenses and- Rehabilitation allowance ### End" @@ -1931,6 +3453,13 @@ Ans. b (1.75%) (Ref. Text book of PSM by Park 22nd/ 760; style=""font-size: 1.04 Answer the following medical question: A 10–year old child is undergoing squint surgery. He suddenly developed increased heart rate, arrhythmia, high fever, metabolic and respiratory acidosis on arterial blood gases and elevation of end tidal CO2. Which of the following would be the first agent of choice in the management of this condition?, with the following options: A: Dantrolene, B: Paracetamol, C: Procainamide, D: Sodium bicarbonate +### Response: +",This is a case of malignant hyperthermia. Dantrolene is the drug of choice for malignant hyperthermia.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 10–year old child is undergoing squint surgery. He suddenly developed increased heart rate, arrhythmia, high fever, metabolic and respiratory acidosis on arterial blood gases and elevation of end tidal CO2. Which of the following would be the first agent of choice in the management of this condition?, with the following options: A: Dantrolene, B: Paracetamol, C: Procainamide, D: Sodium bicarbonate + ### Response: This is a case of malignant hyperthermia. Dantrolene is the drug of choice for malignant hyperthermia. ### End" @@ -1940,6 +3469,13 @@ This is a case of malignant hyperthermia. Dantrolene is the drug of choice for m Answer the following medical question: % of HIV infection in child of a HIV +ve mother is-, with the following options: A: 20-30%, B: 10-20%, C: 70-80%, D: 100% +### Response: +","Ans. is 'a' i.e., 20-30%","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: % of HIV infection in child of a HIV +ve mother is-, with the following options: A: 20-30%, B: 10-20%, C: 70-80%, D: 100% + ### Response: Ans. is 'a' i.e., 20-30% ### End" @@ -1949,6 +3485,13 @@ Ans. is 'a' i.e., 20-30% Answer the following medical question: NAD+ linked dehydrogenase is ?, with the following options: A: PDH, B: G6PD, C: Enoyl reductase, D: Succinate dehydrogenase +### Response: +","NAD/ -linked dehydrogenases Pyruvate dehydrogenase, isocitrate dehydrogenase, malate dehydrogenase, a-ketoglutarate dehydrogenase, glutamate dehydrogenase, glyceraldehyde-3-P dehydrogenase, lactate dehydrogenase, 3-hydroxy acyl CoA dehydrogenase, glycerol 3-P dehydrogenase (cytoplasmic).NADP+-linked dehydrogenases Glucose-6-P dehydrogenase, 6-Phosphogluconate dehydrogenase, 3-ketoacyl reductase, Enoyl reductase.FAD-linked dehydrogenases Succinate dehydrogenase, fatty acyl CoA dehydrogenase, glycerol-3P dehydrogenase (mitochondria]).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: NAD+ linked dehydrogenase is ?, with the following options: A: PDH, B: G6PD, C: Enoyl reductase, D: Succinate dehydrogenase + ### Response: NAD/ -linked dehydrogenases Pyruvate dehydrogenase, isocitrate dehydrogenase, malate dehydrogenase, a-ketoglutarate dehydrogenase, glutamate dehydrogenase, glyceraldehyde-3-P dehydrogenase, lactate dehydrogenase, 3-hydroxy acyl CoA dehydrogenase, glycerol 3-P dehydrogenase (cytoplasmic).NADP+-linked dehydrogenases Glucose-6-P dehydrogenase, 6-Phosphogluconate dehydrogenase, 3-ketoacyl reductase, Enoyl reductase.FAD-linked dehydrogenases Succinate dehydrogenase, fatty acyl CoA dehydrogenase, glycerol-3P dehydrogenase (mitochondria]). ### End" @@ -1958,6 +3501,13 @@ NAD/ -linked dehydrogenases Pyruvate dehydrogenase, isocitrate dehydrogenase, ma Answer the following medical question: A male child presents with repeated urinary infections and failure to gain weight. A MCU was carried out as shown in plate, most probable diagnosis is?, with the following options: A: Posterior urethral valve, B: Meatal stenosis, C: Bladder diverticula, D: Bladder polyp +### Response: +","a. Posterior urethral valve(Ref: Nelson's 20/e p 2562-2567, Ghai 8/e p 485-486)Voiding cystourethrogram in an infant with posterior urethral valves showing the dilation of the prostatic urethra and the transverse linear filling defect corresponding to the valves.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A male child presents with repeated urinary infections and failure to gain weight. A MCU was carried out as shown in plate, most probable diagnosis is?, with the following options: A: Posterior urethral valve, B: Meatal stenosis, C: Bladder diverticula, D: Bladder polyp + ### Response: a. Posterior urethral valve(Ref: Nelson's 20/e p 2562-2567, Ghai 8/e p 485-486)Voiding cystourethrogram in an infant with posterior urethral valves showing the dilation of the prostatic urethra and the transverse linear filling defect corresponding to the valves. ### End" @@ -1967,6 +3517,13 @@ a. Posterior urethral valve(Ref: Nelson's 20/e p 2562-2567, Ghai 8/e p 485-486)V Answer the following medical question: Benzopyrene change to carcinogen in animal occurs due to all except -, with the following options: A: Epoxide formation, B: p53 activation, C: Cytochrome C activation, D: By inducing metabolism of cyt p450 +### Response: +",. Cytochrome C activation,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Benzopyrene change to carcinogen in animal occurs due to all except -, with the following options: A: Epoxide formation, B: p53 activation, C: Cytochrome C activation, D: By inducing metabolism of cyt p450 + ### Response: . Cytochrome C activation ### End" @@ -1976,6 +3533,13 @@ Answer the following medical question: Benzopyrene change to carcinogen in anima Answer the following medical question: The test which detects ONLY P. falciparum amongst the following is -, with the following options: A: LDH, B: HRP-2, C: Thick blood film, D: QBC +### Response: +","Complicated P. falciparum malaria Severe malaria should be considered in any non-immune patient with a parasite count greater than 2% or with complications, and is a medical emergency (see Box 11.54). Management includes early and appropriate antimalarial chemotherapy, active treatment of complications, correction of fluid, electrolyte and acid-base balance, and avoidance of harmful ancillary treatments. The treatment of choice is intravenous aesunate. Late haemolysis is a treatment side-effect in some patients. Rectal administration of aesunate is also being developed to allow administration in remote rural areas. Quinine salt is the alternative. Exchange transfusion has not been tested in randomisedcontrolled trials but may be beneficial for non-immune patients with persisting high parasitaemias (>10% circulating erythrocytes). Rapid diagnostic tests (RDTs) are a critical tool for malaria diagnosis in most endemic areas. The most common RDT target for the detection of Plasmodium falciparum is the antigen histidine-rich protein 2 (HRP2). Indeed, parasites( specific for plasmodium falciparum) can delete the genes encoding these proteins and continue to transmit in communities. Ref Harrison20th edition pg 1034","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The test which detects ONLY P. falciparum amongst the following is -, with the following options: A: LDH, B: HRP-2, C: Thick blood film, D: QBC + ### Response: Complicated P. falciparum malaria Severe malaria should be considered in any non-immune patient with a parasite count greater than 2% or with complications, and is a medical emergency (see Box 11.54). Management includes early and appropriate antimalarial chemotherapy, active treatment of complications, correction of fluid, electrolyte and acid-base balance, and avoidance of harmful ancillary treatments. The treatment of choice is intravenous aesunate. Late haemolysis is a treatment side-effect in some patients. Rectal administration of aesunate is also being developed to allow administration in remote rural areas. Quinine salt is the alternative. Exchange transfusion has not been tested in randomisedcontrolled trials but may be beneficial for non-immune patients with persisting high parasitaemias (>10% circulating erythrocytes). Rapid diagnostic tests (RDTs) are a critical tool for malaria diagnosis in most endemic areas. The most common RDT target for the detection of Plasmodium falciparum is the antigen histidine-rich protein 2 (HRP2). Indeed, parasites( specific for plasmodium falciparum) can delete the genes encoding these proteins and continue to transmit in communities. Ref Harrison20th edition pg 1034 ### End" @@ -1985,6 +3549,13 @@ Complicated P. falciparum malaria Severe malaria should be considered in any non Answer the following medical question: Only hepatitis virus which can be cultured is, with the following options: A: >HAV, B: >HBV, C: >HDV, D: >HCV +### Response: +",HAV Hepatitis A virus can be grown in some human and simian cultures and it is the only human hepatitis virus which can be cultivated in vitro. It has also been cloned.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Only hepatitis virus which can be cultured is, with the following options: A: >HAV, B: >HBV, C: >HDV, D: >HCV + ### Response: HAV Hepatitis A virus can be grown in some human and simian cultures and it is the only human hepatitis virus which can be cultivated in vitro. It has also been cloned. ### End" @@ -1994,6 +3565,13 @@ HAV Hepatitis A virus can be grown in some human and simian cultures and it is t Answer the following medical question: A child presented with blunt abdominal trauma, the first investigation to be done is -, with the following options: A: USG, B: CT Scan, C: Complete Hemogram, D: Abdominal Xray +### Response: +","Ans. is 'a' i.e., USG o The prime aim of investigations in a pt. of blunt trauma abdomen is to determine whether the patient needs an exploratory laparotomy or not.# Previously DPL was the inv. of choice to determine the presence of intra-abdominal hemorrhage, but currently Ultrasound has replaced DPI.# U/S is the investigation of choice in both stable as well as unstable patients.Schwartz writes- ""Blunt abdominal trauma initially is evaluated by FAST examination in most major trauma centers, and this has largely supplanted DPL. FAST is not 100% sensitive, however, so diagnostic peritoneal aspiration is still advocated in hemodynamically unstable patients without a defined source of blood loss to rule out abdominal hemorrhage. Patients with fluid on FAST examination, considered a 'positive FAST', who do not have immediate indications for laparotomy and are hemodynamically stable undergo CT scanning to quantify their injuries.""","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A child presented with blunt abdominal trauma, the first investigation to be done is -, with the following options: A: USG, B: CT Scan, C: Complete Hemogram, D: Abdominal Xray + ### Response: Ans. is 'a' i.e., USG o The prime aim of investigations in a pt. of blunt trauma abdomen is to determine whether the patient needs an exploratory laparotomy or not.# Previously DPL was the inv. of choice to determine the presence of intra-abdominal hemorrhage, but currently Ultrasound has replaced DPI.# U/S is the investigation of choice in both stable as well as unstable patients.Schwartz writes- ""Blunt abdominal trauma initially is evaluated by FAST examination in most major trauma centers, and this has largely supplanted DPL. FAST is not 100% sensitive, however, so diagnostic peritoneal aspiration is still advocated in hemodynamically unstable patients without a defined source of blood loss to rule out abdominal hemorrhage. Patients with fluid on FAST examination, considered a 'positive FAST', who do not have immediate indications for laparotomy and are hemodynamically stable undergo CT scanning to quantify their injuries."" ### End" @@ -2003,6 +3581,13 @@ Ans. is 'a' i.e., USG o The prime aim of investigations in a pt. of blunt trauma Answer the following medical question: Diffuse multiple bone involvement, cafe-au-lait pigmentation and endocrine disturbances are the features of:, with the following options: A: McCune Albright syndrome, B: Jaffe's syndrome., C: Mazabrauds syndrome, D: All of the above +### Response: +","Polyostotic Fibrous dysplasia is of 2 types. In Jaffe type there is multiple bone involvement associated with cafe-au-lait spots. Extreme or diffuse multiple bone involvement, cafe-au-lait pigmentation, and endocrine disturbances are important features of McCune-Albright's syndrome. In polyostotic form, the curvature of femoral neck and proximal shaft of the femur increase markedly causing a shepherd's crook deformity.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Diffuse multiple bone involvement, cafe-au-lait pigmentation and endocrine disturbances are the features of:, with the following options: A: McCune Albright syndrome, B: Jaffe's syndrome., C: Mazabrauds syndrome, D: All of the above + ### Response: Polyostotic Fibrous dysplasia is of 2 types. In Jaffe type there is multiple bone involvement associated with cafe-au-lait spots. Extreme or diffuse multiple bone involvement, cafe-au-lait pigmentation, and endocrine disturbances are important features of McCune-Albright's syndrome. In polyostotic form, the curvature of femoral neck and proximal shaft of the femur increase markedly causing a shepherd's crook deformity. ### End" @@ -2012,6 +3597,13 @@ Polyostotic Fibrous dysplasia is of 2 types. In Jaffe type there is multiple bon Answer the following medical question: A most common complication of extracapsular cataract surgery is –, with the following options: A: Retinal detachment, B: Opacification of posterior capsule, C: Vitreous haemorrhage, D: None +### Response: +","""Opacification of the posterior capsule caused by the proliferation of cells in capsular bag remains the most frequent complication of ECCE and IOL surgery"". _____ Vajpayee","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A most common complication of extracapsular cataract surgery is –, with the following options: A: Retinal detachment, B: Opacification of posterior capsule, C: Vitreous haemorrhage, D: None + ### Response: ""Opacification of the posterior capsule caused by the proliferation of cells in capsular bag remains the most frequent complication of ECCE and IOL surgery"". _____ Vajpayee ### End" @@ -2021,6 +3613,13 @@ Answer the following medical question: A most common complication of extracapsul Answer the following medical question: Action of cholecystokinin include all of the following except:, with the following options: A: Contraction of gall bladder, B: Secretion of pancreatic juice rich in enzymes, C: Increases the secretion of enterokinase, D: Stimulated gastric emptying +### Response: +","Ans. D. Stimulated gastric emptying(1) Distribution: -a. CCK8 and CCK12 - secreted by duodenum and duodenum.b. CCK-4 - by enteric nerves and pancreatic nervesc. CCK58 and CCK8 - found in brain ~ especially in cerebral cortex, where involved in the regulation of food intake, anxiety and analgesia.(2) Function of CCK: -a. Contraction of gall bladderb. Secretion of the pancreatic juice rich in enzymec. Augments the action of secretin producing secretion an alkaline pancreatic juice.d. Inhibits gastric emptyinge. Exerts a trophic effect on the pancreas,f. Increases the secretion of enterokinaseg. Enhance the motility of the small intestine.h. Augments the contraction of pyloric sphincteri. CCK and gastrin - stimulate glucagon secretion.3) Secretion of CCK is increased by: -a. Contact of the intestinal mucosa with the products of digestion particularly peptides, and amino acidsb. By the presence of fatty acids containing more than 10 carbon atoms in duodenum.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Action of cholecystokinin include all of the following except:, with the following options: A: Contraction of gall bladder, B: Secretion of pancreatic juice rich in enzymes, C: Increases the secretion of enterokinase, D: Stimulated gastric emptying + ### Response: Ans. D. Stimulated gastric emptying(1) Distribution: -a. CCK8 and CCK12 - secreted by duodenum and duodenum.b. CCK-4 - by enteric nerves and pancreatic nervesc. CCK58 and CCK8 - found in brain ~ especially in cerebral cortex, where involved in the regulation of food intake, anxiety and analgesia.(2) Function of CCK: -a. Contraction of gall bladderb. Secretion of the pancreatic juice rich in enzymec. Augments the action of secretin producing secretion an alkaline pancreatic juice.d. Inhibits gastric emptyinge. Exerts a trophic effect on the pancreas,f. Increases the secretion of enterokinaseg. Enhance the motility of the small intestine.h. Augments the contraction of pyloric sphincteri. CCK and gastrin - stimulate glucagon secretion.3) Secretion of CCK is increased by: -a. Contact of the intestinal mucosa with the products of digestion particularly peptides, and amino acidsb. By the presence of fatty acids containing more than 10 carbon atoms in duodenum. ### End" @@ -2030,6 +3629,13 @@ Ans. D. Stimulated gastric emptying(1) Distribution: -a. CCK8 and CCK12 - secret Answer the following medical question: Cleidocranial dysplasia is due to a defect in which gene, with the following options: A: RANKL, B: RUNX2, C: HOXD13, D: COL2A1 +### Response: +","Loss-of-function mutations in the RUNX2 gene result in cleidocranial dysplasia, an autosomal dominant disorderIt is characterized by patent fontanelles, delayed closure of cranial sutures, Wormian bones (extra bones that occur within a cranial suture), delayed eruption of secondary teeth, primitive clavicles, and sho height.Robbins pathology 9e pg: 1184","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cleidocranial dysplasia is due to a defect in which gene, with the following options: A: RANKL, B: RUNX2, C: HOXD13, D: COL2A1 + ### Response: Loss-of-function mutations in the RUNX2 gene result in cleidocranial dysplasia, an autosomal dominant disorderIt is characterized by patent fontanelles, delayed closure of cranial sutures, Wormian bones (extra bones that occur within a cranial suture), delayed eruption of secondary teeth, primitive clavicles, and sho height.Robbins pathology 9e pg: 1184 ### End" @@ -2039,6 +3645,13 @@ Loss-of-function mutations in the RUNX2 gene result in cleidocranial dysplasia, Answer the following medical question: A patient aged 65 years, is diagnosed to have severe aplastic anemia. HLA compatible sibling is available. What is the BEST treatment option for this patient?, with the following options: A: Antithymocyte globulin followed by cyclosporine, B: A conventional bone marrow transplantation from the HLA identical sibling, C: A non-myeloablative bone marrow transplantation from the HLA identical sibling, D: Cyclosporine +### Response: +","Hematopoietic stem cell transplant from an HLA identical sibling is the best therapy for younger patient with aplastic anemia. Whereas older patients do better better with antithymocyte globulin given in combination with cyclosporine. In older patients transplantation is preferred if granulocytopenia is found. Increasing age and the severity of neutropenia are the most impoant factors weighing in the decision between transplant and immunosuppression in adults who have a matched family donor: For allogeneic transplant from fully matched siblings, long-term survival rates for children are approximately 90%. Transplant morbidity and moality are increased among adults, due mainly to the higher risk of chronic GVHD and serious infections. The standard regimen of ATG in combination with cyclosporine induces hematologic recovery in 60% of patients. Improvement in granulocyte number is generally apparent within 2 months of treatment. Ref: Harrison's Principles of Internal Medicine, 18e chapter 107, By Neal S. Young.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A patient aged 65 years, is diagnosed to have severe aplastic anemia. HLA compatible sibling is available. What is the BEST treatment option for this patient?, with the following options: A: Antithymocyte globulin followed by cyclosporine, B: A conventional bone marrow transplantation from the HLA identical sibling, C: A non-myeloablative bone marrow transplantation from the HLA identical sibling, D: Cyclosporine + ### Response: Hematopoietic stem cell transplant from an HLA identical sibling is the best therapy for younger patient with aplastic anemia. Whereas older patients do better better with antithymocyte globulin given in combination with cyclosporine. In older patients transplantation is preferred if granulocytopenia is found. Increasing age and the severity of neutropenia are the most impoant factors weighing in the decision between transplant and immunosuppression in adults who have a matched family donor: For allogeneic transplant from fully matched siblings, long-term survival rates for children are approximately 90%. Transplant morbidity and moality are increased among adults, due mainly to the higher risk of chronic GVHD and serious infections. The standard regimen of ATG in combination with cyclosporine induces hematologic recovery in 60% of patients. Improvement in granulocyte number is generally apparent within 2 months of treatment. Ref: Harrison's Principles of Internal Medicine, 18e chapter 107, By Neal S. Young. ### End" @@ -2048,6 +3661,13 @@ Hematopoietic stem cell transplant from an HLA identical sibling is the best the Answer the following medical question: Which of the following doesn't resemble panic attack?, with the following options: A: Hypoglycemia, B: GTCS, C: Myocardial infarction, D: Temporal lobe epilepsy +### Response: +","Hypoglyemia, MI and even temporal lobe epilepsy can produce symptoms of anxiety. But GTCS presents with only tonic - clonic seizures.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following doesn't resemble panic attack?, with the following options: A: Hypoglycemia, B: GTCS, C: Myocardial infarction, D: Temporal lobe epilepsy + ### Response: Hypoglyemia, MI and even temporal lobe epilepsy can produce symptoms of anxiety. But GTCS presents with only tonic - clonic seizures. ### End" @@ -2057,6 +3677,13 @@ Hypoglyemia, MI and even temporal lobe epilepsy can produce symptoms of anxiety. Answer the following medical question: Post translational modification of hydroxylysine and hydroxyproline is by, with the following options: A: Vit C, B: Vit K, C: Vit E, D: Vit D +### Response: +","Ans: a (Vit C) Ref: Vasudevan 4th ed/p.415Post translational modification:-* Gamma carboxylation of glutamic acid residues of prothrombin under the influence of vitamin K.* Hydroxylation of proline and lysine in collagen with the help of Vitamin C* C- terminal amidation and cyclisation of N-terminal amino acid of TRH* Phosphorylation of hydroxyl groups of serine, threonine or tyrosine by kinases.eg. glycogen phosphory- laseCotranslational glycosylation, whereby carbohydrates are attached to serine or Threonine residues* Methylation of lysine, Histidine and Arginine residues eg. Histones* Acylation eg.myelin proteolipid or transferring receptor.Post transcriptional modification:-* 5' capping: - this is the first of the processing reactions for hn RNA. 7-methyl guanosine is attached 'backwards' to the 5' terminal of the mRNA. This serves to stabilise the mRNA.* Addition of poly-A tail (3' polyadenylation): About 40-200 adenine are attached to the 3' end of the mRNA. These tails help to stabilize the mRNA and facilitate its exit from the nucleus. After mRNAenters the cytosol, the poly-A tail is gradually shortened.Removal of introns (splicing):- Introns or intervening sequences that do not code for protein are removed. This splicing occurs in the nucleus and serves to bring the exons together. After removal of the introns, the mature mRNA molecules leave the nucleus.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Post translational modification of hydroxylysine and hydroxyproline is by, with the following options: A: Vit C, B: Vit K, C: Vit E, D: Vit D + ### Response: Ans: a (Vit C) Ref: Vasudevan 4th ed/p.415Post translational modification:-* Gamma carboxylation of glutamic acid residues of prothrombin under the influence of vitamin K.* Hydroxylation of proline and lysine in collagen with the help of Vitamin C* C- terminal amidation and cyclisation of N-terminal amino acid of TRH* Phosphorylation of hydroxyl groups of serine, threonine or tyrosine by kinases.eg. glycogen phosphory- laseCotranslational glycosylation, whereby carbohydrates are attached to serine or Threonine residues* Methylation of lysine, Histidine and Arginine residues eg. Histones* Acylation eg.myelin proteolipid or transferring receptor.Post transcriptional modification:-* 5' capping: - this is the first of the processing reactions for hn RNA. 7-methyl guanosine is attached 'backwards' to the 5' terminal of the mRNA. This serves to stabilise the mRNA.* Addition of poly-A tail (3' polyadenylation): About 40-200 adenine are attached to the 3' end of the mRNA. These tails help to stabilize the mRNA and facilitate its exit from the nucleus. After mRNAenters the cytosol, the poly-A tail is gradually shortened.Removal of introns (splicing):- Introns or intervening sequences that do not code for protein are removed. This splicing occurs in the nucleus and serves to bring the exons together. After removal of the introns, the mature mRNA molecules leave the nucleus. ### End" @@ -2066,6 +3693,13 @@ Ans: a (Vit C) Ref: Vasudevan 4th ed/p.415Post translational modification:-* Gam Answer the following medical question: TLC is:, with the following options: A: 4.2 lt, B: 3lt, C: 5lt, D: 6lt +### Response: +","TLC: the volume of air left in the lung at the end of maximal inspiration. TLC= TV+IRv+ERV+Rv Ref: G K Pal textbook of Practical physiology 4th edition, page number: 158,159","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: TLC is:, with the following options: A: 4.2 lt, B: 3lt, C: 5lt, D: 6lt + ### Response: TLC: the volume of air left in the lung at the end of maximal inspiration. TLC= TV+IRv+ERV+Rv Ref: G K Pal textbook of Practical physiology 4th edition, page number: 158,159 ### End" @@ -2075,6 +3709,13 @@ TLC: the volume of air left in the lung at the end of maximal inspiration. TLC= Answer the following medical question: D cells of pancreas secrete: September 2012, with the following options: A: Glucagon, B: Insulin, C: Somatostatin, D: Pancreatic polypeptide +### Response: +","Ans. C i.e. SomatostatinPancreasIt is a dual-function gland, having features of both endocrine and exocrine glands.The pa of the pancreas with endocrine function is made up of approximately a million cell clusters called islets of Langerhans.Four main cell types exist in the islets. They can be classified by their secretion:- Alpha cells secrete glucagon (increase glucose in blood),- Beta cells secrete insulin (decrease glucose in blood),Delta cells secrete somatostatin (regulates/stops alpha and beta cells) and- PP cells, or gamma cells, secrete pancreatic polypeptide","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: D cells of pancreas secrete: September 2012, with the following options: A: Glucagon, B: Insulin, C: Somatostatin, D: Pancreatic polypeptide + ### Response: Ans. C i.e. SomatostatinPancreasIt is a dual-function gland, having features of both endocrine and exocrine glands.The pa of the pancreas with endocrine function is made up of approximately a million cell clusters called islets of Langerhans.Four main cell types exist in the islets. They can be classified by their secretion:- Alpha cells secrete glucagon (increase glucose in blood),- Beta cells secrete insulin (decrease glucose in blood),Delta cells secrete somatostatin (regulates/stops alpha and beta cells) and- PP cells, or gamma cells, secrete pancreatic polypeptide ### End" @@ -2084,6 +3725,13 @@ Ans. C i.e. SomatostatinPancreasIt is a dual-function gland, having features of Answer the following medical question: Transposons are, with the following options: A: Jumping genes, B: Cosmid, C: Episome, D: None +### Response: +","Transposons are segments of DNA that can move around to different positions in the genome of a single cell. In the process, they may cause mutations increase (or decrease) the amount of DNA in the genome of the cell, and if the cell is the precursor of a gamete, in the genomes of any descendants. These mobile segments of DNA are sometimes called ""jumping genes"". Ref-Sathyanarayana 4/e","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Transposons are, with the following options: A: Jumping genes, B: Cosmid, C: Episome, D: None + ### Response: Transposons are segments of DNA that can move around to different positions in the genome of a single cell. In the process, they may cause mutations increase (or decrease) the amount of DNA in the genome of the cell, and if the cell is the precursor of a gamete, in the genomes of any descendants. These mobile segments of DNA are sometimes called ""jumping genes"". Ref-Sathyanarayana 4/e ### End" @@ -2093,6 +3741,13 @@ Transposons are segments of DNA that can move around to different positions in t Answer the following medical question: A neurosurgeon performs a surgical resection of a rare meningeal tumor in the sacral region. He tries to avoid an injury of the nerve that arises from the lumbosacral plexus and remains within the abdominal or pelvic cavity. To which of the following nerves should he pay paicular attention, with the following options: A: Ilioinguinal nerve, B: Genitofemoral nerve, C: Lumbosacral trunk, D: Femoral nerve +### Response: +",The Lumbosacral trunk is formed by pa of the ventral ramus of the fouh lumbar nerve and the ventral ramus of the fifth lumbar nerve. This trunk contributes to the formation of the sacral plexus by joining the ventral ramus of the first sacral nerve in the pelvic cavity and does not leave the pelvic cavity. All other nerves leave the abdominal and pelvic cavities. other options are branches of only lumbar plexus no sacral involvement,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A neurosurgeon performs a surgical resection of a rare meningeal tumor in the sacral region. He tries to avoid an injury of the nerve that arises from the lumbosacral plexus and remains within the abdominal or pelvic cavity. To which of the following nerves should he pay paicular attention, with the following options: A: Ilioinguinal nerve, B: Genitofemoral nerve, C: Lumbosacral trunk, D: Femoral nerve + ### Response: The Lumbosacral trunk is formed by pa of the ventral ramus of the fouh lumbar nerve and the ventral ramus of the fifth lumbar nerve. This trunk contributes to the formation of the sacral plexus by joining the ventral ramus of the first sacral nerve in the pelvic cavity and does not leave the pelvic cavity. All other nerves leave the abdominal and pelvic cavities. other options are branches of only lumbar plexus no sacral involvement ### End" @@ -2102,6 +3757,13 @@ The Lumbosacral trunk is formed by pa of the ventral ramus of the fouh lumbar ne Answer the following medical question: Sectoral sign is positive in ?, with the following options: A: Avascular necrosis of femur head, B: Osteoahritis of hip, C: Protrusio acetabuli, D: Slipped capital femoral epiphyses +### Response: +","Ans. is 'a' i.e., Avascular necrosis of femur head Clinical features of AVN In the earlier stages of AVN, the patient is asymptomatic, and by the time patient presents, the lesion is well advanced. Common histories patient gives (Any of the following) : - i) Dislocation of Hip ii) Alcoholism iii) Steroid intake for any disorder iv) Nephrotic syndrome Pain is a common complaint. Pain is felt in the grain and may radiate to knee. Decreased range of motion especially internal rotation followed by abduction. Sectoral sign or Differential rotation : - Internal rotation is possible in extended position of hip, but as seen as the hip is flexed to 90deg no internal rotation is possible. This is the characteristic sign of AVN. o Limp with antalgic gait. Trendelenberg's test positive.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Sectoral sign is positive in ?, with the following options: A: Avascular necrosis of femur head, B: Osteoahritis of hip, C: Protrusio acetabuli, D: Slipped capital femoral epiphyses + ### Response: Ans. is 'a' i.e., Avascular necrosis of femur head Clinical features of AVN In the earlier stages of AVN, the patient is asymptomatic, and by the time patient presents, the lesion is well advanced. Common histories patient gives (Any of the following) : - i) Dislocation of Hip ii) Alcoholism iii) Steroid intake for any disorder iv) Nephrotic syndrome Pain is a common complaint. Pain is felt in the grain and may radiate to knee. Decreased range of motion especially internal rotation followed by abduction. Sectoral sign or Differential rotation : - Internal rotation is possible in extended position of hip, but as seen as the hip is flexed to 90deg no internal rotation is possible. This is the characteristic sign of AVN. o Limp with antalgic gait. Trendelenberg's test positive. ### End" @@ -2111,6 +3773,13 @@ Ans. is 'a' i.e., Avascular necrosis of femur head Clinical features of AVN In t Answer the following medical question: Which of the following is not trophoblast related:, with the following options: A: Choriocarcinoma, B: H. mole, C: Placental Site tropboblast tumor, D: Chorioangioma +### Response: +","Ans-D* Chorioangiomas the most common tumor of the placenta* It is a benign vascular tumor of placental origin and is usually found incidentally.* They are thought to arise as a malformation of the primitive angioblastic tissue of the placenta.* The angiomas are perfused by the fetal circulation. Therefore when they are large, they may represent a significant impediment to fetal cardiac activity.* This angiomasmay also sequester platelets and can, in turn, give a fetal thrombocytopenia* They can also cause the increase in levels of maternal serum alpha-fetoprotein (MSAFP) and may prompt sonographic evaluation.Modified WHO Classification of Gestational Trophoblastic DiseaseMolar lesionsNonpolar lesions* Hydatidiform mole# Complete# Partial* Invasive mole* Choriocarcinoma* Placental site trophoblastic tumor* Epithelioid trophoblastic tumor* Choriocarcinoma: A morphologic term applied to a highly malignant type of trophoblastic neoplasia in which both the cytotrophoblast and syncytiotrophoblast grow in a malignant fashion.# Chorionic villi are absent. These tumors tend to be hemorrhagic and necrotic* H. Mole: A placental abnormality involving swollen placental villi and trophoblastic hyperplasia with loss of fetal blood vessels. There are two types: partial and complete.# Partial: A molar pregnancy with swelling of all placental villi. Fetal tissues are absent.# Complete: A molar pregnancy with some normal and some swollen villi plus fetal, cord, and/or amniotic membrane elements.* Placental-Site Trophoblastic Tumor A rare type of GTD arising in the uterus that secretes human placental lactogen and human chorionic gonadotrophin (HCG).* NOTE: Persistent abnormal bleeding following normal pregnancy, abortion, or ectopic pregnancy should lead to a consideration of the diagnosis of GTD. The finding of pulmonary nodules on chest radiograph after normal pregnancy suggests GTD.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is not trophoblast related:, with the following options: A: Choriocarcinoma, B: H. mole, C: Placental Site tropboblast tumor, D: Chorioangioma + ### Response: Ans-D* Chorioangiomas the most common tumor of the placenta* It is a benign vascular tumor of placental origin and is usually found incidentally.* They are thought to arise as a malformation of the primitive angioblastic tissue of the placenta.* The angiomas are perfused by the fetal circulation. Therefore when they are large, they may represent a significant impediment to fetal cardiac activity.* This angiomasmay also sequester platelets and can, in turn, give a fetal thrombocytopenia* They can also cause the increase in levels of maternal serum alpha-fetoprotein (MSAFP) and may prompt sonographic evaluation.Modified WHO Classification of Gestational Trophoblastic DiseaseMolar lesionsNonpolar lesions* Hydatidiform mole# Complete# Partial* Invasive mole* Choriocarcinoma* Placental site trophoblastic tumor* Epithelioid trophoblastic tumor* Choriocarcinoma: A morphologic term applied to a highly malignant type of trophoblastic neoplasia in which both the cytotrophoblast and syncytiotrophoblast grow in a malignant fashion.# Chorionic villi are absent. These tumors tend to be hemorrhagic and necrotic* H. Mole: A placental abnormality involving swollen placental villi and trophoblastic hyperplasia with loss of fetal blood vessels. There are two types: partial and complete.# Partial: A molar pregnancy with swelling of all placental villi. Fetal tissues are absent.# Complete: A molar pregnancy with some normal and some swollen villi plus fetal, cord, and/or amniotic membrane elements.* Placental-Site Trophoblastic Tumor A rare type of GTD arising in the uterus that secretes human placental lactogen and human chorionic gonadotrophin (HCG).* NOTE: Persistent abnormal bleeding following normal pregnancy, abortion, or ectopic pregnancy should lead to a consideration of the diagnosis of GTD. The finding of pulmonary nodules on chest radiograph after normal pregnancy suggests GTD. ### End" @@ -2120,6 +3789,13 @@ Ans-D* Chorioangiomas the most common tumor of the placenta* It is a benign vasc Answer the following medical question: The following features of panophthalmitis differentiate it from endophthalmitis except:, with the following options: A: Presence of pus in the anterior chamber, B: Proptosis, C: Limited and painful ocular movements, D: Complete loss of vision +### Response: +",Ans. Presence of pus in the anterior chamber,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The following features of panophthalmitis differentiate it from endophthalmitis except:, with the following options: A: Presence of pus in the anterior chamber, B: Proptosis, C: Limited and painful ocular movements, D: Complete loss of vision + ### Response: Ans. Presence of pus in the anterior chamber ### End" @@ -2129,6 +3805,14 @@ Ans. Presence of pus in the anterior chamber Answer the following medical question: Radiographic finding of floating teeth can be seen in -, with the following options: A: Ectodermal dysplasis, B: Cleido cranial dysplasia, C: Osteopetrosis, D: Histiocytosis - X +### Response: +","On radiographic examination of mandible, erosion of the bony alveoli around the teeth, so that they seem to be floating in space. +Seen in histiocytosis X.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Radiographic finding of floating teeth can be seen in -, with the following options: A: Ectodermal dysplasis, B: Cleido cranial dysplasia, C: Osteopetrosis, D: Histiocytosis - X + ### Response: On radiographic examination of mandible, erosion of the bony alveoli around the teeth, so that they seem to be floating in space. Seen in histiocytosis X. @@ -2139,6 +3823,13 @@ Seen in histiocytosis X. Answer the following medical question: True about the treatment of nocturnal enuresis -, with the following options: A: Imipramine, B: CPZ, C: Alprazolam, D: Haloperidol +### Response: +","Behavioral therapy is the treatment of choice for nocturnal enuresis. If behavioral therapy fails, Desmopressin (DOC) or imipramine can be used.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about the treatment of nocturnal enuresis -, with the following options: A: Imipramine, B: CPZ, C: Alprazolam, D: Haloperidol + ### Response: Behavioral therapy is the treatment of choice for nocturnal enuresis. If behavioral therapy fails, Desmopressin (DOC) or imipramine can be used. ### End" @@ -2148,6 +3839,13 @@ Behavioral therapy is the treatment of choice for nocturnal enuresis. If behavio Answer the following medical question: Proteus antigen cross react with which of the following organism?, with the following options: A: Klebsiella, B: Chlamydiae, C: Rickettsiae, D: E.coli +### Response: +","Proteus antigen cross react with Rickettsiae. Proteus antigens (OX19, OX2 & OXK strains) cross reacts with group specific lipopolysaccharide rickettsial antigens. This is the basis of Weil Felix (heterophile agglutination) test. It is used for diagnosis of rickettsial infections. The test detects anti-rickettsial antibodies that cross-react with O antigens of ceain non motile strains of Proteus.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Proteus antigen cross react with which of the following organism?, with the following options: A: Klebsiella, B: Chlamydiae, C: Rickettsiae, D: E.coli + ### Response: Proteus antigen cross react with Rickettsiae. Proteus antigens (OX19, OX2 & OXK strains) cross reacts with group specific lipopolysaccharide rickettsial antigens. This is the basis of Weil Felix (heterophile agglutination) test. It is used for diagnosis of rickettsial infections. The test detects anti-rickettsial antibodies that cross-react with O antigens of ceain non motile strains of Proteus. ### End" @@ -2157,6 +3855,13 @@ Proteus antigen cross react with Rickettsiae. Proteus antigens (OX19, OX2 & OXK Answer the following medical question: Name the structure labelled D, with the following options: A: Right common carotid aery, B: Right subclan aery, C: Brachiocephalic trunk, D: Left subclan aery +### Response: +","(a) Right common carotid aery(b) Right subclan aery(c) Brachiocephalic trunk(d) Left subclan aery(e) Left common carotid aeryAngiography may be performed using CT, MRI or conventional angiography with a catheter. The catheter can be seen on this image in the aoic arch. Normal variants occur in the great vessels so it is impoant to understand normal anatomy to be able to identify any abnormality. An estimated 65% people have the 'normal' anatomy described in textbooks. The commonest anomaly is seen in 5% where the left veebral aery arises directly from the aoic arch, between the origins of the left common carotid and left subclan aeries.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Name the structure labelled D, with the following options: A: Right common carotid aery, B: Right subclan aery, C: Brachiocephalic trunk, D: Left subclan aery + ### Response: (a) Right common carotid aery(b) Right subclan aery(c) Brachiocephalic trunk(d) Left subclan aery(e) Left common carotid aeryAngiography may be performed using CT, MRI or conventional angiography with a catheter. The catheter can be seen on this image in the aoic arch. Normal variants occur in the great vessels so it is impoant to understand normal anatomy to be able to identify any abnormality. An estimated 65% people have the 'normal' anatomy described in textbooks. The commonest anomaly is seen in 5% where the left veebral aery arises directly from the aoic arch, between the origins of the left common carotid and left subclan aeries. ### End" @@ -2166,6 +3871,13 @@ Answer the following medical question: Name the structure labelled D, with the f Answer the following medical question: Which of the following does not pass through the primitive umbilical ring?, with the following options: A: Allantois, B: Amnion, C: Yolk sac, D: Connecting stalk +### Response: +","The amnion does not pass through the primitive umbilical ring. As craniocaudal folding occurs, the amnion becomes the outer covering of the umbilical cord.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following does not pass through the primitive umbilical ring?, with the following options: A: Allantois, B: Amnion, C: Yolk sac, D: Connecting stalk + ### Response: The amnion does not pass through the primitive umbilical ring. As craniocaudal folding occurs, the amnion becomes the outer covering of the umbilical cord. ### End" @@ -2175,6 +3887,13 @@ The amnion does not pass through the primitive umbilical ring. As craniocaudal f Answer the following medical question: A female on steroids developed hip pain. Investigations show the evidence of avascular necrosis of head of the femur. The most common fracture site in this patient will be:, with the following options: A: Subcapital region, B: Transcervical region, C: Subchondral region, D: Trochanteric region +### Response: +","Osteonecrosis of the femoral head can occur in young patients. Risk factors include steroid use, alcoholism, trauma, marrow-replacing diseases (such as Gaucher disease), high-dose radiation treatment, and hypercoagulable states (sickle cell disease, hypofibrinolysis, thrombophilia, protein S and C deficiencies). The disease course consists of decreased blood flow to the femoral head, resulting in osteonecrosis, subchondral fracture, and eventually collapse. Subchondral fracture of the hip is most clearly seen on the lateral radiograph. Also know: Avascular necrosis of the hip may be classified according the Ficat grading system: Type I (no radiographic signs of avascular necrosis) Type II (changes of the femoral head subchondral bone without collapse) Type III (subchondral fracture with collapse) Type IV (collapse of the femoral head with changes on the acetabular side) Ref: Srinivasan R.C., Tolhurst S., Vanderhave K.L. (2010). Chapter 40. Ohopedic Surgery. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A female on steroids developed hip pain. Investigations show the evidence of avascular necrosis of head of the femur. The most common fracture site in this patient will be:, with the following options: A: Subcapital region, B: Transcervical region, C: Subchondral region, D: Trochanteric region + ### Response: Osteonecrosis of the femoral head can occur in young patients. Risk factors include steroid use, alcoholism, trauma, marrow-replacing diseases (such as Gaucher disease), high-dose radiation treatment, and hypercoagulable states (sickle cell disease, hypofibrinolysis, thrombophilia, protein S and C deficiencies). The disease course consists of decreased blood flow to the femoral head, resulting in osteonecrosis, subchondral fracture, and eventually collapse. Subchondral fracture of the hip is most clearly seen on the lateral radiograph. Also know: Avascular necrosis of the hip may be classified according the Ficat grading system: Type I (no radiographic signs of avascular necrosis) Type II (changes of the femoral head subchondral bone without collapse) Type III (subchondral fracture with collapse) Type IV (collapse of the femoral head with changes on the acetabular side) Ref: Srinivasan R.C., Tolhurst S., Vanderhave K.L. (2010). Chapter 40. Ohopedic Surgery. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e. ### End" @@ -2184,6 +3903,13 @@ Osteonecrosis of the femoral head can occur in young patients. Risk factors incl Answer the following medical question: All of the following effects the height of block in spinal anesthesia except, with the following options: A: Age, B: Height, C: Sex, D: Weight +### Response: +","Explanation The gender of the patient is the factor that least affects the height of the neuraxial block, among the options given. Gender can affect the block height theoretically. The density of CSF is lower in women compared with men. Although this may affect relative baricity of local anesthetics, the clinical variation in the spread is probably unimpoant. Hence this is the best answer to choose from the above options. Other Options : Age: Higher anesthetic levels are achieved in the elderly for a given dosage of spinal anesthetic. Age-related decreases in CSF volume and the higher sensitivity of the nerve roots to local anesthetic are the possible reasons. Pregnancy: Increased intraabdominal pressure or conditions that cause engorgement of the epidural veins, decrease CSF volume and thus increase block height. This includes conditions such as pregnancy, ascites, and large abdominal tumors. Height: Within the range of ""normal-sized"" adults, patient height does not seem to affect the spread of spinal anesthesia. But extremes of height can affect the block height.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following effects the height of block in spinal anesthesia except, with the following options: A: Age, B: Height, C: Sex, D: Weight + ### Response: Explanation The gender of the patient is the factor that least affects the height of the neuraxial block, among the options given. Gender can affect the block height theoretically. The density of CSF is lower in women compared with men. Although this may affect relative baricity of local anesthetics, the clinical variation in the spread is probably unimpoant. Hence this is the best answer to choose from the above options. Other Options : Age: Higher anesthetic levels are achieved in the elderly for a given dosage of spinal anesthetic. Age-related decreases in CSF volume and the higher sensitivity of the nerve roots to local anesthetic are the possible reasons. Pregnancy: Increased intraabdominal pressure or conditions that cause engorgement of the epidural veins, decrease CSF volume and thus increase block height. This includes conditions such as pregnancy, ascites, and large abdominal tumors. Height: Within the range of ""normal-sized"" adults, patient height does not seem to affect the spread of spinal anesthesia. But extremes of height can affect the block height. ### End" @@ -2193,6 +3919,13 @@ Explanation The gender of the patient is the factor that least affects the heigh Answer the following medical question: Empirical antibiotic treatment in a suspected case of pneumonia who has received no antibiotics in the past three months to be managed on outpatient basis is -, with the following options: A: Oral Clarithromycin, B: Oral fluoroquinolone, C: Oral beta lactam with injectable aminoglycoside, D: Oral linezolid +### Response: +","Ans. is 'a' i.e., Oral Clarithromycin * As per the recommendations for empirical antibiotic management oral clarithromycin is the Empirical antibiotic treatment in a suspected case of pneumonia who has received no antibiotics in the past three months to be managed on outpatient basis.Empirical Antibotic Treatment of Community-Acquired PneumoniaOutpatientsPreviousuly healthy and no antibiotics in past 3 months* A macrolide (clarithromycin (500 mg PO bid) or azithromycin (500 mg PO once, then 250mg qd) or* Doxycycline (100mg PO bid)Comorbidities or antibiotics in past 3 months: select an alternative from a different class.* A respiratory fluoroquinolone or* A b-lactam .* A b-lactam plus a macrolide Inpatients, ICU* A b-lactam (cefotaxime (1-2 g IV q8h), ceftriaxone (2g IV qd), ampicilin-sulbactam (2g IV 48h)] plus* Azithromycin or a fluoroquinolone (as listed above for inpatients, non-ICU)Special ConcernsIf Pseudomonas is a consideration* An antipneumococal, antipseudomonal b - lactam (piperacilin/tazobactam (4-5 g IV q6h), meropenem (lg IV q8h)] plus either ciprofloxacin (400 mg IV q 12h) or levofloxacin (750mg IV qd)* The above b-lactams plus an aminoglycoside * The above b-lactams plus an aminoglycoside plus an antipneumococcal fluoroquinoloneIf CA-MRSA is a consideration* Add linezolid (600 mg IV q 12h) or vancomycin (lg IV q 12h).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Empirical antibiotic treatment in a suspected case of pneumonia who has received no antibiotics in the past three months to be managed on outpatient basis is -, with the following options: A: Oral Clarithromycin, B: Oral fluoroquinolone, C: Oral beta lactam with injectable aminoglycoside, D: Oral linezolid + ### Response: Ans. is 'a' i.e., Oral Clarithromycin * As per the recommendations for empirical antibiotic management oral clarithromycin is the Empirical antibiotic treatment in a suspected case of pneumonia who has received no antibiotics in the past three months to be managed on outpatient basis.Empirical Antibotic Treatment of Community-Acquired PneumoniaOutpatientsPreviousuly healthy and no antibiotics in past 3 months* A macrolide (clarithromycin (500 mg PO bid) or azithromycin (500 mg PO once, then 250mg qd) or* Doxycycline (100mg PO bid)Comorbidities or antibiotics in past 3 months: select an alternative from a different class.* A respiratory fluoroquinolone or* A b-lactam .* A b-lactam plus a macrolide Inpatients, ICU* A b-lactam (cefotaxime (1-2 g IV q8h), ceftriaxone (2g IV qd), ampicilin-sulbactam (2g IV 48h)] plus* Azithromycin or a fluoroquinolone (as listed above for inpatients, non-ICU)Special ConcernsIf Pseudomonas is a consideration* An antipneumococal, antipseudomonal b - lactam (piperacilin/tazobactam (4-5 g IV q6h), meropenem (lg IV q8h)] plus either ciprofloxacin (400 mg IV q 12h) or levofloxacin (750mg IV qd)* The above b-lactams plus an aminoglycoside * The above b-lactams plus an aminoglycoside plus an antipneumococcal fluoroquinoloneIf CA-MRSA is a consideration* Add linezolid (600 mg IV q 12h) or vancomycin (lg IV q 12h). ### End" @@ -2202,6 +3935,13 @@ Ans. is 'a' i.e., Oral Clarithromycin * As per the recommendations for empirical Answer the following medical question: Temperature and timing in autoclaving -, with the following options: A: 121degC for 15 minutes, B: 160degC for 45 minutes, C: 190degC for 1.5 minutes, D: 134degC for 15 minutes +### Response: +","Ans. is 'a' i.e., 121degC for 15 minutes MethodTemperature (degC)Holding time (in minutes)Autoclave12112613415103Hot air oven16017018019045187-5T5","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Temperature and timing in autoclaving -, with the following options: A: 121degC for 15 minutes, B: 160degC for 45 minutes, C: 190degC for 1.5 minutes, D: 134degC for 15 minutes + ### Response: Ans. is 'a' i.e., 121degC for 15 minutes MethodTemperature (degC)Holding time (in minutes)Autoclave12112613415103Hot air oven16017018019045187-5T5 ### End" @@ -2211,6 +3951,13 @@ Ans. is 'a' i.e., 121degC for 15 minutes MethodTemperature (degC)Holding time (i Answer the following medical question: True about proto oncogene, with the following options: A: Impoant for normal cell growth, B: May get conveed into oncogene, C: C much over expression causes lymphoma, D: Their mutation causes retinoblastomaactiv +### Response: +","Ref Robbins 9/e p284 A,B,C options are answers A proto-oncogene is a normal gene that could become an oncogene due to mutations or increased expression. Proto-oncogenes code for proteins that help to regulate the cell growth and differentiation. Proto-oncogenes are often involved in signal transduction and execution of mitogenic signals, usually through their protein products. Upon acquiring an activating mutation, a proto-oncogene becomes a tumor-inducing agent, an oncogene.Examples of proto-oncogenes include RAS, WNT, MYC, ERK, and TRK. The MYC gene is implicated in Burkitt's lymphoma, which stas when a chromosomal translocation moves an enhancer sequence within the vicinity of the MYC gene. The MYC gene codes for widely used transcription factors. When the enhancer sequence is wrongly placed, these transcription factors are produced at much higher rates. Another example of an oncogene is the Bcr-Abl gene found on the Philadelphia chromosome, a piece of genetic material seen in Chronic Myelogenous Leukemia caused by the translocation of pieces from chromosomes 9 and 22. Bcr-Abl codes for a tyrosine kinase, which is constitutively active, leading to uncontrolled cell proliferation.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about proto oncogene, with the following options: A: Impoant for normal cell growth, B: May get conveed into oncogene, C: C much over expression causes lymphoma, D: Their mutation causes retinoblastomaactiv + ### Response: Ref Robbins 9/e p284 A,B,C options are answers A proto-oncogene is a normal gene that could become an oncogene due to mutations or increased expression. Proto-oncogenes code for proteins that help to regulate the cell growth and differentiation. Proto-oncogenes are often involved in signal transduction and execution of mitogenic signals, usually through their protein products. Upon acquiring an activating mutation, a proto-oncogene becomes a tumor-inducing agent, an oncogene.Examples of proto-oncogenes include RAS, WNT, MYC, ERK, and TRK. The MYC gene is implicated in Burkitt's lymphoma, which stas when a chromosomal translocation moves an enhancer sequence within the vicinity of the MYC gene. The MYC gene codes for widely used transcription factors. When the enhancer sequence is wrongly placed, these transcription factors are produced at much higher rates. Another example of an oncogene is the Bcr-Abl gene found on the Philadelphia chromosome, a piece of genetic material seen in Chronic Myelogenous Leukemia caused by the translocation of pieces from chromosomes 9 and 22. Bcr-Abl codes for a tyrosine kinase, which is constitutively active, leading to uncontrolled cell proliferation. ### End" @@ -2220,6 +3967,13 @@ Ref Robbins 9/e p284 A,B,C options are answers A proto-oncogene is a normal gene Answer the following medical question: Carey coombs murmur, which is false –, with the following options: A: Delayed diastolic murmur, B: Seen in rheumatic fever, C: Can be associated with A.R., D: Low pitched murmur +### Response: +","A short, mid-diastolic murmur is rarely heard during an episode of acute rheumatic fever (Carey-Coombs murmur) and probably is due to flow through an edematous mitral valve. An opening snap is not present in the acute phase, and the murmur dissipates with resolution of the acute attack. Complete heart block with dyssynchronous atrial and ventricular activation may be associated with intermittent mid- to late diastolic murmurs if atrial contraction occurs when the mitral valve is partially closed. Mid-diastolic murmurs indicative of increased tricuspid valve flow can occur with severe, isolated TR and with large ASDs and significant left-to-right shunting. Other signs of an ASD are present ( Chap. 236 ), including fixed splitting of S 2 and a mid-systolic murmur at the mid- to upper left sternal border. TTE is indicated for evaluation of a patient with a mid- to late diastolic murmur.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Carey coombs murmur, which is false –, with the following options: A: Delayed diastolic murmur, B: Seen in rheumatic fever, C: Can be associated with A.R., D: Low pitched murmur + ### Response: A short, mid-diastolic murmur is rarely heard during an episode of acute rheumatic fever (Carey-Coombs murmur) and probably is due to flow through an edematous mitral valve. An opening snap is not present in the acute phase, and the murmur dissipates with resolution of the acute attack. Complete heart block with dyssynchronous atrial and ventricular activation may be associated with intermittent mid- to late diastolic murmurs if atrial contraction occurs when the mitral valve is partially closed. Mid-diastolic murmurs indicative of increased tricuspid valve flow can occur with severe, isolated TR and with large ASDs and significant left-to-right shunting. Other signs of an ASD are present ( Chap. 236 ), including fixed splitting of S 2 and a mid-systolic murmur at the mid- to upper left sternal border. TTE is indicated for evaluation of a patient with a mid- to late diastolic murmur. ### End" @@ -2229,6 +3983,13 @@ A short, mid-diastolic murmur is rarely heard during an episode of acute rheumat Answer the following medical question: Aminopeptidase is elevated in obstruction of:, with the following options: A: Ureter, B: Urethra, C: CBD, D: Bladder +### Response: +","Leucine Aminopeptidase: Increased Leucine aminopeptidase (LAP) activity is seen in: Carcinoma of the pancreas, choledocholithiasis, acute pancreatitis Viral hepatitis. Cirrhosis, carcinoma with liver metastasis In common bile duct obstruction,whether due to carcinoma pancreas or choledocholithiasis, the elevated serum LAP levels returned to normal following relief of the obstruction. This is in agreement with the hypothesis that the increased serum LAP activity in these conditions is the result of bile duct obstrcution Ref: American journal of Gastroenterology Dec1963 Vol. 41 Issue 6, pgno: 620","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Aminopeptidase is elevated in obstruction of:, with the following options: A: Ureter, B: Urethra, C: CBD, D: Bladder + ### Response: Leucine Aminopeptidase: Increased Leucine aminopeptidase (LAP) activity is seen in: Carcinoma of the pancreas, choledocholithiasis, acute pancreatitis Viral hepatitis. Cirrhosis, carcinoma with liver metastasis In common bile duct obstruction,whether due to carcinoma pancreas or choledocholithiasis, the elevated serum LAP levels returned to normal following relief of the obstruction. This is in agreement with the hypothesis that the increased serum LAP activity in these conditions is the result of bile duct obstrcution Ref: American journal of Gastroenterology Dec1963 Vol. 41 Issue 6, pgno: 620 ### End" @@ -2238,6 +3999,13 @@ Leucine Aminopeptidase: Increased Leucine aminopeptidase (LAP) activity is seen Answer the following medical question: Which of the following is most commonly used for the treatment of early carcinoma of vocal cord?, with the following options: A: Radical radiotherapy, B: High-dose chemotherapy, C: Total laryngectomy, D: Hemilaryngectomy followed by chemotherapy +### Response: +","Ans. a (Radical radiotherapy) (Ref. ENT secrets 3rd ed., 277)LARYNGEAL CANCER: TREATMENT OPTION OVERVIEWThree types of standard treatment are used:Radiation TherapyRadiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.SurgerySurgery (removing the cancer in an operation) is a common treatment for all stages of laryngeal cancer. The following urgical procedures may be used:OperationCommentsCordectomy# Surgery to remove the vocal cords only.Supraglottic laryngectomy# Surgery to remove the supraglottis only.Hemilaryngectomy# Surgery to remove half of the larynx. A hemilaryngectomy saves the voice.Partial laryngectomy# Surgery to remove part of the larynx. A partial laryngectomy helps keep the patient's ability to talk.Total laryngectomy# Surgery to remove the whole larynx. During this operation tracheostomy is done.Laser surgery# A surgical procedure that uses a laser beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove a surface lesion such as a tumor.ChemotherapyTreatment options by stage:Stage I Laryngeal Cancer# Treatment of stage I laryngeal cancer depends on where cancer is found in the larynx.-If cancer is in the supraglottis, treatment may include the following:# Radiation therapy.# Supraglottic laryngectomy.-If cancer is in the glottis, treatment may include the following:# Radiation therapy.# Cordectomy.# Partial laryngectomy, hemilaryngectomy, or total laryngectomy.# Laser surgery.-If cancer is in the subglottis, treatment may include the following:# Radiation therapy with or without surgery.# Surgery alone.Stage II Laryngeal Cancer# Treatment of stage II laryngeal cancer depends on where cancer is found in the larynx.-If cancer is in the supraglottis, treatment may include the following:# Radiation therapy.# Supraglottic laryngectomy or total laryngectomy with or without radiation therapy.- If cancer is in the glottis, treatment may include the following:# Radiation therapy.# Partial laryngectomy, hemilaryngectomy, or total laryngectomy.# Laser surgery.- If cancer is in the subglottis, treatment may include the following:# Radiation therapy with or without surgery.# Surgery alone.Stage III Laryngeal Cancer# Treatment of stage III laryngeal cancer depends on where cancer is found in the larynx.- If cancer is in the supraglottis or glottis, treatment may include the following:# Surgery with or without radiation therapy.# Radiation therapy with or without surgery.# A clinical trial of chemotherapy combined with radiation therapy, with or without laryngectomy.- If cancer is in the subglottis, treatment may include the following:# Laryngectomy plus total thyroidectomy and removal of lymph nodes in the throat, usually followed by radiation therapy.# Radiation therapy with or without surgery.# A clinical trial of radiation therapy.# A clinical trial of chemotherapy.Stage IV Laryngeal Cancer# Treatment of stage IV laryngeal cancer depends on where cancer is found in the larynx.- If cancer is in the supraglottis or glottis, treatment may include the following:# Total laryngectomy with radiation therapy.# Radiation therapy with or without surgery.# A clinical trial of chemotherapy combined with radiation therapy, with or without laryngectomy.- If cancer is in the subglottis, treatment may include the following:# Laryngectomy plus total thyroidectomy and removal of lymph nodes in the throat, usually with radiation therapy.# Radiation therapy.# A clinical trial of radiation therapy.# A clinical trial of chemotherapy combined with radiation therapy.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is most commonly used for the treatment of early carcinoma of vocal cord?, with the following options: A: Radical radiotherapy, B: High-dose chemotherapy, C: Total laryngectomy, D: Hemilaryngectomy followed by chemotherapy + ### Response: Ans. a (Radical radiotherapy) (Ref. ENT secrets 3rd ed., 277)LARYNGEAL CANCER: TREATMENT OPTION OVERVIEWThree types of standard treatment are used:Radiation TherapyRadiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.SurgerySurgery (removing the cancer in an operation) is a common treatment for all stages of laryngeal cancer. The following urgical procedures may be used:OperationCommentsCordectomy# Surgery to remove the vocal cords only.Supraglottic laryngectomy# Surgery to remove the supraglottis only.Hemilaryngectomy# Surgery to remove half of the larynx. A hemilaryngectomy saves the voice.Partial laryngectomy# Surgery to remove part of the larynx. A partial laryngectomy helps keep the patient's ability to talk.Total laryngectomy# Surgery to remove the whole larynx. During this operation tracheostomy is done.Laser surgery# A surgical procedure that uses a laser beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove a surface lesion such as a tumor.ChemotherapyTreatment options by stage:Stage I Laryngeal Cancer# Treatment of stage I laryngeal cancer depends on where cancer is found in the larynx.-If cancer is in the supraglottis, treatment may include the following:# Radiation therapy.# Supraglottic laryngectomy.-If cancer is in the glottis, treatment may include the following:# Radiation therapy.# Cordectomy.# Partial laryngectomy, hemilaryngectomy, or total laryngectomy.# Laser surgery.-If cancer is in the subglottis, treatment may include the following:# Radiation therapy with or without surgery.# Surgery alone.Stage II Laryngeal Cancer# Treatment of stage II laryngeal cancer depends on where cancer is found in the larynx.-If cancer is in the supraglottis, treatment may include the following:# Radiation therapy.# Supraglottic laryngectomy or total laryngectomy with or without radiation therapy.- If cancer is in the glottis, treatment may include the following:# Radiation therapy.# Partial laryngectomy, hemilaryngectomy, or total laryngectomy.# Laser surgery.- If cancer is in the subglottis, treatment may include the following:# Radiation therapy with or without surgery.# Surgery alone.Stage III Laryngeal Cancer# Treatment of stage III laryngeal cancer depends on where cancer is found in the larynx.- If cancer is in the supraglottis or glottis, treatment may include the following:# Surgery with or without radiation therapy.# Radiation therapy with or without surgery.# A clinical trial of chemotherapy combined with radiation therapy, with or without laryngectomy.- If cancer is in the subglottis, treatment may include the following:# Laryngectomy plus total thyroidectomy and removal of lymph nodes in the throat, usually followed by radiation therapy.# Radiation therapy with or without surgery.# A clinical trial of radiation therapy.# A clinical trial of chemotherapy.Stage IV Laryngeal Cancer# Treatment of stage IV laryngeal cancer depends on where cancer is found in the larynx.- If cancer is in the supraglottis or glottis, treatment may include the following:# Total laryngectomy with radiation therapy.# Radiation therapy with or without surgery.# A clinical trial of chemotherapy combined with radiation therapy, with or without laryngectomy.- If cancer is in the subglottis, treatment may include the following:# Laryngectomy plus total thyroidectomy and removal of lymph nodes in the throat, usually with radiation therapy.# Radiation therapy.# A clinical trial of radiation therapy.# A clinical trial of chemotherapy combined with radiation therapy. ### End" @@ -2248,7 +4016,14 @@ Ans. a (Radical radiotherapy) (Ref. ENT secrets 3rd ed., 277)LARYNGEAL CANCER: T Answer the following medical question: Most anteriorly located valve of the hea is, with the following options: A: Pulmonary, B: Bicuspid, C: Aoic, D: Tricuspid ### Response: -. +",.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most anteriorly located valve of the hea is, with the following options: A: Pulmonary, B: Bicuspid, C: Aoic, D: Tricuspid + +### Response: +. ### End" 238,"Below is an instruction that describes a task. Write a response that appropriately completes the request. @@ -2256,6 +4031,13 @@ Answer the following medical question: Most anteriorly located valve of the hea Answer the following medical question: Misoprostol is a -, with the following options: A: Prostaglandin E1 analogue, B: Prostaglandin E2 analogue, C: Prostaglandin antagonist, D: Antiprogestin +### Response: +","Ans. is 'a' i.e., Prostaglandin El analogue Misoprostol is a stable analogue of Prostaglandin E1 - KDT","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Misoprostol is a -, with the following options: A: Prostaglandin E1 analogue, B: Prostaglandin E2 analogue, C: Prostaglandin antagonist, D: Antiprogestin + ### Response: Ans. is 'a' i.e., Prostaglandin El analogue Misoprostol is a stable analogue of Prostaglandin E1 - KDT ### End" @@ -2265,6 +4047,13 @@ Ans. is 'a' i.e., Prostaglandin El analogue Misoprostol is a stable analogue of Answer the following medical question: Which of the following has the lowest risk of causing nausea & vomiting?, with the following options: A: Semaglutide, B: Lixisenatide, C: Albiglutide, D: Liraglutide +### Response: +","Nausea & vomiting is the most common side effect of all GLP-1 analogues, but Albiglutide has the lowest risk of causing nausea & vomiting.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following has the lowest risk of causing nausea & vomiting?, with the following options: A: Semaglutide, B: Lixisenatide, C: Albiglutide, D: Liraglutide + ### Response: Nausea & vomiting is the most common side effect of all GLP-1 analogues, but Albiglutide has the lowest risk of causing nausea & vomiting. ### End" @@ -2274,6 +4063,13 @@ Nausea & vomiting is the most common side effect of all GLP-1 analogues, but Al Answer the following medical question: In a case of carcinoma cervix involvement of parametrium, lower 1/3 of vagina and no free space on P/R examination means stage :, with the following options: A: Ila, B: Ilb, C: Illa, D: Illb +### Response: +",Ilb,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In a case of carcinoma cervix involvement of parametrium, lower 1/3 of vagina and no free space on P/R examination means stage :, with the following options: A: Ila, B: Ilb, C: Illa, D: Illb + ### Response: Ilb ### End" @@ -2283,6 +4079,17 @@ Ilb Answer the following medical question: If suture marks are to be avoided, skin sutures should be removed by -, with the following options: A: 72 hours, B: 1 week, C: 2 weeks, D: 3 weeks +### Response: +","• Suture marks may be minimised by using monofilament sutures that are removed early (3–5 days). +• Sutures inserted under tension will leave marks. +• The wound can be strengthened post suture removal by the use of sticky strips. +• Fine sutures (6/0 or smaller) placed close to the wound margins tend to leave less scarring. +• Subcuticular suturing avoids suture marks either side of the wound or incision.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: If suture marks are to be avoided, skin sutures should be removed by -, with the following options: A: 72 hours, B: 1 week, C: 2 weeks, D: 3 weeks + ### Response: • Suture marks may be minimised by using monofilament sutures that are removed early (3–5 days). • Sutures inserted under tension will leave marks. @@ -2296,6 +4103,13 @@ Answer the following medical question: If suture marks are to be avoided, skin s Answer the following medical question: Alpha -1 antitrypsin deficiency presents as ?, with the following options: A: Emphysema, B: Bronchitectasis, C: Empyema, D: Bronchogenic carcinoma +### Response: +","Alpha-1 antitrypsin deficiency-associated lung disease is characterized by progressive degenerative and destructive changes in the lungs (emphysema, commonly of the panacinar type). Emphysema is a chronic, usually slowly progressive illness, which most commonly causes shoness of breath. Other symptoms may include chronic cough, phlegm production, and wheezing. Emphysema is caused due to alpha 1 antitrypsin deficiency. Reference: GHAI Essential pediatrics, 8th edition","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Alpha -1 antitrypsin deficiency presents as ?, with the following options: A: Emphysema, B: Bronchitectasis, C: Empyema, D: Bronchogenic carcinoma + ### Response: Alpha-1 antitrypsin deficiency-associated lung disease is characterized by progressive degenerative and destructive changes in the lungs (emphysema, commonly of the panacinar type). Emphysema is a chronic, usually slowly progressive illness, which most commonly causes shoness of breath. Other symptoms may include chronic cough, phlegm production, and wheezing. Emphysema is caused due to alpha 1 antitrypsin deficiency. Reference: GHAI Essential pediatrics, 8th edition ### End" @@ -2305,6 +4119,14 @@ Alpha-1 antitrypsin deficiency-associated lung disease is characterized by progr Answer the following medical question: In children, the most common lesion in anterior teeth are due to, with the following options: A: Nursing bottle caries, B: Dental trauma, C: Malformation of tooth, D: Discolouration +### Response: +","- In children, the most common lesion in anterior teeth are due to nursing bottle caries. +- These lesions begin on the labial surface of all anterior and they progress rapidly as diffused demineralization of the entire surface of all existing teeth.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In children, the most common lesion in anterior teeth are due to, with the following options: A: Nursing bottle caries, B: Dental trauma, C: Malformation of tooth, D: Discolouration + ### Response: - In children, the most common lesion in anterior teeth are due to nursing bottle caries. - These lesions begin on the labial surface of all anterior and they progress rapidly as diffused demineralization of the entire surface of all existing teeth. @@ -2315,6 +4137,13 @@ Answer the following medical question: In children, the most common lesion in an Answer the following medical question: All of the following are causes of acalculous cholecystitis except, with the following options: A: Bile duct stricture, B: Schitosoma, C: Prolonged TPN, D: Major operations +### Response: +","Causes of Acalculous cholecystitis Common causes Elderly and critically ill patients after trauma Burns Longterm TPN Major operations(Abdominal aneurysm repair and cardiopulmonary bypass) Diabetes mellitus Uncommon causes Vasculitis Obstructing GB adenocarcinoma GB torsion Parasitic infestation Unusual bacterial infection - Leptospira, streptococcus, salmonella , Vibrio cholera Ref: Harrison's 19th edition Pgno : 2081","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following are causes of acalculous cholecystitis except, with the following options: A: Bile duct stricture, B: Schitosoma, C: Prolonged TPN, D: Major operations + ### Response: Causes of Acalculous cholecystitis Common causes Elderly and critically ill patients after trauma Burns Longterm TPN Major operations(Abdominal aneurysm repair and cardiopulmonary bypass) Diabetes mellitus Uncommon causes Vasculitis Obstructing GB adenocarcinoma GB torsion Parasitic infestation Unusual bacterial infection - Leptospira, streptococcus, salmonella , Vibrio cholera Ref: Harrison's 19th edition Pgno : 2081 ### End" @@ -2324,6 +4153,13 @@ Causes of Acalculous cholecystitis Common causes Elderly and critically ill pati Answer the following medical question: False statement about selegeline is -, with the following options: A: It is a MAO -A inhibitor, B: Does not cause cheese reaction, C: May be used in on - off phenomenon, D: It is used in parkinsonism +### Response: +","Ans. is 'a' i.e., It is a MAO-A inhibitor o Selegeline (deprenyl) inhibitis MAO-B o Unlike nonselective MAO inhibitors, selegiline in low doses does not interfere with peripheral metabolism of dietary amine (tyramine), accumulation and hypeensive reaction (cheese reaction) does not develop, while intracerebral degradation of dopamine is retarded. o Adminstered with levodopa, it prolongs levodopa action, attenuates motor fluctuation and decreases ""wearing off' and ""on of' effects.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: False statement about selegeline is -, with the following options: A: It is a MAO -A inhibitor, B: Does not cause cheese reaction, C: May be used in on - off phenomenon, D: It is used in parkinsonism + ### Response: Ans. is 'a' i.e., It is a MAO-A inhibitor o Selegeline (deprenyl) inhibitis MAO-B o Unlike nonselective MAO inhibitors, selegiline in low doses does not interfere with peripheral metabolism of dietary amine (tyramine), accumulation and hypeensive reaction (cheese reaction) does not develop, while intracerebral degradation of dopamine is retarded. o Adminstered with levodopa, it prolongs levodopa action, attenuates motor fluctuation and decreases ""wearing off' and ""on of' effects. ### End" @@ -2333,6 +4169,14 @@ Ans. is 'a' i.e., It is a MAO-A inhibitor o Selegeline (deprenyl) inhibitis MAO- Answer the following medical question: Which of the following type of facebow is most commonly used for complete denture fabrication:, with the following options: A: Kinematic face bow., B: Arbitrary face bow., C: Any of the above., D: None. +### Response: +","Arbitrary face bows are used to record terminal hinge axis arbitrarily. It is most commonly used in complete denture prosthodontics. It may be of facia type or earpiece type. +Kinematic face bow is used to determine and locate the exact hinge axis point. It is attached to lower jaw. It is not used for complete denture fabrication. It is generally used for the fabrication of FPD and full mouth rehabilitation.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following type of facebow is most commonly used for complete denture fabrication:, with the following options: A: Kinematic face bow., B: Arbitrary face bow., C: Any of the above., D: None. + ### Response: Arbitrary face bows are used to record terminal hinge axis arbitrarily. It is most commonly used in complete denture prosthodontics. It may be of facia type or earpiece type. Kinematic face bow is used to determine and locate the exact hinge axis point. It is attached to lower jaw. It is not used for complete denture fabrication. It is generally used for the fabrication of FPD and full mouth rehabilitation. @@ -2343,6 +4187,13 @@ Kinematic face bow is used to determine and locate the exact hinge axis point. I Answer the following medical question: Neostigmine is used for reversing the adverse effect of:, with the following options: A: dTC + pancuronium, B: d TC only, C: Alcuronium only, D: Ketamine complication +### Response: +","A i.e. dTC + Pancuronium As d-TC & Panduronium, both are non-depolarizing muscle relaxant, so neostigmine is used to reverse the drugs.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Neostigmine is used for reversing the adverse effect of:, with the following options: A: dTC + pancuronium, B: d TC only, C: Alcuronium only, D: Ketamine complication + ### Response: A i.e. dTC + Pancuronium As d-TC & Panduronium, both are non-depolarizing muscle relaxant, so neostigmine is used to reverse the drugs. ### End" @@ -2352,6 +4203,13 @@ A i.e. dTC + Pancuronium As d-TC & Panduronium, both are non-depolarizing muscle Answer the following medical question: Key features of kangaroo mother care are all the following EXCEPT?, with the following options: A: Skin to skin contact between mother and baby, B: Exclusive breast feeding, C: Initiated in a facility and continued at home, D: Done for babies with cyanosis +### Response: +","Ans. (d) Done for babies with cyanosisRef: OP Ghai 8th ed./148* Kangaroo care is a technique practiced on newborn, usually preterm, infants wherein the infant is held, skin- to-skin, with an adult.* The kangaroo position provides ready access to nourishment.* The parents stable body temperature helps to regulate the neonates temperature more smoothly than an incubator, and allows for readily accessible breastfeeding.* Babies who are eligible for kangaroo care include pre- term infants, weighing less than 1,500 grams, and breathing independently.* Cardiopulmonary monitoring, oximetry, supplemental oxygen or nasal (continuous positive airway pressure) ventilation, intravenous infusion, and monitor leads do not prevent kangaroo care.* Babies who are in kangaroo care tend to be less prone to apnea and bradycardia and have stabilization of oxygen needs.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Key features of kangaroo mother care are all the following EXCEPT?, with the following options: A: Skin to skin contact between mother and baby, B: Exclusive breast feeding, C: Initiated in a facility and continued at home, D: Done for babies with cyanosis + ### Response: Ans. (d) Done for babies with cyanosisRef: OP Ghai 8th ed./148* Kangaroo care is a technique practiced on newborn, usually preterm, infants wherein the infant is held, skin- to-skin, with an adult.* The kangaroo position provides ready access to nourishment.* The parents stable body temperature helps to regulate the neonates temperature more smoothly than an incubator, and allows for readily accessible breastfeeding.* Babies who are eligible for kangaroo care include pre- term infants, weighing less than 1,500 grams, and breathing independently.* Cardiopulmonary monitoring, oximetry, supplemental oxygen or nasal (continuous positive airway pressure) ventilation, intravenous infusion, and monitor leads do not prevent kangaroo care.* Babies who are in kangaroo care tend to be less prone to apnea and bradycardia and have stabilization of oxygen needs. ### End" @@ -2361,6 +4219,13 @@ Ans. (d) Done for babies with cyanosisRef: OP Ghai 8th ed./148* Kangaroo care is Answer the following medical question: The limit of loudness expressed as decibels that people can tolerate without substanial damage to their hearing is -, with the following options: A: 55, B: 65, C: 75, D: 85 +### Response: +","Sound in dB Effect 20 Whispering 40 Quiet library 60 Normal conversation 70 heavy street traffic 80 printing press 85 Recommended maximum 110 Train passing through station 120 Motor car horn 140 Threshold of pain 150-160 Mechanical damage Park's Textbook of Preventive and Social Medicine, 25th edition, Page No. 802","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The limit of loudness expressed as decibels that people can tolerate without substanial damage to their hearing is -, with the following options: A: 55, B: 65, C: 75, D: 85 + ### Response: Sound in dB Effect 20 Whispering 40 Quiet library 60 Normal conversation 70 heavy street traffic 80 printing press 85 Recommended maximum 110 Train passing through station 120 Motor car horn 140 Threshold of pain 150-160 Mechanical damage Park's Textbook of Preventive and Social Medicine, 25th edition, Page No. 802 ### End" @@ -2370,6 +4235,13 @@ Sound in dB Effect 20 Whispering 40 Quiet library 60 Normal conversation 70 heav Answer the following medical question: Maximum fat is found in -, with the following options: A: Buffalo milk, B: Goat milk, C: Human milk, D: Cow milk +### Response: +","Ans. is 'a' i.e., Buffalo milkNutritive value of milks compared (value per 100 grams) BuffaloCowGoatHumanFat(g)6[?]54[?]14[?]53[?]4Protein(g)4[?]33[?]23[?]31[?]1Lactose(g)5[?]14[?]44[?]67[?]4Calcium(mg)21012017028Iron(mg)0[?]20[?]20[?]3 Vitamin C(mg)1213Minerals(g)0[?]80[?]80[?]80[?]1Water(g)8108786[?]888Energy(kcal)117677265o Fat content of milt. Buffalo > Goat > Cow > Human.o Protein content of milk: Buffalo > Goat > Cow > Human,o Lactose content of milk: Human > Buffalo > Goat > Cow.o Energy> content of milk: Buffalo > Goat > Cow > Human.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Maximum fat is found in -, with the following options: A: Buffalo milk, B: Goat milk, C: Human milk, D: Cow milk + ### Response: Ans. is 'a' i.e., Buffalo milkNutritive value of milks compared (value per 100 grams) BuffaloCowGoatHumanFat(g)6[?]54[?]14[?]53[?]4Protein(g)4[?]33[?]23[?]31[?]1Lactose(g)5[?]14[?]44[?]67[?]4Calcium(mg)21012017028Iron(mg)0[?]20[?]20[?]3 Vitamin C(mg)1213Minerals(g)0[?]80[?]80[?]80[?]1Water(g)8108786[?]888Energy(kcal)117677265o Fat content of milt. Buffalo > Goat > Cow > Human.o Protein content of milk: Buffalo > Goat > Cow > Human,o Lactose content of milk: Human > Buffalo > Goat > Cow.o Energy> content of milk: Buffalo > Goat > Cow > Human. ### End" @@ -2379,6 +4251,13 @@ Ans. is 'a' i.e., Buffalo milkNutritive value of milks compared (value per 100 g Answer the following medical question: Hyperprolactinemia is a side effect of-, with the following options: A: Bromocriptine, B: Levodopa, C: Amantadine, D: Metoclopramide +### Response: +","Ans. is 'd' i.e., Metoclopramide","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hyperprolactinemia is a side effect of-, with the following options: A: Bromocriptine, B: Levodopa, C: Amantadine, D: Metoclopramide + ### Response: Ans. is 'd' i.e., Metoclopramide ### End" @@ -2388,6 +4267,13 @@ Ans. is 'd' i.e., Metoclopramide Answer the following medical question: Staphylococcal capsule is made up of:, with the following options: A: Hyaluronic acid, B: Polysaccharide, C: Polypeptide, D: Poly-D-glutamic acid +### Response: +","Ref: Ananthanarayan, Paniker CJ. Textbook of Microbiology. 6th Ed, London: John Wiley & Sons: 2000. & Prescott LM. Microbiology. 5th Ed. London: McGraw-Hill: 2002.Explanation:Capsules usually are composed of polysaccharides, but they may be constructed ot other materials.But, Bacillus anthracis has a capsule of poly-D- glutamic acid (polypeptide).Capsules and Slime LayersSome bacteria have a layer of material lying outside the cell wall.When the layer is well organized and not easily washed off. it is called a capsule.A slime layer is a zone of diffuse, unorganized material that is removed easily.Capsules and slime layers usually are composed of polysaccharides, but they may be constructed of other materials. For example. Bacillus anthracis has a capsule of poly-D-glutamic acid.Capsules are clearly visible in the light microscope when negative stains or special capsule stains are employedThey help bacteria resist phagocytosisCapsules contain a great deal of water and can protect bacteria against desiccationAlso aids bacterial attachmentGliding bacteria often produce slime, which presumably aids in their motilityS-LayersMany gram-positive and gram-negative bacteria have a regularly structured layer called an S-layer on their surface.The S-layer has a pattern something like floor tiles and is composed of protein or glycoproteinIn gram-negative bacteria the S-layer adheres directly to the outer membrane; it is associated with the peptidoglycan surface in gram-positive bacteria.It may protect the cell against ion and pH fluctuations, osmotic stress, enzymes.The S-layer also helps maintain the shape and envelope rigidity of at least some bacterial cells.It can promote cell adhesion to surfaces.The layer seems to protect some pathogens against complement attack and phagocytosis.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Staphylococcal capsule is made up of:, with the following options: A: Hyaluronic acid, B: Polysaccharide, C: Polypeptide, D: Poly-D-glutamic acid + ### Response: Ref: Ananthanarayan, Paniker CJ. Textbook of Microbiology. 6th Ed, London: John Wiley & Sons: 2000. & Prescott LM. Microbiology. 5th Ed. London: McGraw-Hill: 2002.Explanation:Capsules usually are composed of polysaccharides, but they may be constructed ot other materials.But, Bacillus anthracis has a capsule of poly-D- glutamic acid (polypeptide).Capsules and Slime LayersSome bacteria have a layer of material lying outside the cell wall.When the layer is well organized and not easily washed off. it is called a capsule.A slime layer is a zone of diffuse, unorganized material that is removed easily.Capsules and slime layers usually are composed of polysaccharides, but they may be constructed of other materials. For example. Bacillus anthracis has a capsule of poly-D-glutamic acid.Capsules are clearly visible in the light microscope when negative stains or special capsule stains are employedThey help bacteria resist phagocytosisCapsules contain a great deal of water and can protect bacteria against desiccationAlso aids bacterial attachmentGliding bacteria often produce slime, which presumably aids in their motilityS-LayersMany gram-positive and gram-negative bacteria have a regularly structured layer called an S-layer on their surface.The S-layer has a pattern something like floor tiles and is composed of protein or glycoproteinIn gram-negative bacteria the S-layer adheres directly to the outer membrane; it is associated with the peptidoglycan surface in gram-positive bacteria.It may protect the cell against ion and pH fluctuations, osmotic stress, enzymes.The S-layer also helps maintain the shape and envelope rigidity of at least some bacterial cells.It can promote cell adhesion to surfaces.The layer seems to protect some pathogens against complement attack and phagocytosis. ### End" @@ -2397,6 +4283,13 @@ Ref: Ananthanarayan, Paniker CJ. Textbook of Microbiology. 6th Ed, London: John Answer the following medical question: A 30-year-old athlete complains of amenorrhea for 1 year. Her BMI is 20 kg/m2. LH and FSH are in low normal range. Clinical and USG findings are normal. Most likely cause is:, with the following options: A: Depression, B: Excessive exercise, C: Premature menopause, D: Anorexia nervosa +### Response: +","Ans. is b, i.e. Excessive exerciseThis athlete has BMI =20kg/m2, i.e. she is underweightHer FSH and LH are in low normal rangeAll these findings point towards that either there is a problem in hypothalamus or pituitary.One of the causes of hypothalamic amenorrhea is excessive exercise which is the most probable cause in this case.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 30-year-old athlete complains of amenorrhea for 1 year. Her BMI is 20 kg/m2. LH and FSH are in low normal range. Clinical and USG findings are normal. Most likely cause is:, with the following options: A: Depression, B: Excessive exercise, C: Premature menopause, D: Anorexia nervosa + ### Response: Ans. is b, i.e. Excessive exerciseThis athlete has BMI =20kg/m2, i.e. she is underweightHer FSH and LH are in low normal rangeAll these findings point towards that either there is a problem in hypothalamus or pituitary.One of the causes of hypothalamic amenorrhea is excessive exercise which is the most probable cause in this case. ### End" @@ -2406,6 +4299,13 @@ Ans. is b, i.e. Excessive exerciseThis athlete has BMI =20kg/m2, i.e. she is und Answer the following medical question: This patient came with this complaint one month after an extramarital sexual contact. He has no pain. Which one of the following statements is true?, with the following options: A: A single dose of 2.4 million units of benzathine penicillin IM is the treatment, B: Examination of the groin will reveal a characteristic Groove Sign, C: It is caused by Hemophilus ducreyi, D: He is likely to develop ahritis of the knee +### Response: +","Genito-urinary ulcer disease:Genital ulcerPainless, InduratedPainful/ Non-induratedSyphilisLGVGranuloma inguinale/ DonovanosisHerpesChancroidTreponema pallidumChlamydia trachomatis (L1, L2, L3 strains)Klebsiella (Calymmatobacterium)granulomatisHerpes simplex virus type 2Hemophilus ducreyiNon-bleeding, usually single punched out ulcer (Hard chancre)Rubbery Lymph NodesAsymptomatic, single, non-bleeding ulcerMatted Lymph Nodes (BUBO)Vaginal & rectal strictures & elephantiasis (Esthiomine)Groove sign ++Single/ multiple, bleeding ulcersMostly involves genitalia & inguinal region, no lymphadenopathy (Pseudo Bubo)Genital swelling (Pseudo elephantiasis)Multiple, painful, non-indurated, bleeding, mostly presents as vesicular lesionsMultiple, bleeding on touch (vascular base)L.Ns- Painful, Fluctuant, spontaneously rupture &suppurateIncubation period: 9-90 days3 days- 6 weeks1-4 weeks2-7 days1-14 daysTreponema pallidum:General characteristicsCultural characteristics*Spirochete motile with endoflagellum*Levaditi and Fontana staining*Cork screw & lashing, Flexion-extension & rotatory motilityDoes not follow Koch's postulatesBiochemical reactionsClinical featuresHyaluronidase +ve*Incubation period: 9- 90 days*Primary - painless punched out genital ulcer (chancre) *Secondary - condylomata lata, palmar rashes*Teiary - gumma*Neurosyphilis - General paresis of insane, Tabes dorsalis*Cardiosyphilis - a syphilitic aneurysm Congenital syphilis Diagnosis*Early - Snuffles , rhinitis *Late - Interstitial keratitis , 8th nerve deafness , clutton's joints*Residual stigmata - Hutchinson's teeth , Mulberry molars, Saddle nose, Saber shins*Hutchinson triad- Hutchinson's teeth (pegged/notched teeth)+ interstitial keratitis+ sensorineural deafness*Dark ground microscopy - Detection limit - 104 /ml*Specific test - FTA - ABS, TPHA, TPI*Nonspecific test - VDRL, RPR*For monitoring treatment - VDRL and RPR*For CSF testing: VDRL> RPR in sensitivity *VDRL not done for plasma samples*Microscope required for interpretation for VDRL but not for RPRTreatment*Primary, secondary or early latent: Benzathine Penicillin single dose of 2.4 mU I.M*Late latent, cardiovascular or bening teiary: Benzathine Penicillin 2.4 mU I.M weekly for 3 weeks*Neurosyphilis: Aqueous Procaine Penicillin G 2.4 mU/d I.M + oral Probenecid 500mg qid both for 10- 14 daysSecondary syphilis:Cutaneous` lesions*Roseolar syphilide*Papular syphilide*Psoriasiform lesion *Condylomalata*Malignant syphilide*Palm & sole lesion ( Coppery red lesion )Mucosal lesions *Mucous patches *Snail track ulcers Lymphadenopathy *Generalized symmetrical rubbery lymphadenopathy Systemic involvement *Periosteitis, Ahritis *Iridocyclitis, Uveitis, Chorioretinitis*Nephritic syndrome Ref: Ananthanarayan 9th edition, p373-376","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: This patient came with this complaint one month after an extramarital sexual contact. He has no pain. Which one of the following statements is true?, with the following options: A: A single dose of 2.4 million units of benzathine penicillin IM is the treatment, B: Examination of the groin will reveal a characteristic Groove Sign, C: It is caused by Hemophilus ducreyi, D: He is likely to develop ahritis of the knee + ### Response: Genito-urinary ulcer disease:Genital ulcerPainless, InduratedPainful/ Non-induratedSyphilisLGVGranuloma inguinale/ DonovanosisHerpesChancroidTreponema pallidumChlamydia trachomatis (L1, L2, L3 strains)Klebsiella (Calymmatobacterium)granulomatisHerpes simplex virus type 2Hemophilus ducreyiNon-bleeding, usually single punched out ulcer (Hard chancre)Rubbery Lymph NodesAsymptomatic, single, non-bleeding ulcerMatted Lymph Nodes (BUBO)Vaginal & rectal strictures & elephantiasis (Esthiomine)Groove sign ++Single/ multiple, bleeding ulcersMostly involves genitalia & inguinal region, no lymphadenopathy (Pseudo Bubo)Genital swelling (Pseudo elephantiasis)Multiple, painful, non-indurated, bleeding, mostly presents as vesicular lesionsMultiple, bleeding on touch (vascular base)L.Ns- Painful, Fluctuant, spontaneously rupture &suppurateIncubation period: 9-90 days3 days- 6 weeks1-4 weeks2-7 days1-14 daysTreponema pallidum:General characteristicsCultural characteristics*Spirochete motile with endoflagellum*Levaditi and Fontana staining*Cork screw & lashing, Flexion-extension & rotatory motilityDoes not follow Koch's postulatesBiochemical reactionsClinical featuresHyaluronidase +ve*Incubation period: 9- 90 days*Primary - painless punched out genital ulcer (chancre) *Secondary - condylomata lata, palmar rashes*Teiary - gumma*Neurosyphilis - General paresis of insane, Tabes dorsalis*Cardiosyphilis - a syphilitic aneurysm Congenital syphilis Diagnosis*Early - Snuffles , rhinitis *Late - Interstitial keratitis , 8th nerve deafness , clutton's joints*Residual stigmata - Hutchinson's teeth , Mulberry molars, Saddle nose, Saber shins*Hutchinson triad- Hutchinson's teeth (pegged/notched teeth)+ interstitial keratitis+ sensorineural deafness*Dark ground microscopy - Detection limit - 104 /ml*Specific test - FTA - ABS, TPHA, TPI*Nonspecific test - VDRL, RPR*For monitoring treatment - VDRL and RPR*For CSF testing: VDRL> RPR in sensitivity *VDRL not done for plasma samples*Microscope required for interpretation for VDRL but not for RPRTreatment*Primary, secondary or early latent: Benzathine Penicillin single dose of 2.4 mU I.M*Late latent, cardiovascular or bening teiary: Benzathine Penicillin 2.4 mU I.M weekly for 3 weeks*Neurosyphilis: Aqueous Procaine Penicillin G 2.4 mU/d I.M + oral Probenecid 500mg qid both for 10- 14 daysSecondary syphilis:Cutaneous` lesions*Roseolar syphilide*Papular syphilide*Psoriasiform lesion *Condylomalata*Malignant syphilide*Palm & sole lesion ( Coppery red lesion )Mucosal lesions *Mucous patches *Snail track ulcers Lymphadenopathy *Generalized symmetrical rubbery lymphadenopathy Systemic involvement *Periosteitis, Ahritis *Iridocyclitis, Uveitis, Chorioretinitis*Nephritic syndrome Ref: Ananthanarayan 9th edition, p373-376 ### End" @@ -2415,6 +4315,13 @@ Genito-urinary ulcer disease:Genital ulcerPainless, InduratedPainful/ Non-indura Answer the following medical question: Fracture of shaft of humerus leads to:, with the following options: A: Radial nerve injury, B: Ulnar nerve injury, C: Median nerve injury, D: Musculocutaneous nerve injury +### Response: +","Ans. A Radial nerve injuryRef: BDC, 6th ed. vol. I pg. 98* Radial nerve gets injured in cases of humerus shaft fracture.* Ulnar nerve injury may take place when there is damage to medial epicondyle of humerus and in cases of tardive ulnar palsy.* Median nerve damage can be secondary to compression (for ex- carpal tunnel syndrome), which may lead to gun stock deformity, ape thumb deformity.Extra Mile* Median nerve aka labourer's nerve as it supplies most of the long muscles of the front of forearm.* Ulnar nerve aka musician's nerve as it controls the fine movements of hand.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Fracture of shaft of humerus leads to:, with the following options: A: Radial nerve injury, B: Ulnar nerve injury, C: Median nerve injury, D: Musculocutaneous nerve injury + ### Response: Ans. A Radial nerve injuryRef: BDC, 6th ed. vol. I pg. 98* Radial nerve gets injured in cases of humerus shaft fracture.* Ulnar nerve injury may take place when there is damage to medial epicondyle of humerus and in cases of tardive ulnar palsy.* Median nerve damage can be secondary to compression (for ex- carpal tunnel syndrome), which may lead to gun stock deformity, ape thumb deformity.Extra Mile* Median nerve aka labourer's nerve as it supplies most of the long muscles of the front of forearm.* Ulnar nerve aka musician's nerve as it controls the fine movements of hand. ### End" @@ -2424,6 +4331,13 @@ Ans. A Radial nerve injuryRef: BDC, 6th ed. vol. I pg. 98* Radial nerve gets inj Answer the following medical question: In XLR diseases, a modified inheritance pattern called 'pseudodominance' occurs when, with the following options: A: One parent is affected homozygote and another is unaffected homozygote, B: One parent is unaffected heterozygote and another is affected homozygote, C: One parent is normal and another is unaffected het- erozygote, D: Both parents are unaffected +### Response: +","Ans. b (One parent is unaffected heterozygote and another is affected homozygote). (Fig. Harrison 18th/61/l 1)In most instances of AR inheritance, an affected individual is the offspring of heterozygous parents. In this situation, there is a 25% chance that the offspring will have a normal genotype, a 50% probability of a heterozygous state, and a 25% risk of homozygosity for the recessive alleles, in the case of one unaffected heterozygous and one affected homozygous parent, the probability of disease increases to 50% for each child. In this instance, the pedigree analysis mimics an autosomal dominant mode of inheritance (pseudodominance). In contrast to autosomal dominant disorders, new mutations in recessive alleles are rarely manifest because they usually result in an asymptomatic carrier state.PSEUDODOMINANCE# The sudden appearance of a recessive phenotype in a pedigree, due to deletion of a masking dominant gene.# The phenomenon in which a recessive allele shows itself in the phenotype when only one copy of the allele is present, as in hemizygous alleles or in deletion heterozygotes.# An autosomal recessive condition present in individuals in two or more generations of a family, thereby appearing to follow a dominant inheritance patterns.Common explanations include:# A high carrier frequency.# Birth of an affected child to an affected individual and a genetically related (consanguinous) reproductive partner.# In populations with high frequencies of heterozygotes for autosomal recessive conditions, such as in geographically isolated communities, the mating of a homozygote with a heterozygote may result in an inheritance pattern mimicking dominant inheritance (pseudodominance).Examples of diseases with pseudodominance# Storgordt disease (caused by ABCR mutations)# Pseudoxanthoma elasticum (is caused by mutations in the ABCC6 gene, inherited in an autosomal recessive manner and presence of disease in two generations is due to pseudodominance.)# Glycogen storage disease type VII (Tarui's) - it is autosomal recessive, although a few cases with pseudodominance or sumptomatic heterozygous individuals have been found.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In XLR diseases, a modified inheritance pattern called 'pseudodominance' occurs when, with the following options: A: One parent is affected homozygote and another is unaffected homozygote, B: One parent is unaffected heterozygote and another is affected homozygote, C: One parent is normal and another is unaffected het- erozygote, D: Both parents are unaffected + ### Response: Ans. b (One parent is unaffected heterozygote and another is affected homozygote). (Fig. Harrison 18th/61/l 1)In most instances of AR inheritance, an affected individual is the offspring of heterozygous parents. In this situation, there is a 25% chance that the offspring will have a normal genotype, a 50% probability of a heterozygous state, and a 25% risk of homozygosity for the recessive alleles, in the case of one unaffected heterozygous and one affected homozygous parent, the probability of disease increases to 50% for each child. In this instance, the pedigree analysis mimics an autosomal dominant mode of inheritance (pseudodominance). In contrast to autosomal dominant disorders, new mutations in recessive alleles are rarely manifest because they usually result in an asymptomatic carrier state.PSEUDODOMINANCE# The sudden appearance of a recessive phenotype in a pedigree, due to deletion of a masking dominant gene.# The phenomenon in which a recessive allele shows itself in the phenotype when only one copy of the allele is present, as in hemizygous alleles or in deletion heterozygotes.# An autosomal recessive condition present in individuals in two or more generations of a family, thereby appearing to follow a dominant inheritance patterns.Common explanations include:# A high carrier frequency.# Birth of an affected child to an affected individual and a genetically related (consanguinous) reproductive partner.# In populations with high frequencies of heterozygotes for autosomal recessive conditions, such as in geographically isolated communities, the mating of a homozygote with a heterozygote may result in an inheritance pattern mimicking dominant inheritance (pseudodominance).Examples of diseases with pseudodominance# Storgordt disease (caused by ABCR mutations)# Pseudoxanthoma elasticum (is caused by mutations in the ABCC6 gene, inherited in an autosomal recessive manner and presence of disease in two generations is due to pseudodominance.)# Glycogen storage disease type VII (Tarui's) - it is autosomal recessive, although a few cases with pseudodominance or sumptomatic heterozygous individuals have been found. ### End" @@ -2433,6 +4347,13 @@ Ans. b (One parent is unaffected heterozygote and another is affected homozygote Answer the following medical question: 18 years old male hears voices discussing him in 3rd person has, with the following options: A: Obsession, B: Depression, C: Mania, D: Schizophrenia +### Response: +",Voices discussing the person in 3rd person (third person hallucination) is characteristic of schizophrenia.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: 18 years old male hears voices discussing him in 3rd person has, with the following options: A: Obsession, B: Depression, C: Mania, D: Schizophrenia + ### Response: Voices discussing the person in 3rd person (third person hallucination) is characteristic of schizophrenia. ### End" @@ -2442,6 +4363,13 @@ Voices discussing the person in 3rd person (third person hallucination) is chara Answer the following medical question: M/C gene nutation in fibroid., with the following options: A: MED-12, B: COL 4 A5-A6, C: FH, D: None of above +### Response: +","Ans. is a, i.e. MED-12(Ref: Williams Gynae 3rd/ed, p203)The 2 M/C gene mutations in fibroid are* MED-12 mutation* HMGA2 gene mutation","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: M/C gene nutation in fibroid., with the following options: A: MED-12, B: COL 4 A5-A6, C: FH, D: None of above + ### Response: Ans. is a, i.e. MED-12(Ref: Williams Gynae 3rd/ed, p203)The 2 M/C gene mutations in fibroid are* MED-12 mutation* HMGA2 gene mutation ### End" @@ -2451,6 +4379,13 @@ Ans. is a, i.e. MED-12(Ref: Williams Gynae 3rd/ed, p203)The 2 M/C gene mutations Answer the following medical question: A Person ate some milk products in a party and after 6 hours started vomiting. Which organism is most likely the cause:, with the following options: A: Bacillus cereus, B: Clostridium perfringens, C: Staphylococcus, D: Clostridium botulism +### Response: +","Ans. (c) StaphylococcusRef: Harriosn 18th ed. / 128, Microbiology by Ananthanarayan and Paniker 8th ed. /198* Staphylococcus causes food poisoning by enterotoxin A, due to intake of milk or milk products.# It is a preformed, heat stable enterotoxin, which stimulate the vagus nerve causing vomiting as main and first symptom.# I.P. < 6 hours* Outbreaks following picnics where potato salad, mayonnaise, and cream pastries have been served offer classic examples of staphylococcal food poisoning.* Bacillus cereus is an important cause of food poisoning, isolated from soil, vegetables, milk cereals, meat etc.* It produces 2 types of food poisoning:Diarrhea type- main symptomEmetic type- main symptom* Associated with wide range of food intake including meat, puddings etc.* I.P. 8-16 hrs* Occurs due to heat labile enterotoxin* Associated with intake of Chinese fried rice* I.P. 1-5 hrs* Due to pre-formed, heat stable toxin# Clostridium perfringens causes gastroenteritis after intake of infected meat or meat products. I.P. - 8-16 hours.# Clostridium botulism causes food poisoning due to consumption of canned food. I.P. 1 to 3 days.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A Person ate some milk products in a party and after 6 hours started vomiting. Which organism is most likely the cause:, with the following options: A: Bacillus cereus, B: Clostridium perfringens, C: Staphylococcus, D: Clostridium botulism + ### Response: Ans. (c) StaphylococcusRef: Harriosn 18th ed. / 128, Microbiology by Ananthanarayan and Paniker 8th ed. /198* Staphylococcus causes food poisoning by enterotoxin A, due to intake of milk or milk products.# It is a preformed, heat stable enterotoxin, which stimulate the vagus nerve causing vomiting as main and first symptom.# I.P. < 6 hours* Outbreaks following picnics where potato salad, mayonnaise, and cream pastries have been served offer classic examples of staphylococcal food poisoning.* Bacillus cereus is an important cause of food poisoning, isolated from soil, vegetables, milk cereals, meat etc.* It produces 2 types of food poisoning:Diarrhea type- main symptomEmetic type- main symptom* Associated with wide range of food intake including meat, puddings etc.* I.P. 8-16 hrs* Occurs due to heat labile enterotoxin* Associated with intake of Chinese fried rice* I.P. 1-5 hrs* Due to pre-formed, heat stable toxin# Clostridium perfringens causes gastroenteritis after intake of infected meat or meat products. I.P. - 8-16 hours.# Clostridium botulism causes food poisoning due to consumption of canned food. I.P. 1 to 3 days. ### End" @@ -2460,6 +4395,13 @@ Ans. (c) StaphylococcusRef: Harriosn 18th ed. / 128, Microbiology by Ananthanara Answer the following medical question: Saccular diveiculum of extrahepatic bile duct in choledochal cyst is classified as -, with the following options: A: Type I, B: Type II, C: Type III, D: Type IV +### Response: +","Ans. is 'b' i.e., Type II","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Saccular diveiculum of extrahepatic bile duct in choledochal cyst is classified as -, with the following options: A: Type I, B: Type II, C: Type III, D: Type IV + ### Response: Ans. is 'b' i.e., Type II ### End" @@ -2469,6 +4411,13 @@ Ans. is 'b' i.e., Type II Answer the following medical question: Chepuwa is, with the following options: A: Beating on soles, B: Beating on abdomen, C: Thighs tied with bamboo, D: Suspension by wrist +### Response: +","Chepuwa is a common type of toure practiced on Bhutanese refugees in Nepal, victims legs or thighs are clamped very tightly with bamboo sticks or similar objects causing severe pain. Ref: Dogra and Rudra Lyon's Medical Jurisprudence and Toxicology eleventh edition page 693","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Chepuwa is, with the following options: A: Beating on soles, B: Beating on abdomen, C: Thighs tied with bamboo, D: Suspension by wrist + ### Response: Chepuwa is a common type of toure practiced on Bhutanese refugees in Nepal, victims legs or thighs are clamped very tightly with bamboo sticks or similar objects causing severe pain. Ref: Dogra and Rudra Lyon's Medical Jurisprudence and Toxicology eleventh edition page 693 ### End" @@ -2478,6 +4427,13 @@ Chepuwa is a common type of toure practiced on Bhutanese refugees in Nepal, vict Answer the following medical question: True about pseudohypoparathyroidism-, with the following options: A: Heterotopic calcification, B: edCa2+, C: iedP04, D: TedPTH +### Response: +","most patients have PHP -1a and reveal characteristic features of AHO consisting of sho stature, round face, skeletal anomalies and heterotopic calcification ( Harrison 17 pg 2394)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about pseudohypoparathyroidism-, with the following options: A: Heterotopic calcification, B: edCa2+, C: iedP04, D: TedPTH + ### Response: most patients have PHP -1a and reveal characteristic features of AHO consisting of sho stature, round face, skeletal anomalies and heterotopic calcification ( Harrison 17 pg 2394) ### End" @@ -2487,6 +4443,13 @@ most patients have PHP -1a and reveal characteristic features of AHO consisting Answer the following medical question: Following can cause endometrial cancer :, with the following options: A: Metropathia hemorrhagica, B: Gynandroblastoma, C: Dysgerminoma, D: Teratoma +### Response: +",Metropathia haemorrhagica Characterised by periods of amenorrhoea followed by prolonged and heavy bleeding May be associated cystic glandular hyperplasia of endometrium and risk of future endometrial cancer Granulosa cell tumors secrete estrogen which produces endometrial hyperplasia and may predispose to endometrial cancer Germ cell tumors are not associated with endometrial cancer Reference: Textbook of Gynaecology; Sheila balakrishnan; 2nd edition; Pg no:50,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Following can cause endometrial cancer :, with the following options: A: Metropathia hemorrhagica, B: Gynandroblastoma, C: Dysgerminoma, D: Teratoma + ### Response: Metropathia haemorrhagica Characterised by periods of amenorrhoea followed by prolonged and heavy bleeding May be associated cystic glandular hyperplasia of endometrium and risk of future endometrial cancer Granulosa cell tumors secrete estrogen which produces endometrial hyperplasia and may predispose to endometrial cancer Germ cell tumors are not associated with endometrial cancer Reference: Textbook of Gynaecology; Sheila balakrishnan; 2nd edition; Pg no:50 ### End" @@ -2496,6 +4459,13 @@ Metropathia haemorrhagica Characterised by periods of amenorrhoea followed by pr Answer the following medical question: Which of the following is the products formed from alcohol but not the intermediates of TCA cycle/ glycolysis: (PGI Dec 2006), with the following options: A: Acetaldehyde, B: Pyruvate, C: Lactate, D: Oxalate +### Response: +",Ans: A (Acetaldehyde) Acetaldehyde is formed from alcohol but it is not intermediate ofTCA cycleQ Malate & oxalate are intermediates in TCA cycle (Harper27th/14 7) whereas pyruvate & lactate are intermediates in glycolysisfHarper 27th/lS3)Ethanol + NADPH + H+ + O2 MEOS AcetaldehydeFig. Metabolic pathway of alcohol,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is the products formed from alcohol but not the intermediates of TCA cycle/ glycolysis: (PGI Dec 2006), with the following options: A: Acetaldehyde, B: Pyruvate, C: Lactate, D: Oxalate + ### Response: Ans: A (Acetaldehyde) Acetaldehyde is formed from alcohol but it is not intermediate ofTCA cycleQ Malate & oxalate are intermediates in TCA cycle (Harper27th/14 7) whereas pyruvate & lactate are intermediates in glycolysisfHarper 27th/lS3)Ethanol + NADPH + H+ + O2 MEOS AcetaldehydeFig. Metabolic pathway of alcohol ### End" @@ -2505,6 +4475,14 @@ Ans: A (Acetaldehyde) Acetaldehyde is formed from alcohol but it is not intermed Answer the following medical question: A patient with pneumonia for 5 days is admitted to the hospital in altered sensorium. He suddenly ceases to recognize the doctor and staff. He thinks that he is in jail and complains of scorpion attacking him. His probable diagnosis is -, with the following options: A: Acute dementia, B: Acute delirium, C: Acute schizophrenia, D: Acute paranoia +### Response: +","Infection (like pneumonia) is one of the cause of delirium. +Altered sensorium, disorientation to place (Patient thinks he is in jail) and person (not recognizing the doctor and staff), and hallucinations (scorpions attacking him) suggest the diagnosis of delirium.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A patient with pneumonia for 5 days is admitted to the hospital in altered sensorium. He suddenly ceases to recognize the doctor and staff. He thinks that he is in jail and complains of scorpion attacking him. His probable diagnosis is -, with the following options: A: Acute dementia, B: Acute delirium, C: Acute schizophrenia, D: Acute paranoia + ### Response: Infection (like pneumonia) is one of the cause of delirium. Altered sensorium, disorientation to place (Patient thinks he is in jail) and person (not recognizing the doctor and staff), and hallucinations (scorpions attacking him) suggest the diagnosis of delirium. @@ -2515,6 +4493,13 @@ Altered sensorium, disorientation to place (Patient thinks he is in jail) and pe Answer the following medical question: A 25-years-old sexually active unmarried male presents with urethral discharge after unprotected sex with a sexual worker. Gram stain pic was given; what may be the possible organisms?, with the following options: A: Neisseria, B: Chlamydia, C: Trichomonas, D: Ureaplasma +### Response: +","Ans. a. NeisseriaN. gonorrhoeae is Gram [?] diplococci.Metabolize glucose and produce IgA proteases.Contain lipooligosaccharides (LOS) with strong endotoxin activity.N gonorrhoeae is often intracellular (within neutrophils)GONOCOCCINo polysaccharide capsuleNo maltose metabolizedNo vaccine due to antigenic variation of pilus proteinsSexually or perinatally transmittedCauses gonorrhea, septic arthritis, neonatal conjunctivitis (2-5 days after birth), pelvic inflammatory disease (PID), and Fitz-Hugh- Curtis syndromeCondoms decreases sexual transmission, erythromycin eye ointment prevents neonatal blindnessTreatment: Ceftriaxone + (azithromycin or doxycycline) for possible chlamydial coinfection","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 25-years-old sexually active unmarried male presents with urethral discharge after unprotected sex with a sexual worker. Gram stain pic was given; what may be the possible organisms?, with the following options: A: Neisseria, B: Chlamydia, C: Trichomonas, D: Ureaplasma + ### Response: Ans. a. NeisseriaN. gonorrhoeae is Gram [?] diplococci.Metabolize glucose and produce IgA proteases.Contain lipooligosaccharides (LOS) with strong endotoxin activity.N gonorrhoeae is often intracellular (within neutrophils)GONOCOCCINo polysaccharide capsuleNo maltose metabolizedNo vaccine due to antigenic variation of pilus proteinsSexually or perinatally transmittedCauses gonorrhea, septic arthritis, neonatal conjunctivitis (2-5 days after birth), pelvic inflammatory disease (PID), and Fitz-Hugh- Curtis syndromeCondoms decreases sexual transmission, erythromycin eye ointment prevents neonatal blindnessTreatment: Ceftriaxone + (azithromycin or doxycycline) for possible chlamydial coinfection ### End" @@ -2524,6 +4509,13 @@ Ans. a. NeisseriaN. gonorrhoeae is Gram [?] diplococci.Metabolize glucose and pr Answer the following medical question: Which of these is a conservative mutator:, with the following options: A: Glutamic acid- glutamine, B: Histidine-glycine, C: Alanine- leucine, D: Arginine-aspaic acid +### Response: +",C i.e. Alanine - leucine,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of these is a conservative mutator:, with the following options: A: Glutamic acid- glutamine, B: Histidine-glycine, C: Alanine- leucine, D: Arginine-aspaic acid + ### Response: C i.e. Alanine - leucine ### End" @@ -2533,6 +4525,14 @@ C i.e. Alanine - leucine Answer the following medical question: A 25 year old G2P, at 39 weeks gestation is electing to have spinal anaesthesia for a repeat cesarean section. 5 minutes after bupivacaine spinal injection, the patient becomes hypotensive and is complaining of tingling in her fingers with subjective difficulty breathing. Her oxygen saturation remains 100% and blood pressure in 90/60 mmHg The most likely etiology is., with the following options: A: Severe patient anxiety, B: Increased peripheral nerve sensitization to local anaesthetics, C: Decrease in volume of CSF in subarachnoid space facilitated higher spread of local anaesthetics, D: Engorgement of epidural veins contributed to inadvertent intravascular injection of local anaesthetic +### Response: +","In pregnancy, CSF volume is decreased, thereby decreasing dose requirement of local anaesthetic. This facilitates spread of local anaesthetic when spinal anaesthesia is given. +Option D would have been correct, if question mentioned Epidural anaesthesia.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 25 year old G2P, at 39 weeks gestation is electing to have spinal anaesthesia for a repeat cesarean section. 5 minutes after bupivacaine spinal injection, the patient becomes hypotensive and is complaining of tingling in her fingers with subjective difficulty breathing. Her oxygen saturation remains 100% and blood pressure in 90/60 mmHg The most likely etiology is., with the following options: A: Severe patient anxiety, B: Increased peripheral nerve sensitization to local anaesthetics, C: Decrease in volume of CSF in subarachnoid space facilitated higher spread of local anaesthetics, D: Engorgement of epidural veins contributed to inadvertent intravascular injection of local anaesthetic + ### Response: In pregnancy, CSF volume is decreased, thereby decreasing dose requirement of local anaesthetic. This facilitates spread of local anaesthetic when spinal anaesthesia is given. Option D would have been correct, if question mentioned Epidural anaesthesia. @@ -2543,6 +4543,14 @@ Option D would have been correct, if question mentioned Epidural anaesthesia. Answer the following medical question: Pallas sign seen in, with the following options: A: Sarcoidosis, B: Emphysema, C: Pulmonary embolism, D: Myeloma +### Response: +","Chest radiograph signs in PE are , +Pallas sign – enlarged right descending pulmonary artery Hamptons hump- wedge shaped density above diaphragm Westermark sign- focal oligemia.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pallas sign seen in, with the following options: A: Sarcoidosis, B: Emphysema, C: Pulmonary embolism, D: Myeloma + ### Response: Chest radiograph signs in PE are , Pallas sign – enlarged right descending pulmonary artery Hamptons hump- wedge shaped density above diaphragm Westermark sign- focal oligemia. @@ -2553,6 +4561,13 @@ Pallas sign – enlarged right descending pulmonary artery Hamptons hump- wedge Answer the following medical question: Development of human kidney begins in: March 2002, with the following options: A: Dorsal region, B: Lumbar region, C: Thoracolumbar region, D: Sacral region +### Response: +",Ans. D i.e. Sacral region,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Development of human kidney begins in: March 2002, with the following options: A: Dorsal region, B: Lumbar region, C: Thoracolumbar region, D: Sacral region + ### Response: Ans. D i.e. Sacral region ### End" @@ -2562,6 +4577,14 @@ Ans. D i.e. Sacral region Answer the following medical question: Results of a test were given as very satisfied, satisfied, dissatisfied, it represents -, with the following options: A: Nominal scale, B: Ordinal scale, C: Interval scale, D: Ratio scale +### Response: +","In this question, data has been placed into categories, i.e. very satisfied, satisfied and dissatisfied. +So, an ordinal scale should be used.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Results of a test were given as very satisfied, satisfied, dissatisfied, it represents -, with the following options: A: Nominal scale, B: Ordinal scale, C: Interval scale, D: Ratio scale + ### Response: In this question, data has been placed into categories, i.e. very satisfied, satisfied and dissatisfied. So, an ordinal scale should be used. @@ -2572,6 +4595,13 @@ So, an ordinal scale should be used. Answer the following medical question: True about nabothian cyst is all except -, with the following options: A: Squamous epithelium occludes the mouth of the glands, B: It is seen in chronic irritation and inflammation, C: It is a pathology of the cervix, D: It is pre - malignant +### Response: +","Ans. is 'd' i.e., It is pre - malignant Nabothian cvsts# Seen in chronic inflammation of cervix.# It is the result of blockage of mouth of the glands of the cervix.# During the process of healing, the squamous epithelium replaces the columnar epithelium.# The blocked glands become distended with secretion and form small cysts which can be seen with the naked eye, the so-called nabothian follicles.# The condition is neither malignant nor pre-malignant.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about nabothian cyst is all except -, with the following options: A: Squamous epithelium occludes the mouth of the glands, B: It is seen in chronic irritation and inflammation, C: It is a pathology of the cervix, D: It is pre - malignant + ### Response: Ans. is 'd' i.e., It is pre - malignant Nabothian cvsts# Seen in chronic inflammation of cervix.# It is the result of blockage of mouth of the glands of the cervix.# During the process of healing, the squamous epithelium replaces the columnar epithelium.# The blocked glands become distended with secretion and form small cysts which can be seen with the naked eye, the so-called nabothian follicles.# The condition is neither malignant nor pre-malignant. ### End" @@ -2581,6 +4611,13 @@ Ans. is 'd' i.e., It is pre - malignant Nabothian cvsts# Seen in chronic inflamm Answer the following medical question: The following statements regarding peritoneal ligaments are TRUE, EXCEPT:, with the following options: A: Gastrophrenic ligament is present between stomach and diaphragm above the spleen, B: Lienorenal ligament is present between spleen and kidney, C: Gastrocolic ligament is present between stomach and transverse colon, D: Phrenicocolic ligament is present between diaphragm and descending colon +### Response: +","Phrenicocolic ligament is present between diaphragm and transverse colon. The peritoneal ligaments recognized in the greater omentum are:Gastrophrenic ligament: between the stomach and diaphragm above the spleenGastrolienal ligament: between stomach and spleenLienorenal ligament: between spleen and kidneyPhrenicocolic ligament: between diaphragm and transverse colonGastrocolic ligament: between stomach and transverse colonRef: Anatomy: Embryology, Gross Anatomy, Neuroanatomy, Microanatomy edited by Raymond E. Papka page 42","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The following statements regarding peritoneal ligaments are TRUE, EXCEPT:, with the following options: A: Gastrophrenic ligament is present between stomach and diaphragm above the spleen, B: Lienorenal ligament is present between spleen and kidney, C: Gastrocolic ligament is present between stomach and transverse colon, D: Phrenicocolic ligament is present between diaphragm and descending colon + ### Response: Phrenicocolic ligament is present between diaphragm and transverse colon. The peritoneal ligaments recognized in the greater omentum are:Gastrophrenic ligament: between the stomach and diaphragm above the spleenGastrolienal ligament: between stomach and spleenLienorenal ligament: between spleen and kidneyPhrenicocolic ligament: between diaphragm and transverse colonGastrocolic ligament: between stomach and transverse colonRef: Anatomy: Embryology, Gross Anatomy, Neuroanatomy, Microanatomy edited by Raymond E. Papka page 42 ### End" @@ -2590,6 +4627,13 @@ Phrenicocolic ligament is present between diaphragm and transverse colon. The pe Answer the following medical question: Congenital Adrenal Hyperplasia is due to deficiency of:, with the following options: A: 21 beta hydroxylase, B: 17 alpha hydroxylase, C: 5 alpha reductase, D: 17 beta reductase +### Response: +","a. 21 beta hydroxylase(Ref: Nelson's 20/e p 2714-2723, Ghai 8/e p 526-527)Most common cause of Congenital Adrenal Hyperplasia is 21 beta hydroxylase deficiency.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Congenital Adrenal Hyperplasia is due to deficiency of:, with the following options: A: 21 beta hydroxylase, B: 17 alpha hydroxylase, C: 5 alpha reductase, D: 17 beta reductase + ### Response: a. 21 beta hydroxylase(Ref: Nelson's 20/e p 2714-2723, Ghai 8/e p 526-527)Most common cause of Congenital Adrenal Hyperplasia is 21 beta hydroxylase deficiency. ### End" @@ -2599,6 +4643,13 @@ a. 21 beta hydroxylase(Ref: Nelson's 20/e p 2714-2723, Ghai 8/e p 526-527)Most c Answer the following medical question: Which of the following inhalational agent can cause coronary steal phenomenon-, with the following options: A: Isoflurane, B: Sevoflurane, C: Desflurane, D: Halothane +### Response: +","Isoflurane more than other inhalational agents increases coronary blood flow many times beyond that of the myocardial oxygen demand, thereby, creating potential for ""Steel"", steel is diversion of blood from a myocardial bed with limited or inadequate perfusion to a bed with more adequate perfusion.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following inhalational agent can cause coronary steal phenomenon-, with the following options: A: Isoflurane, B: Sevoflurane, C: Desflurane, D: Halothane + ### Response: Isoflurane more than other inhalational agents increases coronary blood flow many times beyond that of the myocardial oxygen demand, thereby, creating potential for ""Steel"", steel is diversion of blood from a myocardial bed with limited or inadequate perfusion to a bed with more adequate perfusion. ### End" @@ -2608,6 +4659,13 @@ Isoflurane more than other inhalational agents increases coronary blood flow man Answer the following medical question: Metabolic complication in CRF include all of the following except, with the following options: A: Hyperkalemia, B: Hypophosphataemia, C: Hypocalcemia, D: Hypokalemia +### Response: +",Metabolic complication in CRF include Hyperphosphatemia Hyerkalemia Hyponatremia refer Harrison 18/e,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Metabolic complication in CRF include all of the following except, with the following options: A: Hyperkalemia, B: Hypophosphataemia, C: Hypocalcemia, D: Hypokalemia + ### Response: Metabolic complication in CRF include Hyperphosphatemia Hyerkalemia Hyponatremia refer Harrison 18/e ### End" @@ -2617,6 +4675,13 @@ Metabolic complication in CRF include Hyperphosphatemia Hyerkalemia Hyponatremia Answer the following medical question: Which of the following is not a test for diabetes mellitus, with the following options: A: Fasting blood glucose, B: Random blood glucose, C: D-Xylose test, D: Oral Glucose tolerance test +### Response: +","Answer is C (D-Xylose test): The D-Xylose test is a test for assessment of proximal small intestinal mucosa' fUnction. D- Xylose test is used to assess carbohydrate malabsorption and is not a test for assessment of Diabetes mellitus Fasting blood glucose, Random blood glucose and Oral Glucose Tolerance test are all used for assessment of diabetes mellitus. Criteria for the diagnosis of Diabetes Mellitus Symptoms of diabetes plus random blood glucose concentration 11.1 mmol/L (200 mg/dL) or Fasting plasma glucose 7.0 mmol/L (126 mg/dL) or Two-hour plasma glucose 11.1 mmol/L (200 mg/dL) during an oral glucose tolerance test.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is not a test for diabetes mellitus, with the following options: A: Fasting blood glucose, B: Random blood glucose, C: D-Xylose test, D: Oral Glucose tolerance test + ### Response: Answer is C (D-Xylose test): The D-Xylose test is a test for assessment of proximal small intestinal mucosa' fUnction. D- Xylose test is used to assess carbohydrate malabsorption and is not a test for assessment of Diabetes mellitus Fasting blood glucose, Random blood glucose and Oral Glucose Tolerance test are all used for assessment of diabetes mellitus. Criteria for the diagnosis of Diabetes Mellitus Symptoms of diabetes plus random blood glucose concentration 11.1 mmol/L (200 mg/dL) or Fasting plasma glucose 7.0 mmol/L (126 mg/dL) or Two-hour plasma glucose 11.1 mmol/L (200 mg/dL) during an oral glucose tolerance test. ### End" @@ -2626,6 +4691,13 @@ Answer is C (D-Xylose test): The D-Xylose test is a test for assessment of proxi Answer the following medical question: All are TRUE about clavicle, EXCEPT, with the following options: A: No treatment required for fracture but rest, B: Breaks at mid point, C: First bone to ossify, D: Ossifies in membrane +### Response: +",A i.e. No treatment required for fracture but rest,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are TRUE about clavicle, EXCEPT, with the following options: A: No treatment required for fracture but rest, B: Breaks at mid point, C: First bone to ossify, D: Ossifies in membrane + ### Response: A i.e. No treatment required for fracture but rest ### End" @@ -2635,6 +4707,13 @@ A i.e. No treatment required for fracture but rest Answer the following medical question: Gottron's papules are seen in -, with the following options: A: Dermatomyositis, B: Sarcoidosis, C: Scleroderma, D: Fungal infection +### Response: +","Ans. is 'a' i.e., Dermatomyositis Cutaneous signs of dermatomyosits1. Gottron's papules lilac or violaceous papules on knuckle, dorsa of hands.2. Gottron's sign Violaceous erythema with edema over shoulder, arms, forearms.3. Heliotrope sign Violaceous erythema with edema over eyelids, periorbital region.4. Poikiloderma Atrophy of skin, hypopigmentaion, dilated blood vessels over trunk.5. Mechanic hand Symmetric hyperkeratosis along ulnar aspect of thumb and radial aspect of fingers.6. Shawl Sign Violaceous erythema extending from dorsolateral aspect of hands, forearms, and arms to shoulder & neck.7. Calcinosis cutis Calcium deposits in skin (in Juvenile variant).8. Miscellaneous signs Photosensitivity, vasculitis, panniculitis, Nail-fold telangiectasia.Extracutaneous invplvement1. Proximal myositis2. Cardiomyopathy 3. Raynaud's phenomenon4. Arthralgia","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Gottron's papules are seen in -, with the following options: A: Dermatomyositis, B: Sarcoidosis, C: Scleroderma, D: Fungal infection + ### Response: Ans. is 'a' i.e., Dermatomyositis Cutaneous signs of dermatomyosits1. Gottron's papules lilac or violaceous papules on knuckle, dorsa of hands.2. Gottron's sign Violaceous erythema with edema over shoulder, arms, forearms.3. Heliotrope sign Violaceous erythema with edema over eyelids, periorbital region.4. Poikiloderma Atrophy of skin, hypopigmentaion, dilated blood vessels over trunk.5. Mechanic hand Symmetric hyperkeratosis along ulnar aspect of thumb and radial aspect of fingers.6. Shawl Sign Violaceous erythema extending from dorsolateral aspect of hands, forearms, and arms to shoulder & neck.7. Calcinosis cutis Calcium deposits in skin (in Juvenile variant).8. Miscellaneous signs Photosensitivity, vasculitis, panniculitis, Nail-fold telangiectasia.Extracutaneous invplvement1. Proximal myositis2. Cardiomyopathy 3. Raynaud's phenomenon4. Arthralgia ### End" @@ -2644,6 +4723,13 @@ Ans. is 'a' i.e., Dermatomyositis Cutaneous signs of dermatomyosits1. Gottron's Answer the following medical question: Virulence determinant implicated in pathogenesis of scarlet fever is -, with the following options: A: Hyaluronidase, B: M protein, C: Pyrogenic exotoxin, D: Streptokinase +### Response: +","Ans. is 'a' i.e., Pyrogenic exotoxin","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Virulence determinant implicated in pathogenesis of scarlet fever is -, with the following options: A: Hyaluronidase, B: M protein, C: Pyrogenic exotoxin, D: Streptokinase + ### Response: Ans. is 'a' i.e., Pyrogenic exotoxin ### End" @@ -2653,6 +4739,13 @@ Ans. is 'a' i.e., Pyrogenic exotoxin Answer the following medical question: Portal of entry of poliovirus in mainly:, with the following options: A: GIT, B: Nasal mucosa, C: Lung, D: Skin +### Response: +","Ans. is 'a' i.e., GITPathogenesis of poliomyelitis:On entering the body, the virus infects and multiplies in the tonsils and Peyer's patch of the ileum. It then spreads to regional lymph nodes and enters the blood, causing a primary viremia. On continued infection and multiplication of virus in the reticuloendothelial cells, it invades the blood stream again and causes secondary viremia. During this period of viremia. the poliovirus crosses the blood-brain barrier or gains access to the brain by infecting skeletal muscle and travelling up on the nerves to the brain as in rabies virus.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Portal of entry of poliovirus in mainly:, with the following options: A: GIT, B: Nasal mucosa, C: Lung, D: Skin + ### Response: Ans. is 'a' i.e., GITPathogenesis of poliomyelitis:On entering the body, the virus infects and multiplies in the tonsils and Peyer's patch of the ileum. It then spreads to regional lymph nodes and enters the blood, causing a primary viremia. On continued infection and multiplication of virus in the reticuloendothelial cells, it invades the blood stream again and causes secondary viremia. During this period of viremia. the poliovirus crosses the blood-brain barrier or gains access to the brain by infecting skeletal muscle and travelling up on the nerves to the brain as in rabies virus. ### End" @@ -2662,6 +4755,13 @@ Ans. is 'a' i.e., GITPathogenesis of poliomyelitis:On entering the body, the vir Answer the following medical question: Barr body is found in following phase of cell cycle?, with the following options: A: Interphase, B: Metaphase, C: G1 phase, D: Telophase +### Response: +","Ans. is 'a' i.e. Interphase Barr body (sex-chromatin)* t is a densely staining inactivated condensed 'X' chromosome that is present in each somatic cells of female. It is found in the nucleus. It is used as a test of genetic femaleness - it is possible to determine the genetic sex of an individual according as to whether there is a chromatin mass present on the inner surface of the nuclear membrane of cells with resting or intermittent nuclei.* Chromatid body (Barr body or sex chromatin) is derived from one of the two X-chromosomes which becomes inactivated. The number of Barr bodies is thus one less than the number of X-chromosomes* It is particularly visible when the cell is in interphase, meaning it is not currently undergoing cell division.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Barr body is found in following phase of cell cycle?, with the following options: A: Interphase, B: Metaphase, C: G1 phase, D: Telophase + ### Response: Ans. is 'a' i.e. Interphase Barr body (sex-chromatin)* t is a densely staining inactivated condensed 'X' chromosome that is present in each somatic cells of female. It is found in the nucleus. It is used as a test of genetic femaleness - it is possible to determine the genetic sex of an individual according as to whether there is a chromatin mass present on the inner surface of the nuclear membrane of cells with resting or intermittent nuclei.* Chromatid body (Barr body or sex chromatin) is derived from one of the two X-chromosomes which becomes inactivated. The number of Barr bodies is thus one less than the number of X-chromosomes* It is particularly visible when the cell is in interphase, meaning it is not currently undergoing cell division. ### End" @@ -2671,6 +4771,13 @@ Ans. is 'a' i.e. Interphase Barr body (sex-chromatin)* t is a densely staining i Answer the following medical question: Cetuxirnab (an EGFR antagonist) can be used in, with the following options: A: Palliation in head and neck cancer, B: Anal canal ca, C: Gastric ca, D: Lung ca +### Response: +",Palliation in head Neck cancer Cetuximab is a monoclonal antibody that acts against EGFR (Epidermal growth factor receptor). EGFR is a signalling protein that normally controls cell division. In some cancers this is altered to cause uncontrolled cell division. Cetuximab attaches itself to EGFR and prevents the receptor from being activated. This prevent the cancer cells from uncontrolled cell division. Cetuximab is a chimeric monoclonal antibody. Chimeric antibodies are formed using pas of mouse proteins and pas of human proteins. Uses of Cetuximab Head and Neck cancer Cetuximab was approved by FDA in march 2006 for use in combination with radiation therapy for treating squamous cell carcinoma of the head and neck or as a single agent in patients who had prior platinum based therapy. Colorectal cancer Cetuximab was approved by the FDA in 2004 for the treatment of EGFR positive metastatic colorectal cancer as a single agent in patients who could not tolerate irinotecan based therapy or in combination with irinotecan for refractory patient.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cetuxirnab (an EGFR antagonist) can be used in, with the following options: A: Palliation in head and neck cancer, B: Anal canal ca, C: Gastric ca, D: Lung ca + ### Response: Palliation in head Neck cancer Cetuximab is a monoclonal antibody that acts against EGFR (Epidermal growth factor receptor). EGFR is a signalling protein that normally controls cell division. In some cancers this is altered to cause uncontrolled cell division. Cetuximab attaches itself to EGFR and prevents the receptor from being activated. This prevent the cancer cells from uncontrolled cell division. Cetuximab is a chimeric monoclonal antibody. Chimeric antibodies are formed using pas of mouse proteins and pas of human proteins. Uses of Cetuximab Head and Neck cancer Cetuximab was approved by FDA in march 2006 for use in combination with radiation therapy for treating squamous cell carcinoma of the head and neck or as a single agent in patients who had prior platinum based therapy. Colorectal cancer Cetuximab was approved by the FDA in 2004 for the treatment of EGFR positive metastatic colorectal cancer as a single agent in patients who could not tolerate irinotecan based therapy or in combination with irinotecan for refractory patient. ### End" @@ -2680,6 +4787,13 @@ Palliation in head Neck cancer Cetuximab is a monoclonal antibody that acts agai Answer the following medical question: 30 year male with chronic diarrhoea, anemis, raised liver enzymes. Most likely associated with-, with the following options: A: Antimitochondrial antibody, B: Anti-endomysial antibody, C: Anti-smooth muscle antibody, D: Antinuclear antibody +### Response: +",IgA anti-endomysial antibodies are found in 90% coeliac patients. They are a very specific & sensitive marker for coeliac disease and dermatitis herpetiformis. The anti-endomysial antibody test has been suggested to be 98% sensitive and 98% specific for clinical or subclinical coeliac disease Ref Davidson edition23rd pg 805,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: 30 year male with chronic diarrhoea, anemis, raised liver enzymes. Most likely associated with-, with the following options: A: Antimitochondrial antibody, B: Anti-endomysial antibody, C: Anti-smooth muscle antibody, D: Antinuclear antibody + ### Response: IgA anti-endomysial antibodies are found in 90% coeliac patients. They are a very specific & sensitive marker for coeliac disease and dermatitis herpetiformis. The anti-endomysial antibody test has been suggested to be 98% sensitive and 98% specific for clinical or subclinical coeliac disease Ref Davidson edition23rd pg 805 ### End" @@ -2689,6 +4803,13 @@ IgA anti-endomysial antibodies are found in 90% coeliac patients. They are a ver Answer the following medical question: Which of the following is not the new entity added in the proposed ICD-11?, with the following options: A: Olfactory reference disorder, B: Compulsive sexual behavior disorder, C: Complex post-traumatic stress disorder, D: Schizophreniform disorder +### Response: +","Ans. D Schizophreniform disorderOlfactory Reference Disorder is characterized by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only slightly noticeable to others. Individuals experience excessive self-consciousness about the perceived odour, often with ideas of reference (i.e., the conviction that people are taking notice, judging, or talking about the odour).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is not the new entity added in the proposed ICD-11?, with the following options: A: Olfactory reference disorder, B: Compulsive sexual behavior disorder, C: Complex post-traumatic stress disorder, D: Schizophreniform disorder + ### Response: Ans. D Schizophreniform disorderOlfactory Reference Disorder is characterized by persistent preoccupation with the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only slightly noticeable to others. Individuals experience excessive self-consciousness about the perceived odour, often with ideas of reference (i.e., the conviction that people are taking notice, judging, or talking about the odour). ### End" @@ -2698,6 +4819,13 @@ Ans. D Schizophreniform disorderOlfactory Reference Disorder is characterized by Answer the following medical question: Macula is, with the following options: A: Optic nerve, B: Optic tract, C: Periodic bluring of vision, D: Constant blinking +### Response: +",Ans. Constant blinking,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Macula is, with the following options: A: Optic nerve, B: Optic tract, C: Periodic bluring of vision, D: Constant blinking + ### Response: Ans. Constant blinking ### End" @@ -2707,6 +4835,13 @@ Ans. Constant blinking Answer the following medical question: A 62-year-old man presents to his new primary care physician for a first visit. The patient has not seen a doctor for more than 10 years. He has mild intermittent bronchial asthma. The patient is sexually active with a single long-term partner. He does not recall receiving any vaccines since childhood. Which of the following vaccines should be offered?, with the following options: A: Pneumococcal, influenza, zoster, and tetanus-diphtheria-acellular pertussis (Tdap), B: Pneumococcal, influenza, zoster, and tetanus-diphtheria (Td), C: Pneumococcal, influenza, and HPV, D: Pneumococcal, influenza, and tetanus-diphtheria-acellular pertussis (Tdap) +### Response: +","Assessment for adult vaccination should be based on age, comorbidities, immunization history, and other risk factors such as travel plans and sexual behaviors. Adults should get tetanus and diphtheria vaccine (Td) every 10 years. Tetanus, diphtheria, and acellular pertussis (Tdap) vaccine should replace one of the Td vaccines if not given before or during adult life. Zoster vaccine is indicated for individuals over 60 years of age. The influenza vaccine is recommended for all persons aged 6 months and older, including all adults. Pneumococcal vaccine is indicated in patients with chronic illnesses such as heart failure, bronchial asthma, chronic obstructive pulmonary disease, chronic kidney disease, and diabetes mellitus. Otherwise, the pneumococcal vaccine is administered once at the age of 65. HPV vaccine is indicated in females and males who are 11 to 26 years of age. The meningococcal vaccination is recommended for adults with anatomic or functional asplenia or persistent complement component deficiencies, as well as adults with HIV infection. Meningococcal vaccine is also indicated for patients traveling to meningitis endemic areas.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 62-year-old man presents to his new primary care physician for a first visit. The patient has not seen a doctor for more than 10 years. He has mild intermittent bronchial asthma. The patient is sexually active with a single long-term partner. He does not recall receiving any vaccines since childhood. Which of the following vaccines should be offered?, with the following options: A: Pneumococcal, influenza, zoster, and tetanus-diphtheria-acellular pertussis (Tdap), B: Pneumococcal, influenza, zoster, and tetanus-diphtheria (Td), C: Pneumococcal, influenza, and HPV, D: Pneumococcal, influenza, and tetanus-diphtheria-acellular pertussis (Tdap) + ### Response: Assessment for adult vaccination should be based on age, comorbidities, immunization history, and other risk factors such as travel plans and sexual behaviors. Adults should get tetanus and diphtheria vaccine (Td) every 10 years. Tetanus, diphtheria, and acellular pertussis (Tdap) vaccine should replace one of the Td vaccines if not given before or during adult life. Zoster vaccine is indicated for individuals over 60 years of age. The influenza vaccine is recommended for all persons aged 6 months and older, including all adults. Pneumococcal vaccine is indicated in patients with chronic illnesses such as heart failure, bronchial asthma, chronic obstructive pulmonary disease, chronic kidney disease, and diabetes mellitus. Otherwise, the pneumococcal vaccine is administered once at the age of 65. HPV vaccine is indicated in females and males who are 11 to 26 years of age. The meningococcal vaccination is recommended for adults with anatomic or functional asplenia or persistent complement component deficiencies, as well as adults with HIV infection. Meningococcal vaccine is also indicated for patients traveling to meningitis endemic areas. ### End" @@ -2716,6 +4851,13 @@ Assessment for adult vaccination should be based on age, comorbidities, immuniza Answer the following medical question: IPC 197 is related to, with the following options: A: Medical negligence, B: Issuing false ceificate by doctor, C: Giving false evidence under oath, D: Summons +### Response: +",IPC 197 - Knowingly issuing or signing a false ceificate relating to any fact of which such ceificate is by law admissible in evidence. Punishment as for False Evidence. Ref: Krishnan vij ; 5th ed; Page no: 582,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: IPC 197 is related to, with the following options: A: Medical negligence, B: Issuing false ceificate by doctor, C: Giving false evidence under oath, D: Summons + ### Response: IPC 197 - Knowingly issuing or signing a false ceificate relating to any fact of which such ceificate is by law admissible in evidence. Punishment as for False Evidence. Ref: Krishnan vij ; 5th ed; Page no: 582 ### End" @@ -2725,6 +4867,13 @@ IPC 197 - Knowingly issuing or signing a false ceificate relating to any fact of Answer the following medical question: A 40-year old man with central obesity, ""buffalo hump"" and veical purple striae on abdomen, has fasting blood glucose levels in high normal range. Plasma levels of ACTH and coisol are both increased compared to normal. An overnight high-dose dexamethasone test produces 75% suppression of coisol levels. This patient most likely has, with the following options: A: Addison's disease, B: An ectopic ACTH-secreting tumor, C: Conn's syndrome, D: Cushing's disease +### Response: +","- Given patient has increased coisol & ACTH levels with cushingoid signs & symptoms. - This could result from either functional ACTH-secreting tumor in pituitary (Cushing's disease) or an ectopic tumor (such as a small cell carcinoma of lung, choice B). - To distinguish b/w these two,high doses of potent synthetic glucocoicoid(dexamethasone) is administered High-dose dexamethasone suppresses ACTH secretion at least by 50% in Cushing's disease Whereas secretion from ectopic tumor is not suppressed by dexamethasone. - As 75% suppression of coisol levels is seen in this pt, diagnosis is cushing's disease. OTHER OPTIONS: Addison's disease (choice A) is primary adrenal insufficiency, with increased plasma ACTH (producing hyperpigmentation) & decreased plasma coisol, aldosterone levels compared to normal. Conn's syndrome (choice C) results from hypersecretion of aldosterone by adrenal coex resulting in decreased ACTH production.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 40-year old man with central obesity, ""buffalo hump"" and veical purple striae on abdomen, has fasting blood glucose levels in high normal range. Plasma levels of ACTH and coisol are both increased compared to normal. An overnight high-dose dexamethasone test produces 75% suppression of coisol levels. This patient most likely has, with the following options: A: Addison's disease, B: An ectopic ACTH-secreting tumor, C: Conn's syndrome, D: Cushing's disease + ### Response: - Given patient has increased coisol & ACTH levels with cushingoid signs & symptoms. - This could result from either functional ACTH-secreting tumor in pituitary (Cushing's disease) or an ectopic tumor (such as a small cell carcinoma of lung, choice B). - To distinguish b/w these two,high doses of potent synthetic glucocoicoid(dexamethasone) is administered High-dose dexamethasone suppresses ACTH secretion at least by 50% in Cushing's disease Whereas secretion from ectopic tumor is not suppressed by dexamethasone. - As 75% suppression of coisol levels is seen in this pt, diagnosis is cushing's disease. OTHER OPTIONS: Addison's disease (choice A) is primary adrenal insufficiency, with increased plasma ACTH (producing hyperpigmentation) & decreased plasma coisol, aldosterone levels compared to normal. Conn's syndrome (choice C) results from hypersecretion of aldosterone by adrenal coex resulting in decreased ACTH production. ### End" @@ -2734,6 +4883,13 @@ Answer the following medical question: A 40-year old man with central obesity, " Answer the following medical question: ""Double PCL"" sign on MRI knee is seen in, with the following options: A: Lateral meniscus tear, B: Medial meniscus tear, C: PCL tear, D: ACL tear +### Response: +","The double PCL signal appears on sagittal MRI images of the knee when a bucket handle tear of medial meniscus flips so that comes to lie anteroinferior to the posterior cruciate ligament (PCL) mimicking a second smaller PCL. Identifying a double PCL sign is highly specific for the detection of displaced bucket-handle tears. Ref: Internet sources src="" alt="""" width=""200"" height=""142"" />","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: ""Double PCL"" sign on MRI knee is seen in, with the following options: A: Lateral meniscus tear, B: Medial meniscus tear, C: PCL tear, D: ACL tear + ### Response: The double PCL signal appears on sagittal MRI images of the knee when a bucket handle tear of medial meniscus flips so that comes to lie anteroinferior to the posterior cruciate ligament (PCL) mimicking a second smaller PCL. Identifying a double PCL sign is highly specific for the detection of displaced bucket-handle tears. Ref: Internet sources src="" alt="""" width=""200"" height=""142"" /> ### End" @@ -2743,6 +4899,13 @@ The double PCL signal appears on sagittal MRI images of the knee when a bucket h Answer the following medical question: In severe acute malnutrition, arm circumference is less than (in cm):, with the following options: A: 11.5, B: 12, C: 12.5, D: 13 +### Response: +","In children who are 6-59 months of age, severe acute malnutrition is defined asWeight-for-height <= -3 Z-score, orMid-upper-arm circumference <11.5 cm, orPresence of bilateral edema(Refer: Nelson's Textbook of Pediatrics, SAE, 1st edition, pg no. 301)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In severe acute malnutrition, arm circumference is less than (in cm):, with the following options: A: 11.5, B: 12, C: 12.5, D: 13 + ### Response: In children who are 6-59 months of age, severe acute malnutrition is defined asWeight-for-height <= -3 Z-score, orMid-upper-arm circumference <11.5 cm, orPresence of bilateral edema(Refer: Nelson's Textbook of Pediatrics, SAE, 1st edition, pg no. 301) ### End" @@ -2752,6 +4915,14 @@ In children who are 6-59 months of age, severe acute malnutrition is defined asW Answer the following medical question: An 8 year old has 1st molar in a cusp-to-cusp relation. The treatment is:, with the following options: A: Fixed appliance, B: Removable appliance, C: Continuous recall and observe, D: None of the above +### Response: +","When the deciduous second molars are in a fIush terminal plane, the permanent first molar erupts initially into a cusp-to-cusp relationship, which later transforms into a Class I molar relation using the primate spaces. +Later, cusp-to-cusp relationship of the permanent first molar can be converted to a Class I relationship by the mesial shift of the permanent first molar following exfoliation of the primary molar and thus making use of the Leeway space (late mesial shift).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: An 8 year old has 1st molar in a cusp-to-cusp relation. The treatment is:, with the following options: A: Fixed appliance, B: Removable appliance, C: Continuous recall and observe, D: None of the above + ### Response: When the deciduous second molars are in a fIush terminal plane, the permanent first molar erupts initially into a cusp-to-cusp relationship, which later transforms into a Class I molar relation using the primate spaces. Later, cusp-to-cusp relationship of the permanent first molar can be converted to a Class I relationship by the mesial shift of the permanent first molar following exfoliation of the primary molar and thus making use of the Leeway space (late mesial shift). @@ -2762,6 +4933,13 @@ Later, cusp-to-cusp relationship of the permanent first molar can be converted t Answer the following medical question: Zileuton is -, with the following options: A: 5 lipooxygenase inhibitor, B: TX A2 inhibitor, C: Leukotriene receptor antagonist, D: Prostaglandins synthesis inhibitor +### Response: +","Ans. is 'a' i.e., 5 lipooxygenase inhibitor 5-lipoxygenase inhibitoro 5-lipoxygenase involved in production of leukotrienes especially LTB4 (chemoattractant) and LTC4, LTD4 (Bronchoconstrictor). These are the most important mediators in bronchial asthma.o Zileuton inhibits 5-lip>>xygenase and thereby the production of leukotrienes. Therefore, Zileuton is useful in the treatment of asthma.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Zileuton is -, with the following options: A: 5 lipooxygenase inhibitor, B: TX A2 inhibitor, C: Leukotriene receptor antagonist, D: Prostaglandins synthesis inhibitor + ### Response: Ans. is 'a' i.e., 5 lipooxygenase inhibitor 5-lipoxygenase inhibitoro 5-lipoxygenase involved in production of leukotrienes especially LTB4 (chemoattractant) and LTC4, LTD4 (Bronchoconstrictor). These are the most important mediators in bronchial asthma.o Zileuton inhibits 5-lip>>xygenase and thereby the production of leukotrienes. Therefore, Zileuton is useful in the treatment of asthma. ### End" @@ -2771,6 +4949,13 @@ Ans. is 'a' i.e., 5 lipooxygenase inhibitor 5-lipoxygenase inhibitoro 5-lipoxyge Answer the following medical question: All of the followings can cause hemolytic anaemia except-, with the following options: A: Isoniazid, B: Rifampicin, C: Co-trimoxazole, D: Propanolol +### Response: +","Ans. is 'd' i.e., Propanolol Drugs causing hemolytic anaemia o Isoniazid o Sulfonamide o Procainamide o Phenacetin o Melphalan o Rifampicin o Quinidine o Penicillin o Dapsone","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the followings can cause hemolytic anaemia except-, with the following options: A: Isoniazid, B: Rifampicin, C: Co-trimoxazole, D: Propanolol + ### Response: Ans. is 'd' i.e., Propanolol Drugs causing hemolytic anaemia o Isoniazid o Sulfonamide o Procainamide o Phenacetin o Melphalan o Rifampicin o Quinidine o Penicillin o Dapsone ### End" @@ -2780,6 +4965,13 @@ Ans. is 'd' i.e., Propanolol Drugs causing hemolytic anaemia o Isoniazid o Sulfo Answer the following medical question: A diabetic patient is undergoing dialysis. Aspiration done around the knee joint would show which of the following?, with the following options: A: A- b2 microglobulin, B: AA, C: AL, D: Lactoferrin +### Response: +","Chronic renal failure patients undergoing long term hemodialysis develop amyloidosis. Amyloidosis in such cases is associated with the deposition of a protein called A- b2 microglobulin. Such amyloid deposits are common in synovium, joints and tendon sheaths. So an aspirate obtained from knee joint would likely reveal A- b2 microglobulin.Ref: Pathologic Basis Of Disease, Robbins, 6th Edition, Page 253; 7th Edition, Page 260, 261.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A diabetic patient is undergoing dialysis. Aspiration done around the knee joint would show which of the following?, with the following options: A: A- b2 microglobulin, B: AA, C: AL, D: Lactoferrin + ### Response: Chronic renal failure patients undergoing long term hemodialysis develop amyloidosis. Amyloidosis in such cases is associated with the deposition of a protein called A- b2 microglobulin. Such amyloid deposits are common in synovium, joints and tendon sheaths. So an aspirate obtained from knee joint would likely reveal A- b2 microglobulin.Ref: Pathologic Basis Of Disease, Robbins, 6th Edition, Page 253; 7th Edition, Page 260, 261. ### End" @@ -2789,6 +4981,13 @@ Chronic renal failure patients undergoing long term hemodialysis develop amyloid Answer the following medical question: Uncommon in Colle's fracture: March 2007, with the following options: A: Non-union, B: Mal-union, C: Rupture of EPL tendon, D: Reflex sympathetic dystrophy +### Response: +","Ans. A: Non-union A. CoIle's fracture is usually produced by a FOOSH (fall on an outstretched handy mechanism with the wrist in dorsiflexion. The fracture is dorsally displaced and may be comminuted. The fracture pattern is often described as a silver or dinner-fork deformity. Two classification systems are used: The Association for Osteosynthesis (AO) system The Frykman system. Complications of the Colles fracture include: Post-traumatic stiffness Mal-union Subluxation of the inferior radio-ulnar joint Acute carpal tunnel syndrome Sudeck's osteodystrophy. Rupture of the extensor pollicis longus tendon B. An impact to the dorsum of the hand or a hyperflexion or hypersupination injury results in Smith's fracture. A Smith fracture is usually called a reverse Colles fracture because the distal fragment is displaced volarly. It is often described as a garden-spade deformity. C. Baon fractures are classified as dorsal or palmar (always intra-aicular), and they always involve carpal subluxation. The volar Baon fracture is thought to occur with the same mechanism as the Smith fracture, with more force and loading on the wrist. The dorsal Baon fracture is caused by a fall on an extended and pronated wrist, increasing carpal compression force on the dorsal rim. The salient feature is a subluxation of the wrist. By definition, this fracture has some degree of carpal displacement, which distinguishes it from a Colles or Smith fracture. The palmar variety is more common than the dorsal type. D. The chauffeur's fracture derives its name from injuries that were acquired, in the days when motor vehicles were cranked, when a vehicle backfired. The force is described as a direct axial compression of the scaphoid into the radial facet. The radial styloid is fractured, with associated avulsion of the radial collateral ligament. A chauffeur's fracture represents an avulsion related to the attachment sites of the radiocarpal ligaments or of the radial collateral ligament. E. Galeazzi fracture results from a FOOSH mechanism with the forearm hyperpronated or from a direct impact to the dorsal radial wrist. The radial diaphysis at the distal and middle third junction is fractured, with associated subluxation of the distal radioulnar joint. On PA views, the radius is shoened and the radioulnar joint is disrupted. On the lateral view, the distal radius is angulated either volarly or radially as a result of the pull of the brachioradialis muscle with more than 3 mm of ulnar displacement. F. The Essex-Lopresti fracture consists of a comminuted and displaced radial head fracture along with disruption of the distal radioulnar joint and interosseous membrane.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Uncommon in Colle's fracture: March 2007, with the following options: A: Non-union, B: Mal-union, C: Rupture of EPL tendon, D: Reflex sympathetic dystrophy + ### Response: Ans. A: Non-union A. CoIle's fracture is usually produced by a FOOSH (fall on an outstretched handy mechanism with the wrist in dorsiflexion. The fracture is dorsally displaced and may be comminuted. The fracture pattern is often described as a silver or dinner-fork deformity. Two classification systems are used: The Association for Osteosynthesis (AO) system The Frykman system. Complications of the Colles fracture include: Post-traumatic stiffness Mal-union Subluxation of the inferior radio-ulnar joint Acute carpal tunnel syndrome Sudeck's osteodystrophy. Rupture of the extensor pollicis longus tendon B. An impact to the dorsum of the hand or a hyperflexion or hypersupination injury results in Smith's fracture. A Smith fracture is usually called a reverse Colles fracture because the distal fragment is displaced volarly. It is often described as a garden-spade deformity. C. Baon fractures are classified as dorsal or palmar (always intra-aicular), and they always involve carpal subluxation. The volar Baon fracture is thought to occur with the same mechanism as the Smith fracture, with more force and loading on the wrist. The dorsal Baon fracture is caused by a fall on an extended and pronated wrist, increasing carpal compression force on the dorsal rim. The salient feature is a subluxation of the wrist. By definition, this fracture has some degree of carpal displacement, which distinguishes it from a Colles or Smith fracture. The palmar variety is more common than the dorsal type. D. The chauffeur's fracture derives its name from injuries that were acquired, in the days when motor vehicles were cranked, when a vehicle backfired. The force is described as a direct axial compression of the scaphoid into the radial facet. The radial styloid is fractured, with associated avulsion of the radial collateral ligament. A chauffeur's fracture represents an avulsion related to the attachment sites of the radiocarpal ligaments or of the radial collateral ligament. E. Galeazzi fracture results from a FOOSH mechanism with the forearm hyperpronated or from a direct impact to the dorsal radial wrist. The radial diaphysis at the distal and middle third junction is fractured, with associated subluxation of the distal radioulnar joint. On PA views, the radius is shoened and the radioulnar joint is disrupted. On the lateral view, the distal radius is angulated either volarly or radially as a result of the pull of the brachioradialis muscle with more than 3 mm of ulnar displacement. F. The Essex-Lopresti fracture consists of a comminuted and displaced radial head fracture along with disruption of the distal radioulnar joint and interosseous membrane. ### End" @@ -2798,6 +4997,13 @@ Ans. A: Non-union A. CoIle's fracture is usually produced by a FOOSH (fall on an Answer the following medical question: Medial rotator of thigh at hip joint is, with the following options: A: Obturator externus, B: Obturator internus, C: Gluteus maximus, D: Gluteus minimus +### Response: +","Gluteus medius, Gluteus minimus, Tensor fascia lata (collectively referred to as TRIO muscles)- Medial rotators of thigh Obturator internus, Obturator externus, Gluteus maximus -lateral rotators of thigh.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Medial rotator of thigh at hip joint is, with the following options: A: Obturator externus, B: Obturator internus, C: Gluteus maximus, D: Gluteus minimus + ### Response: Gluteus medius, Gluteus minimus, Tensor fascia lata (collectively referred to as TRIO muscles)- Medial rotators of thigh Obturator internus, Obturator externus, Gluteus maximus -lateral rotators of thigh. ### End" @@ -2807,6 +5013,13 @@ Gluteus medius, Gluteus minimus, Tensor fascia lata (collectively referred to as Answer the following medical question: All are the features of primary TB except, with the following options: A: Pleural effusion, B: Consolidation, C: Pulmonary fibrosis, D: None of the above +### Response: +",All of the above are features of Primary TB,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are the features of primary TB except, with the following options: A: Pleural effusion, B: Consolidation, C: Pulmonary fibrosis, D: None of the above + ### Response: All of the above are features of Primary TB ### End" @@ -2816,6 +5029,13 @@ All of the above are features of Primary TB Answer the following medical question: All are TRUE regarding filariasis except -, with the following options: A: Man is an intermediate host, B: Caused by wuchereria bancrofti, C: Involves lymphatic system, D: DEC is used in treatment +### Response: +","

Filariasis:- Causative agent- W.bancrofti, B.malayi and B.timori. Man is definitive host. Mosquito is the intermediate host. Infective stage- microfilaria. The maximum density of microfilaria in blood is repoed between 10 pm-2am. Treatment- DEC. Filarial control in community. {Reference: park&;s textbook of preventive and social medicine, 23rd edition, pg no.274}

","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are TRUE regarding filariasis except -, with the following options: A: Man is an intermediate host, B: Caused by wuchereria bancrofti, C: Involves lymphatic system, D: DEC is used in treatment + ### Response:

Filariasis:- Causative agent- W.bancrofti, B.malayi and B.timori. Man is definitive host. Mosquito is the intermediate host. Infective stage- microfilaria. The maximum density of microfilaria in blood is repoed between 10 pm-2am. Treatment- DEC. Filarial control in community. {Reference: park&;s textbook of preventive and social medicine, 23rd edition, pg no.274}

### End" @@ -2825,6 +5045,13 @@ Answer the following medical question: All are TRUE regarding filariasis except Answer the following medical question: All of the following are true about herd immunity, EXCEPT:, with the following options: A: It can be achieved by immunizing a population with a vaccine that interrupts transmission, B: The live virus in the vaccine can replicate in the immunized person and spread to other members of the population, C: Herd immunity can be achieved only by vaccines., D: The vaccine must prevent transmission of the virus as well as prevent disease. +### Response: +","Herd immunity can be achieved by immunizing a population with a vaccine that interrupts transmission, such as the live, attenuated polio vaccine, but not with a vaccine that does not interrupt transmission, such as the killed polio vaccine (even though it protects the immunized individual against disease). In addition, the live virus in the vaccine can replicate in the immunized person and spread to other members of the population, thereby increasing the number of people protected. Herd immunity can be achieved by natural infection as well as vaccines (e.g., measles). For herd immunity to occur, the vaccine must prevent transmission of the virus as well as prevent disease. Ref: Levinson W. (2012). Chapter 33. Host Defenses. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following are true about herd immunity, EXCEPT:, with the following options: A: It can be achieved by immunizing a population with a vaccine that interrupts transmission, B: The live virus in the vaccine can replicate in the immunized person and spread to other members of the population, C: Herd immunity can be achieved only by vaccines., D: The vaccine must prevent transmission of the virus as well as prevent disease. + ### Response: Herd immunity can be achieved by immunizing a population with a vaccine that interrupts transmission, such as the live, attenuated polio vaccine, but not with a vaccine that does not interrupt transmission, such as the killed polio vaccine (even though it protects the immunized individual against disease). In addition, the live virus in the vaccine can replicate in the immunized person and spread to other members of the population, thereby increasing the number of people protected. Herd immunity can be achieved by natural infection as well as vaccines (e.g., measles). For herd immunity to occur, the vaccine must prevent transmission of the virus as well as prevent disease. Ref: Levinson W. (2012). Chapter 33. Host Defenses. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e. ### End" @@ -2834,6 +5061,13 @@ Herd immunity can be achieved by immunizing a population with a vaccine that int Answer the following medical question: Which MRI sequence is best suited for this lesion?, with the following options: A: T2W, B: Chemical shift imaging MRI, C: DWI, D: D STIR +### Response: +","Ans. B. Chemical shift Imaging MRI* This is a post contrast axial CT scan of the upper abdomen which shows a mildly enhancing lesion in right adrenal.* This lesion could be an adenoma; however, the other differentials include serious entities like metastases or carcinomas.* Differentiating between them is vital and more emphasis is on imaging as adrenals are small retroperitoneal organs which are surrounded by vascular structure thus obtaining an image guided biopsy becomes difficult.* There are various techniques used to differentiate between them, one of which is in and out phase imaging which is based on the premise that adrenal adenomas are rich in their lipid contents whereas other lesions like carcinoma and metastases are lipid poor.* The characterization of a lesion as an adenoma relies on the ratio of a decreased relative signal intensity from in phase to opposed phase images and the ratio of adrenal mass and various organs on T2-weighted and chemical shift images. Sometimes at the interface of water and fat the adenoma can give rise to dark bands - India ink artefacts.* Other commonly used indices include the relative and absolute washout values of CT scan which used HU values of CT of same area in unenhanced, enhanced and delayed scans.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which MRI sequence is best suited for this lesion?, with the following options: A: T2W, B: Chemical shift imaging MRI, C: DWI, D: D STIR + ### Response: Ans. B. Chemical shift Imaging MRI* This is a post contrast axial CT scan of the upper abdomen which shows a mildly enhancing lesion in right adrenal.* This lesion could be an adenoma; however, the other differentials include serious entities like metastases or carcinomas.* Differentiating between them is vital and more emphasis is on imaging as adrenals are small retroperitoneal organs which are surrounded by vascular structure thus obtaining an image guided biopsy becomes difficult.* There are various techniques used to differentiate between them, one of which is in and out phase imaging which is based on the premise that adrenal adenomas are rich in their lipid contents whereas other lesions like carcinoma and metastases are lipid poor.* The characterization of a lesion as an adenoma relies on the ratio of a decreased relative signal intensity from in phase to opposed phase images and the ratio of adrenal mass and various organs on T2-weighted and chemical shift images. Sometimes at the interface of water and fat the adenoma can give rise to dark bands - India ink artefacts.* Other commonly used indices include the relative and absolute washout values of CT scan which used HU values of CT of same area in unenhanced, enhanced and delayed scans. ### End" @@ -2843,6 +5077,13 @@ Ans. B. Chemical shift Imaging MRI* This is a post contrast axial CT scan of the Answer the following medical question: Pioneer in concept of 'Specific protection by vaccine:, with the following options: A: Chinese medicine, B: Robert Koch, C: Ambroise Pare, D: Louis Pasteur +### Response: +","Ans. (a) Chinese medicine* Chinese were early pioneers of immunization* They practiced variolation to prevent smallpoxALSO REMEMBERChinese Barefoot Doctors* Farmers who received minimal basic medical and para- medical training and worked in rural villages of China* Name comes from southern farmers, who would often work barefoot in the rice paddies promoted basic hygiene, preventive health care, family planning and treated common illnesses* Purpose: To bring health care to rural areas where urban-trained doctors would not settle","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pioneer in concept of 'Specific protection by vaccine:, with the following options: A: Chinese medicine, B: Robert Koch, C: Ambroise Pare, D: Louis Pasteur + ### Response: Ans. (a) Chinese medicine* Chinese were early pioneers of immunization* They practiced variolation to prevent smallpoxALSO REMEMBERChinese Barefoot Doctors* Farmers who received minimal basic medical and para- medical training and worked in rural villages of China* Name comes from southern farmers, who would often work barefoot in the rice paddies promoted basic hygiene, preventive health care, family planning and treated common illnesses* Purpose: To bring health care to rural areas where urban-trained doctors would not settle ### End" @@ -2852,6 +5093,13 @@ Ans. (a) Chinese medicine* Chinese were early pioneers of immunization* They pra Answer the following medical question: Sexual gratification is obtained by inflicting injuries to sexual paner in, with the following options: A: Masochism, B: Sadism, C: Fetichism, D: Necrophilia +### Response: +","Sadisim In sadism, the sexual gratification is obtained by inflicting injuries on the sexual paner. It is most commonly seen in men. To obtain sexual gratification, the sadist may bite , whip, beat, or produce cut injuries on the sexual paner Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 312","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Sexual gratification is obtained by inflicting injuries to sexual paner in, with the following options: A: Masochism, B: Sadism, C: Fetichism, D: Necrophilia + ### Response: Sadisim In sadism, the sexual gratification is obtained by inflicting injuries on the sexual paner. It is most commonly seen in men. To obtain sexual gratification, the sadist may bite , whip, beat, or produce cut injuries on the sexual paner Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 312 ### End" @@ -2861,6 +5109,13 @@ Sadisim In sadism, the sexual gratification is obtained by inflicting injuries o Answer the following medical question: In a surgical post-op ward, a pt. developed wound infection. Subsequently 3 other pts. developed similar infections in the ward. What is the most effective way of preventing the spread of infection:, with the following options: A: Give IV antibiotics to all pts. in the ward, B: Proper handwashing of all ward personnel's, C: Fumigation of the ward, D: Wash OT instrumens with 1% perchlorate +### Response: +","Ans. is 'b' ie. Proper hand washing of all ward personnel's ""Given the prominence of cross infection, hand washing is the single most important preventive measure in the hospital"" - Harrison 15/eHarrison 17/e writes- ""Given the prominence of cross-infection, hand hygiene is the single most important preventive measure in hospitals. Use of alcohol hand rubs between patient contacts is now recommended for all health care workers except when the hands are visibly soiled, in which case washing with soap and water is still required""","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In a surgical post-op ward, a pt. developed wound infection. Subsequently 3 other pts. developed similar infections in the ward. What is the most effective way of preventing the spread of infection:, with the following options: A: Give IV antibiotics to all pts. in the ward, B: Proper handwashing of all ward personnel's, C: Fumigation of the ward, D: Wash OT instrumens with 1% perchlorate + ### Response: Ans. is 'b' ie. Proper hand washing of all ward personnel's ""Given the prominence of cross infection, hand washing is the single most important preventive measure in the hospital"" - Harrison 15/eHarrison 17/e writes- ""Given the prominence of cross-infection, hand hygiene is the single most important preventive measure in hospitals. Use of alcohol hand rubs between patient contacts is now recommended for all health care workers except when the hands are visibly soiled, in which case washing with soap and water is still required"" ### End" @@ -2870,6 +5125,13 @@ Ans. is 'b' ie. Proper hand washing of all ward personnel's ""Given the prominen Answer the following medical question: Extended-spectrum beta-lactamases (ESBLs) are characterized by activity against all except :, with the following options: A: Penicillinases, B: Cephalosporinases, C: Oxyimino–cephalosporinases, D: Carbapenems +### Response: +",Carbapenems like imipenem are the only beta-lactams reliably efficacious against ESBL producing bacteria.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Extended-spectrum beta-lactamases (ESBLs) are characterized by activity against all except :, with the following options: A: Penicillinases, B: Cephalosporinases, C: Oxyimino–cephalosporinases, D: Carbapenems + ### Response: Carbapenems like imipenem are the only beta-lactams reliably efficacious against ESBL producing bacteria. ### End" @@ -2879,6 +5141,13 @@ Carbapenems like imipenem are the only beta-lactams reliably efficacious against Answer the following medical question: Sphagetti and meat ball appearance is seen in -, with the following options: A: Pityriasis rosacae, B: Tinea capitis, C: Tinea carporis, D: Tinea versicolor +### Response: +","Ans. is 'd' i.e., Tinea versicolor Pitvriasis versicolor (tinea versicolor)o Tinea versicolor is a misnomer as it is not caused by a dermatophyte; it is caused by a nondermatophvtic fungus called Pity rosporum ovale (malasezia furfur). Usually affects young adults.Clinical featureso There are multiple scaly hypopigmented (more common) or hyperpigmented macules. Scaling is fufuracious or rice powder like. Macules start around the hair follicles and they merge with each other to form large areas. Affects trunk and shoulders (mainly chest and back). There may be loosening of scales with finger nails- coupled onle or stroke of nail. Lesions are recurrent in nature.Diagnosis1. Examination of scales in 10% KOH shows short hyphae and round spores (sphagetti and meat ball appearance). Wood's lamp shows apple green fluorescence(blue-green fluorescnce).2.Skin surface biopsy - a cyanoacrylate adhesive is used to separate the layer of stratum comeum on glass slide and then stained with PAS reagent.Treatment1 .Systemic agentssystemic azoles provide convenient therapeutic option. Drugs used are ketokonazole, fluconazole or iatroconazole2. Topical antifun gals used are -Azoles clotrimazole, econazole, miconazole, ketoconazoleOthers selenium sulphide, sodium thiosulphate, whitefield's ointment (3% salicylic acid + 6% benzoic acid).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Sphagetti and meat ball appearance is seen in -, with the following options: A: Pityriasis rosacae, B: Tinea capitis, C: Tinea carporis, D: Tinea versicolor + ### Response: Ans. is 'd' i.e., Tinea versicolor Pitvriasis versicolor (tinea versicolor)o Tinea versicolor is a misnomer as it is not caused by a dermatophyte; it is caused by a nondermatophvtic fungus called Pity rosporum ovale (malasezia furfur). Usually affects young adults.Clinical featureso There are multiple scaly hypopigmented (more common) or hyperpigmented macules. Scaling is fufuracious or rice powder like. Macules start around the hair follicles and they merge with each other to form large areas. Affects trunk and shoulders (mainly chest and back). There may be loosening of scales with finger nails- coupled onle or stroke of nail. Lesions are recurrent in nature.Diagnosis1. Examination of scales in 10% KOH shows short hyphae and round spores (sphagetti and meat ball appearance). Wood's lamp shows apple green fluorescence(blue-green fluorescnce).2.Skin surface biopsy - a cyanoacrylate adhesive is used to separate the layer of stratum comeum on glass slide and then stained with PAS reagent.Treatment1 .Systemic agentssystemic azoles provide convenient therapeutic option. Drugs used are ketokonazole, fluconazole or iatroconazole2. Topical antifun gals used are -Azoles clotrimazole, econazole, miconazole, ketoconazoleOthers selenium sulphide, sodium thiosulphate, whitefield's ointment (3% salicylic acid + 6% benzoic acid). ### End" @@ -2888,6 +5157,13 @@ Ans. is 'd' i.e., Tinea versicolor Pitvriasis versicolor (tinea versicolor)o Tin Answer the following medical question: Mondor's disease of breast is a variant of:, with the following options: A: Mycotic infection, B: Malignancy, C: Thrombophlebitis, D: Lymphadenitis +### Response: +","Mondor's disease is a variant of thrombophlebitis that involves the superficial veins of the anterior chest wall and breast. In 1939, Mondor described the condition as ""string phlebitis,"" a thrombosed vein presenting as a tender, cord-like structure. Frequently involved veins include the lateral thoracic vein, the thoracoepigastric vein, and, less commonly, the superficial epigastric vein. Typically, a woman presents with acute pain in the lateral aspect of the breast or the anterior chest wall. A tender, firm cord is found to follow the distribution of one of the major superficial veins Ref: Schwaz's principle of surgery 9th edition, chapter 17.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mondor's disease of breast is a variant of:, with the following options: A: Mycotic infection, B: Malignancy, C: Thrombophlebitis, D: Lymphadenitis + ### Response: Mondor's disease is a variant of thrombophlebitis that involves the superficial veins of the anterior chest wall and breast. In 1939, Mondor described the condition as ""string phlebitis,"" a thrombosed vein presenting as a tender, cord-like structure. Frequently involved veins include the lateral thoracic vein, the thoracoepigastric vein, and, less commonly, the superficial epigastric vein. Typically, a woman presents with acute pain in the lateral aspect of the breast or the anterior chest wall. A tender, firm cord is found to follow the distribution of one of the major superficial veins Ref: Schwaz's principle of surgery 9th edition, chapter 17. ### End" @@ -2897,6 +5173,20 @@ Mondor's disease is a variant of thrombophlebitis that involves the superficial Answer the following medical question: The operative procedure is known as ""microfracture"" is done for the -, with the following options: A: Delayed union of femur, B: Non union of tibia, C: Loose bodies of ankle joint, D: Osteochondral defect of femur +### Response: +","Microfracture surgery + +Microfracture surgery is one of the articular cartilage repair surgical techniques that works by creating tiny fractures in the underlying bone. +This cause new cartilage to develop a so-called super-clot. +The surgery is performed by arthroscopy and in the area of the osteochondral defect, tiny fractures are created in the subchondral bone. +Blood and bone marrow (which contains stem cells) seep out of the fractures, creating a blood clot that releases cartilage-building cells. + +Note: Osteochondral defect means there is a loss of cartilage along with subchondral bone from a small area of a joint.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The operative procedure is known as ""microfracture"" is done for the -, with the following options: A: Delayed union of femur, B: Non union of tibia, C: Loose bodies of ankle joint, D: Osteochondral defect of femur + ### Response: Microfracture surgery @@ -2913,6 +5203,13 @@ Note: Osteochondral defect means there is a loss of cartilage along with subchon Answer the following medical question: Which of the following drugs has the highest bactericidal activity against Mycobacterium leprae?, with the following options: A: Rifampicin, B: Clofazimine, C: Dapsone, D: Minocycline +### Response: +","Rifampicin has a high bactericidal activity against M. leprae. A single dose of 1500 mg appears to kill 99% of the organisms. Ref: Park 21st edition, page 296.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following drugs has the highest bactericidal activity against Mycobacterium leprae?, with the following options: A: Rifampicin, B: Clofazimine, C: Dapsone, D: Minocycline + ### Response: Rifampicin has a high bactericidal activity against M. leprae. A single dose of 1500 mg appears to kill 99% of the organisms. Ref: Park 21st edition, page 296. ### End" @@ -2922,6 +5219,13 @@ Rifampicin has a high bactericidal activity against M. leprae. A single dose of Answer the following medical question: A lady with amenorrhea and galactorrhea, what is the cause of this?, with the following options: A: Pituitary adenoma, B: Adrenal hyperplasia, C: 70 alpha hydroxylase deficiency, D: None of above +### Response: +","In patients with both galactorrhea and amenorrhea, approximately two-thirds will have hyperprolactinemia; of those, approximately one-third will have a pituitary adenoma. A prolactin level as high as 150-200 ng/mL is almost always due to a pituitary adenoma.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A lady with amenorrhea and galactorrhea, what is the cause of this?, with the following options: A: Pituitary adenoma, B: Adrenal hyperplasia, C: 70 alpha hydroxylase deficiency, D: None of above + ### Response: In patients with both galactorrhea and amenorrhea, approximately two-thirds will have hyperprolactinemia; of those, approximately one-third will have a pituitary adenoma. A prolactin level as high as 150-200 ng/mL is almost always due to a pituitary adenoma. ### End" @@ -2931,6 +5235,13 @@ In patients with both galactorrhea and amenorrhea, approximately two-thirds will Answer the following medical question: The best investigation for diagnosing Best disease is, with the following options: A: EEG, B: Electroneurogram, C: Electrooculogram, D: Electroretinogram +### Response: +","Best diseaseAutosomal dominant inheritance due to mutation of bestrophin gene on 11q13 chromosomeLipofuscin accumulation throughout the RPELarge yellow yolk like ( vitelliform ) lesion - EGG YOLK APPEARANCEBest investigation for diagnosis of Best disease is made on the basis of abnormal electrooculogram findings - a severe loss of light response of the standing potential occursArden ratio - less than 1.5 & frequently near 1.1Electro-retinography - reduced C waveBEST disease - relatively normal electroretinographic results with abnormal electro oculographic findings(Refer: AH Khurana, Comprehensive Textbook of Ophthalmology,5thedition, pg no: 520-521)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The best investigation for diagnosing Best disease is, with the following options: A: EEG, B: Electroneurogram, C: Electrooculogram, D: Electroretinogram + ### Response: Best diseaseAutosomal dominant inheritance due to mutation of bestrophin gene on 11q13 chromosomeLipofuscin accumulation throughout the RPELarge yellow yolk like ( vitelliform ) lesion - EGG YOLK APPEARANCEBest investigation for diagnosis of Best disease is made on the basis of abnormal electrooculogram findings - a severe loss of light response of the standing potential occursArden ratio - less than 1.5 & frequently near 1.1Electro-retinography - reduced C waveBEST disease - relatively normal electroretinographic results with abnormal electro oculographic findings(Refer: AH Khurana, Comprehensive Textbook of Ophthalmology,5thedition, pg no: 520-521) ### End" @@ -2940,6 +5251,13 @@ Best diseaseAutosomal dominant inheritance due to mutation of bestrophin gene on Answer the following medical question: Stretch stimulus is mediated by which of the following receptors?, with the following options: A: Merkel's disc, B: Meissner, C: Golgi tendon organ, D: Muscle spindle +### Response: +","Stretch reflex (Myotatic reflex) is mediated by Muscle Spindle. Stretch reflex occurs when the muscle is stretched passively which activates Ia fibres and alpha motor neuron is activated and brings out contraction. Inverse Stretch reflex is mediated by Golgi tendon organ. Inverse stretch reflex/Golgi tendon reflex/Inverse myotatic reflex is disynaptic and is the opposite of the stretch reflex Golgi tendon reflex is a protective mechanism to prevent tearing of the muscle or avulsion of the tendon from its attachments to the bone by inhibitory effect from the Golgi tendon organ,when extreme tension on muscle is applied. It leads to instantaneous relaxation of the muscle called as lengthening reaction.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Stretch stimulus is mediated by which of the following receptors?, with the following options: A: Merkel's disc, B: Meissner, C: Golgi tendon organ, D: Muscle spindle + ### Response: Stretch reflex (Myotatic reflex) is mediated by Muscle Spindle. Stretch reflex occurs when the muscle is stretched passively which activates Ia fibres and alpha motor neuron is activated and brings out contraction. Inverse Stretch reflex is mediated by Golgi tendon organ. Inverse stretch reflex/Golgi tendon reflex/Inverse myotatic reflex is disynaptic and is the opposite of the stretch reflex Golgi tendon reflex is a protective mechanism to prevent tearing of the muscle or avulsion of the tendon from its attachments to the bone by inhibitory effect from the Golgi tendon organ,when extreme tension on muscle is applied. It leads to instantaneous relaxation of the muscle called as lengthening reaction. ### End" @@ -2949,6 +5267,13 @@ Stretch reflex (Myotatic reflex) is mediated by Muscle Spindle. Stretch reflex o Answer the following medical question: Which nerve is involved in this presentation?, with the following options: A: Long thoracic Nerve, B: Musculocutaneous nerve, C: Lateral anterior thoracic nerve, D: Thoracodorsal nerve +### Response: +",Ans. A long thoracic nerveNerve involvedMuscleLong thoracic NerveSerratus anteriorMusculocutaneous NerveCoracobrachialis muscleLateral anterior thoracic NervePectoralis major muscleThoracodorsal NerveLatissimus Dorsi,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which nerve is involved in this presentation?, with the following options: A: Long thoracic Nerve, B: Musculocutaneous nerve, C: Lateral anterior thoracic nerve, D: Thoracodorsal nerve + ### Response: Ans. A long thoracic nerveNerve involvedMuscleLong thoracic NerveSerratus anteriorMusculocutaneous NerveCoracobrachialis muscleLateral anterior thoracic NervePectoralis major muscleThoracodorsal NerveLatissimus Dorsi ### End" @@ -2958,6 +5283,13 @@ Ans. A long thoracic nerveNerve involvedMuscleLong thoracic NerveSerratus anteri Answer the following medical question: Steeple sign is characteristis of -, with the following options: A: Acute epiglotitis, B: Laryngotrancheobronchitis, C: In both, D: None of above +### Response: +","Ans. is 'b' i.e., Laryngotrancheobronchitis Croupy Me cause of acute upper airway obstruction.Mild upper RTI for 1-3 days followed by upper airway obstruction.Barking cough, hoarsness, Inspiratory stridor.X-ray shows subglottic narrowing or steeple sign.Acute epiglottitisy Acute potential fatal condition.Redpirafry progressine respiratory obstruction.Cherry red swollen epiglottis.X-ray shows thumb signy The steeple sign as seen on an anteroposterior neck X-ray of a child with croup","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Steeple sign is characteristis of -, with the following options: A: Acute epiglotitis, B: Laryngotrancheobronchitis, C: In both, D: None of above + ### Response: Ans. is 'b' i.e., Laryngotrancheobronchitis Croupy Me cause of acute upper airway obstruction.Mild upper RTI for 1-3 days followed by upper airway obstruction.Barking cough, hoarsness, Inspiratory stridor.X-ray shows subglottic narrowing or steeple sign.Acute epiglottitisy Acute potential fatal condition.Redpirafry progressine respiratory obstruction.Cherry red swollen epiglottis.X-ray shows thumb signy The steeple sign as seen on an anteroposterior neck X-ray of a child with croup ### End" @@ -2967,6 +5299,13 @@ Ans. is 'b' i.e., Laryngotrancheobronchitis Croupy Me cause of acute upper airwa Answer the following medical question: A 4 yr old partially immunized boy came to OPD with history of bouts of coughing. On staining the sputum sample an organism with bipolar staining was seen. Which among the following organism it would be?, with the following options: A: Y. Pestis, B: B. pertussis, C: S. Agalactae, D: K. Pneumonae +### Response: +","REF: (B) B. pertussisREF: Jawetz Microbiology, 24th Ed Ch. 19BORDETELLA PERTUSSIS:The organisms are minute gram-negative coccobacilli resembling H influenzae. With toluidine blue stain, bipolar metachromatic granules can be demonstrated. A capsule is present. After an incubation period of about 2 weeks, the ""catarrhal stage"" develops, with mild coughing and sneezing. During this stage, large numbers of organisms are sprayed in droplets, and the patient is highly infectious but not very ill. During the ""paroxysmal"" stage, the cough develops its explosive character and the characteristic ""whoop"" upon inhalation. This leads to rapid exhaustion and may be associated with vomiting, cyanosis, and convulsions. The ""whoop"" and major complications occur predominantly in infants; paroxysmal coughing predominates in older children and adults. The white blood count is high (16,000-30,000/ uL), with an absolute lymphocytosis. Among provided options, T. pestis and B. pertussis produce bipolar metachromatic appearance, but considering the partial immunization status and age of patient, b. pertussis is answer of choice.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 4 yr old partially immunized boy came to OPD with history of bouts of coughing. On staining the sputum sample an organism with bipolar staining was seen. Which among the following organism it would be?, with the following options: A: Y. Pestis, B: B. pertussis, C: S. Agalactae, D: K. Pneumonae + ### Response: REF: (B) B. pertussisREF: Jawetz Microbiology, 24th Ed Ch. 19BORDETELLA PERTUSSIS:The organisms are minute gram-negative coccobacilli resembling H influenzae. With toluidine blue stain, bipolar metachromatic granules can be demonstrated. A capsule is present. After an incubation period of about 2 weeks, the ""catarrhal stage"" develops, with mild coughing and sneezing. During this stage, large numbers of organisms are sprayed in droplets, and the patient is highly infectious but not very ill. During the ""paroxysmal"" stage, the cough develops its explosive character and the characteristic ""whoop"" upon inhalation. This leads to rapid exhaustion and may be associated with vomiting, cyanosis, and convulsions. The ""whoop"" and major complications occur predominantly in infants; paroxysmal coughing predominates in older children and adults. The white blood count is high (16,000-30,000/ uL), with an absolute lymphocytosis. Among provided options, T. pestis and B. pertussis produce bipolar metachromatic appearance, but considering the partial immunization status and age of patient, b. pertussis is answer of choice. ### End" @@ -2976,6 +5315,13 @@ REF: (B) B. pertussisREF: Jawetz Microbiology, 24th Ed Ch. 19BORDETELLA PERTUSSI Answer the following medical question: Most common cause of non-gonococcal urethritis -, with the following options: A: Mycoplasma hominis, B: Mycoplasma genitalium, C: Ureoplasma urealyticum, D: Chlamydia trachomatis +### Response: +","Ans. is 'd' i.e., Chlamydia trachomatis urethritisGonococcal Nongonococcal Neisseria gonorrhea Chlamydia Trachomatis (most common) Ureoplasmaurealyticum Mycoplasmagenitalium Bacterioides Haemophilus species Candida albicans T.vaginalis","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common cause of non-gonococcal urethritis -, with the following options: A: Mycoplasma hominis, B: Mycoplasma genitalium, C: Ureoplasma urealyticum, D: Chlamydia trachomatis + ### Response: Ans. is 'd' i.e., Chlamydia trachomatis urethritisGonococcal Nongonococcal Neisseria gonorrhea Chlamydia Trachomatis (most common) Ureoplasmaurealyticum Mycoplasmagenitalium Bacterioides Haemophilus species Candida albicans T.vaginalis ### End" @@ -2985,6 +5331,13 @@ Ans. is 'd' i.e., Chlamydia trachomatis urethritisGonococcal Nongonococcal Neiss Answer the following medical question: A child with a unilateral white reflex raised IOP. The required investigations are:, with the following options: A: USG, B: Observation under anesthesia, C: Tonometry, D: All +### Response: +","ALL Investigations for Leucocoria - Examination under anaesthesia X Ray-orbit, UltrasoundQ, CT scan to look for calcification size, and extent of tumor MRI to rule out ectopic intracranial retinoblastoma & optic nerve involvement. LDH level is raised in aqueous Measurement of IOP by Tonometry Distant metastasis is suspected by CSF examination (lumbar puncture), bone /liver/spleen scan, bone marrow aspiration biopsy etc","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A child with a unilateral white reflex raised IOP. The required investigations are:, with the following options: A: USG, B: Observation under anesthesia, C: Tonometry, D: All + ### Response: ALL Investigations for Leucocoria - Examination under anaesthesia X Ray-orbit, UltrasoundQ, CT scan to look for calcification size, and extent of tumor MRI to rule out ectopic intracranial retinoblastoma & optic nerve involvement. LDH level is raised in aqueous Measurement of IOP by Tonometry Distant metastasis is suspected by CSF examination (lumbar puncture), bone /liver/spleen scan, bone marrow aspiration biopsy etc ### End" @@ -2994,6 +5347,13 @@ ALL Investigations for Leucocoria - Examination under anaesthesia X Ray-orbit, U Answer the following medical question: A x ray film of skull is given, what is the diagnosis?, with the following options: A: Osteoblastoma, B: Osteoma, C: Sinusitis, D: Multiple myeloma +### Response: +","Multiple paranasal osteomas are found in Gardner's syndrome. Multiple osteoma of the mandible and maxilla, along with the frontal, sphenoid and ethmoid sinuses, rarely the long bones or phalanges. Cutaneous and soft tissue tumors. Association between colonic Polyps With a predilection to malignant degeneration. Ref :David Sutton 9th ed","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A x ray film of skull is given, what is the diagnosis?, with the following options: A: Osteoblastoma, B: Osteoma, C: Sinusitis, D: Multiple myeloma + ### Response: Multiple paranasal osteomas are found in Gardner's syndrome. Multiple osteoma of the mandible and maxilla, along with the frontal, sphenoid and ethmoid sinuses, rarely the long bones or phalanges. Cutaneous and soft tissue tumors. Association between colonic Polyps With a predilection to malignant degeneration. Ref :David Sutton 9th ed ### End" @@ -3003,6 +5363,13 @@ Multiple paranasal osteomas are found in Gardner's syndrome. Multiple osteoma of Answer the following medical question: 50 years old male presents with 2 cm right solitary pulmonary nodule on X ray chest with scalloped margins and patient currently smokes 12 cigarettes per day. what is the risk of developing invasive carcinoma for such a patient ?, with the following options: A: Very low, B: Low, C: Intermidiate, D: High +### Response: +","Ans. is 'c' i.e., Intermidiate","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: 50 years old male presents with 2 cm right solitary pulmonary nodule on X ray chest with scalloped margins and patient currently smokes 12 cigarettes per day. what is the risk of developing invasive carcinoma for such a patient ?, with the following options: A: Very low, B: Low, C: Intermidiate, D: High + ### Response: Ans. is 'c' i.e., Intermidiate ### End" @@ -3013,13 +5380,27 @@ Ans. is 'c' i.e., Intermidiate Answer the following medical question: 'Weak giants' are produced by:, with the following options: A: Thyroid adenomas, B: Thyroid carcinomas, C: Parathyroid adenomas, D: Pituitary adenomas ### Response: -d. Pituitary adenomas(Ref: Nelson's 20/e p 2714-2724)Hyperpituitarism causes tall stature (Giants), with weak muscles; Most common cause of Hyperpituitarism is Pituitary adenoma. -### End" -321,"Below is an instruction that describes a task. Write a response that appropriately completes the request. +","d. Pituitary adenomas(Ref: Nelson's 20/e p 2714-2724)Hyperpituitarism causes tall stature (Giants), with weak muscles; Most common cause of Hyperpituitarism is Pituitary adenoma.","Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: -Answer the following medical question: One of the patients in paediatric ICU has developed VF and the staff have staed CPR. You are the physician on call. You want to try DC shock so as to reve to it to normal rhythm. What is the energy you would use in this scenario? The child is 3 years old, weight - 15 kg, SPO2 - 88, BP unrecordable, RR - 40/minute., with the following options: A: 60 J, B: 280 J, C: 250 J, D: 320 J +Answer the following medical question: 'Weak giants' are produced by:, with the following options: A: Thyroid adenomas, B: Thyroid carcinomas, C: Parathyroid adenomas, D: Pituitary adenomas + +### Response: +d. Pituitary adenomas(Ref: Nelson's 20/e p 2714-2724)Hyperpituitarism causes tall stature (Giants), with weak muscles; Most common cause of Hyperpituitarism is Pituitary adenoma. +### End" +321,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: One of the patients in paediatric ICU has developed VF and the staff have staed CPR. You are the physician on call. You want to try DC shock so as to reve to it to normal rhythm. What is the energy you would use in this scenario? The child is 3 years old, weight - 15 kg, SPO2 - 88, BP unrecordable, RR - 40/minute., with the following options: A: 60 J, B: 280 J, C: 250 J, D: 320 J + +### Response: +","In this case a single shock of 4 J/kg can be given. This should be immediately followed by CPR - 15:2 for 2 minutes. During CPR make sure you correct the reversible causes of arrhythmia like hypoxia, hypovolemia, metabolic disturbance etc. Ref: Oxford Handbook of Clinical Specialities, 8th Edition, Page 239","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: One of the patients in paediatric ICU has developed VF and the staff have staed CPR. You are the physician on call. You want to try DC shock so as to reve to it to normal rhythm. What is the energy you would use in this scenario? The child is 3 years old, weight - 15 kg, SPO2 - 88, BP unrecordable, RR - 40/minute., with the following options: A: 60 J, B: 280 J, C: 250 J, D: 320 J ### Response: In this case a single shock of 4 J/kg can be given. This should be immediately followed by CPR - 15:2 for 2 minutes. During CPR make sure you correct the reversible causes of arrhythmia like hypoxia, hypovolemia, metabolic disturbance etc. Ref: Oxford Handbook of Clinical Specialities, 8th Edition, Page 239 @@ -3030,6 +5411,13 @@ In this case a single shock of 4 J/kg can be given. This should be immediately f Answer the following medical question: Physiological jaundice in a term baby lasts upto: March 2005 & September 2010, with the following options: A: 4 days, B: 7 days, C: 10 days, D: 14 days +### Response: +","Ans. C: 10 days Characteristics of physiological jaundice: First appears between 24-72 hours of age Maximum intensity seen on 4-5th day in term and 7th day in preterm neonates Clinically undetectable after 14 days No treatment is required but baby should be observed closely for signs of worsening jaundice. Hyperbilirubinemia in the first week of life is usually of the indirect variety. Causes are usually classified based on the time of onset of jaundice. Appearing within 24 hours of age: -- Hemolytic disease of newborn: Rh, ABO and minor group incompatibility Infections: intrauterine viral, bacterial; malaria -- G-6PD deficiency Appearing between 24-72 hours of life: - Physiological - Sepsis neonatorum Polycythemia - Concealed hemorrhages: cephalhematoma, subarachnoid bleed, IVH -- Increased enterohepatic circulation Appearing after 72 hours: -- Sepsis neonatorum' - Neonatal hepatitis Extra hepatic biliary atresia - Breast milk jaundice - Metabolic disorders","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Physiological jaundice in a term baby lasts upto: March 2005 & September 2010, with the following options: A: 4 days, B: 7 days, C: 10 days, D: 14 days + ### Response: Ans. C: 10 days Characteristics of physiological jaundice: First appears between 24-72 hours of age Maximum intensity seen on 4-5th day in term and 7th day in preterm neonates Clinically undetectable after 14 days No treatment is required but baby should be observed closely for signs of worsening jaundice. Hyperbilirubinemia in the first week of life is usually of the indirect variety. Causes are usually classified based on the time of onset of jaundice. Appearing within 24 hours of age: -- Hemolytic disease of newborn: Rh, ABO and minor group incompatibility Infections: intrauterine viral, bacterial; malaria -- G-6PD deficiency Appearing between 24-72 hours of life: - Physiological - Sepsis neonatorum Polycythemia - Concealed hemorrhages: cephalhematoma, subarachnoid bleed, IVH -- Increased enterohepatic circulation Appearing after 72 hours: -- Sepsis neonatorum' - Neonatal hepatitis Extra hepatic biliary atresia - Breast milk jaundice - Metabolic disorders ### End" @@ -3039,6 +5427,13 @@ Ans. C: 10 days Characteristics of physiological jaundice: First appears between Answer the following medical question: Wernicke's encephalopathy, during refeeding syndrome, can be precipitated in deficiency of which of the following vitamin: September 2011, with the following options: A: Riboflavin, B: Pyridoxine, C: Thiamin, D: Vitamin C +### Response: +","Ans. C: Thiamin In patients who are thiamin deficient, Wernicke's encephalopathy can be precipitated by refeeding with carbohydrates This is prevented by administering thiamin before staing nutritional suppo","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Wernicke's encephalopathy, during refeeding syndrome, can be precipitated in deficiency of which of the following vitamin: September 2011, with the following options: A: Riboflavin, B: Pyridoxine, C: Thiamin, D: Vitamin C + ### Response: Ans. C: Thiamin In patients who are thiamin deficient, Wernicke's encephalopathy can be precipitated by refeeding with carbohydrates This is prevented by administering thiamin before staing nutritional suppo ### End" @@ -3048,6 +5443,13 @@ Ans. C: Thiamin In patients who are thiamin deficient, Wernicke's encephalopathy Answer the following medical question: Contraindications for pancreaticoduodenectomy for carcinoma head of pancreas would include all of the following EXCEPT:, with the following options: A: Infiltration of poal vein, B: Metastases to coelic grop of lymph nodes, C: Infiltration of the second pa of the duodenum, D: Tumour measuring 6 cm in size +### Response: +","Patients with duct cell cancers should be considered for resection, which are: * Late maternal death: A late maternal death is the death of a woman from direct or indirect obstetric causes more than 42 days but less than one year after termination of pregnancy.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: According to WHO, MMR is, with the following options: A: Death immediately after the delivery, B: Death after 42 days, C: Death after 30 days, D: Death after 7 days + ### Response: (B) Death after 42 days > Late maternal death: A late maternal death is the death of a woman from direct or indirect obstetric causes more than 42 days but less than one year after termination of pregnancy. ### End" @@ -3120,6 +5571,23 @@ Answer the following medical question: According to WHO, MMR is, with the follow Answer the following medical question: The glucose transporter which is stimulated by insulin is located in:, with the following options: A: Brain and retina, B: Liver and beta cells of pancreas, C: Skeletal muscle and adipose tissue, D: RBCs and intestine +### Response: +","Key Concept: + +Widely distributed Glucose transporter-GLUT-1 +Most abundant Glucose transporter in RBC-GLUT-1 +Major glucose transporter of Brain-GLUT-1 +Major glucose transporter of neurons-GLUT-3 +Major glucose transporter of placenta-GLUT-1 +Glucose transporter of blastocyst-GLUT-8 +Insulin-dependent Glucose transporters-GLUT-4, GLUT-8, GLUT-12 +GLUT-3 is present in neurons, whereas GLUT-1 is not present in neurons +Urate transporter is GLUT-9","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The glucose transporter which is stimulated by insulin is located in:, with the following options: A: Brain and retina, B: Liver and beta cells of pancreas, C: Skeletal muscle and adipose tissue, D: RBCs and intestine + ### Response: Key Concept: @@ -3139,6 +5607,13 @@ Urate transporter is GLUT-9 Answer the following medical question: Splenectomy is contraindicated in which of the following haemolytic anemia:, with the following options: A: Stomatocytosis, B: Elliptocytosis, C: Sickle cell disease, D: All of the above +### Response: +","Stomatocytosis: This rare condition with autosomal dominant inheritance draws its name (mouth-like cells) from the fact that the normally round-shaped central pallor of red cells is replaced by a linear-shaped central pallor. Hemolysis is usually relatively mild. Splenectomy is contraindicated as it has been followed in a majority of cases by severe thromboembolic complications. Ref: Harrison's principle of internal medicine 17th Edition, Chapter 101.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Splenectomy is contraindicated in which of the following haemolytic anemia:, with the following options: A: Stomatocytosis, B: Elliptocytosis, C: Sickle cell disease, D: All of the above + ### Response: Stomatocytosis: This rare condition with autosomal dominant inheritance draws its name (mouth-like cells) from the fact that the normally round-shaped central pallor of red cells is replaced by a linear-shaped central pallor. Hemolysis is usually relatively mild. Splenectomy is contraindicated as it has been followed in a majority of cases by severe thromboembolic complications. Ref: Harrison's principle of internal medicine 17th Edition, Chapter 101. ### End" @@ -3148,6 +5623,13 @@ Stomatocytosis: This rare condition with autosomal dominant inheritance draws it Answer the following medical question: A patient with fibronectin mesangial deposits was diagnosed having fibronectin nephropathy. Which of the following is NOT true about fibronectin nephropathy?, with the following options: A: Autosomal recessive inheritance, B: PAS positivity is seen in glomerulus and mesangial basement membrane, C: No deposition of any immune complexes or complement components on immunofluorescence microscopy, D: Glomerular enlargement with fibronectin deposition in mesangium and basement membrane is characteristic +### Response: +","Fibronectin nephropathy: It is an autosomal dominant disease, presents with proteinuria and slowly progressive loss of renal function. The principle light microscopic change is glomerular enlargement and lobulation resulting from PAS and trichrome-positive mesangial deposits and mild mesangial proliferation. By immunofluorescence microscopy, the glomeruli do not consistently stain for immunoglobulin or complement components. The most consistent ultrastructural finding is large (giant), mesangial and subendothelial electron-dense deposits that mirror the location of the PAS-positive, fibronectin deposits. Ref: Heptinstall's Pathology of the Kidney By J. Charles Jennette, Robe H. Heptinstall, 2007, Page 931, 932, 933.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A patient with fibronectin mesangial deposits was diagnosed having fibronectin nephropathy. Which of the following is NOT true about fibronectin nephropathy?, with the following options: A: Autosomal recessive inheritance, B: PAS positivity is seen in glomerulus and mesangial basement membrane, C: No deposition of any immune complexes or complement components on immunofluorescence microscopy, D: Glomerular enlargement with fibronectin deposition in mesangium and basement membrane is characteristic + ### Response: Fibronectin nephropathy: It is an autosomal dominant disease, presents with proteinuria and slowly progressive loss of renal function. The principle light microscopic change is glomerular enlargement and lobulation resulting from PAS and trichrome-positive mesangial deposits and mild mesangial proliferation. By immunofluorescence microscopy, the glomeruli do not consistently stain for immunoglobulin or complement components. The most consistent ultrastructural finding is large (giant), mesangial and subendothelial electron-dense deposits that mirror the location of the PAS-positive, fibronectin deposits. Ref: Heptinstall's Pathology of the Kidney By J. Charles Jennette, Robe H. Heptinstall, 2007, Page 931, 932, 933. ### End" @@ -3157,6 +5639,13 @@ Fibronectin nephropathy: It is an autosomal dominant disease, presents with prot Answer the following medical question: Who coined the term ""Psychiatry""?, with the following options: A: Johann Christian Reil, B: Sigmund Freud, C: Erik Erikson, D: Carl Jung +### Response: +","The term 'Psychiatry' was given by Johann Christian Reil Sigmund Freud is the father of psychoanalysis Eric Erikson gave an eight-stage psychosocial theory of development. According to this theory, development occurs in eight different stages, as a person gets older Carl Jung was a Swiss psychiatrist and psychoanalyst who founded analytical psychology.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Who coined the term ""Psychiatry""?, with the following options: A: Johann Christian Reil, B: Sigmund Freud, C: Erik Erikson, D: Carl Jung + ### Response: The term 'Psychiatry' was given by Johann Christian Reil Sigmund Freud is the father of psychoanalysis Eric Erikson gave an eight-stage psychosocial theory of development. According to this theory, development occurs in eight different stages, as a person gets older Carl Jung was a Swiss psychiatrist and psychoanalyst who founded analytical psychology. ### End" @@ -3166,6 +5655,14 @@ The term 'Psychiatry' was given by Johann Christian Reil Sigmund Freud is the fa Answer the following medical question: Excessive sexual desires in Male's is called as, with the following options: A: Nymphomania, B: Fetishism, C: Satyriasis, D: Frigidity +### Response: +","Excessive sexual desire in Male's - Satyriasis. +Excessive sexual desire in Female's - Nymphomania.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Excessive sexual desires in Male's is called as, with the following options: A: Nymphomania, B: Fetishism, C: Satyriasis, D: Frigidity + ### Response: Excessive sexual desire in Male's - Satyriasis. Excessive sexual desire in Female's - Nymphomania. @@ -3176,6 +5673,13 @@ Excessive sexual desire in Female's - Nymphomania. Answer the following medical question: Which of the following local anesthetic is most cardiotoxic -, with the following options: A: Lignocaine, B: Procaine, C: Mepivacaine, D: Bupivacaine +### Response: +","Ans. is 'd' i.e., Bupivacaine o Bupivacaine is the most cardiotoxic local anaesthetic.Important facts about LAo Chlorprocaine is the shortest acting LA.o Dibucaine is the longest acting, most potent and most toxic LA.o Bupivacaine is the most cardiotoxic LA (Ropivacaine is a newer bupivacaine congener with less cardiotoxicity).o Levobupivacaine (The S (-) enantiomer of bupivacaine) is less cardiotoxic and less prone to cause seizure.o Prilocaine can cause Methaemoglobinemia.o Lignocaine is the most commonly used LA.o Bupivacaine has the highest local tissue irritancy.o Chlorprocaine is contraindicated in spinal anaesthesia as it can cause paraplegia due to presence of neurotoxic preservative sodium metabisulphite.o Procaine is the LA of choice in malignant hyperthermia.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following local anesthetic is most cardiotoxic -, with the following options: A: Lignocaine, B: Procaine, C: Mepivacaine, D: Bupivacaine + ### Response: Ans. is 'd' i.e., Bupivacaine o Bupivacaine is the most cardiotoxic local anaesthetic.Important facts about LAo Chlorprocaine is the shortest acting LA.o Dibucaine is the longest acting, most potent and most toxic LA.o Bupivacaine is the most cardiotoxic LA (Ropivacaine is a newer bupivacaine congener with less cardiotoxicity).o Levobupivacaine (The S (-) enantiomer of bupivacaine) is less cardiotoxic and less prone to cause seizure.o Prilocaine can cause Methaemoglobinemia.o Lignocaine is the most commonly used LA.o Bupivacaine has the highest local tissue irritancy.o Chlorprocaine is contraindicated in spinal anaesthesia as it can cause paraplegia due to presence of neurotoxic preservative sodium metabisulphite.o Procaine is the LA of choice in malignant hyperthermia. ### End" @@ -3185,6 +5689,13 @@ Ans. is 'd' i.e., Bupivacaine o Bupivacaine is the most cardiotoxic local anaest Answer the following medical question: During regulatory volume decrease, many cells will increase:, with the following options: A: Their volume, B: Influx of Na+, C: Efflux of K+, D: Synthesis of sorbitol +### Response: +","Ans. C. Efflux of K+a. K+ is the major intracellular ion; efflux of K+ will produce an osmotic flow of water out of the cell.b. Water exit will lead to a decrease in cell volume.c. An influx of Na+ and synthesis of sorbitol do not occur during this process because both processes would increase intracellular osmolytes and drive water into the cell, increasing cell volume.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: During regulatory volume decrease, many cells will increase:, with the following options: A: Their volume, B: Influx of Na+, C: Efflux of K+, D: Synthesis of sorbitol + ### Response: Ans. C. Efflux of K+a. K+ is the major intracellular ion; efflux of K+ will produce an osmotic flow of water out of the cell.b. Water exit will lead to a decrease in cell volume.c. An influx of Na+ and synthesis of sorbitol do not occur during this process because both processes would increase intracellular osmolytes and drive water into the cell, increasing cell volume. ### End" @@ -3194,6 +5705,13 @@ Ans. C. Efflux of K+a. K+ is the major intracellular ion; efflux of K+ will prod Answer the following medical question: Cleft lip is repaired at: (Repeat), with the following options: A: 2 - 4month, B: 1-4 weeks, C: 6-12 months, D: 12-18 months +### Response: +","Ans: A (2 - 4 months) Ref: Nelson's Textbook of Pediatrics. 19th Edition Explanation: Timing of elective surgery for various conditions Cleft lip 3 months Cleft soft palate. 3 months Cleft hard palate. 12-15 months Combined soft and hard palate. 1 year Combined lip and soft palate. 3 months Hypospadias. 6-12 months Umbilical hernia.- conservative till 2 years of age. Surgery if still symptomatic Inguinal hernia. As early as possible Hydrocele. >1 year Undescended testis. 6 months - 1 year PDA. At birth COA. 3-4 year or as soon as child is medically fit. ""Surgical closure of a cleft lip is usually performed by 3 months of age. When the infant has shown satisfactory weight gain and is free of any oral, respiratory, or systemic infection. "" Ref: Nelson ""In an otherwise healthy child, closure of the palate is usually done before 1 year of age to enhance normal speech development."" Ref: Nelson Modification of the Millard rotation- advancement technique is the most commonly used technique; a staggered suture line minimizes notching of the lip from retraction of scar tissue. The initial repair may be revised at 4 or 5 yr of age. Corrective surgery on the nose may be delayed until adolescence. Nasal surgery can also be performed at the time of the lip repair. Cosmetic results depend on the extent of the original deformity, healing potential of the individual patient, absence of infection, and the skill of the surgeon.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cleft lip is repaired at: (Repeat), with the following options: A: 2 - 4month, B: 1-4 weeks, C: 6-12 months, D: 12-18 months + ### Response: Ans: A (2 - 4 months) Ref: Nelson's Textbook of Pediatrics. 19th Edition Explanation: Timing of elective surgery for various conditions Cleft lip 3 months Cleft soft palate. 3 months Cleft hard palate. 12-15 months Combined soft and hard palate. 1 year Combined lip and soft palate. 3 months Hypospadias. 6-12 months Umbilical hernia.- conservative till 2 years of age. Surgery if still symptomatic Inguinal hernia. As early as possible Hydrocele. >1 year Undescended testis. 6 months - 1 year PDA. At birth COA. 3-4 year or as soon as child is medically fit. ""Surgical closure of a cleft lip is usually performed by 3 months of age. When the infant has shown satisfactory weight gain and is free of any oral, respiratory, or systemic infection. "" Ref: Nelson ""In an otherwise healthy child, closure of the palate is usually done before 1 year of age to enhance normal speech development."" Ref: Nelson Modification of the Millard rotation- advancement technique is the most commonly used technique; a staggered suture line minimizes notching of the lip from retraction of scar tissue. The initial repair may be revised at 4 or 5 yr of age. Corrective surgery on the nose may be delayed until adolescence. Nasal surgery can also be performed at the time of the lip repair. Cosmetic results depend on the extent of the original deformity, healing potential of the individual patient, absence of infection, and the skill of the surgeon. ### End" @@ -3203,6 +5721,13 @@ Ans: A (2 - 4 months) Ref: Nelson's Textbook of Pediatrics. 19th Edition Explana Answer the following medical question: Best prognosis in never injury, with the following options: A: Neuropraxia, B: Axonotmesis, C: Neurotmesis, D: Complete transaction +### Response: +","Ans. (a) Neuropraxia(Ref: Maheshwari, orthopedics/p.60)Neuropraxia#Nerve in continuity#Due to compression or ischemia#Only local conduction block seen#Spontaneous recovery in minutes (best prognosis)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Best prognosis in never injury, with the following options: A: Neuropraxia, B: Axonotmesis, C: Neurotmesis, D: Complete transaction + ### Response: Ans. (a) Neuropraxia(Ref: Maheshwari, orthopedics/p.60)Neuropraxia#Nerve in continuity#Due to compression or ischemia#Only local conduction block seen#Spontaneous recovery in minutes (best prognosis) ### End" @@ -3212,6 +5737,13 @@ Ans. (a) Neuropraxia(Ref: Maheshwari, orthopedics/p.60)Neuropraxia#Nerve in cont Answer the following medical question: Panhypopituitarism in adults may lead to all of the following EXCEPT:, with the following options: A: Loss of secondary sexual characteristics, B: Pigmentation of skin, C: Intolerance to cold, D: Infeility +### Response: +","Panhypopituitarism in adult leads to: - Hypothyroidism - intolerance to cold Depressed production of glucocoicoids by adrenal glands. Loss of sexual functions, d/t suppressed secretions of the gonadotropic hormones Pigmentation is due to effect of MSH secreted by pituitary. In panhypopituitarism, levels of MSH decreases thus no pigmentation of skin","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Panhypopituitarism in adults may lead to all of the following EXCEPT:, with the following options: A: Loss of secondary sexual characteristics, B: Pigmentation of skin, C: Intolerance to cold, D: Infeility + ### Response: Panhypopituitarism in adult leads to: - Hypothyroidism - intolerance to cold Depressed production of glucocoicoids by adrenal glands. Loss of sexual functions, d/t suppressed secretions of the gonadotropic hormones Pigmentation is due to effect of MSH secreted by pituitary. In panhypopituitarism, levels of MSH decreases thus no pigmentation of skin ### End" @@ -3221,6 +5753,13 @@ Panhypopituitarism in adult leads to: - Hypothyroidism - intolerance to cold Dep Answer the following medical question: Which of the following is false about Vibrio parahaemolyticus, with the following options: A: Can tolerate maximum 1% salt, B: Can tolerate maximum 3% salt, C: Can tolerate maximum 7% salt, D: Can tolerate maximum 10% salt +### Response: +",V.parahemolyticus grow in a medium containing NaCl. It can tolerate salt concentrations up to 8% but not 10%. Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th Edition; Pg:317,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is false about Vibrio parahaemolyticus, with the following options: A: Can tolerate maximum 1% salt, B: Can tolerate maximum 3% salt, C: Can tolerate maximum 7% salt, D: Can tolerate maximum 10% salt + ### Response: V.parahemolyticus grow in a medium containing NaCl. It can tolerate salt concentrations up to 8% but not 10%. Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th Edition; Pg:317 ### End" @@ -3230,6 +5769,13 @@ V.parahemolyticus grow in a medium containing NaCl. It can tolerate salt concent Answer the following medical question: All of the following process shows features of acute inflammation except, with the following options: A: Apoptosis, B: Pyroptosis, C: Necroptosis, D: Necrosis +### Response: +",Necrosis Plasma membrane - disrupted Cellular contents - may leak out - adjacent inflammation Pathogenesis: - Apoptosis: Hallmarks of Apoptosis Intact Plasma Membrane Shrunken cell size Chromatin condensation - Most Characteristic feature Absent inflammation Pyroptosis:- associated with bacterial infection. associated with the release of IL-1 and activation of Caspase 1 and Caspase 11. inflammation is seen Necroptosis: Caspase independent Programmed cell death. (Programmed Necrosis). it is also having inflammation,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following process shows features of acute inflammation except, with the following options: A: Apoptosis, B: Pyroptosis, C: Necroptosis, D: Necrosis + ### Response: Necrosis Plasma membrane - disrupted Cellular contents - may leak out - adjacent inflammation Pathogenesis: - Apoptosis: Hallmarks of Apoptosis Intact Plasma Membrane Shrunken cell size Chromatin condensation - Most Characteristic feature Absent inflammation Pyroptosis:- associated with bacterial infection. associated with the release of IL-1 and activation of Caspase 1 and Caspase 11. inflammation is seen Necroptosis: Caspase independent Programmed cell death. (Programmed Necrosis). it is also having inflammation ### End" @@ -3239,6 +5785,13 @@ Necrosis Plasma membrane - disrupted Cellular contents - may leak out - adjacent Answer the following medical question: Charcot&;s triad Except, with the following options: A: Pain, B: Fever, C: Jaundice, D: Anaemia +### Response: +","Seen in ascending cholangitis, stone in the CBD due to impaction causes obstruction and stasis. obstruction causes jaundice and pain, stasis leads to infection, bacteremia and fever Reference SRB edition: 5 page:651","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Charcot&;s triad Except, with the following options: A: Pain, B: Fever, C: Jaundice, D: Anaemia + ### Response: Seen in ascending cholangitis, stone in the CBD due to impaction causes obstruction and stasis. obstruction causes jaundice and pain, stasis leads to infection, bacteremia and fever Reference SRB edition: 5 page:651 ### End" @@ -3248,6 +5801,13 @@ Seen in ascending cholangitis, stone in the CBD due to impaction causes obstruct Answer the following medical question: Ring of Sommerring is seen in, with the following options: A: Galactosemia, B: Dislocation of lens, C: Acute congestive glaucoma, D: After cataract +### Response: +",D i.e. After cataract,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ring of Sommerring is seen in, with the following options: A: Galactosemia, B: Dislocation of lens, C: Acute congestive glaucoma, D: After cataract + ### Response: D i.e. After cataract ### End" @@ -3257,6 +5817,13 @@ D i.e. After cataract Answer the following medical question: Fungal spores may be produced-, with the following options: A: Singly, B: In chains, C: In sporangium, D: All of the above +### Response: +","Fungal spores have different morphology. They may be unicellular, multicellular or in chains. - Fungi can reproduce sexually by forming sexual spores and asexually by forming conidia or asexual spores. - Sexual spores are of three types: zygospores, ascospores, and basidiospores. Ascospores are formed in a sac called ascus, Basidiospores are formed outside on the tip of a pedestal called a basidium. Zygospores are single, large spores with thick wall. - Asexual spores are produced by mitosis. Fungi reproduce asexually by forming conidia. Asexual spores can be vegetative or aerial spores as follows: A) Vegetative spores: These include (a) ahrospores, (b) chlamydospores, and (c) blastospores. B)Aerial spores: These include (a) sporangiospores, (b) conidiospores, (c) microconidia, and (d) macroconidia. Sporangiospores are spores formed within a sac called sporangium, which develops at the ends of the hyphae called sporangiophores (e.g., Mucor and Rhizopus).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Fungal spores may be produced-, with the following options: A: Singly, B: In chains, C: In sporangium, D: All of the above + ### Response: Fungal spores have different morphology. They may be unicellular, multicellular or in chains. - Fungi can reproduce sexually by forming sexual spores and asexually by forming conidia or asexual spores. - Sexual spores are of three types: zygospores, ascospores, and basidiospores. Ascospores are formed in a sac called ascus, Basidiospores are formed outside on the tip of a pedestal called a basidium. Zygospores are single, large spores with thick wall. - Asexual spores are produced by mitosis. Fungi reproduce asexually by forming conidia. Asexual spores can be vegetative or aerial spores as follows: A) Vegetative spores: These include (a) ahrospores, (b) chlamydospores, and (c) blastospores. B)Aerial spores: These include (a) sporangiospores, (b) conidiospores, (c) microconidia, and (d) macroconidia. Sporangiospores are spores formed within a sac called sporangium, which develops at the ends of the hyphae called sporangiophores (e.g., Mucor and Rhizopus). ### End" @@ -3266,6 +5833,13 @@ Fungal spores have different morphology. They may be unicellular, multicellular Answer the following medical question: The Loop diuretic acts at, with the following options: A: PCT, B: DCT, C: Ascending loop, D: Descending loop +### Response: +","(C) Ascending loop # Loop diuretics: are diuretics that act on the ascending loop of Henle in the kidney.> They are primarily used in medicine to treat hypertension and edema often due to congestive heart failure or renal insufficiency.# Mechanism of action:> Loop diuretics act on the Na+-K+-2CI' symporter (cotransporter) in the thick ascending limb of the loop of Henle to inhibit sodium & chloride reabsorption. This is achieved by competing for the Cl' binding site.> Because magnesium and calcium reabsorption in the thick ascending limb is dependent on sodium and chloride concentrations, loop diuretics also inhibit their reabsorption> By disrupting the reabsorption of these ions, loop diuretics prevent the urine from becoming concentrated and disrupt the generation of a hypertonic renal medulla","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The Loop diuretic acts at, with the following options: A: PCT, B: DCT, C: Ascending loop, D: Descending loop + ### Response: (C) Ascending loop # Loop diuretics: are diuretics that act on the ascending loop of Henle in the kidney.> They are primarily used in medicine to treat hypertension and edema often due to congestive heart failure or renal insufficiency.# Mechanism of action:> Loop diuretics act on the Na+-K+-2CI' symporter (cotransporter) in the thick ascending limb of the loop of Henle to inhibit sodium & chloride reabsorption. This is achieved by competing for the Cl' binding site.> Because magnesium and calcium reabsorption in the thick ascending limb is dependent on sodium and chloride concentrations, loop diuretics also inhibit their reabsorption> By disrupting the reabsorption of these ions, loop diuretics prevent the urine from becoming concentrated and disrupt the generation of a hypertonic renal medulla ### End" @@ -3275,6 +5849,13 @@ Answer the following medical question: The Loop diuretic acts at, with the follo Answer the following medical question: Hea-lung machines are sterilized by?, with the following options: A: Glutaraldehyde, B: Ethylene oxide, C: Carbolic acid, D: Aqueous solution of iodine +### Response: +","ETHYLENE DIOXIDE its action is due to alkylating the amino ,carboxy,hydroxyland sulphydrl groups in protein molecules. In addition it reacts with DNA and RNA. It is use as a disinfectant presents a potential toxicity to human beings including mutagenicity and carcinogenicity. it diffuses through many types of porous materials nad readily penetrates some plastics.it is especially used for sterilising hea lung machines ,respirators sutures dental equipments books and clothing.it is unsuitable for fumigating rooms because of its explosive propey. it has been successfully used to sterilise a wide range of materials such as glass metas and paper surfaces clothing ,plastics,soil, some foods and tobacco. REF:Ananthanarayan and Panicker's Textbook ofMicrobiology 8thEdition pg no:37","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hea-lung machines are sterilized by?, with the following options: A: Glutaraldehyde, B: Ethylene oxide, C: Carbolic acid, D: Aqueous solution of iodine + ### Response: ETHYLENE DIOXIDE its action is due to alkylating the amino ,carboxy,hydroxyland sulphydrl groups in protein molecules. In addition it reacts with DNA and RNA. It is use as a disinfectant presents a potential toxicity to human beings including mutagenicity and carcinogenicity. it diffuses through many types of porous materials nad readily penetrates some plastics.it is especially used for sterilising hea lung machines ,respirators sutures dental equipments books and clothing.it is unsuitable for fumigating rooms because of its explosive propey. it has been successfully used to sterilise a wide range of materials such as glass metas and paper surfaces clothing ,plastics,soil, some foods and tobacco. REF:Ananthanarayan and Panicker's Textbook ofMicrobiology 8thEdition pg no:37 ### End" @@ -3284,6 +5865,13 @@ ETHYLENE DIOXIDE its action is due to alkylating the amino ,carboxy,hydroxyland Answer the following medical question: Secretion of all of the following hormones is decreased on sectioning of pituitary stalk except:, with the following options: A: Prolactin, B: GH, C: Vasopressin, D: FSH +### Response: +",Normally prolactin is under the inhibitory control of hypothalamus. Destruction of pituitary stalk leads to release of prolactin producing cell; ultimately resulting in  increased prolactin.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Secretion of all of the following hormones is decreased on sectioning of pituitary stalk except:, with the following options: A: Prolactin, B: GH, C: Vasopressin, D: FSH + ### Response: Normally prolactin is under the inhibitory control of hypothalamus. Destruction of pituitary stalk leads to release of prolactin producing cell; ultimately resulting in  increased prolactin. ### End" @@ -3293,6 +5881,13 @@ Normally prolactin is under the inhibitory control of hypothalamus. Destruction Answer the following medical question: ADH is secreted by?, with the following options: A: Supraoptic nucleus, B: Paraventricular nucleus, C: Neurohypophysis, D: Adenohypophysis +### Response: +","ANSWER: (A) Supraoptic nucleusREF: Ganongs 22nd ed p. 243, Handbook of Human Physiology by Vidya Ratan page 302The hormones of posterior pituitary gland (vasipressin St oxytocin) are secreted by neurosecretory cells (in hypothalamus) of supraoptic nucleus (secretes vasopressin AKA- ADH) and paraventricular nucleus (secretes oxytocin). These hormones travel through hypothalamo- hypophyseal tract to be stored in posterior pituitary","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: ADH is secreted by?, with the following options: A: Supraoptic nucleus, B: Paraventricular nucleus, C: Neurohypophysis, D: Adenohypophysis + ### Response: ANSWER: (A) Supraoptic nucleusREF: Ganongs 22nd ed p. 243, Handbook of Human Physiology by Vidya Ratan page 302The hormones of posterior pituitary gland (vasipressin St oxytocin) are secreted by neurosecretory cells (in hypothalamus) of supraoptic nucleus (secretes vasopressin AKA- ADH) and paraventricular nucleus (secretes oxytocin). These hormones travel through hypothalamo- hypophyseal tract to be stored in posterior pituitary ### End" @@ -3302,6 +5897,13 @@ ANSWER: (A) Supraoptic nucleusREF: Ganongs 22nd ed p. 243, Handbook of Human Phy Answer the following medical question: Hyperbilirubinemia with the absence of urobilinogen in urine is seen in:, with the following options: A: G6PD enzyme deficiency, B: Cirrhosis of liver, C: Paroxysmal Nocturnal Hemoglobinuria, D: Obstruction of the common bile duct +### Response: +","Urobilinogen is formed from degradation of bile pigments by bacterial action. In case of obstruction to bile flow as happens in cholelithiasis or any kind of biliary obstruction,There will be no urobilinogen in urine. So, No formation of stercobilinogen and the patient passes clay colored stools. Option analysis: Hemolysis produces a lot of urobilinogen which is excreted in urine - option a and c are excluded. In hepatocellular jaundice, urobilinogen can be normal or reduced. The question specifically uses the word ""absent"" - options c is also excluded. Parameter Pre-hepatic Hepatocellular Obstructive Basic mechanism of raised bilirubin Hemolysis defective uptake, conjugation and excretion of bilirubin by hepatocytes defective excretion of bile due to the obstruction of biliary tract Type of serum bilirubin raised mainly unconjugated unconjugated + conjugated mainly conjugated (>50%) Urine bilirubin absent present present Urine urobilinogen present present absent Prototype example Hemolytic anaemia viral hepatitis common bile duct stone Prothrombin time normal abnormal; that is n't corrected by vitamin K inj. abnormal; that is corrected by the vitamin K inj. Additional features features of hemolysis on peripheral blood smear, reticuloytosis, low Hb, low haptoglobin Marked rise of serum ALT and ALP Marked rise of serum ALP (>3 times)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hyperbilirubinemia with the absence of urobilinogen in urine is seen in:, with the following options: A: G6PD enzyme deficiency, B: Cirrhosis of liver, C: Paroxysmal Nocturnal Hemoglobinuria, D: Obstruction of the common bile duct + ### Response: Urobilinogen is formed from degradation of bile pigments by bacterial action. In case of obstruction to bile flow as happens in cholelithiasis or any kind of biliary obstruction,There will be no urobilinogen in urine. So, No formation of stercobilinogen and the patient passes clay colored stools. Option analysis: Hemolysis produces a lot of urobilinogen which is excreted in urine - option a and c are excluded. In hepatocellular jaundice, urobilinogen can be normal or reduced. The question specifically uses the word ""absent"" - options c is also excluded. Parameter Pre-hepatic Hepatocellular Obstructive Basic mechanism of raised bilirubin Hemolysis defective uptake, conjugation and excretion of bilirubin by hepatocytes defective excretion of bile due to the obstruction of biliary tract Type of serum bilirubin raised mainly unconjugated unconjugated + conjugated mainly conjugated (>50%) Urine bilirubin absent present present Urine urobilinogen present present absent Prototype example Hemolytic anaemia viral hepatitis common bile duct stone Prothrombin time normal abnormal; that is n't corrected by vitamin K inj. abnormal; that is corrected by the vitamin K inj. Additional features features of hemolysis on peripheral blood smear, reticuloytosis, low Hb, low haptoglobin Marked rise of serum ALT and ALP Marked rise of serum ALP (>3 times) ### End" @@ -3311,6 +5913,13 @@ Urobilinogen is formed from degradation of bile pigments by bacterial action. In Answer the following medical question: An 18 year old boy presented with a belief that his penis is retracting in the abdomen and he will die when it complete retracts. What is this disorder called as?, with the following options: A: Dhaat syndrome, B: Koro, C: Latah, D: Munchausen syndrome +### Response: +","* Koro: The patient has a fear that his penis will retract into the abdomen and would result in death Culture-bound syndromes are the disorders that are limited to a paicular culture and are not seen worldwide. Few common culture-bound syndromes are: * Dhat syndrome: It is prevalent in the Indian subcontinent. The patient has a belief that he is passing semen in urine and this is resulting in physical and mental weakness. * Latah: It is characterized by automatic obedience, echolalia and echopraxia. Munchausen syndrome is a factitious disorder in which there is a willful production of symptoms to get medical attention .","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: An 18 year old boy presented with a belief that his penis is retracting in the abdomen and he will die when it complete retracts. What is this disorder called as?, with the following options: A: Dhaat syndrome, B: Koro, C: Latah, D: Munchausen syndrome + ### Response: * Koro: The patient has a fear that his penis will retract into the abdomen and would result in death Culture-bound syndromes are the disorders that are limited to a paicular culture and are not seen worldwide. Few common culture-bound syndromes are: * Dhat syndrome: It is prevalent in the Indian subcontinent. The patient has a belief that he is passing semen in urine and this is resulting in physical and mental weakness. * Latah: It is characterized by automatic obedience, echolalia and echopraxia. Munchausen syndrome is a factitious disorder in which there is a willful production of symptoms to get medical attention . ### End" @@ -3320,6 +5929,13 @@ Answer the following medical question: An 18 year old boy presented with a belie Answer the following medical question: Best suture for common bile duct is -, with the following options: A: Synthetic absorbable synthetic, B: Synthetic non-absorbable, C: Non-synthetic absorbable, D: Non-synthetic non-absorbable +### Response: +",Ans. is 'c' i.e. Non-synthetic absorbable,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Best suture for common bile duct is -, with the following options: A: Synthetic absorbable synthetic, B: Synthetic non-absorbable, C: Non-synthetic absorbable, D: Non-synthetic non-absorbable + ### Response: Ans. is 'c' i.e. Non-synthetic absorbable ### End" @@ -3329,6 +5945,13 @@ Ans. is 'c' i.e. Non-synthetic absorbable Answer the following medical question: An anganwadi worker is trained for-, with the following options: A: 3 months, B: 4 months, C: 5 months, D: 6 months +### Response: +",Ans. is 'b' i.e.. 4 months,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: An anganwadi worker is trained for-, with the following options: A: 3 months, B: 4 months, C: 5 months, D: 6 months + ### Response: Ans. is 'b' i.e.. 4 months ### End" @@ -3338,6 +5961,13 @@ Ans. is 'b' i.e.. 4 months Answer the following medical question: Hydrogen breath test is/ae used for, with the following options: A: Lactose intolerance, B: GERD, C: H.Pylori, D: Irritable bowel syndrome +### Response: +",

Davidson&;s principles and practice of medicine 22nd edition. *The lactose hydrogen breath test is an useful non invasive confirmatory investigation.

,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hydrogen breath test is/ae used for, with the following options: A: Lactose intolerance, B: GERD, C: H.Pylori, D: Irritable bowel syndrome + ### Response:

Davidson&;s principles and practice of medicine 22nd edition. *The lactose hydrogen breath test is an useful non invasive confirmatory investigation.

### End" @@ -3347,6 +5977,13 @@ Answer the following medical question: Hydrogen breath test is/ae used for, with Answer the following medical question: Myocardial stunning pattern' in ECG, which mimics myocardial infarction?, with the following options: A: Takotsubo cardiomyopathy, B: Restrictive cardiomyopathy, C: Brugada Syndrome, D: Pericardial effusion +### Response: +","(A) Takotsubo cardiomyopathy[?]""Myocardial Stunning"" is a condition where certain segments of myocardium (corresponding to area of major coronary occlusion) shows forms of contractile abnormality.oSegmental dysfunction persisting for a variable period of time, about 2 weeks, even after ischemia has been relieved (by for Instance Angioplasty or Coronary Artery Bypass Surgery).oTakotsubo cardiomyopathy or Takotsubo syndrome, is a temporary condition where the heart muscle becomes suddenly weakened or 'stunned'.oSymptoms of Takotsubo (stress-related) cardiomyopathy often start abruptly with chest pain & shortness of breath.oThis cardiomyopathy, is triggered by an emotionally or physically stressful event & may mimic acute MI.oAssociated ECG abnormalities: ST-segment elevation & elevated biomarkers of myocardial injury.Other Options[?]Restrictive Cardiomyopathy:-It is dominated by abnormal diastolic function, often with mildly decreased contractility & ejection fraction (usually >30-50%).-Seen in Amyloidosis, sarcoidosis, hemochromatosis etc.,-Ventricles become rigid & lack the flexibility to expand during diastole.-SOB, fatigue, palpitations & syncope.-Other Common Findings: Atrial fibrilation, conduction delays.-ECG shows Low voltage, non-specific ST-T wave abnormalities & various arrhythmias.[?]Brugada byndrome:-ECG shows >0.2mV of ST-segment elevation with coved ST segment & negative T wave in more than one anterior precordial lead (V1 -V3 ) and episodes of syncope or cardiac arrest due to polymorphic VT in the absence of structural heart disease.-Cardiac arrest may occur during sleep or be provoked by febrile illness.-Males are more commonly affected than females.-Quinidine used successfully to suppress frequent episodes of VT[?]Pericardial Effusion:oClassical triad of findings for pericardial effusionowith cardiac tamponade:-Sinus tachycardia,-Low QRS voltage,-Electrical alternans (Best seen in V3 & V4 )","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Myocardial stunning pattern' in ECG, which mimics myocardial infarction?, with the following options: A: Takotsubo cardiomyopathy, B: Restrictive cardiomyopathy, C: Brugada Syndrome, D: Pericardial effusion + ### Response: (A) Takotsubo cardiomyopathy[?]""Myocardial Stunning"" is a condition where certain segments of myocardium (corresponding to area of major coronary occlusion) shows forms of contractile abnormality.oSegmental dysfunction persisting for a variable period of time, about 2 weeks, even after ischemia has been relieved (by for Instance Angioplasty or Coronary Artery Bypass Surgery).oTakotsubo cardiomyopathy or Takotsubo syndrome, is a temporary condition where the heart muscle becomes suddenly weakened or 'stunned'.oSymptoms of Takotsubo (stress-related) cardiomyopathy often start abruptly with chest pain & shortness of breath.oThis cardiomyopathy, is triggered by an emotionally or physically stressful event & may mimic acute MI.oAssociated ECG abnormalities: ST-segment elevation & elevated biomarkers of myocardial injury.Other Options[?]Restrictive Cardiomyopathy:-It is dominated by abnormal diastolic function, often with mildly decreased contractility & ejection fraction (usually >30-50%).-Seen in Amyloidosis, sarcoidosis, hemochromatosis etc.,-Ventricles become rigid & lack the flexibility to expand during diastole.-SOB, fatigue, palpitations & syncope.-Other Common Findings: Atrial fibrilation, conduction delays.-ECG shows Low voltage, non-specific ST-T wave abnormalities & various arrhythmias.[?]Brugada byndrome:-ECG shows >0.2mV of ST-segment elevation with coved ST segment & negative T wave in more than one anterior precordial lead (V1 -V3 ) and episodes of syncope or cardiac arrest due to polymorphic VT in the absence of structural heart disease.-Cardiac arrest may occur during sleep or be provoked by febrile illness.-Males are more commonly affected than females.-Quinidine used successfully to suppress frequent episodes of VT[?]Pericardial Effusion:oClassical triad of findings for pericardial effusionowith cardiac tamponade:-Sinus tachycardia,-Low QRS voltage,-Electrical alternans (Best seen in V3 & V4 ) ### End" @@ -3356,6 +5993,29 @@ Answer the following medical question: Myocardial stunning pattern' in ECG, whic Answer the following medical question: Fundamental desire for learning in an individual is:, with the following options: A: Interest., B: Motivation., C: Participation, D: Learning by doing. +### Response: +","Principles of health education: + +Credibility +Interest +Participation +Motivation +Comprehension +Reinforcement +Learning by doing +Known to unknown +Setting an example +Good human relations +Feedback +Community Leaders +Soil, Seed, Sower + +Motivation is defined as ""the fundamental desire for learning in an individual"".","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Fundamental desire for learning in an individual is:, with the following options: A: Interest., B: Motivation., C: Participation, D: Learning by doing. + ### Response: Principles of health education: @@ -3381,6 +6041,14 @@ Motivation is defined as ""the fundamental desire for learning in an individual" Answer the following medical question: Most frequent chromosomal abnormality found in those with heart defect, with the following options: A: Trisomy 13, B: Trisomy 21, C: Trisomy 18, D: Monosomy X +### Response: +","Trisomy 21 >> Trisomy 18 >> 22q Microdeletion >> Trisomy 13 >> monosomy X. +This is order of occurrence of heart defect most commonly and frequently.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most frequent chromosomal abnormality found in those with heart defect, with the following options: A: Trisomy 13, B: Trisomy 21, C: Trisomy 18, D: Monosomy X + ### Response: Trisomy 21 >> Trisomy 18 >> 22q Microdeletion >> Trisomy 13 >> monosomy X. This is order of occurrence of heart defect most commonly and frequently. @@ -3391,6 +6059,13 @@ This is order of occurrence of heart defect most commonly and frequently. Answer the following medical question: Which of the following is not expressed in majority of cases of pediatric B-cell acute lymphoblastic leukemia?, with the following options: A: Terminal deoxynucleotidyl transferase (TdT), B: CD19, C: CD10, D: CD7 +### Response: +","CD19 is a pan B-cell marker. CALLA (common acute lymphoblastic leukemia antigen) is CD 10. CD45 is known as leukocyte common antigen (LCA). Terminal deoxynucleotidyl transferase (TdT), a specialized DNA polymerase that is expressed only in pre-B and pre-T lymphoblasts, is positive in more than 95% of cases. CD7 is commonly expressed in T-cell ALL.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is not expressed in majority of cases of pediatric B-cell acute lymphoblastic leukemia?, with the following options: A: Terminal deoxynucleotidyl transferase (TdT), B: CD19, C: CD10, D: CD7 + ### Response: CD19 is a pan B-cell marker. CALLA (common acute lymphoblastic leukemia antigen) is CD 10. CD45 is known as leukocyte common antigen (LCA). Terminal deoxynucleotidyl transferase (TdT), a specialized DNA polymerase that is expressed only in pre-B and pre-T lymphoblasts, is positive in more than 95% of cases. CD7 is commonly expressed in T-cell ALL. ### End" @@ -3400,6 +6075,13 @@ CD19 is a pan B-cell marker. CALLA (common acute lymphoblastic leukemia antigen) Answer the following medical question: Drug of choice for organophosphorous poisoning: March 2013 (e), with the following options: A: EDTA, B: BAL, C: PAM, D: All of the above +### Response: +",Ans. C i.e. PAM Treatment of organophosphate poisoning Current antidotes for OP poisoning consist of a pretreatment with carbamates to protect AChE from inhibition by OP compounds and post-exposure treatments with anti-cholinergic drugs. Anti-cholinergic drugs work to counteract the effects of excess acetylcholine and reactivate AChE. Atropine can be used as an antidote in conjunction with pralidoxime or other pyridinium oximes (such as trimedoxime or obidoxime),"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Drug of choice for organophosphorous poisoning: March 2013 (e), with the following options: A: EDTA, B: BAL, C: PAM, D: All of the above + ### Response: Ans. C i.e. PAM Treatment of organophosphate poisoning Current antidotes for OP poisoning consist of a pretreatment with carbamates to protect AChE from inhibition by OP compounds and post-exposure treatments with anti-cholinergic drugs. Anti-cholinergic drugs work to counteract the effects of excess acetylcholine and reactivate AChE. Atropine can be used as an antidote in conjunction with pralidoxime or other pyridinium oximes (such as trimedoxime or obidoxime) ### End" @@ -3409,6 +6091,13 @@ Ans. C i.e. PAM Treatment of organophosphate poisoning Current antidotes for OP Answer the following medical question: Treatment of Hirsutism in PCOD, Drug used is :, with the following options: A: Menopausal Gonadotropin, B: GnRH, C: Spironolactone, D: Hcg +### Response: +","In PCOD with Hirustism,drugs given are; a.oral contraceptive b.anti androgens Antiandrogens in PCOD Used are spironolactone, cyproterone acetate, Flutamide and Finasteride Spironolactone in a dose of 100-200 mg daily, blocks the androgen receptors, reduces it production and increases its metabolism and thus prevents hirsutism in 60%cases. It is best given with combined oral pills to avoid irregular menstruation and possible feminisation of male fetus during therapy Maintainance dose after 6-12 months is 50mg of spironolactone with oral pills Ref : SHAW'S TEXTBOOKOF GYNECOLOGY; 15th edition; Pg no:117","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Treatment of Hirsutism in PCOD, Drug used is :, with the following options: A: Menopausal Gonadotropin, B: GnRH, C: Spironolactone, D: Hcg + ### Response: In PCOD with Hirustism,drugs given are; a.oral contraceptive b.anti androgens Antiandrogens in PCOD Used are spironolactone, cyproterone acetate, Flutamide and Finasteride Spironolactone in a dose of 100-200 mg daily, blocks the androgen receptors, reduces it production and increases its metabolism and thus prevents hirsutism in 60%cases. It is best given with combined oral pills to avoid irregular menstruation and possible feminisation of male fetus during therapy Maintainance dose after 6-12 months is 50mg of spironolactone with oral pills Ref : SHAW'S TEXTBOOKOF GYNECOLOGY; 15th edition; Pg no:117 ### End" @@ -3418,6 +6107,13 @@ In PCOD with Hirustism,drugs given are; a.oral contraceptive b.anti androgens An Answer the following medical question: The metal responsible for this disease is:, with the following options: A: Mercury, B: Lead, C: Arsenic, D: Copper +### Response: +","Ans. (A). MercuryAcrodynia (pink disease, erythroedema, or swift- feer's disease)Due to idiosyncratic reaction to mercury among childrenMaculopapular rash (fingertips, toes)Pus-filled skin eruptionsSwollen and painful extremities","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The metal responsible for this disease is:, with the following options: A: Mercury, B: Lead, C: Arsenic, D: Copper + ### Response: Ans. (A). MercuryAcrodynia (pink disease, erythroedema, or swift- feer's disease)Due to idiosyncratic reaction to mercury among childrenMaculopapular rash (fingertips, toes)Pus-filled skin eruptionsSwollen and painful extremities ### End" @@ -3427,6 +6123,13 @@ Ans. (A). MercuryAcrodynia (pink disease, erythroedema, or swift- feer's disease Answer the following medical question: Atenolol is indicated in all except, with the following options: A: Hypertension, B: Partial heart block, C: Hypertrophic obstructive cardiomyopathy, D: Classical angina +### Response: +",Ans. (B) Partial heart block(Ref: KDT 8th/e p160-161)b -blockers are contraindicated in partial or complete heart block as they cause bradycardia.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Atenolol is indicated in all except, with the following options: A: Hypertension, B: Partial heart block, C: Hypertrophic obstructive cardiomyopathy, D: Classical angina + ### Response: Ans. (B) Partial heart block(Ref: KDT 8th/e p160-161)b -blockers are contraindicated in partial or complete heart block as they cause bradycardia. ### End" @@ -3436,6 +6139,13 @@ Ans. (B) Partial heart block(Ref: KDT 8th/e p160-161)b -blockers are contraindic Answer the following medical question: What is true regarding sulfasalazine?, with the following options: A: Active moiety is 5 amino salicylic acid in ulcerative colitis, B: Inactive moiety is 5 amino salicylic acid in ulcerative colitis, C: Inactive moiety in rheumatoid ahritis is Sulfapyridine, D: It gets activated in the stomach +### Response: +","Around 90% of a dose of sulfasalazine reaches the colon, where most of it is metabolized by bacteria into sulfapyridine and mesalazine (also known as 5-aminosalicylic acid or 5-ASA).5 ASA is the active moiety produced in the colon in U.Colitis.In rheumatoid ahritis the active moiety is sulphapyridine.Ref: Katzung 13th ed. Pg: 1072","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What is true regarding sulfasalazine?, with the following options: A: Active moiety is 5 amino salicylic acid in ulcerative colitis, B: Inactive moiety is 5 amino salicylic acid in ulcerative colitis, C: Inactive moiety in rheumatoid ahritis is Sulfapyridine, D: It gets activated in the stomach + ### Response: Around 90% of a dose of sulfasalazine reaches the colon, where most of it is metabolized by bacteria into sulfapyridine and mesalazine (also known as 5-aminosalicylic acid or 5-ASA).5 ASA is the active moiety produced in the colon in U.Colitis.In rheumatoid ahritis the active moiety is sulphapyridine.Ref: Katzung 13th ed. Pg: 1072 ### End" @@ -3445,6 +6155,13 @@ Around 90% of a dose of sulfasalazine reaches the colon, where most of it is met Answer the following medical question: A 9-year-old boy presents with a several day history of progressive arm and leg weakness. He has been well except for an upper respiratory infection two weeks ago. The patient is ale and oriented. On repeated examination, the hea rate varies between 60 and 140 beats/minute and the blood pressure varies between 90/60 and 140/90 mm Hg. Respirations are shallow with a rate of 50/minute. There is symmetric weakness of the face and all four extremities. Deep tendon reflexes are absent. Sensation is intact. The most likely diagnosis is:, with the following options: A: Polymyositis, B: Myasthenia gravis, C: Transverse myelitis, D: Guillain-Barre syndrome +### Response: +","Progressive, symmetric motor weakness, areflexia, and autonomic instability, with mild or absent sensory signs, are typical features of Guillain-Barre syndrome. Frequently there is a history of infection (often respiratory) in the several weeks preceding clinical onset of the syndrome. Suppoive evidence for the diagnosis includes elevation of cerebrospinal fluid protein concentration with a mild (10 or fewer cells/mL) mononuclear pleocytosis and slowing of nerve conduction velocities. Ref: Greenberg D.A., Aminoff M.J., Simon R.P. (2012). Chapter 10. Sensory Disorders. In D.A. Greenberg, M.J. Aminoff, R.P. Simon (Eds), Clinical Neurology, 8e.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 9-year-old boy presents with a several day history of progressive arm and leg weakness. He has been well except for an upper respiratory infection two weeks ago. The patient is ale and oriented. On repeated examination, the hea rate varies between 60 and 140 beats/minute and the blood pressure varies between 90/60 and 140/90 mm Hg. Respirations are shallow with a rate of 50/minute. There is symmetric weakness of the face and all four extremities. Deep tendon reflexes are absent. Sensation is intact. The most likely diagnosis is:, with the following options: A: Polymyositis, B: Myasthenia gravis, C: Transverse myelitis, D: Guillain-Barre syndrome + ### Response: Progressive, symmetric motor weakness, areflexia, and autonomic instability, with mild or absent sensory signs, are typical features of Guillain-Barre syndrome. Frequently there is a history of infection (often respiratory) in the several weeks preceding clinical onset of the syndrome. Suppoive evidence for the diagnosis includes elevation of cerebrospinal fluid protein concentration with a mild (10 or fewer cells/mL) mononuclear pleocytosis and slowing of nerve conduction velocities. Ref: Greenberg D.A., Aminoff M.J., Simon R.P. (2012). Chapter 10. Sensory Disorders. In D.A. Greenberg, M.J. Aminoff, R.P. Simon (Eds), Clinical Neurology, 8e. ### End" @@ -3454,6 +6171,13 @@ Progressive, symmetric motor weakness, areflexia, and autonomic instability, wit Answer the following medical question: Perioral rash and pigmentation of palmar area and eczematous skin lesions are seen in:, with the following options: A: Selenium deficiency, B: Zinc deficiency, C: Chromium deficiency, D: Iodine deficiency +### Response: +","Ans. B. zinc deficiencyZinc is a component of over 100 metal enzymes and participates in many biological processes. Zinc regulates gene transcription and participates in nucleic acid metabolism, protein synthesis and thereby cellular growth. Zinc deficiency is usually seen as a part of malnutrition or malabsorption syndromes, caused by low dietary intake or intestinal disease. Acrodermatitis enteropathica is an autosomal recessive syndrome of severe zinc deficiency, caused by defective intestinal absorption due to intestinal zinc transporter protein. Presentation in early infancy, with vesicobullous, dry, scaly or eczematous skin lesions chiefly involving the perioral, perineal and acral areas. Alopecia and eye changes such as conjunctivitis, blepharitis and photophobia may be present.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Perioral rash and pigmentation of palmar area and eczematous skin lesions are seen in:, with the following options: A: Selenium deficiency, B: Zinc deficiency, C: Chromium deficiency, D: Iodine deficiency + ### Response: Ans. B. zinc deficiencyZinc is a component of over 100 metal enzymes and participates in many biological processes. Zinc regulates gene transcription and participates in nucleic acid metabolism, protein synthesis and thereby cellular growth. Zinc deficiency is usually seen as a part of malnutrition or malabsorption syndromes, caused by low dietary intake or intestinal disease. Acrodermatitis enteropathica is an autosomal recessive syndrome of severe zinc deficiency, caused by defective intestinal absorption due to intestinal zinc transporter protein. Presentation in early infancy, with vesicobullous, dry, scaly or eczematous skin lesions chiefly involving the perioral, perineal and acral areas. Alopecia and eye changes such as conjunctivitis, blepharitis and photophobia may be present. ### End" @@ -3463,6 +6187,13 @@ Ans. B. zinc deficiencyZinc is a component of over 100 metal enzymes and partici Answer the following medical question: Number of milk teeth: NEET 13, with the following options: A: 12, B: 16, C: 20, D: 24 +### Response: +",Ans. 20,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Number of milk teeth: NEET 13, with the following options: A: 12, B: 16, C: 20, D: 24 + ### Response: Ans. 20 ### End" @@ -3472,6 +6203,13 @@ Ans. 20 Answer the following medical question: Not a strategy for measles elimination ?, with the following options: A: Mop up: Vaccinate kids left with routine vaccination, B: Catch up: One time nation wide vaccination 9 month- 14 years old children, C: Keep up: Vaccinate > 95% successive bih, D: Follow up: Nationwide vaccination every 2-4 years +### Response: +","Ans. is 'a' i.e., Mop up: Vaccinate kids left with routine vaccination The prioies of countries persuing measles control include :- Improve routine vaccination coverage level to at least 90%. Active coverage of more than 90% in catch-up and follow-up campaigns or active coverage of more than 90% with routine second dose of measles vaccine. Establish case - based surveillance with laboratory confirmation of suspected cases and virus isolation from all chains of transmission. Conduct supplementary vaccination campaign together with administration of vitamin 'A' in high risk areas. In India, measles is a major cause of morbidity and a significant contributor to childhood moality. Prior to the immunization programme, cyclical increase in the incidence of measles were recorded every third year. With the increase in immunization coverage levels, the intervals between cyclic peaks has increased and the intensity of the peak minimized. Epidemic of measles occur if propoion of susceptible children is > 40% If measles is introduced in a virgin community, it infects > 90% of children. Eradication of measles requires vaccine coverage >96%","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Not a strategy for measles elimination ?, with the following options: A: Mop up: Vaccinate kids left with routine vaccination, B: Catch up: One time nation wide vaccination 9 month- 14 years old children, C: Keep up: Vaccinate > 95% successive bih, D: Follow up: Nationwide vaccination every 2-4 years + ### Response: Ans. is 'a' i.e., Mop up: Vaccinate kids left with routine vaccination The prioies of countries persuing measles control include :- Improve routine vaccination coverage level to at least 90%. Active coverage of more than 90% in catch-up and follow-up campaigns or active coverage of more than 90% with routine second dose of measles vaccine. Establish case - based surveillance with laboratory confirmation of suspected cases and virus isolation from all chains of transmission. Conduct supplementary vaccination campaign together with administration of vitamin 'A' in high risk areas. In India, measles is a major cause of morbidity and a significant contributor to childhood moality. Prior to the immunization programme, cyclical increase in the incidence of measles were recorded every third year. With the increase in immunization coverage levels, the intervals between cyclic peaks has increased and the intensity of the peak minimized. Epidemic of measles occur if propoion of susceptible children is > 40% If measles is introduced in a virgin community, it infects > 90% of children. Eradication of measles requires vaccine coverage >96% ### End" @@ -3481,6 +6219,13 @@ Ans. is 'a' i.e., Mop up: Vaccinate kids left with routine vaccination The prioi Answer the following medical question: Possible causes of choriocarcinoma after hydatidiform mole are all except:, with the following options: A: Rising hCG, B: More theca lutein cysts, C: Increased uterus size, D: Suburethral nodule +### Response: +",Ans. D. Suburethral nodule* Choriocarcinoma consists of sheets of anaplastic cytotrophoblast and syncytiotrophoblast cells without chorionic villi.* Metastases are always choriocarcinoma.* Choriocarcinomas are commonly accompanied by ovarian theca lutein cysts.* Choriocarcinoma is seen in postmenopausal women.* Pelvic mass is also palpable.* | hCG level is seen in choriocarcinoma.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Possible causes of choriocarcinoma after hydatidiform mole are all except:, with the following options: A: Rising hCG, B: More theca lutein cysts, C: Increased uterus size, D: Suburethral nodule + ### Response: Ans. D. Suburethral nodule* Choriocarcinoma consists of sheets of anaplastic cytotrophoblast and syncytiotrophoblast cells without chorionic villi.* Metastases are always choriocarcinoma.* Choriocarcinomas are commonly accompanied by ovarian theca lutein cysts.* Choriocarcinoma is seen in postmenopausal women.* Pelvic mass is also palpable.* | hCG level is seen in choriocarcinoma. ### End" @@ -3490,6 +6235,13 @@ Ans. D. Suburethral nodule* Choriocarcinoma consists of sheets of anaplastic cyt Answer the following medical question: Which of the following aminoacid in a protein is involved in urea cycle and is required for synthesis of NO?, with the following options: A: Arginine, B: Histidine, C: Tryptophan, D: Lysine +### Response: +","Ans. A. ArginineFallowing are required for Nitric Oxide (NO) synthesis: Arginine, NO synthase, Ca++_and NADPH.Urea cycle:","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following aminoacid in a protein is involved in urea cycle and is required for synthesis of NO?, with the following options: A: Arginine, B: Histidine, C: Tryptophan, D: Lysine + ### Response: Ans. A. ArginineFallowing are required for Nitric Oxide (NO) synthesis: Arginine, NO synthase, Ca++_and NADPH.Urea cycle: ### End" @@ -3499,6 +6251,13 @@ Ans. A. ArginineFallowing are required for Nitric Oxide (NO) synthesis: Arginine Answer the following medical question: Hand-Foot-Mouth disease (HFMD) is caused by, with the following options: A: CMV, B: EBV, C: HHV-7, D: Enterovirus-71 +### Response: +","Ans. d (Enterovirus-71) (Ref. Ananthanarayan, Microbiology, 8th/p. 491).Hand, foot, and mouth disease (HFMD), is a contagious enteroviral infection occurring primarily in children and characterized by a vesicular palmoplantar eruption and erosive stomatitis. It is caused by enterovirus-71 & coxsackie A5, 7, 9, 10, 16, Bl, 2, 5, with coxsackie A16 being the most common cause. Coxsackie viruses are typical enteroviruses. Enteroviruses are believed to spread via fecal-oral and perhaps respiratory routes.Coxsackie viruses also cause:# Herpangina# Aseptic meningitis# Bornholm disease (epidemic pleurodynia)# Myocarditis/ Pericarditis# Juvenile diabetes# Orchitis# Post viral fatigue synd. Educational PointsThe 72 Enteroviruses include:1 to 3 - 3 - Polio4 to 27 - 24 - Coxsackie A (Coxsackie A 23 is same as ECHO 9)28 to 33 - 6 - Coxsackie B34 to 67 - 34 - ECHO (ECHO 10 is Reo, ECHO 28 Rhino 1 A, ECHO 34 is Coxsackie A24)68 to 72 - 5 - Enterovirus 68 to 72 (Entero Virus 72 is Hepatitis A Virus)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hand-Foot-Mouth disease (HFMD) is caused by, with the following options: A: CMV, B: EBV, C: HHV-7, D: Enterovirus-71 + ### Response: Ans. d (Enterovirus-71) (Ref. Ananthanarayan, Microbiology, 8th/p. 491).Hand, foot, and mouth disease (HFMD), is a contagious enteroviral infection occurring primarily in children and characterized by a vesicular palmoplantar eruption and erosive stomatitis. It is caused by enterovirus-71 & coxsackie A5, 7, 9, 10, 16, Bl, 2, 5, with coxsackie A16 being the most common cause. Coxsackie viruses are typical enteroviruses. Enteroviruses are believed to spread via fecal-oral and perhaps respiratory routes.Coxsackie viruses also cause:# Herpangina# Aseptic meningitis# Bornholm disease (epidemic pleurodynia)# Myocarditis/ Pericarditis# Juvenile diabetes# Orchitis# Post viral fatigue synd. Educational PointsThe 72 Enteroviruses include:1 to 3 - 3 - Polio4 to 27 - 24 - Coxsackie A (Coxsackie A 23 is same as ECHO 9)28 to 33 - 6 - Coxsackie B34 to 67 - 34 - ECHO (ECHO 10 is Reo, ECHO 28 Rhino 1 A, ECHO 34 is Coxsackie A24)68 to 72 - 5 - Enterovirus 68 to 72 (Entero Virus 72 is Hepatitis A Virus) ### End" @@ -3508,6 +6267,13 @@ Ans. d (Enterovirus-71) (Ref. Ananthanarayan, Microbiology, 8th/p. 491).Hand, fo Answer the following medical question: The Antidote for Cyanide poisoning is, with the following options: A: Atropine, B: 2-Pralidoxime, C: Sodium nitrite with sodium thiosulfate, D: None of the above +### Response: +","(C) Sodium nitrite with sodium thiosulfate # Cyanide poisoning:> Treatment: Stomach wash or emesis, activated charcoal and cathartic. 100 ml. of 50% glucose, 2 mg. naloxone, and 100 mg. thiamine i.v. 5 to 10 mg. diazepam, if the patient is violent or aggressive. Assure the patient that he will I recover. If flashbacks occur give antianxiety and if necessary antipsychotic drugs, such as haloperidol. Psychotherapy.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The Antidote for Cyanide poisoning is, with the following options: A: Atropine, B: 2-Pralidoxime, C: Sodium nitrite with sodium thiosulfate, D: None of the above + ### Response: (C) Sodium nitrite with sodium thiosulfate # Cyanide poisoning:> Treatment: Stomach wash or emesis, activated charcoal and cathartic. 100 ml. of 50% glucose, 2 mg. naloxone, and 100 mg. thiamine i.v. 5 to 10 mg. diazepam, if the patient is violent or aggressive. Assure the patient that he will I recover. If flashbacks occur give antianxiety and if necessary antipsychotic drugs, such as haloperidol. Psychotherapy. ### End" @@ -3517,6 +6283,13 @@ Answer the following medical question: The Antidote for Cyanide poisoning is, wi Answer the following medical question: ""Westermark sign"" is seen in:, with the following options: A: Pneumomediastinum, B: Pulmonary adenocarcinoma, C: Pulmonary embolism, D: Pancoast syndrome +### Response: +","""Westermark Sign"" is focal oligemia seen distal to arterial block, on chest X-ray.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: ""Westermark sign"" is seen in:, with the following options: A: Pneumomediastinum, B: Pulmonary adenocarcinoma, C: Pulmonary embolism, D: Pancoast syndrome + ### Response: ""Westermark Sign"" is focal oligemia seen distal to arterial block, on chest X-ray. ### End" @@ -3526,6 +6299,13 @@ Answer the following medical question: ""Westermark sign"" is seen in:, with the Answer the following medical question: A patient presents with nephrotic syndrome and hypoalbuminemia. Protein binding of which drug is not affected -, with the following options: A: Tolbutamide, B: Morphine, C: Diazepam, D: Valproate +### Response: +","Ans. is 'b' i.e., Morphine in nephrotic syndrome there is no effect on protein binding. o Other three drugs are plasma protein bound drugs.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A patient presents with nephrotic syndrome and hypoalbuminemia. Protein binding of which drug is not affected -, with the following options: A: Tolbutamide, B: Morphine, C: Diazepam, D: Valproate + ### Response: Ans. is 'b' i.e., Morphine in nephrotic syndrome there is no effect on protein binding. o Other three drugs are plasma protein bound drugs. ### End" @@ -3535,6 +6315,13 @@ Ans. is 'b' i.e., Morphine in nephrotic syndrome there is no effect on protein b Answer the following medical question: The maximum dose of isotretinoin should not exceed, with the following options: A: 30-60mg/kg, B: 60-90 mg/kg, C: 90-120 mg/kg, D: 120-150 mg/kg +### Response: +",Oral isotretinoin duration of treatment varies according to dose but post-therapy relapse is minimized by treatment courses that amount to the total of 120-150 mg/kg Ref Harrison 20th edition pg 1233,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The maximum dose of isotretinoin should not exceed, with the following options: A: 30-60mg/kg, B: 60-90 mg/kg, C: 90-120 mg/kg, D: 120-150 mg/kg + ### Response: Oral isotretinoin duration of treatment varies according to dose but post-therapy relapse is minimized by treatment courses that amount to the total of 120-150 mg/kg Ref Harrison 20th edition pg 1233 ### End" @@ -3544,6 +6331,13 @@ Oral isotretinoin duration of treatment varies according to dose but post-therap Answer the following medical question: A 28-year-old pregnant woman is admitted to the obstetrics department for delivery. In the final stages of labor a caudal anesthetic is administered via the sacral hiatus. Into which of the following spaces in the sacral canal is the anesthetic placed?, with the following options: A: Vertebral canal, B: Vertebral venous plexus, C: Epidural space, D: Subarachnoid space +### Response: +","The vertebral canal is the longitudinal canal that extends through the vertebrae, containing the meninges, spinal cord, and associated ligaments. The vertebral venous plexus is the valveless network of veins extending longitudinally along the vertebral canal. Neither of these answer choices describes a specific space. The epidural space is found superficially to the dura mater. It is a fat-filled space extending from C1 to the coccyx. The subarachnoid space is a true space containing CSF. It is found within the CNS and extends to the level of S2. The subdural space is a potential space between the dura and the arachnoid mater. Normally these two layers are fused due to the pressure of CSF in the subarachnoid space.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 28-year-old pregnant woman is admitted to the obstetrics department for delivery. In the final stages of labor a caudal anesthetic is administered via the sacral hiatus. Into which of the following spaces in the sacral canal is the anesthetic placed?, with the following options: A: Vertebral canal, B: Vertebral venous plexus, C: Epidural space, D: Subarachnoid space + ### Response: The vertebral canal is the longitudinal canal that extends through the vertebrae, containing the meninges, spinal cord, and associated ligaments. The vertebral venous plexus is the valveless network of veins extending longitudinally along the vertebral canal. Neither of these answer choices describes a specific space. The epidural space is found superficially to the dura mater. It is a fat-filled space extending from C1 to the coccyx. The subarachnoid space is a true space containing CSF. It is found within the CNS and extends to the level of S2. The subdural space is a potential space between the dura and the arachnoid mater. Normally these two layers are fused due to the pressure of CSF in the subarachnoid space. ### End" @@ -3553,6 +6347,13 @@ The vertebral canal is the longitudinal canal that extends through the vertebrae Answer the following medical question: LMP-1 gene plays a role in oncogenesis induced by:, with the following options: A: Human T cell leukemia virus type I, B: Hepatitis B virus, C: Epstein-Barr virus, D: Human papilloma virus +### Response: +",LMP-1 gene plays a role in oncogenesis induced by EBV. LMP-1 signaling leads to up-regulation of antiapoptotic proteins and provide growth signals in latently infected cells.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: LMP-1 gene plays a role in oncogenesis induced by:, with the following options: A: Human T cell leukemia virus type I, B: Hepatitis B virus, C: Epstein-Barr virus, D: Human papilloma virus + ### Response: LMP-1 gene plays a role in oncogenesis induced by EBV. LMP-1 signaling leads to up-regulation of antiapoptotic proteins and provide growth signals in latently infected cells. ### End" @@ -3562,6 +6363,13 @@ LMP-1 gene plays a role in oncogenesis induced by EBV. LMP-1 signaling leads to Answer the following medical question: Increased BP & decreased heart rate is seen in, with the following options: A: Hemorrhage, B: High altitude, C: Raised intracranial pressure, D: Anemia +### Response: +","Raised intracranial pressure initiates Cushing’s reflex. Cushing’s reflex leads to a rise in arterial pressure, which restores the blood supply to the brain. At the same time, the raised BP causes reflex Bradycardia through the baroreceptors.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Increased BP & decreased heart rate is seen in, with the following options: A: Hemorrhage, B: High altitude, C: Raised intracranial pressure, D: Anemia + ### Response: Raised intracranial pressure initiates Cushing’s reflex. Cushing’s reflex leads to a rise in arterial pressure, which restores the blood supply to the brain. At the same time, the raised BP causes reflex Bradycardia through the baroreceptors. ### End" @@ -3571,6 +6379,13 @@ Raised intracranial pressure initiates Cushing’s reflex. Cushing’s reflex le Answer the following medical question: Stability of venom is dependent on :, with the following options: A: H bond, B: Disulphate bond, C: Van der waal's, D: Ionic interaction +### Response: +",B i.e. Disulfide bond,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Stability of venom is dependent on :, with the following options: A: H bond, B: Disulphate bond, C: Van der waal's, D: Ionic interaction + ### Response: B i.e. Disulfide bond ### End" @@ -3580,6 +6395,13 @@ B i.e. Disulfide bond Answer the following medical question: Castleman's disease is associated with defect in:, with the following options: A: IL 1, B: IL 4, C: IL 6, D: IL8 +### Response: +","Castleman's disease histologically, a condition that has been linked to IL-6 overproduction. The endocrine manifestations include amenorrhea in women and impotence and gynecomastia in men. Hyperprolactinemia due to loss of normal inhibitory control by the hypothalamus may be associated with other central nervous system manifestations such as papilledema and elevated cerebrospinal fluid pressure and protein. Type 2 diabetes mellitus occurs in about one-third of patients. Hypothyroidism and adrenal insufficiency are occasionally noted. Ref: Harrison's principle of internal medicine 17th edition, chapter 102.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Castleman's disease is associated with defect in:, with the following options: A: IL 1, B: IL 4, C: IL 6, D: IL8 + ### Response: Castleman's disease histologically, a condition that has been linked to IL-6 overproduction. The endocrine manifestations include amenorrhea in women and impotence and gynecomastia in men. Hyperprolactinemia due to loss of normal inhibitory control by the hypothalamus may be associated with other central nervous system manifestations such as papilledema and elevated cerebrospinal fluid pressure and protein. Type 2 diabetes mellitus occurs in about one-third of patients. Hypothyroidism and adrenal insufficiency are occasionally noted. Ref: Harrison's principle of internal medicine 17th edition, chapter 102. ### End" @@ -3589,6 +6411,13 @@ Castleman's disease histologically, a condition that has been linked to IL-6 ove Answer the following medical question: Risk of kernicterus is increased in all except ?, with the following options: A: Low level of serum albumin, B: Prematurity, C: Acidosis, D: High levels of serum albumin +### Response: +","Ans. is 'd' i.e., High level of serum albumin o The toxic effects of elevated serum levels of unconjugated bilirubin are increased by following factors ? Hypoproteinemia (.1 albumin) --> Normally unconjugated bilirubin binds to albumin in circulation. If the level of albumin decreases, concentration of free unconjugated bilirubin will increase.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Risk of kernicterus is increased in all except ?, with the following options: A: Low level of serum albumin, B: Prematurity, C: Acidosis, D: High levels of serum albumin + ### Response: Ans. is 'd' i.e., High level of serum albumin o The toxic effects of elevated serum levels of unconjugated bilirubin are increased by following factors ? Hypoproteinemia (.1 albumin) --> Normally unconjugated bilirubin binds to albumin in circulation. If the level of albumin decreases, concentration of free unconjugated bilirubin will increase. ### End" @@ -3598,6 +6427,13 @@ Ans. is 'd' i.e., High level of serum albumin o The toxic effects of elevated se Answer the following medical question: All about warfarin are true EXCEPT?, with the following options: A: Half-life is 36 hours, B: Crosses placenta, C: Contraindicated in hepatic failure, D: Inhibits all vitamin K dependent clotting factors +### Response: +","Ans. is 'c' i.e., Contraindicated in hepatic failure o Liver disease requires dose reduction, but is not a contraindication. Effect of liver disease on warfarin o In liver diseases the dose of oral anticoagulats needs to be decreased because in liver disease the hepatic synthesis of clotting factors is reduced. o Thus there is already a deficiency of clotting factors (i.e. there is preexisting anticoagulant state). o Administration of warfarin is this state increases the risk of bleeding. About other options o Warfarin is an indirectly acting anticoagulant, i.e. it inhibits vitamin K which in turn inhibits coagulation factors. o T1/2 of warfarin is 36 hrs. o Warfarin can cross placenta and cause fetal warfarin syndrome. Therefore it is contraindicated pregnancy. Patient is switched to heparin from warfarin during pregnancy.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All about warfarin are true EXCEPT?, with the following options: A: Half-life is 36 hours, B: Crosses placenta, C: Contraindicated in hepatic failure, D: Inhibits all vitamin K dependent clotting factors + ### Response: Ans. is 'c' i.e., Contraindicated in hepatic failure o Liver disease requires dose reduction, but is not a contraindication. Effect of liver disease on warfarin o In liver diseases the dose of oral anticoagulats needs to be decreased because in liver disease the hepatic synthesis of clotting factors is reduced. o Thus there is already a deficiency of clotting factors (i.e. there is preexisting anticoagulant state). o Administration of warfarin is this state increases the risk of bleeding. About other options o Warfarin is an indirectly acting anticoagulant, i.e. it inhibits vitamin K which in turn inhibits coagulation factors. o T1/2 of warfarin is 36 hrs. o Warfarin can cross placenta and cause fetal warfarin syndrome. Therefore it is contraindicated pregnancy. Patient is switched to heparin from warfarin during pregnancy. ### End" @@ -3607,6 +6443,13 @@ Ans. is 'c' i.e., Contraindicated in hepatic failure o Liver disease requires do Answer the following medical question: FALSE statement ragarding HIV-associated TB is:, with the following options: A: Extrapulmonary TB is common among HIV-infected patients, B: The diagnosis of TB in HIV-infected patients may be difficult, C: Immune reconstitution inflammatory syndrome (IRIS) is more common among patients with advanced immunosuppression and extra pulmonary TB, D: Patients with both HIV infection and TB are more infectious than persons without HIV co-infection +### Response: +","The most infectious patients have cavitary pulmonary disease. Patients with sputum smear-negative and those with culture-negative pulmonary TB and extrapulmonary TB are essentially noninfectious. Because persons with both HIV infection and TB are less likely to have cavitations, and they are less likely to be smear positive they may be less infectious than persons without HIV co-infection. Ref: Harrisons principles of internal medicine, 18th edition, Page: 1342.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: FALSE statement ragarding HIV-associated TB is:, with the following options: A: Extrapulmonary TB is common among HIV-infected patients, B: The diagnosis of TB in HIV-infected patients may be difficult, C: Immune reconstitution inflammatory syndrome (IRIS) is more common among patients with advanced immunosuppression and extra pulmonary TB, D: Patients with both HIV infection and TB are more infectious than persons without HIV co-infection + ### Response: The most infectious patients have cavitary pulmonary disease. Patients with sputum smear-negative and those with culture-negative pulmonary TB and extrapulmonary TB are essentially noninfectious. Because persons with both HIV infection and TB are less likely to have cavitations, and they are less likely to be smear positive they may be less infectious than persons without HIV co-infection. Ref: Harrisons principles of internal medicine, 18th edition, Page: 1342. ### End" @@ -3616,6 +6459,13 @@ The most infectious patients have cavitary pulmonary disease. Patients with sput Answer the following medical question: pKa is the pH at which, with the following options: A: There is 50% drug in active form, B: There is 50% ionized and 50% non-ionized fraction of the drug, C: All the drug is in non-ionized form, D: All the drug is in ionized form +### Response: +","(B) There is 50% ionized and 50% non-ionized fraction of the drugIONIZATIONpKa is the negative logarithm of acidic disassociation constant of the weak electrolyte, which is equivalent to the pH at which 50% drug is ionized and 50% is unionized.E.g. if a drug has pKa 3.5, it means at pH 3.5 it is 50% ionized and 50% unionized.pH=pKa+log Ionization is the process in which ions are formed from neutral compounds.pH is the measure of acidity.pKa of a drug is the measure of the acid strength (i.e., its tendency to dissociate) with reference to pH scale.Many drugs are weak acids or bases that are present in the solution as both ionized & non-ionised form.Drug ionization reduces a drug's ability to cross a lipid bilayer.The non-ionised molecules are lipid soluble and cross the membrane.The ionised molecules are water soluble and cannot cross the membrane.Amount of ionization depends on pKa (dissociation constant)For acids, the smaller the pKa, the more acidic the substance is (the more easily a proton is lost, thus the lower the pH).E.g. an acid with a pKa of 2 is 10 X as strong as an acid with pKa of 3The basic strength of drugs increases with the pKa, a basic drug of pKa of 9 is 10X as strong as base with pKa 8.The relationship between pH, pKa and the extent of ionization is given by Henderson-Hasselbalch equation.WEAK ELECTROLYTES AND THE INFLUENCE OF pHMany drugs are weak acids or bases that are present in solution as both the non-ionized & ionized species.Non-ionized molecules usually are more lipid soluble and can diffuse readily across the cell membrane.Ionized molecules usually are less able to penetrate the lipid membrane because of their low lipid solubility, & passage will depend on the leakiness of the membrane related to the membrane's electrical resistance.Transmembrane distribution of a weak electrolyte is influenced by its pKa and the pH gradient across the membrane.pKa is the pH at which half the drug (weak acid or base electrolyte) is in its ionized form.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: pKa is the pH at which, with the following options: A: There is 50% drug in active form, B: There is 50% ionized and 50% non-ionized fraction of the drug, C: All the drug is in non-ionized form, D: All the drug is in ionized form + ### Response: (B) There is 50% ionized and 50% non-ionized fraction of the drugIONIZATIONpKa is the negative logarithm of acidic disassociation constant of the weak electrolyte, which is equivalent to the pH at which 50% drug is ionized and 50% is unionized.E.g. if a drug has pKa 3.5, it means at pH 3.5 it is 50% ionized and 50% unionized.pH=pKa+log Ionization is the process in which ions are formed from neutral compounds.pH is the measure of acidity.pKa of a drug is the measure of the acid strength (i.e., its tendency to dissociate) with reference to pH scale.Many drugs are weak acids or bases that are present in the solution as both ionized & non-ionised form.Drug ionization reduces a drug's ability to cross a lipid bilayer.The non-ionised molecules are lipid soluble and cross the membrane.The ionised molecules are water soluble and cannot cross the membrane.Amount of ionization depends on pKa (dissociation constant)For acids, the smaller the pKa, the more acidic the substance is (the more easily a proton is lost, thus the lower the pH).E.g. an acid with a pKa of 2 is 10 X as strong as an acid with pKa of 3The basic strength of drugs increases with the pKa, a basic drug of pKa of 9 is 10X as strong as base with pKa 8.The relationship between pH, pKa and the extent of ionization is given by Henderson-Hasselbalch equation.WEAK ELECTROLYTES AND THE INFLUENCE OF pHMany drugs are weak acids or bases that are present in solution as both the non-ionized & ionized species.Non-ionized molecules usually are more lipid soluble and can diffuse readily across the cell membrane.Ionized molecules usually are less able to penetrate the lipid membrane because of their low lipid solubility, & passage will depend on the leakiness of the membrane related to the membrane's electrical resistance.Transmembrane distribution of a weak electrolyte is influenced by its pKa and the pH gradient across the membrane.pKa is the pH at which half the drug (weak acid or base electrolyte) is in its ionized form. ### End" @@ -3625,6 +6475,14 @@ Answer the following medical question: pKa is the pH at which, with the followin Answer the following medical question: A 7 year old female patient complains of multiple carious teeth and has the habit of frequent snacking, is fond of chocolates and does not brush twice daily. Intra-oral examination shows grossly carious deciduous mandibular molars and proximal caries with mandibular canines. Which type of finish line was used during the crown preparation in the restored tooth shown in the post-operative radiograph of this patient?, with the following options: A: Chamfer, B: Feathered edge, C: Chisel, D: Shoulder +### Response: +","Adequately contoured stainless steel crowns have maintained function and the relationship of the primary teeth in the arch. The gingival margin of the preparation on the proximal surface should  be a smooth feathered edge with no ledge or shoulder present. +The stainless steel crown (SSC) is an extremely durable restoration. Children with extensive decay, large lesions or multiple surface lesions in primary molars should be treated with stainless steel crowns. Because of the protection from future decay provided by their feature of full coverage and  their increased durability and longevity, strong consideration should be given to the use of SSCs in  children who require general anesthesia.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 7 year old female patient complains of multiple carious teeth and has the habit of frequent snacking, is fond of chocolates and does not brush twice daily. Intra-oral examination shows grossly carious deciduous mandibular molars and proximal caries with mandibular canines. Which type of finish line was used during the crown preparation in the restored tooth shown in the post-operative radiograph of this patient?, with the following options: A: Chamfer, B: Feathered edge, C: Chisel, D: Shoulder + ### Response: Adequately contoured stainless steel crowns have maintained function and the relationship of the primary teeth in the arch. The gingival margin of the preparation on the proximal surface should  be a smooth feathered edge with no ledge or shoulder present. The stainless steel crown (SSC) is an extremely durable restoration. Children with extensive decay, large lesions or multiple surface lesions in primary molars should be treated with stainless steel crowns. Because of the protection from future decay provided by their feature of full coverage and  their increased durability and longevity, strong consideration should be given to the use of SSCs in  children who require general anesthesia. @@ -3635,6 +6493,13 @@ The stainless steel crown (SSC) is an extremely durable restoration. Children wi Answer the following medical question: A 43-year-old man had a subarachnoid hemorrhage from an intracranial aneurysm 8 years ago. He has also had progressive renal impairment associated with hematuria. The most likely diagnosis isFor the above patient with a medical problem, select the most likely diagnosis or renal impairment., with the following options: A: polycystic kidney disease, B: medullary sponge kidney, C: medullary cystic disease, D: Liddle syndrome +### Response: +","The autosomal dominant form of polycystic kidney disease is often associated with hepatic cysts, intracranial aneurysms, and colonic diverticula. The occurrence of renal failure is usually in the third decade or later. Complications include infection, obstruction by stone or clot, and gross hematuria.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 43-year-old man had a subarachnoid hemorrhage from an intracranial aneurysm 8 years ago. He has also had progressive renal impairment associated with hematuria. The most likely diagnosis isFor the above patient with a medical problem, select the most likely diagnosis or renal impairment., with the following options: A: polycystic kidney disease, B: medullary sponge kidney, C: medullary cystic disease, D: Liddle syndrome + ### Response: The autosomal dominant form of polycystic kidney disease is often associated with hepatic cysts, intracranial aneurysms, and colonic diverticula. The occurrence of renal failure is usually in the third decade or later. Complications include infection, obstruction by stone or clot, and gross hematuria. ### End" @@ -3644,6 +6509,13 @@ The autosomal dominant form of polycystic kidney disease is often associated wit Answer the following medical question: Pus formation in lacerated wound occurs in:, with the following options: A: 12-24 hours, B: 24-48 hours, C: 48-72 hours, D: 1 week +### Response: +","Normally, pus formation occurs in about 48 hours, but in a lacerated wound it occurs slightly earlier.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pus formation in lacerated wound occurs in:, with the following options: A: 12-24 hours, B: 24-48 hours, C: 48-72 hours, D: 1 week + ### Response: Normally, pus formation occurs in about 48 hours, but in a lacerated wound it occurs slightly earlier. ### End" @@ -3653,6 +6525,13 @@ Normally, pus formation occurs in about 48 hours, but in a lacerated wound it oc Answer the following medical question: Stone which is resistant to lithotripsy:, with the following options: A: Calcium oxalate, B: Triple phosphate stone, C: Cystine stone, D: Uric acid stone +### Response: +",Answer is C (Cystine stones): Cystine stones are most resiatnt to Lithorriosy.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Stone which is resistant to lithotripsy:, with the following options: A: Calcium oxalate, B: Triple phosphate stone, C: Cystine stone, D: Uric acid stone + ### Response: Answer is C (Cystine stones): Cystine stones are most resiatnt to Lithorriosy. ### End" @@ -3662,6 +6541,13 @@ Answer is C (Cystine stones): Cystine stones are most resiatnt to Lithorriosy. Answer the following medical question: DEC provocation test is done in:, with the following options: A: Filariasis, B: Strongyloidiasis, C: Taeniasis, D: Trichuriasis +### Response: +",Ans. A. FilariasisDEC provocation test is done to detect microfilaria in blood anytime which are otherwise seen after 10 pm in the night.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: DEC provocation test is done in:, with the following options: A: Filariasis, B: Strongyloidiasis, C: Taeniasis, D: Trichuriasis + ### Response: Ans. A. FilariasisDEC provocation test is done to detect microfilaria in blood anytime which are otherwise seen after 10 pm in the night. ### End" @@ -3671,6 +6557,13 @@ Ans. A. FilariasisDEC provocation test is done to detect microfilaria in blood a Answer the following medical question: Least rates of HIV transmission is seen in?, with the following options: A: Forceps delivery, B: Normal delivery, C: Breast feeding, D: Cesarean Section +### Response: +",ANSWER: (D) Cesarea SectionREF: Williams Obstetric 22niedition chapter 59The two principal approaches suggested for prevention of maternal-neonatal transmission of HIVinfectionare antiretroviral therapy and cesarean delivery.Antiretroviral therapy should be offered to all HIV-infected pregnant women to begin maternal treatment as well as to reduce the risk of perinatal transmission regardless of CD4~ T-cell count or HIV RNA level.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Least rates of HIV transmission is seen in?, with the following options: A: Forceps delivery, B: Normal delivery, C: Breast feeding, D: Cesarean Section + ### Response: ANSWER: (D) Cesarea SectionREF: Williams Obstetric 22niedition chapter 59The two principal approaches suggested for prevention of maternal-neonatal transmission of HIVinfectionare antiretroviral therapy and cesarean delivery.Antiretroviral therapy should be offered to all HIV-infected pregnant women to begin maternal treatment as well as to reduce the risk of perinatal transmission regardless of CD4~ T-cell count or HIV RNA level. ### End" @@ -3680,6 +6573,13 @@ ANSWER: (D) Cesarea SectionREF: Williams Obstetric 22niedition chapter 59The two Answer the following medical question: Adhesion of platelets to collagen is due to -, with the following options: A: Factor IX, B: Fibrinogen, C: Von Willebrand factor, D: Fibronectin +### Response: +",. Von Willebrand factor,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Adhesion of platelets to collagen is due to -, with the following options: A: Factor IX, B: Fibrinogen, C: Von Willebrand factor, D: Fibronectin + ### Response: . Von Willebrand factor ### End" @@ -3689,6 +6589,13 @@ Answer the following medical question: Adhesion of platelets to collagen is due Answer the following medical question: Which condition doctor is passive, with the following options: A: Classical psychoanalysis, B: Psychoanalytic psychoanalysis, C: None, D: Both +### Response: +","Feature Classical Psychoanalysis Psychoanalytic Psychotherapy Expressive Mode Suppoive Mode Frequency 4to5 times/wk; 50-min to hour 1to3times/wk 1/2 to 1 hr 1 time/wk; 1/2 to 1 hr Duration Long-term; usually 3 to 5+ yrs Sho- or long-term; several sessions to months or years Sho- or intermittent long-term; single session to a lifetime Setting Patient primarily on the couch with analyst out of view Patient and therapist face-to-face; occasional use of couch Patient and therapist face-to-face; couch contraindicated Modus operandi analysis of all positive and negative transference and resistance; transference is facilitated; regression encouraged Paial analysis of dynamics and defenses; focus on current interpersonal events Formation of therapeutic alliance and real object relationship. Analyst/therapist role Absolute neutrality; reflector/mirror role (passive) Modified neutrality Neutrality suspended; direction, and disclosure Major techniques* Free association dynamic interpretation Limited free association; confrontation, clarification, and paial interpretation Suggestion,abreaction confrontation, clarification Adjunct treatment Primarily avoided; Psychotrophics used Psychotrophics used Reference: P.925chap 35.1Psychoanalysis and Psychoanalytic PsychotherapyKaplan & Sadock's Synopsis of psychiatry clinical Psychiatry, 10th Edition","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which condition doctor is passive, with the following options: A: Classical psychoanalysis, B: Psychoanalytic psychoanalysis, C: None, D: Both + ### Response: Feature Classical Psychoanalysis Psychoanalytic Psychotherapy Expressive Mode Suppoive Mode Frequency 4to5 times/wk; 50-min to hour 1to3times/wk 1/2 to 1 hr 1 time/wk; 1/2 to 1 hr Duration Long-term; usually 3 to 5+ yrs Sho- or long-term; several sessions to months or years Sho- or intermittent long-term; single session to a lifetime Setting Patient primarily on the couch with analyst out of view Patient and therapist face-to-face; occasional use of couch Patient and therapist face-to-face; couch contraindicated Modus operandi analysis of all positive and negative transference and resistance; transference is facilitated; regression encouraged Paial analysis of dynamics and defenses; focus on current interpersonal events Formation of therapeutic alliance and real object relationship. Analyst/therapist role Absolute neutrality; reflector/mirror role (passive) Modified neutrality Neutrality suspended; direction, and disclosure Major techniques* Free association dynamic interpretation Limited free association; confrontation, clarification, and paial interpretation Suggestion,abreaction confrontation, clarification Adjunct treatment Primarily avoided; Psychotrophics used Psychotrophics used Reference: P.925chap 35.1Psychoanalysis and Psychoanalytic PsychotherapyKaplan & Sadock's Synopsis of psychiatry clinical Psychiatry, 10th Edition ### End" @@ -3698,6 +6605,13 @@ Feature Classical Psychoanalysis Psychoanalytic Psychotherapy Expressive Mode Su Answer the following medical question: All of the following are adverse effects of nicotinic acid except ?, with the following options: A: Vasodilation, B: Pancreatitis, C: Liver dysfunction, D: Hyperpigmentation +### Response: +","Ans. is 'b' i.e., Pancreatitis Adverse effects of nicotine Adverse effects - 1) Marked flushing, itching (pruritis) and heat due to cutaneous vasodilatation, 2) Dyspepsia, vomiting and diarrhoea, 3) Liver dysfunction, 4) Hyperpigmentation and dryness of skin, 5) Hyperglycemia and hyperuricemia. The cutaneous effects of nicotinic acid include flushing and pruritis of face and upper trunk, skin rashes and acanthosis nigricans. These symptoms are due to vasodilatory action of niacin through release of PGs and can be prevented by pretreatment with aspirin.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following are adverse effects of nicotinic acid except ?, with the following options: A: Vasodilation, B: Pancreatitis, C: Liver dysfunction, D: Hyperpigmentation + ### Response: Ans. is 'b' i.e., Pancreatitis Adverse effects of nicotine Adverse effects - 1) Marked flushing, itching (pruritis) and heat due to cutaneous vasodilatation, 2) Dyspepsia, vomiting and diarrhoea, 3) Liver dysfunction, 4) Hyperpigmentation and dryness of skin, 5) Hyperglycemia and hyperuricemia. The cutaneous effects of nicotinic acid include flushing and pruritis of face and upper trunk, skin rashes and acanthosis nigricans. These symptoms are due to vasodilatory action of niacin through release of PGs and can be prevented by pretreatment with aspirin. ### End" @@ -3707,6 +6621,13 @@ Ans. is 'b' i.e., Pancreatitis Adverse effects of nicotine Adverse effects - 1) Answer the following medical question: A sexually active female came with green coloured profuse frothy foul smelling discharge with intense itching. O/E strawberry cervix revealed. What condition she belongs to?, with the following options: A: Candidiasis, B: Trichomonas vaginitis, C: Bacterial vaginosis, D: None +### Response: +","Trichomoniasis Caused by Trichomonas vaginalis - flagellate protozoan motile organism Symptoms: severe itching and severe pruritis ColpitisMacularis (Strawberry Vagina) Greenish yellow, frothy discharge Rx: Metronidazole Rx both female and male paner","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A sexually active female came with green coloured profuse frothy foul smelling discharge with intense itching. O/E strawberry cervix revealed. What condition she belongs to?, with the following options: A: Candidiasis, B: Trichomonas vaginitis, C: Bacterial vaginosis, D: None + ### Response: Trichomoniasis Caused by Trichomonas vaginalis - flagellate protozoan motile organism Symptoms: severe itching and severe pruritis ColpitisMacularis (Strawberry Vagina) Greenish yellow, frothy discharge Rx: Metronidazole Rx both female and male paner ### End" @@ -3716,6 +6637,13 @@ Trichomoniasis Caused by Trichomonas vaginalis - flagellate protozoan motile org Answer the following medical question: All of the following statements about Pseudopancreatic cysts are true except :, with the following options: A: Percutaneous aspiration is treatment of choice, B: Cystojejunostomy is treatment of choice, C: Serum amylase levels are increased, D: Presents as an epigastric mass +### Response: +","Answer is A (Percutaneous aspiration is treatment of choice) Percutaneous aspiration has emerged as a simple and frequently used initial procedure in the management of uncomplicated persistant pancreatic pseudocysts. However it cannot be termed as the treatment of choice. Surgical internal drainage in the farm of cystojejunostomy continues to be the treatment of choice. Treatment of Pancreatic Psuedocyst : If the pseudocyst is expanding, or not responding to above treatment, or is complicated by rupture, hemorrhage or abscess formation. Operative treatment is indicative Either external or preferably internal drainage of the cyst can be done *A singnificant number of pseudocyst will resovle sponteaneously more than 6 weeks after their formations.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following statements about Pseudopancreatic cysts are true except :, with the following options: A: Percutaneous aspiration is treatment of choice, B: Cystojejunostomy is treatment of choice, C: Serum amylase levels are increased, D: Presents as an epigastric mass + ### Response: Answer is A (Percutaneous aspiration is treatment of choice) Percutaneous aspiration has emerged as a simple and frequently used initial procedure in the management of uncomplicated persistant pancreatic pseudocysts. However it cannot be termed as the treatment of choice. Surgical internal drainage in the farm of cystojejunostomy continues to be the treatment of choice. Treatment of Pancreatic Psuedocyst : If the pseudocyst is expanding, or not responding to above treatment, or is complicated by rupture, hemorrhage or abscess formation. Operative treatment is indicative Either external or preferably internal drainage of the cyst can be done *A singnificant number of pseudocyst will resovle sponteaneously more than 6 weeks after their formations. ### End" @@ -3725,6 +6653,13 @@ Answer is A (Percutaneous aspiration is treatment of choice) Percutaneous aspira Answer the following medical question: All are seen in PNH except-, with the following options: A: Aerial thrombosis, B: Venous thrombosis, C: Aplastic anemia, D: Hemolytic anemia +### Response: +","PNH is paroxysmal nocturnal hemoglobinuria.Its a disease results from acquired mutation in PIGA an enzyme that is essential for the synthesis of ceain membrane associated complement regulatory proteins. Thrombosis is the leading cause of disease related death in PNH.About 40% patient suffer from venous thrombosis of hepatic, poal or cerebral veins. In PNH GPI linked proteins are deficient because of somatic mutation that inactivate PIGA.In RBC proteins are attached to cell membrane through a linkage to a specialised phospholipid called GPI.It is hypothesised that bone marrow cells with PIGA mutation increase in numbers only in rare instances where they have selective advantages such as in setting autoimmune reaction against GPI linked antigens. This explains the frequent association of PNH with aplastic anaemia. Red cell deficient in these GPI linked factors are abnormally susceptible to lysis or injury by complement. Manifest as intravascular hemolysis.PNH is the only hemolytic anaemia caused by an acquired genetic defect. Reference :ROBBINS AND COTRAN PATHOLOGIC BASIS OF DISEASE.SOUTH ASIA EDITION. VOL 1. PAGE NO.642,643","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are seen in PNH except-, with the following options: A: Aerial thrombosis, B: Venous thrombosis, C: Aplastic anemia, D: Hemolytic anemia + ### Response: PNH is paroxysmal nocturnal hemoglobinuria.Its a disease results from acquired mutation in PIGA an enzyme that is essential for the synthesis of ceain membrane associated complement regulatory proteins. Thrombosis is the leading cause of disease related death in PNH.About 40% patient suffer from venous thrombosis of hepatic, poal or cerebral veins. In PNH GPI linked proteins are deficient because of somatic mutation that inactivate PIGA.In RBC proteins are attached to cell membrane through a linkage to a specialised phospholipid called GPI.It is hypothesised that bone marrow cells with PIGA mutation increase in numbers only in rare instances where they have selective advantages such as in setting autoimmune reaction against GPI linked antigens. This explains the frequent association of PNH with aplastic anaemia. Red cell deficient in these GPI linked factors are abnormally susceptible to lysis or injury by complement. Manifest as intravascular hemolysis.PNH is the only hemolytic anaemia caused by an acquired genetic defect. Reference :ROBBINS AND COTRAN PATHOLOGIC BASIS OF DISEASE.SOUTH ASIA EDITION. VOL 1. PAGE NO.642,643 ### End" @@ -3734,6 +6669,13 @@ PNH is paroxysmal nocturnal hemoglobinuria.Its a disease results from acquired m Answer the following medical question: Which one of the following is not a Novel biomarker of acute kidney injury ?, with the following options: A: NGAL, B: Kim - 1, C: Cystain - C, D: ß - Trace protein +### Response: +",ß - Trace protein  is a biomarker of Chronic kidney disease.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which one of the following is not a Novel biomarker of acute kidney injury ?, with the following options: A: NGAL, B: Kim - 1, C: Cystain - C, D: ß - Trace protein + ### Response: ß - Trace protein  is a biomarker of Chronic kidney disease. ### End" @@ -3743,6 +6685,13 @@ Answer the following medical question: Which one of the following is not a Novel Answer the following medical question: Acute intravascular hemolysis can be caused by infection due to all of the following organisms except, with the following options: A: Clostridium tetani, B: Baonella bacilliformis, C: Plasmodium falciparum, D: Babesia microti +### Response: +","* Baonella bacilliformis causes Oroya fever. The patient develops fever, severe headache and chills followed by severe anaemia due to the destruction of erythrocytes. * Plasmodium falciparum and babesia microti cause RBC destruction. * Clostridium produces tetanospasmin which blocks synaptic inhibition in the spinal cord which results in muscle rigidity and spasm. Ref: Baveja textbook of microbiology; 4th edition","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Acute intravascular hemolysis can be caused by infection due to all of the following organisms except, with the following options: A: Clostridium tetani, B: Baonella bacilliformis, C: Plasmodium falciparum, D: Babesia microti + ### Response: * Baonella bacilliformis causes Oroya fever. The patient develops fever, severe headache and chills followed by severe anaemia due to the destruction of erythrocytes. * Plasmodium falciparum and babesia microti cause RBC destruction. * Clostridium produces tetanospasmin which blocks synaptic inhibition in the spinal cord which results in muscle rigidity and spasm. Ref: Baveja textbook of microbiology; 4th edition ### End" @@ -3752,6 +6701,13 @@ Answer the following medical question: Acute intravascular hemolysis can be caus Answer the following medical question: First line of therapy in treatment of shock:, with the following options: A: Antibiotics, B: Ionotropic agents, C: Chronotropic agents, D: IV fluids +### Response: +","In all cases of shock, regardless of classification, hypovolemia and inadequate preload must be addressed before other therapy is instituted. First-line therapy, therefore, is intravenous access and administration of intravenous fluids.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: First line of therapy in treatment of shock:, with the following options: A: Antibiotics, B: Ionotropic agents, C: Chronotropic agents, D: IV fluids + ### Response: In all cases of shock, regardless of classification, hypovolemia and inadequate preload must be addressed before other therapy is instituted. First-line therapy, therefore, is intravenous access and administration of intravenous fluids. ### End" @@ -3762,13 +6718,27 @@ In all cases of shock, regardless of classification, hypovolemia and inadequate Answer the following medical question: The Astler-Coller modification of the Dukes classification is used to classify cancers of the, with the following options: A: Liver, B: Colon, C: Lung, D: Stomach ### Response: -Colon cancer may be found in the left side of the colon (producing a ""napkin ring"" or ""apple core"" appearance) or the right side of the colon (producing a polypoid mass). In either location, bleeding may produce an iron-deficiency anemia. Histologically, the vast majority of colon cancers are adenocarcinomas. Currently the most common classification used to stage colon carcinomas is the Astler-Coller modification of the Dukes classification of colon cancer. This classification is as follows: A = mucosa (or submucosa, arbitrary); B1 = into muscularis propria; B2 = through muscularis propria; C1 = into muscularis propria with lymph node metastasis; C2 = through muscularis propria with lymph node metastasis; D = distant spread. Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition -### End" -401,"Below is an instruction that describes a task. Write a response that appropriately completes the request. +","Colon cancer may be found in the left side of the colon (producing a ""napkin ring"" or ""apple core"" appearance) or the right side of the colon (producing a polypoid mass). In either location, bleeding may produce an iron-deficiency anemia. Histologically, the vast majority of colon cancers are adenocarcinomas. Currently the most common classification used to stage colon carcinomas is the Astler-Coller modification of the Dukes classification of colon cancer. This classification is as follows: A = mucosa (or submucosa, arbitrary); B1 = into muscularis propria; B2 = through muscularis propria; C1 = into muscularis propria with lymph node metastasis; C2 = through muscularis propria with lymph node metastasis; D = distant spread. Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition","Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: -Answer the following medical question: Following are of B Cell origin except-, with the following options: A: CLL, B: ALL, C: Sezary syndrome, D: Burkitt's Lymphoma +Answer the following medical question: The Astler-Coller modification of the Dukes classification is used to classify cancers of the, with the following options: A: Liver, B: Colon, C: Lung, D: Stomach + +### Response: +Colon cancer may be found in the left side of the colon (producing a ""napkin ring"" or ""apple core"" appearance) or the right side of the colon (producing a polypoid mass). In either location, bleeding may produce an iron-deficiency anemia. Histologically, the vast majority of colon cancers are adenocarcinomas. Currently the most common classification used to stage colon carcinomas is the Astler-Coller modification of the Dukes classification of colon cancer. This classification is as follows: A = mucosa (or submucosa, arbitrary); B1 = into muscularis propria; B2 = through muscularis propria; C1 = into muscularis propria with lymph node metastasis; C2 = through muscularis propria with lymph node metastasis; D = distant spread. Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition +### End" +401,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Following are of B Cell origin except-, with the following options: A: CLL, B: ALL, C: Sezary syndrome, D: Burkitt's Lymphoma + +### Response: +","Ans. is 'c' i.e., Sezary syndrome","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Following are of B Cell origin except-, with the following options: A: CLL, B: ALL, C: Sezary syndrome, D: Burkitt's Lymphoma ### Response: Ans. is 'c' i.e., Sezary syndrome @@ -3779,6 +6749,13 @@ Ans. is 'c' i.e., Sezary syndrome Answer the following medical question: An 18-year-old man who is known to have non-penicillinase producing gonococcal urethritis is given an injection of penicillin and probenecid. What is the mechanism used by probenecid that makes penicillin more efficacious, with the following options: A: Prolongs the duration of action by affecting the liver metabolism of penicillin, B: Increases the half-life and serum level by decreasing the renal excretion of penicillin, C: Promotes entry of the penicillin into the bacteria, D: Decreases the bacterial resistance by inhibiting penicillinase production +### Response: +","PENICILLIN-G (BENZYL PENICILLIN) Pharmacokinetics :- Penicillin G is acid labile, therefore destroyed by gastric acid. As such, less than 1/3rd of an oral dose is absorbed in the active form. Absorption of sod. PnG from i.m. site is rapid and complete; peak plasma level is attained in 30 min. It is distributed mainly extracellularly; reaches most body fluids, but penetration in serous cavities and CSF is poor. However, in the presence of inflammation (sinovitis, meningitis, etc.) adequate amounts may reach these sites. About 60% is plasma protein bound. It is little metabolized because of rapid excretion. The pharmacokinetics of PnG is dominated by very rapid renal excretion; about 10% by glomerular filtration and the rest by tubular secretion. The plasma t 1/2 of PnG in healthy adult is 30 min. Neonates have slower tubular secretion-- t 1/2 of PnG is longer; but approaches adult value at 3 months and then is even shoer during childhood. Aged and those with renal failure excrete penicillin slowly. Tubular secretion of PnG can be blocked by probenecid--higher and longer lasting plasma concentrations are achieved. Probenecid also decreases the volume of distribution of penicillins. Ref:- kd tripathi; pg num:-718","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: An 18-year-old man who is known to have non-penicillinase producing gonococcal urethritis is given an injection of penicillin and probenecid. What is the mechanism used by probenecid that makes penicillin more efficacious, with the following options: A: Prolongs the duration of action by affecting the liver metabolism of penicillin, B: Increases the half-life and serum level by decreasing the renal excretion of penicillin, C: Promotes entry of the penicillin into the bacteria, D: Decreases the bacterial resistance by inhibiting penicillinase production + ### Response: PENICILLIN-G (BENZYL PENICILLIN) Pharmacokinetics :- Penicillin G is acid labile, therefore destroyed by gastric acid. As such, less than 1/3rd of an oral dose is absorbed in the active form. Absorption of sod. PnG from i.m. site is rapid and complete; peak plasma level is attained in 30 min. It is distributed mainly extracellularly; reaches most body fluids, but penetration in serous cavities and CSF is poor. However, in the presence of inflammation (sinovitis, meningitis, etc.) adequate amounts may reach these sites. About 60% is plasma protein bound. It is little metabolized because of rapid excretion. The pharmacokinetics of PnG is dominated by very rapid renal excretion; about 10% by glomerular filtration and the rest by tubular secretion. The plasma t 1/2 of PnG in healthy adult is 30 min. Neonates have slower tubular secretion-- t 1/2 of PnG is longer; but approaches adult value at 3 months and then is even shoer during childhood. Aged and those with renal failure excrete penicillin slowly. Tubular secretion of PnG can be blocked by probenecid--higher and longer lasting plasma concentrations are achieved. Probenecid also decreases the volume of distribution of penicillins. Ref:- kd tripathi; pg num:-718 ### End" @@ -3788,6 +6765,13 @@ PENICILLIN-G (BENZYL PENICILLIN) Pharmacokinetics :- Penicillin G is acid labile Answer the following medical question: Supination in flexed elbow is produced by ?, with the following options: A: Supinator, B: Biceps, C: Coracobrachialis, D: Brachialis +### Response: +",Ans. B. Biceps,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Supination in flexed elbow is produced by ?, with the following options: A: Supinator, B: Biceps, C: Coracobrachialis, D: Brachialis + ### Response: Ans. B. Biceps ### End" @@ -3797,6 +6781,13 @@ Ans. B. Biceps Answer the following medical question: Diarrhoea in AIDS can be caused by all of the following organisms, EXCEPT:, with the following options: A: Mycobacterium, B: Cryptosporidium, C: Cytomegalovirus, D: None of the above +### Response: +","Common enteric pathogens often cause a more severe and protracted diarrheal illness in persons with AIDS. Oppounistic infections causing diarrhoea in AIDS: Mycobacterium species Viruses (cytomegalovirus, adenovirus, and herpes simplex) Protozoa (Cryptosporidium, Isospora belli, Microsporida, and Blastocystis hominis) may also play a role Agents transmitted venereally per rectum (e.g., Neisseria gonorrhoeae, Treponema pallidum, Chlamydia) may contribute to proctocolitis. Ref: Camilleri M., Murray J.A. (2012). Chapter 40. Diarrhea and Constipation. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Diarrhoea in AIDS can be caused by all of the following organisms, EXCEPT:, with the following options: A: Mycobacterium, B: Cryptosporidium, C: Cytomegalovirus, D: None of the above + ### Response: Common enteric pathogens often cause a more severe and protracted diarrheal illness in persons with AIDS. Oppounistic infections causing diarrhoea in AIDS: Mycobacterium species Viruses (cytomegalovirus, adenovirus, and herpes simplex) Protozoa (Cryptosporidium, Isospora belli, Microsporida, and Blastocystis hominis) may also play a role Agents transmitted venereally per rectum (e.g., Neisseria gonorrhoeae, Treponema pallidum, Chlamydia) may contribute to proctocolitis. Ref: Camilleri M., Murray J.A. (2012). Chapter 40. Diarrhea and Constipation. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e. ### End" @@ -3806,6 +6797,15 @@ Common enteric pathogens often cause a more severe and protracted diarrheal illn Answer the following medical question: Selective media for vibrio -, with the following options: A: TCBS, B: Stuart, C: Skirrows, D: MYPA +### Response: +","TCBS (Thiosulfate Citrate Bile salts Sucrose Agar) is a Selective media for Vibrio. +V. Cholerae can ferment sucrose and it produces Yellow colonies on TCBS. +Whereas V.parahemolyticus produces green colonies on TCBS","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Selective media for vibrio -, with the following options: A: TCBS, B: Stuart, C: Skirrows, D: MYPA + ### Response: TCBS (Thiosulfate Citrate Bile salts Sucrose Agar) is a Selective media for Vibrio. V. Cholerae can ferment sucrose and it produces Yellow colonies on TCBS. @@ -3817,6 +6817,13 @@ Whereas V.parahemolyticus produces green colonies on TCBS Answer the following medical question: A 48 yrs old male with triple vessel disease and longstanding diabetes had gangrene developed in left lower foot. Which is best mode of anesthetics:-, with the following options: A: Popliteal block, B: Sciatic block, C: Femoral block, D: Saphenous nerve block +### Response: +","Popliteal nerve block provide excellent coverage for foot and ankle surgery, while sparing much of the hamstring muscles. The popliteal nerve block is a form of regional anesthesia utilized for a variety of foot and ankle conditions. This form of anesthesia has become a popular technique to decrease postoperative pain, decrease narcotic use, and increase patient satisfaction. There are several approaches to administering a popliteal sciatic nerve block, all with unique advantages and disadvantages. Commonly, a posterior approach is employed with the patient positioned prone. Alternatively, the lateral approach can be used with patient in the supine position. There are several approaches to administering a popliteal sciatic nerve block, all with unique advantages and disadvantages. Commonly, a posterior approach is employed with the patient positioned prone. Alternatively, the lateral approach can be used with patient in the supine position.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 48 yrs old male with triple vessel disease and longstanding diabetes had gangrene developed in left lower foot. Which is best mode of anesthetics:-, with the following options: A: Popliteal block, B: Sciatic block, C: Femoral block, D: Saphenous nerve block + ### Response: Popliteal nerve block provide excellent coverage for foot and ankle surgery, while sparing much of the hamstring muscles. The popliteal nerve block is a form of regional anesthesia utilized for a variety of foot and ankle conditions. This form of anesthesia has become a popular technique to decrease postoperative pain, decrease narcotic use, and increase patient satisfaction. There are several approaches to administering a popliteal sciatic nerve block, all with unique advantages and disadvantages. Commonly, a posterior approach is employed with the patient positioned prone. Alternatively, the lateral approach can be used with patient in the supine position. There are several approaches to administering a popliteal sciatic nerve block, all with unique advantages and disadvantages. Commonly, a posterior approach is employed with the patient positioned prone. Alternatively, the lateral approach can be used with patient in the supine position. ### End" @@ -3826,6 +6833,13 @@ Popliteal nerve block provide excellent coverage for foot and ankle surgery, whi Answer the following medical question: Which of the following arrhythmias is most frequent in Holiday Hea Syndrome:, with the following options: A: Atrial Flutter, B: Atrial Fibrillation, C: Ventricular Premature Depolarization, D: Ventricular Tachycardia +### Response: +",Atrial Fibrillation is the most common arrhythmia observed with holiday hea syndrome. Holiday hea syndrome refers to the occurence of acute cardiac rhythm and/or conduction disturbances in a person without any clinical evidence of structural hea disease after a Binge of Alcohol consumption (Binge Drinking).The most common arrhythmia associated with holiday Hea syndrome is Atrial Fibrillation. Alcoholic cardiotoxicity: Holiday Hea syndrome: Typically appears after a drinking binge Presents with arrhythmia without ove hea failure Atrial fibrillation is most frequently observed arrhythmia Atrial flutter or Ventricular premature depolarisation may also be seen. DIlated Cardiomyopathy: Seen with chronic consumption of large quatities of alcohol Presents with hea failure Ref: Braunwald&;s Hea Disease: A Textbook of Cardiovascular medicine,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following arrhythmias is most frequent in Holiday Hea Syndrome:, with the following options: A: Atrial Flutter, B: Atrial Fibrillation, C: Ventricular Premature Depolarization, D: Ventricular Tachycardia + ### Response: Atrial Fibrillation is the most common arrhythmia observed with holiday hea syndrome. Holiday hea syndrome refers to the occurence of acute cardiac rhythm and/or conduction disturbances in a person without any clinical evidence of structural hea disease after a Binge of Alcohol consumption (Binge Drinking).The most common arrhythmia associated with holiday Hea syndrome is Atrial Fibrillation. Alcoholic cardiotoxicity: Holiday Hea syndrome: Typically appears after a drinking binge Presents with arrhythmia without ove hea failure Atrial fibrillation is most frequently observed arrhythmia Atrial flutter or Ventricular premature depolarisation may also be seen. DIlated Cardiomyopathy: Seen with chronic consumption of large quatities of alcohol Presents with hea failure Ref: Braunwald&;s Hea Disease: A Textbook of Cardiovascular medicine ### End" @@ -3835,6 +6849,13 @@ Atrial Fibrillation is the most common arrhythmia observed with holiday hea synd Answer the following medical question: A 10 year old girl presents with sore throat and fever. She denies any cough or rhinorrhea. A throat culture grows bacitracin-sensitive bacterial colonies. The infecting organism would be protected from the lytic action of detergents by its?, with the following options: A: Keratin-like proteins in the spore coat, B: Lipopolysaccharide in the outer membrane, C: Peptidoglycan layer, D: Periplasmic space +### Response: +","This girl has streptococcal pharyngitis. The infecting organism is group A beta-hemolytic streptococcus (S. pyogenes); its growth is inhibited by the placement of a bacitracin disk on the throat culture plate. (Beta-hemolysis occurs as the result of the bacterial hemolysin streptolysin S). This is a gram-positive bacterium and therefore possesses a very thick peptidoglycan layer that would protect it from lysis by detergents. (Note that gram-positives also contain teichoic acid.) In contrast, gram-negatives have a thin peptidoglycan layer. Keratin-like proteins in the spore coat and calcium ion chelators (dipicolinic acid) are found in spores formed by species of Bacillus and Clostridium. These protect the spores from the elements: dehydration, heat, chemicals, radiation, etc. Lipopolysaccharide in the outer membrane and a periplasmic space are found in gram-negative organisms. The lipopolysaccharide is an endotoxin and the periplasmic space contains beta-lactamase in some species. Ref: Ray C.G., Ryan K.J. (2010). Chapter 25. Streptococci and Enterococci. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 10 year old girl presents with sore throat and fever. She denies any cough or rhinorrhea. A throat culture grows bacitracin-sensitive bacterial colonies. The infecting organism would be protected from the lytic action of detergents by its?, with the following options: A: Keratin-like proteins in the spore coat, B: Lipopolysaccharide in the outer membrane, C: Peptidoglycan layer, D: Periplasmic space + ### Response: This girl has streptococcal pharyngitis. The infecting organism is group A beta-hemolytic streptococcus (S. pyogenes); its growth is inhibited by the placement of a bacitracin disk on the throat culture plate. (Beta-hemolysis occurs as the result of the bacterial hemolysin streptolysin S). This is a gram-positive bacterium and therefore possesses a very thick peptidoglycan layer that would protect it from lysis by detergents. (Note that gram-positives also contain teichoic acid.) In contrast, gram-negatives have a thin peptidoglycan layer. Keratin-like proteins in the spore coat and calcium ion chelators (dipicolinic acid) are found in spores formed by species of Bacillus and Clostridium. These protect the spores from the elements: dehydration, heat, chemicals, radiation, etc. Lipopolysaccharide in the outer membrane and a periplasmic space are found in gram-negative organisms. The lipopolysaccharide is an endotoxin and the periplasmic space contains beta-lactamase in some species. Ref: Ray C.G., Ryan K.J. (2010). Chapter 25. Streptococci and Enterococci. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e. ### End" @@ -3844,6 +6865,13 @@ This girl has streptococcal pharyngitis. The infecting organism is group A beta- Answer the following medical question: About posterior cruciate ligment true statement is ?, with the following options: A: Prevent posterior displacement of Tibia, B: Attaches to lateral femoral condyle., C: Intra synol, D: Inseed on medial side of medial femoral condyle. +### Response: +",A i.e. Prevents posterior displacement of tibia PCL is intracapsular extra'synol ligamentQ which is attached on lateral surface of medial femoral condyleQ. It prevents posterior subluxation of tibia on femur(2. It is larger & stronger than ACL.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: About posterior cruciate ligment true statement is ?, with the following options: A: Prevent posterior displacement of Tibia, B: Attaches to lateral femoral condyle., C: Intra synol, D: Inseed on medial side of medial femoral condyle. + ### Response: A i.e. Prevents posterior displacement of tibia PCL is intracapsular extra'synol ligamentQ which is attached on lateral surface of medial femoral condyleQ. It prevents posterior subluxation of tibia on femur(2. It is larger & stronger than ACL. ### End" @@ -3853,6 +6881,13 @@ A i.e. Prevents posterior displacement of tibia PCL is intracapsular extra'synol Answer the following medical question: Keshan disease is manifestation of?, with the following options: A: Selenium excess, B: Zinc excess, C: Selenium deficiency, D: Zine deficiency +### Response: +",Keshan disease is endemic cardiomyopathy due to selenium deficiency.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Keshan disease is manifestation of?, with the following options: A: Selenium excess, B: Zinc excess, C: Selenium deficiency, D: Zine deficiency + ### Response: Keshan disease is endemic cardiomyopathy due to selenium deficiency. ### End" @@ -3862,6 +6897,13 @@ Keshan disease is endemic cardiomyopathy due to selenium deficiency. Answer the following medical question: Rosen's incision is used for ?, with the following options: A: Septoplasty, B: SMR, C: Stapedectomy, D: Tonsillectomy +### Response: +","Ans. is 'c' i.e., Stapedectomy Rosen's incision is the most commonly used for stapedectomy through endomeatal or transcanal approach. Also know Lempe's incision is used for endural approach. Wilde's incision is used for postaural approach.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Rosen's incision is used for ?, with the following options: A: Septoplasty, B: SMR, C: Stapedectomy, D: Tonsillectomy + ### Response: Ans. is 'c' i.e., Stapedectomy Rosen's incision is the most commonly used for stapedectomy through endomeatal or transcanal approach. Also know Lempe's incision is used for endural approach. Wilde's incision is used for postaural approach. ### End" @@ -3871,6 +6913,13 @@ Ans. is 'c' i.e., Stapedectomy Rosen's incision is the most commonly used for st Answer the following medical question: In which of the following conditions would oxygen therapy be most effective in alleting hypoxia?, with the following options: A: Anemia due to blood loss, B: Edematous tissues, C: Emphysema, D: Localized circulatory deficiencies +### Response: +","Chronic pulmonary emphysema is characterized by distention of small air spaces distal to the respiratory bronchioles and destruction of alveolar septa. Long-term cigarette smoking is the usual cause. The marked loss of lung parenchyma associated with emphysema leads to a decrease in the diffusion capacity of the lungs, which reduces their ability to oxygenate blood and remove carbon dioxide. When aerial hypoxemia is persistent and severe, oxygen therapy should therefore be considered. Oxygen therapy is less effective for treating the hypoxia associated with anemia , edematous tissues , localized circulatory deficiencies , and right-to-left cardiac shunts , because in each case, there is already adequate oxygen available in the alveoli. The problem in each of these situations is inadequate transpo of oxygen to the tissues, blunting the effects of increasing the oxygen tension of the inspired air. Oxygen therapy will nonetheless increase the amount of dissolved oxygen carried in the blood, which may be life-saving in some instances. Ref:Smith D.A. (2011). Chapter 33. Pulmonary Emergencies. In R.L. Humphries, C. Stone (Eds), CURRENT Diagnosis & Treatment Emergency Medicine, 7e.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In which of the following conditions would oxygen therapy be most effective in alleting hypoxia?, with the following options: A: Anemia due to blood loss, B: Edematous tissues, C: Emphysema, D: Localized circulatory deficiencies + ### Response: Chronic pulmonary emphysema is characterized by distention of small air spaces distal to the respiratory bronchioles and destruction of alveolar septa. Long-term cigarette smoking is the usual cause. The marked loss of lung parenchyma associated with emphysema leads to a decrease in the diffusion capacity of the lungs, which reduces their ability to oxygenate blood and remove carbon dioxide. When aerial hypoxemia is persistent and severe, oxygen therapy should therefore be considered. Oxygen therapy is less effective for treating the hypoxia associated with anemia , edematous tissues , localized circulatory deficiencies , and right-to-left cardiac shunts , because in each case, there is already adequate oxygen available in the alveoli. The problem in each of these situations is inadequate transpo of oxygen to the tissues, blunting the effects of increasing the oxygen tension of the inspired air. Oxygen therapy will nonetheless increase the amount of dissolved oxygen carried in the blood, which may be life-saving in some instances. Ref:Smith D.A. (2011). Chapter 33. Pulmonary Emergencies. In R.L. Humphries, C. Stone (Eds), CURRENT Diagnosis & Treatment Emergency Medicine, 7e. ### End" @@ -3880,6 +6929,13 @@ Chronic pulmonary emphysema is characterized by distention of small air spaces d Answer the following medical question: Elevated AFP levels are seen in all of the following except:, with the following options: A: Hepatoblastoma, B: Seminoma, C: Teratoma, D: None of the above +### Response: +",Seminoma,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Elevated AFP levels are seen in all of the following except:, with the following options: A: Hepatoblastoma, B: Seminoma, C: Teratoma, D: None of the above + ### Response: Seminoma ### End" @@ -3889,6 +6945,13 @@ Seminoma Answer the following medical question: True regarding metapneumovirus is:, with the following options: A: Segmented negative sense single stranded RNA virus, B: Incidence is 5% of total respiratory infection, C: Spreads through sexual contact and blood transfusion, D: Human metapneumovirus contains NS1 and NS2 antigens +### Response: +","Human metapneumovirus Belongs to family paramyxoviridae Contains negative sense single stranded RNA. Do not have any non structural proteins and contain 6 structural protiens Do not spread by sexual contact and blood transfusion Cause upper and lower respiratory disease in people of all ages, especially among young children, older adults, and people with weakened immune systems.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True regarding metapneumovirus is:, with the following options: A: Segmented negative sense single stranded RNA virus, B: Incidence is 5% of total respiratory infection, C: Spreads through sexual contact and blood transfusion, D: Human metapneumovirus contains NS1 and NS2 antigens + ### Response: Human metapneumovirus Belongs to family paramyxoviridae Contains negative sense single stranded RNA. Do not have any non structural proteins and contain 6 structural protiens Do not spread by sexual contact and blood transfusion Cause upper and lower respiratory disease in people of all ages, especially among young children, older adults, and people with weakened immune systems. ### End" @@ -3898,6 +6961,13 @@ Human metapneumovirus Belongs to family paramyxoviridae Contains negative sense Answer the following medical question: Which of the following is ideal in moderate hemorrhagic shock: September 2007, with the following options: A: Dextrose, B: Ringer lactate, C: Blood, D: Dextran +### Response: +","Ans. C: Blood Features of moderate hemorrhagic shock: Lactic acidosis:++ Urine output: reduced Level of consciousness:Drowsy Respiratory rate: Increased Pulse rate: increased Blood pressure: Mild hypotension Management of hemorrhagic shock: The oxygen carrying capacity of the colloids and crystalloids is zero so if blood is lost, the ideal replacement is blood, although crystalloid can be given while awaiting blood products","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is ideal in moderate hemorrhagic shock: September 2007, with the following options: A: Dextrose, B: Ringer lactate, C: Blood, D: Dextran + ### Response: Ans. C: Blood Features of moderate hemorrhagic shock: Lactic acidosis:++ Urine output: reduced Level of consciousness:Drowsy Respiratory rate: Increased Pulse rate: increased Blood pressure: Mild hypotension Management of hemorrhagic shock: The oxygen carrying capacity of the colloids and crystalloids is zero so if blood is lost, the ideal replacement is blood, although crystalloid can be given while awaiting blood products ### End" @@ -3907,6 +6977,13 @@ Ans. C: Blood Features of moderate hemorrhagic shock: Lactic acidosis:++ Urine o Answer the following medical question: Drug of choice for nodulocystic acne is:, with the following options: A: Tetracyclines, B: Azithromycin, C: Isotretioin, D: Coicosteroids +### Response: +",Nodulocystic acne / grade IV acne- DOC- Isotretinoin. Isotretinoin- 13 cis isomer of retinoic acid Dose :0.5-1mg/kg/ k/bwt Max cumulative dose: 120-150mg/kg/bwt,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Drug of choice for nodulocystic acne is:, with the following options: A: Tetracyclines, B: Azithromycin, C: Isotretioin, D: Coicosteroids + ### Response: Nodulocystic acne / grade IV acne- DOC- Isotretinoin. Isotretinoin- 13 cis isomer of retinoic acid Dose :0.5-1mg/kg/ k/bwt Max cumulative dose: 120-150mg/kg/bwt ### End" @@ -3916,6 +6993,13 @@ Nodulocystic acne / grade IV acne- DOC- Isotretinoin. Isotretinoin- 13 cis isome Answer the following medical question: All are true about Substantia nigra except:-, with the following options: A: Pars compacta is rich in melanin, B: Pallor of substantia nigra indicates Parkinsonism, C: Afferents are derived from caudate nucleus, D: Efferent fibers are rich in GABA +### Response: +",Substantia nigra is the pigmented sheet of nerve cells between the tegmentum and crus cerebri of mid brain It extends from the cranial border of Pons to sub thalamic region. It consists of dorsal pigmented and compact pa known as pars compacta (cell rich zone) and ventral less pigmented reticular pa known as pars reticularis (cell poor zone). Neurons of pars compacta are rich in melanin and those of pars reticularis are rich in iron. Afferents:- From the caudate nucleus and putamen as Strio-nigral fibers. These fibers convey Gama Amino Butyric Acid (GABA) to pars reticularis and exe inhibition in neuro transmission. Efferents:- They are Nigro-striate fibers from pars compacta to caudate nucleus and putamen. They are rich in dopamine which on reaching the neurons of striatum inhibits the excitation of later and prevent tremor and other involuntary acts.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are true about Substantia nigra except:-, with the following options: A: Pars compacta is rich in melanin, B: Pallor of substantia nigra indicates Parkinsonism, C: Afferents are derived from caudate nucleus, D: Efferent fibers are rich in GABA + ### Response: Substantia nigra is the pigmented sheet of nerve cells between the tegmentum and crus cerebri of mid brain It extends from the cranial border of Pons to sub thalamic region. It consists of dorsal pigmented and compact pa known as pars compacta (cell rich zone) and ventral less pigmented reticular pa known as pars reticularis (cell poor zone). Neurons of pars compacta are rich in melanin and those of pars reticularis are rich in iron. Afferents:- From the caudate nucleus and putamen as Strio-nigral fibers. These fibers convey Gama Amino Butyric Acid (GABA) to pars reticularis and exe inhibition in neuro transmission. Efferents:- They are Nigro-striate fibers from pars compacta to caudate nucleus and putamen. They are rich in dopamine which on reaching the neurons of striatum inhibits the excitation of later and prevent tremor and other involuntary acts. ### End" @@ -3925,6 +7009,13 @@ Substantia nigra is the pigmented sheet of nerve cells between the tegmentum and Answer the following medical question: What is the management for the given case?, with the following options: A: Vitamin supplements, B: Antifungals treatment for oral candidiasis, C: Stop smoking and screen for carcinoma, D: Dapsone plus steroids +### Response: +","Ans. B. Antifungal treatment for oral candidiasisOropharyngeal Candidiasis* Oropharyngeal candidiasis is also called thrush.* It is most commonly caused by Candida albicans.* It occurs most commonly in neonates and immunocompromised patients, especially in AIDS patients. It is also seen in recipients of prolonged antibiotic or glucocorticoid therapy.Clinical symptoms: Sore throat, burning tongue, white or gray plaques on the gingiva, tongue, and oral mucosa.Treatment: Oral antifungal suspension (nystatin or clotrimazole) or oral fluconazole.* Fluconazole refractory thrush seen in some patients with HIV/AIDS; in this case, oral itraconazole or voriconazole or IV echinocandin (caspofungin, micafungin or anidulafungin) is preferred.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What is the management for the given case?, with the following options: A: Vitamin supplements, B: Antifungals treatment for oral candidiasis, C: Stop smoking and screen for carcinoma, D: Dapsone plus steroids + ### Response: Ans. B. Antifungal treatment for oral candidiasisOropharyngeal Candidiasis* Oropharyngeal candidiasis is also called thrush.* It is most commonly caused by Candida albicans.* It occurs most commonly in neonates and immunocompromised patients, especially in AIDS patients. It is also seen in recipients of prolonged antibiotic or glucocorticoid therapy.Clinical symptoms: Sore throat, burning tongue, white or gray plaques on the gingiva, tongue, and oral mucosa.Treatment: Oral antifungal suspension (nystatin or clotrimazole) or oral fluconazole.* Fluconazole refractory thrush seen in some patients with HIV/AIDS; in this case, oral itraconazole or voriconazole or IV echinocandin (caspofungin, micafungin or anidulafungin) is preferred. ### End" @@ -3934,6 +7025,13 @@ Ans. B. Antifungal treatment for oral candidiasisOropharyngeal Candidiasis* Orop Answer the following medical question: Contents of deep perenial pouch include all of the following except, with the following options: A: Dorsal nerve of penis, B: Bulbourethral gland, C: Root of penis, D: Sphincter urethrae +### Response: +","The deep perenial pouch includes deep transverse perineal pouch,membraneous poion of urethra,bulbourethral gland.Deep perineal pouch is the anatomic spacde enclosed by perineum and located superior to the perinial membrane. ref - BDC vol2 6e pg 355,360","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Contents of deep perenial pouch include all of the following except, with the following options: A: Dorsal nerve of penis, B: Bulbourethral gland, C: Root of penis, D: Sphincter urethrae + ### Response: The deep perenial pouch includes deep transverse perineal pouch,membraneous poion of urethra,bulbourethral gland.Deep perineal pouch is the anatomic spacde enclosed by perineum and located superior to the perinial membrane. ref - BDC vol2 6e pg 355,360 ### End" @@ -3943,6 +7041,13 @@ The deep perenial pouch includes deep transverse perineal pouch,membraneous poio Answer the following medical question: While doing cesarean section, the lower segment of the uterus is physically identified by :, with the following options: A: Loose attachment of visceral peritoneum, B: Dilated venous sinuses, C: Deflection of uterine aery towards upper segment, D: Thinness of its wall as compared to the upper segment +### Response: +",Loose attachment of visceral peritoneum,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: While doing cesarean section, the lower segment of the uterus is physically identified by :, with the following options: A: Loose attachment of visceral peritoneum, B: Dilated venous sinuses, C: Deflection of uterine aery towards upper segment, D: Thinness of its wall as compared to the upper segment + ### Response: Loose attachment of visceral peritoneum ### End" @@ -3952,6 +7057,13 @@ Loose attachment of visceral peritoneum Answer the following medical question: A 14-year-old boy presents with acute onset of right flank pain, which developed after he helped his father paint the ceiling of his bedroom. Physical examination demonstrates an area of ecchymosis in the right flank that is tender to palpation. The patient has a lifelong history of easy bruising. His brother shows the same tendency. The serum level of clotting factor VIII is less than 2% of normal. Which of the following is the most likely underlying mechanism for bleeding tendency in this patient?, with the following options: A: Circulating antibodies directed against factor VIII, B: Decreased hepatic synthesis of multiple coagulation factors, C: Deficiency of vitamin K, D: Genetic defect involving the factor VIII gene +### Response: +","Hemophilia A -X-linked recessive disorder of blood clotting that results in spontaneous bleeding, paicularly into joints, muscles, and internal organs and easy bruising. -Classic hemophilia results from mutations in the gene encoding factor VIII . -Intrinsic Pathway affected -Factor VIIIa complex is the most impoant activator of factor X required for conversion of prothrombin to thrombin.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 14-year-old boy presents with acute onset of right flank pain, which developed after he helped his father paint the ceiling of his bedroom. Physical examination demonstrates an area of ecchymosis in the right flank that is tender to palpation. The patient has a lifelong history of easy bruising. His brother shows the same tendency. The serum level of clotting factor VIII is less than 2% of normal. Which of the following is the most likely underlying mechanism for bleeding tendency in this patient?, with the following options: A: Circulating antibodies directed against factor VIII, B: Decreased hepatic synthesis of multiple coagulation factors, C: Deficiency of vitamin K, D: Genetic defect involving the factor VIII gene + ### Response: Hemophilia A -X-linked recessive disorder of blood clotting that results in spontaneous bleeding, paicularly into joints, muscles, and internal organs and easy bruising. -Classic hemophilia results from mutations in the gene encoding factor VIII . -Intrinsic Pathway affected -Factor VIIIa complex is the most impoant activator of factor X required for conversion of prothrombin to thrombin. ### End" @@ -3961,6 +7073,13 @@ Hemophilia A -X-linked recessive disorder of blood clotting that results in spon Answer the following medical question: Renal vein thrombosis is associated with which underlying disease of the kidney?, with the following options: A: Chronic glomerulonephritis, B: Pyelonephritis, C: SLE, D: Nephrotic syndrome +### Response: +","Renal vein thrombosis (RVT) - occurs most commonly in patients with nephrotic syndrome The syndrome is responsible for a hypercoagulable state. Kidneys are enlarged Hematuria is present The excessive urinary protein loss is associated with decreased antithrombin III, a relative excess of fibrinogen, and changes in other clotting factors; all lead to a propensity to clot. Magnetic resonance venography -Most sensitive and specific noninvasive form of imaging to make the diagnosis of renal vein thrombosis","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Renal vein thrombosis is associated with which underlying disease of the kidney?, with the following options: A: Chronic glomerulonephritis, B: Pyelonephritis, C: SLE, D: Nephrotic syndrome + ### Response: Renal vein thrombosis (RVT) - occurs most commonly in patients with nephrotic syndrome The syndrome is responsible for a hypercoagulable state. Kidneys are enlarged Hematuria is present The excessive urinary protein loss is associated with decreased antithrombin III, a relative excess of fibrinogen, and changes in other clotting factors; all lead to a propensity to clot. Magnetic resonance venography -Most sensitive and specific noninvasive form of imaging to make the diagnosis of renal vein thrombosis ### End" @@ -3970,6 +7089,13 @@ Renal vein thrombosis (RVT) - occurs most commonly in patients with nephrotic sy Answer the following medical question: Pancreaticoduodenectomy is not indicated in:, with the following options: A: Multiple cyst and calcifications in head of the pancreas, B: Duodenal cancer, C: Failed drainage procedure for chronic pancreatitis, D: Ampullary carcinoma with secondaries in peritoneum +### Response: +",Pancreaticoduodenectomy Indications Contraindications Carcinoma head of pancreas & Ampullary carcinoma Cystic tumors of pancreas Chronic pancreatitis Duodenal carcinoma Common bile duct cancer(Cholangiocarcinoma) Mucinous cystadenoma Pancreatic trauma Metastatic disease in abdominal cavity or nearby organ,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pancreaticoduodenectomy is not indicated in:, with the following options: A: Multiple cyst and calcifications in head of the pancreas, B: Duodenal cancer, C: Failed drainage procedure for chronic pancreatitis, D: Ampullary carcinoma with secondaries in peritoneum + ### Response: Pancreaticoduodenectomy Indications Contraindications Carcinoma head of pancreas & Ampullary carcinoma Cystic tumors of pancreas Chronic pancreatitis Duodenal carcinoma Common bile duct cancer(Cholangiocarcinoma) Mucinous cystadenoma Pancreatic trauma Metastatic disease in abdominal cavity or nearby organ ### End" @@ -3979,6 +7105,13 @@ Pancreaticoduodenectomy Indications Contraindications Carcinoma head of pancreas Answer the following medical question: Molecular change in Lysosomal storage disorder is:, with the following options: A: Defective fusion of lysosomes and phagosomes, B: Increased synthesis of some substrates, C: Mutation of genes encoding lysosomal hydrolases, D: Membrane defect of lysosomes +### Response: +","C i.e. Mutation of genes encoding lysosomal hydrolasesLysosomal storage diseases (LSD) are caused by mutations in genes encoding lysosomal hydrolasesQ responsible for breaking down of macromolecules, which results in accumulation of corresponsing substrate (macromolecule). ISDs are classified on the basis of accumulated substrate into sphingolipidosis, mucolipidosis, mucopolysaccharidoses, glycoproteinoses etc.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Molecular change in Lysosomal storage disorder is:, with the following options: A: Defective fusion of lysosomes and phagosomes, B: Increased synthesis of some substrates, C: Mutation of genes encoding lysosomal hydrolases, D: Membrane defect of lysosomes + ### Response: C i.e. Mutation of genes encoding lysosomal hydrolasesLysosomal storage diseases (LSD) are caused by mutations in genes encoding lysosomal hydrolasesQ responsible for breaking down of macromolecules, which results in accumulation of corresponsing substrate (macromolecule). ISDs are classified on the basis of accumulated substrate into sphingolipidosis, mucolipidosis, mucopolysaccharidoses, glycoproteinoses etc. ### End" @@ -3988,6 +7121,14 @@ C i.e. Mutation of genes encoding lysosomal hydrolasesLysosomal storage diseases Answer the following medical question: Type of human papilloma virus associated with carcinoma cervix, with the following options: A: Types 6,12,18, B: Types 16,18,31, C: Types 6,8,11, D: Types 3,10,19 +### Response: +","High risk HPV: HPV-16, 18, 31, 33 & 45 → associated with cervical cancer. +Low risk HPV : HPV- 6 & 11 → associated with precursor lesions & CIN","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Type of human papilloma virus associated with carcinoma cervix, with the following options: A: Types 6,12,18, B: Types 16,18,31, C: Types 6,8,11, D: Types 3,10,19 + ### Response: High risk HPV: HPV-16, 18, 31, 33 & 45 → associated with cervical cancer. Low risk HPV : HPV- 6 & 11 → associated with precursor lesions & CIN @@ -3998,6 +7139,13 @@ Low risk HPV : HPV- 6 & 11 → associated with precursor lesions & CIN Answer the following medical question: Most common site of tuberculosis in gastrointestinal tract is -, with the following options: A: Stomach, B: Small intestine, C: Rectum, D: Ileocecal junction +### Response: +","Ans. is 'd' i.e., Ileocecal junction Tubercular ulcero The ileocecal region is the most common site of involvememt; i.e. ileocecal tuberculosis. Intestinal TB is divided into three typesUlcerative form : It is the most common form. It is characterized by multiple superficial ulcers placed transversly along ileum.Hypertrophic form : There is thickening of bowel wall with scarring, fibrosis and narrowing of lumen.Ulcerohypertrophic form : It has combination of features of both ulcerative and hypertrophic forms.o In contrast to typhoid ulcer, stricture is common in Tubercular ulcer.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common site of tuberculosis in gastrointestinal tract is -, with the following options: A: Stomach, B: Small intestine, C: Rectum, D: Ileocecal junction + ### Response: Ans. is 'd' i.e., Ileocecal junction Tubercular ulcero The ileocecal region is the most common site of involvememt; i.e. ileocecal tuberculosis. Intestinal TB is divided into three typesUlcerative form : It is the most common form. It is characterized by multiple superficial ulcers placed transversly along ileum.Hypertrophic form : There is thickening of bowel wall with scarring, fibrosis and narrowing of lumen.Ulcerohypertrophic form : It has combination of features of both ulcerative and hypertrophic forms.o In contrast to typhoid ulcer, stricture is common in Tubercular ulcer. ### End" @@ -4007,6 +7155,13 @@ Ans. is 'd' i.e., Ileocecal junction Tubercular ulcero The ileocecal region is t Answer the following medical question: The infectivity of chicken pox lasts for, with the following options: A: Till the last scab falls, B: 6 days after onset of rash, C: 3 days after onset of rash, D: Till the fever subsides +### Response: +",Period of communicability: Chicken pox: 1-2 days before to 4-5 days after appearance of rash. Measles: 4 days before to 5 days after appearance of rash. Diphtheria: 14-28 days from disease onset Poliomyelitis: 7-10 days before and after onset of symptoms. CHICKEN POX: Also known as &;Varicella&; Causative agent: Varicella Zoster Virus (Human (alpha) Herpes Virus-3) Secondary attack rate: 90% Incubation period : 14-16 days. Rash : Chicken Pox rash Small pox Rash Dew drops on rose petal appearance Centripetal distribution Pleomorphic rash No dew drop Centrifugal distribution Non-pleomorphic MC late complication of chicken pox: Shingles (caused by reactivation of the virus decades after the initial episode of chicken pox) Aspirin must not be given to children with chicken pox: Risk of Reye Syndrome. Strain of live attenuated chicken pox vaccine: OKA strain Congenital Varicella: Most threatening if transmitted in 1st trimester of pregnancy. Ref: Park 25th edition Pgno: 157,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The infectivity of chicken pox lasts for, with the following options: A: Till the last scab falls, B: 6 days after onset of rash, C: 3 days after onset of rash, D: Till the fever subsides + ### Response: Period of communicability: Chicken pox: 1-2 days before to 4-5 days after appearance of rash. Measles: 4 days before to 5 days after appearance of rash. Diphtheria: 14-28 days from disease onset Poliomyelitis: 7-10 days before and after onset of symptoms. CHICKEN POX: Also known as &;Varicella&; Causative agent: Varicella Zoster Virus (Human (alpha) Herpes Virus-3) Secondary attack rate: 90% Incubation period : 14-16 days. Rash : Chicken Pox rash Small pox Rash Dew drops on rose petal appearance Centripetal distribution Pleomorphic rash No dew drop Centrifugal distribution Non-pleomorphic MC late complication of chicken pox: Shingles (caused by reactivation of the virus decades after the initial episode of chicken pox) Aspirin must not be given to children with chicken pox: Risk of Reye Syndrome. Strain of live attenuated chicken pox vaccine: OKA strain Congenital Varicella: Most threatening if transmitted in 1st trimester of pregnancy. Ref: Park 25th edition Pgno: 157 ### End" @@ -4016,6 +7171,13 @@ Period of communicability: Chicken pox: 1-2 days before to 4-5 days after appear Answer the following medical question: All of the following are raised in PCOS except, with the following options: A: E2 :E1, B: LH :FSH, C: LDL :HDL, D: Fasting serum insulin +### Response: +","Ans. is a, i.e. E2 :E1 Ref: Shaw gynae 15th/ed, p370 Table 38.1In PCOS:* E1 :E2 Ratio is increased not E2 :E1 * LDL:HDL Ratio is increased* LH:FSH Ratio is increased* Fasting insulin levels were raised* Fasting glucose/insulin ratio is decreased <4.5","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following are raised in PCOS except, with the following options: A: E2 :E1, B: LH :FSH, C: LDL :HDL, D: Fasting serum insulin + ### Response: Ans. is a, i.e. E2 :E1 Ref: Shaw gynae 15th/ed, p370 Table 38.1In PCOS:* E1 :E2 Ratio is increased not E2 :E1 * LDL:HDL Ratio is increased* LH:FSH Ratio is increased* Fasting insulin levels were raised* Fasting glucose/insulin ratio is decreased <4.5 ### End" @@ -4025,6 +7187,20 @@ Ans. is a, i.e. E2 :E1 Ref: Shaw gynae 15th/ed, p370 Table 38.1In PCOS:* E1 :E2 Answer the following medical question: A male Shyam, age 30 years presented with Trismus, fever, swelling pushing the tonsils medially and spreading laterally posterior to the middle sternocleidomastoid. He gives an h/o excision of 3rd molar a few days back for dental caries. The diagnosis is -, with the following options: A: Retropharyngeal abscess, B: Ludwig's angina, C: Submental abscess, D: Parapharyngeal abscess +### Response: +","Clinical features of parapharyngeal abscess + +Sixty percent of patients develop it as a complication of tonsillitis or tonsillectomy and 40 percent as a result of either infection or extraction of the lower third molar tooth. Mastoid infection can extend into space on rare occasions. +There is fever and marked trismus because of spasm in medial pterygoid muscle. +The tonsil, if it is normal, is pushed medially. +The most marked swelling is in the neck at the posterior part of the middle third of the sternomastoid (behind the angle of jaw). There may also be swelling in the retromolar area. +There is torticollis (due to spasm of prevertebral muscles), sore throat, marked odynophagia and signs of toxaemia. +Further extension of the disease may cause involvement of IX, X, XI, XII cranial nerve and sympathetic chain.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A male Shyam, age 30 years presented with Trismus, fever, swelling pushing the tonsils medially and spreading laterally posterior to the middle sternocleidomastoid. He gives an h/o excision of 3rd molar a few days back for dental caries. The diagnosis is -, with the following options: A: Retropharyngeal abscess, B: Ludwig's angina, C: Submental abscess, D: Parapharyngeal abscess + ### Response: Clinical features of parapharyngeal abscess @@ -4041,6 +7217,13 @@ Further extension of the disease may cause involvement of IX, X, XI, XII cranial Answer the following medical question: Recurrent periductal mastitis is NOT RELATED - MEDICINE, with the following options: A: Mondor's disease, B: Zuska's disease, C: Cooper's disease, D: Schimmelbusch disease +### Response: +","Zuska's disease, also called recurrent periductal mastitis, is a condition of recurrent retroareolar infections and abscesses. Smoking has been implicated as a risk factor for this condition. This syndrome is managed symptomatically by antibiotics coupled with incision and drainage as necessary.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Recurrent periductal mastitis is NOT RELATED - MEDICINE, with the following options: A: Mondor's disease, B: Zuska's disease, C: Cooper's disease, D: Schimmelbusch disease + ### Response: Zuska's disease, also called recurrent periductal mastitis, is a condition of recurrent retroareolar infections and abscesses. Smoking has been implicated as a risk factor for this condition. This syndrome is managed symptomatically by antibiotics coupled with incision and drainage as necessary. ### End" @@ -4050,6 +7233,13 @@ Zuska's disease, also called recurrent periductal mastitis, is a condition of re Answer the following medical question: Function of floccunodular lobe of cerebellum is: March 2008, with the following options: A: Co-ordination of movements, B: Equilibrium, C: Chemoreception, D: Planning of movements +### Response: +","Ans. B: Equilibrium From a functional point of view, the cerebellum is divided into three pas: The nodulus in the vermis and the flanking flocculus in the hemisphere on each side form the flocculonodular lobe, or vestibulocerebellum. This lobe, which is phylogenetically the oldest pa of the cerebellum, has vestibular connections and is concerned with equilibrium. The rest of the vermis and the adjacent medial poions of the hemispheres form the spinocerebellum, the region that receives proprioceptive input from the body as well as a copy of the ""motor plan"" from the motor coex. By comparing plan with performance, it smoothes and coordinates movements that are ongoing. The vermis projects to the brainstem area concerned with control of axial and proximal limb muscles, whereas the hemispheres project the brainstem areas concerned with control of distal limb muscles. The lateral poions of the cerebellar hemispheres are called the cerebrocerebellum, or neocerebellum. They are the newest from a phylogenetic point of view, reaching their greatest development in humans. They interact with the motor coex in planning and programming movements.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Function of floccunodular lobe of cerebellum is: March 2008, with the following options: A: Co-ordination of movements, B: Equilibrium, C: Chemoreception, D: Planning of movements + ### Response: Ans. B: Equilibrium From a functional point of view, the cerebellum is divided into three pas: The nodulus in the vermis and the flanking flocculus in the hemisphere on each side form the flocculonodular lobe, or vestibulocerebellum. This lobe, which is phylogenetically the oldest pa of the cerebellum, has vestibular connections and is concerned with equilibrium. The rest of the vermis and the adjacent medial poions of the hemispheres form the spinocerebellum, the region that receives proprioceptive input from the body as well as a copy of the ""motor plan"" from the motor coex. By comparing plan with performance, it smoothes and coordinates movements that are ongoing. The vermis projects to the brainstem area concerned with control of axial and proximal limb muscles, whereas the hemispheres project the brainstem areas concerned with control of distal limb muscles. The lateral poions of the cerebellar hemispheres are called the cerebrocerebellum, or neocerebellum. They are the newest from a phylogenetic point of view, reaching their greatest development in humans. They interact with the motor coex in planning and programming movements. ### End" @@ -4059,6 +7249,13 @@ Ans. B: Equilibrium From a functional point of view, the cerebellum is divided i Answer the following medical question: duration criteria for bulimia nervosa is, with the following options: A: 3 months, B: 5 months, C: 4 months, D: 6 months +### Response: +","Bulimia nervosa * Gender==== more common in females * Age=======adolescence * Comorbidity=== depression and social phobia * Duration====3 months * Criteria= * Binge eating at least once a week for 3 months * Uses laxatives, diuretics, self-induced vomiting * Association= * Impulsive behaviors * increased interest in sex * They may be of normal weight * Less secretive * Mood disorders * Complication * Electrolyte abnormalities * Hypokalemia * Hypochloremia alkalosis * Russel's sign==== as these patients uses their fingers to be stick out in the throat and vomit, there is a lesion in meta carpo phalangeal joints. * Drugs * Carbamazepine * MAOI * SSRI Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 509","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: duration criteria for bulimia nervosa is, with the following options: A: 3 months, B: 5 months, C: 4 months, D: 6 months + ### Response: Bulimia nervosa * Gender==== more common in females * Age=======adolescence * Comorbidity=== depression and social phobia * Duration====3 months * Criteria= * Binge eating at least once a week for 3 months * Uses laxatives, diuretics, self-induced vomiting * Association= * Impulsive behaviors * increased interest in sex * They may be of normal weight * Less secretive * Mood disorders * Complication * Electrolyte abnormalities * Hypokalemia * Hypochloremia alkalosis * Russel's sign==== as these patients uses their fingers to be stick out in the throat and vomit, there is a lesion in meta carpo phalangeal joints. * Drugs * Carbamazepine * MAOI * SSRI Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 509 ### End" @@ -4068,6 +7265,39 @@ Bulimia nervosa * Gender==== more common in females * Age=======adolescence * Co Answer the following medical question: Which of the following is known as the ""guardian of the genome"" -, with the following options: A: p53, B: Mdm2, C: p14, D: ATM +### Response: +","p53; Guardian of genome + +p53 is a tumor suppressor gene. +p53 gene is located on chromosome 17. +p53 acts as molecular policeman that prevents the propagation of genetically damage cell. +p53 gene product, i.e. p53 protein is a DNA binding protein in the nucleus, when called into action, it controls the transcription of several other genes. +The ma 'or functional activities of the 53 rotein are cell c cle arrest and initiation of a o v.tosis in res onse to DNA damage. +When there is DNA damage due to irradiation, UV light or mutagenic chemicals, there is rapid increase in p53 levels. +p53 causes - + +Cell cycle arrest + + +p-53 induces transcription of p21, a CDK inhibitor. +p21 inhibit cyclin D-CDK-4 complex and there is arrest of cell cycle late in G1 phase. +This allows time for DNA repair. + +DNA repair + +p-53 also helps in DNA repair directly by inducing transcription of GADD 45 (growth arrest and DNA damage). +GADD 45 encodes a protein that is involved in DNA repair. +If DNA damage is repaired successfully, p53 activate MDM-3 and this MDM-3 induce degradation of p-53 → Relieve in cell cycle block. +If DNA damage cannot be successfully repaired, p53 induces apoptosis by inducing the activation of apoptosis-inducing gene BAX. +So p53 prevents replication of cell with defective DNA → p53 functions as a critical gatekeeper against the formation of cancer. +Mutation in p53 leads to carcinogenesis because of loss of the above protective mechanism. +p-53 is the most common target for genetic alteration in human tumors: A little over 50% of human tumors contain mutation in this gene. +(Note - Amongst oncogene RAS is involved most commonly).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is known as the ""guardian of the genome"" -, with the following options: A: p53, B: Mdm2, C: p14, D: ATM + ### Response: p53; Guardian of genome @@ -4103,6 +7333,13 @@ p-53 is the most common target for genetic alteration in human tumors: A little Answer the following medical question: Most common type of schizophrenia, with the following options: A: Simple, B: Hebephrenic, C: Catatonic, D: Paranoid +### Response: +",D i.e. Paranoid,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common type of schizophrenia, with the following options: A: Simple, B: Hebephrenic, C: Catatonic, D: Paranoid + ### Response: D i.e. Paranoid ### End" @@ -4112,6 +7349,16 @@ D i.e. Paranoid Answer the following medical question: What is the function of a template during procedure of tooth extraction and insertion of immediate denture?, with the following options: A: Trimming the jagged edge of bone, B: Conditioning the tissues, C: To promote healing of socket, D: To take impression of the edentulous space +### Response: +","Surgical Template + +It is a thin, transparent form duplicating the tissue surface of an immediate denture and used as a guide for surgically shaping the alveolar process. +It can be used as a guide used to assist in proper surgical placement and angulation of dental implants.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What is the function of a template during procedure of tooth extraction and insertion of immediate denture?, with the following options: A: Trimming the jagged edge of bone, B: Conditioning the tissues, C: To promote healing of socket, D: To take impression of the edentulous space + ### Response: Surgical Template @@ -4125,14 +7372,33 @@ It can be used as a guide used to assist in proper surgical placement and angula Answer the following medical question: The Finance Commission derives its authority from the, with the following options: A: Constitution of India, B: Parliament of India, C: President of India, D: Supreme cou of India ### Response: -Ref: 25th Ed K.Park's Textbook Of Preventive and Social Medicine -### End" +",Ref: 25th Ed K.Park's Textbook Of Preventive and Social Medicine,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The Finance Commission derives its authority from the, with the following options: A: Constitution of India, B: Parliament of India, C: President of India, D: Supreme cou of India + +### Response: +Ref: 25th Ed K.Park's Textbook Of Preventive and Social Medicine +### End" 437,"Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Social Mobility is –, with the following options: A: From rural to urban areas for work, B: Industrialization, C: Interaction between cultures, D: Movement in socio–economic stratas +### Response: +","Social mobility + +Social mobility is the degree to which an individual's is family or group's social status can change throughout the course of their life through a system of social hierarchy or stratification. +The individual or family can move up or down the social classes based on achievements or factors beyond their control. +If such mobility involves a change in position, especially in occupation, but no change in social class, it is called ""horizontal mobility"". Example → a person who moves from a managerial position in one company to a similar position in another. +If the move involves a change in social class it is called ""vertical mobility"". Example → An industrial worker who becomes a wealthy businessman moves upward in the class system.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Social Mobility is –, with the following options: A: From rural to urban areas for work, B: Industrialization, C: Interaction between cultures, D: Movement in socio–economic stratas + ### Response: Social mobility @@ -4147,6 +7413,13 @@ If the move involves a change in social class it is called ""vertical mobility"" Answer the following medical question: Cu deficiency manfest as -, with the following options: A: Anaemia, B: Cardiomyopathy, C: Hepatomegaly, D: Hypothyroidism +### Response: +","*Deficiency of copper causes microcytic hypochromic anaemia, neutropenia,retoed growth,dermatosis. The characteristic hematological (blood) effects of copper deficiency are anemia (which may be microcytic, normocytic or macrocytic) and neutropenia. Thrombocytopenia (low blood platelets) is unusual. The peripheral blood and bone marrow aspirate findings in copper deficiency can mimic myelodysplastic syndrome Ref Harrison 20th edition pg 99e","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cu deficiency manfest as -, with the following options: A: Anaemia, B: Cardiomyopathy, C: Hepatomegaly, D: Hypothyroidism + ### Response: *Deficiency of copper causes microcytic hypochromic anaemia, neutropenia,retoed growth,dermatosis. The characteristic hematological (blood) effects of copper deficiency are anemia (which may be microcytic, normocytic or macrocytic) and neutropenia. Thrombocytopenia (low blood platelets) is unusual. The peripheral blood and bone marrow aspirate findings in copper deficiency can mimic myelodysplastic syndrome Ref Harrison 20th edition pg 99e ### End" @@ -4156,6 +7429,13 @@ Answer the following medical question: Cu deficiency manfest as -, with the foll Answer the following medical question: Wide QRS complex is typically seen in -, with the following options: A: Bundle Branch block, B: Sick sinus syndrome, C: Mobitz type 1 block, D: Mobithz type II block +### Response: +","Ans. is 'a' i.e., Bundle Branch block o Intrinsic intraventricular conduction delays such as left bundle block and right bundle branch block are associated with wide QRS complex.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Wide QRS complex is typically seen in -, with the following options: A: Bundle Branch block, B: Sick sinus syndrome, C: Mobitz type 1 block, D: Mobithz type II block + ### Response: Ans. is 'a' i.e., Bundle Branch block o Intrinsic intraventricular conduction delays such as left bundle block and right bundle branch block are associated with wide QRS complex. ### End" @@ -4165,6 +7445,13 @@ Ans. is 'a' i.e., Bundle Branch block o Intrinsic intraventricular conduction de Answer the following medical question: Microorganisms that enter freshly laid eggs are, with the following options: A: Salmonella, B: Brucella, C: Shigella, D: Vibrio cholerae +### Response: +","Ans. is 'a' i.e., Salmonella . Salmonella can enter through the shell if eggs are left on contaminated chicken feed or feces and grow inside.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Microorganisms that enter freshly laid eggs are, with the following options: A: Salmonella, B: Brucella, C: Shigella, D: Vibrio cholerae + ### Response: Ans. is 'a' i.e., Salmonella . Salmonella can enter through the shell if eggs are left on contaminated chicken feed or feces and grow inside. ### End" @@ -4174,6 +7461,13 @@ Ans. is 'a' i.e., Salmonella . Salmonella can enter through the shell if eggs ar Answer the following medical question: A malignant tumor of childhood, that metastasizes to bones most often, is –, with the following options: A: Wilm's tumor, B: Neuroblastoma, C: Adrenal gland tumors, D: Granulosa cell tumor of ovary +### Response: +","Metastasis present in 60-70% of children at time of diagnosis are usually to the skeleton, characteristically to the facial bones and the skull and to the bone marrow and nodes'","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A malignant tumor of childhood, that metastasizes to bones most often, is –, with the following options: A: Wilm's tumor, B: Neuroblastoma, C: Adrenal gland tumors, D: Granulosa cell tumor of ovary + ### Response: Metastasis present in 60-70% of children at time of diagnosis are usually to the skeleton, characteristically to the facial bones and the skull and to the bone marrow and nodes' ### End" @@ -4183,6 +7477,13 @@ Metastasis present in 60-70% of children at time of diagnosis are usually to the Answer the following medical question: Exaltation is defined as -, with the following options: A: Decreased virulence, B: Increased virulence, C: No change, D: None +### Response: +",The virulence of a strain is not constant and may undergo spontaneous or induced variations. Enhancement of virulence is known as exaltation Ref Ananthanarayan & paniker's Textbook of Microbiology 9th edition pg no 74,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Exaltation is defined as -, with the following options: A: Decreased virulence, B: Increased virulence, C: No change, D: None + ### Response: The virulence of a strain is not constant and may undergo spontaneous or induced variations. Enhancement of virulence is known as exaltation Ref Ananthanarayan & paniker's Textbook of Microbiology 9th edition pg no 74 ### End" @@ -4192,6 +7493,13 @@ The virulence of a strain is not constant and may undergo spontaneous or induced Answer the following medical question: A physician monitoring a newborn infant's hea sounds using a stethoscope hears the characteristic murmur of a patent ductus aeriosus. How soon after bih should this murmur normally disappear?, with the following options: A: 1-2 months, B: 1-2 weeks, C: 1-2 days, D: Immediate closure +### Response: +","Ductus aeriosus closure- Functionally-immediately after bih Structurally-1-3 months after bih The ductus aeriosus functionally closes immediatly (1-2 hours) after bih smooth muscle contraction of the tunica media. Before bih, the patency of the ductus aeriosus is controlled by the low oxygen content of the blood flowing through it, which in turn stimulates production of prostaglandins, which cause smooth muscle to relax. After bih, the high oxygen content of the blood due to lung ventilation inhibits production of prostaglandins, causing smooth muscle contraction. Premature infants can be treated with prostaglandin synthesis inhibitors (such as indomethacin) to promote closure of the ductus aeriosus.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A physician monitoring a newborn infant's hea sounds using a stethoscope hears the characteristic murmur of a patent ductus aeriosus. How soon after bih should this murmur normally disappear?, with the following options: A: 1-2 months, B: 1-2 weeks, C: 1-2 days, D: Immediate closure + ### Response: Ductus aeriosus closure- Functionally-immediately after bih Structurally-1-3 months after bih The ductus aeriosus functionally closes immediatly (1-2 hours) after bih smooth muscle contraction of the tunica media. Before bih, the patency of the ductus aeriosus is controlled by the low oxygen content of the blood flowing through it, which in turn stimulates production of prostaglandins, which cause smooth muscle to relax. After bih, the high oxygen content of the blood due to lung ventilation inhibits production of prostaglandins, causing smooth muscle contraction. Premature infants can be treated with prostaglandin synthesis inhibitors (such as indomethacin) to promote closure of the ductus aeriosus. ### End" @@ -4201,6 +7509,13 @@ Ductus aeriosus closure- Functionally-immediately after bih Structurally-1-3 mon Answer the following medical question: DeQuervains thyroiditis is also known as, with the following options: A: Granulomatous thyroiditis, B: Struma lymphomatosa, C: Acute thyroiditis, D: Hashimotos thyroiditis +### Response: +",Refer Robbins page no DeQuervains thyroiditis is also referred to as Granulomatous thyroiditis,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: DeQuervains thyroiditis is also known as, with the following options: A: Granulomatous thyroiditis, B: Struma lymphomatosa, C: Acute thyroiditis, D: Hashimotos thyroiditis + ### Response: Refer Robbins page no DeQuervains thyroiditis is also referred to as Granulomatous thyroiditis ### End" @@ -4210,6 +7525,13 @@ Refer Robbins page no DeQuervains thyroiditis is also referred to as Granulomato Answer the following medical question: False about p24 is -, with the following options: A: Seen after 3 weeks of infection, B: Cant be seen in first week, C: Cant be detected after seroconversion, D: Detected by ELISA +### Response: +",p24Ag seen with in first few weeks of infection.cant be detected after sero conversion.(coincide eith seroconveesion).detected by ELISA REF:MICROBIOLOGY ANANTHA NARAYANAN NINTH EDITION PAGE.577,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: False about p24 is -, with the following options: A: Seen after 3 weeks of infection, B: Cant be seen in first week, C: Cant be detected after seroconversion, D: Detected by ELISA + ### Response: p24Ag seen with in first few weeks of infection.cant be detected after sero conversion.(coincide eith seroconveesion).detected by ELISA REF:MICROBIOLOGY ANANTHA NARAYANAN NINTH EDITION PAGE.577 ### End" @@ -4219,6 +7541,13 @@ p24Ag seen with in first few weeks of infection.cant be detected after sero conv Answer the following medical question: Which bone tumor occurs in the epiphysis?, with the following options: A: Osteoclastoma, B: Ewing's sarcoma, C: Chondro-myxoid fibroma, D: Osteosarcoma +### Response: +","Osteoclastoma also known as giant cell tumour of bone is a potentially malignant that arises in the cancellous end of long bones in the young. These neoplasms arise in the epiphysis. Most common sites are lower end of radius, upper end of tibia, lower end of femur. Osteosarcoma and chondromyxoidfibroma are metaphyseal tumours while Ewing's sarcoma is diaphyseal in origin. Ref: Essential Ohopedics by Maheshwari 3rd Edition, Page 216; Campbel's Ohopaedics 11th Edition, Page 793-854.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which bone tumor occurs in the epiphysis?, with the following options: A: Osteoclastoma, B: Ewing's sarcoma, C: Chondro-myxoid fibroma, D: Osteosarcoma + ### Response: Osteoclastoma also known as giant cell tumour of bone is a potentially malignant that arises in the cancellous end of long bones in the young. These neoplasms arise in the epiphysis. Most common sites are lower end of radius, upper end of tibia, lower end of femur. Osteosarcoma and chondromyxoidfibroma are metaphyseal tumours while Ewing's sarcoma is diaphyseal in origin. Ref: Essential Ohopedics by Maheshwari 3rd Edition, Page 216; Campbel's Ohopaedics 11th Edition, Page 793-854. ### End" @@ -4228,6 +7557,13 @@ Osteoclastoma also known as giant cell tumour of bone is a potentially malignant Answer the following medical question: Which one of the following is an abductor of vocal cords:, with the following options: A: Posterior cricoarytenoid, B: Transverse arytenoids, C: Cricothyroid, D: Aryepiglotticus +### Response: +","Ans. (a) Posterior cricoarytenoidRef: P.L. Dhingra 5th ed. / 317* All intrinsic muscles of the larynx are supplied by the recurrent laryngeal nerve except cricothyroid which is supplied by external branch of superior laryngeal nerve.* Recurrent laryngeal nerve supplies posterior cricoarytenoid, lateral cricoarytenoid, transverse and oblique arytenoids, aryepiglotticus, thyroarytenoid, thyroepiglotticus muscle.Also Know About laryngeal muscles movementsMovementMusclesNerve supply* Abduction of vocal cordsPosterior cricoarytenoids onlyRecurrent laryngeal nerve* Adduction of the vocal cordsLateral cricoarytenoidsInterarytenoidsThyroarytenoidsRecurrent laryngeal nerve* Tensor of vocal cordsCricothyroidSuperior laryngeal nerve* Relaxor of vocal cordThyroarytenoidRecurrent laryngealnerve* Elevation of larynxThyrohyoid, mylohyoid* Depression of larynxSternothyroid, sternohyoid","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which one of the following is an abductor of vocal cords:, with the following options: A: Posterior cricoarytenoid, B: Transverse arytenoids, C: Cricothyroid, D: Aryepiglotticus + ### Response: Ans. (a) Posterior cricoarytenoidRef: P.L. Dhingra 5th ed. / 317* All intrinsic muscles of the larynx are supplied by the recurrent laryngeal nerve except cricothyroid which is supplied by external branch of superior laryngeal nerve.* Recurrent laryngeal nerve supplies posterior cricoarytenoid, lateral cricoarytenoid, transverse and oblique arytenoids, aryepiglotticus, thyroarytenoid, thyroepiglotticus muscle.Also Know About laryngeal muscles movementsMovementMusclesNerve supply* Abduction of vocal cordsPosterior cricoarytenoids onlyRecurrent laryngeal nerve* Adduction of the vocal cordsLateral cricoarytenoidsInterarytenoidsThyroarytenoidsRecurrent laryngeal nerve* Tensor of vocal cordsCricothyroidSuperior laryngeal nerve* Relaxor of vocal cordThyroarytenoidRecurrent laryngealnerve* Elevation of larynxThyrohyoid, mylohyoid* Depression of larynxSternothyroid, sternohyoid ### End" @@ -4237,6 +7573,13 @@ Ans. (a) Posterior cricoarytenoidRef: P.L. Dhingra 5th ed. / 317* All intrinsic Answer the following medical question: In a case of secondary amenorrhea who fails to get withdrawl bleeding after taking E and P, the fault lies at the level of :, with the following options: A: Pituitary, B: Hypothalamus, C: Ovary, D: Endometrium +### Response: +","Ans. is d i.e. Endometrium Read the question carefully, it says absence of withdraw! bleeding after estrogen-progesterone challenge test. Oestrogen progesterone challenge test Procedure : Ethinyl estradiol (.02 mg) or conjugated equine estrogen (1.25 mg) is given daily for 25 days. Medroxy progesterone acetate 10mg daily is added from day 15 - 25 (Alternatively estrogen is given for 21 days and progesterone is added in last 5 days). The test creates a condition similar to normal Menstrual cycle Withdraw! bleeding occurs Means endometrium and outflow tract are normal and if provided by normal hormonal levels, result in menstruation. Defect lies in production of estrogen i.e. either in ovare/Pituitarya/Hypothalamus No withdraw! bleeding Means their is a defect in endometriumdeg or outflow tractdeg (As despite normal hormonal sequence no bleeding occurs).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In a case of secondary amenorrhea who fails to get withdrawl bleeding after taking E and P, the fault lies at the level of :, with the following options: A: Pituitary, B: Hypothalamus, C: Ovary, D: Endometrium + ### Response: Ans. is d i.e. Endometrium Read the question carefully, it says absence of withdraw! bleeding after estrogen-progesterone challenge test. Oestrogen progesterone challenge test Procedure : Ethinyl estradiol (.02 mg) or conjugated equine estrogen (1.25 mg) is given daily for 25 days. Medroxy progesterone acetate 10mg daily is added from day 15 - 25 (Alternatively estrogen is given for 21 days and progesterone is added in last 5 days). The test creates a condition similar to normal Menstrual cycle Withdraw! bleeding occurs Means endometrium and outflow tract are normal and if provided by normal hormonal levels, result in menstruation. Defect lies in production of estrogen i.e. either in ovare/Pituitarya/Hypothalamus No withdraw! bleeding Means their is a defect in endometriumdeg or outflow tractdeg (As despite normal hormonal sequence no bleeding occurs). ### End" @@ -4246,6 +7589,13 @@ Ans. is d i.e. Endometrium Read the question carefully, it says absence of withd Answer the following medical question: Example of disability limitation:-, with the following options: A: DOTS, B: Quit smoking, C: BCG vaccine, D: Spectacles for refractory errors +### Response: +",Disability Limitation:- Teiary level of prevention when patient repos late in pathogenesis phase. Prevent transition of disease from impairment to handicap. Spectacles in refractive error stabilizes visual acuity (Disability limitation) and provides visual clarity (Rehabilitation) too.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Example of disability limitation:-, with the following options: A: DOTS, B: Quit smoking, C: BCG vaccine, D: Spectacles for refractory errors + ### Response: Disability Limitation:- Teiary level of prevention when patient repos late in pathogenesis phase. Prevent transition of disease from impairment to handicap. Spectacles in refractive error stabilizes visual acuity (Disability limitation) and provides visual clarity (Rehabilitation) too. ### End" @@ -4255,6 +7605,13 @@ Disability Limitation:- Teiary level of prevention when patient repos late in pa Answer the following medical question: A middle aged person reported to Psychiatric OPD with the complaints of fear of leaving home, fear of travelling alone and fear of being in a crowd. He develops marked anxiety with palpitations and sweating if he is in these situations. He often avoids public transport to go his place of work. The most likely diagnosis is -, with the following options: A: Generalised anxiety disorder, B: Schizophrenia, C: Personality disorder, D: Agoraphobia +### Response: +","Fear of leaving home, fear of travelling alone and fear of being in a crowd suggest the diagnosis of Agoraphobia.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A middle aged person reported to Psychiatric OPD with the complaints of fear of leaving home, fear of travelling alone and fear of being in a crowd. He develops marked anxiety with palpitations and sweating if he is in these situations. He often avoids public transport to go his place of work. The most likely diagnosis is -, with the following options: A: Generalised anxiety disorder, B: Schizophrenia, C: Personality disorder, D: Agoraphobia + ### Response: Fear of leaving home, fear of travelling alone and fear of being in a crowd suggest the diagnosis of Agoraphobia. ### End" @@ -4264,6 +7621,13 @@ Fear of leaving home, fear of travelling alone and fear of being in a crowd sugg Answer the following medical question: The level of drug metabolizing enzymes in the liver determines how fast a drug is removed from the circulation. Therefore, it would be expected to find drug metabolizing enzymes, with the following options: A: Higher in smokers than in nonsmokers, B: Similar in smokers and nonsmokers, C: Lower in smokers than in nonsmokers, D: Simulated by malnutri on +### Response: +","Smokers inhale polycyclic aromatic hydrocarbons, which stimulate drug-metabolizing enzymes. Therefore, smokers have higher levels of hepa c drug-metabolizing enzymes than nonsmokers.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The level of drug metabolizing enzymes in the liver determines how fast a drug is removed from the circulation. Therefore, it would be expected to find drug metabolizing enzymes, with the following options: A: Higher in smokers than in nonsmokers, B: Similar in smokers and nonsmokers, C: Lower in smokers than in nonsmokers, D: Simulated by malnutri on + ### Response: Smokers inhale polycyclic aromatic hydrocarbons, which stimulate drug-metabolizing enzymes. Therefore, smokers have higher levels of hepa c drug-metabolizing enzymes than nonsmokers. ### End" @@ -4273,6 +7637,13 @@ Smokers inhale polycyclic aromatic hydrocarbons, which stimulate drug-metabolizi Answer the following medical question: False statement about amyloidosis is, with the following options: A: Made of calcified proteins, B: A complication of chronic infections, C: Associated with extracellular eosinophilic hyaline material, D: Apple green birefringence in polarized light +### Response: +","harshmohan textbook of pathology 7th edition. *extracellular deposition of fibrillar insoluble proteinatious substance called amyloid having common morphological appearance, staining propey and physical structures but with variable protein composition.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: False statement about amyloidosis is, with the following options: A: Made of calcified proteins, B: A complication of chronic infections, C: Associated with extracellular eosinophilic hyaline material, D: Apple green birefringence in polarized light + ### Response: harshmohan textbook of pathology 7th edition. *extracellular deposition of fibrillar insoluble proteinatious substance called amyloid having common morphological appearance, staining propey and physical structures but with variable protein composition. ### End" @@ -4282,6 +7653,13 @@ harshmohan textbook of pathology 7th edition. *extracellular deposition of fibri Answer the following medical question: Joint involved in rheumatoid arthritis are all EXCEPT:, with the following options: A: PIP, B: DIP, C: MCP, D: Cervical spine +### Response: +",ANSWER: (B) DIPREF: Apley's 8th e p. 51-58Commonly involved joints in RA:WristMCPPIPElbow7KneeAnkleMTPLess commonly involved joints:Upper cervical spine with atlanto axial subluxationHip jointTM jointSubtalar and foot jointsJoints not involved in RA:Lumbar spineDIP,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Joint involved in rheumatoid arthritis are all EXCEPT:, with the following options: A: PIP, B: DIP, C: MCP, D: Cervical spine + ### Response: ANSWER: (B) DIPREF: Apley's 8th e p. 51-58Commonly involved joints in RA:WristMCPPIPElbow7KneeAnkleMTPLess commonly involved joints:Upper cervical spine with atlanto axial subluxationHip jointTM jointSubtalar and foot jointsJoints not involved in RA:Lumbar spineDIP ### End" @@ -4291,6 +7669,13 @@ ANSWER: (B) DIPREF: Apley's 8th e p. 51-58Commonly involved joints in RA:WristMC Answer the following medical question: Commonest cause of posterior staphyloma:, with the following options: A: Glaucoma, B: Retinal detachment, C: Iridocyclitis, D: High myopia +### Response: +","Ans. D: High myopia Degenerative high axial myopia is the most common cause of posterior staphyloma Staphyloma It is an abnormal protrusion of the uveal tissue through a weak point in the eyeball. The protrusion is generally black in colour, due to the inner layers of the eye. It occurs due to weakening of outer layer of eye (cornea or sclera) by an inflammatory or degenerative condition. It may be of 5 types, depending on the location on the eye ball (bulbus oculi). Anterior (corneal) staphyloma In the anterior segment of the eye, involving the cornea and the nearby sclera. Intercalary staphyloma It is the name given to the localised bulge in limbal area, lined by the root of the iris. It results due to ectasia of weak scar tissue formed at the limbus, following healing of a perforating injury or a peripheral corneal ulcer. There may be associated secondary angle closure glaucoma, may cause progression of the bulge if not treated. Defective vision occurs due to marked corneal astigmatism. Treatment consists of localised staphylectomy under heavy doses of oral steroids. Ciliary staphyloma It is the bulge of weak sclera lined by ciliary body, which occurs about 2-3 mm away from the limbus. Its common causes are thinning of sclera following perforating injury, scleritis and absolute glaucoma. Equatorial staphyloma Seen on the equator of the eye (region circumferencing the largest diameter ohogonal to the visual axis). Its causes are scleritis and degeneration of sclera in pathological myopia. It occurs more commonly in the regions of sclera which are perforated by voex veins. Posterior staphyloma It is seen in the posterior segment of the eye, typically diagnosed at the region of the macula, deforming the eye in a way that the eye-length is extended associated with myopia (nearsightedness). It is diagnosed by ophthalmoscopy, which shows an area of retinal excavation in the region of the staphvloma","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Commonest cause of posterior staphyloma:, with the following options: A: Glaucoma, B: Retinal detachment, C: Iridocyclitis, D: High myopia + ### Response: Ans. D: High myopia Degenerative high axial myopia is the most common cause of posterior staphyloma Staphyloma It is an abnormal protrusion of the uveal tissue through a weak point in the eyeball. The protrusion is generally black in colour, due to the inner layers of the eye. It occurs due to weakening of outer layer of eye (cornea or sclera) by an inflammatory or degenerative condition. It may be of 5 types, depending on the location on the eye ball (bulbus oculi). Anterior (corneal) staphyloma In the anterior segment of the eye, involving the cornea and the nearby sclera. Intercalary staphyloma It is the name given to the localised bulge in limbal area, lined by the root of the iris. It results due to ectasia of weak scar tissue formed at the limbus, following healing of a perforating injury or a peripheral corneal ulcer. There may be associated secondary angle closure glaucoma, may cause progression of the bulge if not treated. Defective vision occurs due to marked corneal astigmatism. Treatment consists of localised staphylectomy under heavy doses of oral steroids. Ciliary staphyloma It is the bulge of weak sclera lined by ciliary body, which occurs about 2-3 mm away from the limbus. Its common causes are thinning of sclera following perforating injury, scleritis and absolute glaucoma. Equatorial staphyloma Seen on the equator of the eye (region circumferencing the largest diameter ohogonal to the visual axis). Its causes are scleritis and degeneration of sclera in pathological myopia. It occurs more commonly in the regions of sclera which are perforated by voex veins. Posterior staphyloma It is seen in the posterior segment of the eye, typically diagnosed at the region of the macula, deforming the eye in a way that the eye-length is extended associated with myopia (nearsightedness). It is diagnosed by ophthalmoscopy, which shows an area of retinal excavation in the region of the staphvloma ### End" @@ -4300,6 +7685,13 @@ Ans. D: High myopia Degenerative high axial myopia is the most common cause of p Answer the following medical question: Treatment of choice in Wegner's granulomatosis is, with the following options: A: Cyclosporine, B: Cyclophosphamide, C: Steroids, D: Radiotherapy +### Response: +","Answer- B. CyclophosphamideCyclophosphamide alongwith glucocoicoids is the treatment of choice, For selected patients whose disease is not immediately life threatening or in those patients who have experienced significant cyclophosphamide toxicity, methotrexate together with glucocoicoids may be considered as an alternative","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Treatment of choice in Wegner's granulomatosis is, with the following options: A: Cyclosporine, B: Cyclophosphamide, C: Steroids, D: Radiotherapy + ### Response: Answer- B. CyclophosphamideCyclophosphamide alongwith glucocoicoids is the treatment of choice, For selected patients whose disease is not immediately life threatening or in those patients who have experienced significant cyclophosphamide toxicity, methotrexate together with glucocoicoids may be considered as an alternative ### End" @@ -4309,6 +7701,13 @@ Answer- B. CyclophosphamideCyclophosphamide alongwith glucocoicoids is the treat Answer the following medical question: The lesions seen on this infants face are usually associated with?, with the following options: A: Acquired rubella, B: Congenital rubella, C: Syphilis, D: Rubeola +### Response: +","Congenital rubella - Blueberry muffins eruptions -Generalized dark blue to magenta, nonblanchable, indurated, hemispheric purpuric papules. Lesions or the head, neck, and trunk. Triad of congenital rubella:? Cataract? Congenital hea defects? Deafness","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The lesions seen on this infants face are usually associated with?, with the following options: A: Acquired rubella, B: Congenital rubella, C: Syphilis, D: Rubeola + ### Response: Congenital rubella - Blueberry muffins eruptions -Generalized dark blue to magenta, nonblanchable, indurated, hemispheric purpuric papules. Lesions or the head, neck, and trunk. Triad of congenital rubella:? Cataract? Congenital hea defects? Deafness ### End" @@ -4318,6 +7717,13 @@ Congenital rubella - Blueberry muffins eruptions -Generalized dark blue to magen Answer the following medical question: First epiphysis to appear around the elbow region is: March 2005, with the following options: A: Head of radius, B: Capitulum, C: Trochlea, D: Medial condyle +### Response: +",Ans. B: Capitulum The most commonly used mnemonic for the sequence of ossification around the elbow is CRITOE or CRITOL (mean ossification times) C- Capitulum (2 years) R- Radial head (4 years) I- Internal (medial) epicondyle (6 years) T- Trochlea (8 years) 0- Olecranon (9 years) E- External or Lateral epicondyle (12 years),"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: First epiphysis to appear around the elbow region is: March 2005, with the following options: A: Head of radius, B: Capitulum, C: Trochlea, D: Medial condyle + ### Response: Ans. B: Capitulum The most commonly used mnemonic for the sequence of ossification around the elbow is CRITOE or CRITOL (mean ossification times) C- Capitulum (2 years) R- Radial head (4 years) I- Internal (medial) epicondyle (6 years) T- Trochlea (8 years) 0- Olecranon (9 years) E- External or Lateral epicondyle (12 years) ### End" @@ -4327,6 +7733,13 @@ Ans. B: Capitulum The most commonly used mnemonic for the sequence of ossificati Answer the following medical question: The following may be used in erectile dysfunction except -, with the following options: A: Phenylephrine, B: Apomorphine, C: Alprostidil, D: All +### Response: +","Ans. is 'a' i.e., Phenylephrine Drugs used in erectile dysfunction Phosphodiesterase-5 inhibitors (Siledenafil, Todafil, Vardenafil). Alprastadil (Prostaglandin El) Papaverine Androgens Apomorphine","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The following may be used in erectile dysfunction except -, with the following options: A: Phenylephrine, B: Apomorphine, C: Alprostidil, D: All + ### Response: Ans. is 'a' i.e., Phenylephrine Drugs used in erectile dysfunction Phosphodiesterase-5 inhibitors (Siledenafil, Todafil, Vardenafil). Alprastadil (Prostaglandin El) Papaverine Androgens Apomorphine ### End" @@ -4336,6 +7749,13 @@ Ans. is 'a' i.e., Phenylephrine Drugs used in erectile dysfunction Phosphodieste Answer the following medical question: What is true about ulcerative colitis-, with the following options: A: Involves rectum and then whole colon backwards, B: Involves only colon, C: Skip lesions seen, D: Ileum not involved +### Response: +",Ulcerative colitis involves the rectum and extends proximally in a retrograde fashion to involve the entire colon (pancolitis) in more severe cases.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What is true about ulcerative colitis-, with the following options: A: Involves rectum and then whole colon backwards, B: Involves only colon, C: Skip lesions seen, D: Ileum not involved + ### Response: Ulcerative colitis involves the rectum and extends proximally in a retrograde fashion to involve the entire colon (pancolitis) in more severe cases. ### End" @@ -4345,6 +7765,13 @@ Ulcerative colitis involves the rectum and extends proximally in a retrograde fa Answer the following medical question: Steady state concentration of a drug is achieved in:-, with the following options: A: 2-3 half lives, B: 3-4 half lives, C: 4-5 half lives, D: 5-6 half lives +### Response: +","STEADY STATE - If fixed dose of a drug is administered after regular intervals, its plasma concentration stas increasing. - However, as plasma concentration rises, rate of elimination also stas increasing. When rate of administration becomes equal to rate of elimination, plasma concentration stabilizes. This is called steady state. - Time to reach steady state depends on t 1/2 . It takes approximately 4-5 half lives. - Steady state plasma concentration achieved depends on dose rate. - Variation between peak and trough concentration at steady state depends on dosing interval. However, average steady state plasma concentration remains same irrespective of dosing interval provided dose rate remains same.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Steady state concentration of a drug is achieved in:-, with the following options: A: 2-3 half lives, B: 3-4 half lives, C: 4-5 half lives, D: 5-6 half lives + ### Response: STEADY STATE - If fixed dose of a drug is administered after regular intervals, its plasma concentration stas increasing. - However, as plasma concentration rises, rate of elimination also stas increasing. When rate of administration becomes equal to rate of elimination, plasma concentration stabilizes. This is called steady state. - Time to reach steady state depends on t 1/2 . It takes approximately 4-5 half lives. - Steady state plasma concentration achieved depends on dose rate. - Variation between peak and trough concentration at steady state depends on dosing interval. However, average steady state plasma concentration remains same irrespective of dosing interval provided dose rate remains same. ### End" @@ -4354,6 +7781,13 @@ STEADY STATE - If fixed dose of a drug is administered after regular intervals, Answer the following medical question: Child of 1 year old presents with cough, cold and RR 40/minute. Your diagnosis is:, with the following options: A: No Pneumonia, B: Pneumonia, C: Severe Pneumonia, D: Very severe Pneumonia +### Response: +",Ans. A. No PneumoniaCut off criteria for diagnosing pneumonia in children depending upon age < 2 months: 60/minute 2 -12 months: 50/minute 12-5 years: 40/minute,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Child of 1 year old presents with cough, cold and RR 40/minute. Your diagnosis is:, with the following options: A: No Pneumonia, B: Pneumonia, C: Severe Pneumonia, D: Very severe Pneumonia + ### Response: Ans. A. No PneumoniaCut off criteria for diagnosing pneumonia in children depending upon age < 2 months: 60/minute 2 -12 months: 50/minute 12-5 years: 40/minute ### End" @@ -4363,6 +7797,13 @@ Ans. A. No PneumoniaCut off criteria for diagnosing pneumonia in children depend Answer the following medical question: All are precancerous lesions of oral cavity except, with the following options: A: Leukoplakia, B: Erythroplakia, C: Diffuse oral submucous fibrosis, D: Diffuse aphthous ulcers +### Response: +","Premalignant Lesions - Leukoplakia Erythroplakia Oral submucous fibrosis Melanosis and mucosal hyperpigmentation Ref: Dhingra; Textbook of Ear, Nose and Throat; 7th Edition; Page 253","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are precancerous lesions of oral cavity except, with the following options: A: Leukoplakia, B: Erythroplakia, C: Diffuse oral submucous fibrosis, D: Diffuse aphthous ulcers + ### Response: Premalignant Lesions - Leukoplakia Erythroplakia Oral submucous fibrosis Melanosis and mucosal hyperpigmentation Ref: Dhingra; Textbook of Ear, Nose and Throat; 7th Edition; Page 253 ### End" @@ -4372,6 +7813,13 @@ Premalignant Lesions - Leukoplakia Erythroplakia Oral submucous fibrosis Melanos Answer the following medical question: Lesch-Nyhan syndrome is caused by deficiency of which enzyme?, with the following options: A: Orotate Phosphoribosyl transferase, B: Uracil Phosphoribosyl transferase, C: Quinolinate Phosphoribosyl transferase, D: Hypoxanthine-guanine Phosphoribosyl transferase (HGPRT) +### Response: +","(D) Hypoxanthine-guanine Phosphoribosyl transferase (HGPRT)[?]LESCH-NYHAN SYNDROMEoMnemonic:-Lips and fingers are bitten-Excessive uric acid production-Self mutilation-Choreoathetosis-HGPRT deficiency-NYHAN sounds like man-Affects boys-X linked recessive[?]Lesch-Nyhan syndrome characterized by:oHyperuricaemia, excessive UA synthesis, neurological problems,-Spasticity, mental retardation and self-mutilation very severe or complete deficiency of HGPRTase.-X-linked males affected.-Defect also leads to excretion of elevated levels of Hypoxanthine and xanthine.-More than 200 mutations reported - these mutations to the loss of enz protein, loss of enzyme activity, km mutants, Enzyme with short half life.-Prenatal diagnosis:-1st trimester - chorionic biopsy-CORONATE-II trimester - HGPRT assays or cultured fibroblasts.[?]Lesch Nyhan SyndromeoIntroduction-Hypoxanthine Guanine Phosphoribosyltransferase (HGPRT) deficiency-X-linked genetic conditionoClinical Features-Neurological Symptoms: Severe neurological disease, characterized by self-mutilating behaviors such as lip and finger biting and/or head banging.-GoutoInvestigation: Serum uric acid level up to 20 times |, the uric acid in the | urine than in normal individuals.[?]Lesch-Nyhan Syndrome (LNS) Also known as Nyhan's syndrome, Kelly Seegmiller Syndrome and Juvenile GoutoIt is a hereditary Disorder of purine metabolism, characterized by mental retardation, self-mutation of the fingers and lips by biting, impaired renal function, and abnormal physical development.oIt is a recessive disease that is linked to the X chromosome.oIt is caused by a deficiency of the enzyme hypoxanthine-guanine phosphoribosyl transferase (HPRT)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Lesch-Nyhan syndrome is caused by deficiency of which enzyme?, with the following options: A: Orotate Phosphoribosyl transferase, B: Uracil Phosphoribosyl transferase, C: Quinolinate Phosphoribosyl transferase, D: Hypoxanthine-guanine Phosphoribosyl transferase (HGPRT) + ### Response: (D) Hypoxanthine-guanine Phosphoribosyl transferase (HGPRT)[?]LESCH-NYHAN SYNDROMEoMnemonic:-Lips and fingers are bitten-Excessive uric acid production-Self mutilation-Choreoathetosis-HGPRT deficiency-NYHAN sounds like man-Affects boys-X linked recessive[?]Lesch-Nyhan syndrome characterized by:oHyperuricaemia, excessive UA synthesis, neurological problems,-Spasticity, mental retardation and self-mutilation very severe or complete deficiency of HGPRTase.-X-linked males affected.-Defect also leads to excretion of elevated levels of Hypoxanthine and xanthine.-More than 200 mutations reported - these mutations to the loss of enz protein, loss of enzyme activity, km mutants, Enzyme with short half life.-Prenatal diagnosis:-1st trimester - chorionic biopsy-CORONATE-II trimester - HGPRT assays or cultured fibroblasts.[?]Lesch Nyhan SyndromeoIntroduction-Hypoxanthine Guanine Phosphoribosyltransferase (HGPRT) deficiency-X-linked genetic conditionoClinical Features-Neurological Symptoms: Severe neurological disease, characterized by self-mutilating behaviors such as lip and finger biting and/or head banging.-GoutoInvestigation: Serum uric acid level up to 20 times |, the uric acid in the | urine than in normal individuals.[?]Lesch-Nyhan Syndrome (LNS) Also known as Nyhan's syndrome, Kelly Seegmiller Syndrome and Juvenile GoutoIt is a hereditary Disorder of purine metabolism, characterized by mental retardation, self-mutation of the fingers and lips by biting, impaired renal function, and abnormal physical development.oIt is a recessive disease that is linked to the X chromosome.oIt is caused by a deficiency of the enzyme hypoxanthine-guanine phosphoribosyl transferase (HPRT) ### End" @@ -4381,6 +7829,13 @@ Answer the following medical question: Lesch-Nyhan syndrome is caused by deficie Answer the following medical question: Golgi receptors, with the following options: A: Inhibited by stretching of muscle, B: Stimulated by stretching of muscle, C: Both, D: None +### Response: +",(B) Stimulated by stretching of musc\e,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Golgi receptors, with the following options: A: Inhibited by stretching of muscle, B: Stimulated by stretching of muscle, C: Both, D: None + ### Response: (B) Stimulated by stretching of musc\e ### End" @@ -4390,6 +7845,13 @@ Answer the following medical question: Golgi receptors, with the following optio Answer the following medical question: Life span of LNGIUD is -, with the following options: A: 2 years, B: 5 years, C: 10 years, D: 12 years +### Response: +","Ans. is 'b' i.e., 5 years IUDsLife spanFirst generation:Lippe's loop (obsolete)--Second generationCopper-T--CuT-200-B4 yrCuT-2003yrCuT-220C--Nova-T5 yrMultiload - 2503 yr3755 yrCuT-3 80A10 yrThird generationProgestasert1 yrLNG-20 (Mirena)5 yr (Ref: Novak p263; Note that Park mentions the life span of mirena to be 10 yrs)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Life span of LNGIUD is -, with the following options: A: 2 years, B: 5 years, C: 10 years, D: 12 years + ### Response: Ans. is 'b' i.e., 5 years IUDsLife spanFirst generation:Lippe's loop (obsolete)--Second generationCopper-T--CuT-200-B4 yrCuT-2003yrCuT-220C--Nova-T5 yrMultiload - 2503 yr3755 yrCuT-3 80A10 yrThird generationProgestasert1 yrLNG-20 (Mirena)5 yr (Ref: Novak p263; Note that Park mentions the life span of mirena to be 10 yrs) ### End" @@ -4399,6 +7861,13 @@ Ans. is 'b' i.e., 5 years IUDsLife spanFirst generation:Lippe's loop (obsolete)- Answer the following medical question: True about cholera vibrios is -, with the following options: A: Can tolerate wide range of alkaline pH, B: Non motile bacilli, C: Can't be grown in media, D: All +### Response: +","Ans. is 'a' i.e., Can tolerate wide range of alkaline pH VIBRIO CHOLERAE Morphology - Gram negative - Bacilli - Non capsulated - Comma shaped - S-shaped or spiral form may be seen. - Arranged in parallel rows --> Fish in stream appearance. - Motile by polar flegellum ---> Daing type motility. - Actively motile vibrios suggest a 'Swarm of gnats' . Culture characteristic - Strongly aerobic (obligate aerobe) - Growth is better in alkaline medium (pH 6-4-9.6) - 0.5-1% Nacl is required for optimal growth. - MaConkeys agar --> Initial colourless colonies, later become reddish due to late lactose fermentation. - Blood agar --> Initially sorrounded by a zone of greening, which later become clear due to hemodigestion. - In gelatin stab culture, infundibulifornz (funnel shaped) or napiform (turnip shaped) liquefaction occur. Remember . While 0.5-1% NaCl is required for optimal growth, 6% or above NaCl inhibits the growth.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about cholera vibrios is -, with the following options: A: Can tolerate wide range of alkaline pH, B: Non motile bacilli, C: Can't be grown in media, D: All + ### Response: Ans. is 'a' i.e., Can tolerate wide range of alkaline pH VIBRIO CHOLERAE Morphology - Gram negative - Bacilli - Non capsulated - Comma shaped - S-shaped or spiral form may be seen. - Arranged in parallel rows --> Fish in stream appearance. - Motile by polar flegellum ---> Daing type motility. - Actively motile vibrios suggest a 'Swarm of gnats' . Culture characteristic - Strongly aerobic (obligate aerobe) - Growth is better in alkaline medium (pH 6-4-9.6) - 0.5-1% Nacl is required for optimal growth. - MaConkeys agar --> Initial colourless colonies, later become reddish due to late lactose fermentation. - Blood agar --> Initially sorrounded by a zone of greening, which later become clear due to hemodigestion. - In gelatin stab culture, infundibulifornz (funnel shaped) or napiform (turnip shaped) liquefaction occur. Remember . While 0.5-1% NaCl is required for optimal growth, 6% or above NaCl inhibits the growth. ### End" @@ -4408,6 +7877,13 @@ Ans. is 'a' i.e., Can tolerate wide range of alkaline pH VIBRIO CHOLERAE Morphol Answer the following medical question: Somatomedin mediates, with the following options: A: Deposition of chondroitin sulfate, B: Lipolysis, C: Gluconeogenesis, D: Decreased rate of glucose uptake by cells +### Response: +","Somatomedin is a group of peptides found in the liver and in other tissues which mediate the effect of growth hormone (somatotropin)on cailage; also called insulin-like growth factor II, is synthesized in the liver and probably in the kidney; it is capable of stimulating ceain anabolic processes in bone and cailage, such as synthesis of DNA, RNA, and protein (including chondro mucoprotein), and the sulfation of mucopolysaccharides; secretion and biologic activity of somatomedin is known to depend on somatotropin.Ref: Ganong&;s review of medical physiology; 24th edition; page no:-327","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Somatomedin mediates, with the following options: A: Deposition of chondroitin sulfate, B: Lipolysis, C: Gluconeogenesis, D: Decreased rate of glucose uptake by cells + ### Response: Somatomedin is a group of peptides found in the liver and in other tissues which mediate the effect of growth hormone (somatotropin)on cailage; also called insulin-like growth factor II, is synthesized in the liver and probably in the kidney; it is capable of stimulating ceain anabolic processes in bone and cailage, such as synthesis of DNA, RNA, and protein (including chondro mucoprotein), and the sulfation of mucopolysaccharides; secretion and biologic activity of somatomedin is known to depend on somatotropin.Ref: Ganong&;s review of medical physiology; 24th edition; page no:-327 ### End" @@ -4417,6 +7893,13 @@ Somatomedin is a group of peptides found in the liver and in other tissues which Answer the following medical question: Piles occurs at-, with the following options: A: Superior rectal vein, B: Inferior rectal vein, C: Superior Hemorrhoidal aery, D: None +### Response: +","Answer- A. Superior rectal veinInternal hemorrhoids in association with superior rectal vessels are located at 3, 7 and 11 O'clock positions corresponding to left, right posterior and right anterior branches of these vessels.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Piles occurs at-, with the following options: A: Superior rectal vein, B: Inferior rectal vein, C: Superior Hemorrhoidal aery, D: None + ### Response: Answer- A. Superior rectal veinInternal hemorrhoids in association with superior rectal vessels are located at 3, 7 and 11 O'clock positions corresponding to left, right posterior and right anterior branches of these vessels. ### End" @@ -4426,6 +7909,13 @@ Answer- A. Superior rectal veinInternal hemorrhoids in association with superior Answer the following medical question: Which of the following is not a common manifestation of nephrotic syndrome?, with the following options: A: Hyperlipidemia, B: Hematuria, C: Anasarca, D: Hypoalbuminemia +### Response: +","Nephrotic syndrome is characterized by: Heavy/'nephrotic range' proteinuria (more than 3.5 g/day), Hypoalbuminemia, Severe edema or anasarca, Hyperlipidemia, and Lipiduria (lipid in the urine) Hematuria is seen in nephritic syndrome.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is not a common manifestation of nephrotic syndrome?, with the following options: A: Hyperlipidemia, B: Hematuria, C: Anasarca, D: Hypoalbuminemia + ### Response: Nephrotic syndrome is characterized by: Heavy/'nephrotic range' proteinuria (more than 3.5 g/day), Hypoalbuminemia, Severe edema or anasarca, Hyperlipidemia, and Lipiduria (lipid in the urine) Hematuria is seen in nephritic syndrome. ### End" @@ -4435,6 +7925,13 @@ Nephrotic syndrome is characterized by: Heavy/'nephrotic range' proteinuria (mor Answer the following medical question: Insulin release due to K+ closure is seen with, with the following options: A: Nateglinide, B: Acarbose, C: Exenatide, D: Sitagliptin +### Response: +",Glinides acts by the closure of potassium channels like sulphonylureas REF KD TRIpathi 8th ed,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Insulin release due to K+ closure is seen with, with the following options: A: Nateglinide, B: Acarbose, C: Exenatide, D: Sitagliptin + ### Response: Glinides acts by the closure of potassium channels like sulphonylureas REF KD TRIpathi 8th ed ### End" @@ -4444,6 +7941,13 @@ Glinides acts by the closure of potassium channels like sulphonylureas REF KD TR Answer the following medical question: All of the following nerves are commonly used for grafting except -, with the following options: A: Medial antebrachial Cutaneous nerve, B: Dorsal sensory branch of vagal nerve, C: Musculocutaneous nerve, D: Sural nerve +### Response: +",Answer- C. Musculocutaneous nerveMost common nerves used for grafting:Medial antebrachial Cutaneous nerveDorsal sensory branch of vagal nerveGreater AuricularSural nerve,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following nerves are commonly used for grafting except -, with the following options: A: Medial antebrachial Cutaneous nerve, B: Dorsal sensory branch of vagal nerve, C: Musculocutaneous nerve, D: Sural nerve + ### Response: Answer- C. Musculocutaneous nerveMost common nerves used for grafting:Medial antebrachial Cutaneous nerveDorsal sensory branch of vagal nerveGreater AuricularSural nerve ### End" @@ -4453,6 +7957,13 @@ Answer- C. Musculocutaneous nerveMost common nerves used for grafting:Medial ant Answer the following medical question: The bluish discoloration of vaginal mucosa in 8th week of pregnancy is called, with the following options: A: Jacquemier's sign, B: Goodell's sign, C: Hegar's sign, D: Palmer's sign +### Response: +",Jacquemier's sign or Chadwick's sign This is the bluish discoloration of the vaginal mucosa due to pelvic congestion. It is seen about 8th week of pregnancy. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 330,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The bluish discoloration of vaginal mucosa in 8th week of pregnancy is called, with the following options: A: Jacquemier's sign, B: Goodell's sign, C: Hegar's sign, D: Palmer's sign + ### Response: Jacquemier's sign or Chadwick's sign This is the bluish discoloration of the vaginal mucosa due to pelvic congestion. It is seen about 8th week of pregnancy. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 330 ### End" @@ -4462,6 +7973,13 @@ Jacquemier's sign or Chadwick's sign This is the bluish discoloration of the vag Answer the following medical question: In AIDS, lymphadenopathy is most often due to ?, with the following options: A: TB, B: Lymphoma, C: Non specific enlargement of lymph node, D: Kaposi's sarcoma +### Response: +","Answer is 'c' i.e. Non specific enlargement of lymph node In AIDS, the lymphadenopathy is most often due to the chronic non specific lymphadenitis producing follicular hyperplasia.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In AIDS, lymphadenopathy is most often due to ?, with the following options: A: TB, B: Lymphoma, C: Non specific enlargement of lymph node, D: Kaposi's sarcoma + ### Response: Answer is 'c' i.e. Non specific enlargement of lymph node In AIDS, the lymphadenopathy is most often due to the chronic non specific lymphadenitis producing follicular hyperplasia. ### End" @@ -4471,6 +7989,13 @@ Answer is 'c' i.e. Non specific enlargement of lymph node In AIDS, the lymphaden Answer the following medical question: Comment on the diagnosis., with the following options: A: Turner syndrome, B: Klinefelter syndrome, C: Down syndrome, D: Cridu-chat syndrome +### Response: +",Ans. (a) Turner syndrome.Image source-,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Comment on the diagnosis., with the following options: A: Turner syndrome, B: Klinefelter syndrome, C: Down syndrome, D: Cridu-chat syndrome + ### Response: Ans. (a) Turner syndrome.Image source- ### End" @@ -4480,6 +8005,13 @@ Ans. (a) Turner syndrome.Image source- Answer the following medical question: Recurrent epistaxis in a 15 year old female the most common cause is:, with the following options: A: juvenile nasopharyngeal fibroma, B: Rhinosporidiosis, C: Foreign body, D: Hematopoietic disorder +### Response: +",Answer is not given any where but we can come to correct conclusion by: option a is juvenile nasopharyngeal fibroma option b is rhinosporidiosis is a cause of epistaxis but usually occurs in young males from India. option c is foreign body which is cause of epistaxis in children and is not commonly seen in 15 years of age. so we are left with hematopoietic disorder which can be seen in a 15 year old female.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Recurrent epistaxis in a 15 year old female the most common cause is:, with the following options: A: juvenile nasopharyngeal fibroma, B: Rhinosporidiosis, C: Foreign body, D: Hematopoietic disorder + ### Response: Answer is not given any where but we can come to correct conclusion by: option a is juvenile nasopharyngeal fibroma option b is rhinosporidiosis is a cause of epistaxis but usually occurs in young males from India. option c is foreign body which is cause of epistaxis in children and is not commonly seen in 15 years of age. so we are left with hematopoietic disorder which can be seen in a 15 year old female. ### End" @@ -4489,6 +8021,13 @@ Answer is not given any where but we can come to correct conclusion by: option a Answer the following medical question: Alderman Nerve is:, with the following options: A: Nerve to Pterygoid, B: Nervus Intermedius, C: Auricular Branch of Vagus Nerve, D: Tympanic branch of Glossopharyngeal Nerve +### Response: +","Ans. C. Auricular Branch of Vagus NerveThe auricular branch of the vagus nerve is often termed the Alderman's nerve or Arnold's nerve. The latter name is an eponym for Friedrich Arnold. It supplies sensory innervation to the skin of the ear canal, tragus, and auricle.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Alderman Nerve is:, with the following options: A: Nerve to Pterygoid, B: Nervus Intermedius, C: Auricular Branch of Vagus Nerve, D: Tympanic branch of Glossopharyngeal Nerve + ### Response: Ans. C. Auricular Branch of Vagus NerveThe auricular branch of the vagus nerve is often termed the Alderman's nerve or Arnold's nerve. The latter name is an eponym for Friedrich Arnold. It supplies sensory innervation to the skin of the ear canal, tragus, and auricle. ### End" @@ -4499,13 +8038,27 @@ Ans. C. Auricular Branch of Vagus NerveThe auricular branch of the vagus nerve i Answer the following medical question: CrPC 26 -, with the following options: A: Division of offence, B: Division of negligence, C: Division of malpractice, D: None ### Response: -Ans. is 'a' i.e.. Division of offenceo According to Sec 26 of CrPC, 1973, Offences under the Criminal Procedure Code (hereinafter the ""CrPC1') are divided into:1. Offences under Indian Penal Code (IPC) (triable by HC, Sessions Court and other court shown in the 1st Schedule to the CrPC)2. Offences under any other law (empowers HC, when no court is mentioned for any offence under any law other than IPC, to try such offences) -### End" -478,"Below is an instruction that describes a task. Write a response that appropriately completes the request. +","Ans. is 'a' i.e.. Division of offenceo According to Sec 26 of CrPC, 1973, Offences under the Criminal Procedure Code (hereinafter the ""CrPC1') are divided into:1. Offences under Indian Penal Code (IPC) (triable by HC, Sessions Court and other court shown in the 1st Schedule to the CrPC)2. Offences under any other law (empowers HC, when no court is mentioned for any offence under any law other than IPC, to try such offences)","Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: -Answer the following medical question: Most appropriate management of advanced stage rectal carcinoma, with the following options: A: Anterior resection, B: Abdominoperineal resection, C: Proximal colostomy, D: Ileostomy +Answer the following medical question: CrPC 26 -, with the following options: A: Division of offence, B: Division of negligence, C: Division of malpractice, D: None + +### Response: +Ans. is 'a' i.e.. Division of offenceo According to Sec 26 of CrPC, 1973, Offences under the Criminal Procedure Code (hereinafter the ""CrPC1') are divided into:1. Offences under Indian Penal Code (IPC) (triable by HC, Sessions Court and other court shown in the 1st Schedule to the CrPC)2. Offences under any other law (empowers HC, when no court is mentioned for any offence under any law other than IPC, to try such offences) +### End" +478,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most appropriate management of advanced stage rectal carcinoma, with the following options: A: Anterior resection, B: Abdominoperineal resection, C: Proximal colostomy, D: Ileostomy + +### Response: +","(B) Abdominoperineal resection # 'RECTAL CARCINOMA' located at 5 cm from the anal verge lies in the lower rectum.> Considering the conventional methods of treatments Anterior resection is possible for tumors of upper 2/3rd of rectum Abdominoperineal resection is indicated for tumors of lower 1/3rd of rectum> General site specific plan> Upper Rectum (> 11 cm) Anterior Resection , Mid Rectum (6-11 cm) Low Anterior resection , Lower Rectum (< 6 cm) Abdominal- perineal resection> Note: Length of rectum is about 12 to 15 cm and the anal canal is about 4 cm, any tumor 5 cm from anal verge would thus lie at lower rectum.> General considerations for tumors in lower Rectum: Abdominoperineal Resection (APR) is the gold standard for the treatment of distal rectal cancer. 'APR' involves complete excision of rectum and anus, by concomitant dissection through abdomen and perineum, with permanent closure of perineal rafe and creation of an end colostomy. The most significant disadvantage of this procedure is that it sacrifices the sphincter mechanism and hence now focus is shifting towards a number of sphincter sparing procedures.> It is important however to note here that the information provided is too limited to comment upon the possibility of performing sphincter saving procedures such as local resection or a posterior proctotomy.> Sphincter sparing procedures may be carried out for Young patients who have a favourable body habitus Patients with good preoperative sphincter function Lack of sphincter involvement by tumor Limited extension of tumor into rectal wall (T1 or T2 lesions) Low grade tumors> Sphincter sparing procedures include: Colonal anastomosis Local excision Transanal excision Trans sphincteric excision Posterior proctotomy (Kraske procedure)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most appropriate management of advanced stage rectal carcinoma, with the following options: A: Anterior resection, B: Abdominoperineal resection, C: Proximal colostomy, D: Ileostomy ### Response: (B) Abdominoperineal resection # 'RECTAL CARCINOMA' located at 5 cm from the anal verge lies in the lower rectum.> Considering the conventional methods of treatments Anterior resection is possible for tumors of upper 2/3rd of rectum Abdominoperineal resection is indicated for tumors of lower 1/3rd of rectum> General site specific plan> Upper Rectum (> 11 cm) Anterior Resection , Mid Rectum (6-11 cm) Low Anterior resection , Lower Rectum (< 6 cm) Abdominal- perineal resection> Note: Length of rectum is about 12 to 15 cm and the anal canal is about 4 cm, any tumor 5 cm from anal verge would thus lie at lower rectum.> General considerations for tumors in lower Rectum: Abdominoperineal Resection (APR) is the gold standard for the treatment of distal rectal cancer. 'APR' involves complete excision of rectum and anus, by concomitant dissection through abdomen and perineum, with permanent closure of perineal rafe and creation of an end colostomy. The most significant disadvantage of this procedure is that it sacrifices the sphincter mechanism and hence now focus is shifting towards a number of sphincter sparing procedures.> It is important however to note here that the information provided is too limited to comment upon the possibility of performing sphincter saving procedures such as local resection or a posterior proctotomy.> Sphincter sparing procedures may be carried out for Young patients who have a favourable body habitus Patients with good preoperative sphincter function Lack of sphincter involvement by tumor Limited extension of tumor into rectal wall (T1 or T2 lesions) Low grade tumors> Sphincter sparing procedures include: Colonal anastomosis Local excision Transanal excision Trans sphincteric excision Posterior proctotomy (Kraske procedure) @@ -4516,6 +8069,13 @@ Answer the following medical question: Most appropriate management of advanced s Answer the following medical question: Which of the following is not included in an adoption triad, with the following options: A: Adoptive parent, B: Adopted child, C: Hospital from which the child is adopted, D: Bih parent +### Response: +",Adoption triad includes : Bih parents Adoptive parents Adopted child Adoption triad does not include the hospital from which the child is adopted.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is not included in an adoption triad, with the following options: A: Adoptive parent, B: Adopted child, C: Hospital from which the child is adopted, D: Bih parent + ### Response: Adoption triad includes : Bih parents Adoptive parents Adopted child Adoption triad does not include the hospital from which the child is adopted. ### End" @@ -4525,6 +8085,13 @@ Adoption triad includes : Bih parents Adoptive parents Adopted child Adoption tr Answer the following medical question: Jarisch Herxheimer reaction is commonly seen in-, with the following options: A: Early syphilis, B: Late congenital syphilis, C: Latent syphilis, D: Syphilis of cardiovascular system +### Response: +","Jarisch herxheimer reaction acute self limiting febrile reaction that follow antibiotic therapy for syphilis develops after few hrs after initiation of treatment avg-6-7 hrs common in : early syphilis, secondary syphilis subsides in 12-48hrs clinical features: flu like symptoms, myalgia, ahralgias, headache,fever and hypotension lab: elevated neutrophils, and raised esr treatment: rest, asprin prevention : prednisone exercises 5mg aid 2 days prior to Rex, chlorphenaramine maleate prior to penicillin injection iadvl textbook of dermatology page 1836","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Jarisch Herxheimer reaction is commonly seen in-, with the following options: A: Early syphilis, B: Late congenital syphilis, C: Latent syphilis, D: Syphilis of cardiovascular system + ### Response: Jarisch herxheimer reaction acute self limiting febrile reaction that follow antibiotic therapy for syphilis develops after few hrs after initiation of treatment avg-6-7 hrs common in : early syphilis, secondary syphilis subsides in 12-48hrs clinical features: flu like symptoms, myalgia, ahralgias, headache,fever and hypotension lab: elevated neutrophils, and raised esr treatment: rest, asprin prevention : prednisone exercises 5mg aid 2 days prior to Rex, chlorphenaramine maleate prior to penicillin injection iadvl textbook of dermatology page 1836 ### End" @@ -4534,6 +8101,13 @@ Jarisch herxheimer reaction acute self limiting febrile reaction that follow ant Answer the following medical question: Total amount of CNS in CSF ?, with the following options: A: 100-150ml, B: 300-350 ml, C: 500-550 ml, D: 600-650ml +### Response: +","Ans. is 'a' i.e., 100-150 mlThe major source of CSF is the choroidal plexus of all 4 ventricles, mainly in two lateral ventricles.Other sources of CSF are ependymal cells of the ventricles and the brain itself, perivascular spaces.The total volume of CSF in an adult is about 125-150 ml.The rate of formation of CSF is about 500-550 ml/day. Thus the CSF is replaced 3-4 times every day.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Total amount of CNS in CSF ?, with the following options: A: 100-150ml, B: 300-350 ml, C: 500-550 ml, D: 600-650ml + ### Response: Ans. is 'a' i.e., 100-150 mlThe major source of CSF is the choroidal plexus of all 4 ventricles, mainly in two lateral ventricles.Other sources of CSF are ependymal cells of the ventricles and the brain itself, perivascular spaces.The total volume of CSF in an adult is about 125-150 ml.The rate of formation of CSF is about 500-550 ml/day. Thus the CSF is replaced 3-4 times every day. ### End" @@ -4543,6 +8117,13 @@ Ans. is 'a' i.e., 100-150 mlThe major source of CSF is the choroidal plexus of a Answer the following medical question: Gastric acid secretion is decreased by all except:, with the following options: A: Somatostatin, B: Histamine, C: Cholecystokinin, D: Prostaglandins +### Response: +","Enteric hormones that inhibit H+ secretion Hormone Source CCK I cells of duodenum and jejunum and neurons in ileum and colon Secretin S cells in small intestine VIP ENS neurons GIP K cells in duodenum and jejunum Neurotensin Endocrine cells in ileum Peptide YY Endocrine cells in ileum and colon Somatostatin D cells of stomach and duodenum, & cells of pancreatic islets","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Gastric acid secretion is decreased by all except:, with the following options: A: Somatostatin, B: Histamine, C: Cholecystokinin, D: Prostaglandins + ### Response: Enteric hormones that inhibit H+ secretion Hormone Source CCK I cells of duodenum and jejunum and neurons in ileum and colon Secretin S cells in small intestine VIP ENS neurons GIP K cells in duodenum and jejunum Neurotensin Endocrine cells in ileum Peptide YY Endocrine cells in ileum and colon Somatostatin D cells of stomach and duodenum, & cells of pancreatic islets ### End" @@ -4552,6 +8133,13 @@ Enteric hormones that inhibit H+ secretion Hormone Source CCK I cells of duodenu Answer the following medical question: Which of the following syndromes have mitochondrial inheritance?, with the following options: A: Leigh's syndrome, B: NARP syndrome, C: MELAS syndrome, D: All of the above +### Response: +",All are example of mitochondrial inheritance.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following syndromes have mitochondrial inheritance?, with the following options: A: Leigh's syndrome, B: NARP syndrome, C: MELAS syndrome, D: All of the above + ### Response: All are example of mitochondrial inheritance. ### End" @@ -4561,6 +8149,13 @@ All are example of mitochondrial inheritance. Answer the following medical question: A young man is prescribed parenteral antibiotics for respiratory tract infection. He collapses immediately after receiving the first dose, with tachycaiidia,wheezing,and a drop in blood pressure. The most appropriate immediate interventions this situation would be to administer -, with the following options: A: Intravenous saline, B: Intravenous hydrocoisone, C: Subcutaneous epinephrine, D: Nebulized salbutamol +### Response: +","anaphylactoid reactions usually manifest in the skin and gastrointestinal, respiratory, and cardiovascular systems. Primary symptoms and signs include pruritus, uicaria, nausea, vomiting, abdominal cramps, bronchospasm, laryngeal edema, and, occasionally, anaphylactic shock with hypotension,and death. They occur within minutes of drug exposure. Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, and radiocontrast media are frequent causes of direct mast cell degranulation or anaphylactoid reactions, which can occur on first exposure. Penicillins and muscle relaxants used in general anesthesia are the most frequent causes of IgE-dependent reactions to drugs, which require prior sensitization. ref:harrison&;s principles of internal medicine,ed 18,pg no 3132","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A young man is prescribed parenteral antibiotics for respiratory tract infection. He collapses immediately after receiving the first dose, with tachycaiidia,wheezing,and a drop in blood pressure. The most appropriate immediate interventions this situation would be to administer -, with the following options: A: Intravenous saline, B: Intravenous hydrocoisone, C: Subcutaneous epinephrine, D: Nebulized salbutamol + ### Response: anaphylactoid reactions usually manifest in the skin and gastrointestinal, respiratory, and cardiovascular systems. Primary symptoms and signs include pruritus, uicaria, nausea, vomiting, abdominal cramps, bronchospasm, laryngeal edema, and, occasionally, anaphylactic shock with hypotension,and death. They occur within minutes of drug exposure. Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, and radiocontrast media are frequent causes of direct mast cell degranulation or anaphylactoid reactions, which can occur on first exposure. Penicillins and muscle relaxants used in general anesthesia are the most frequent causes of IgE-dependent reactions to drugs, which require prior sensitization. ref:harrison&;s principles of internal medicine,ed 18,pg no 3132 ### End" @@ -4570,6 +8165,13 @@ anaphylactoid reactions usually manifest in the skin and gastrointestinal, respi Answer the following medical question: True about High roughage in diet is :, with the following options: A: Decreases stool transit time, B: Increase stool transit time, C: Normalise stool transit, D: No effect on stool transit time +### Response: +",A i.e. Decreases stool transit time,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about High roughage in diet is :, with the following options: A: Decreases stool transit time, B: Increase stool transit time, C: Normalise stool transit, D: No effect on stool transit time + ### Response: A i.e. Decreases stool transit time ### End" @@ -4579,6 +8181,13 @@ A i.e. Decreases stool transit time Answer the following medical question: The Epwoh scale is used for assessing?, with the following options: A: Body mass index, B: Vital capacity in post-operative patients, C: Sleep apnea, D: Risk of embolism in perioperative patient +### Response: +","The Epwoh sleepiness scale has been validated primarily in obstructive sleep apnea, though it has also shown success in detecting narcolepsy and idiopathic hypersomnia. It is used to measure excessive daytime sleepiness and is repeated after the administration of treatment (e.g. CPAP) to document improvement of symptoms. Fill up a questionnaire and if score is >8 medical advices is recommended and a polysomnography should be done. In narcolepsy, the Epwoh sleepiness scale has both a high specificity (100%) and sensitivity (93.5%).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The Epwoh scale is used for assessing?, with the following options: A: Body mass index, B: Vital capacity in post-operative patients, C: Sleep apnea, D: Risk of embolism in perioperative patient + ### Response: The Epwoh sleepiness scale has been validated primarily in obstructive sleep apnea, though it has also shown success in detecting narcolepsy and idiopathic hypersomnia. It is used to measure excessive daytime sleepiness and is repeated after the administration of treatment (e.g. CPAP) to document improvement of symptoms. Fill up a questionnaire and if score is >8 medical advices is recommended and a polysomnography should be done. In narcolepsy, the Epwoh sleepiness scale has both a high specificity (100%) and sensitivity (93.5%). ### End" @@ -4588,6 +8197,13 @@ The Epwoh sleepiness scale has been validated primarily in obstructive sleep apn Answer the following medical question: Maximum oral bioavailability among statins is of which drug -, with the following options: A: Fluvastatin, B: Atorvastatin, C: Pravastatin, D: Simvastatin +### Response: +","Ans. is 'a' i.e., Fluvastatino All statins can be absorbed orally (maximum fluvastatin). Food increases absorption of all drugs except pravastatin. Lovastatin and simvastatin undergo extensive first pass metabolism and are administered as prodrugs.Remembero Statins are the most effective and best tolerated hypolipidemic drugs,o All Statins, except rosuvastatin and pravastatin are metabolized.o Food increases absorption of all statins except pravastatin.o Lovastatin and simvastatin are prodrugs, while pravastatin, fluvastatin, ator\>astatin and rosuvastatin are administered in active form.o Rosuvastatin is the longest acting and most potent statin,o Rosuvastatin causes greater rise in HDL - cholesterol than other statins,o Pravastatin decreases plasma fibrinogen level,o Atorvastatin has additional antioxidant property.o Because HMG-CoA reductase activity is maximum at midnight, all statins are administered at bed time to obtain maximum effectiveness. However, this is not necessary? for atorvastatin and rosuvastatin, which have long plasma t 1/2 .o Statins also have pleotropic effects (antioxidant, antiinflammatory and antiproliferative properties) which are responsible for lowering the risk of athrosclerosis.o Statins are the first choice drugs for primary hyperlipidemias with raised LDL and total CH (Type IIa, lIb, V) as well as for secondary hypercholesterolaemia.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Maximum oral bioavailability among statins is of which drug -, with the following options: A: Fluvastatin, B: Atorvastatin, C: Pravastatin, D: Simvastatin + ### Response: Ans. is 'a' i.e., Fluvastatino All statins can be absorbed orally (maximum fluvastatin). Food increases absorption of all drugs except pravastatin. Lovastatin and simvastatin undergo extensive first pass metabolism and are administered as prodrugs.Remembero Statins are the most effective and best tolerated hypolipidemic drugs,o All Statins, except rosuvastatin and pravastatin are metabolized.o Food increases absorption of all statins except pravastatin.o Lovastatin and simvastatin are prodrugs, while pravastatin, fluvastatin, ator\>astatin and rosuvastatin are administered in active form.o Rosuvastatin is the longest acting and most potent statin,o Rosuvastatin causes greater rise in HDL - cholesterol than other statins,o Pravastatin decreases plasma fibrinogen level,o Atorvastatin has additional antioxidant property.o Because HMG-CoA reductase activity is maximum at midnight, all statins are administered at bed time to obtain maximum effectiveness. However, this is not necessary? for atorvastatin and rosuvastatin, which have long plasma t 1/2 .o Statins also have pleotropic effects (antioxidant, antiinflammatory and antiproliferative properties) which are responsible for lowering the risk of athrosclerosis.o Statins are the first choice drugs for primary hyperlipidemias with raised LDL and total CH (Type IIa, lIb, V) as well as for secondary hypercholesterolaemia. ### End" @@ -4597,6 +8213,13 @@ Ans. is 'a' i.e., Fluvastatino All statins can be absorbed orally (maximum fluva Answer the following medical question: In flap method of amputation, which structure is kept shoer than the level of amputation?, with the following options: A: Bone, B: Muscles, C: Nerves, D: Vessels +### Response: +","Bone is kept shoer than soft tissue in flap method of amputation to facilitate closure of amputation stump. Also know: In guillotine amputation, limb is transected at one level through skin, muscle and bone. Ref: Campbell's operative Ohopaedics 10/e, page 544.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In flap method of amputation, which structure is kept shoer than the level of amputation?, with the following options: A: Bone, B: Muscles, C: Nerves, D: Vessels + ### Response: Bone is kept shoer than soft tissue in flap method of amputation to facilitate closure of amputation stump. Also know: In guillotine amputation, limb is transected at one level through skin, muscle and bone. Ref: Campbell's operative Ohopaedics 10/e, page 544. ### End" @@ -4606,6 +8229,24 @@ Bone is kept shoer than soft tissue in flap method of amputation to facilitate c Answer the following medical question: A 2 year old boy suffering from leukemia, following are the x–ray findings –a) Osteolytic lesion in flat bonesb) Metaphyseal osteoporosisc) Periosteal new bone formationd) Osteosclerosis of long bonese) Transverse line of dark band below the growth plate, with the following options: A: ab, B: bce, C: acd, D: ace +### Response: +","Characteristically, there are zones of rarefaction with delicate subperiosteal new bone formation in the metaphysial regions of femur, humerus or spine and pelvis. +X-ray reveals subepriosteal and subepiphyseal resorption of bones. +Dark bands above the metaphysis called Growth Arrest Lines. +Metaphyseal lucencies affects maximum growth. +Osteolytic lesions seen in half of the cases and is commonest in shaft of long bones. +Osteoblastic lesions are rare, occur in metaphysis. +ALL may show following features on X-ray. + + +Periosteal Reaction +Metaphyseal cortical erosions +Altered medullary trabeculations, subepiphyseal bone resorption.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 2 year old boy suffering from leukemia, following are the x–ray findings –a) Osteolytic lesion in flat bonesb) Metaphyseal osteoporosisc) Periosteal new bone formationd) Osteosclerosis of long bonese) Transverse line of dark band below the growth plate, with the following options: A: ab, B: bce, C: acd, D: ace + ### Response: Characteristically, there are zones of rarefaction with delicate subperiosteal new bone formation in the metaphysial regions of femur, humerus or spine and pelvis. X-ray reveals subepriosteal and subepiphyseal resorption of bones. @@ -4626,6 +8267,13 @@ Altered medullary trabeculations, subepiphyseal bone resorption. Answer the following medical question: A 17 year old girl with acne has been taking a drug for the last two years. She now presents with blue black pigmentation of nails. The likely medication causing the above pigmentation is:, with the following options: A: Tetracycline, B: Minocycline, C: Doxycycline, D: Azithromycin +### Response: +","There may be diffuse blue-gray, muddy appearance in sun exposed areas and hyperpigmentation of mucous membranes, teeth, nails, bones and thyroid in patients taking minocycline for longer duration. Ref: Skin Diseases and Sexually Transmitted Infection, Uday Khopkar, 6th Edition, Page 110; Handbook of Dermatologic Drug Therapy By Steven R. Feldman, Kathy C. Phelps, Kelly Campbell Verzino, Page 42; Harrison's Principles of Internal Medicine, 16th Edition, Pages 303, 1229.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 17 year old girl with acne has been taking a drug for the last two years. She now presents with blue black pigmentation of nails. The likely medication causing the above pigmentation is:, with the following options: A: Tetracycline, B: Minocycline, C: Doxycycline, D: Azithromycin + ### Response: There may be diffuse blue-gray, muddy appearance in sun exposed areas and hyperpigmentation of mucous membranes, teeth, nails, bones and thyroid in patients taking minocycline for longer duration. Ref: Skin Diseases and Sexually Transmitted Infection, Uday Khopkar, 6th Edition, Page 110; Handbook of Dermatologic Drug Therapy By Steven R. Feldman, Kathy C. Phelps, Kelly Campbell Verzino, Page 42; Harrison's Principles of Internal Medicine, 16th Edition, Pages 303, 1229. ### End" @@ -4635,6 +8283,13 @@ There may be diffuse blue-gray, muddy appearance in sun exposed areas and hyperp Answer the following medical question: Which of the following is an example of feedforward mechanism?, with the following options: A: Increase blood pressure during supine posture, B: Salivation on smelling food, C: Shivering on exposure to cold environment, D: None of the above +### Response: +","Ans. (c) Shivering on exposure to cold environmentRef: Ganongs Review of Medical Physiology 25th Ed; Page No- 249* Thermoreceptors are located within the body (central Thermoreceptors) as well as in the skin surface (peripheral thermoreceptor).* Thermoreceptors within body function as conventional feedback sensor. If the CORE body temperature drops back to 37degC set point.* In contrast, thermoreceptors in the skin function as feed-forward sensor. How? Decreases in environmental temperature are rapidly sensed by skin thermoreceptors, and compensatory thermoregulatory responses are initiated before there is any appreciable fall in CORE body temperature.* Other example of feed-forward system:# Increased Heart rate and respiratory rate even before the start of exercise due to psychic stimulation.# Some rapid movement of body parts occurs so rapidly that there is not enough time for feedback control (slow). Thus brain controls these movements by feed-forward system.Extra MileThermoreceptorsReceptorsNerve fibers typeDetectsCool receptorsAdSkin cooling (<25degC)Warm receptorsCSkin warming (>35degC)Heat nociceptorsAdHot temperature (>45degC)Cold nociceptorsCCold temperature (<5degC)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is an example of feedforward mechanism?, with the following options: A: Increase blood pressure during supine posture, B: Salivation on smelling food, C: Shivering on exposure to cold environment, D: None of the above + ### Response: Ans. (c) Shivering on exposure to cold environmentRef: Ganongs Review of Medical Physiology 25th Ed; Page No- 249* Thermoreceptors are located within the body (central Thermoreceptors) as well as in the skin surface (peripheral thermoreceptor).* Thermoreceptors within body function as conventional feedback sensor. If the CORE body temperature drops back to 37degC set point.* In contrast, thermoreceptors in the skin function as feed-forward sensor. How? Decreases in environmental temperature are rapidly sensed by skin thermoreceptors, and compensatory thermoregulatory responses are initiated before there is any appreciable fall in CORE body temperature.* Other example of feed-forward system:# Increased Heart rate and respiratory rate even before the start of exercise due to psychic stimulation.# Some rapid movement of body parts occurs so rapidly that there is not enough time for feedback control (slow). Thus brain controls these movements by feed-forward system.Extra MileThermoreceptorsReceptorsNerve fibers typeDetectsCool receptorsAdSkin cooling (<25degC)Warm receptorsCSkin warming (>35degC)Heat nociceptorsAdHot temperature (>45degC)Cold nociceptorsCCold temperature (<5degC) ### End" @@ -4644,6 +8299,13 @@ Ans. (c) Shivering on exposure to cold environmentRef: Ganongs Review of Medical Answer the following medical question: Most common site for cystic Hygroma, with the following options: A: Lower third of neck, B: Overlying the parotid gland, C: Along the Zygomatic prominence, D: Post auricular +### Response: +","Ans. (a) Lower third of neckRef: Bailey and Love 26th edition, Page 700* Cystic hygroma presents as swelling in posterior triangle in lower part of neck","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common site for cystic Hygroma, with the following options: A: Lower third of neck, B: Overlying the parotid gland, C: Along the Zygomatic prominence, D: Post auricular + ### Response: Ans. (a) Lower third of neckRef: Bailey and Love 26th edition, Page 700* Cystic hygroma presents as swelling in posterior triangle in lower part of neck ### End" @@ -4653,6 +8315,13 @@ Ans. (a) Lower third of neckRef: Bailey and Love 26th edition, Page 700* Cystic Answer the following medical question: Following an incised wound in the front of wrist, the subject is unable to oppose the tips of the little finger and the thumb. The nerve (s) involved is are-, with the following options: A: Ulnar nerve alone, B: Median nerve alone, C: Median and ulnar nerves, D: Radial and ulnar nerves +### Response: +","Opponens digiti minimi and opponens pollicis are both involved, as otherwise either of them will be able to oppose the thumb with the little finger if the other is paralysed. So it is clear that both median nerve and ulnar nerve is involved.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Following an incised wound in the front of wrist, the subject is unable to oppose the tips of the little finger and the thumb. The nerve (s) involved is are-, with the following options: A: Ulnar nerve alone, B: Median nerve alone, C: Median and ulnar nerves, D: Radial and ulnar nerves + ### Response: Opponens digiti minimi and opponens pollicis are both involved, as otherwise either of them will be able to oppose the thumb with the little finger if the other is paralysed. So it is clear that both median nerve and ulnar nerve is involved. ### End" @@ -4662,6 +8331,13 @@ Opponens digiti minimi and opponens pollicis are both involved, as otherwise eit Answer the following medical question: Blisters are seen in, with the following options: A: 1st degree burn, B: Superficial 2nd degree burn, C: Deep 2nd degree burn, D: 3rd degree burn +### Response: +",Superficial second degree burns Involve upper layer of dermis (papillary dermis) Erythematous Blisters are seen Blanch to touch Painful Heals without scarring in 7-14 days Ref: Sabiston 20th edition Pgno :506-507,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Blisters are seen in, with the following options: A: 1st degree burn, B: Superficial 2nd degree burn, C: Deep 2nd degree burn, D: 3rd degree burn + ### Response: Superficial second degree burns Involve upper layer of dermis (papillary dermis) Erythematous Blisters are seen Blanch to touch Painful Heals without scarring in 7-14 days Ref: Sabiston 20th edition Pgno :506-507 ### End" @@ -4671,6 +8347,13 @@ Superficial second degree burns Involve upper layer of dermis (papillary dermis) Answer the following medical question: False statement regarding chorionic villous sampling, with the following options: A: Chorionic villous sampling done at 16-21 weeks, B: Done for chromosomal abnormality, C: Increased nuchal Translucency indication for chorionic villous sampling, D: Taken from the developing placenta +### Response: +",Chorionic villous sampling Is performed for pre-natal diagnosis of genetic disorders Done around 10 to 13 weeks Can be done in 1st trimester safely Complications Fetal loss (1-2%) Oromandibular limb deformities Taken from the developing placenta through transvaginal route or transabdominal route,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: False statement regarding chorionic villous sampling, with the following options: A: Chorionic villous sampling done at 16-21 weeks, B: Done for chromosomal abnormality, C: Increased nuchal Translucency indication for chorionic villous sampling, D: Taken from the developing placenta + ### Response: Chorionic villous sampling Is performed for pre-natal diagnosis of genetic disorders Done around 10 to 13 weeks Can be done in 1st trimester safely Complications Fetal loss (1-2%) Oromandibular limb deformities Taken from the developing placenta through transvaginal route or transabdominal route ### End" @@ -4680,6 +8363,13 @@ Chorionic villous sampling Is performed for pre-natal diagnosis of genetic disor Answer the following medical question: Compound used for fixation of protozoa found in stool is:, with the following options: A: Phenol, B: Hypochlorite, C: Formalin, D: Alcohol +### Response: +",Ans. d. Alcohol,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Compound used for fixation of protozoa found in stool is:, with the following options: A: Phenol, B: Hypochlorite, C: Formalin, D: Alcohol + ### Response: Ans. d. Alcohol ### End" @@ -4689,6 +8379,13 @@ Ans. d. Alcohol Answer the following medical question: Itchy polygonal violaceous papules seen in -, with the following options: A: Psoriasis, B: Pemphigus, C: Lichen planus, D: Pityriasis rosea +### Response: +","LICHEN PLANUS:- Inflammatory T cell mediated auto immune disorder affecting skin, hair,nails and mucous membranes.Four Ps- purple , polygonal and pruritic papule.Classic lesion- small polygonal shaped, and red/ violet, flat topped papule. Surface is slightly shiny/ transparent,and a network of fine,white lines called 'Wickhams striae' or small grey white puncta is also seen. Intense itching seen. Koebner phenomenon seen. IADVL textbook of dermatology, page 1070","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Itchy polygonal violaceous papules seen in -, with the following options: A: Psoriasis, B: Pemphigus, C: Lichen planus, D: Pityriasis rosea + ### Response: LICHEN PLANUS:- Inflammatory T cell mediated auto immune disorder affecting skin, hair,nails and mucous membranes.Four Ps- purple , polygonal and pruritic papule.Classic lesion- small polygonal shaped, and red/ violet, flat topped papule. Surface is slightly shiny/ transparent,and a network of fine,white lines called 'Wickhams striae' or small grey white puncta is also seen. Intense itching seen. Koebner phenomenon seen. IADVL textbook of dermatology, page 1070 ### End" @@ -4698,6 +8395,13 @@ LICHEN PLANUS:- Inflammatory T cell mediated auto immune disorder affecting skin Answer the following medical question: Density of cells in adult corneal endothelium ?, with the following options: A: 2000 cells/mm2, B: 3000 cells/mm2, C: 4000 cells/mm2, D: 5000 cells/mm2 +### Response: +","Ans. is 'b' i.e., 3000 cells/mm2 The cell density of corneal endothelium is around 3000 cells/mm2 in young adults, which decreases with the advancing age.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Density of cells in adult corneal endothelium ?, with the following options: A: 2000 cells/mm2, B: 3000 cells/mm2, C: 4000 cells/mm2, D: 5000 cells/mm2 + ### Response: Ans. is 'b' i.e., 3000 cells/mm2 The cell density of corneal endothelium is around 3000 cells/mm2 in young adults, which decreases with the advancing age. ### End" @@ -4707,6 +8411,13 @@ Ans. is 'b' i.e., 3000 cells/mm2 The cell density of corneal endothelium is arou Answer the following medical question: Non-essential amino acid :, with the following options: A: Tryptophan, B: Tyrosine, C: Arginine, D: Histidine +### Response: +","Essential amino acids are those which can't be synthesised in the body and must be taken in the diet. Alanine can be synthesized from pyruvate by transamination in a single step. So, alanine is not a dietarily essential amino acid. Semi-essential amino acids: Those which can be synthesized in body but to some extent.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Non-essential amino acid :, with the following options: A: Tryptophan, B: Tyrosine, C: Arginine, D: Histidine + ### Response: Essential amino acids are those which can't be synthesised in the body and must be taken in the diet. Alanine can be synthesized from pyruvate by transamination in a single step. So, alanine is not a dietarily essential amino acid. Semi-essential amino acids: Those which can be synthesized in body but to some extent. ### End" @@ -4716,6 +8427,13 @@ Essential amino acids are those which can't be synthesised in the body and must Answer the following medical question: True about gluconeogenesis, with the following options: A: Occurs mainly in muscle, B: It is reverse of glycolysis, C: Alanine & lactate both can serve as substrate, D: Glycerol is not a substrate +### Response: +","Gluconeogenesis: Gluconeogenesis is the formation of glucose from non-carbohydrate sources. Gluconeogenesis helps to maintain the glucose level in the blood, so that the brain, RBC, and muscle can extract glucose from it to meet their metabolic demands when dietary glucose is low. This process is very much necessary in the body because brain and RBC utilizes only glucose as energy fuel. The major non-carbohydrate precursors of glucose are lactate, glucogenic amino acids (all except leucine) and glycerol. Lactate is formed by RBC in glycolysis because mitochondria are absent. Lactate is also formed by active skeletal muscle when the rate of glycolysis exceeds the rate of TCA cycle, the pyruvate formed is conveed to lactate. Amino acids are derived from proteins in the diet and during starvation, from the breakdown of proteins in skeletal muscle. Glycerol is derived from the hydrolysis of triacylglycerol's (TAG). Gluconeogenesis occurs mainly in liver and kidney. It also occurs in brain and muscle to some extent. Gluconeogenesis occurs during (1) Starvation, (2) To clear lactate formed in RBC and muscle, (3) When carbohydrates in the diet are low, (4) Pregnancy, (5) Lactation, (6) Febrile diseases. Gluconeogenesis is almost the reversal of glycolysis excepting at three steps which are irreversible in glycolysis. These steps are reversed by enzymes known as the key enzymes of gluconeogenesis i.e. those enzymes specific for gluconeogenesis only but not for any other pathway.Ref: DM Vasudevan, 7th edition, page no: 117","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about gluconeogenesis, with the following options: A: Occurs mainly in muscle, B: It is reverse of glycolysis, C: Alanine & lactate both can serve as substrate, D: Glycerol is not a substrate + ### Response: Gluconeogenesis: Gluconeogenesis is the formation of glucose from non-carbohydrate sources. Gluconeogenesis helps to maintain the glucose level in the blood, so that the brain, RBC, and muscle can extract glucose from it to meet their metabolic demands when dietary glucose is low. This process is very much necessary in the body because brain and RBC utilizes only glucose as energy fuel. The major non-carbohydrate precursors of glucose are lactate, glucogenic amino acids (all except leucine) and glycerol. Lactate is formed by RBC in glycolysis because mitochondria are absent. Lactate is also formed by active skeletal muscle when the rate of glycolysis exceeds the rate of TCA cycle, the pyruvate formed is conveed to lactate. Amino acids are derived from proteins in the diet and during starvation, from the breakdown of proteins in skeletal muscle. Glycerol is derived from the hydrolysis of triacylglycerol's (TAG). Gluconeogenesis occurs mainly in liver and kidney. It also occurs in brain and muscle to some extent. Gluconeogenesis occurs during (1) Starvation, (2) To clear lactate formed in RBC and muscle, (3) When carbohydrates in the diet are low, (4) Pregnancy, (5) Lactation, (6) Febrile diseases. Gluconeogenesis is almost the reversal of glycolysis excepting at three steps which are irreversible in glycolysis. These steps are reversed by enzymes known as the key enzymes of gluconeogenesis i.e. those enzymes specific for gluconeogenesis only but not for any other pathway.Ref: DM Vasudevan, 7th edition, page no: 117 ### End" @@ -4725,6 +8443,13 @@ Gluconeogenesis: Gluconeogenesis is the formation of glucose from non-carbohydra Answer the following medical question: As regards to intraocular retinoblastoma, which one of the following statement is FALSE?, with the following options: A: 94% of cases are sporadic, B: Patients with sporadic retinoblastoma do not pass their genes to their offsprings, C: Calcification in the tumor can be detected on ultrasound scan, D: Reese-El Is woh classification is useful in predicting visual prognosis following radiotherapy +### Response: +","Retinoblastoma is the most common intraocular malignancy of childhood. . 90% of patients with newly diagnosed retinoblastoma are sporadic and 10% of cases are familial. All patients with familial retinoblastoma are at risk to pass the predisposition for the development of the tumor to their offspring. About 25% of sporadic unilateral cases are heritable. Hereditary form of retinoblastoma, is diagnosed earlier than the non hereditary form of the disease, it carries a risk of other malignancies and can affect the offspring of the affected individual. The non hereditary form of the disease is unilateral, the children of affected individual are normal and this form of disease is not associated with increased risk of other malignancies. Ref: Genetic Diseases of the Eye edited by Elias I. Traboulsi page 829, Perez and Brady's Principles and Practice of Radiation Oncology, Page 438 edited by Edward C. Halperin, page 787.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: As regards to intraocular retinoblastoma, which one of the following statement is FALSE?, with the following options: A: 94% of cases are sporadic, B: Patients with sporadic retinoblastoma do not pass their genes to their offsprings, C: Calcification in the tumor can be detected on ultrasound scan, D: Reese-El Is woh classification is useful in predicting visual prognosis following radiotherapy + ### Response: Retinoblastoma is the most common intraocular malignancy of childhood. . 90% of patients with newly diagnosed retinoblastoma are sporadic and 10% of cases are familial. All patients with familial retinoblastoma are at risk to pass the predisposition for the development of the tumor to their offspring. About 25% of sporadic unilateral cases are heritable. Hereditary form of retinoblastoma, is diagnosed earlier than the non hereditary form of the disease, it carries a risk of other malignancies and can affect the offspring of the affected individual. The non hereditary form of the disease is unilateral, the children of affected individual are normal and this form of disease is not associated with increased risk of other malignancies. Ref: Genetic Diseases of the Eye edited by Elias I. Traboulsi page 829, Perez and Brady's Principles and Practice of Radiation Oncology, Page 438 edited by Edward C. Halperin, page 787. ### End" @@ -4734,6 +8459,13 @@ Retinoblastoma is the most common intraocular malignancy of childhood. . 90% of Answer the following medical question: Discarded cytotoxic medicines should be disposed in:, with the following options: A: Blue bag, B: Black bag, C: Red bag, D: Yellow bag +### Response: +",Black bag,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Discarded cytotoxic medicines should be disposed in:, with the following options: A: Blue bag, B: Black bag, C: Red bag, D: Yellow bag + ### Response: Black bag ### End" @@ -4743,6 +8475,13 @@ Black bag Answer the following medical question: Spongiosis is seen in -, with the following options: A: Acute eczema, B: Lichen Planus, C: Psoriasis, D: Pemphigus +### Response: +",Spongiosis is the accumulation of edema fluid within the intercellular space of epidermis and is characteristic of acute eczematous dermatitis.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Spongiosis is seen in -, with the following options: A: Acute eczema, B: Lichen Planus, C: Psoriasis, D: Pemphigus + ### Response: Spongiosis is the accumulation of edema fluid within the intercellular space of epidermis and is characteristic of acute eczematous dermatitis. ### End" @@ -4752,6 +8491,13 @@ Spongiosis is the accumulation of edema fluid within the intercellular space of Answer the following medical question: Bismuth classification for cholangiocarcinoma, type IV is, with the following options: A: Common hepatic duct, B: Bifurcation only, C: Bifurcation and B/L secondary intrahepatic ducts, D: Bifurcation and B/L right secondary intrahepatic ducts +### Response: +",Answer- C. Bifurcation and B/L secondary intrahepatic ducts,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Bismuth classification for cholangiocarcinoma, type IV is, with the following options: A: Common hepatic duct, B: Bifurcation only, C: Bifurcation and B/L secondary intrahepatic ducts, D: Bifurcation and B/L right secondary intrahepatic ducts + ### Response: Answer- C. Bifurcation and B/L secondary intrahepatic ducts ### End" @@ -4761,6 +8507,13 @@ Answer- C. Bifurcation and B/L secondary intrahepatic ducts Answer the following medical question: Vaginal delivery is contraindicated in :, with the following options: A: Central placenta prae, B: Previous LSCS, C: Eclampsia, D: Antepaum hemorrhage +### Response: +",Central placenta prae,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Vaginal delivery is contraindicated in :, with the following options: A: Central placenta prae, B: Previous LSCS, C: Eclampsia, D: Antepaum hemorrhage + ### Response: Central placenta prae ### End" @@ -4770,6 +8523,13 @@ Central placenta prae Answer the following medical question: Which of the following is associated with least common Suicidal tendencies, with the following options: A: Alone, B: Depression, C: Male, D: Married person +### Response: +","Risk factors for suicide are: Age>40years, male, staying single, previous suicidal attempts, depression, suicidal preoccupation, alcohol or drug dependence, social isolation, recent serious loss or major stressful life events. (Ref: a sho textbook of psychiatry, Niraj Ahuja, 7th edition, pg no.223)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is associated with least common Suicidal tendencies, with the following options: A: Alone, B: Depression, C: Male, D: Married person + ### Response: Risk factors for suicide are: Age>40years, male, staying single, previous suicidal attempts, depression, suicidal preoccupation, alcohol or drug dependence, social isolation, recent serious loss or major stressful life events. (Ref: a sho textbook of psychiatry, Niraj Ahuja, 7th edition, pg no.223) ### End" @@ -4779,6 +8539,13 @@ Risk factors for suicide are: Age>40years, male, staying single, previous suicid Answer the following medical question: Which one of the following groups of people may be at increased risk for HIV infection?, with the following options: A: Members of a household in which there is a person who is HIV-positive, B: Receptionists at a hospital, C: Factory workers whose coworkers are HIV-positive, D: Foreign service employees who are hospitalized in Zaire for bleeding ulcers +### Response: +","Many believe that casual contact with patients who are HIV-positive increases the risk of acquiring the disease. This is not the case. It is also clear that homosexual females have a low rate of HIV acquisition. Because a substantial portion of the blood supply in Central African countries is HIV-infected, hospitalization is risky particularly if transfusion is necessary.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which one of the following groups of people may be at increased risk for HIV infection?, with the following options: A: Members of a household in which there is a person who is HIV-positive, B: Receptionists at a hospital, C: Factory workers whose coworkers are HIV-positive, D: Foreign service employees who are hospitalized in Zaire for bleeding ulcers + ### Response: Many believe that casual contact with patients who are HIV-positive increases the risk of acquiring the disease. This is not the case. It is also clear that homosexual females have a low rate of HIV acquisition. Because a substantial portion of the blood supply in Central African countries is HIV-infected, hospitalization is risky particularly if transfusion is necessary. ### End" @@ -4788,6 +8555,13 @@ Many believe that casual contact with patients who are HIV-positive increases th Answer the following medical question: Indication of Acyclovir in pregnancy :, with the following options: A: Disseminated herpes, B: Chicken-pox in first trimester, C: Prophylaxis in recurrent herpes, D: All of the above +### Response: +",All of the above,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Indication of Acyclovir in pregnancy :, with the following options: A: Disseminated herpes, B: Chicken-pox in first trimester, C: Prophylaxis in recurrent herpes, D: All of the above + ### Response: All of the above ### End" @@ -4797,6 +8571,13 @@ All of the above Answer the following medical question: A 44-year-old man with a history of quadriplegia presented to the emergency department with symptoms of a urinary tract infection. What is the diagnosis?, with the following options: A: Bladder perforation, B: Neurogenic megacolon, C: Chronic constipation, D: Gastric distention +### Response: +","Answer B. Neurogenic megacolonThe correct answer is neurogenic megacolon. This condition is prevalent among older patients with long-standing spinal cord injuries. Complications of megacolon include abdominal compartment syndrome, volvulus, and fecal impaction. Definitive treatment includes colectomy, colostomy, or medical management. This patient opted for conservative medical management and was careful to avoid antimotility agents.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 44-year-old man with a history of quadriplegia presented to the emergency department with symptoms of a urinary tract infection. What is the diagnosis?, with the following options: A: Bladder perforation, B: Neurogenic megacolon, C: Chronic constipation, D: Gastric distention + ### Response: Answer B. Neurogenic megacolonThe correct answer is neurogenic megacolon. This condition is prevalent among older patients with long-standing spinal cord injuries. Complications of megacolon include abdominal compartment syndrome, volvulus, and fecal impaction. Definitive treatment includes colectomy, colostomy, or medical management. This patient opted for conservative medical management and was careful to avoid antimotility agents. ### End" @@ -4806,6 +8587,13 @@ Answer B. Neurogenic megacolonThe correct answer is neurogenic megacolon. This c Answer the following medical question: Rule of nine true is used to denote ?, with the following options: A: Depth of burns, B: % of total body surface area, C: Severity of burns, D: Type of burn +### Response: +","Ans. is 'b' i.e., % of total body surface area Extent of burns The surface area burnt is more impoant than the degree of burn, in assessing prognosis of a given case. For example, a first degree burn over a wide area is more dangerous than a third degree burn over a limited area. For estimation of burn area, there is rule of 9 (Wallace's formula) :? In adults surface area is calculated by :? 9% for the head and neck. 9% for each upper limb. 9% for the front of each lower limb. 9% for the back of each lower limb. 9% for the front of the chest. 9% for the back of the chest. 9% for the front of the abdomen. 9% for the back of the abdomen. 1% for the genitalia.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Rule of nine true is used to denote ?, with the following options: A: Depth of burns, B: % of total body surface area, C: Severity of burns, D: Type of burn + ### Response: Ans. is 'b' i.e., % of total body surface area Extent of burns The surface area burnt is more impoant than the degree of burn, in assessing prognosis of a given case. For example, a first degree burn over a wide area is more dangerous than a third degree burn over a limited area. For estimation of burn area, there is rule of 9 (Wallace's formula) :? In adults surface area is calculated by :? 9% for the head and neck. 9% for each upper limb. 9% for the front of each lower limb. 9% for the back of each lower limb. 9% for the front of the chest. 9% for the back of the chest. 9% for the front of the abdomen. 9% for the back of the abdomen. 1% for the genitalia. ### End" @@ -4815,6 +8603,15 @@ Ans. is 'b' i.e., % of total body surface area Extent of burns The surface area Answer the following medical question: The persistent suppression of bacterial growth that may occur after limited exposure to some antimicrobial drug is called :, with the following options: A: Time dependent killing, B: Post antibiotic effect, C: Concentration dependent killing, D: Sequential blockade +### Response: +","Time dependent killing kinetics is shown by aminoglycosides. Here, the killing activity depends upon the length of time, plasma concentration is above MIC. +Concentration dependent killing is shown by β lactam drugs. Here, killing activity depends upon the ratio of plasma concentration to MIC. +Post-antibiotic effect is the suppression of bacterial growth after limited exposure to the antibiotic.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The persistent suppression of bacterial growth that may occur after limited exposure to some antimicrobial drug is called :, with the following options: A: Time dependent killing, B: Post antibiotic effect, C: Concentration dependent killing, D: Sequential blockade + ### Response: Time dependent killing kinetics is shown by aminoglycosides. Here, the killing activity depends upon the length of time, plasma concentration is above MIC. Concentration dependent killing is shown by β lactam drugs. Here, killing activity depends upon the ratio of plasma concentration to MIC. @@ -4826,6 +8623,26 @@ Post-antibiotic effect is the suppression of bacterial growth after limited expo Answer the following medical question: Which one of the following blood fractions is stored at - 40ºC, with the following options: A: Cryoprecipitate, B: human albumin, C: Platelet concentrate, D: Packed red cells +### Response: +","Red Cells + +42 days with the appropriate additives +2–6 ºC + +Platelets + +5 days +20–24 ºC + +Cryoprecipitate + +12 months +At –25 ºC or below","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which one of the following blood fractions is stored at - 40ºC, with the following options: A: Cryoprecipitate, B: human albumin, C: Platelet concentrate, D: Packed red cells + ### Response: Red Cells @@ -4848,6 +8665,13 @@ At –25 ºC or below Answer the following medical question: The blood-air barrier consists of all of the following except:, with the following options: A: Alveolar pores, B: A layer of surfactant, C: Type I alveolar cell cytoplasm, D: Fused basal lamina of alveolar and endothelial cells +### Response: +",Alveolar pores connect neighboring alveoli and func­tion in equalizing pressure in the alveoli and enable collateral circulation of air. They do not constitute part of the blood-air barrier.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The blood-air barrier consists of all of the following except:, with the following options: A: Alveolar pores, B: A layer of surfactant, C: Type I alveolar cell cytoplasm, D: Fused basal lamina of alveolar and endothelial cells + ### Response: Alveolar pores connect neighboring alveoli and func­tion in equalizing pressure in the alveoli and enable collateral circulation of air. They do not constitute part of the blood-air barrier. ### End" @@ -4857,6 +8681,13 @@ Alveolar pores connect neighboring alveoli and func­tion in equalizing pressure Answer the following medical question: Erythopoiesis in gestation age takes place in -, with the following options: A: Yolk sac, B: Placenta, C: Amniotic sac, D: Chorion +### Response: +","Ans. is 'a' i.e., Yolk sac Erythropoiesis siteso Intrauterine* 0-10 weeks-Yolk sac* 10 weeks - 5 months-Liver (major organ) and spleen* 5 month onwrard-Bone marrowo After birth* Upto 20 years-Bone marrow of all bones* After 20 years-Flat bones of axial skeletal and proximal end of humerus and femur.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Erythopoiesis in gestation age takes place in -, with the following options: A: Yolk sac, B: Placenta, C: Amniotic sac, D: Chorion + ### Response: Ans. is 'a' i.e., Yolk sac Erythropoiesis siteso Intrauterine* 0-10 weeks-Yolk sac* 10 weeks - 5 months-Liver (major organ) and spleen* 5 month onwrard-Bone marrowo After birth* Upto 20 years-Bone marrow of all bones* After 20 years-Flat bones of axial skeletal and proximal end of humerus and femur. ### End" @@ -4867,7 +8698,14 @@ Ans. is 'a' i.e., Yolk sac Erythropoiesis siteso Intrauterine* 0-10 weeks-Yolk s Answer the following medical question: In the hea, which muscarinic receptor inhibits adenyl cyclase activity?, with the following options: A: M1, B: M2, C: M3, D: M4 ### Response: -M2 receptors are located in the hea.Ref: HL Sharma 3rd ed Pg: 119 +",M2 receptors are located in the hea.Ref: HL Sharma 3rd ed Pg: 119,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In the hea, which muscarinic receptor inhibits adenyl cyclase activity?, with the following options: A: M1, B: M2, C: M3, D: M4 + +### Response: +M2 receptors are located in the hea.Ref: HL Sharma 3rd ed Pg: 119 ### End" 516,"Below is an instruction that describes a task. Write a response that appropriately completes the request. @@ -4875,6 +8713,13 @@ M2 receptors are located in the hea.Ref: HL Sharma 3rd ed Pg: 119 Answer the following medical question: Choose the drug whose single oral dose affords clinical cure of uncomplicated malaria caused by chloroquine sensitive /resistant P. Falciparum as well as P. Vivax, with the following options: A: Quinine, B: Mefloquine, C: Aesunate, D: Proguanil +### Response: +",Mefloquine is effective as a single dose treatment of malaria. It can be used for both chloroquine sensitive as well resistant bacteria Refer KDT 6th/787,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Choose the drug whose single oral dose affords clinical cure of uncomplicated malaria caused by chloroquine sensitive /resistant P. Falciparum as well as P. Vivax, with the following options: A: Quinine, B: Mefloquine, C: Aesunate, D: Proguanil + ### Response: Mefloquine is effective as a single dose treatment of malaria. It can be used for both chloroquine sensitive as well resistant bacteria Refer KDT 6th/787 ### End" @@ -4884,6 +8729,13 @@ Mefloquine is effective as a single dose treatment of malaria. It can be used fo Answer the following medical question: Best assay for deficiency of von Willebamd factor is:, with the following options: A: Bleeding time, B: BT + APTT, C: BT + APTT + vWF-ristocetin factor assay, D: PT +### Response: +","Answer is C (BT + APTT + vWF-ristocetin factor assay) Estimation of BT, APTT and VWF-Ristocetin factor assay would provide the maximal information to aid a diagnosis of VWF disease (amongst the options provided)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Best assay for deficiency of von Willebamd factor is:, with the following options: A: Bleeding time, B: BT + APTT, C: BT + APTT + vWF-ristocetin factor assay, D: PT + ### Response: Answer is C (BT + APTT + vWF-ristocetin factor assay) Estimation of BT, APTT and VWF-Ristocetin factor assay would provide the maximal information to aid a diagnosis of VWF disease (amongst the options provided) ### End" @@ -4893,6 +8745,13 @@ Answer is C (BT + APTT + vWF-ristocetin factor assay) Estimation of BT, APTT and Answer the following medical question: Proved association of celiac sprue is with:, with the following options: A: Dermatitis herpetiformis, B: Scleroderma, C: Pemphigus, D: Pemphoid +### Response: +","Answer is A (Dermatitis Herpetiformis) Celiac disease is associated with Dermatitis Herpetiformis Dermatitis Herpetiformis is regarded as cutaneous variant of celiac disease. Almost all patients with dermatitis N as Herpetiformis have evidence of celiac disease on intestinal biopsy' - CMD Associations of Celiac Disease (CMDT & Harrisons) Dermatitis Herpetiformis Other autoimmune disease including: (CMDT) - Addison's disease - Grave's disease Diabetes mellitus- Type I (Harrisons) - Myaesthenia Gravis - Slogren syndrome - Atrophic Gastritis - Pancreatic insufficiency IgA deficiency (Harrisons) Lymphomas (Harrisons) Note Celiac disease is associated with an increased risk of cancer including Lymphomas (NHL, Intestinal T cell Lymphoma) The possibility of Lymphoma must be considered whenever a patient with celiac sprue previously doing well on a gluten free diet is no longer responsive to gluten free diet' - Harrisons","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Proved association of celiac sprue is with:, with the following options: A: Dermatitis herpetiformis, B: Scleroderma, C: Pemphigus, D: Pemphoid + ### Response: Answer is A (Dermatitis Herpetiformis) Celiac disease is associated with Dermatitis Herpetiformis Dermatitis Herpetiformis is regarded as cutaneous variant of celiac disease. Almost all patients with dermatitis N as Herpetiformis have evidence of celiac disease on intestinal biopsy' - CMD Associations of Celiac Disease (CMDT & Harrisons) Dermatitis Herpetiformis Other autoimmune disease including: (CMDT) - Addison's disease - Grave's disease Diabetes mellitus- Type I (Harrisons) - Myaesthenia Gravis - Slogren syndrome - Atrophic Gastritis - Pancreatic insufficiency IgA deficiency (Harrisons) Lymphomas (Harrisons) Note Celiac disease is associated with an increased risk of cancer including Lymphomas (NHL, Intestinal T cell Lymphoma) The possibility of Lymphoma must be considered whenever a patient with celiac sprue previously doing well on a gluten free diet is no longer responsive to gluten free diet' - Harrisons ### End" @@ -4902,6 +8761,13 @@ Answer is A (Dermatitis Herpetiformis) Celiac disease is associated with Dermati Answer the following medical question: Gingival hypertrophy and hirsutism are the side effects of following Antiepileptic drug use, with the following options: A: Diazepam, B: Primidone, C: Carbamazepine, D: Diphenylhydantoin +### Response: +","(D) Diphenylhydantoin # Gum hypertrophy: Commonest (20% incidence), more in younger patients, can be minimized by maintaining oral hygiene.> Hirsutism, coarsening of facial features (troublesome in young girls), acne.# Adverse effects These are numerous; some occur at therapeutic plasma concentration after prolonged use, while others are manifestation or toxicity due to overdose.# At therapeutic levels> Gum hypertrophy: Commonest (20% incidence), more in younger patients, can be minimized by maintaining oral hygiene.> Hirsutism, coarsening of facial features (troublesome in young girls), acne.> Hypersensitivity reactions are--rashes, DLE, lymphadenopathy; neutropenia is rare but requires discontinuation of therapy.> Megaloblastic anaemia: phenytoin decreases folate absorption and increases its excretion.> Osteomalacia: phenytoin desensitizes target tissues to vitamin D and interferes with calcium metabolism.> It can inhibit insulin release and cause hyperglycaemia.> Used during pregnancy--can produce foetal hydantoin syndrome (hypoplastic phalanges, cleft palate, hare lip, microcephaly), which is probably caused by its areneoxide metabolite.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Gingival hypertrophy and hirsutism are the side effects of following Antiepileptic drug use, with the following options: A: Diazepam, B: Primidone, C: Carbamazepine, D: Diphenylhydantoin + ### Response: (D) Diphenylhydantoin # Gum hypertrophy: Commonest (20% incidence), more in younger patients, can be minimized by maintaining oral hygiene.> Hirsutism, coarsening of facial features (troublesome in young girls), acne.# Adverse effects These are numerous; some occur at therapeutic plasma concentration after prolonged use, while others are manifestation or toxicity due to overdose.# At therapeutic levels> Gum hypertrophy: Commonest (20% incidence), more in younger patients, can be minimized by maintaining oral hygiene.> Hirsutism, coarsening of facial features (troublesome in young girls), acne.> Hypersensitivity reactions are--rashes, DLE, lymphadenopathy; neutropenia is rare but requires discontinuation of therapy.> Megaloblastic anaemia: phenytoin decreases folate absorption and increases its excretion.> Osteomalacia: phenytoin desensitizes target tissues to vitamin D and interferes with calcium metabolism.> It can inhibit insulin release and cause hyperglycaemia.> Used during pregnancy--can produce foetal hydantoin syndrome (hypoplastic phalanges, cleft palate, hare lip, microcephaly), which is probably caused by its areneoxide metabolite. ### End" @@ -4911,6 +8777,13 @@ Answer the following medical question: Gingival hypertrophy and hirsutism are th Answer the following medical question: Symptoms of narcolepsy are all except, with the following options: A: Cataplexy, B: Catalepsy, C: Daytime sleepiness, D: hypnagogic hallucinations +### Response: +","NarcolepsyThe classic tetrad of symptoms is:i. Sleep attacks (most common): ii. Cataplexy: iii. Hypnagogic hallucinations: iv. Sleep paralysis (least common): Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 138","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Symptoms of narcolepsy are all except, with the following options: A: Cataplexy, B: Catalepsy, C: Daytime sleepiness, D: hypnagogic hallucinations + ### Response: NarcolepsyThe classic tetrad of symptoms is:i. Sleep attacks (most common): ii. Cataplexy: iii. Hypnagogic hallucinations: iv. Sleep paralysis (least common): Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 138 ### End" @@ -4920,6 +8793,13 @@ NarcolepsyThe classic tetrad of symptoms is:i. Sleep attacks (most common): ii. Answer the following medical question: Which of the following genes is not associated with Autosomal Dominant Tubulointerstitial Kidney Disease?, with the following options: A: MUC1, B: HNF1b, C: UMOD, D: NPHS2 +### Response: +","Autosomal recessive FSGS results from mutations in the NPHS2 gene, which maps to chromosome 1q25-q31 and encodes the protein product podocin. Autosomal dominant tubulointerstitial kidney disease (ADTKD): Previously known as medullary cystic kidney disease Variable presence of cysts, which often are not located in the medulla Now recognized to be due to following genetic mutations: MUC1 encodes mucin-1 (expressed in distal nephrons) UMOD encodes uromodulin (expressed in thick ascending limb of loop of Henle) REN encodes preprorenin (expressed by juxtaglomerular apparatus) HNF1b encodes hepatocyte nuclear factor 1b, a transcription factor that regulates multiple genes, including UMOD ADTKD is associated with non-specific clinical and pathologic findings and causes progressive renal failure in adult life The pathogenic mechanisms are unknown","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following genes is not associated with Autosomal Dominant Tubulointerstitial Kidney Disease?, with the following options: A: MUC1, B: HNF1b, C: UMOD, D: NPHS2 + ### Response: Autosomal recessive FSGS results from mutations in the NPHS2 gene, which maps to chromosome 1q25-q31 and encodes the protein product podocin. Autosomal dominant tubulointerstitial kidney disease (ADTKD): Previously known as medullary cystic kidney disease Variable presence of cysts, which often are not located in the medulla Now recognized to be due to following genetic mutations: MUC1 encodes mucin-1 (expressed in distal nephrons) UMOD encodes uromodulin (expressed in thick ascending limb of loop of Henle) REN encodes preprorenin (expressed by juxtaglomerular apparatus) HNF1b encodes hepatocyte nuclear factor 1b, a transcription factor that regulates multiple genes, including UMOD ADTKD is associated with non-specific clinical and pathologic findings and causes progressive renal failure in adult life The pathogenic mechanisms are unknown ### End" @@ -4929,6 +8809,13 @@ Autosomal recessive FSGS results from mutations in the NPHS2 gene, which maps to Answer the following medical question: Wood's lamp is made up of -, with the following options: A: 9% nickel oxide with 6% barium silicate, B: 9% nickel oxide with 9% barium silicate, C: 6% nickel oxide with 6% barium silicate, D: 9% nickel oxide with barium silicate +### Response: +",Wood's Lamp It is a low intensity ultraviolet light(360nm) emitted by a high pressure mercury lamp fitted with a special filter made up of 9% nickel oxide and silica.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Wood's lamp is made up of -, with the following options: A: 9% nickel oxide with 6% barium silicate, B: 9% nickel oxide with 9% barium silicate, C: 6% nickel oxide with 6% barium silicate, D: 9% nickel oxide with barium silicate + ### Response: Wood's Lamp It is a low intensity ultraviolet light(360nm) emitted by a high pressure mercury lamp fitted with a special filter made up of 9% nickel oxide and silica. ### End" @@ -4938,6 +8825,13 @@ Wood's Lamp It is a low intensity ultraviolet light(360nm) emitted by a high pre Answer the following medical question: Which occurs first in wound healing?, with the following options: A: Thin continuous epithelial cover appears, B: Fibroblasts lay down collagen fiber, C: Granulation tissue fills the wound, D: Neutrophils line the wound edge +### Response: +","STEPS IN WOUND HEALING Within 24 hours, neutrophils are seen at the incision margin ,migrating toward the fibrin clot (neutrophilic infiltration + blood clot) Within 24 to 48 hours, epithelial cells from both edges have begun to migrate and proliferate along the dermis and form continuous thin epithelial layer. day 3, neutrophils have been largely replaced by macrophages, and granulation tissue progressively invades the incision space , Collagen fibers are now evident at the incision margins but donot bridge the incision day 5, neovascularization reaches its peak as granulation tissue fills the incisional space , collagen fibrils bridge the incision , full epithelial thickness with surface keratinisation second week, there is continued collagen accumulation and fibroblast proliferation end of the first month, the scar consists of a cellular connective tissue, largely devoid of inflammatory cells, replacement of collagen type 3 with collagen type 1 ref:-basic pathology,robbins 9thed , page 71","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which occurs first in wound healing?, with the following options: A: Thin continuous epithelial cover appears, B: Fibroblasts lay down collagen fiber, C: Granulation tissue fills the wound, D: Neutrophils line the wound edge + ### Response: STEPS IN WOUND HEALING Within 24 hours, neutrophils are seen at the incision margin ,migrating toward the fibrin clot (neutrophilic infiltration + blood clot) Within 24 to 48 hours, epithelial cells from both edges have begun to migrate and proliferate along the dermis and form continuous thin epithelial layer. day 3, neutrophils have been largely replaced by macrophages, and granulation tissue progressively invades the incision space , Collagen fibers are now evident at the incision margins but donot bridge the incision day 5, neovascularization reaches its peak as granulation tissue fills the incisional space , collagen fibrils bridge the incision , full epithelial thickness with surface keratinisation second week, there is continued collagen accumulation and fibroblast proliferation end of the first month, the scar consists of a cellular connective tissue, largely devoid of inflammatory cells, replacement of collagen type 3 with collagen type 1 ref:-basic pathology,robbins 9thed , page 71 ### End" @@ -4947,6 +8841,13 @@ STEPS IN WOUND HEALING Within 24 hours, neutrophils are seen at the incision mar Answer the following medical question: All of the following are associated with better prognosis in schizophrenia, EXCEPT:, with the following options: A: Married, B: Late onset, C: Acute onset, D: Negative symptoms +### Response: +","Late , acute onset of symptoms and married status all are associated with good prognosis in schizophrenia.Factors associated with good prognosis in schizophrenia are married, acute onset , positive symptoms, late onset of disease, presence of good suppo systems, mood disorder symptoms, obvious precipitating factors, family history of mood disorders, good premorbid social, sexual and work histories.Ref: Kaplan and Sadock's Study Guide and Self-Examination Review in Psychiatry By Benjamin J. Sadock, page 135.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following are associated with better prognosis in schizophrenia, EXCEPT:, with the following options: A: Married, B: Late onset, C: Acute onset, D: Negative symptoms + ### Response: Late , acute onset of symptoms and married status all are associated with good prognosis in schizophrenia.Factors associated with good prognosis in schizophrenia are married, acute onset , positive symptoms, late onset of disease, presence of good suppo systems, mood disorder symptoms, obvious precipitating factors, family history of mood disorders, good premorbid social, sexual and work histories.Ref: Kaplan and Sadock's Study Guide and Self-Examination Review in Psychiatry By Benjamin J. Sadock, page 135. ### End" @@ -4956,6 +8857,13 @@ Late , acute onset of symptoms and married status all are associated with good p Answer the following medical question: Transplant of kidney from mother to son is an example of:-, with the following options: A: Autograft, B: Allograft, C: Isograft, D: Xenograft +### Response: +","Graft Autograft Isograft Homograft (Allograft) Heterograft (Xenograft) Tissue transplanted from one site to another on the same patient Transplant form a genetically identical donor, such as an identical twin Transplant from individual of same species Transplant from another species Xenograft Concordant Xenograft Discordant Xenograft Transplant between closely related species Example: For humans, old world monkeys & apes Advantage: Hyperacute rejections is not a threat Disadvantages: Zoonotic transfer of disease (Paicularly retroviral transmission) Transplant between distant related or divergent species Example: For humans, new- world monkeys & other mammals For physiological concern (organ size & availability) pigs are preferred animal donor Disadvantages: High risk of hyperacute rejection","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Transplant of kidney from mother to son is an example of:-, with the following options: A: Autograft, B: Allograft, C: Isograft, D: Xenograft + ### Response: Graft Autograft Isograft Homograft (Allograft) Heterograft (Xenograft) Tissue transplanted from one site to another on the same patient Transplant form a genetically identical donor, such as an identical twin Transplant from individual of same species Transplant from another species Xenograft Concordant Xenograft Discordant Xenograft Transplant between closely related species Example: For humans, old world monkeys & apes Advantage: Hyperacute rejections is not a threat Disadvantages: Zoonotic transfer of disease (Paicularly retroviral transmission) Transplant between distant related or divergent species Example: For humans, new- world monkeys & other mammals For physiological concern (organ size & availability) pigs are preferred animal donor Disadvantages: High risk of hyperacute rejection ### End" @@ -4965,6 +8873,13 @@ Graft Autograft Isograft Homograft (Allograft) Heterograft (Xenograft) Tissue tr Answer the following medical question: Conjugated bilirubin is increased in?, with the following options: A: Rotor Syndrome, B: Gilberts syndrome, C: CrigglerNajjar syndrome 1, D: CrigglerNajjar syndrome 2 +### Response: +",Ans. (a) Rotor SyndromeRef: Harrison's 17th Ed Ch Table 43-1,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Conjugated bilirubin is increased in?, with the following options: A: Rotor Syndrome, B: Gilberts syndrome, C: CrigglerNajjar syndrome 1, D: CrigglerNajjar syndrome 2 + ### Response: Ans. (a) Rotor SyndromeRef: Harrison's 17th Ed Ch Table 43-1 ### End" @@ -4974,6 +8889,13 @@ Ans. (a) Rotor SyndromeRef: Harrison's 17th Ed Ch Table 43-1 Answer the following medical question: All of the following differentiaties theca Lutein cysts from corpus Luteum cysts, except, with the following options: A: Massively enlarged ovaries, B: Honeycombed appearance, C: Unilateral, D: Lobulated buish - tinged cysts +### Response: +",Theca Lutein cysts in contrast to corpus luteum cysts are bilateral.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following differentiaties theca Lutein cysts from corpus Luteum cysts, except, with the following options: A: Massively enlarged ovaries, B: Honeycombed appearance, C: Unilateral, D: Lobulated buish - tinged cysts + ### Response: Theca Lutein cysts in contrast to corpus luteum cysts are bilateral. ### End" @@ -4983,6 +8905,13 @@ Theca Lutein cysts in contrast to corpus luteum cysts are bilateral. Answer the following medical question: Which of the following is not required for conversion of acetyl CoA to palmitate?, with the following options: A: ATP, B: Niacin, C: NADPH, D: Biotin +### Response: +","The pathway conves acetyl-CoA to palmitate and requires NADPH, ATP, Mn2+, biotin, pantothenic acid, and as cofactors. Ref: Harper 28th edition, chapter 23.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is not required for conversion of acetyl CoA to palmitate?, with the following options: A: ATP, B: Niacin, C: NADPH, D: Biotin + ### Response: The pathway conves acetyl-CoA to palmitate and requires NADPH, ATP, Mn2+, biotin, pantothenic acid, and as cofactors. Ref: Harper 28th edition, chapter 23. ### End" @@ -4992,6 +8921,13 @@ The pathway conves acetyl-CoA to palmitate and requires NADPH, ATP, Mn2+, biotin Answer the following medical question: A child is passing blood with act of defecation. The probable diagnosis is, with the following options: A: Juvenile rectal polyp, B: Adenomatous Polyposis, C: Rectal ulcer, D: Post Surgery +### Response: +",Ans. (a) Juvenile rectal polypRef : Bailey & Love 26th ed. /1224The most common cause of bleeding per rectum in children is juvenile rectal polyp up to adolescence age. Though in infants and young children (up to 1 yrs) the cause is anal fissure.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A child is passing blood with act of defecation. The probable diagnosis is, with the following options: A: Juvenile rectal polyp, B: Adenomatous Polyposis, C: Rectal ulcer, D: Post Surgery + ### Response: Ans. (a) Juvenile rectal polypRef : Bailey & Love 26th ed. /1224The most common cause of bleeding per rectum in children is juvenile rectal polyp up to adolescence age. Though in infants and young children (up to 1 yrs) the cause is anal fissure. ### End" @@ -5001,6 +8937,13 @@ Ans. (a) Juvenile rectal polypRef : Bailey & Love 26th ed. /1224The most common Answer the following medical question: Which type of pulmonary TB is most likely to give sputum positive ?, with the following options: A: Fibronodular, B: Pleural effusion, C: Cavitary, D: None +### Response: +","Ans. is 'c' i.e., Cavitary Sputum smears are usually positive in patients with laryngeal TB, endobronchial TB and cavitary pulmonary TB"" -- Kelley 's ""Patients with cavitary pulmonary TB have high bacterial load in their sputum"" -- Internet","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which type of pulmonary TB is most likely to give sputum positive ?, with the following options: A: Fibronodular, B: Pleural effusion, C: Cavitary, D: None + ### Response: Ans. is 'c' i.e., Cavitary Sputum smears are usually positive in patients with laryngeal TB, endobronchial TB and cavitary pulmonary TB"" -- Kelley 's ""Patients with cavitary pulmonary TB have high bacterial load in their sputum"" -- Internet ### End" @@ -5010,6 +8953,13 @@ Ans. is 'c' i.e., Cavitary Sputum smears are usually positive in patients with l Answer the following medical question: In post-ductal coarctation of aoa collaterals may be formed by all of the following, except, with the following options: A: Veebral aery, B: Suprascapular a ery, C: Subscapular aery, D: Posterior intercostal aery +### Response: +","Coarctation of the aoa is a congenital condition whereby the aoa is narrow, usually in the area where the ductus aerioses inses. The word ""coarctation"" means narrowing. Coarctations are most common in the aoic arch. The arch may be small in babies with coarctations. Other hea defects may also occur when coarctation is present, typically occurring on the left side of the hea. When a patient has a coarctation, the left ventricle has to work harder. Since the aoa is narrowed, the left ventricle must generate a much higher pressure than normal in order to force enough blood through the aoa to deliver blood to the lower pa of the body. Ref - researchgate.net","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In post-ductal coarctation of aoa collaterals may be formed by all of the following, except, with the following options: A: Veebral aery, B: Suprascapular a ery, C: Subscapular aery, D: Posterior intercostal aery + ### Response: Coarctation of the aoa is a congenital condition whereby the aoa is narrow, usually in the area where the ductus aerioses inses. The word ""coarctation"" means narrowing. Coarctations are most common in the aoic arch. The arch may be small in babies with coarctations. Other hea defects may also occur when coarctation is present, typically occurring on the left side of the hea. When a patient has a coarctation, the left ventricle has to work harder. Since the aoa is narrowed, the left ventricle must generate a much higher pressure than normal in order to force enough blood through the aoa to deliver blood to the lower pa of the body. Ref - researchgate.net ### End" @@ -5019,6 +8969,13 @@ Coarctation of the aoa is a congenital condition whereby the aoa is narrow, usua Answer the following medical question: Patient with history of amenorrhea and hirsutism. USG of ovary is given below. Diagnosis:, with the following options: A: PCOS, B: Endometriosis, C: Adenomyomatosis, D: Choriocarcinoma +### Response: +","Ans. (a) PCOS Ref : Shaws 15th ed. /115-116, Image- * GARLAND/NECKLACE pattern on USG: PCOS * Comet tail appearance: Adenomyomatosis * Snowstorm appearance: Choriocarcinoma Polycystic ovarian syndrome (PCOS), recently referred also as hyperandrogenic anovulation, is a chronic anovulation syndrome associated with androgen excess. The diagnosis is made on the combined clinical, biochemical and sonographic grounds. The revised 2003 ASRM/ESHRE Rotterdam consensus criteria 4 require two of the following three criteria for the diagnosis: oligo- or anovulation hyperandrogenism (clinical or biochemical) and follicle count on imaging As well as the exclusion of other aetiologies, such as congenital adrenal hyperplasia, Cushing syndrome and/or an androgen-secreting tumour. Subsequently, the Androgen Excess and PCOS society (AE-PCOS) 9 specified a similar set of criteria for diagnosing PCOS but added that PCOS should be seen primarily as a disorder of androgen excess or hyperandrogenism. The criteria set forward was: presence of hyperandrogenism (clinical and/or biochemical) ovarian dysfunction (oligo-anovulation and/or polycystic ovaries) exclusion of related disorders Terminology Hyperandrogenic anovulation has been proposed as more accurate and potentially less confusing term, as the ovarian feature is of multiple follicles and not cysts13. At this stage, however, PCOS remains the term that is widely known and used. Epidemiology The estimated prevalence is ~6% (range 4-8%) of women of reproductive age but this varies (up to 20%) depending on the diagnostic criteria used 11. Clinical presentation The classic triad of PCOS is: oligomenorrhea hirsutism obesity In addition to this, patients may have infertility, acne, male pattern balding or biochemically show increased androgen levels. Pathology Markers Luteinizing hormone (LH) is usually increased and follicle stimulating hormone (FSH) can be normal or decreased 10. Normally premenopausal LH:FSH is 1:1. In PCOS it may be >2:1 or >3:1. Anti-Mullerian hormone (AMH) levels are generally increased. Associations subfertility and recurrent pregnancy loss. long-term increased risk of type 2 diabetes cardiovascular disease endometrial cancer 6 women with polycystic ovarian morphology are at increased risk of OHSS when undergoing IVF, regardless of whether they have PCOS15 Radiographic features Ultrasound Current recommended sonographic criteria for multifollicular ovarian morphology: 25 or more follicles per ovary (superseding the earlier Rotterdam criteria of 12 or more follicles) 14 increased ovarian size (>10 cc): less sensitive than the follicle number criteria, but has a role when image resolution does not allow accurate follicle count, e.g. transabdominal scanning, older equipment Other morphological features include: hyperechoic central stroma peripheral location of follicles: which can give a string of pearl appearance follicles of similar size measuring 2-9 mm The presence of a single multifollicular ovary is sufficient to provide the sonographic criterion for PCOS2. Ovaries may be normal in PCOS, and conversely, polycystic ovaries may be seen in women without the syndrome. Diagnosis requires correlation with features of hyperandrogenism and oligo-anovulation. MRI MRI is not warranted routinely in the investigation of PCOS, nonetheless pelvic MRI may show most or all of the above sonographic features. Signal characteristics include: T1: small uniform follicles are low in signal while the central stroma is of intermediate signal (vs normal myometrium) T2: follicles have high T2 signal while the central stroma is of comparatively low T2 signal 8 Practical points with a lack of consensus sometimes it is easier to report the number of follicles in each ovary rather than attempt to label the ovaries as ""polycystic"" or ""multifollicular"" History and etymology The syndrome was first described by I.F. Stein and M.L. Leventhal in 1935 7.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Patient with history of amenorrhea and hirsutism. USG of ovary is given below. Diagnosis:, with the following options: A: PCOS, B: Endometriosis, C: Adenomyomatosis, D: Choriocarcinoma + ### Response: Ans. (a) PCOS Ref : Shaws 15th ed. /115-116, Image- * GARLAND/NECKLACE pattern on USG: PCOS * Comet tail appearance: Adenomyomatosis * Snowstorm appearance: Choriocarcinoma Polycystic ovarian syndrome (PCOS), recently referred also as hyperandrogenic anovulation, is a chronic anovulation syndrome associated with androgen excess. The diagnosis is made on the combined clinical, biochemical and sonographic grounds. The revised 2003 ASRM/ESHRE Rotterdam consensus criteria 4 require two of the following three criteria for the diagnosis: oligo- or anovulation hyperandrogenism (clinical or biochemical) and follicle count on imaging As well as the exclusion of other aetiologies, such as congenital adrenal hyperplasia, Cushing syndrome and/or an androgen-secreting tumour. Subsequently, the Androgen Excess and PCOS society (AE-PCOS) 9 specified a similar set of criteria for diagnosing PCOS but added that PCOS should be seen primarily as a disorder of androgen excess or hyperandrogenism. The criteria set forward was: presence of hyperandrogenism (clinical and/or biochemical) ovarian dysfunction (oligo-anovulation and/or polycystic ovaries) exclusion of related disorders Terminology Hyperandrogenic anovulation has been proposed as more accurate and potentially less confusing term, as the ovarian feature is of multiple follicles and not cysts13. At this stage, however, PCOS remains the term that is widely known and used. Epidemiology The estimated prevalence is ~6% (range 4-8%) of women of reproductive age but this varies (up to 20%) depending on the diagnostic criteria used 11. Clinical presentation The classic triad of PCOS is: oligomenorrhea hirsutism obesity In addition to this, patients may have infertility, acne, male pattern balding or biochemically show increased androgen levels. Pathology Markers Luteinizing hormone (LH) is usually increased and follicle stimulating hormone (FSH) can be normal or decreased 10. Normally premenopausal LH:FSH is 1:1. In PCOS it may be >2:1 or >3:1. Anti-Mullerian hormone (AMH) levels are generally increased. Associations subfertility and recurrent pregnancy loss. long-term increased risk of type 2 diabetes cardiovascular disease endometrial cancer 6 women with polycystic ovarian morphology are at increased risk of OHSS when undergoing IVF, regardless of whether they have PCOS15 Radiographic features Ultrasound Current recommended sonographic criteria for multifollicular ovarian morphology: 25 or more follicles per ovary (superseding the earlier Rotterdam criteria of 12 or more follicles) 14 increased ovarian size (>10 cc): less sensitive than the follicle number criteria, but has a role when image resolution does not allow accurate follicle count, e.g. transabdominal scanning, older equipment Other morphological features include: hyperechoic central stroma peripheral location of follicles: which can give a string of pearl appearance follicles of similar size measuring 2-9 mm The presence of a single multifollicular ovary is sufficient to provide the sonographic criterion for PCOS2. Ovaries may be normal in PCOS, and conversely, polycystic ovaries may be seen in women without the syndrome. Diagnosis requires correlation with features of hyperandrogenism and oligo-anovulation. MRI MRI is not warranted routinely in the investigation of PCOS, nonetheless pelvic MRI may show most or all of the above sonographic features. Signal characteristics include: T1: small uniform follicles are low in signal while the central stroma is of intermediate signal (vs normal myometrium) T2: follicles have high T2 signal while the central stroma is of comparatively low T2 signal 8 Practical points with a lack of consensus sometimes it is easier to report the number of follicles in each ovary rather than attempt to label the ovaries as ""polycystic"" or ""multifollicular"" History and etymology The syndrome was first described by I.F. Stein and M.L. Leventhal in 1935 7. ### End" @@ -5028,6 +8985,13 @@ Ans. (a) PCOS Ref : Shaws 15th ed. /115-116, Image- * GARLAND/NECKLACE pattern o Answer the following medical question: A 25 years of male presents to emergency depament following a road traffic accident. On examination there is pelvic fracture and blood at urethral meatus. All of the following are true about patient except:, with the following options: A: Anterior urethra is the most likely site of injury, B: Retrograde urethrography should be done after the patient is stabilized, C: Foley catheter may be carefully passed if the RGU is normal, D: Rectal examination may reveal a large pelvic hematoma +### Response: +","INJURIES TO POSTERIOR URETHRA ETIOLOGY MC site injured in pelvic fracture is membranous urethra. CLINICAL FEATURES Retention of urine + Blood at urethral meatus + Pelvic hematoma and high lying prostate Presence of blood at external urethral meatus indicates thatImmediate urethrography Pie in sky appearance on IVP in membranous urethral injury. INSTRUMENTAL EXAMINATION In suspected paial injury, gentle single attempt to catheterize the patient acts as a stent over which urethra heals. Retrograde urethrography should be done after the patient is stabilized","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 25 years of male presents to emergency depament following a road traffic accident. On examination there is pelvic fracture and blood at urethral meatus. All of the following are true about patient except:, with the following options: A: Anterior urethra is the most likely site of injury, B: Retrograde urethrography should be done after the patient is stabilized, C: Foley catheter may be carefully passed if the RGU is normal, D: Rectal examination may reveal a large pelvic hematoma + ### Response: INJURIES TO POSTERIOR URETHRA ETIOLOGY MC site injured in pelvic fracture is membranous urethra. CLINICAL FEATURES Retention of urine + Blood at urethral meatus + Pelvic hematoma and high lying prostate Presence of blood at external urethral meatus indicates thatImmediate urethrography Pie in sky appearance on IVP in membranous urethral injury. INSTRUMENTAL EXAMINATION In suspected paial injury, gentle single attempt to catheterize the patient acts as a stent over which urethra heals. Retrograde urethrography should be done after the patient is stabilized ### End" @@ -5037,6 +9001,13 @@ INJURIES TO POSTERIOR URETHRA ETIOLOGY MC site injured in pelvic fracture is mem Answer the following medical question: Pulmonary plethora is not seen in:, with the following options: A: VSD, B: TOF, C: Truncus arteriosus, D: TAPVC +### Response: +","Ref: Pediatric Cardiology by Myung K.Park 5th edition: page no.217Explanation:Cyantic heart disease with increased pulmonary blood flowDouble outlet right ventricle (DORV) with sub pulmonary VSD (Taussig-Bing anomaly)Total anomalous pulmonary venous return (TAPVR);Transposition of the great arteries (TGA)Single ventricle (without PS)Persistent truncus arteriosus type ICyantic heart disease with decreased pulmonary blood flowTetralogy of Fallot (TOF)Ebstein's anomalyPulmonary atresiaTricuspid atresiaTGA and PSPersistent truncus arteriosus (type II or III)Single ventricle and PSCyanotic heart disease with increased pulmonary blood flow and acyanotic heart disease with left to right shunt (VSD, ASD, PDA) are associated with pulmonary plethora.- Cyanotic heart disease with decreased pulmonary blood flow are associated with pulmonary oligemia.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pulmonary plethora is not seen in:, with the following options: A: VSD, B: TOF, C: Truncus arteriosus, D: TAPVC + ### Response: Ref: Pediatric Cardiology by Myung K.Park 5th edition: page no.217Explanation:Cyantic heart disease with increased pulmonary blood flowDouble outlet right ventricle (DORV) with sub pulmonary VSD (Taussig-Bing anomaly)Total anomalous pulmonary venous return (TAPVR);Transposition of the great arteries (TGA)Single ventricle (without PS)Persistent truncus arteriosus type ICyantic heart disease with decreased pulmonary blood flowTetralogy of Fallot (TOF)Ebstein's anomalyPulmonary atresiaTricuspid atresiaTGA and PSPersistent truncus arteriosus (type II or III)Single ventricle and PSCyanotic heart disease with increased pulmonary blood flow and acyanotic heart disease with left to right shunt (VSD, ASD, PDA) are associated with pulmonary plethora.- Cyanotic heart disease with decreased pulmonary blood flow are associated with pulmonary oligemia. ### End" @@ -5046,6 +9017,13 @@ Ref: Pediatric Cardiology by Myung K.Park 5th edition: page no.217Explanation:Cy Answer the following medical question: A diabetic patient presents with pus from the eye. Colonies of isolated organisms are grey-white with a microscopic feature of non-septate hyphae and obtuse branching. Diagnosis is, with the following options: A: Aspergillosis, B: Candidiasis, C: Mucormycosis, D: Histoplasmosis +### Response: +","Mucor, Rhizopus, lichthemia are associated with mucormycosis. Primary infection is usually in upper respiratory tract or nose spreading the infection to orbit, paranasal sinuses, brain. On microscopy, specimen shows non-septate hyphae. In SDA medium the colonies are grey-white with a thick cotton fluffy surface. Ref: Baveja textbook of microbiology; 4th edition","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A diabetic patient presents with pus from the eye. Colonies of isolated organisms are grey-white with a microscopic feature of non-septate hyphae and obtuse branching. Diagnosis is, with the following options: A: Aspergillosis, B: Candidiasis, C: Mucormycosis, D: Histoplasmosis + ### Response: Mucor, Rhizopus, lichthemia are associated with mucormycosis. Primary infection is usually in upper respiratory tract or nose spreading the infection to orbit, paranasal sinuses, brain. On microscopy, specimen shows non-septate hyphae. In SDA medium the colonies are grey-white with a thick cotton fluffy surface. Ref: Baveja textbook of microbiology; 4th edition ### End" @@ -5055,6 +9033,13 @@ Mucor, Rhizopus, lichthemia are associated with mucormycosis. Primary infection Answer the following medical question: Duodenal blow out is usually seen at which day of the post operative period?, with the following options: A: 4th, B: 11th, C: 2nd, D: 7th +### Response: +","Ans: a (4th day)Duodenal blow out usually occurs between 2-7 days of surgery, more specifically on the 4th.It presents as abdominal pain, tachycardia, worsening of the general condition of the patient.It usually occurs after Billroth -II gastrectomyManagement:Total parenteral nutrution is given, catheter is placed immediately below the right costal margin and the electrolytes are replenished.Billroth I:Billroth IILower half of the stomach removed and is anastomosed to the Ist part of duodenum2/3rd of the stomach is removed; duodenal stump is closed and stomach is anastomosed to the jejunum.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Duodenal blow out is usually seen at which day of the post operative period?, with the following options: A: 4th, B: 11th, C: 2nd, D: 7th + ### Response: Ans: a (4th day)Duodenal blow out usually occurs between 2-7 days of surgery, more specifically on the 4th.It presents as abdominal pain, tachycardia, worsening of the general condition of the patient.It usually occurs after Billroth -II gastrectomyManagement:Total parenteral nutrution is given, catheter is placed immediately below the right costal margin and the electrolytes are replenished.Billroth I:Billroth IILower half of the stomach removed and is anastomosed to the Ist part of duodenum2/3rd of the stomach is removed; duodenal stump is closed and stomach is anastomosed to the jejunum. ### End" @@ -5064,6 +9049,13 @@ Ans: a (4th day)Duodenal blow out usually occurs between 2-7 days of surgery, mo Answer the following medical question: Degloving injury:-, with the following options: A: Separation of skin only, B: Separation of skin + subcutaneous tissue, C: Separation of skin + subcutaneous tissue + fascia exposing tendons, D: Separation of tendon exposing the bone +### Response: +","Degloving injury: Definition: Occurs when the skin & subcutaneous fat are stripped by avulsion from the underlying fascia leaving neurovascular structures, tendon or bone exposed E.g.: - 1. Ring avulsion injury with loss of finger skin - open degloving injury 2. Rollover injury over a limb caused by motor vehicle - Closed degloving injury DEGLOVING INJURY More severe","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Degloving injury:-, with the following options: A: Separation of skin only, B: Separation of skin + subcutaneous tissue, C: Separation of skin + subcutaneous tissue + fascia exposing tendons, D: Separation of tendon exposing the bone + ### Response: Degloving injury: Definition: Occurs when the skin & subcutaneous fat are stripped by avulsion from the underlying fascia leaving neurovascular structures, tendon or bone exposed E.g.: - 1. Ring avulsion injury with loss of finger skin - open degloving injury 2. Rollover injury over a limb caused by motor vehicle - Closed degloving injury DEGLOVING INJURY More severe ### End" @@ -5073,6 +9065,13 @@ Degloving injury: Definition: Occurs when the skin & subcutaneous fat are stripp Answer the following medical question: Height independent obesity index:, with the following options: A: Corpulence index, B: Quetlet index, C: Brocca index, D: Ponderal index +### Response: +","- So, Corpulence Index is ""Height independent "" index of obesity; cutoff <= 1.2. Other indices depend on height: Broca's index =Ht -100","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Height independent obesity index:, with the following options: A: Corpulence index, B: Quetlet index, C: Brocca index, D: Ponderal index + ### Response: - So, Corpulence Index is ""Height independent "" index of obesity; cutoff <= 1.2. Other indices depend on height: Broca's index =Ht -100 ### End" @@ -5082,6 +9081,13 @@ Answer the following medical question: Height independent obesity index:, with t Answer the following medical question: Most common tumor of submandibular gland is -, with the following options: A: Pleomorphic adenoma, B: Adenolymphoma, C: Oncocytoma, D: Hemangioma +### Response: +","Ans. is 'a' i.e., Pleomorphic adenoma * Pleomorphic adenoma - Most common benign tumor of submandibular gland* Adenoid cystic carcinoma - Most common malignant tumor of submandibular gland.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common tumor of submandibular gland is -, with the following options: A: Pleomorphic adenoma, B: Adenolymphoma, C: Oncocytoma, D: Hemangioma + ### Response: Ans. is 'a' i.e., Pleomorphic adenoma * Pleomorphic adenoma - Most common benign tumor of submandibular gland* Adenoid cystic carcinoma - Most common malignant tumor of submandibular gland. ### End" @@ -5091,6 +9097,13 @@ Ans. is 'a' i.e., Pleomorphic adenoma * Pleomorphic adenoma - Most common benign Answer the following medical question: The ""String of pearl"" colonies on Nutrient agar is produced by -, with the following options: A: Klebsiella, B: Proteus, C: Bacillus, D: Salmonella +### Response: +","Ans. is 'c' i.e., Bacillus String of pearl reactiono String of pearl reaction is used to differentiate B. anthracis from B. cereus and other aerobic spore forming bacteria,o When B. antharcis is grown on a solid medium containing penicillin, the cells become larger, spherical and occur in chains on the surface of the agar, resembling a string of pearls.Important characteristic feature of B. Anthraciso Gram positiveo Non-motile fall other members of genus Bacillus are motile)o Polypeptide capsuleo ""Frosted glass appearance "" of cultureo ""Invertedfor tree appearance "" of cultureo Medusa head colonieso String of pearl's reactiono ""Cut glass appearance""o MTadyean's reactiono Selective media - PLET medium","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The ""String of pearl"" colonies on Nutrient agar is produced by -, with the following options: A: Klebsiella, B: Proteus, C: Bacillus, D: Salmonella + ### Response: Ans. is 'c' i.e., Bacillus String of pearl reactiono String of pearl reaction is used to differentiate B. anthracis from B. cereus and other aerobic spore forming bacteria,o When B. antharcis is grown on a solid medium containing penicillin, the cells become larger, spherical and occur in chains on the surface of the agar, resembling a string of pearls.Important characteristic feature of B. Anthraciso Gram positiveo Non-motile fall other members of genus Bacillus are motile)o Polypeptide capsuleo ""Frosted glass appearance "" of cultureo ""Invertedfor tree appearance "" of cultureo Medusa head colonieso String of pearl's reactiono ""Cut glass appearance""o MTadyean's reactiono Selective media - PLET medium ### End" @@ -5100,6 +9113,13 @@ Ans. is 'c' i.e., Bacillus String of pearl reactiono String of pearl reaction is Answer the following medical question: All drugs are used in AIDS EXCEPT:, with the following options: A: Abacavir, B: Ritonavir, C: Acyclovir, D: Tenofovir +### Response: +","Ans. (c) AcyclovirRef. Katzung 11th ed. / 860* Acyclovir is an acyclic guanosine derivative with clinical activity against HSV-1, HSV-2, and VZV. In vitro activity against Epstein-Barr virus (EBV), cytomegalovirus (CMV), and human herpesvirus-6 (HHV-6).ANTI-RETROVIRAL DRUGS* Nucleoside reverse tanscriptase inhibitor: Zidovudine, Stavudine, Lamivudine, Didanosine, Emtricitabine, Zalcitabine, Abacavir* Nucleotide reverse tanscriptase inhibitor: Tenofovir* Protease inhibitors: Indinavir, Saquinavir, Ritonavir, Atazanavir, Nelfinavir, Amprenavir, Lopinavir.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All drugs are used in AIDS EXCEPT:, with the following options: A: Abacavir, B: Ritonavir, C: Acyclovir, D: Tenofovir + ### Response: Ans. (c) AcyclovirRef. Katzung 11th ed. / 860* Acyclovir is an acyclic guanosine derivative with clinical activity against HSV-1, HSV-2, and VZV. In vitro activity against Epstein-Barr virus (EBV), cytomegalovirus (CMV), and human herpesvirus-6 (HHV-6).ANTI-RETROVIRAL DRUGS* Nucleoside reverse tanscriptase inhibitor: Zidovudine, Stavudine, Lamivudine, Didanosine, Emtricitabine, Zalcitabine, Abacavir* Nucleotide reverse tanscriptase inhibitor: Tenofovir* Protease inhibitors: Indinavir, Saquinavir, Ritonavir, Atazanavir, Nelfinavir, Amprenavir, Lopinavir. ### End" @@ -5109,6 +9129,13 @@ Ans. (c) AcyclovirRef. Katzung 11th ed. / 860* Acyclovir is an acyclic guanosine Answer the following medical question: The investigation of choice in a 55-year-old post menopausal women who has presented with postmenopausal bleeding is :, with the following options: A: Pap smear, B: Fractional curettage, C: Transvaginal ultrasound, D: CA-125 +### Response: +","D&C is required to rule out endometrial cancer. It is necessary in a woman complaining of menstrual disorder and postmenopausal bleeding Reference : Shaw's Textbook of Gynaecology 16th edition, page no 399.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The investigation of choice in a 55-year-old post menopausal women who has presented with postmenopausal bleeding is :, with the following options: A: Pap smear, B: Fractional curettage, C: Transvaginal ultrasound, D: CA-125 + ### Response: D&C is required to rule out endometrial cancer. It is necessary in a woman complaining of menstrual disorder and postmenopausal bleeding Reference : Shaw's Textbook of Gynaecology 16th edition, page no 399. ### End" @@ -5118,6 +9145,13 @@ D&C is required to rule out endometrial cancer. It is necessary in a woman compl Answer the following medical question: Aerial supply of caecum is through:, with the following options: A: Right colic aery, B: Middle colic aery, C: Ileocolic aery, D: All of the above +### Response: +",Ileocolic aery,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Aerial supply of caecum is through:, with the following options: A: Right colic aery, B: Middle colic aery, C: Ileocolic aery, D: All of the above + ### Response: Ileocolic aery ### End" @@ -5127,6 +9161,13 @@ Ileocolic aery Answer the following medical question: A two year old child with a long history of purulent nasal discharge & fever now presents with conjunctival congestion and edema. His fever is 102deg/103degF and WBC count 12,000. The culture of eye discharge was negative. X-rays show opacification of ethmoid sinus. Which of the following should be the next step in evaluating this patient?, with the following options: A: CT Scan, B: Urine Culture, C: Blood culture, D: Repeat culture of eye discharge +### Response: +","A patient presenting with long standing history of purulent nasal discharge, fever, opacification of sinus and development of conjunctival congestion with edema suggests a diagnosis of chronic sinusitis associated with orbital complications (orbital cellulitis or abscess). Therefore, a CT scan or ultrasound of the orbit should be next step in this patient's evaluation. Ref: Diseases of Ear, Nose and Throat By PL Dhingra, 4th Edition, Chapter 37 and 38; Handbook of Otolaryngology : Head and Neck Surgery By David Goldenberg, Bradley Goldstein","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A two year old child with a long history of purulent nasal discharge & fever now presents with conjunctival congestion and edema. His fever is 102deg/103degF and WBC count 12,000. The culture of eye discharge was negative. X-rays show opacification of ethmoid sinus. Which of the following should be the next step in evaluating this patient?, with the following options: A: CT Scan, B: Urine Culture, C: Blood culture, D: Repeat culture of eye discharge + ### Response: A patient presenting with long standing history of purulent nasal discharge, fever, opacification of sinus and development of conjunctival congestion with edema suggests a diagnosis of chronic sinusitis associated with orbital complications (orbital cellulitis or abscess). Therefore, a CT scan or ultrasound of the orbit should be next step in this patient's evaluation. Ref: Diseases of Ear, Nose and Throat By PL Dhingra, 4th Edition, Chapter 37 and 38; Handbook of Otolaryngology : Head and Neck Surgery By David Goldenberg, Bradley Goldstein ### End" @@ -5136,6 +9177,13 @@ A patient presenting with long standing history of purulent nasal discharge, fev Answer the following medical question: Which toxin of streptococcus causes hemolysis around colonies:, with the following options: A: Streptolysin O, B: Streptolysin S, C: Streptodornanse, D: Hyaluronidase +### Response: +","Option 1, 2 Streptolysin 'O' Streptolysin 'S' Oxygen labile Oxygen stable Hemolysis in reduced state only Hemolysis around streptococcal colonies. Cannot cause hemolysis on the surface of blood agar. Option 3 DNase/ Deoxyribonuclease/Streptodornanse : Diagnostic use: Anti-DNase B > 300-350 U is useful for the retrospective diagnosis of skin infections (pyoderma) and acute glomerulonephritis where ASO titer is low. Option 4 Hyaluronidase (spreading factor): Expressed by non-capsulated strains, such as M type 4 and 22.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which toxin of streptococcus causes hemolysis around colonies:, with the following options: A: Streptolysin O, B: Streptolysin S, C: Streptodornanse, D: Hyaluronidase + ### Response: Option 1, 2 Streptolysin 'O' Streptolysin 'S' Oxygen labile Oxygen stable Hemolysis in reduced state only Hemolysis around streptococcal colonies. Cannot cause hemolysis on the surface of blood agar. Option 3 DNase/ Deoxyribonuclease/Streptodornanse : Diagnostic use: Anti-DNase B > 300-350 U is useful for the retrospective diagnosis of skin infections (pyoderma) and acute glomerulonephritis where ASO titer is low. Option 4 Hyaluronidase (spreading factor): Expressed by non-capsulated strains, such as M type 4 and 22. ### End" @@ -5145,6 +9193,13 @@ Option 1, 2 Streptolysin 'O' Streptolysin 'S' Oxygen labile Oxygen stable Hemoly Answer the following medical question: Most common cause of ruheosis iridis ?, with the following options: A: Tumor, B: CRAO, C: Radiation retinopathy, D: Diabetic retinopathy +### Response: +","Ans. is 'd' i.e., Diabetic retinopathy Causes of rubeosis iridis (neovascularization of iris) Common :- Diabetic retinopathy (most common cause), central retinal vein occlusion, Eale's disease, sickle-cell retinopathy. Rare causes :- Long standing retinal detachment, central retinal aery occlusion, intraocular inflammation (uveitis), intraocular tumors (choroidal melanoma, retinoblastoma), radiation retinopathy, ocular ischemic syndrome (carotid aery disease, carotid-cavernous fistula).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common cause of ruheosis iridis ?, with the following options: A: Tumor, B: CRAO, C: Radiation retinopathy, D: Diabetic retinopathy + ### Response: Ans. is 'd' i.e., Diabetic retinopathy Causes of rubeosis iridis (neovascularization of iris) Common :- Diabetic retinopathy (most common cause), central retinal vein occlusion, Eale's disease, sickle-cell retinopathy. Rare causes :- Long standing retinal detachment, central retinal aery occlusion, intraocular inflammation (uveitis), intraocular tumors (choroidal melanoma, retinoblastoma), radiation retinopathy, ocular ischemic syndrome (carotid aery disease, carotid-cavernous fistula). ### End" @@ -5154,6 +9209,13 @@ Ans. is 'd' i.e., Diabetic retinopathy Causes of rubeosis iridis (neovasculariza Answer the following medical question: Lucid interval is seen in which of the following?, with the following options: A: Subaractnoid hemorrhage, B: Extradural hemorrhage, C: Subdural hemorrhage, D: Seen in all head injury cases +### Response: +",Lucid interval is a state of consciousness between two episodes of unconsciousness. It is classical of extradural hemorrhage.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Lucid interval is seen in which of the following?, with the following options: A: Subaractnoid hemorrhage, B: Extradural hemorrhage, C: Subdural hemorrhage, D: Seen in all head injury cases + ### Response: Lucid interval is a state of consciousness between two episodes of unconsciousness. It is classical of extradural hemorrhage. ### End" @@ -5163,6 +9225,13 @@ Lucid interval is a state of consciousness between two episodes of unconsciousne Answer the following medical question: Characteristic postmoem finding of carbolic acid poisoning is?, with the following options: A: Greenish stomach, B: Yellow charred stomach, C: Brown Leathery stomach, D: Black charred stomach +### Response: +","Note: On contact, carbolic acid hardens the tissues. Stomach mucosa hardens and becomes leathery like. That's why, gastric lavage can be donein carbolic acid poisoning.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Characteristic postmoem finding of carbolic acid poisoning is?, with the following options: A: Greenish stomach, B: Yellow charred stomach, C: Brown Leathery stomach, D: Black charred stomach + ### Response: Note: On contact, carbolic acid hardens the tissues. Stomach mucosa hardens and becomes leathery like. That's why, gastric lavage can be donein carbolic acid poisoning. ### End" @@ -5172,6 +9241,25 @@ Note: On contact, carbolic acid hardens the tissues. Stomach mucosa hardens and Answer the following medical question: Which of the following is not targeted in Millennium Development Goals (MDGs) ?, with the following options: A: Eradicating extreme poverty, B: Fostering global partnership for development, C: Reducing child mortality, D: Improving health care delivery +### Response: +","MILLENNIUM DEVELOPMENT GOALS (MDGS - TO BE ACHIEVED BY 2015) : + +Millennium Development Goals (MDGs) is a set of 8 Goals adopted by 189 countries at UN Millennium Summit in September 2000. +Baseline year was taken as 1990: 'All MDGs have to be achieved by 2015' +3 of 8 goals (Goal 4, 5, 6), 8 of 18 targets and 18 of 48 indicators are 'directly' health related +Goal 1: Eradicate extreme poverty and hunger +Goal 2: Achieve universal primary education +Goal 3: Promote gender equality and empower women +Goal 4: Reduce child mortality (Reduce by two-thirds the under-five mortality rate) +Goal 5: Improve maternal health (Reduce by three-quarters the maternal mortality ratio) +Goal 6: Combat HIV/AIDS, malaria and other diseases +Goal 7: Ensure environmental sustainability +Goal 8: Develop a global partnership for development","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is not targeted in Millennium Development Goals (MDGs) ?, with the following options: A: Eradicating extreme poverty, B: Fostering global partnership for development, C: Reducing child mortality, D: Improving health care delivery + ### Response: MILLENNIUM DEVELOPMENT GOALS (MDGS - TO BE ACHIEVED BY 2015) : @@ -5193,6 +9281,13 @@ Goal 8: Develop a global partnership for development Answer the following medical question: All are true regarding Tumor lysis syndrome except:, with the following options: A: Hypercalcemia, B: Hypocalcemia, C: hyperphosphatemia, D: Hyperkalemia +### Response: +","Ref: Harrisons Principles of Internal Medicine, 18,th edition, pg 2274Explanation:Tumor lysis syndrome (TLS)Characteristic biochemical changes in Tumor lysis SyndromeHyperuricemia,Hyperkalemia,Hypocalcemia,Hyperphosphatemia.AcidosisAcute renal failure.Caused by destruction of large number of rapidly multiplying neoplastic cells: During Burkin's lymohoma. ALL. CLL on chemotherapyChemotherapy commonly associated are-Fludarabine.Letrozole,Tamoxifen.Glucocorticoids,RituximabGemtuzumabAcute hyperurecemic nephropathy- urinary uric acid ! urine creatinine > 1High calcium:phosphate ratio - renal failureTumor burden, hyperuricemia & high LDH - high risk for TLS.TreatmentAllopurinolRasburicase (recombinant urate oxidase): contraind in G6PD deficiency, can cause bronchospasm, hypotension & hypoxiaAggressive hydration with Vi NSUrinary alkalinization with pH > 7 with IV sodium bicarbonateHemodialysis/hemofUtration:If S.potassium > 6;S. Uric acid > 10.S.Phosphate >10.S.Creat > 10 with severe hypocalcemiaCauses of hypercalcemia: VITAMINS TRAPVitamin D, A intoxication. VIPomaImmobilisationThiazide. TPNAddison'sMilk-alkali syndromeInfection: TuberculosisNeoplasm- Myeloma, secondary depositsSarcoidosisTuberculosis, ThyrotoxicosisRadiationAIDSParathyroid excess- primary /tertiary; Paget's","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are true regarding Tumor lysis syndrome except:, with the following options: A: Hypercalcemia, B: Hypocalcemia, C: hyperphosphatemia, D: Hyperkalemia + ### Response: Ref: Harrisons Principles of Internal Medicine, 18,th edition, pg 2274Explanation:Tumor lysis syndrome (TLS)Characteristic biochemical changes in Tumor lysis SyndromeHyperuricemia,Hyperkalemia,Hypocalcemia,Hyperphosphatemia.AcidosisAcute renal failure.Caused by destruction of large number of rapidly multiplying neoplastic cells: During Burkin's lymohoma. ALL. CLL on chemotherapyChemotherapy commonly associated are-Fludarabine.Letrozole,Tamoxifen.Glucocorticoids,RituximabGemtuzumabAcute hyperurecemic nephropathy- urinary uric acid ! urine creatinine > 1High calcium:phosphate ratio - renal failureTumor burden, hyperuricemia & high LDH - high risk for TLS.TreatmentAllopurinolRasburicase (recombinant urate oxidase): contraind in G6PD deficiency, can cause bronchospasm, hypotension & hypoxiaAggressive hydration with Vi NSUrinary alkalinization with pH > 7 with IV sodium bicarbonateHemodialysis/hemofUtration:If S.potassium > 6;S. Uric acid > 10.S.Phosphate >10.S.Creat > 10 with severe hypocalcemiaCauses of hypercalcemia: VITAMINS TRAPVitamin D, A intoxication. VIPomaImmobilisationThiazide. TPNAddison'sMilk-alkali syndromeInfection: TuberculosisNeoplasm- Myeloma, secondary depositsSarcoidosisTuberculosis, ThyrotoxicosisRadiationAIDSParathyroid excess- primary /tertiary; Paget's ### End" @@ -5202,6 +9297,13 @@ Ref: Harrisons Principles of Internal Medicine, 18,th edition, pg 2274Explanatio Answer the following medical question: Flash process for pasteurisation of milk is, with the following options: A: 630C for 15-20sec, B: 720C for 15-20sec, C: 630C for 30minutes, D: 720C for 30min +### Response: +","For pasteurization of milk with temperatures below 100oC: The milk is heated at either 63oC for 30minutes or 72oC for 15-20seconds followed by cooling quickly to 13oC or lower.By these processes, all non-sporing pathogens such as mycobacteria and salmonella are destroyedRef: Ananthanarayan; 7th edition; Page no: 26","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Flash process for pasteurisation of milk is, with the following options: A: 630C for 15-20sec, B: 720C for 15-20sec, C: 630C for 30minutes, D: 720C for 30min + ### Response: For pasteurization of milk with temperatures below 100oC: The milk is heated at either 63oC for 30minutes or 72oC for 15-20seconds followed by cooling quickly to 13oC or lower.By these processes, all non-sporing pathogens such as mycobacteria and salmonella are destroyedRef: Ananthanarayan; 7th edition; Page no: 26 ### End" @@ -5211,6 +9313,13 @@ For pasteurization of milk with temperatures below 100oC: The milk is heated at Answer the following medical question: A 57 year old male suffering from acute pancreatitis develops sudden onset breathlessness with a CVP< 18mmHg. The chest xray shows bilateral infiltrates. The possible diagnosis is, with the following options: A: ARDS, B: Myocardial infarction, C: Congestive left hea failure, D: Pulmonary embolism +### Response: +","Answer- A. ARDSARDS CriteriaAcute, meaning onset over 1 week or less.Bilateral opacities consistent with pulmonary edema must be present and may be detected on CT or chest radiograph.PF ratio < 300 mmHg with a minimum of 5 cmH20 PEEP (or CPAP).CVP < l8 mmHg.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 57 year old male suffering from acute pancreatitis develops sudden onset breathlessness with a CVP< 18mmHg. The chest xray shows bilateral infiltrates. The possible diagnosis is, with the following options: A: ARDS, B: Myocardial infarction, C: Congestive left hea failure, D: Pulmonary embolism + ### Response: Answer- A. ARDSARDS CriteriaAcute, meaning onset over 1 week or less.Bilateral opacities consistent with pulmonary edema must be present and may be detected on CT or chest radiograph.PF ratio < 300 mmHg with a minimum of 5 cmH20 PEEP (or CPAP).CVP < l8 mmHg. ### End" @@ -5220,6 +9329,17 @@ Answer- A. ARDSARDS CriteriaAcute, meaning onset over 1 week or less.Bilateral o Answer the following medical question: A component of conversion disorder is, with the following options: A: Hystericfits, B: Derealisation, C: Depersonaiisation, D: Amnesia +### Response: +","ICD 10 includes conversion disorders under dissociative disorders, +however, traditionally conversion disorders are known as hysteria Conversion disorder may present with +1. Hysterical fits +2. Motor symptoms like abnormal movements and gait disturbance or inability to move +3. Sensory symptoms like Blindness but walks and doesn't injure himself Tubular vision Glove stocking anesthesia Loss of sensation (not dermatomal)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A component of conversion disorder is, with the following options: A: Hystericfits, B: Derealisation, C: Depersonaiisation, D: Amnesia + ### Response: ICD 10 includes conversion disorders under dissociative disorders, however, traditionally conversion disorders are known as hysteria Conversion disorder may present with @@ -5233,6 +9353,13 @@ however, traditionally conversion disorders are known as hysteria Conversion dis Answer the following medical question: Multiparous pregnancy predispose to all, except:, with the following options: A: Postpaum hemorrhage, B: Pregnancy include hypeension, C: Anemia, D: Malpresentation +### Response: +",Pregnancy include hypeension,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Multiparous pregnancy predispose to all, except:, with the following options: A: Postpaum hemorrhage, B: Pregnancy include hypeension, C: Anemia, D: Malpresentation + ### Response: Pregnancy include hypeension ### End" @@ -5243,7 +9370,14 @@ Pregnancy include hypeension Answer the following medical question: A patient presents with thrombocytopenia, eczema and recurrent infections. What is the most probable diagnosis?, with the following options: A: Wiskott Aldrich syndrome, B: A beta gammaglobulinemia, C: Chediak higashi syndrome, D: Lazy leukocyte syndrome ### Response: -Wiskott-Aldrich syndrome (WAS) is an X-linked platelet/immunologic disorder caused by mutations in the WASP gene. The triad of eczema, recurrent infections, and microthrombocytopenia that characterizes WAS only occurs in 27% of the cases. The immunologic defects include low serum concentrations of IgM, while IgA and IgG are normal and IgE is frequently increased. Ref: The Elements of Immunology By Fahim Halim Khan, 2009, Page 413 ; Harrison's 17th ed chapter 310 +","Wiskott-Aldrich syndrome (WAS) is an X-linked platelet/immunologic disorder caused by mutations in the WASP gene. The triad of eczema, recurrent infections, and microthrombocytopenia that characterizes WAS only occurs in 27% of the cases. The immunologic defects include low serum concentrations of IgM, while IgA and IgG are normal and IgE is frequently increased. Ref: The Elements of Immunology By Fahim Halim Khan, 2009, Page 413 ; Harrison's 17th ed chapter 310","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A patient presents with thrombocytopenia, eczema and recurrent infections. What is the most probable diagnosis?, with the following options: A: Wiskott Aldrich syndrome, B: A beta gammaglobulinemia, C: Chediak higashi syndrome, D: Lazy leukocyte syndrome + +### Response: +Wiskott-Aldrich syndrome (WAS) is an X-linked platelet/immunologic disorder caused by mutations in the WASP gene. The triad of eczema, recurrent infections, and microthrombocytopenia that characterizes WAS only occurs in 27% of the cases. The immunologic defects include low serum concentrations of IgM, while IgA and IgG are normal and IgE is frequently increased. Ref: The Elements of Immunology By Fahim Halim Khan, 2009, Page 413 ; Harrison's 17th ed chapter 310 ### End" 556,"Below is an instruction that describes a task. Write a response that appropriately completes the request. @@ -5251,6 +9385,13 @@ Wiskott-Aldrich syndrome (WAS) is an X-linked platelet/immunologic disorder caus Answer the following medical question: All are treatable diseases of spinal cord EXCEPT:, with the following options: A: ALS, B: Multiple sclerosis, C: Syringomyelia, D: A-V malformation +### Response: +","ANSWER: (A) ALSREF: Harrison's 18th ed ch: 377Option (A):ALS or amyotrophic lateral sclerosis : No treatment arrests the underlying pathologic process in ALS. The drug riluzole (100 mg/d) was approved for ALS because it produces a modest lengthening of survival.Option (B):Multiple sclerosis : Therapy for MS can be divided into several categories:treatment of acute attacks,treatment with disease-modifying agents that reduce the biological activity of MS, andsymptomatic therapy. Treatments that promote remyelination or neural repair do not currently exist but would be highly desirableOption (C):Syringomelia: Treatment of syringomyelia is generally unsatisfactory. The Chiari tonsillar herniation is usually decompressed, generally by suboccipital craniectomy, upper cervical laminectomy, and placement of a dural graft. Obstruction of fourth ventricular outflow is reestablished by this procedure. If the syrinx cavity is large, some surgeons recommend direct decompression or drainage by one of a number of methods, but the added benefit of this procedure is uncertain, and morbidity is common.With Chiari malformations, shunting of hydrocephalus should generally precede any attempt to correct the syrinx. Surgery may stabilize the neurologic deficit, and some patients improve.Syringomyelia secondary to trauma or infection is treated with a decompression and drainage procedure in which a small shunt is inserted between the syrinx cavity and the subarachnoid space; alternatively, the cavity can be fenestrated. Cases due to intramedullary spinal cord tumor are generally managed by resection of the tumor.Option (D): A-V Malformations: treatment of AVM is largely surgical.Although the text creates confusion, but a table in Harrisons 18th Ed solves the question. The questions seems to have been taken directly from itTREATABLE SPINAL CORD DISORDERSCompressiveEpidural, intradural, or intramedullary neoplasmEpidural abscessEpidural hemorrhageCervical spondylosisHerniated diskPosttraumatic compression by fractured or displaced vertebra or hemorrhageVascularArteriovenous malformationAntiphospholipid syndrome and other hypercoagulable statesInflammatoryMultiple sclerosisNeuromyelitis opticaTransverse myelitisSarcoidosisSjogren-related myelopathySystemic lupus erythematosusVasculitisInfectiousViral: VZV, HSV-1 and -2, CMV, HIV, HTLV-I, othersBacterial and mycobacterial: Borrelia, Listeria, syphilis, othersMycoplasma pneumoniaeParasitic: schistosomiasis, toxoplasmosisDevelopmentalSyringomyeliaMeningomyeloceleTethered cord syndromeMetabolicVitamin B12 deficiency (subacute combined degeneration)Copper deficiencyAbbreviations: CMV, cytomegalovirus; HSV. herpes simplex virus; HTLV","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are treatable diseases of spinal cord EXCEPT:, with the following options: A: ALS, B: Multiple sclerosis, C: Syringomyelia, D: A-V malformation + ### Response: ANSWER: (A) ALSREF: Harrison's 18th ed ch: 377Option (A):ALS or amyotrophic lateral sclerosis : No treatment arrests the underlying pathologic process in ALS. The drug riluzole (100 mg/d) was approved for ALS because it produces a modest lengthening of survival.Option (B):Multiple sclerosis : Therapy for MS can be divided into several categories:treatment of acute attacks,treatment with disease-modifying agents that reduce the biological activity of MS, andsymptomatic therapy. Treatments that promote remyelination or neural repair do not currently exist but would be highly desirableOption (C):Syringomelia: Treatment of syringomyelia is generally unsatisfactory. The Chiari tonsillar herniation is usually decompressed, generally by suboccipital craniectomy, upper cervical laminectomy, and placement of a dural graft. Obstruction of fourth ventricular outflow is reestablished by this procedure. If the syrinx cavity is large, some surgeons recommend direct decompression or drainage by one of a number of methods, but the added benefit of this procedure is uncertain, and morbidity is common.With Chiari malformations, shunting of hydrocephalus should generally precede any attempt to correct the syrinx. Surgery may stabilize the neurologic deficit, and some patients improve.Syringomyelia secondary to trauma or infection is treated with a decompression and drainage procedure in which a small shunt is inserted between the syrinx cavity and the subarachnoid space; alternatively, the cavity can be fenestrated. Cases due to intramedullary spinal cord tumor are generally managed by resection of the tumor.Option (D): A-V Malformations: treatment of AVM is largely surgical.Although the text creates confusion, but a table in Harrisons 18th Ed solves the question. The questions seems to have been taken directly from itTREATABLE SPINAL CORD DISORDERSCompressiveEpidural, intradural, or intramedullary neoplasmEpidural abscessEpidural hemorrhageCervical spondylosisHerniated diskPosttraumatic compression by fractured or displaced vertebra or hemorrhageVascularArteriovenous malformationAntiphospholipid syndrome and other hypercoagulable statesInflammatoryMultiple sclerosisNeuromyelitis opticaTransverse myelitisSarcoidosisSjogren-related myelopathySystemic lupus erythematosusVasculitisInfectiousViral: VZV, HSV-1 and -2, CMV, HIV, HTLV-I, othersBacterial and mycobacterial: Borrelia, Listeria, syphilis, othersMycoplasma pneumoniaeParasitic: schistosomiasis, toxoplasmosisDevelopmentalSyringomyeliaMeningomyeloceleTethered cord syndromeMetabolicVitamin B12 deficiency (subacute combined degeneration)Copper deficiencyAbbreviations: CMV, cytomegalovirus; HSV. herpes simplex virus; HTLV ### End" @@ -5260,6 +9401,13 @@ ANSWER: (A) ALSREF: Harrison's 18th ed ch: 377Option (A):ALS or amyotrophic late Answer the following medical question: What is the condition affecting this newborn with facial dysmorphisms and the features shown below?, with the following options: A: Edward's syndrome, B: Turner's syndrome, C: Alagile syndrome, D: William's syndrome +### Response: +","The newborn with facial dysmorphism, index finger overlapping other fingers, and rocker bottom feet are suggestive of Edward&;s syndrome (Trisomy 18). Clinical features of Edward&;s syndrome: Hypeonia Microcephaly/Micrognathia Eighteen trisomy/Elongated skull Digit overlapping with a closed fist Webbing of 2nd and 3rd toes Absent intellect (severe developmental delay)/Absent radii/Ahrogryposis Rocker bottom feet Cardiac Disorders (Ventricular septal defect, patent ductus aeriosus, atrial septal defect) and kidney, death. Smaller lower jaw (Micrognathia), sho sternum, small nipples Ref: Nelson textbook of pediatrics 21st edition Pgno: 663,664","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What is the condition affecting this newborn with facial dysmorphisms and the features shown below?, with the following options: A: Edward's syndrome, B: Turner's syndrome, C: Alagile syndrome, D: William's syndrome + ### Response: The newborn with facial dysmorphism, index finger overlapping other fingers, and rocker bottom feet are suggestive of Edward&;s syndrome (Trisomy 18). Clinical features of Edward&;s syndrome: Hypeonia Microcephaly/Micrognathia Eighteen trisomy/Elongated skull Digit overlapping with a closed fist Webbing of 2nd and 3rd toes Absent intellect (severe developmental delay)/Absent radii/Ahrogryposis Rocker bottom feet Cardiac Disorders (Ventricular septal defect, patent ductus aeriosus, atrial septal defect) and kidney, death. Smaller lower jaw (Micrognathia), sho sternum, small nipples Ref: Nelson textbook of pediatrics 21st edition Pgno: 663,664 ### End" @@ -5269,6 +9417,13 @@ The newborn with facial dysmorphism, index finger overlapping other fingers, and Answer the following medical question: A lady presents with grade-III dyspnea. She has severe mitral stenosis with atrial fibrillation. Along with increased ventricular rate, clots in the left atrium are seen. Which of the following should not be done?, with the following options: A: Diltiazem to reduce the hea rate, B: Warfarin therapy, C: Open mitral commissurotomy and removal of clot, D: Cardioversion with percutaneous balloon valvotomy +### Response: +","Atrial fibrillation with retained clots is due to the stasis of blood in the poorly contracting Left atrium. If cardioversion is done in this setting, the normal sinus rhythm ensues and the proper contraction of atria may result in dislodgement of clots from the atria. The PMV procedure dilates the mitral annulus, relieves the annulus and the chances of clots embolizing a bigger orifice increase. If cardioversion is indicated more urgently, then intravenous heparin should be provided and TEE performed to exclude the presence of left atrial thrombus before the procedure.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A lady presents with grade-III dyspnea. She has severe mitral stenosis with atrial fibrillation. Along with increased ventricular rate, clots in the left atrium are seen. Which of the following should not be done?, with the following options: A: Diltiazem to reduce the hea rate, B: Warfarin therapy, C: Open mitral commissurotomy and removal of clot, D: Cardioversion with percutaneous balloon valvotomy + ### Response: Atrial fibrillation with retained clots is due to the stasis of blood in the poorly contracting Left atrium. If cardioversion is done in this setting, the normal sinus rhythm ensues and the proper contraction of atria may result in dislodgement of clots from the atria. The PMV procedure dilates the mitral annulus, relieves the annulus and the chances of clots embolizing a bigger orifice increase. If cardioversion is indicated more urgently, then intravenous heparin should be provided and TEE performed to exclude the presence of left atrial thrombus before the procedure. ### End" @@ -5278,6 +9433,13 @@ Atrial fibrillation with retained clots is due to the stasis of blood in the poo Answer the following medical question: The IPC section that denotes the death of the human being,unless the contrary appears from the context is, with the following options: A: 44, B: 45, C: 46, D: 51 +### Response: +","IPC section 46 denotes the death of the human being unless the contrary appears from the context. In the simple words, the word denotes the death of human being unless the contest suggests otherwise Other options *IPC44 :Denotes the Section on injury.The word injury denotes the death of a human being unless the context suggests otherwise *IPC45:Denotes section on life.The word life denotes the life of a human being,unless the contrary appears from the context *IPC 51:Denotes the section on Oath Reference The essentials of Forensic Medicine and toxicology 33rd edition, page number 139","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The IPC section that denotes the death of the human being,unless the contrary appears from the context is, with the following options: A: 44, B: 45, C: 46, D: 51 + ### Response: IPC section 46 denotes the death of the human being unless the contrary appears from the context. In the simple words, the word denotes the death of human being unless the contest suggests otherwise Other options *IPC44 :Denotes the Section on injury.The word injury denotes the death of a human being unless the context suggests otherwise *IPC45:Denotes section on life.The word life denotes the life of a human being,unless the contrary appears from the context *IPC 51:Denotes the section on Oath Reference The essentials of Forensic Medicine and toxicology 33rd edition, page number 139 ### End" @@ -5287,6 +9449,13 @@ IPC section 46 denotes the death of the human being unless the contrary appears Answer the following medical question: ACR-TIRADS scan for thyroid nodule characteristics include all except, with the following options: A: Margin, B: Echogenicity, C: Vascularity, D: Shape +### Response: +",Ans. (c) VascularityRef: ACR-TIRADS journalACR-TIRADS is based on* Composition* Echogenicity* Shape* Margin* Echogenic FociAll the above findings on USG are given points from 0 to 3 and total score calculated. Based on the total score* TR-1 - Benign: No FNA needed* TR-2 - Not suspicious: No FNA needed* TR-3 - Mildly Suspicious: (FNA if Size >2.5cm and Follow up if Size >1.5cm)* TR-4 - Moderately Suspicious (FNA if Size >1.5cm and Follow up if size >1cm)* TR- 5 - Highly Suspicious (FNA if Size >1cm and Follow up if size >0.5cm),"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: ACR-TIRADS scan for thyroid nodule characteristics include all except, with the following options: A: Margin, B: Echogenicity, C: Vascularity, D: Shape + ### Response: Ans. (c) VascularityRef: ACR-TIRADS journalACR-TIRADS is based on* Composition* Echogenicity* Shape* Margin* Echogenic FociAll the above findings on USG are given points from 0 to 3 and total score calculated. Based on the total score* TR-1 - Benign: No FNA needed* TR-2 - Not suspicious: No FNA needed* TR-3 - Mildly Suspicious: (FNA if Size >2.5cm and Follow up if Size >1.5cm)* TR-4 - Moderately Suspicious (FNA if Size >1.5cm and Follow up if size >1cm)* TR- 5 - Highly Suspicious (FNA if Size >1cm and Follow up if size >0.5cm) ### End" @@ -5296,6 +9465,13 @@ Ans. (c) VascularityRef: ACR-TIRADS journalACR-TIRADS is based on* Composition* Answer the following medical question: Tangier disease is characterized by, with the following options: A: Low HDL, B: Defective LDL receptors, C: No chylomicrons, D: Overproduction of VLDL +### Response: +","DyslipoproteinemiasDefectRemarksFamilial alpha-lipoprotein deficiencyTangier diseaseFish-eye diseaseApo-A-I deficienciesAll have a low or near absence of HDLA tendency toward hyperiacylglycerolemia as a resultof the absence of apo C-ll, causing inactive LPL. Low LDLlevels. Atherosclerosis in the elderlyRef: Harper&;s biochemistry; 30th edition; Chapter 26; Cholesterol Synthesis, Transpo, & Excretion","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Tangier disease is characterized by, with the following options: A: Low HDL, B: Defective LDL receptors, C: No chylomicrons, D: Overproduction of VLDL + ### Response: DyslipoproteinemiasDefectRemarksFamilial alpha-lipoprotein deficiencyTangier diseaseFish-eye diseaseApo-A-I deficienciesAll have a low or near absence of HDLA tendency toward hyperiacylglycerolemia as a resultof the absence of apo C-ll, causing inactive LPL. Low LDLlevels. Atherosclerosis in the elderlyRef: Harper&;s biochemistry; 30th edition; Chapter 26; Cholesterol Synthesis, Transpo, & Excretion ### End" @@ -5305,6 +9481,13 @@ DyslipoproteinemiasDefectRemarksFamilial alpha-lipoprotein deficiencyTangier dis Answer the following medical question: Which one of the following is not a cause of vitamin B12 deficiency?, with the following options: A: Blind-loop syndrome., B: Dietary deficiency., C: Intrinsic factor deficiency., D: Resection of ascending colon. +### Response: +","- Vit B12 is absorbed from ileum; hence resection of ascending colon has nothing to do with Vit B12 deficiency - Vit B12 deficiency is caused d/t: | Intake | Absorption - d/t decreased intrinsic factor, pancreatic & ileal diseases, fish tape worm infection | Requirement - as in children, pregnancy, lactation, blind loop syndrome","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which one of the following is not a cause of vitamin B12 deficiency?, with the following options: A: Blind-loop syndrome., B: Dietary deficiency., C: Intrinsic factor deficiency., D: Resection of ascending colon. + ### Response: - Vit B12 is absorbed from ileum; hence resection of ascending colon has nothing to do with Vit B12 deficiency - Vit B12 deficiency is caused d/t: | Intake | Absorption - d/t decreased intrinsic factor, pancreatic & ileal diseases, fish tape worm infection | Requirement - as in children, pregnancy, lactation, blind loop syndrome ### End" @@ -5314,6 +9497,13 @@ Answer the following medical question: Which one of the following is not a cause Answer the following medical question: Aeroplane splint is used in:, with the following options: A: Radial nerve injury, B: Ulnar nerve injury, C: Brachial plexus injury, D: Scoliosis +### Response: +",Aeroplane splint is used for brachial plexus palsy.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Aeroplane splint is used in:, with the following options: A: Radial nerve injury, B: Ulnar nerve injury, C: Brachial plexus injury, D: Scoliosis + ### Response: Aeroplane splint is used for brachial plexus palsy. ### End" @@ -5323,6 +9513,28 @@ Aeroplane splint is used for brachial plexus palsy. Answer the following medical question: In erect posture commonest site of foreign body in bronchus -, with the following options: A: Right posterior basal, B: Right anterior basal, C: Lateral basal, D: Medial basal +### Response: +","From Schwart, 7/e→ ""The most common anatomic location for a foreign body is the right main stem bronchus or the rt. lower lobe."" +From Pretest (Pretest has quoted Harrison, 14/e, p 994) +"" The right main stem bronchus is wider, shorter and vertically placed, and therefore the posterior segments of the right upper lobe (if the pt. aspirated while supine) are anatomically susceptible to aspiration pneumonia. The superior segments of the right lower lobe and left lower lobe (if the pt. supine) are also susceptible to aspiration pneumonia. These three segments are often referred to as the aspiration segments of the lung. The basilar segments of both lungs are susceptible to aspiration if the pts. aspirates while erect or sitting up."" + + +Inference : Segments involved + +Aspiration in Supine Position : + +RL upper lobe - posterior segment +Rt. lower lobe - superior segment +Lt. lower lobe - superior segment + +Aspiration in sitting or erection position + +Rt. basilar segments (of lower lobe).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In erect posture commonest site of foreign body in bronchus -, with the following options: A: Right posterior basal, B: Right anterior basal, C: Lateral basal, D: Medial basal + ### Response: From Schwart, 7/e→ ""The most common anatomic location for a foreign body is the right main stem bronchus or the rt. lower lobe."" From Pretest (Pretest has quoted Harrison, 14/e, p 994) @@ -5347,6 +9559,13 @@ Rt. basilar segments (of lower lobe). Answer the following medical question: Which of the following organisms is unlikely to be found in the sputum of a patient with cystic fibrosis?, with the following options: A: Haemophilus influenzae, B: Mycobacterium tuberculosis, C: Pseudomonas, D: Aspergillus fumigatus +### Response: +","Patients with cystic fibrosis are at risk for colonization and/or infection with a number of pathogens, and in general, these infections have a temporal relationship.In childhood, the most frequently isolated organisms are Haemophilus influenza and Staphylococcus aureus.As patients age, Pseudomonas aeruginosa becomes the predominant pathogen. Interestingly, Aspergillus fumigatus is found in the airways of up to 50% of cystic fibrosis patients.All these organisms merely colonize the airways but occasionally can also cause disease.Atypical mycobacteria can occasionally be found in the sputum but are often merely colonizers.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following organisms is unlikely to be found in the sputum of a patient with cystic fibrosis?, with the following options: A: Haemophilus influenzae, B: Mycobacterium tuberculosis, C: Pseudomonas, D: Aspergillus fumigatus + ### Response: Patients with cystic fibrosis are at risk for colonization and/or infection with a number of pathogens, and in general, these infections have a temporal relationship.In childhood, the most frequently isolated organisms are Haemophilus influenza and Staphylococcus aureus.As patients age, Pseudomonas aeruginosa becomes the predominant pathogen. Interestingly, Aspergillus fumigatus is found in the airways of up to 50% of cystic fibrosis patients.All these organisms merely colonize the airways but occasionally can also cause disease.Atypical mycobacteria can occasionally be found in the sputum but are often merely colonizers. ### End" @@ -5356,6 +9575,13 @@ Patients with cystic fibrosis are at risk for colonization and/or infection with Answer the following medical question: Which flap-based procedure is used for pilonidal sinus surgery?, with the following options: A: Rhomboid flap, B: Rotational flap, C: Free flap, D: Circular flap +### Response: +","Ans. A. Rhomboid flapPilonidal sinus* Pilonidal sinus describes a condition found in the natal cleft near the coccyx, consisting of single or multiple noninfected in the midline.* It is commonly seen in jeep drivers. Therefore, it is also called Jeepers bottom mainly seen at the gluteal cleft.* Seen in young age: 20-29 years.* It is present in the interdigital cleft in hands of a hair dresser, also seen in umbilicus, axilla.* Recurrence rate is very high after surgery.* Excision of all tracks and then closure by some other means designed to avoid a midline wound (Z-plasty, Karydakis procedure, and Limbergs flap).* Bascoms procedure involves an incision lateral to the midline to gain access to the sinus cavity, which is rid of hair and granulation tissue.Flaps and UsesRhomboid flapFor cheek, temple, back, and flat surface defectsTransposition flapThe most basic design, leaving a graftable donor siteAdvancement flapFor flexor surfaces; may need triangles excised at the base to make it work (commonly called Burows triangles)Z-plastyFor lengthening scars or tissuesBilobed flapFor convex surfaces, especially the noseRotation flapFor convex surfacesV-to-Y advancementCommonly used for Fingertips and extremitiesBipedicle flapFor eyelids, rarely elsewhereRhomboid flapTransposition flapZ-PlastyTwo triangular transposition flaps interposedBilobed flapBipedicle flapRotation flap","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which flap-based procedure is used for pilonidal sinus surgery?, with the following options: A: Rhomboid flap, B: Rotational flap, C: Free flap, D: Circular flap + ### Response: Ans. A. Rhomboid flapPilonidal sinus* Pilonidal sinus describes a condition found in the natal cleft near the coccyx, consisting of single or multiple noninfected in the midline.* It is commonly seen in jeep drivers. Therefore, it is also called Jeepers bottom mainly seen at the gluteal cleft.* Seen in young age: 20-29 years.* It is present in the interdigital cleft in hands of a hair dresser, also seen in umbilicus, axilla.* Recurrence rate is very high after surgery.* Excision of all tracks and then closure by some other means designed to avoid a midline wound (Z-plasty, Karydakis procedure, and Limbergs flap).* Bascoms procedure involves an incision lateral to the midline to gain access to the sinus cavity, which is rid of hair and granulation tissue.Flaps and UsesRhomboid flapFor cheek, temple, back, and flat surface defectsTransposition flapThe most basic design, leaving a graftable donor siteAdvancement flapFor flexor surfaces; may need triangles excised at the base to make it work (commonly called Burows triangles)Z-plastyFor lengthening scars or tissuesBilobed flapFor convex surfaces, especially the noseRotation flapFor convex surfacesV-to-Y advancementCommonly used for Fingertips and extremitiesBipedicle flapFor eyelids, rarely elsewhereRhomboid flapTransposition flapZ-PlastyTwo triangular transposition flaps interposedBilobed flapBipedicle flapRotation flap ### End" @@ -5365,6 +9591,13 @@ Ans. A. Rhomboid flapPilonidal sinus* Pilonidal sinus describes a condition foun Answer the following medical question: Immunoprophylaxis of leprosy is best done by which of the following given choices?, with the following options: A: MMR, B: Killed ICRC bacillus, C: Plague bacillus, D: Anthrax bacillus +### Response: +","Maximum work has been done with BCG+ heat killed M. leprae (will be the best answer). In the choices given Cat 2 killed ICRC bacillus is used for Immunoprophylaxis of leprosy. Ref: Park, 20th Edition, Page 286.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Immunoprophylaxis of leprosy is best done by which of the following given choices?, with the following options: A: MMR, B: Killed ICRC bacillus, C: Plague bacillus, D: Anthrax bacillus + ### Response: Maximum work has been done with BCG+ heat killed M. leprae (will be the best answer). In the choices given Cat 2 killed ICRC bacillus is used for Immunoprophylaxis of leprosy. Ref: Park, 20th Edition, Page 286. ### End" @@ -5374,6 +9607,13 @@ Maximum work has been done with BCG+ heat killed M. leprae (will be the best ans Answer the following medical question: Seagull sign is seen in -, with the following options: A: Chronic pancreatitis, B: Gall stone, C: Appendicitis, D: Acute cholecystitis +### Response: +","(B) Gall Stone (1106-Baily and Love 26th) (862 S. Das 7th)* Mercedes Benz Sign (Seagull Sign): When gas in the gall-stone, a characterstic shape will be seen on x- ray.The Seagull Sign:* In patients with severe aortic stenosis and heavily calcified valves the associates harsh loud crescendo- decrescendo murmur often takes on a high pitched musical quality, initiating the cooling sound of a seagull. We have now found that there is 'seagull sign' to accompany this 'seagull murmur'.* Murphy's sign - During deep palpation of the right upper quadrant the patient is asked to take deep breath in and out. Patient complains of acute pain during deep inspiration with inspiratory arrest when tender inflammed gall bladder comes down and touching the palpating fingers.* Boa's sign is diagnostic of acute cholecystitis. This is an area of hyperaesthesia between the 9th and 11th ribs posteriorly on the right side.EFFECTS AND COMPLICATION OF GALL STONES1) In the gall bladder2) In the common bilei) Asymptomatic gall stonesii) Hydrops of the gall bladderiii) Flatulent dyspepsiaiv) Gall stone colicv) Acute obstructive cholecystitis which may lead to -a) Mucoceleb) Empyemac) Gangrened) Perforation and fistula formatione) Chronic cholecystitisf) Carcinomai) Obstructive jaundiceii) Liver failureiii) Cholangitisiv) Acute or recurrent pancreatitis3) In the pancreas -4) In the intestine -i) Acute pancreatitisii) Acute relapsing pancreatitisiii) Chronic pancreatitisGall stone ileusSaint's Triad - GALL STONE. HIATUS HERNIA AND DIVERTICULOSIS OF THE COLON.* MEDICAL TREATMENT OF GALL BLADDER STONE IN***i) Cholesterol stoneii) Functioning of the gall bladderiii) Radiolucent stone <10 mm in diameter.* Incidence of gall stone formation is maximum in Ileal resection*** Factors associated with gall bladder stone formation -i) Impaired GB function - Emptying, Absorption, Excretionii) Supersaturated bile - Age, Sex, Genetics, Obesity, Diet.iii) Cholesterol nucleating factors - Mucus, Glycoprotein and Infection.iv) Absorption/enterhepatic circulation of bile - Deoxycholate, Bowel transit time, Faecal enteric flora Ileal resection, Cholestyramine***.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Seagull sign is seen in -, with the following options: A: Chronic pancreatitis, B: Gall stone, C: Appendicitis, D: Acute cholecystitis + ### Response: (B) Gall Stone (1106-Baily and Love 26th) (862 S. Das 7th)* Mercedes Benz Sign (Seagull Sign): When gas in the gall-stone, a characterstic shape will be seen on x- ray.The Seagull Sign:* In patients with severe aortic stenosis and heavily calcified valves the associates harsh loud crescendo- decrescendo murmur often takes on a high pitched musical quality, initiating the cooling sound of a seagull. We have now found that there is 'seagull sign' to accompany this 'seagull murmur'.* Murphy's sign - During deep palpation of the right upper quadrant the patient is asked to take deep breath in and out. Patient complains of acute pain during deep inspiration with inspiratory arrest when tender inflammed gall bladder comes down and touching the palpating fingers.* Boa's sign is diagnostic of acute cholecystitis. This is an area of hyperaesthesia between the 9th and 11th ribs posteriorly on the right side.EFFECTS AND COMPLICATION OF GALL STONES1) In the gall bladder2) In the common bilei) Asymptomatic gall stonesii) Hydrops of the gall bladderiii) Flatulent dyspepsiaiv) Gall stone colicv) Acute obstructive cholecystitis which may lead to -a) Mucoceleb) Empyemac) Gangrened) Perforation and fistula formatione) Chronic cholecystitisf) Carcinomai) Obstructive jaundiceii) Liver failureiii) Cholangitisiv) Acute or recurrent pancreatitis3) In the pancreas -4) In the intestine -i) Acute pancreatitisii) Acute relapsing pancreatitisiii) Chronic pancreatitisGall stone ileusSaint's Triad - GALL STONE. HIATUS HERNIA AND DIVERTICULOSIS OF THE COLON.* MEDICAL TREATMENT OF GALL BLADDER STONE IN***i) Cholesterol stoneii) Functioning of the gall bladderiii) Radiolucent stone <10 mm in diameter.* Incidence of gall stone formation is maximum in Ileal resection*** Factors associated with gall bladder stone formation -i) Impaired GB function - Emptying, Absorption, Excretionii) Supersaturated bile - Age, Sex, Genetics, Obesity, Diet.iii) Cholesterol nucleating factors - Mucus, Glycoprotein and Infection.iv) Absorption/enterhepatic circulation of bile - Deoxycholate, Bowel transit time, Faecal enteric flora Ileal resection, Cholestyramine***. ### End" @@ -5383,6 +9623,13 @@ Answer the following medical question: Seagull sign is seen in -, with the follo Answer the following medical question: Clubbing is the least common in, with the following options: A: Squamous cell carcinoma, B: Small cell carcinoma, C: Adenocarcinoma, D: Mesothelioma +### Response: +",Skeletal connective tissue syndrome including clubbing is usually not seen in small cell carcinoma. Ref Harrison 19th edition pg 250,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Clubbing is the least common in, with the following options: A: Squamous cell carcinoma, B: Small cell carcinoma, C: Adenocarcinoma, D: Mesothelioma + ### Response: Skeletal connective tissue syndrome including clubbing is usually not seen in small cell carcinoma. Ref Harrison 19th edition pg 250 ### End" @@ -5392,6 +9639,13 @@ Skeletal connective tissue syndrome including clubbing is usually not seen in sm Answer the following medical question: Absolutely contraindicated antihypeensive drug in pregnancy is-, with the following options: A: Enalapril, B: Diazoxide, C: Atenolol, D: Nifedipine +### Response: +","Ans. is 'a' i.e., Enalapril","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Absolutely contraindicated antihypeensive drug in pregnancy is-, with the following options: A: Enalapril, B: Diazoxide, C: Atenolol, D: Nifedipine + ### Response: Ans. is 'a' i.e., Enalapril ### End" @@ -5401,6 +9655,13 @@ Ans. is 'a' i.e., Enalapril Answer the following medical question: Clathrin is used in:, with the following options: A: Receptor mediated endocytosis, B: Exocytosis, C: Cell adhesion, D: All +### Response: +","Clathrin and megalin are associated with endocytosis Endocytosis is a vesicular transpo system, it is an active process","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Clathrin is used in:, with the following options: A: Receptor mediated endocytosis, B: Exocytosis, C: Cell adhesion, D: All + ### Response: Clathrin and megalin are associated with endocytosis Endocytosis is a vesicular transpo system, it is an active process ### End" @@ -5410,6 +9671,13 @@ Clathrin and megalin are associated with endocytosis Endocytosis is a vesicular Answer the following medical question: Which of the following statement about Penicillin G is true?, with the following options: A: It is commonly administered orally, B: It has a broad spectrum of antibacterial activity, C: It can be used for the treatment rat bite fever, D: Concomitant probenecid decreases its duration of action +### Response: +","Prophylactic uses (a) Rheumatic fever: Low concentrations of penicillin prevent colonization by streptococci responsible for rheumatic fever. Benzathine penicillin 1 .2 MU every 4 weeks till 18 years of age or 5 years after an attack, whichever is more. (b) Bacterial endocarditis: Dental extractions, endoscopies, catheterization, etc. cause bacteremia which in patients with valvular defects can cause endocarditis. PnG can afford protection, but amoxicillin is preferred now. (c) Agranulocytosis patients: Penicillin may be used alone or in combination with an aminoglycoside antibiotic to prevent respiratory and other acute infections. Pharmacokinetics: Penicillin G is acid labile-destroyed by gastric acid. As such, less than 1 /3rd of an oral dose is absorbed in the active form. Absorption of sod. PnG from i.m. site is rapid and complete; peak plasma level is attained in 30 min. It is distributed mainly extracellularly; reaches most body fluids, but penetration in serous cavities and CSF is poor. However, in the presence of inflammation (sinovitis, meningitis, etc.) adequate amounts may reach these sites. About 60% is plasma protein bound. It is little metabolized because of rapid excretion. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:697,699","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following statement about Penicillin G is true?, with the following options: A: It is commonly administered orally, B: It has a broad spectrum of antibacterial activity, C: It can be used for the treatment rat bite fever, D: Concomitant probenecid decreases its duration of action + ### Response: Prophylactic uses (a) Rheumatic fever: Low concentrations of penicillin prevent colonization by streptococci responsible for rheumatic fever. Benzathine penicillin 1 .2 MU every 4 weeks till 18 years of age or 5 years after an attack, whichever is more. (b) Bacterial endocarditis: Dental extractions, endoscopies, catheterization, etc. cause bacteremia which in patients with valvular defects can cause endocarditis. PnG can afford protection, but amoxicillin is preferred now. (c) Agranulocytosis patients: Penicillin may be used alone or in combination with an aminoglycoside antibiotic to prevent respiratory and other acute infections. Pharmacokinetics: Penicillin G is acid labile-destroyed by gastric acid. As such, less than 1 /3rd of an oral dose is absorbed in the active form. Absorption of sod. PnG from i.m. site is rapid and complete; peak plasma level is attained in 30 min. It is distributed mainly extracellularly; reaches most body fluids, but penetration in serous cavities and CSF is poor. However, in the presence of inflammation (sinovitis, meningitis, etc.) adequate amounts may reach these sites. About 60% is plasma protein bound. It is little metabolized because of rapid excretion. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:697,699 ### End" @@ -5419,6 +9687,13 @@ Prophylactic uses (a) Rheumatic fever: Low concentrations of penicillin prevent Answer the following medical question: Multiple infection of RBC is seen with -, with the following options: A: Plasmodium ovale, B: Plasmodium vivax, C: Plasmodium falciparum, D: Plasmodium malariae +### Response: +","In erythrocytic schizogony- P. falciparum - more than one parasite (2-6) invade an erythrocyte. Plasmodium vivax, Plasmodium malariae and Plasmodium ovale - single parasite with in RBC.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Multiple infection of RBC is seen with -, with the following options: A: Plasmodium ovale, B: Plasmodium vivax, C: Plasmodium falciparum, D: Plasmodium malariae + ### Response: In erythrocytic schizogony- P. falciparum - more than one parasite (2-6) invade an erythrocyte. Plasmodium vivax, Plasmodium malariae and Plasmodium ovale - single parasite with in RBC. ### End" @@ -5428,6 +9703,13 @@ In erythrocytic schizogony- P. falciparum - more than one parasite (2-6) invade Answer the following medical question: Which of the following reflexes is not present at bih-, with the following options: A: Asymmetric Tonic Neck Reflex, B: Moro's Reflex, C: Symmetric tonic neck reflex, D: Crossed extensor reflex +### Response: +","Ans. is 'c' i.e., Symmetric Tonic neck reflexes Neonatal reflexes o A number of primitive neonatal reflexes can be elicited in healthy term neonate. o These disappear as the child grows ---> These reflexes are inhibited by frontal lobes as child grows. o Absence of reflex responses indicates dysfunction of central or peripheral motor function. o Abnormal persistence of neonatal reflexes is pathognomonic of central motor lesions. Reflexes are A. Reflexes present at bih Rooting, sucking & swallowing reflexes 4. Crossed extensor appears at 4-6 months appears at 8-9 months --> appears at 10 months"" align=""left"" height=""84"" width=""385"">Moro reflex 5. Assymmetric tonic neck reflex Palmar grasp (grasp reflex) B. Reflexes appear after bih Symmetric tonic neck Parachute reflex Landau reflex","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following reflexes is not present at bih-, with the following options: A: Asymmetric Tonic Neck Reflex, B: Moro's Reflex, C: Symmetric tonic neck reflex, D: Crossed extensor reflex + ### Response: Ans. is 'c' i.e., Symmetric Tonic neck reflexes Neonatal reflexes o A number of primitive neonatal reflexes can be elicited in healthy term neonate. o These disappear as the child grows ---> These reflexes are inhibited by frontal lobes as child grows. o Absence of reflex responses indicates dysfunction of central or peripheral motor function. o Abnormal persistence of neonatal reflexes is pathognomonic of central motor lesions. Reflexes are A. Reflexes present at bih Rooting, sucking & swallowing reflexes 4. Crossed extensor appears at 4-6 months appears at 8-9 months --> appears at 10 months"" align=""left"" height=""84"" width=""385"">Moro reflex 5. Assymmetric tonic neck reflex Palmar grasp (grasp reflex) B. Reflexes appear after bih Symmetric tonic neck Parachute reflex Landau reflex ### End" @@ -5437,6 +9719,13 @@ Ans. is 'c' i.e., Symmetric Tonic neck reflexes Neonatal reflexes o A number of Answer the following medical question: True about CHPS is all except -, with the following options: A: Males commonly affected, B: Commonly presents at 3-8 weeks, C: X-Ray shows gastric dilation and gasless small intestines, D: USG is of no use in diagnosis +### Response: +","CHPS Hypertrophy of circular muscle fibers of pylorus with proximal extension into gastric antrum Increase incidence in the firstborn male child with M:F ratio 4:1. Inherited as a dominant polygenic trait. Manifestations: a. The usual age of presentation is 3-6 weeks of life with non-bilious projectile vomiting b. Palpable olive-shaped epigastric mass c. Nasogastric aspirate >10ml d. Positive family history e. Hypochloremic, hypokalemic metabolic alkalosis Upper gi imaging (barium study) Precaution: (1) Empty stomach via nasogastric tube before study (2) Remove contrast at end of the study Barium study features of chps a. Elongation and narrowing of the pyloric canal (2-4 cm length) b. Passing of small barium streak through pyloric canal is seen as a string of barium known as string sign. c. Crowding of muscle folds in pyloric canal known as double/triple track sign. d. Transient triangular tent-like cleft/niche in mid portion of the pyloric canal with the apex pointing inferiorly; e. Outpouching along lesser curvature due to disruption of antral peristalsis, known as pyloric teat/teat sign. f. The mass impression upon antrum with a streak of barium pointing toward the pyloric channel, known as beak sign/antral beaking. g. Indentation of the base of duodenal bulb known as umbrella/kirkling/ mushroom sign. h. Gastric hyperperistaltic waves are known as caterpillar sign. i.Gastric distension with fluid.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about CHPS is all except -, with the following options: A: Males commonly affected, B: Commonly presents at 3-8 weeks, C: X-Ray shows gastric dilation and gasless small intestines, D: USG is of no use in diagnosis + ### Response: CHPS Hypertrophy of circular muscle fibers of pylorus with proximal extension into gastric antrum Increase incidence in the firstborn male child with M:F ratio 4:1. Inherited as a dominant polygenic trait. Manifestations: a. The usual age of presentation is 3-6 weeks of life with non-bilious projectile vomiting b. Palpable olive-shaped epigastric mass c. Nasogastric aspirate >10ml d. Positive family history e. Hypochloremic, hypokalemic metabolic alkalosis Upper gi imaging (barium study) Precaution: (1) Empty stomach via nasogastric tube before study (2) Remove contrast at end of the study Barium study features of chps a. Elongation and narrowing of the pyloric canal (2-4 cm length) b. Passing of small barium streak through pyloric canal is seen as a string of barium known as string sign. c. Crowding of muscle folds in pyloric canal known as double/triple track sign. d. Transient triangular tent-like cleft/niche in mid portion of the pyloric canal with the apex pointing inferiorly; e. Outpouching along lesser curvature due to disruption of antral peristalsis, known as pyloric teat/teat sign. f. The mass impression upon antrum with a streak of barium pointing toward the pyloric channel, known as beak sign/antral beaking. g. Indentation of the base of duodenal bulb known as umbrella/kirkling/ mushroom sign. h. Gastric hyperperistaltic waves are known as caterpillar sign. i.Gastric distension with fluid. ### End" @@ -5446,6 +9735,13 @@ CHPS Hypertrophy of circular muscle fibers of pylorus with proximal extension in Answer the following medical question: A 50 years old women present's with post coital bleeding. A visible growth on cervix is detected on per speculum examination. Next investigation is :, with the following options: A: Punch biopsy, B: Colposcopic biopsy, C: Pap smear, D: Cone Biopsy +### Response: +",Ans. is a i.e. Punch biopsy,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 50 years old women present's with post coital bleeding. A visible growth on cervix is detected on per speculum examination. Next investigation is :, with the following options: A: Punch biopsy, B: Colposcopic biopsy, C: Pap smear, D: Cone Biopsy + ### Response: Ans. is a i.e. Punch biopsy ### End" @@ -5455,6 +9751,13 @@ Ans. is a i.e. Punch biopsy Answer the following medical question: A 20-year-old male patient presented with acute pain in the left hip region and inability to bear weight on left hip region. On examination, deformity of left lower limb was noticed. The lower limb was in slight flexion, adduction, and internal rotation. The patient gave a history of road accident while he was driving a car and suddenly, he had to stop the car. Neurovascular examination was normal. Which of the following x-rays will most likely correspond to the above condition: -, with the following options: A: , B: , C: , D: All of the above +### Response: +",THIS IS A CLASSICAL CASE OF POSTERIOR FEMUR DISLOCATION DUE TO DASHBOARD INJURY. IMAGE A DENOTES POSTERIOR HIP DISLOCATION. IMAGE B DENOTES ANTERIOR HIP DISLOCATION. IMAGE C DENOTES CENTRAL HIP DISLOCATION.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 20-year-old male patient presented with acute pain in the left hip region and inability to bear weight on left hip region. On examination, deformity of left lower limb was noticed. The lower limb was in slight flexion, adduction, and internal rotation. The patient gave a history of road accident while he was driving a car and suddenly, he had to stop the car. Neurovascular examination was normal. Which of the following x-rays will most likely correspond to the above condition: -, with the following options: A: , B: , C: , D: All of the above + ### Response: THIS IS A CLASSICAL CASE OF POSTERIOR FEMUR DISLOCATION DUE TO DASHBOARD INJURY. IMAGE A DENOTES POSTERIOR HIP DISLOCATION. IMAGE B DENOTES ANTERIOR HIP DISLOCATION. IMAGE C DENOTES CENTRAL HIP DISLOCATION. ### End" @@ -5464,6 +9767,13 @@ THIS IS A CLASSICAL CASE OF POSTERIOR FEMUR DISLOCATION DUE TO DASHBOARD INJURY. Answer the following medical question: Synkinesis is a sequel of, with the following options: A: Facial nerve paralysis, B: Trigeminal nerve paralysis, C: Superficial temporal nerve paralysis, D: Greater petrosal nerve paralysis +### Response: +",Synkinesis or mass movement is a complication of peripheral facial nerve paralysis which occurs due to cross-innervation of fibres. Ref: Dhingra 6th edition pg. 98,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Synkinesis is a sequel of, with the following options: A: Facial nerve paralysis, B: Trigeminal nerve paralysis, C: Superficial temporal nerve paralysis, D: Greater petrosal nerve paralysis + ### Response: Synkinesis or mass movement is a complication of peripheral facial nerve paralysis which occurs due to cross-innervation of fibres. Ref: Dhingra 6th edition pg. 98 ### End" @@ -5473,6 +9783,13 @@ Synkinesis or mass movement is a complication of peripheral facial nerve paralys Answer the following medical question: Prolonged postoperative ileus is best treated by?, with the following options: A: Long tube inseion, B: Calcium pantothenate, C: Laparotomy and exploration, D: Peristaltic stimulants +### Response: +","Most patients developed transient ileus after a major abdominal operation. Most of these resolve within 3 to 5 days. Condition like extensive operative manipulation, major small bowel injury, heavy narcotic use, intra abdominal infection and pancreatitis- can prolong the ileum to 5 to 7 days. Ileus prolonged beyond this period is viewed with suspicion. Management of postoperative ileus The essence of treatment is prevention, with the use of nasogastric suction and restriction of oral intake until bowel sounds and passage of flatus return. Electrolyte abnormality, if any is corrected. A battery of laboratory tests are conducted to look for primary causes. which, if found is treated. ""If paralytic ileus is prolonged and threatens life, a laparotomy should be considered to exclude a hidden cause and facilitate bowel decompression"" Ref: Bailey & Love 25/e, Page 1201.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Prolonged postoperative ileus is best treated by?, with the following options: A: Long tube inseion, B: Calcium pantothenate, C: Laparotomy and exploration, D: Peristaltic stimulants + ### Response: Most patients developed transient ileus after a major abdominal operation. Most of these resolve within 3 to 5 days. Condition like extensive operative manipulation, major small bowel injury, heavy narcotic use, intra abdominal infection and pancreatitis- can prolong the ileum to 5 to 7 days. Ileus prolonged beyond this period is viewed with suspicion. Management of postoperative ileus The essence of treatment is prevention, with the use of nasogastric suction and restriction of oral intake until bowel sounds and passage of flatus return. Electrolyte abnormality, if any is corrected. A battery of laboratory tests are conducted to look for primary causes. which, if found is treated. ""If paralytic ileus is prolonged and threatens life, a laparotomy should be considered to exclude a hidden cause and facilitate bowel decompression"" Ref: Bailey & Love 25/e, Page 1201. ### End" @@ -5482,6 +9799,13 @@ Most patients developed transient ileus after a major abdominal operation. Most Answer the following medical question: The CNS tumor present with calcification ?, with the following options: A: Oligodendroglioma, B: Astrocytoma, C: Medulloblastoma, D: Pheochromocytoma +### Response: +","Ans. is 'a' Oligodendroglioma Although many intracranial tumors show calcification, oligodendroglioma shows calcification in 70-90% of cases.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The CNS tumor present with calcification ?, with the following options: A: Oligodendroglioma, B: Astrocytoma, C: Medulloblastoma, D: Pheochromocytoma + ### Response: Ans. is 'a' Oligodendroglioma Although many intracranial tumors show calcification, oligodendroglioma shows calcification in 70-90% of cases. ### End" @@ -5491,6 +9815,13 @@ Ans. is 'a' Oligodendroglioma Although many intracranial tumors show calcificati Answer the following medical question: All of the following are known predesposing factors for cholangiocarcinoma except :, with the following options: A: CBD stones, B: Clonorchis sinensis, C: Ulcerative colitis, D: Primary sclerosing cholangitis +### Response: +",Answer is A (CBD stone) : Cholelithiasis is not clearly a predisposing factor for Cholangiocarcinoma - Harrison The predisposing factors of cholangiocarcinoma include : I. Chronic hepato-biliary parasite infection (Clonorchiasis or Asiatic cholangio-hepatitis) Q Congenital Anomaly with ectatic ducts (Choledochal cyst).Q Sclerosing cholangitis Q Ulcerative colitis Occupational exposure to carcinogensQ(Rubber + Automotive plants) Note: Nodular lesions that arise at the bifitrcation of hepatic ducts are called Klastskin tumors. Q,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following are known predesposing factors for cholangiocarcinoma except :, with the following options: A: CBD stones, B: Clonorchis sinensis, C: Ulcerative colitis, D: Primary sclerosing cholangitis + ### Response: Answer is A (CBD stone) : Cholelithiasis is not clearly a predisposing factor for Cholangiocarcinoma - Harrison The predisposing factors of cholangiocarcinoma include : I. Chronic hepato-biliary parasite infection (Clonorchiasis or Asiatic cholangio-hepatitis) Q Congenital Anomaly with ectatic ducts (Choledochal cyst).Q Sclerosing cholangitis Q Ulcerative colitis Occupational exposure to carcinogensQ(Rubber + Automotive plants) Note: Nodular lesions that arise at the bifitrcation of hepatic ducts are called Klastskin tumors. Q ### End" @@ -5500,6 +9831,13 @@ Answer is A (CBD stone) : Cholelithiasis is not clearly a predisposing factor fo Answer the following medical question: Anton syndrome is, with the following options: A: Cortical blindness, B: Patients densies that he is blind, C: Both of the above, D: None +### Response: +","(C) Both of the above # Bilateral infarction in the distal PCAs produces cortical blindness (blindness with preserved pupillary light reaction). The patient is often unaware of the blindness or may even deny it (Anton's syndrome).> Tiny islands of vision may persist, and the patient may report that vision fluctuates as images are captured in the preserved portions. Rarely, only peripheral vision is lost and central vision is spared, resulting in ""gun-barrel"" vision.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Anton syndrome is, with the following options: A: Cortical blindness, B: Patients densies that he is blind, C: Both of the above, D: None + ### Response: (C) Both of the above # Bilateral infarction in the distal PCAs produces cortical blindness (blindness with preserved pupillary light reaction). The patient is often unaware of the blindness or may even deny it (Anton's syndrome).> Tiny islands of vision may persist, and the patient may report that vision fluctuates as images are captured in the preserved portions. Rarely, only peripheral vision is lost and central vision is spared, resulting in ""gun-barrel"" vision. ### End" @@ -5509,6 +9847,13 @@ Answer the following medical question: Anton syndrome is, with the following opt Answer the following medical question: Mechanism of action of an oral contraceptive containing a combination of oestrogen-progestin is the following except-, with the following options: A: Inhibition of ovulation, B: A change in the cervical mucus, C: Inhibition of motility of the uterine tubes, D: All +### Response: +","Ans. is 'c' i.e., Inhibition of motility of the uterine tubes Mechanism of action of OCPs 1. Inihibition of gonadotropin release from pitutary by reinforcement of normal feedback inhibition No prevulatory LH surge No ovulation This is the most impoant mechanism. Thickning of cervical mucus secretion (due to progesterone) ---> hostile to sperm penetration. Even if ovulation and feilization occur, the blastocyte fails to implant because endometrium is either hyperproliferative or hypersecretory - not suitable for nidation -> Impoant in case of postcoital pill. Uterine and tubal contractions may be modified to disour feilization. Postcoital pills may dislodge a just implated blastocyte or may interfere feilization/implantation.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mechanism of action of an oral contraceptive containing a combination of oestrogen-progestin is the following except-, with the following options: A: Inhibition of ovulation, B: A change in the cervical mucus, C: Inhibition of motility of the uterine tubes, D: All + ### Response: Ans. is 'c' i.e., Inhibition of motility of the uterine tubes Mechanism of action of OCPs 1. Inihibition of gonadotropin release from pitutary by reinforcement of normal feedback inhibition No prevulatory LH surge No ovulation This is the most impoant mechanism. Thickning of cervical mucus secretion (due to progesterone) ---> hostile to sperm penetration. Even if ovulation and feilization occur, the blastocyte fails to implant because endometrium is either hyperproliferative or hypersecretory - not suitable for nidation -> Impoant in case of postcoital pill. Uterine and tubal contractions may be modified to disour feilization. Postcoital pills may dislodge a just implated blastocyte or may interfere feilization/implantation. ### End" @@ -5518,6 +9863,13 @@ Ans. is 'c' i.e., Inhibition of motility of the uterine tubes Mechanism of actio Answer the following medical question: Oxidation of lactate to pyruvate requires which vitamin -, with the following options: A: Riboflavin, B: Niacin, C: Folic acid, D: Biotin +### Response: +","Ans. is 'b' i.e., Niacin o Niacin is required as NAD+","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Oxidation of lactate to pyruvate requires which vitamin -, with the following options: A: Riboflavin, B: Niacin, C: Folic acid, D: Biotin + ### Response: Ans. is 'b' i.e., Niacin o Niacin is required as NAD+ ### End" @@ -5527,6 +9879,13 @@ Ans. is 'b' i.e., Niacin o Niacin is required as NAD+ Answer the following medical question: Pathogenesis of all of the following is granulomatous except, with the following options: A: Wagner's granulomatosis, B: Burgers diseases, C: Takayasu aeritis, D: Microscopic angitis +### Response: +","Refer robbins 9/e 510 Microscopic Polyangiitis (MPA) Microscopic polyangiitis is a disease that results from blood vessel inflammation that can result in damage to organ systems. Areas most commonly affected by MPA include the kidneys, lung, nerves, skin, and joints. Robbins clearly mentions"" microscopic polyangiitis is characterized by segmental fibrinoid necrosis of the media with focal transmural necrotizing lesions, granulomatous lesions are absent","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pathogenesis of all of the following is granulomatous except, with the following options: A: Wagner's granulomatosis, B: Burgers diseases, C: Takayasu aeritis, D: Microscopic angitis + ### Response: Refer robbins 9/e 510 Microscopic Polyangiitis (MPA) Microscopic polyangiitis is a disease that results from blood vessel inflammation that can result in damage to organ systems. Areas most commonly affected by MPA include the kidneys, lung, nerves, skin, and joints. Robbins clearly mentions"" microscopic polyangiitis is characterized by segmental fibrinoid necrosis of the media with focal transmural necrotizing lesions, granulomatous lesions are absent ### End" @@ -5536,6 +9895,13 @@ Refer robbins 9/e 510 Microscopic Polyangiitis (MPA) Microscopic polyangiitis is Answer the following medical question: Cadaveric position of vocal cords is, with the following options: A: Midline, B: 1.5 mm from midline, C: 3.5 mm from midline, D: 7.5 mm from midline +### Response: +","As all the laryngeal muscles are paralyzed, both cords lie in cadaveric position. There is also total anaesthesia of the larynx. This is the neutral position of the cricoarytenoid joint. It is about 3.5 mm from the midline. The healthy cord is unable to approximate the paralyzed cord, thus causing glottic incompetence. This results in hoarseness of voice and aspiration of liquids through the glottis. Cough is ineffective due to air waste. Ref: PL Dhingra Textbook of Ear, Nose and Throat, Edition 7, page - 338","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cadaveric position of vocal cords is, with the following options: A: Midline, B: 1.5 mm from midline, C: 3.5 mm from midline, D: 7.5 mm from midline + ### Response: As all the laryngeal muscles are paralyzed, both cords lie in cadaveric position. There is also total anaesthesia of the larynx. This is the neutral position of the cricoarytenoid joint. It is about 3.5 mm from the midline. The healthy cord is unable to approximate the paralyzed cord, thus causing glottic incompetence. This results in hoarseness of voice and aspiration of liquids through the glottis. Cough is ineffective due to air waste. Ref: PL Dhingra Textbook of Ear, Nose and Throat, Edition 7, page - 338 ### End" @@ -5545,6 +9911,13 @@ As all the laryngeal muscles are paralyzed, both cords lie in cadaveric position Answer the following medical question: Clergyman's knee involves ?, with the following options: A: Olecranon bursa, B: Suprapatellar bursa, C: Infrapatellar bursa, D: Prepatellar bursa +### Response: +","Ans. is 'c' i.e., lnfrapatellar bursa","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Clergyman's knee involves ?, with the following options: A: Olecranon bursa, B: Suprapatellar bursa, C: Infrapatellar bursa, D: Prepatellar bursa + ### Response: Ans. is 'c' i.e., lnfrapatellar bursa ### End" @@ -5554,6 +9927,13 @@ Ans. is 'c' i.e., lnfrapatellar bursa Answer the following medical question: Molluscum contagiosum is a:, with the following options: A: Bacteria, B: Fungus, C: Virus, D: Parasite +### Response: +","Ans. (c) VirusRef: Microbiology by Ananthanarayan and Paniker 8th ed. /443, 445* Moluscum contagiosum is a viral infection of skin which is caused by a virus, the moluscum contagiosum virus, from pox virus family.* The virus is contagious through direct contact.* The virus also can be spread by sexual contact and can occur in people with compromised immune systems.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Molluscum contagiosum is a:, with the following options: A: Bacteria, B: Fungus, C: Virus, D: Parasite + ### Response: Ans. (c) VirusRef: Microbiology by Ananthanarayan and Paniker 8th ed. /443, 445* Moluscum contagiosum is a viral infection of skin which is caused by a virus, the moluscum contagiosum virus, from pox virus family.* The virus is contagious through direct contact.* The virus also can be spread by sexual contact and can occur in people with compromised immune systems. ### End" @@ -5563,6 +9943,13 @@ Ans. (c) VirusRef: Microbiology by Ananthanarayan and Paniker 8th ed. /443, 445* Answer the following medical question: Risk factors for Placenta Accreta include all of the following, except:, with the following options: A: Previous LSCS scar, B: Previous curettage, C: Previous myomectomy, D: Previous placenta prae +### Response: +","In placenta accreta, there is a failure of normal decidua to form which causes the placenta to be directly anchored to the myometrium either paially or completely without any intervening decidua. Placenta prae in the present pregnancy is a risk factor for placenta accreta but previous placenta prae is not a risk factor. Ref: Manual of Pathology of the Human Placenta By Rebecca N. Baergen, Ku Benirschke; 2nd edition, Pages 192-97; Dutta textbook of Obstetrics 6th edition, Pages 420-21","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Risk factors for Placenta Accreta include all of the following, except:, with the following options: A: Previous LSCS scar, B: Previous curettage, C: Previous myomectomy, D: Previous placenta prae + ### Response: In placenta accreta, there is a failure of normal decidua to form which causes the placenta to be directly anchored to the myometrium either paially or completely without any intervening decidua. Placenta prae in the present pregnancy is a risk factor for placenta accreta but previous placenta prae is not a risk factor. Ref: Manual of Pathology of the Human Placenta By Rebecca N. Baergen, Ku Benirschke; 2nd edition, Pages 192-97; Dutta textbook of Obstetrics 6th edition, Pages 420-21 ### End" @@ -5572,6 +9959,13 @@ In placenta accreta, there is a failure of normal decidua to form which causes t Answer the following medical question: Function of leptin is-, with the following options: A: Reduce food intake, B: Stimulation of AgRP, C: Decrease lipolysis, D: All of the above +### Response: +","Ans. is 'a' i.e., Reduce food intake Leptin* Leptin is a protein hormone produced by fat cells. It acts on hypothalamus to reduce food intake, decrease lipogenesis and increase lipolysis, thereby reducing the body fat stores.* The effect of leptin on appetite is mediated through a-MSH (a-melanocyte stimulating hormone), a pro- opiomelanocortin (POMC) derivative. Leptin acts by increasing the synthesis of POMC which is converted into a-MSH. a-MSH acts through melanocortin-4 receptors to depress appetite.* Leptin also inhibits the secretion of Agouti-related peptide (AgRP), a neuropeptide that increases food intake.* Plasma leptin levels are proportional to the amount of body fat and are therefore higher in women and obese individuals.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Function of leptin is-, with the following options: A: Reduce food intake, B: Stimulation of AgRP, C: Decrease lipolysis, D: All of the above + ### Response: Ans. is 'a' i.e., Reduce food intake Leptin* Leptin is a protein hormone produced by fat cells. It acts on hypothalamus to reduce food intake, decrease lipogenesis and increase lipolysis, thereby reducing the body fat stores.* The effect of leptin on appetite is mediated through a-MSH (a-melanocyte stimulating hormone), a pro- opiomelanocortin (POMC) derivative. Leptin acts by increasing the synthesis of POMC which is converted into a-MSH. a-MSH acts through melanocortin-4 receptors to depress appetite.* Leptin also inhibits the secretion of Agouti-related peptide (AgRP), a neuropeptide that increases food intake.* Plasma leptin levels are proportional to the amount of body fat and are therefore higher in women and obese individuals. ### End" @@ -5581,6 +9975,13 @@ Ans. is 'a' i.e., Reduce food intake Leptin* Leptin is a protein hormone produce Answer the following medical question: All of the following are histological features of papillary carcinoma of thyroid, except:, with the following options: A: Complex branching papillae with fibrovascular core, B: Orphan Annie eye nuclei and intranuclear grooves, C: Psammoma bodies, D: Amyloid deposits +### Response: +","Histological features of Papillary thyroid carcinoma: Papillary carcinomas contain branching papillae having fibrovascular stalk covered by a single to multiple layers of cuboidal epithelial cells. Nuclei of papillary carcinoma cells contain finely dispersed chromatin, which impas an optically clear or empty appearance, giving rise to ground-glass appearance / Orphan Annie eye nuclei. Invaginations of cytoplasm often give appearance of intranuclear inclusions (""pseudo-inclusions"") or intranuclear grooves. Concentrically calcified structures termed Psammoma bodies are often present within lesion, usually within cores of papillae Metastases to adjacent cervical lymph nodes occur in upto half of cases. Involvement of blood vessels is relatively uncommon, paicularly in smaller lesions. Amyloid deposits are found in medullary carcinoma of thyroid.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following are histological features of papillary carcinoma of thyroid, except:, with the following options: A: Complex branching papillae with fibrovascular core, B: Orphan Annie eye nuclei and intranuclear grooves, C: Psammoma bodies, D: Amyloid deposits + ### Response: Histological features of Papillary thyroid carcinoma: Papillary carcinomas contain branching papillae having fibrovascular stalk covered by a single to multiple layers of cuboidal epithelial cells. Nuclei of papillary carcinoma cells contain finely dispersed chromatin, which impas an optically clear or empty appearance, giving rise to ground-glass appearance / Orphan Annie eye nuclei. Invaginations of cytoplasm often give appearance of intranuclear inclusions (""pseudo-inclusions"") or intranuclear grooves. Concentrically calcified structures termed Psammoma bodies are often present within lesion, usually within cores of papillae Metastases to adjacent cervical lymph nodes occur in upto half of cases. Involvement of blood vessels is relatively uncommon, paicularly in smaller lesions. Amyloid deposits are found in medullary carcinoma of thyroid. ### End" @@ -5590,6 +9991,13 @@ Histological features of Papillary thyroid carcinoma: Papillary carcinomas conta Answer the following medical question: Chlamydia pneumoniae causes causes:, with the following options: A: LGV, B: Atherosclerosis, C: Inclusion conjunctivitis, D: Trachoma +### Response: +","Ans. is. 'b' i. e., Atherosclerosis","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Chlamydia pneumoniae causes causes:, with the following options: A: LGV, B: Atherosclerosis, C: Inclusion conjunctivitis, D: Trachoma + ### Response: Ans. is. 'b' i. e., Atherosclerosis ### End" @@ -5600,7 +10008,7 @@ Ans. is. 'b' i. e., Atherosclerosis Answer the following medical question: The most common late CNS complication of HIV is, with the following options: A: Dementia, B: Ataxia, C: Seizures, D: Deliruim ### Response: -CNS involvement in AIDS +","CNS involvement in AIDS Involvement of the CNS is a common and important manifestation of AIDS. In addition to the lymphoid system, the nervous system is a major target of HIV infection. @@ -5618,22 +10026,61 @@ Peripheral neuropathies and Most commonly a progressive encephalopathy designated clinically as the AIDS dementia complex. AIDS dementia complex It is the commonest neurological complication in subacute or chronic HIV encephalitis. Earlier it was called AIDS encephalopathy or encephalitis. -It present as slowly or rapidly progressive dementia accompanied by abnormalities of motor function. -### End" -594,"Below is an instruction that describes a task. Write a response that appropriately completes the request. +It present as slowly or rapidly progressive dementia accompanied by abnormalities of motor function.","Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: -Answer the following medical question: Major criteria for jones classification is, with the following options: A: Fever, B: Arthralgia, C: Chorea, D: TPR Interval +Answer the following medical question: The most common late CNS complication of HIV is, with the following options: A: Dementia, B: Ataxia, C: Seizures, D: Deliruim ### Response: -i.e. (Chorea): (380 - Ghai 7th)JONES CRITERIA FOR RHEUMATIC FEVERMajor Criteria Minor Criteria* Carditis* Arthritis* Subcutaneous nodule* Chorea* Erythema marginatumA. Clinicali. Feverii. Arthralgiaiii. Previous rheumatic fever rheumatic heart diseaseB. Laboratoryi. Acute phase reactants leukocytosis, elevated ESR and CRPii. Prolonged PR interval on ECGEssential criteriaEvidence for recent streptococcal infection as evidenced bya. Increased antistreptolycin 'O' titerb. Positive throat culturec. Recent scarlet feverTwo major qr one major and two minor criteria are required in the presence of essential criteria to diagnose acute rheumatic feverAssessment for Presence of Heart DiseaseNadas' CriteriaMajor Minor* Systolic murmur* Systolic murmur less than grade III* Grade III or more* Abnormal second sound* Diastolic murmur* Abnormal ECG* Cyanosis* Abnormal X-ray* CHF* Abnormal blood pressurePresence of one major or two minor criteria indicate heart disease (399- Ghai 7th) -### End" -595,"Below is an instruction that describes a task. Write a response that appropriately completes the request. - -### Instruction: +CNS involvement in AIDS -Answer the following medical question: Which of the following metabolic abnormality it seen in multiple myelona -, with the following options: A: Hyponatremia, B: Hypokalemia, C: Hypercalcemia, D: Hyperphosphatemia +Involvement of the CNS is a common and important manifestation of AIDS. +In addition to the lymphoid system, the nervous system is a major target of HIV infection. +Macrophages and microglial cells in the central nervous system that belong to the monocyte and macrophage lineage are predominant to the types in the brain that are infected with HIV. +It is widely believed that HIV is carried into the brain by infected monocytes. +Ninety per cent of patients demonstrate some form of neurological involvement at autopsy. +In addition to opportunistic infection and neoplasm, several virally determined neuropathological changes occur. + +These include + +A self limited meningioencephalitis. +Aseptic meningitis +Vascular myelopathy +Peripheral neuropathies and +Most commonly a progressive encephalopathy designated clinically as the AIDS dementia complex. AIDS dementia complex +It is the commonest neurological complication in subacute or chronic HIV encephalitis. +Earlier it was called AIDS encephalopathy or encephalitis. +It present as slowly or rapidly progressive dementia accompanied by abnormalities of motor function. +### End" +594,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Major criteria for jones classification is, with the following options: A: Fever, B: Arthralgia, C: Chorea, D: TPR Interval + +### Response: +","i.e. (Chorea): (380 - Ghai 7th)JONES CRITERIA FOR RHEUMATIC FEVERMajor Criteria Minor Criteria* Carditis* Arthritis* Subcutaneous nodule* Chorea* Erythema marginatumA. Clinicali. Feverii. Arthralgiaiii. Previous rheumatic fever rheumatic heart diseaseB. Laboratoryi. Acute phase reactants leukocytosis, elevated ESR and CRPii. Prolonged PR interval on ECGEssential criteriaEvidence for recent streptococcal infection as evidenced bya. Increased antistreptolycin 'O' titerb. Positive throat culturec. Recent scarlet feverTwo major qr one major and two minor criteria are required in the presence of essential criteria to diagnose acute rheumatic feverAssessment for Presence of Heart DiseaseNadas' CriteriaMajor Minor* Systolic murmur* Systolic murmur less than grade III* Grade III or more* Abnormal second sound* Diastolic murmur* Abnormal ECG* Cyanosis* Abnormal X-ray* CHF* Abnormal blood pressurePresence of one major or two minor criteria indicate heart disease (399- Ghai 7th)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Major criteria for jones classification is, with the following options: A: Fever, B: Arthralgia, C: Chorea, D: TPR Interval + +### Response: +i.e. (Chorea): (380 - Ghai 7th)JONES CRITERIA FOR RHEUMATIC FEVERMajor Criteria Minor Criteria* Carditis* Arthritis* Subcutaneous nodule* Chorea* Erythema marginatumA. Clinicali. Feverii. Arthralgiaiii. Previous rheumatic fever rheumatic heart diseaseB. Laboratoryi. Acute phase reactants leukocytosis, elevated ESR and CRPii. Prolonged PR interval on ECGEssential criteriaEvidence for recent streptococcal infection as evidenced bya. Increased antistreptolycin 'O' titerb. Positive throat culturec. Recent scarlet feverTwo major qr one major and two minor criteria are required in the presence of essential criteria to diagnose acute rheumatic feverAssessment for Presence of Heart DiseaseNadas' CriteriaMajor Minor* Systolic murmur* Systolic murmur less than grade III* Grade III or more* Abnormal second sound* Diastolic murmur* Abnormal ECG* Cyanosis* Abnormal X-ray* CHF* Abnormal blood pressurePresence of one major or two minor criteria indicate heart disease (399- Ghai 7th) +### End" +595,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following metabolic abnormality it seen in multiple myelona -, with the following options: A: Hyponatremia, B: Hypokalemia, C: Hypercalcemia, D: Hyperphosphatemia + +### Response: +","Multiple myeloma is a plasma cell neoplasm commonly associated with lytic bone lesions, hypercalcemia, renal failure and acquired immune abnormalities. Bone resorption leads to hypercalcemia and Pathologic fractures. Reference : Robbins and Cotran Pathologic basis of disease.South Asia Edition volume 1.page no. 599","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following metabolic abnormality it seen in multiple myelona -, with the following options: A: Hyponatremia, B: Hypokalemia, C: Hypercalcemia, D: Hyperphosphatemia ### Response: Multiple myeloma is a plasma cell neoplasm commonly associated with lytic bone lesions, hypercalcemia, renal failure and acquired immune abnormalities. Bone resorption leads to hypercalcemia and Pathologic fractures. Reference : Robbins and Cotran Pathologic basis of disease.South Asia Edition volume 1.page no. 599 @@ -5644,6 +10091,13 @@ Multiple myeloma is a plasma cell neoplasm commonly associated with lytic bone l Answer the following medical question: True about malignant hypehermia is all except, with the following options: A: Most common cause is Sch, B: Dantrolene is the drug of choice, C: End tidal CO, is increased, D: Bradycardia occurs +### Response: +","Ans. is 'd' i.e., Bradycardia","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about malignant hypehermia is all except, with the following options: A: Most common cause is Sch, B: Dantrolene is the drug of choice, C: End tidal CO, is increased, D: Bradycardia occurs + ### Response: Ans. is 'd' i.e., Bradycardia ### End" @@ -5653,6 +10107,13 @@ Ans. is 'd' i.e., Bradycardia Answer the following medical question: All of the following are indicated in drug induced vomiting EXCEPT:, with the following options: A: Ondansetron, B: Metoclopramide, C: Hyoscine, D: Chlorpromazine +### Response: +","Ref: KD Tripathi, 6th ed. pg. 641, 642, 644, 646HYOSINE* It is the most effective drug for motion sickness.* Suitable only for short brisk journeys.* It acts by blocking conduction of nerve impulses in the pathway leading from the vestibular apparatus to the vomiting centre and is not effective in vomiting of other etiologies.ONDANSETRON* It is considered as the drug of choice for drug induced vomiting.* Used mainly to control cancer chemotherapy induced vomiting.* Effective in postoperative nausea and vomiting as well.METOCLOPRAMIDE* It is an effective and popular drug for many types of vomiting like: Postoperative, drug induced, disease associated (especially migraine), radiation sickness, etc.CHLORPROMAZINE* These are from typical antipsychotic having potent antiemetic action; act by blocking D2 receptors in the CTZ.* They have broad spectrum antiemetic action effective in:# Drug induced and post anaesthetic nausea and vomiting# Disease induced vomiting# Malignancy associated and cancer chemotherapy induced vomiting# Radiation sickness vomiting and morning sickness.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following are indicated in drug induced vomiting EXCEPT:, with the following options: A: Ondansetron, B: Metoclopramide, C: Hyoscine, D: Chlorpromazine + ### Response: Ref: KD Tripathi, 6th ed. pg. 641, 642, 644, 646HYOSINE* It is the most effective drug for motion sickness.* Suitable only for short brisk journeys.* It acts by blocking conduction of nerve impulses in the pathway leading from the vestibular apparatus to the vomiting centre and is not effective in vomiting of other etiologies.ONDANSETRON* It is considered as the drug of choice for drug induced vomiting.* Used mainly to control cancer chemotherapy induced vomiting.* Effective in postoperative nausea and vomiting as well.METOCLOPRAMIDE* It is an effective and popular drug for many types of vomiting like: Postoperative, drug induced, disease associated (especially migraine), radiation sickness, etc.CHLORPROMAZINE* These are from typical antipsychotic having potent antiemetic action; act by blocking D2 receptors in the CTZ.* They have broad spectrum antiemetic action effective in:# Drug induced and post anaesthetic nausea and vomiting# Disease induced vomiting# Malignancy associated and cancer chemotherapy induced vomiting# Radiation sickness vomiting and morning sickness. ### End" @@ -5662,6 +10123,13 @@ Ref: KD Tripathi, 6th ed. pg. 641, 642, 644, 646HYOSINE* It is the most effectiv Answer the following medical question: Fracture of mid face does not lead to, with the following options: A: Proptosis, B: Lengthening of face, C: Malocclusion of teeth, D: Anesthesia of upper lip +### Response: +",Proptosis is the forward protrusion or displacement of the eyeball. It does not occur in fracture of middle third of the face. It may occur in the fractures of the upper third of face especially fracture of the supraorbital ridge. Ref: Textbook of ENT; Dhingra; pg 181,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Fracture of mid face does not lead to, with the following options: A: Proptosis, B: Lengthening of face, C: Malocclusion of teeth, D: Anesthesia of upper lip + ### Response: Proptosis is the forward protrusion or displacement of the eyeball. It does not occur in fracture of middle third of the face. It may occur in the fractures of the upper third of face especially fracture of the supraorbital ridge. Ref: Textbook of ENT; Dhingra; pg 181 ### End" @@ -5671,6 +10139,13 @@ Proptosis is the forward protrusion or displacement of the eyeball. It does not Answer the following medical question: ""International prognostic index"" for lymphoma includes the following prognostic factors, EXCEPT:, with the following options: A: LDH, B: Stage of disease, C: Hemoglobin and Albumin, D: Number of extralymphatic sites involved +### Response: +","Hemoglobin and Albumin are not included as prognostic factors in International prognostic index. International prognostic index of lymphoma can predict the prognosis of lymphoma accurately. It is widely used to categorize patients with intermediate-grade lymphoma into risk group. Prognostic factors includes: Age of 60 or above Stage III or IV disease Performance status High level of lactate dehydrogenase (LDH) Involvement of 2 or more organs outside the lymph nodes Patients with no risk factors or one risk factor have high complete response rates (80%) to standard immunochemotherapy. Patients with two risk factors have a 70% complete response rate. Patients with higher-risk disease have lower response rates and poor survival with standard treatment regimens, and alternative treatments are needed. Ref: Current Medical Diagnosis and Treatment, 2012, Chapter 13; Johns Hopkins Medicine Patients Guide to Lymphoma By Aditya Bardia, Chapter 1","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: ""International prognostic index"" for lymphoma includes the following prognostic factors, EXCEPT:, with the following options: A: LDH, B: Stage of disease, C: Hemoglobin and Albumin, D: Number of extralymphatic sites involved + ### Response: Hemoglobin and Albumin are not included as prognostic factors in International prognostic index. International prognostic index of lymphoma can predict the prognosis of lymphoma accurately. It is widely used to categorize patients with intermediate-grade lymphoma into risk group. Prognostic factors includes: Age of 60 or above Stage III or IV disease Performance status High level of lactate dehydrogenase (LDH) Involvement of 2 or more organs outside the lymph nodes Patients with no risk factors or one risk factor have high complete response rates (80%) to standard immunochemotherapy. Patients with two risk factors have a 70% complete response rate. Patients with higher-risk disease have lower response rates and poor survival with standard treatment regimens, and alternative treatments are needed. Ref: Current Medical Diagnosis and Treatment, 2012, Chapter 13; Johns Hopkins Medicine Patients Guide to Lymphoma By Aditya Bardia, Chapter 1 ### End" @@ -5680,6 +10155,13 @@ Hemoglobin and Albumin are not included as prognostic factors in International p Answer the following medical question: Drug that binds bile acids in the intestine and prevents their return to liver the enterohepatic circulation is-, with the following options: A: Niacin, B: Fenofibrate, C: Cholestyramine, D: Gugulipid +### Response: +","Ans. is 'c' i.e., Cholestyramine ""Chlestyramine is a bile acid sequesterant""","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Drug that binds bile acids in the intestine and prevents their return to liver the enterohepatic circulation is-, with the following options: A: Niacin, B: Fenofibrate, C: Cholestyramine, D: Gugulipid + ### Response: Ans. is 'c' i.e., Cholestyramine ""Chlestyramine is a bile acid sequesterant"" ### End" @@ -5689,6 +10171,13 @@ Ans. is 'c' i.e., Cholestyramine ""Chlestyramine is a bile acid sequesterant"" Answer the following medical question: Following is true about GnRH agonists except ?, with the following options: A: Used in cases of precocious pubey, B: They have action similar to gonadotropin releasing hormone, C: Long acting preparations can be used as nasal spray, D: Ganirelix is the most potent agent +### Response: +","Ans. is 'd' i.e., Ganirelix is the most potent agent GnRH agonists Long acting GnRH (LHRH) agonists causes reversible pharmacological orchiectomy (medical castration) and are used for precocious pubey, prostatic carcinoma, endometriosis, premenopausal breast cancer, uterine leiomyoma, polycystic ovarian disease and to assist induced ovulation. GnRH agonists have action similar to Gonadotropin releasing hormone, i.e., they increase the secretion of gonadotropins (FSH, LH). Then how do they suppress gonadol function ? Lets see. GnRH agonists increases Gn secretion. But after 1-2 weeks they cause desensitization and down-regulation of FSH/LH receptors. (continous exposure to agonist may cause down regulation of receptors) --> suppression of gonadal function. Spermatogenesis/ovulation cease and testosterone/estrogen levels fall to castration level because the action of Gonadotropins (FSH & LH) is not there (these hormones promote gametogenesis and secretion of gonadal hormones). Preparation of superactive GnRH analogues are --> Busereline, Goserelin, Leuprolide, Nafarelin, Triptorelin. Superactive/Long acting GnRH are used as nasal spray or SC injection. Cetrorelix, ganirelix and abarelix are GnRh antagonists. These are used subcutanously for the treatment of uterine fibroid & endoinetriosis and for controlled ovarian stimulation in in-vitro feilization. GnRh agonists as well as GnRh antagonists can cause hot flushes, loss of libido and osteoporosis as adverse effects.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Following is true about GnRH agonists except ?, with the following options: A: Used in cases of precocious pubey, B: They have action similar to gonadotropin releasing hormone, C: Long acting preparations can be used as nasal spray, D: Ganirelix is the most potent agent + ### Response: Ans. is 'd' i.e., Ganirelix is the most potent agent GnRH agonists Long acting GnRH (LHRH) agonists causes reversible pharmacological orchiectomy (medical castration) and are used for precocious pubey, prostatic carcinoma, endometriosis, premenopausal breast cancer, uterine leiomyoma, polycystic ovarian disease and to assist induced ovulation. GnRH agonists have action similar to Gonadotropin releasing hormone, i.e., they increase the secretion of gonadotropins (FSH, LH). Then how do they suppress gonadol function ? Lets see. GnRH agonists increases Gn secretion. But after 1-2 weeks they cause desensitization and down-regulation of FSH/LH receptors. (continous exposure to agonist may cause down regulation of receptors) --> suppression of gonadal function. Spermatogenesis/ovulation cease and testosterone/estrogen levels fall to castration level because the action of Gonadotropins (FSH & LH) is not there (these hormones promote gametogenesis and secretion of gonadal hormones). Preparation of superactive GnRH analogues are --> Busereline, Goserelin, Leuprolide, Nafarelin, Triptorelin. Superactive/Long acting GnRH are used as nasal spray or SC injection. Cetrorelix, ganirelix and abarelix are GnRh antagonists. These are used subcutanously for the treatment of uterine fibroid & endoinetriosis and for controlled ovarian stimulation in in-vitro feilization. GnRh agonists as well as GnRh antagonists can cause hot flushes, loss of libido and osteoporosis as adverse effects. ### End" @@ -5698,6 +10187,13 @@ Ans. is 'd' i.e., Ganirelix is the most potent agent GnRH agonists Long acting G Answer the following medical question: Surfactant is secreted by which of the following:, with the following options: A: Type I pneumocyte, B: Type II pneumocyte, C: Seoli cell, D: Leydig cell +### Response: +","Type I pneumocyte: Involved in gas exchange makes up 80-90% of alveolar cells. Type II pneumocyte: Secrete surfactant makes up 5-10 % area alveolar cells. Seoli cell: Present in seminiferous tubules, responsible for nourishment spermatozoa during spermatogenesis, has FSH receptors & secrete inhibin. Leydig cell: Produces testosterone in response to LH.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Surfactant is secreted by which of the following:, with the following options: A: Type I pneumocyte, B: Type II pneumocyte, C: Seoli cell, D: Leydig cell + ### Response: Type I pneumocyte: Involved in gas exchange makes up 80-90% of alveolar cells. Type II pneumocyte: Secrete surfactant makes up 5-10 % area alveolar cells. Seoli cell: Present in seminiferous tubules, responsible for nourishment spermatozoa during spermatogenesis, has FSH receptors & secrete inhibin. Leydig cell: Produces testosterone in response to LH. ### End" @@ -5707,6 +10203,13 @@ Type I pneumocyte: Involved in gas exchange makes up 80-90% of alveolar cells. T Answer the following medical question: A 1.5 Kg child born at 32 weeks through LSCS, presents with moderate respiratory difficulty. Which of the following is the appropriate management -?, with the following options: A: CPAP, B: Mechanical ventilation, C: Warm oxygen, D: Surfactant and ventilation +### Response: +","CPAP The symptoms suggests neonatal respiratory distress syndrome / hyaline membrane disease. Respiratory distress syndrome / hyaline membrane disease occurs because of inadequate production of surfactant. - Since surfactant deficiency is the basis of RDS, exogenous surfactant is now recommended as the treatment of choice in neonates with RDS. - It is given to all neonates less than 28 weeks irrespective of presence or absence of RDS (Rescue treatment). -Beyond this age surfactant therapy is given according to the clinical condition of the patient. - If the distress is severe surfactant is required. - In the question the neonate is 32 weeks old and presents with moderate respiratory distress. - Surfactant is not necessary in such patient. Remember ""Surfactant is not universally indicated in all cases of respiratory distress syndrome"". Management of Respiratory distress syndrome Management of respiratory distress syndrome begins with administration of warm humidified oxygen. - This should maintain the aerial levels between 50 and 70 mm Hg (85-95% saturation) to maintain normal tissue oxygenation. If Pa02 cannot be maintained above 50 min Hg at inspired 02 concentration of 60% or greater CPAP should be applied. - If the patient is VLBW (very low bih weight) then CPAP is used early (t/t begins with CPAP instead of oxygen). - Another approach in VLBW infant is to intubate the infant, administer intracheal surfactant, then extubutate the patient and put him on CPAP. (In the question the infant is 1.5 kg at 32 weeks, his weight for age is adequate). Infants with severe RDS require mechanical ventilation.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 1.5 Kg child born at 32 weeks through LSCS, presents with moderate respiratory difficulty. Which of the following is the appropriate management -?, with the following options: A: CPAP, B: Mechanical ventilation, C: Warm oxygen, D: Surfactant and ventilation + ### Response: CPAP The symptoms suggests neonatal respiratory distress syndrome / hyaline membrane disease. Respiratory distress syndrome / hyaline membrane disease occurs because of inadequate production of surfactant. - Since surfactant deficiency is the basis of RDS, exogenous surfactant is now recommended as the treatment of choice in neonates with RDS. - It is given to all neonates less than 28 weeks irrespective of presence or absence of RDS (Rescue treatment). -Beyond this age surfactant therapy is given according to the clinical condition of the patient. - If the distress is severe surfactant is required. - In the question the neonate is 32 weeks old and presents with moderate respiratory distress. - Surfactant is not necessary in such patient. Remember ""Surfactant is not universally indicated in all cases of respiratory distress syndrome"". Management of Respiratory distress syndrome Management of respiratory distress syndrome begins with administration of warm humidified oxygen. - This should maintain the aerial levels between 50 and 70 mm Hg (85-95% saturation) to maintain normal tissue oxygenation. If Pa02 cannot be maintained above 50 min Hg at inspired 02 concentration of 60% or greater CPAP should be applied. - If the patient is VLBW (very low bih weight) then CPAP is used early (t/t begins with CPAP instead of oxygen). - Another approach in VLBW infant is to intubate the infant, administer intracheal surfactant, then extubutate the patient and put him on CPAP. (In the question the infant is 1.5 kg at 32 weeks, his weight for age is adequate). Infants with severe RDS require mechanical ventilation. ### End" @@ -5716,6 +10219,13 @@ CPAP The symptoms suggests neonatal respiratory distress syndrome / hyaline memb Answer the following medical question: Genital herpes is caused by ?, with the following options: A: HSV-1, B: HSV-2, C: VZV, D: None +### Response: +","Ans. is 'b' i.e., HSV-2","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Genital herpes is caused by ?, with the following options: A: HSV-1, B: HSV-2, C: VZV, D: None + ### Response: Ans. is 'b' i.e., HSV-2 ### End" @@ -5725,6 +10235,13 @@ Ans. is 'b' i.e., HSV-2 Answer the following medical question: Peripheral nerves can withstand ischemia upto ?, with the following options: A: 30 minutes, B: 1 hour, C: 2 hours, D: None +### Response: +",Ans. is 'None',"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Peripheral nerves can withstand ischemia upto ?, with the following options: A: 30 minutes, B: 1 hour, C: 2 hours, D: None + ### Response: Ans. is 'None' ### End" @@ -5734,6 +10251,13 @@ Ans. is 'None' Answer the following medical question: Jaegers cha is used to measure, with the following options: A: Distant vision, B: Near vision, C: Color vision, D: Contrast sensitivity +### Response: +","Jaeger's cha is used for measuring Near Vision The Jaeger cha is an eye cha used in testing near vision acuity. It is a card on which paragraphs of text are printed, with the text sizes increasing from 0.37mm to 2.5mm. This card is to be held by a patient at a fixed distance from the eye dependent on the J size being read. The smallest print that the patient can read determines their visual acuity","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Jaegers cha is used to measure, with the following options: A: Distant vision, B: Near vision, C: Color vision, D: Contrast sensitivity + ### Response: Jaeger's cha is used for measuring Near Vision The Jaeger cha is an eye cha used in testing near vision acuity. It is a card on which paragraphs of text are printed, with the text sizes increasing from 0.37mm to 2.5mm. This card is to be held by a patient at a fixed distance from the eye dependent on the J size being read. The smallest print that the patient can read determines their visual acuity ### End" @@ -5743,6 +10267,15 @@ Jaeger's cha is used for measuring Near Vision The Jaeger cha is an eye cha used Answer the following medical question: IFN-β is secreted by, with the following options: A: Leucocytes, B: Fibroblasts, C: Nk cells, D: Macrophage +### Response: +","IFN-α - Leucocytes. +IFN-β - Fibroblasts. +IFN-γ -  T4 and Tc cells, Nk cells.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: IFN-β is secreted by, with the following options: A: Leucocytes, B: Fibroblasts, C: Nk cells, D: Macrophage + ### Response: IFN-α - Leucocytes. IFN-β - Fibroblasts. @@ -5754,6 +10287,13 @@ IFN-γ -  T4 and Tc cells, Nk cells. Answer the following medical question: The carcinoma of thyroid associated with hypocalcemia is -, with the following options: A: Anaplastic, B: Follicular Ca, C: Medullary Ca, D: Papillary cancer +### Response: +","In Medullary carcinoma serum, calcitonin is increased, whose function is to lower serum calcium levels. So hypocalcemia may be found associated with MTC. ""The calcitonin excess (in MTC) is not associated with hypocalcemia."" ""Notably hypocalcemia is not a prominent feature despite the presence of raised calcitonin levels."" Also, know - MTC secrets not only calcitonin but also some other peptides such as : CEA CGRP (Calcitonin gene-related peptide) histaminase prostaglandin E2 and F2a Serotonin ACTH (may lead to Cushing syndrome in about 2 to 4% of pts.) Ref : Schwaz Sx 9/e p1367","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The carcinoma of thyroid associated with hypocalcemia is -, with the following options: A: Anaplastic, B: Follicular Ca, C: Medullary Ca, D: Papillary cancer + ### Response: In Medullary carcinoma serum, calcitonin is increased, whose function is to lower serum calcium levels. So hypocalcemia may be found associated with MTC. ""The calcitonin excess (in MTC) is not associated with hypocalcemia."" ""Notably hypocalcemia is not a prominent feature despite the presence of raised calcitonin levels."" Also, know - MTC secrets not only calcitonin but also some other peptides such as : CEA CGRP (Calcitonin gene-related peptide) histaminase prostaglandin E2 and F2a Serotonin ACTH (may lead to Cushing syndrome in about 2 to 4% of pts.) Ref : Schwaz Sx 9/e p1367 ### End" @@ -5763,6 +10303,19 @@ In Medullary carcinoma serum, calcitonin is increased, whose function is to lowe Answer the following medical question: Which is not a contraindication of apicectomy?, with the following options: A: Inadequate periodontal support, B: Horizontal apical root fracture, C: Lesions situated very close to important anatomical structures, D: None +### Response: +","There are few absolute contraindications for endodontic microsurgery. The following factors play amajor role in the surgical endodontics: + +Inadequate periodontal support and active uncontrollable periodontal disease. +Poor restorability with a postendodontic restoration. +Lesions situated very close to important anatomical structures like the inferior alveolar nerve, lingual nerve, mentaI foramen, maxillary sinus when there is high risk of damage to these structures. +Systemic complications of patients like bleeding disorders, severe heart disease such as a patient recuperating from a myocardial infarction, and immunocompromised patients. +Practitioner’s skill and experience with micro-surgical treatment plays an important role.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which is not a contraindication of apicectomy?, with the following options: A: Inadequate periodontal support, B: Horizontal apical root fracture, C: Lesions situated very close to important anatomical structures, D: None + ### Response: There are few absolute contraindications for endodontic microsurgery. The following factors play amajor role in the surgical endodontics: @@ -5778,6 +10331,13 @@ Practitioner’s skill and experience with micro-surgical treatment plays an imp Answer the following medical question: Cut-off value of cervical length at 24 weeks of gestation for prediction of preterm delivery is:, with the following options: A: 0.5 cm, B: 1.5 cm, C: 2.5 cm, D: 3.5 cm +### Response: +","Ans. is c, i.e. 2.5 cm.Preterm labor (PTL): Preterm labor is defined as labor (regular, painful frequent uterine contractions causing progressive effacement and dilatation of cervix) occurring before 37 completed weeks of gestation.""Risk of preterm birth increases markedly when the cervix is less than 2.5 cm. This measurement has been widely accepted as the threshold to define the risk of premature birth. The possibility of preterm delivery when the cervix is <25 mm is 17.8%. This risk is significantly greater than the normal risk, and hence these women require additional diagnostic tests and special care."" --Fernando Arias 3/e, p 229, 230Also Know:Most common cause of preterm labor is idiopathic followed by infection like urinary tract infection, vaginal infections etcMost common organisms responsible for preterm labor:Ureoplasma urealyticum and Gardenerella vaginum causing bacterial vaginosis.Diagnosis of Preterm labor is by: --Dutta 9/e, p 294-Regular uterine contractions with or without pain (at least 4 in every 20 min or 8 in 60 min).-Dilatation (> 2 cm) and effacement (80%) of cervix.-Length of cervix (measured by TVS) < 2.5 cm and funneling of internal os.-Pelvic pressure, backache and or vaginal discharge or bleeding.Thus for detecting preterm labor -TVS should be done and cervical length measured. Besides this fetal fibronectin if present in vaginal/cervical secretions before 37 weeks indicates preterm labor.Fetal fibronectin:It is a fetal glycoprotein.Normally it is found in the cervicovaginal discharge before 22 weeks and again after rupture of membranes.If detected in cervicovaginal secretions prior to rupture of membranes, it indicates disruption of the maternal-fetal interface and may be predictive of impending preterm labor.It is measured by ELISA and a value equal to or exceeding 50 ng/ml is considered positive and predictive of preterm delivery.When the test is negative it reassures that delivery will not occur within next 14 days.Remember: Fetal fibronectin equal to or more than 50 ng/ml and cervical length <2.5cm on TVS are the best predictors especially in a woman with a prior history of preterm birth.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cut-off value of cervical length at 24 weeks of gestation for prediction of preterm delivery is:, with the following options: A: 0.5 cm, B: 1.5 cm, C: 2.5 cm, D: 3.5 cm + ### Response: Ans. is c, i.e. 2.5 cm.Preterm labor (PTL): Preterm labor is defined as labor (regular, painful frequent uterine contractions causing progressive effacement and dilatation of cervix) occurring before 37 completed weeks of gestation.""Risk of preterm birth increases markedly when the cervix is less than 2.5 cm. This measurement has been widely accepted as the threshold to define the risk of premature birth. The possibility of preterm delivery when the cervix is <25 mm is 17.8%. This risk is significantly greater than the normal risk, and hence these women require additional diagnostic tests and special care."" --Fernando Arias 3/e, p 229, 230Also Know:Most common cause of preterm labor is idiopathic followed by infection like urinary tract infection, vaginal infections etcMost common organisms responsible for preterm labor:Ureoplasma urealyticum and Gardenerella vaginum causing bacterial vaginosis.Diagnosis of Preterm labor is by: --Dutta 9/e, p 294-Regular uterine contractions with or without pain (at least 4 in every 20 min or 8 in 60 min).-Dilatation (> 2 cm) and effacement (80%) of cervix.-Length of cervix (measured by TVS) < 2.5 cm and funneling of internal os.-Pelvic pressure, backache and or vaginal discharge or bleeding.Thus for detecting preterm labor -TVS should be done and cervical length measured. Besides this fetal fibronectin if present in vaginal/cervical secretions before 37 weeks indicates preterm labor.Fetal fibronectin:It is a fetal glycoprotein.Normally it is found in the cervicovaginal discharge before 22 weeks and again after rupture of membranes.If detected in cervicovaginal secretions prior to rupture of membranes, it indicates disruption of the maternal-fetal interface and may be predictive of impending preterm labor.It is measured by ELISA and a value equal to or exceeding 50 ng/ml is considered positive and predictive of preterm delivery.When the test is negative it reassures that delivery will not occur within next 14 days.Remember: Fetal fibronectin equal to or more than 50 ng/ml and cervical length <2.5cm on TVS are the best predictors especially in a woman with a prior history of preterm birth. ### End" @@ -5787,6 +10347,21 @@ Ans. is c, i.e. 2.5 cm.Preterm labor (PTL): Preterm labor is defined as labor (r Answer the following medical question: Organic causes of constipation in infant are all except –a) High fibre dietb) Cystic fibrosisc) Hypothyroidismd) Hyperthyroidism, with the following options: A: b, B: c, C: ac, D: ad +### Response: +","Constipation in infants and children +Constipation is extremely common in pediatric population. The vast majority of cases (90-95%) are functional i.e. 90-95% have functional constipation with no organic disease. In 1-5% cases, the organic disease can be diagnosed as cause of constipation, i.e. only 1-5% have organic causes of constipation. +Organic causes of constipation are: + +Intestinal: Hirschprung disease, Anal/rectal stenosis, Anal fissure, anteriorly displaced anal opening, stric­tures. +Drugs: Narcotics, vincristine, Psychotropics. +Metabolic/endocrine: Cystic fibrosis, hypothyroidism, Panhypopituitrism. +Neuromuscular: Cerebral palsy, Psychomotor retardation, spinal cord lesions, Myotonic dystophy, Neuropathy or myopathy of GIT. +Other causes: Low fibre diet, Milk protein allergy.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Organic causes of constipation in infant are all except –a) High fibre dietb) Cystic fibrosisc) Hypothyroidismd) Hyperthyroidism, with the following options: A: b, B: c, C: ac, D: ad + ### Response: Constipation in infants and children Constipation is extremely common in pediatric population. The vast majority of cases (90-95%) are functional i.e. 90-95% have functional constipation with no organic disease. In 1-5% cases, the organic disease can be diagnosed as cause of constipation, i.e. only 1-5% have organic causes of constipation. @@ -5804,6 +10379,20 @@ Other causes: Low fibre diet, Milk protein allergy. Answer the following medical question: Method (s) to determine protein structure is/are, with the following options: A: X-Ray Crystallography, B: NMR Spectroscopy, C: Infrared spectroscopy, D: All of these +### Response: +","X-ray crystallography (X-ray diffraction) +UV light spectroscopy and infra-red spectroscopy +Nuclear magnetic resonance (NMR) spectroscopy +Polychromatic X-ray crystallography (Laue diffraction)   +Optical rotatory dispersion +Circular dichroism +Computer-based modelling +Mass spectrometry","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Method (s) to determine protein structure is/are, with the following options: A: X-Ray Crystallography, B: NMR Spectroscopy, C: Infrared spectroscopy, D: All of these + ### Response: X-ray crystallography (X-ray diffraction) UV light spectroscopy and infra-red spectroscopy @@ -5820,6 +10409,13 @@ Mass spectrometry Answer the following medical question: Various compounds are added to mitochondria having a tightly coupled oxidative phosphorylation system. Addition of which of the following substrates will generate the LEAST amount of ATP, with the following options: A: Malate, B: Succinate, C: Malate with rotenone, D: Succinate with rotenone +### Response: +","Rotenone is a site-specific inhibitor of electron transpo. it acts at the level of complex I. Malate feeds electrons to reduced nicotinamide adenine dinucleotide (NADH), which in turn is passed into the electron transpo system at the level of complex I, through NADH dehydrogenase just before the blockage induced by this drug. Therefore, no electrons can be transpoed from NADH and no adenosine triphosphates (ATPs) are made. Succinate feeds in electrons from the reduced form of flavin adenine dinucleotide (FADH2) at the level of complex II, through the action of succinyl dehydrogenase. Complex II passes its electrons to coenzyme Q at a point beyond the site of rotenone inhibition; therefore, rotenone has no inhibitory effect and 2 ATPs are produced per atom of oxygen consumed. (The number of ATPs produced per atom of oxygen used is often expressed as the number of phosphate ions taken up divided by the atoms of oxygen used. This is called the P/O ratio.) in the absence of any inhibitor, the P/O ratio for malate is 3 and for succinate 2. Actinomycin D is an inhibitor of DNA synthesis, not oxidative phosphorylation. The inhibitor of electron transpo is actinomycin A. Ref : Biochemistry by U. Satyanarayana 3rd edition Pgno :256","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Various compounds are added to mitochondria having a tightly coupled oxidative phosphorylation system. Addition of which of the following substrates will generate the LEAST amount of ATP, with the following options: A: Malate, B: Succinate, C: Malate with rotenone, D: Succinate with rotenone + ### Response: Rotenone is a site-specific inhibitor of electron transpo. it acts at the level of complex I. Malate feeds electrons to reduced nicotinamide adenine dinucleotide (NADH), which in turn is passed into the electron transpo system at the level of complex I, through NADH dehydrogenase just before the blockage induced by this drug. Therefore, no electrons can be transpoed from NADH and no adenosine triphosphates (ATPs) are made. Succinate feeds in electrons from the reduced form of flavin adenine dinucleotide (FADH2) at the level of complex II, through the action of succinyl dehydrogenase. Complex II passes its electrons to coenzyme Q at a point beyond the site of rotenone inhibition; therefore, rotenone has no inhibitory effect and 2 ATPs are produced per atom of oxygen consumed. (The number of ATPs produced per atom of oxygen used is often expressed as the number of phosphate ions taken up divided by the atoms of oxygen used. This is called the P/O ratio.) in the absence of any inhibitor, the P/O ratio for malate is 3 and for succinate 2. Actinomycin D is an inhibitor of DNA synthesis, not oxidative phosphorylation. The inhibitor of electron transpo is actinomycin A. Ref : Biochemistry by U. Satyanarayana 3rd edition Pgno :256 ### End" @@ -5829,6 +10425,13 @@ Rotenone is a site-specific inhibitor of electron transpo. it acts at the level Answer the following medical question: Which of the following drug shows disulfiram like reaction with alcohol?, with the following options: A: Amphotericin B, B: Griseofulvin, C: Terbinafine, D: Rifampicin +### Response: +","Drugs causing disulfiram like reaction Sorry-Sulfonylureas(1st generation- like chlorpropamide) Pluto-Procarbazine Can't-Cephalosporins(Cefotetan,Cefoperazone) Go-Griseofulvin to Mars-Metronidazole","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following drug shows disulfiram like reaction with alcohol?, with the following options: A: Amphotericin B, B: Griseofulvin, C: Terbinafine, D: Rifampicin + ### Response: Drugs causing disulfiram like reaction Sorry-Sulfonylureas(1st generation- like chlorpropamide) Pluto-Procarbazine Can't-Cephalosporins(Cefotetan,Cefoperazone) Go-Griseofulvin to Mars-Metronidazole ### End" @@ -5838,6 +10441,15 @@ Drugs causing disulfiram like reaction Sorry-Sulfonylureas(1st generation- like Answer the following medical question: Antibody in asthma treatment:, with the following options: A: Omalizumab, B: Rituximab, C: Trastuzumab, D: Daclizumab +### Response: +","Omalizumab: +Omalizumab is a monoclonal antibody directed against IgE; it inhibits the binding of IgE to mast cells and basophils. It is licensed for treatment of refractory chronic spontaneous urticaria and also for severe persistent allergic asthma that has failed to respond to standard therapy. The dose and frequency are determined by baseline IgE (measured before the start of treatment) and body weight. It is under investigation for allergic rhinitis but not yet approved for this indication.  +Reference: Harrison’s P R I N C I P L E S   O F I N T E R N A L M E D I C I N E 20th edition page no 1967","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Antibody in asthma treatment:, with the following options: A: Omalizumab, B: Rituximab, C: Trastuzumab, D: Daclizumab + ### Response: Omalizumab: Omalizumab is a monoclonal antibody directed against IgE; it inhibits the binding of IgE to mast cells and basophils. It is licensed for treatment of refractory chronic spontaneous urticaria and also for severe persistent allergic asthma that has failed to respond to standard therapy. The dose and frequency are determined by baseline IgE (measured before the start of treatment) and body weight. It is under investigation for allergic rhinitis but not yet approved for this indication.  @@ -5849,6 +10461,13 @@ Reference: Harrison���s P R I N C I P L E S   O F I N T E R N A L M E D I C I Answer the following medical question: Which of the follwing gas given off in a fire is most commonly known to cause metabolic poisoning?, with the following options: A: HCN, B: CO, C: CO2, D: H2S +### Response: +","Ans. B. CO. (Ref. Bailey & Love 26th ed. Pg. 386; Summary box 28.3)Metabolic poisoning in burns:# There are many poisonous gases that can be given off in a fire, the most common being carbon monoxide, a product of incomplete combustion that is often produced by fires in enclosed spaces. This is the usual cause of a person being found with altered consciousness at the scene of a fire.# Carbon monoxide binds to haemoglobin with an affinity 240 times greater than that of oxygen and therefore blocks the transport of oxygen. Levels of carboxyhaemoglobin in the bloodstream can be measured. Concentrations above 10% are dangerous and need treatment with pure oxygen for more than 24 hours. Death occurs with concentrations around 60%.# Another metabolic toxin produced in house fires is hydrogen cyanide, which causes a metabolic acidosis by interfering with mitochondrial respiration.Additional educational points:The shock reaction after burns# Bums produce an inflammatory reaction# This leads to vastly increased vascular permeability# Water, solutes and proteins move from the intra- to the extravascular space# The volume of fluid lost is directly proportional to the area of the bum# Above 15% of surface area, the loss of fluid produces shockASPHYXIANTS# Include CO, CO2, Hydrogen sulphide and some war gases.- CO reduces the oxygen carrying capacity of the blood;- Carbon dioxide produces oxygen lack in the tissues;- Hydrogen sulphide paralyses the respiratory centre.Cause of death in burns:# Primary neurogenic shock - instantaneously from fear or pain or within 24-48 hrsfrom severe pains or from injury to vital organ from burning, or from oligemic shock.# If a victim survives this stage, this stage merges rapidly into the stage of secondary shock due to depletion of blood (serum) volume.# Apart from actual burning, death may occur from asphyxia (suffocation) due to inhalation of smoke containing carbon dioxide, carbon monoxide, and other products of combution, which may be poisonous (in recent yrs cyanide intoxication has been recognized as important, especially where plastics and paints are burning), or accidental injuries from falling structures whle trying to escape from abuming house, or from fat embolism.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the follwing gas given off in a fire is most commonly known to cause metabolic poisoning?, with the following options: A: HCN, B: CO, C: CO2, D: H2S + ### Response: Ans. B. CO. (Ref. Bailey & Love 26th ed. Pg. 386; Summary box 28.3)Metabolic poisoning in burns:# There are many poisonous gases that can be given off in a fire, the most common being carbon monoxide, a product of incomplete combustion that is often produced by fires in enclosed spaces. This is the usual cause of a person being found with altered consciousness at the scene of a fire.# Carbon monoxide binds to haemoglobin with an affinity 240 times greater than that of oxygen and therefore blocks the transport of oxygen. Levels of carboxyhaemoglobin in the bloodstream can be measured. Concentrations above 10% are dangerous and need treatment with pure oxygen for more than 24 hours. Death occurs with concentrations around 60%.# Another metabolic toxin produced in house fires is hydrogen cyanide, which causes a metabolic acidosis by interfering with mitochondrial respiration.Additional educational points:The shock reaction after burns# Bums produce an inflammatory reaction# This leads to vastly increased vascular permeability# Water, solutes and proteins move from the intra- to the extravascular space# The volume of fluid lost is directly proportional to the area of the bum# Above 15% of surface area, the loss of fluid produces shockASPHYXIANTS# Include CO, CO2, Hydrogen sulphide and some war gases.- CO reduces the oxygen carrying capacity of the blood;- Carbon dioxide produces oxygen lack in the tissues;- Hydrogen sulphide paralyses the respiratory centre.Cause of death in burns:# Primary neurogenic shock - instantaneously from fear or pain or within 24-48 hrsfrom severe pains or from injury to vital organ from burning, or from oligemic shock.# If a victim survives this stage, this stage merges rapidly into the stage of secondary shock due to depletion of blood (serum) volume.# Apart from actual burning, death may occur from asphyxia (suffocation) due to inhalation of smoke containing carbon dioxide, carbon monoxide, and other products of combution, which may be poisonous (in recent yrs cyanide intoxication has been recognized as important, especially where plastics and paints are burning), or accidental injuries from falling structures whle trying to escape from abuming house, or from fat embolism. ### End" @@ -5858,6 +10477,13 @@ Ans. B. CO. (Ref. Bailey & Love 26th ed. Pg. 386; Summary box 28.3)Metabolic poi Answer the following medical question: Which of the following nerves carry fibres from all the roots of brachial plexus:-, with the following options: A: Axillary, B: Ulnar, C: Median, D: Musculocutaneous +### Response: +","Median nerve is contributed by two roots given by lateral cord: C5, C6, C7 and medial cord: C8; T1. Radial nerve (C5, 6, 7, 8, T1) also carries fibres from all the roots of brachial plexus. If both given in options , Radial nerve > Median nerve .","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following nerves carry fibres from all the roots of brachial plexus:-, with the following options: A: Axillary, B: Ulnar, C: Median, D: Musculocutaneous + ### Response: Median nerve is contributed by two roots given by lateral cord: C5, C6, C7 and medial cord: C8; T1. Radial nerve (C5, 6, 7, 8, T1) also carries fibres from all the roots of brachial plexus. If both given in options , Radial nerve > Median nerve . ### End" @@ -5867,6 +10493,13 @@ Median nerve is contributed by two roots given by lateral cord: C5, C6, C7 and m Answer the following medical question: Which hormone is involved in 'milk secretion reflex'?, with the following options: A: Oxytocin, B: Prolactin, C: Vasopressin, D: Progesterone +### Response: +","In 'milk secretion reflex',- when the baby sucks, nerve endings in nipple carry impulse to anterior pituitary - release of Prolactin - Alveolar glands of breast stimulated to secrete milk. Oxytocin- Milk ejection reflex","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which hormone is involved in 'milk secretion reflex'?, with the following options: A: Oxytocin, B: Prolactin, C: Vasopressin, D: Progesterone + ### Response: In 'milk secretion reflex',- when the baby sucks, nerve endings in nipple carry impulse to anterior pituitary - release of Prolactin - Alveolar glands of breast stimulated to secrete milk. Oxytocin- Milk ejection reflex ### End" @@ -5876,6 +10509,13 @@ In 'milk secretion reflex',- when the baby sucks, nerve endings in nipple carry Answer the following medical question: All of the following are abdominal sling surgeries done for uterine preservation in patients of uterine prolapse, EXCEPT:-, with the following options: A: Khanna, B: Shirodkar, C: Purandare, D: Manchester +### Response: +","Sling Surgery Fixing the Uterus through a Cervical stitch into the abdomen is called 'Abdominal Cervicopexy' Shirodkar- Sling to the sacrum Purandare- To the Rectus Sheath Khannas-To the Anterior superior Iliac spine Manchester/Fothergills surgery: It is a vaginal procedure done for uterine prolapse for preservation of uterus. Here the cervix is amputated and B/L transverse ligaments are plicated in front of the amputated cervix, followed by anterior and posterior colporhaphy.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following are abdominal sling surgeries done for uterine preservation in patients of uterine prolapse, EXCEPT:-, with the following options: A: Khanna, B: Shirodkar, C: Purandare, D: Manchester + ### Response: Sling Surgery Fixing the Uterus through a Cervical stitch into the abdomen is called 'Abdominal Cervicopexy' Shirodkar- Sling to the sacrum Purandare- To the Rectus Sheath Khannas-To the Anterior superior Iliac spine Manchester/Fothergills surgery: It is a vaginal procedure done for uterine prolapse for preservation of uterus. Here the cervix is amputated and B/L transverse ligaments are plicated in front of the amputated cervix, followed by anterior and posterior colporhaphy. ### End" @@ -5885,6 +10525,13 @@ Sling Surgery Fixing the Uterus through a Cervical stitch into the abdomen is ca Answer the following medical question: Thrombotic thrombocytopenic purpura is a syndrome characterized by -, with the following options: A: Thrombocytosis, anemia, neurologic abnormalities, progressive renal failure and fever., B: Thrombocytopenia, anemia, neurologic abnormalities, progressive hepatic failure and fever, C: Thrombocytosis, anemia neurologic abnormalities, progressive renal failure and fever, D: Thrombocytopenia, anemia, neurological abnormalities, progressive renal failure and fever +### Response: +","Ans. is 'd' i.e., Thrombocytopenia, anemia, neurological abnormalities, progressive renal failureand fever o Thrombotic thrombocytopenic purpura is a disorder of 1vessel wall' characterised by lesions in arteriolar walls in various organs that initiate formation of localised platelet thrombi and fibrin deposits at various sites.Clinical pentad of TTPo Microangiopathico Thrombocytopeniao Decreased renalo Disturbed neuro-o FeverHemolytic(due to consumptionfunction (duelogical function Anemia (Coomb's negative)of platelets)deposits in theCharacteristically # HaemolysisRenaland non focal e.g.diffuse # Fragmentation of RBC'sVasculature).# Confusion # Increased LDH (elevated # Aphasia due to intra-vascular # Alteration in hemolysis) consciousness Testes of coagulation are generally normal :-o Normal PTo Normal APTTo Normal Fibrinogen concentrationo Normal Fibrin degradation products","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Thrombotic thrombocytopenic purpura is a syndrome characterized by -, with the following options: A: Thrombocytosis, anemia, neurologic abnormalities, progressive renal failure and fever., B: Thrombocytopenia, anemia, neurologic abnormalities, progressive hepatic failure and fever, C: Thrombocytosis, anemia neurologic abnormalities, progressive renal failure and fever, D: Thrombocytopenia, anemia, neurological abnormalities, progressive renal failure and fever + ### Response: Ans. is 'd' i.e., Thrombocytopenia, anemia, neurological abnormalities, progressive renal failureand fever o Thrombotic thrombocytopenic purpura is a disorder of 1vessel wall' characterised by lesions in arteriolar walls in various organs that initiate formation of localised platelet thrombi and fibrin deposits at various sites.Clinical pentad of TTPo Microangiopathico Thrombocytopeniao Decreased renalo Disturbed neuro-o FeverHemolytic(due to consumptionfunction (duelogical function Anemia (Coomb's negative)of platelets)deposits in theCharacteristically # HaemolysisRenaland non focal e.g.diffuse # Fragmentation of RBC'sVasculature).# Confusion # Increased LDH (elevated # Aphasia due to intra-vascular # Alteration in hemolysis) consciousness Testes of coagulation are generally normal :-o Normal PTo Normal APTTo Normal Fibrinogen concentrationo Normal Fibrin degradation products ### End" @@ -5894,6 +10541,13 @@ Ans. is 'd' i.e., Thrombocytopenia, anemia, neurological abnormalities, progress Answer the following medical question: A pt is brought to the emergency as a case of head injury, following a head on collision road traffic accident. His BP is 90/60 mmHg. Tachycardia is present. Most likely diagnosis is:, with the following options: A: EDH, B: SDH, C: Intracranial hemorrhage, D: Intraabdominal bleed +### Response: +","Answer is D (Intraabdominal bleed) : Although extradural haemorrhage is the most common intracranial complication following head injury, the patient in question is suffering from severe hypotension of 90/60, & has tachycardia, which cannot be explained by extradural haemorrhage alone. A patient with head injury, more than often has other significant injuries and a thorough examination of other systems therefore is a prime necessassity. An intraabdominal source of bleed, like a ruptured spleen for example is a more likely cause for hypotension in this patient.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A pt is brought to the emergency as a case of head injury, following a head on collision road traffic accident. His BP is 90/60 mmHg. Tachycardia is present. Most likely diagnosis is:, with the following options: A: EDH, B: SDH, C: Intracranial hemorrhage, D: Intraabdominal bleed + ### Response: Answer is D (Intraabdominal bleed) : Although extradural haemorrhage is the most common intracranial complication following head injury, the patient in question is suffering from severe hypotension of 90/60, & has tachycardia, which cannot be explained by extradural haemorrhage alone. A patient with head injury, more than often has other significant injuries and a thorough examination of other systems therefore is a prime necessassity. An intraabdominal source of bleed, like a ruptured spleen for example is a more likely cause for hypotension in this patient. ### End" @@ -5903,6 +10557,13 @@ Answer is D (Intraabdominal bleed) : Although extradural haemorrhage is the most Answer the following medical question: Berkesonian bias is due to:, with the following options: A: Presence of confounding factors in both cases and controls, B: Questioning the cases more thoroughly as compared to controls, C: Different rates of admission to hospital due to different diseases, D: Better recall by the cases as compared to controls +### Response: +",Different rates of admission to hospital due to different diseases,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Berkesonian bias is due to:, with the following options: A: Presence of confounding factors in both cases and controls, B: Questioning the cases more thoroughly as compared to controls, C: Different rates of admission to hospital due to different diseases, D: Better recall by the cases as compared to controls + ### Response: Different rates of admission to hospital due to different diseases ### End" @@ -5912,6 +10573,13 @@ Different rates of admission to hospital due to different diseases Answer the following medical question: A newborn baby presented with profuse bleeding from umbilical stump after bih. Probable diagnosis is _______, with the following options: A: Factor XIII deficiency, B: VWF deficiency, C: Factor XII deficiency, D: Glanzmann thrombosthenia +### Response: +","major cause of profuse umbilical stump bleeding in newborn is factor Xlll deficiency. The bleeding diathesis in inherited factor XIII (FXIII) deficiency is severe in most patients. Bleeding from the stump of the umbilical cord within the first days to weeks of life is a characteristic sign that occurs in 80% of affected individuals; bleeding from this specific site is uncommon in other inherited hemostatic diseases except afibrinogenemia Reference : Ghai essential of pediatrics, eighth edition, p.no: 349","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A newborn baby presented with profuse bleeding from umbilical stump after bih. Probable diagnosis is _______, with the following options: A: Factor XIII deficiency, B: VWF deficiency, C: Factor XII deficiency, D: Glanzmann thrombosthenia + ### Response: major cause of profuse umbilical stump bleeding in newborn is factor Xlll deficiency. The bleeding diathesis in inherited factor XIII (FXIII) deficiency is severe in most patients. Bleeding from the stump of the umbilical cord within the first days to weeks of life is a characteristic sign that occurs in 80% of affected individuals; bleeding from this specific site is uncommon in other inherited hemostatic diseases except afibrinogenemia Reference : Ghai essential of pediatrics, eighth edition, p.no: 349 ### End" @@ -5921,6 +10589,13 @@ major cause of profuse umbilical stump bleeding in newborn is factor Xlll defici Answer the following medical question: Most common symptom in ectopic pregnancy -, with the following options: A: Abdominal pain, B: Bleeding per vagina, C: Amenorrhoea, D: Fainting attacks +### Response: +","Ans. is 'a' i.e., Abdominal pain ""Classical traid of symptoms of disturbed tubal pregnancy are :- Abdominal pain (100%), preceeded by amenorrhoea (75%) and lastly vaginal bleeding (70%)""Clinical features of acute ectopic pregnancySymptomsAbdominal pain is the most constant feature. It is acute, agonising or colicky. Located in lower abdomen, may be unilateral, bilateral or generalized.Shoulder tip pain (25%preferred pain d/t diaphragmatic irritation by haemoperitoneum) may be presentAmenorrhoea of short period (6-8 weeks )usually. Sometimes may be absentVaginal bleeding may be slight and continuous.Vomiting and fainting attacks syncopal attack is due to reflex vasomotor disturbance following peritoneum irritation by haemoperitoneum.SignsGeneral look is diagnostic. Patient lies quite and conscious, perspires and looks blanchedPallor is severe and proportionate to amount of internal bleedingShock rapid and feeble pulse, hypotension, cold and clammy extremities.Abdominal examination lower abdomen is tense and tender. Shifting dullness present and muscle guard is absent.Pelvic examination is may precipitate more bleeding due to manipulation.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common symptom in ectopic pregnancy -, with the following options: A: Abdominal pain, B: Bleeding per vagina, C: Amenorrhoea, D: Fainting attacks + ### Response: Ans. is 'a' i.e., Abdominal pain ""Classical traid of symptoms of disturbed tubal pregnancy are :- Abdominal pain (100%), preceeded by amenorrhoea (75%) and lastly vaginal bleeding (70%)""Clinical features of acute ectopic pregnancySymptomsAbdominal pain is the most constant feature. It is acute, agonising or colicky. Located in lower abdomen, may be unilateral, bilateral or generalized.Shoulder tip pain (25%preferred pain d/t diaphragmatic irritation by haemoperitoneum) may be presentAmenorrhoea of short period (6-8 weeks )usually. Sometimes may be absentVaginal bleeding may be slight and continuous.Vomiting and fainting attacks syncopal attack is due to reflex vasomotor disturbance following peritoneum irritation by haemoperitoneum.SignsGeneral look is diagnostic. Patient lies quite and conscious, perspires and looks blanchedPallor is severe and proportionate to amount of internal bleedingShock rapid and feeble pulse, hypotension, cold and clammy extremities.Abdominal examination lower abdomen is tense and tender. Shifting dullness present and muscle guard is absent.Pelvic examination is may precipitate more bleeding due to manipulation. ### End" @@ -5930,6 +10605,13 @@ Ans. is 'a' i.e., Abdominal pain ""Classical traid of symptoms of disturbed tuba Answer the following medical question: Secondary pulmonary tuberculosis usually involves:March 2012, with the following options: A: Base of lungs, B: Apex of lungs, C: Middle lobes, D: Lower lobes +### Response: +","Ans: B i.e. Apex of lungsSecondary pulmonary TB classically involves the apex of the upper lobes of one or both the lungsProgressive primary TB more often resembles an acute bacterial pneumonia, with lower and middle lobe consolidation, hilar adenopathy, and pleural effusion; cavitation is rare.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Secondary pulmonary tuberculosis usually involves:March 2012, with the following options: A: Base of lungs, B: Apex of lungs, C: Middle lobes, D: Lower lobes + ### Response: Ans: B i.e. Apex of lungsSecondary pulmonary TB classically involves the apex of the upper lobes of one or both the lungsProgressive primary TB more often resembles an acute bacterial pneumonia, with lower and middle lobe consolidation, hilar adenopathy, and pleural effusion; cavitation is rare. ### End" @@ -5939,6 +10621,13 @@ Ans: B i.e. Apex of lungsSecondary pulmonary TB classically involves the apex of Answer the following medical question: What is the optimal time during the menstrual cycle when serum progesterone should be drawn to confirm the diagnosis of luteal phase deficiency :, with the following options: A: Day 18, B: Day 21, C: Day 23, D: Day 25 +### Response: +",Day 25,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What is the optimal time during the menstrual cycle when serum progesterone should be drawn to confirm the diagnosis of luteal phase deficiency :, with the following options: A: Day 18, B: Day 21, C: Day 23, D: Day 25 + ### Response: Day 25 ### End" @@ -5948,6 +10637,13 @@ Day 25 Answer the following medical question: Post-traumatic cataract: (E. REPEAT 2009), with the following options: A: Christmas tree, B: Rossette cataract, C: Sunflower cataract, D: Shield cataract +### Response: +",Ref: Multiple Sources. Kanski and Basak's Essentials in OphthalmologyExplanation:Type of cataractRemarksAfter cataract* Elschnig's pearls* Sommerring's ringAnterior polar cataract* Alport syndromeComplicated cataract* Polychromatic luster* Bread crumb appearanceCupulliform cataract* Senile posterior corticai cataractHeat cataract: Glass blowers cataract* Infrared raysOil drop cataract* GalactosemiaPosterior polar cataract Punctate cataract (Blue dot cataract)* Lowe's syndrome* Most common congenital cataractRadiation cataract* Posteror subcapsular cataractSnow flake cataract* Diabetes mellitusPosterior subcapsular cataract* Stercid induced cataractSunflower cataract* Chalcosis (Excess copper accumulation in lens)Traumatic cataract* Vossius rmc* Rosette cataractZonular (lamellar) cataract* Riders are seen* Hypocalcemia,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Post-traumatic cataract: (E. REPEAT 2009), with the following options: A: Christmas tree, B: Rossette cataract, C: Sunflower cataract, D: Shield cataract + ### Response: Ref: Multiple Sources. Kanski and Basak's Essentials in OphthalmologyExplanation:Type of cataractRemarksAfter cataract* Elschnig's pearls* Sommerring's ringAnterior polar cataract* Alport syndromeComplicated cataract* Polychromatic luster* Bread crumb appearanceCupulliform cataract* Senile posterior corticai cataractHeat cataract: Glass blowers cataract* Infrared raysOil drop cataract* GalactosemiaPosterior polar cataract Punctate cataract (Blue dot cataract)* Lowe's syndrome* Most common congenital cataractRadiation cataract* Posteror subcapsular cataractSnow flake cataract* Diabetes mellitusPosterior subcapsular cataract* Stercid induced cataractSunflower cataract* Chalcosis (Excess copper accumulation in lens)Traumatic cataract* Vossius rmc* Rosette cataractZonular (lamellar) cataract* Riders are seen* Hypocalcemia ### End" @@ -5957,6 +10653,13 @@ Ref: Multiple Sources. Kanski and Basak's Essentials in OphthalmologyExplanation Answer the following medical question: Lafora's disease presents with -, with the following options: A: GT.C.S, B: Myoclonic epilepsy, C: Petit mal epilepsy, D: Partial seizures +### Response: +","Ans. is 'b' i.e., Myoclonic epilepsy Lafora's disease (6q 24) Lafora Bodies (a myloid bodies, myoclonus bodies, polyglucosan bodies)o Rounded periodic acid schiff-positive, argyophillic intracytoplasmic inclusion bodies with a dense central basophilic core and a rim that takes up less stain found in the larger neurons of the thalamus, dentate nuclei and substantia nigra in progressive myoclonic epilepsy (lafora body disease) and less abundantly in normal aged brain.Lafora body disease (progressive myoclonic epilepsy with lafora bodies)o Recessively inherited poliencephalomyopathy of late childhood or early adult life.o It is mapped on 6q 24 but there is more than one locus.o It is clinically characterized by# Progressive dementia# Dysarthria# Visual loss# Pyramidal and cerebellar signs# Photoconvulsive progressive myoclonic and other seizure types.o The diagnostic pathological finding is la fora bodies.Intraneuronal inclusion bodiesConditionPicks bodiesPicks diseaseLewy bodiesParkinson s disease and Lewy body diseaseHirano bodiesAlzheimer s diseaseBunina bodiesAmyotrohic lateral sclerosisLafora bodiesProgressive myoclonic epilepsyMarinesco bodiesNormal Brain tissue","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Lafora's disease presents with -, with the following options: A: GT.C.S, B: Myoclonic epilepsy, C: Petit mal epilepsy, D: Partial seizures + ### Response: Ans. is 'b' i.e., Myoclonic epilepsy Lafora's disease (6q 24) Lafora Bodies (a myloid bodies, myoclonus bodies, polyglucosan bodies)o Rounded periodic acid schiff-positive, argyophillic intracytoplasmic inclusion bodies with a dense central basophilic core and a rim that takes up less stain found in the larger neurons of the thalamus, dentate nuclei and substantia nigra in progressive myoclonic epilepsy (lafora body disease) and less abundantly in normal aged brain.Lafora body disease (progressive myoclonic epilepsy with lafora bodies)o Recessively inherited poliencephalomyopathy of late childhood or early adult life.o It is mapped on 6q 24 but there is more than one locus.o It is clinically characterized by# Progressive dementia# Dysarthria# Visual loss# Pyramidal and cerebellar signs# Photoconvulsive progressive myoclonic and other seizure types.o The diagnostic pathological finding is la fora bodies.Intraneuronal inclusion bodiesConditionPicks bodiesPicks diseaseLewy bodiesParkinson s disease and Lewy body diseaseHirano bodiesAlzheimer s diseaseBunina bodiesAmyotrohic lateral sclerosisLafora bodiesProgressive myoclonic epilepsyMarinesco bodiesNormal Brain tissue ### End" @@ -5966,6 +10669,13 @@ Ans. is 'b' i.e., Myoclonic epilepsy Lafora's disease (6q 24) Lafora Bodies (a m Answer the following medical question: True about Bacillus anthracis is?, with the following options: A: Zoonotic disease, B: Man to man transmission posible, C: Agent for bioterrorism, D: Antibiotic has no role +### Response: +","Anthrax is a zoonosis. Animals are infected by ingestion of the spores present in the soil. Direct spread from animal to animal is rare. Human anthrax is contraindicated from animals, directly or indirectly The disease may be cutaneous, pulmonary or intestinal, all types leading to fatal septicemia or meningitis. Reference: Textbook of Microbiology; Anathanarayan and paniker&;s; 10th edition; Page no: 249","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about Bacillus anthracis is?, with the following options: A: Zoonotic disease, B: Man to man transmission posible, C: Agent for bioterrorism, D: Antibiotic has no role + ### Response: Anthrax is a zoonosis. Animals are infected by ingestion of the spores present in the soil. Direct spread from animal to animal is rare. Human anthrax is contraindicated from animals, directly or indirectly The disease may be cutaneous, pulmonary or intestinal, all types leading to fatal septicemia or meningitis. Reference: Textbook of Microbiology; Anathanarayan and paniker&;s; 10th edition; Page no: 249 ### End" @@ -5975,6 +10685,13 @@ Anthrax is a zoonosis. Animals are infected by ingestion of the spores present i Answer the following medical question: Which of the following condition is associated with hepatomegaly with liver pulsation?, with the following options: A: Mitral Stenosis, B: Mitral Regurgitation, C: Tricuspid Regurgitation, D: Pulmonary Hypeension +### Response: +","Characteristic features of Tricuspid regurgitation are marked hepatomegaly and systolic pulsations of the liver. Hepatic pulsation in tricuspid regurgitation is caused by reversed systolic blood flow in the great veins. Ref: Current Medical Diagnosis and Treatment, 2012, Chapter 10; The Cleveland Clinic Cardiology Board Review By Brian P. Griffin, Page 290","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following condition is associated with hepatomegaly with liver pulsation?, with the following options: A: Mitral Stenosis, B: Mitral Regurgitation, C: Tricuspid Regurgitation, D: Pulmonary Hypeension + ### Response: Characteristic features of Tricuspid regurgitation are marked hepatomegaly and systolic pulsations of the liver. Hepatic pulsation in tricuspid regurgitation is caused by reversed systolic blood flow in the great veins. Ref: Current Medical Diagnosis and Treatment, 2012, Chapter 10; The Cleveland Clinic Cardiology Board Review By Brian P. Griffin, Page 290 ### End" @@ -5984,6 +10701,13 @@ Characteristic features of Tricuspid regurgitation are marked hepatomegaly and s Answer the following medical question: Laryngeal papilloma-, with the following options: A: Single, B: Multiple, C: Seen in children, D: All +### Response: +","Ans. is 'a' i.e., Single; 'b' i.e., Multiple & 'c' i.e., Seen in children Laryngeal papilloma o Most common benign tumor of larynx Single or multiple irregular, wa like glottic masses. HPV-6 & 11 may be the causative factor. Treatment is with CO2 laser ablation. a-IFN and indole - 3 - carbinole may also be used.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Laryngeal papilloma-, with the following options: A: Single, B: Multiple, C: Seen in children, D: All + ### Response: Ans. is 'a' i.e., Single; 'b' i.e., Multiple & 'c' i.e., Seen in children Laryngeal papilloma o Most common benign tumor of larynx Single or multiple irregular, wa like glottic masses. HPV-6 & 11 may be the causative factor. Treatment is with CO2 laser ablation. a-IFN and indole - 3 - carbinole may also be used. ### End" @@ -5993,6 +10717,13 @@ Ans. is 'a' i.e., Single; 'b' i.e., Multiple & 'c' i.e., Seen in children Laryng Answer the following medical question: Lethal effect of dry heat is due to ?, with the following options: A: Denaturation of proteins, B: Oxidative damage, C: Toxicity due to metabolites, D: All of the above +### Response: +","Ans. is 'd' i.e., All of the above HEAT STERILIZATION Heat is the most reliable method of sterilisation and should be the method of choice unless contraindicated. o Sterilization by heat is of two types. Dry heat Killing effect is due to protein denaturation, oxidative damage and the toxic effect of elevated metabolites.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Lethal effect of dry heat is due to ?, with the following options: A: Denaturation of proteins, B: Oxidative damage, C: Toxicity due to metabolites, D: All of the above + ### Response: Ans. is 'd' i.e., All of the above HEAT STERILIZATION Heat is the most reliable method of sterilisation and should be the method of choice unless contraindicated. o Sterilization by heat is of two types. Dry heat Killing effect is due to protein denaturation, oxidative damage and the toxic effect of elevated metabolites. ### End" @@ -6002,6 +10733,13 @@ Ans. is 'd' i.e., All of the above HEAT STERILIZATION Heat is the most reliable Answer the following medical question: Which of the following is not a pa of accomodation, with the following options: A: Change is anterior curvature of lens, B: Change in posterior curvature of lens, C: Change in Ciliary zonules tension, D: Contraction of ciliary muscles +### Response: +",No change occurs in posterior curvature of lens in accomodation Accomodation Inherent capacity of eye to focus light rays from near object on retina Due to inc in power of lens because of increase in curvature of lens Inc in curvature of lens of anterior pa of lens Contraction of ciliary muscles causes zonules to relax Lens becomes more convex over anterior surface,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is not a pa of accomodation, with the following options: A: Change is anterior curvature of lens, B: Change in posterior curvature of lens, C: Change in Ciliary zonules tension, D: Contraction of ciliary muscles + ### Response: No change occurs in posterior curvature of lens in accomodation Accomodation Inherent capacity of eye to focus light rays from near object on retina Due to inc in power of lens because of increase in curvature of lens Inc in curvature of lens of anterior pa of lens Contraction of ciliary muscles causes zonules to relax Lens becomes more convex over anterior surface ### End" @@ -6011,6 +10749,13 @@ No change occurs in posterior curvature of lens in accomodation Accomodation Inh Answer the following medical question: All are to access platelet functions EXCEPT:, with the following options: A: Prothrombin time, B: Bleeding time, C: Clot retraction time, D: Prothrombin deactivation +### Response: +","Prothrombin time REF: Wintrobe's hematology lied page 1242 Tests for platelet function: Bleeding time: Hemostasis in a small superficial wound, such as that produced when measuring the bleeding time, depends on the rate at which a stable platelet plug is formed and, thus, provides a measure of the efficiency of the vascular and platelet phases. However, it does not discriminate between vascular defects, thrombocytopenia, and platelet dysfunction. Platelet enumeration Platelet volume measurements Platelet aggregation Clot Retraction: Clot retraction usually is deficient when the platelet count is below 50,000411 and in a rare disorder of platelet function (Glanzmann thrombasthenia). It is normal in most other disorders of platelet function. This test is primarily of historical interest; Glanzmann thrombasthenia is typically diagnosed using platelet aggregation methods or flow cytometer. Tests of Coagulation Phase: Paial thromboplastin time: The PTT is a simple test of the intrinsic and common pathways of coagulation. When a mixture of plasma and a phospholipid platelet substitute is re-calcified, fibrin forms at a normal rate only if the factors involved in the intrinsic pathway (prekallikrein, high-molecular-weight kininogen, and factors XII, XI, IX, and VIII) and in the common pathway (factors X and V, prothrombin, and fibrinogen) are present in normal amounts. The PTT is somewhat more sensitive to deficiencies of factors VIII and IX than to deficiencies of factors XI and XII or factors involved in the common pathway Prothrombin time The production of fibrin by means of the extrinsic and common pathways requires tissue factor and factor VII, in addition to factors X and V, Prothrombin, and fibrinogen Thromboplastin generation test: The thromboplastin generation test is impoant for historical reasons. This two-stage test measures the amount and rate of prothrombinase formation by way of the intrinsic pathway Assay of plasma fibrinogen Interpretation of Common Tests of Hemostasis and Blood Coagulation Test Normal Range a (+-2 Common Causes of Abnormalities SD) and Reference Platelet count Thrombocytopenia, thrombocytosis Phase microscopy 140,000-440,000/u1 Automated 177,000-406,000/111 Paial thromboplastin 26-37 sec Deficiencies or inhibitors of prekallikrein; high? time(activated)* molecular-weight kininogen; factors XII, XI, IX, VIII, X, and V; Prothrombin or fibrinogen; lupus inhibitors; heparin Prothrombin time* 12.0-15.5 sec Deficiencies or inhibitors of factors VII, X, and V; prothrombin or fibrinogen; dysfibrinogenemia; lupus inhibitors; heparin Thrombin time* 18-22 sec A/dys/hypo/hyper-fibrinogenemia; inhibitors of thrombin (heparin) or fibrin polymerization (fibrin degradation products, Para proteins) Fibrinogen assay* 150-430 mg/dl Afibrinogenemia, dysfibrinogenemia, and hypofibrinogenemia; inhibitors of thrombin or fibrinpolymerization Factor VIII assay* 50-150 U/dl Hemophilia A and von Willebrand disease; acquired antibodies to factor VIII Fibrin degradation 0-5 pg/m1 Disseminated intravascular coagulation; fibrinogenolysis; product assay thrombolytic drugs, liver disease; Dysfibrinogenemia NOTE: (1 mark signifies tests affected by heparin","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are to access platelet functions EXCEPT:, with the following options: A: Prothrombin time, B: Bleeding time, C: Clot retraction time, D: Prothrombin deactivation + ### Response: Prothrombin time REF: Wintrobe's hematology lied page 1242 Tests for platelet function: Bleeding time: Hemostasis in a small superficial wound, such as that produced when measuring the bleeding time, depends on the rate at which a stable platelet plug is formed and, thus, provides a measure of the efficiency of the vascular and platelet phases. However, it does not discriminate between vascular defects, thrombocytopenia, and platelet dysfunction. Platelet enumeration Platelet volume measurements Platelet aggregation Clot Retraction: Clot retraction usually is deficient when the platelet count is below 50,000411 and in a rare disorder of platelet function (Glanzmann thrombasthenia). It is normal in most other disorders of platelet function. This test is primarily of historical interest; Glanzmann thrombasthenia is typically diagnosed using platelet aggregation methods or flow cytometer. Tests of Coagulation Phase: Paial thromboplastin time: The PTT is a simple test of the intrinsic and common pathways of coagulation. When a mixture of plasma and a phospholipid platelet substitute is re-calcified, fibrin forms at a normal rate only if the factors involved in the intrinsic pathway (prekallikrein, high-molecular-weight kininogen, and factors XII, XI, IX, and VIII) and in the common pathway (factors X and V, prothrombin, and fibrinogen) are present in normal amounts. The PTT is somewhat more sensitive to deficiencies of factors VIII and IX than to deficiencies of factors XI and XII or factors involved in the common pathway Prothrombin time The production of fibrin by means of the extrinsic and common pathways requires tissue factor and factor VII, in addition to factors X and V, Prothrombin, and fibrinogen Thromboplastin generation test: The thromboplastin generation test is impoant for historical reasons. This two-stage test measures the amount and rate of prothrombinase formation by way of the intrinsic pathway Assay of plasma fibrinogen Interpretation of Common Tests of Hemostasis and Blood Coagulation Test Normal Range a (+-2 Common Causes of Abnormalities SD) and Reference Platelet count Thrombocytopenia, thrombocytosis Phase microscopy 140,000-440,000/u1 Automated 177,000-406,000/111 Paial thromboplastin 26-37 sec Deficiencies or inhibitors of prekallikrein; high? time(activated)* molecular-weight kininogen; factors XII, XI, IX, VIII, X, and V; Prothrombin or fibrinogen; lupus inhibitors; heparin Prothrombin time* 12.0-15.5 sec Deficiencies or inhibitors of factors VII, X, and V; prothrombin or fibrinogen; dysfibrinogenemia; lupus inhibitors; heparin Thrombin time* 18-22 sec A/dys/hypo/hyper-fibrinogenemia; inhibitors of thrombin (heparin) or fibrin polymerization (fibrin degradation products, Para proteins) Fibrinogen assay* 150-430 mg/dl Afibrinogenemia, dysfibrinogenemia, and hypofibrinogenemia; inhibitors of thrombin or fibrinpolymerization Factor VIII assay* 50-150 U/dl Hemophilia A and von Willebrand disease; acquired antibodies to factor VIII Fibrin degradation 0-5 pg/m1 Disseminated intravascular coagulation; fibrinogenolysis; product assay thrombolytic drugs, liver disease; Dysfibrinogenemia NOTE: (1 mark signifies tests affected by heparin ### End" @@ -6020,6 +10765,13 @@ Prothrombin time REF: Wintrobe's hematology lied page 1242 Tests for platelet fu Answer the following medical question: Most specific test for organophosphorous poisoning is:, with the following options: A: RBC cholinesterase level, B: Plasma cholinestrase level, C: RBC uroporphyrin level, D: Measurment of serum level of organophosphorous +### Response: +",B i.e. Plasma cholinesterase level,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most specific test for organophosphorous poisoning is:, with the following options: A: RBC cholinesterase level, B: Plasma cholinestrase level, C: RBC uroporphyrin level, D: Measurment of serum level of organophosphorous + ### Response: B i.e. Plasma cholinesterase level ### End" @@ -6029,6 +10781,13 @@ B i.e. Plasma cholinesterase level Answer the following medical question: All open into middle meatus except ?, with the following options: A: Frontal sinus, B: Sphenoid sinus, C: Maxillary sinus, D: Ethmoidal sinus +### Response: +","Ans. is 'b' i.e., Sphenoid sinus Pa of lateral nasal wallOpeningsInferiorNasolacrimal ductMiddleFrontal sinus, Maxillary sinus, Anterior ethmoidal sinusSuperiorPosterior ethmoidal sinusSphenoethmoidal recessSphenoid sinus","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All open into middle meatus except ?, with the following options: A: Frontal sinus, B: Sphenoid sinus, C: Maxillary sinus, D: Ethmoidal sinus + ### Response: Ans. is 'b' i.e., Sphenoid sinus Pa of lateral nasal wallOpeningsInferiorNasolacrimal ductMiddleFrontal sinus, Maxillary sinus, Anterior ethmoidal sinusSuperiorPosterior ethmoidal sinusSphenoethmoidal recessSphenoid sinus ### End" @@ -6038,6 +10797,13 @@ Ans. is 'b' i.e., Sphenoid sinus Pa of lateral nasal wallOpeningsInferiorNasolac Answer the following medical question: Sternocleidomastoid is not supplied by:, with the following options: A: Occipital Aery, B: Superior thyroid Aery, C: Post Auricular Aery, D: Thyrocervical trunk +### Response: +","Occipital aery, superior thyroid aery and thyrocervical trunk supplies blood to sternocleidomastoid muscle. The thyrocervical trunk gives off the following branches: (1) the inferior thyroid aery, which supplies blood to the thyroid gland; (2) the transverse cervical aery, which passes backward across the neck to supply blood to the trapezius and rhomboid muscles; and (3) the suprascapular aery, which courses laterally across the neck toward the suprascapular notch and paicipates in the elaborate anastomosis of vessels that surround the scapula. The inferior thyroid aery anastomoses with the superior thyroid aery, a branch of the external carotid aery. The posterior auricular aery passes upward, behind the auricle, and supplies blood to the scalp.Also KnowThe sternocleidomastoid muscle creates the borders for both the anterior and the posterior triangles of the neck, and is innervated by the spinal accessory nerve (CN XI). Ref: Dhillon N. (2012). Chapter 1. Anatomy. In A.K. Lalwani (Ed), CURRENT Diagnosis & Treatment in Otolaryngology--Head & Neck Surgery, 3e.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Sternocleidomastoid is not supplied by:, with the following options: A: Occipital Aery, B: Superior thyroid Aery, C: Post Auricular Aery, D: Thyrocervical trunk + ### Response: Occipital aery, superior thyroid aery and thyrocervical trunk supplies blood to sternocleidomastoid muscle. The thyrocervical trunk gives off the following branches: (1) the inferior thyroid aery, which supplies blood to the thyroid gland; (2) the transverse cervical aery, which passes backward across the neck to supply blood to the trapezius and rhomboid muscles; and (3) the suprascapular aery, which courses laterally across the neck toward the suprascapular notch and paicipates in the elaborate anastomosis of vessels that surround the scapula. The inferior thyroid aery anastomoses with the superior thyroid aery, a branch of the external carotid aery. The posterior auricular aery passes upward, behind the auricle, and supplies blood to the scalp.Also KnowThe sternocleidomastoid muscle creates the borders for both the anterior and the posterior triangles of the neck, and is innervated by the spinal accessory nerve (CN XI). Ref: Dhillon N. (2012). Chapter 1. Anatomy. In A.K. Lalwani (Ed), CURRENT Diagnosis & Treatment in Otolaryngology--Head & Neck Surgery, 3e. ### End" @@ -6047,6 +10813,13 @@ Occipital aery, superior thyroid aery and thyrocervical trunk supplies blood to Answer the following medical question: Test predicting the return of renal function in a patient with tumor lysis syndrome is ?, with the following options: A: Serum creatinine, B: Serum phosphate, C: Serum potassium, D: Serum Uric acid +### Response: +","Answer- D. Serum Uric acidThe prognosis of tumor lysis syndrome is excellent, and renal function recovers after the uric acid level is lowered to < l0 mg/dl.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Test predicting the return of renal function in a patient with tumor lysis syndrome is ?, with the following options: A: Serum creatinine, B: Serum phosphate, C: Serum potassium, D: Serum Uric acid + ### Response: Answer- D. Serum Uric acidThe prognosis of tumor lysis syndrome is excellent, and renal function recovers after the uric acid level is lowered to < l0 mg/dl. ### End" @@ -6056,6 +10829,13 @@ Answer- D. Serum Uric acidThe prognosis of tumor lysis syndrome is excellent, an Answer the following medical question: Pastic cover of syringes are disposed in:, with the following options: A: Red bag, B: Yellow bag, C: Black bag, D: Blue bag +### Response: +","Black bag REF: Park 20' edition page 699, Repeated in December 2011 ""Plastic cover of syringe being general non infectious waste is disposed in black bag"" Colour code Type of container Waste disposed Black bag Plastic bag * Noninfectious waste (papers, plastic covers) * Discarded medicines & cytotoxic drugs Red bag Plastic bag/ Disinfected * Infected solid disposable wastes other than sharps container gloves, tunings, catheters, iv sets) * Infected solid wastes contaminated with blood and body fluids(dressing, plaster, linen) * Microbiology/Biotech waste (vaccines, cultures) Yellow bag Plastic bag * Human anatomical waste * Animal waste * Microbiology/Biotech waste (vaccines, cultures) * Infected solid wastes contaminated with blood and body fluids(dressing, plaster, linen) Blue bag Plastic bag/ Puncture * Solid sharps (needles, syringes, scalpels, blades) proof container * Infected solid disposable wastes other than sharps (gloves, tunings, catheters, iv sets)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pastic cover of syringes are disposed in:, with the following options: A: Red bag, B: Yellow bag, C: Black bag, D: Blue bag + ### Response: Black bag REF: Park 20' edition page 699, Repeated in December 2011 ""Plastic cover of syringe being general non infectious waste is disposed in black bag"" Colour code Type of container Waste disposed Black bag Plastic bag * Noninfectious waste (papers, plastic covers) * Discarded medicines & cytotoxic drugs Red bag Plastic bag/ Disinfected * Infected solid disposable wastes other than sharps container gloves, tunings, catheters, iv sets) * Infected solid wastes contaminated with blood and body fluids(dressing, plaster, linen) * Microbiology/Biotech waste (vaccines, cultures) Yellow bag Plastic bag * Human anatomical waste * Animal waste * Microbiology/Biotech waste (vaccines, cultures) * Infected solid wastes contaminated with blood and body fluids(dressing, plaster, linen) Blue bag Plastic bag/ Puncture * Solid sharps (needles, syringes, scalpels, blades) proof container * Infected solid disposable wastes other than sharps (gloves, tunings, catheters, iv sets) ### End" @@ -6065,6 +10845,13 @@ Black bag REF: Park 20' edition page 699, Repeated in December 2011 ""Plastic co Answer the following medical question: An 8-month-old child is brought to a pediatrician because of the mother's concern about the boy's tendency to compulsively bite his fingers. On questioning, the mother repoed that she has noticed yellow-orange crystals in his diapers, but has not mentioned them to anyone. A genetic defect in which of the following pathways should be suspected?, with the following options: A: Aromatic amino acid metabolism, B: Branched chain amino acid metabolism, C: Purine metabolism, D: Pyrimidine metabolism +### Response: +","The condition is Lesch-Nyhan syndrome, and the yellow-orange crystals of uric acid in the diaper are an impoant, but often neglected, clue to early diagnosis. Lesch-Nyhan syndrome is characterized by a tremendous overproduction of purines, because the reutilization of purines the purine salvage pathway is blocked by a near total absence of hypoxanthine-guanine phosphoribosyl-transferase (HGP) activity. Patients with this severe X-linked disease, for reasons that are unknown, show aggressive behavior that leads to self-mutilation. They may also develop gouty ahritis or gouty nephropathy. Phenylketonuria is an example of a disorder of aromatic amino acid metabolism characterized by mental retardation. Maple syrup urine disease is an example of a disorder of branched chain amino acids causing motor abnormalities and seizures. Orotic aciduria is an example of a disorder of pyrimidine metabolism, characterized by retarded growth and development as well as megaloblastic anemia.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: An 8-month-old child is brought to a pediatrician because of the mother's concern about the boy's tendency to compulsively bite his fingers. On questioning, the mother repoed that she has noticed yellow-orange crystals in his diapers, but has not mentioned them to anyone. A genetic defect in which of the following pathways should be suspected?, with the following options: A: Aromatic amino acid metabolism, B: Branched chain amino acid metabolism, C: Purine metabolism, D: Pyrimidine metabolism + ### Response: The condition is Lesch-Nyhan syndrome, and the yellow-orange crystals of uric acid in the diaper are an impoant, but often neglected, clue to early diagnosis. Lesch-Nyhan syndrome is characterized by a tremendous overproduction of purines, because the reutilization of purines the purine salvage pathway is blocked by a near total absence of hypoxanthine-guanine phosphoribosyl-transferase (HGP) activity. Patients with this severe X-linked disease, for reasons that are unknown, show aggressive behavior that leads to self-mutilation. They may also develop gouty ahritis or gouty nephropathy. Phenylketonuria is an example of a disorder of aromatic amino acid metabolism characterized by mental retardation. Maple syrup urine disease is an example of a disorder of branched chain amino acids causing motor abnormalities and seizures. Orotic aciduria is an example of a disorder of pyrimidine metabolism, characterized by retarded growth and development as well as megaloblastic anemia. ### End" @@ -6074,6 +10861,13 @@ The condition is Lesch-Nyhan syndrome, and the yellow-orange crystals of uric ac Answer the following medical question: Octreotide is used in all except, with the following options: A: >Insulinoma, B: >Glucagonoma, C: >Glioma, D: >Carcinoids +### Response: +","Glioma Octreotide is a synthetic analogue of somatostatin and its pharmacological actions are similar to somatostatin. Somatostatin Somatostatin is a hypothalamic peptide that regulates the function of several endocrine and exocrine glands. Somatostatin acts primarily as a negative regulator of a variety of different types of cells blocking processes such as cell secretion, cell growth and smooth muscle contraction. It is secreted from the hypothalamus into the poal circulation and travels to the anterior pituitary gland where it inhibits the production and release of both growth hormone and thyroid stimulating hormone. Somatostatin is present in many tissues other than hypothalamus It is also secreted by the cells in the pancreas and in the intestine where it inhibits the secretion of variety of hormones","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Octreotide is used in all except, with the following options: A: >Insulinoma, B: >Glucagonoma, C: >Glioma, D: >Carcinoids + ### Response: Glioma Octreotide is a synthetic analogue of somatostatin and its pharmacological actions are similar to somatostatin. Somatostatin Somatostatin is a hypothalamic peptide that regulates the function of several endocrine and exocrine glands. Somatostatin acts primarily as a negative regulator of a variety of different types of cells blocking processes such as cell secretion, cell growth and smooth muscle contraction. It is secreted from the hypothalamus into the poal circulation and travels to the anterior pituitary gland where it inhibits the production and release of both growth hormone and thyroid stimulating hormone. Somatostatin is present in many tissues other than hypothalamus It is also secreted by the cells in the pancreas and in the intestine where it inhibits the secretion of variety of hormones ### End" @@ -6083,6 +10877,13 @@ Glioma Octreotide is a synthetic analogue of somatostatin and its pharmacologica Answer the following medical question: Most common site for the congenital diaphragmatic hernia of Morgagni is?, with the following options: A: Left Anterior, B: Right posterior, C: Right Anterior, D: Left posterior +### Response: +",Morgagni hernia is a congenital diaphragmatic hernia that occurs through the foramen of morgagni. It is an anterior retrosternal hernia which is more common on the right side.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common site for the congenital diaphragmatic hernia of Morgagni is?, with the following options: A: Left Anterior, B: Right posterior, C: Right Anterior, D: Left posterior + ### Response: Morgagni hernia is a congenital diaphragmatic hernia that occurs through the foramen of morgagni. It is an anterior retrosternal hernia which is more common on the right side. ### End" @@ -6092,6 +10893,15 @@ Morgagni hernia is a congenital diaphragmatic hernia that occurs through the for Answer the following medical question: During neonatal resuscitation, the chest compression to ventilation ratio is, with the following options: A: 15:01, B: 5:01, C: 10:01, D: 3:01 +### Response: +","It is important to ventilate in between chest compressions. A positive breath should follow every third chest compression(chest compression to ventilation ratio is 3:1).  +In one minute, 90 chest compressions and 30 breaths are administered(120 events). +To obtain this, the chest should be compressed 3 times in 1.5 seconds leaving out approx. 0.5 second for ventilation.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: During neonatal resuscitation, the chest compression to ventilation ratio is, with the following options: A: 15:01, B: 5:01, C: 10:01, D: 3:01 + ### Response: It is important to ventilate in between chest compressions. A positive breath should follow every third chest compression(chest compression to ventilation ratio is 3:1).  In one minute, 90 chest compressions and 30 breaths are administered(120 events). @@ -6103,6 +10913,13 @@ To obtain this, the chest should be compressed 3 times in 1.5 seconds leaving ou Answer the following medical question: The schedule of HDCV in rabies is-, with the following options: A: 0,3, 7,14, 28, B: 0, 3, 14, 28, 90, C: 3, 7, 14, 16,18, D: 0, 7, 14, 16, 18 +### Response: +","Ans- A 0,3, 7,14, 28 Ref- Vaccine Post-exposure prophylaxis depends on the type of contact with the confirmed or suspect rabid animal, as follows: 1. Wound treatment Thorough washing of the wound with soap/detergent and water, followed by the application of ethanol or an aqueous solution of iodine or povidone. 2. Passive immunization Human rabies immunoglobulin (HRIG) or equine rabies immunoglobulin (ERIG) or F(ab')2 products should be used for category III exposures as well as for some category II exposures (see table above). Passive immunization should be administered just before or shortly after administration of the first dose of vaccine given in the post-exposure prophylaxis regimen. If it is not immediately available, passive immunization can be administered up until the seventh day after initiation of the primary series of postexposure prophylaxis (with cell-culture or embryonated-egg rabies vaccine). Dosage and administration: The dose for HRIG is 20 IU/kg body weight and for ERIG and F(ab')2 products 40 IU/kg body weight. The full dose of rabies immunoglobulin, or as much as is anatomically feasible, should be administered into and around the wound site. Any remainder should be injected i.m. at a site distant from the site of active vaccine administration. Multiple needle injections into the wound should be avoided. If the correct dose of rabies immunoglobulin is too small to infiltrate all wounds, as might be true of a severely bitten individual, it can be diluted in physiological buffered saline to ensure greater wound coverage. 3. Active immunization Cell-culture- or embryonated-egg-based rabies vaccines should always be used for post-exposure prophylaxis. They can be administered either i.m. or i.d. Intramuscular regimens: Both a five-dose and a four-dose i.m. regimen are recommended for post-exposure vaccination; the fivedose regimen is the more commonly used: The five-dose regimen is administered on days 0, 3, 7, 14 and 28 into the deltoid muscle. The four-dose regimen is administered as two doses on day 0 (one dose in the right and one in the left arm (deltoid muscles), and then one dose on each of days 7 and 21 into the deltoid muscle. An alternative post-exposure regimen for healthy, fully immunocompetent exposed people who receive wound care plus high-quality rabies immunoglobulin plus WHO-prequalified rabies vaccines consists of four doses administered i.m. on days 0, 3, 7 and 14. Intradermal regimens: Intradermal administration of cell-culture- and embryonated-egg-based rabies vaccines has been successfully used in many developing countries that cannot afford the five- or four-dose i.m. schedules. The two-site i.d. method: one i.d. injection at two sites on days 0, 3, 7 and 28. The volume per intradermal injection should be 0.1 ml with both purified Vero cell rabies vaccine, and purified chick embryo rabies vaccine.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The schedule of HDCV in rabies is-, with the following options: A: 0,3, 7,14, 28, B: 0, 3, 14, 28, 90, C: 3, 7, 14, 16,18, D: 0, 7, 14, 16, 18 + ### Response: Ans- A 0,3, 7,14, 28 Ref- Vaccine Post-exposure prophylaxis depends on the type of contact with the confirmed or suspect rabid animal, as follows: 1. Wound treatment Thorough washing of the wound with soap/detergent and water, followed by the application of ethanol or an aqueous solution of iodine or povidone. 2. Passive immunization Human rabies immunoglobulin (HRIG) or equine rabies immunoglobulin (ERIG) or F(ab')2 products should be used for category III exposures as well as for some category II exposures (see table above). Passive immunization should be administered just before or shortly after administration of the first dose of vaccine given in the post-exposure prophylaxis regimen. If it is not immediately available, passive immunization can be administered up until the seventh day after initiation of the primary series of postexposure prophylaxis (with cell-culture or embryonated-egg rabies vaccine). Dosage and administration: The dose for HRIG is 20 IU/kg body weight and for ERIG and F(ab')2 products 40 IU/kg body weight. The full dose of rabies immunoglobulin, or as much as is anatomically feasible, should be administered into and around the wound site. Any remainder should be injected i.m. at a site distant from the site of active vaccine administration. Multiple needle injections into the wound should be avoided. If the correct dose of rabies immunoglobulin is too small to infiltrate all wounds, as might be true of a severely bitten individual, it can be diluted in physiological buffered saline to ensure greater wound coverage. 3. Active immunization Cell-culture- or embryonated-egg-based rabies vaccines should always be used for post-exposure prophylaxis. They can be administered either i.m. or i.d. Intramuscular regimens: Both a five-dose and a four-dose i.m. regimen are recommended for post-exposure vaccination; the fivedose regimen is the more commonly used: The five-dose regimen is administered on days 0, 3, 7, 14 and 28 into the deltoid muscle. The four-dose regimen is administered as two doses on day 0 (one dose in the right and one in the left arm (deltoid muscles), and then one dose on each of days 7 and 21 into the deltoid muscle. An alternative post-exposure regimen for healthy, fully immunocompetent exposed people who receive wound care plus high-quality rabies immunoglobulin plus WHO-prequalified rabies vaccines consists of four doses administered i.m. on days 0, 3, 7 and 14. Intradermal regimens: Intradermal administration of cell-culture- and embryonated-egg-based rabies vaccines has been successfully used in many developing countries that cannot afford the five- or four-dose i.m. schedules. The two-site i.d. method: one i.d. injection at two sites on days 0, 3, 7 and 28. The volume per intradermal injection should be 0.1 ml with both purified Vero cell rabies vaccine, and purified chick embryo rabies vaccine. ### End" @@ -6112,6 +10929,17 @@ Ans- A 0,3, 7,14, 28 Ref- Vaccine Post-exposure prophylaxis depends on the type Answer the following medical question: Growth is completed in which of the following dimensions at last?, with the following options: A: Width of the dental arches, B: Length of the jaws, C: Height of the face, D: All occur at the same time +### Response: +","For the three planes of space in both the maxilla and mandible, there is a definite sequence in which growth is ""completed"" (i.e., declines to the slow rate that characterizes normal adults). Growth in width is completed first, then growth in length, and finally growth in height.  +Growth in width of both jaws, including the width of the dental arches, tends to be completed before the adolescent growth spurt and is affected minimally if at all by adolescent growth changes. Intercanine width is more likely to decrease than increase after age 12. +Growth in length and height of both jaws continues through the period of puberty. In girls, the maxilla grows slowly downward and forward to age 14 to 15 on the average. +In both sexes, growth in vertical height of the face continues longer than growth in length, with the late vertical growth primarily in the mandible. +Contemporary orthodontics, William Proffit, 4th edition page 112","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Growth is completed in which of the following dimensions at last?, with the following options: A: Width of the dental arches, B: Length of the jaws, C: Height of the face, D: All occur at the same time + ### Response: For the three planes of space in both the maxilla and mandible, there is a definite sequence in which growth is ""completed"" (i.e., declines to the slow rate that characterizes normal adults). Growth in width is completed first, then growth in length, and finally growth in height.  Growth in width of both jaws, including the width of the dental arches, tends to be completed before the adolescent growth spurt and is affected minimally if at all by adolescent growth changes. Intercanine width is more likely to decrease than increase after age 12. @@ -6125,6 +10953,13 @@ Contemporary orthodontics, William Proffit, 4th edition page 112 Answer the following medical question: All of the following are associated with carcinoid syndrome except: September 2005, with the following options: A: Cyanosis, B: Diarrhoea, C: Flushing, D: Acute appendicitis +### Response: +","Ans. A: Cyanosis Carcinoid syndrome develops in some people with carcinoid tumors and is characterized by cutaneous flushing, abdominal cramps, and diarrhea. Carcinoid tumour occur throughout the gastrointestinal tract, most commonly in the appendix, ileum and rectum in decreasing order of frequency. Right-sided valvular hea disease may develop after several years. The syndrome results from vasoactive substances (including serotonin, bradykinin, histamine, prostaglandins, polypeptide hormones) secreted by the tumor, which is typically a metastatic intestinal carcinoid. Diagnosis is clinical and by demonstrating increased urinary 5-hydroxyindoleacetic acid. Tumor localization may require a radionuclide scan or laparotomy. Treatment of symptoms is with somatostatin or octreotide, but surgical removal is performed where possible; chemotherapy may be used for malignant tumors.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following are associated with carcinoid syndrome except: September 2005, with the following options: A: Cyanosis, B: Diarrhoea, C: Flushing, D: Acute appendicitis + ### Response: Ans. A: Cyanosis Carcinoid syndrome develops in some people with carcinoid tumors and is characterized by cutaneous flushing, abdominal cramps, and diarrhea. Carcinoid tumour occur throughout the gastrointestinal tract, most commonly in the appendix, ileum and rectum in decreasing order of frequency. Right-sided valvular hea disease may develop after several years. The syndrome results from vasoactive substances (including serotonin, bradykinin, histamine, prostaglandins, polypeptide hormones) secreted by the tumor, which is typically a metastatic intestinal carcinoid. Diagnosis is clinical and by demonstrating increased urinary 5-hydroxyindoleacetic acid. Tumor localization may require a radionuclide scan or laparotomy. Treatment of symptoms is with somatostatin or octreotide, but surgical removal is performed where possible; chemotherapy may be used for malignant tumors. ### End" @@ -6134,6 +10969,13 @@ Ans. A: Cyanosis Carcinoid syndrome develops in some people with carcinoid tumor Answer the following medical question: Ramnath attends the ophthalmology outpatient clinic in Kanpur, with yellowish white patch on the bulbar conjunctiva, near limbus. Which of the following is false regarding this condition?, with the following options: A: There is elastotic degeneration of the substantia propria, B: Its always unilateral, C: The treatment is excision, D: May rarely undergo conversion into pterygium +### Response: +","The condition described here is typical presentation of Pinguecula which is usually bilateral. Though treatment is not routinely required, it can be excised. Ref: A K Khurana, 2nd Edition, Page 105.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ramnath attends the ophthalmology outpatient clinic in Kanpur, with yellowish white patch on the bulbar conjunctiva, near limbus. Which of the following is false regarding this condition?, with the following options: A: There is elastotic degeneration of the substantia propria, B: Its always unilateral, C: The treatment is excision, D: May rarely undergo conversion into pterygium + ### Response: The condition described here is typical presentation of Pinguecula which is usually bilateral. Though treatment is not routinely required, it can be excised. Ref: A K Khurana, 2nd Edition, Page 105. ### End" @@ -6143,6 +10985,13 @@ The condition described here is typical presentation of Pinguecula which is usua Answer the following medical question: The poison commonly detected in exhumed bodies is:, with the following options: A: Cadmium, B: Arsenic, C: Lead, D: Mercury +### Response: +","The greatest concentration ofarsenicis found inhair and nails. Its deposition in hair may begin in 15 days after administration. Arsenic becomes fixed in thecancellous tissue of bones, chiefly thelong bones, owing to the conversion of their phosphates into arsenates. Its presence can be detected in the bones for prolonged periods. Hence, it is prudent to preserve long bones for chemical analysis in suspected cases of chronic arsenical poisoning when a body is exhumed.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The poison commonly detected in exhumed bodies is:, with the following options: A: Cadmium, B: Arsenic, C: Lead, D: Mercury + ### Response: The greatest concentration ofarsenicis found inhair and nails. Its deposition in hair may begin in 15 days after administration. Arsenic becomes fixed in thecancellous tissue of bones, chiefly thelong bones, owing to the conversion of their phosphates into arsenates. Its presence can be detected in the bones for prolonged periods. Hence, it is prudent to preserve long bones for chemical analysis in suspected cases of chronic arsenical poisoning when a body is exhumed. ### End" @@ -6152,6 +11001,13 @@ The greatest concentration ofarsenicis found inhair and nails. Its deposition in Answer the following medical question: The ideal method of representation of frequency distribution with continuous variable:, with the following options: A: Line diagram, B: Histogram, C: Simple bar diagram, D: Component bar diagram +### Response: +",Histogram,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The ideal method of representation of frequency distribution with continuous variable:, with the following options: A: Line diagram, B: Histogram, C: Simple bar diagram, D: Component bar diagram + ### Response: Histogram ### End" @@ -6161,6 +11017,13 @@ Histogram Answer the following medical question: Posterior communicating aery is a branch of ?, with the following options: A: Internal carotid, B: External carotid, C: Middle cerebral, D: Posterior superior cerebellar +### Response: +",Posterior communicating aery is a branch of the cerebral pa of the internal carotid aery. The cerebral pa lies at the base of the brain.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Posterior communicating aery is a branch of ?, with the following options: A: Internal carotid, B: External carotid, C: Middle cerebral, D: Posterior superior cerebellar + ### Response: Posterior communicating aery is a branch of the cerebral pa of the internal carotid aery. The cerebral pa lies at the base of the brain. ### End" @@ -6170,6 +11033,13 @@ Posterior communicating aery is a branch of the cerebral pa of the internal caro Answer the following medical question: All of the following are features of SVC Syndrome except-, with the following options: A: Facial swelling, B: Dilatation and congestion of neck veins, C: Headache, D: Hoarseness of voice +### Response: +","Ans. is 'd' i.e., H'oarseness of voice SVC Syndromeo Superior vena cava syndrome (SVCS), is a group of symptoms caused by obstruction of the superior vena cava (a short, wide vessel carrying circulating blood into the heart). More than 90% of cases of superior vena cava obstruction are caused by cancer - most commonly bronchogenic carcinomaSigns and symptomso Shortness of breath is the most common symptom, followed by face or arm swellingo Following are frequent symptoms:# Difficulty breathing# Headache# Facial swelling# Venous distention in the neck and distended veins in the upper chest and arms# Upper limb edema# Lightheadedness# Cough# Edema (swelling) of the neck, called the collar of Stokes# Pemberton's sign","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following are features of SVC Syndrome except-, with the following options: A: Facial swelling, B: Dilatation and congestion of neck veins, C: Headache, D: Hoarseness of voice + ### Response: Ans. is 'd' i.e., H'oarseness of voice SVC Syndromeo Superior vena cava syndrome (SVCS), is a group of symptoms caused by obstruction of the superior vena cava (a short, wide vessel carrying circulating blood into the heart). More than 90% of cases of superior vena cava obstruction are caused by cancer - most commonly bronchogenic carcinomaSigns and symptomso Shortness of breath is the most common symptom, followed by face or arm swellingo Following are frequent symptoms:# Difficulty breathing# Headache# Facial swelling# Venous distention in the neck and distended veins in the upper chest and arms# Upper limb edema# Lightheadedness# Cough# Edema (swelling) of the neck, called the collar of Stokes# Pemberton's sign ### End" @@ -6179,6 +11049,13 @@ Ans. is 'd' i.e., H'oarseness of voice SVC Syndromeo Superior vena cava syndrome Answer the following medical question: Which category of hypersensitivity involves complement activation?, with the following options: A: 2, B: 3, C: 2 & 3, D: 4 & 2 +### Response: +","Ans. C. 2 & 3Hypersensitivity reactions: (HSN)Type I: (Immediate/reaginic HSN).a. Antigen also k/a allergantb. Stimulates formation of IgE antibodies.c. Their subsequent binding to mast cell leads to manifestations of histamine release.d. E.g. Hay fever, Acute asthma, Urticaria, Theobald Smith phenomenon, Prausnitz Kustner reaction, Casoni's test, Schultz dale reaction.Type II: Cytotoxic HSNa. Cell bound antigenb. By IgG/IgMc. Activation of classical complement cascade leading to MAC formation and thereby cytotoxic killing.d. E.g. transfusion reactions, Erythroblastosis fetalis, ITP, good Pasteur Syndrome, Acute rheumatic fever.Type III: Immune complex HSNa. Antigen solubleb. Mediated by IgG/IgMc. Ag- Ab complex activates complement leading to destruction by neutrophils via release of lysosomal enzymes.d. E.g. SLE, Rheumatoid arthritis, HSP, PAN, infective endocarditis, Ac. Post Streptococcal glomerulonephritis, Schick test, Type 2 Lepra (ENL) reaction.Type IV: (Delayed HSN).a. No role of antibody.b. By stimulation of T- helper cell and Macrophage recruitment.c. E.g. Contact dermatitis, Lepromin test, Tuberculin test, Type I Lepra reaction, Fries test., Monte negro test.Type V:a. Cell bound antigenb. No activation of complementc. Binding with antibody causes cellular dysfunction leading to stimulation or inhibition.d. E.g. Grave's disease, Myasthenia gravis.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which category of hypersensitivity involves complement activation?, with the following options: A: 2, B: 3, C: 2 & 3, D: 4 & 2 + ### Response: Ans. C. 2 & 3Hypersensitivity reactions: (HSN)Type I: (Immediate/reaginic HSN).a. Antigen also k/a allergantb. Stimulates formation of IgE antibodies.c. Their subsequent binding to mast cell leads to manifestations of histamine release.d. E.g. Hay fever, Acute asthma, Urticaria, Theobald Smith phenomenon, Prausnitz Kustner reaction, Casoni's test, Schultz dale reaction.Type II: Cytotoxic HSNa. Cell bound antigenb. By IgG/IgMc. Activation of classical complement cascade leading to MAC formation and thereby cytotoxic killing.d. E.g. transfusion reactions, Erythroblastosis fetalis, ITP, good Pasteur Syndrome, Acute rheumatic fever.Type III: Immune complex HSNa. Antigen solubleb. Mediated by IgG/IgMc. Ag- Ab complex activates complement leading to destruction by neutrophils via release of lysosomal enzymes.d. E.g. SLE, Rheumatoid arthritis, HSP, PAN, infective endocarditis, Ac. Post Streptococcal glomerulonephritis, Schick test, Type 2 Lepra (ENL) reaction.Type IV: (Delayed HSN).a. No role of antibody.b. By stimulation of T- helper cell and Macrophage recruitment.c. E.g. Contact dermatitis, Lepromin test, Tuberculin test, Type I Lepra reaction, Fries test., Monte negro test.Type V:a. Cell bound antigenb. No activation of complementc. Binding with antibody causes cellular dysfunction leading to stimulation or inhibition.d. E.g. Grave's disease, Myasthenia gravis. ### End" @@ -6188,6 +11065,13 @@ Ans. C. 2 & 3Hypersensitivity reactions: (HSN)Type I: (Immediate/reaginic HSN).a Answer the following medical question: Compartment syndrome is confirmed at pressure above, with the following options: A: 30 mm Hg, B: 40 mm Hg, C: 50 mm Hg, D: 35 mm Hg +### Response: +","Ans. (a) 30 mm HgRef Bailey and Love 27th edition Page 408Compartment Syndrome:* MC cause - Fracture (70%)* Other causes:# Soft tissue contusion# Bleeding disorders# Circumferential Burns# Post ischemic swelling# Tight Casts/Dressings# IV fluids extravasation* C/F- Pain on passive stretch (Early Sign), Late sign (pulselessness)* Absolute pressure >30mmHg or Pressure Gradient (Diastolic pressure - Compartment Syndrome) is less than Equal to 30mmHg is Compartment syndrome.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Compartment syndrome is confirmed at pressure above, with the following options: A: 30 mm Hg, B: 40 mm Hg, C: 50 mm Hg, D: 35 mm Hg + ### Response: Ans. (a) 30 mm HgRef Bailey and Love 27th edition Page 408Compartment Syndrome:* MC cause - Fracture (70%)* Other causes:# Soft tissue contusion# Bleeding disorders# Circumferential Burns# Post ischemic swelling# Tight Casts/Dressings# IV fluids extravasation* C/F- Pain on passive stretch (Early Sign), Late sign (pulselessness)* Absolute pressure >30mmHg or Pressure Gradient (Diastolic pressure - Compartment Syndrome) is less than Equal to 30mmHg is Compartment syndrome. ### End" @@ -6197,6 +11081,13 @@ Ans. (a) 30 mm HgRef Bailey and Love 27th edition Page 408Compartment Syndrome:* Answer the following medical question: Cause of congestive splenomegaly is -, with the following options: A: Visceral Leishmaniasis, B: Budd Chiari Syndrome, C: Gaucher's Disease, D: Hodgkin's Lymphoma +### Response: +","Ans. is 'b' i.e., Budd Chiari Syndrome Causes of congestive splenomegalyo Budd Chiari Syndromeo Hepatic vein obstruction\o Portal vein obstruction","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cause of congestive splenomegaly is -, with the following options: A: Visceral Leishmaniasis, B: Budd Chiari Syndrome, C: Gaucher's Disease, D: Hodgkin's Lymphoma + ### Response: Ans. is 'b' i.e., Budd Chiari Syndrome Causes of congestive splenomegalyo Budd Chiari Syndromeo Hepatic vein obstruction\o Portal vein obstruction ### End" @@ -6206,6 +11097,13 @@ Ans. is 'b' i.e., Budd Chiari Syndrome Causes of congestive splenomegalyo Budd C Answer the following medical question: Tardy ulnar nerve palsy is due to _____:, with the following options: A: Cubitus valgus, B: Fixation of the nerve in the groove by osteoarthritis, C: Excision of elbow joint, D: Fracture of internal condyle +### Response: +",Ans. A. Cubitus valgusTardy ulnar nerve palsy is due to cubitus valgus.Fracture of the lateral condyle of humerus in the long run can lead to complications such as cubitus valgus.Friction neuritis of the ulnar nerve as it moves over the medial epicondyle every time the elbow is flexed and extended may result in a late ulnar nerve palsy called as 'tardy ulnar nerve palsy'.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Tardy ulnar nerve palsy is due to _____:, with the following options: A: Cubitus valgus, B: Fixation of the nerve in the groove by osteoarthritis, C: Excision of elbow joint, D: Fracture of internal condyle + ### Response: Ans. A. Cubitus valgusTardy ulnar nerve palsy is due to cubitus valgus.Fracture of the lateral condyle of humerus in the long run can lead to complications such as cubitus valgus.Friction neuritis of the ulnar nerve as it moves over the medial epicondyle every time the elbow is flexed and extended may result in a late ulnar nerve palsy called as 'tardy ulnar nerve palsy'. ### End" @@ -6215,6 +11113,13 @@ Ans. A. Cubitus valgusTardy ulnar nerve palsy is due to cubitus valgus.Fracture Answer the following medical question: All of the following features can be observed after the injury to axillary nerve, except:, with the following options: A: Loss of rounded contour of shoulder, B: Loss of sensation along lateral side of upper arm, C: Loss of overhead abduction, D: Atrophy of deltoid muscle +### Response: +",C i.e. Loss of overhead abduction,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following features can be observed after the injury to axillary nerve, except:, with the following options: A: Loss of rounded contour of shoulder, B: Loss of sensation along lateral side of upper arm, C: Loss of overhead abduction, D: Atrophy of deltoid muscle + ### Response: C i.e. Loss of overhead abduction ### End" @@ -6224,6 +11129,13 @@ C i.e. Loss of overhead abduction Answer the following medical question: Polytrauma patient back spine examination is by, with the following options: A: Log roll, B: Barrel role, C: Chin lift, D: None +### Response: +",Ans. (a) Log rollRef: Bailey 26th edition Page 329 * Log roll is performed for spine examination.* Log roll tor Spine Examination,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Polytrauma patient back spine examination is by, with the following options: A: Log roll, B: Barrel role, C: Chin lift, D: None + ### Response: Ans. (a) Log rollRef: Bailey 26th edition Page 329 * Log roll is performed for spine examination.* Log roll tor Spine Examination ### End" @@ -6233,6 +11145,13 @@ Ans. (a) Log rollRef: Bailey 26th edition Page 329 * Log roll is performed for s Answer the following medical question: Antegrade amnesia is seen in: AIIMS 10, with the following options: A: Post-traumatic head injury, B: Drug induced, C: Electroconvulsive therapy, D: Stroke +### Response: +",Ans. Post-traumatic head injury,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Antegrade amnesia is seen in: AIIMS 10, with the following options: A: Post-traumatic head injury, B: Drug induced, C: Electroconvulsive therapy, D: Stroke + ### Response: Ans. Post-traumatic head injury ### End" @@ -6242,6 +11161,13 @@ Ans. Post-traumatic head injury Answer the following medical question: Millet seed like pattern is seen in, with the following options: A: Milliary TB, B: Pulmonary hemosiderosis, C: Healed varicella pneumonia, D: All of the above +### Response: +","- Miliary Tuberculosis- Due to Hematogenous spread of infection - At first, the chest radiograph may be normal, but then small, discrete nodules, 1-2 mm in diameter, become apparent, evenly distributed throughout both lungs. - other causes of Miliary shadows seen on Chest X-ray: Tuberculosis Histoplasmosis Sarcoidosis Healed varicella","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Millet seed like pattern is seen in, with the following options: A: Milliary TB, B: Pulmonary hemosiderosis, C: Healed varicella pneumonia, D: All of the above + ### Response: - Miliary Tuberculosis- Due to Hematogenous spread of infection - At first, the chest radiograph may be normal, but then small, discrete nodules, 1-2 mm in diameter, become apparent, evenly distributed throughout both lungs. - other causes of Miliary shadows seen on Chest X-ray: Tuberculosis Histoplasmosis Sarcoidosis Healed varicella ### End" @@ -6251,6 +11177,13 @@ Answer the following medical question: Millet seed like pattern is seen in, with Answer the following medical question: Linitis plastica is a feature of -, with the following options: A: Hiatus hernia, B: Chronic gastric ulcer, C: Chronic gastric ulcer, D: All +### Response: +","Ans. is 'c' i.e., Lymphoma of stomachLinitis plastica Involvement of a broad region of the gastric wall or entire stomach by diffuse stomach cancer cause linitis plastica.It is also known as Brinton's disease.The appearance of stomach is like leather bottle.o The other cause of linitis plastica areu Lye ingestion u Metastatic infiltration of stomach u Syphilisu Sarcoidosis a Non -hodgkin lymphoma of stomach","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Linitis plastica is a feature of -, with the following options: A: Hiatus hernia, B: Chronic gastric ulcer, C: Chronic gastric ulcer, D: All + ### Response: Ans. is 'c' i.e., Lymphoma of stomachLinitis plastica Involvement of a broad region of the gastric wall or entire stomach by diffuse stomach cancer cause linitis plastica.It is also known as Brinton's disease.The appearance of stomach is like leather bottle.o The other cause of linitis plastica areu Lye ingestion u Metastatic infiltration of stomach u Syphilisu Sarcoidosis a Non -hodgkin lymphoma of stomach ### End" @@ -6260,6 +11193,13 @@ Ans. is 'c' i.e., Lymphoma of stomachLinitis plastica Involvement of a broad reg Answer the following medical question: A patient develops a form of lung cancer that spreads to occlude the thoracic duct. Edema involving which of the following sites might be expected as a potential complication?, with the following options: A: Entire left side and right leg, B: Entire right side and left leg, C: Left arm only, D: Right arm and right half of head only +### Response: +","The right lymphatic duct drains the right arm, the right side of the chest, and the right side of the head. The thoracic duct drains the rest of the body. Both the right lymphatic duct and the thoracic duct dump into the large venous channels at the base of the neck. Occlusion of this drainage can produce intractable edema in sites feeding these ducts. The left side and right leg would be affected, rather than the right side and left leg. The entire left side (rather than just the left arm) and right leg drain into the thoracic duct. The right arm and the right half of the head drain to the right lymphatic duct. Ref: Moon D.A., Foreman K.B., Albeine K.H. (2011). Chapter 26. Triangles and Root of the Neck. In D.A. Moon, K.B. Foreman, K.H. Albeine (Eds), The Big Picture: Gross Anatomy","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A patient develops a form of lung cancer that spreads to occlude the thoracic duct. Edema involving which of the following sites might be expected as a potential complication?, with the following options: A: Entire left side and right leg, B: Entire right side and left leg, C: Left arm only, D: Right arm and right half of head only + ### Response: The right lymphatic duct drains the right arm, the right side of the chest, and the right side of the head. The thoracic duct drains the rest of the body. Both the right lymphatic duct and the thoracic duct dump into the large venous channels at the base of the neck. Occlusion of this drainage can produce intractable edema in sites feeding these ducts. The left side and right leg would be affected, rather than the right side and left leg. The entire left side (rather than just the left arm) and right leg drain into the thoracic duct. The right arm and the right half of the head drain to the right lymphatic duct. Ref: Moon D.A., Foreman K.B., Albeine K.H. (2011). Chapter 26. Triangles and Root of the Neck. In D.A. Moon, K.B. Foreman, K.H. Albeine (Eds), The Big Picture: Gross Anatomy ### End" @@ -6269,6 +11209,13 @@ The right lymphatic duct drains the right arm, the right side of the chest, and Answer the following medical question: Age group affected by Osteosarcoma, with the following options: A: Up-to 10 yrs, B: 10 -20 yrs, C: 30-40 yrs, D: Older than 45 yrs +### Response: +","This is predominantly a tumor of childhood or adolescence, occurring most commonly in the 10-25years Refer Maheshwari 6tg/e p 239","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Age group affected by Osteosarcoma, with the following options: A: Up-to 10 yrs, B: 10 -20 yrs, C: 30-40 yrs, D: Older than 45 yrs + ### Response: This is predominantly a tumor of childhood or adolescence, occurring most commonly in the 10-25years Refer Maheshwari 6tg/e p 239 ### End" @@ -6278,6 +11225,13 @@ This is predominantly a tumor of childhood or adolescence, occurring most common Answer the following medical question: Regarding cytosolic Eukaryotic gene expression false is -, with the following options: A: Capping helps in attachment of mRNA to 40 S Ribosome, B: N formyl methionine tRNA will be the first t - RNA to come into action, C: EF2 shifts between GDP & GTP, D: Releasing factor releases the polypeptide chain from the P site +### Response: +","Ans. is 'a' i.e. N formyl Met is the first t-RNA to come into action Genetic information is stored in the chromosomes and transmitted to daughter cells through DNA replication. It is expressed through transcription to RNA (tRNA, mRNA & rRNA). Subsequently, it is translated into polypeptide chain i.e. protein synthesis.Steps of protein synthesisActivation of amino acids.InitiationElongationTerminationWe are not going into detailed steps, as it is a vast topic, so let's discuss the options one by one.Methionine having anticodon UAC is the first amino acid required in binding to the initiation codon AUG on m- RNA. In bacteria and in mitochondria the initiator t-RNA carries an N-formyl ated methionine but in eukaryotes the methionine is not formyl ated so ans. is (a).Recognition of a particular codon in an mRNA sequence is accomplished by the anticodon sequence of the tRNA and it follows the rules of complimentary and antiparallel binding, that is, the mRNA codon is read 5' - 3' by an anticodon pairing in the ""flipped"" (-5') orientation (when writing the sequences of both codons and anticodons, the nucleotide sequence must always be listed in the 5' - 3' order).During elongation of the polypeptide chain, the ribosome moves from the 5' end to the 3' end of the m-RNA that is being translated. This process is facilitated by elongation factors (EF-2) & requires GTP. EF-2 GTP complex is hydrolyzed to EF-2-GDP & the energy released moves the m-RNA forward by one codon.The initiation of protein synthesis starts with dissociation of 80S ribosome into 60S & 40S followed by formation of 43 S Pre initiation complex, which binds to cap structure at the 5'end of m-RNA (present in all eukaryotic cells) & moves down the mRNA until it encounters the initiator codon. But in prokaryotes there is a purine rich sequence of nucleotide bases known as the Shine - Dalgarno sequence of m-RNA. This sequence binds with complimentary sequence near 3'end of 16S r-RNA component of 30S ribosomal subunit.Other important differences in prokaryotes & eukaryotes regarding protein synthesis are:Prokaryotic mRNAs are polycistronic i.e. with several coding regions with its own initiation codon. It can produce separate species of polypeptide while eukaryotic mRNA is monocistronic i.e. codes for only one polypeptide chain.The releasing factors utilized in termination are 3 in prokaryotes RF-1, RJF-2 & RF-3 while in eukaryotes it is only one- eRF.In prokaryotes three initiation factors are known (IF-1, IF-2 & IF-3) whereas in eukaryotes there are at least 10 (designated as- elF)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Regarding cytosolic Eukaryotic gene expression false is -, with the following options: A: Capping helps in attachment of mRNA to 40 S Ribosome, B: N formyl methionine tRNA will be the first t - RNA to come into action, C: EF2 shifts between GDP & GTP, D: Releasing factor releases the polypeptide chain from the P site + ### Response: Ans. is 'a' i.e. N formyl Met is the first t-RNA to come into action Genetic information is stored in the chromosomes and transmitted to daughter cells through DNA replication. It is expressed through transcription to RNA (tRNA, mRNA & rRNA). Subsequently, it is translated into polypeptide chain i.e. protein synthesis.Steps of protein synthesisActivation of amino acids.InitiationElongationTerminationWe are not going into detailed steps, as it is a vast topic, so let's discuss the options one by one.Methionine having anticodon UAC is the first amino acid required in binding to the initiation codon AUG on m- RNA. In bacteria and in mitochondria the initiator t-RNA carries an N-formyl ated methionine but in eukaryotes the methionine is not formyl ated so ans. is (a).Recognition of a particular codon in an mRNA sequence is accomplished by the anticodon sequence of the tRNA and it follows the rules of complimentary and antiparallel binding, that is, the mRNA codon is read 5' - 3' by an anticodon pairing in the ""flipped"" (-5') orientation (when writing the sequences of both codons and anticodons, the nucleotide sequence must always be listed in the 5' - 3' order).During elongation of the polypeptide chain, the ribosome moves from the 5' end to the 3' end of the m-RNA that is being translated. This process is facilitated by elongation factors (EF-2) & requires GTP. EF-2 GTP complex is hydrolyzed to EF-2-GDP & the energy released moves the m-RNA forward by one codon.The initiation of protein synthesis starts with dissociation of 80S ribosome into 60S & 40S followed by formation of 43 S Pre initiation complex, which binds to cap structure at the 5'end of m-RNA (present in all eukaryotic cells) & moves down the mRNA until it encounters the initiator codon. But in prokaryotes there is a purine rich sequence of nucleotide bases known as the Shine - Dalgarno sequence of m-RNA. This sequence binds with complimentary sequence near 3'end of 16S r-RNA component of 30S ribosomal subunit.Other important differences in prokaryotes & eukaryotes regarding protein synthesis are:Prokaryotic mRNAs are polycistronic i.e. with several coding regions with its own initiation codon. It can produce separate species of polypeptide while eukaryotic mRNA is monocistronic i.e. codes for only one polypeptide chain.The releasing factors utilized in termination are 3 in prokaryotes RF-1, RJF-2 & RF-3 while in eukaryotes it is only one- eRF.In prokaryotes three initiation factors are known (IF-1, IF-2 & IF-3) whereas in eukaryotes there are at least 10 (designated as- elF) ### End" @@ -6287,6 +11241,13 @@ Ans. is 'a' i.e. N formyl Met is the first t-RNA to come into action Genetic inf Answer the following medical question: The phenomenon where subsequent generations are at risk of earlier and more severe disease is known as, with the following options: A: Anticipation, B: Pleiotropy, C: Imprinting, D: Mosaicism +### Response: +",Ref Robbins 9/e p169 Anticipating refers to observation that clinical features of a genetic disease worsen with each successive generations.it is observed in fragile X syndrome and Huntington disease commonly,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The phenomenon where subsequent generations are at risk of earlier and more severe disease is known as, with the following options: A: Anticipation, B: Pleiotropy, C: Imprinting, D: Mosaicism + ### Response: Ref Robbins 9/e p169 Anticipating refers to observation that clinical features of a genetic disease worsen with each successive generations.it is observed in fragile X syndrome and Huntington disease commonly ### End" @@ -6296,6 +11257,13 @@ Ref Robbins 9/e p169 Anticipating refers to observation that clinical features o Answer the following medical question: Popcorn-cells' are seen in which variety of hodgkin's disease -, with the following options: A: Nodular sclerosis, B: Mixed cellularity, C: Lymphocyte predominance, D: Lymphocyte depletion +### Response: +",Popcorn cells are found in lymphocytic predominant type of Hodgkin's Lymphoma.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Popcorn-cells' are seen in which variety of hodgkin's disease -, with the following options: A: Nodular sclerosis, B: Mixed cellularity, C: Lymphocyte predominance, D: Lymphocyte depletion + ### Response: Popcorn cells are found in lymphocytic predominant type of Hodgkin's Lymphoma. ### End" @@ -6305,6 +11273,13 @@ Popcorn cells are found in lymphocytic predominant type of Hodgkin's Lymphoma. Answer the following medical question: Most common cause of extracranial solid tumor in children:, with the following options: A: Neuroblastoma, B: Wilm'stumor, C: Thymoma, D: Osteosarcoma +### Response: +",Ans. (a) Neuroblastoma(Ref: Robbins 9th/pg 475-479)Neuroblastoma is the:Most common extracranial solid tumor of childhood QMost common abdominal tumor of childhood QMost frequendy diagnosed tumor of infancy (<1yr of age) Q,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common cause of extracranial solid tumor in children:, with the following options: A: Neuroblastoma, B: Wilm'stumor, C: Thymoma, D: Osteosarcoma + ### Response: Ans. (a) Neuroblastoma(Ref: Robbins 9th/pg 475-479)Neuroblastoma is the:Most common extracranial solid tumor of childhood QMost common abdominal tumor of childhood QMost frequendy diagnosed tumor of infancy (<1yr of age) Q ### End" @@ -6314,6 +11289,13 @@ Ans. (a) Neuroblastoma(Ref: Robbins 9th/pg 475-479)Neuroblastoma is the:Most com Answer the following medical question: The best marker for hyperthyroidism -, with the following options: A: T3, B: T4, C: TSH, D: Thyroglobulin +### Response: +","Ans. is 'c' i.e., TSHo Currently. TSHQ is the most important test for determining thyroid dysfunction in both hypothyroid and hvperthvroid patients.o This has been made possible by the improvement in sensitivity oJ'TSH measurements over the years.o If the results of these sensitive assays for TSH is within the reference interval, it usually excludes thyroid dysfunction.Hyperthyroid patients-Usually have suppressed TSHQ values with the exception ofthose few individuals, who have hyperthyroidism caused by TSH producing pituitary tumours (secondary hypothyroidism).Hypothyroid patients-Most patients have markedly elevated TSHQ but levels are low in individuals with hypothyroidism caused by pituitary or hypothalamic disorders (secondary hypothyroidism).o To confirm the presence of thyroid dysfunction, free T4 determinations with or without T4 along with TSH can be used in patients suspected hypothyroidism or hyperthyroidism.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The best marker for hyperthyroidism -, with the following options: A: T3, B: T4, C: TSH, D: Thyroglobulin + ### Response: Ans. is 'c' i.e., TSHo Currently. TSHQ is the most important test for determining thyroid dysfunction in both hypothyroid and hvperthvroid patients.o This has been made possible by the improvement in sensitivity oJ'TSH measurements over the years.o If the results of these sensitive assays for TSH is within the reference interval, it usually excludes thyroid dysfunction.Hyperthyroid patients-Usually have suppressed TSHQ values with the exception ofthose few individuals, who have hyperthyroidism caused by TSH producing pituitary tumours (secondary hypothyroidism).Hypothyroid patients-Most patients have markedly elevated TSHQ but levels are low in individuals with hypothyroidism caused by pituitary or hypothalamic disorders (secondary hypothyroidism).o To confirm the presence of thyroid dysfunction, free T4 determinations with or without T4 along with TSH can be used in patients suspected hypothyroidism or hyperthyroidism. ### End" @@ -6323,6 +11305,13 @@ Ans. is 'c' i.e., TSHo Currently. TSHQ is the most important test for determinin Answer the following medical question: Which of the following is associated with pregnancy?, with the following options: A: Type I diabetes, B: Type II diabetes, C: Gestational diabetes, D: Juvenile diabetes +### Response: +",Reproductive capacity in either men or women with DM appears to be normal. Menstrual cycles may be associated with alterations in glycemic control in women with DM. Pregnancy is associated with marked insulin resistance; the increased insulin requirements often precipitate DM and lead to the diagnosis of gestational diabetes mellitus (GDM).,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is associated with pregnancy?, with the following options: A: Type I diabetes, B: Type II diabetes, C: Gestational diabetes, D: Juvenile diabetes + ### Response: Reproductive capacity in either men or women with DM appears to be normal. Menstrual cycles may be associated with alterations in glycemic control in women with DM. Pregnancy is associated with marked insulin resistance; the increased insulin requirements often precipitate DM and lead to the diagnosis of gestational diabetes mellitus (GDM). ### End" @@ -6332,6 +11321,13 @@ Reproductive capacity in either men or women with DM appears to be normal. Menst Answer the following medical question: Prevalence of .... % is considered as an epidemic of trachoma and indication for staing chemoprophylaxis., with the following options: A: 1%, B: 3%, C: 5%, D: 10% +### Response: +","Prevalence of 10 % is considered as an epidemic of trachoma and indication for staing chemoprophylaxis * Annual mass drug administration (MDA) with azithromycin (or topical tetracycline) for three years, was recommended by WHO, in combination with other elements of the SAFE strategy, in districts where the prevalence of TF in children aged 1-9 years, determined by programmes using population-based surveys, was at least 10%. * Number of rounds of treatment required: if baseline prevalence is over 30% - 5 rounds of treatment are recommended. If baseline prevalence is between 10% and 30% - 3 rounds of treatment should be conducted. * Prevalence of 10 % is considered as an epidemic of trachoma and indication for staing chemoprophylaxis","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Prevalence of .... % is considered as an epidemic of trachoma and indication for staing chemoprophylaxis., with the following options: A: 1%, B: 3%, C: 5%, D: 10% + ### Response: Prevalence of 10 % is considered as an epidemic of trachoma and indication for staing chemoprophylaxis * Annual mass drug administration (MDA) with azithromycin (or topical tetracycline) for three years, was recommended by WHO, in combination with other elements of the SAFE strategy, in districts where the prevalence of TF in children aged 1-9 years, determined by programmes using population-based surveys, was at least 10%. * Number of rounds of treatment required: if baseline prevalence is over 30% - 5 rounds of treatment are recommended. If baseline prevalence is between 10% and 30% - 3 rounds of treatment should be conducted. * Prevalence of 10 % is considered as an epidemic of trachoma and indication for staing chemoprophylaxis ### End" @@ -6341,6 +11337,13 @@ Prevalence of 10 % is considered as an epidemic of trachoma and indication for s Answer the following medical question: After giving treatment for Syphilis, the response to treatment can be best assessed by -, with the following options: A: FTA- ABS, B: VDRL, C: TPHA, D: Immobilization test +### Response: +","VDRL can be used for treatment monitoring as specific tests remains positive (reactive) after the treatment. A fourfold decrease in titre following therapy suggests adequate therapy, whereas a fourfold increase in titre of reaginic antibodies following therapy suggests reinfection or relapse. FTA-ABS: Treponema-specific test. First test to be positive: FTA-ABS. TPHA: After successful therapy, the hemagglutinating antibodies continue to persist in the serum for a longer time; hence this test is of no prognostic value. T. pallidum immobilization test: TPI test was the first specific treponemal test, that detects the treponemal antibodies in patient's serum, which immobilize motile virulent T. pallidum.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: After giving treatment for Syphilis, the response to treatment can be best assessed by -, with the following options: A: FTA- ABS, B: VDRL, C: TPHA, D: Immobilization test + ### Response: VDRL can be used for treatment monitoring as specific tests remains positive (reactive) after the treatment. A fourfold decrease in titre following therapy suggests adequate therapy, whereas a fourfold increase in titre of reaginic antibodies following therapy suggests reinfection or relapse. FTA-ABS: Treponema-specific test. First test to be positive: FTA-ABS. TPHA: After successful therapy, the hemagglutinating antibodies continue to persist in the serum for a longer time; hence this test is of no prognostic value. T. pallidum immobilization test: TPI test was the first specific treponemal test, that detects the treponemal antibodies in patient's serum, which immobilize motile virulent T. pallidum. ### End" @@ -6350,6 +11353,14 @@ VDRL can be used for treatment monitoring as specific tests remains positive (re Answer the following medical question: Risk factors for Retinal detachment are –a) Diabetic retinopathy b) Myopia c) Hypermetropiad) CRVOe) Retinopathy of prematurity, with the following options: A: abe, B: bcd, C: cde, D: acd +### Response: +","Proliferative diabetic retinopathy and retinopathy of prematurity cause tractional retinal detachment. +Myopia causes rheugmatogenous retinal detachment.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Risk factors for Retinal detachment are –a) Diabetic retinopathy b) Myopia c) Hypermetropiad) CRVOe) Retinopathy of prematurity, with the following options: A: abe, B: bcd, C: cde, D: acd + ### Response: Proliferative diabetic retinopathy and retinopathy of prematurity cause tractional retinal detachment. Myopia causes rheugmatogenous retinal detachment. @@ -6360,6 +11371,13 @@ Myopia causes rheugmatogenous retinal detachment. Answer the following medical question: Anti U1-14NP antibody is seen in?-, with the following options: A: SLE, B: Scleroderma, C: MCTD, D: Dermatomyositis +### Response: +","Robbins basic pathology 9th edition page no 135,Heading =Mixed connective tissue disease Mixed connective tissue disease have high titers of antibodies to an RNP antigen called U1RNP. This disease also have features suggestive of SLE, polymyositis, orSS.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Anti U1-14NP antibody is seen in?-, with the following options: A: SLE, B: Scleroderma, C: MCTD, D: Dermatomyositis + ### Response: Robbins basic pathology 9th edition page no 135,Heading =Mixed connective tissue disease Mixed connective tissue disease have high titers of antibodies to an RNP antigen called U1RNP. This disease also have features suggestive of SLE, polymyositis, orSS. ### End" @@ -6369,6 +11387,13 @@ Robbins basic pathology 9th edition page no 135,Heading =Mixed connective tissue Answer the following medical question: Introns are exised by, with the following options: A: RNA splicing, B: RNA editing, C: Restriction endonuclease, D: DNAase +### Response: +",Introns are excised by RNA splicing by Sn-RNAs/Snurp.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Introns are exised by, with the following options: A: RNA splicing, B: RNA editing, C: Restriction endonuclease, D: DNAase + ### Response: Introns are excised by RNA splicing by Sn-RNAs/Snurp. ### End" @@ -6378,6 +11403,13 @@ Introns are excised by RNA splicing by Sn-RNAs/Snurp. Answer the following medical question: A 60year old male presents with tremors of both hands which are postural, symmetric, high frequency tremors. On examination his pulse rate is 58/mt, neurological examination is normal except for tremors. What is the drug of choice for treatment of this patient?, with the following options: A: Levodopa, B: Propranolol, C: Primidone, D: Trihexyphenidyl +### Response: +","The patient is suffering from essential tremors and drug of choice is propranolol or primidone. As patient is having bradycardia, propranolol is contraindicated in this patient. Hence answer is primidone. Essential tremor is characterized by a high-frequency tremor (6-10 Hz) that predominantly affects the upper extremities. The tremor is most often manifest as a postural or action tremor and, in severe cases, can interfere with functions such as eating and drinking. It is typically bilateral and symmetric but may begin on one side and remain asymmetric. The differential diagnosis includes dystonic tremor or parkinsons disease. PD can usually be differentiated from ET because the former stops at the onset of a voluntary action and is typically associated with bradykinesia with progressive slowing of sequential movements (sequence effect), rigidity, gait and postural instability, and other parkinsonian features. Beta blockers and primidone are the standard drug therapies for ET Propranolol is usually effective at relatively low doses, but higher doses may be needed in some patients. The drug is contraindicated in patients with bradycardia or asthma. Ref Harrison 20th edition page 3132,3133","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 60year old male presents with tremors of both hands which are postural, symmetric, high frequency tremors. On examination his pulse rate is 58/mt, neurological examination is normal except for tremors. What is the drug of choice for treatment of this patient?, with the following options: A: Levodopa, B: Propranolol, C: Primidone, D: Trihexyphenidyl + ### Response: The patient is suffering from essential tremors and drug of choice is propranolol or primidone. As patient is having bradycardia, propranolol is contraindicated in this patient. Hence answer is primidone. Essential tremor is characterized by a high-frequency tremor (6-10 Hz) that predominantly affects the upper extremities. The tremor is most often manifest as a postural or action tremor and, in severe cases, can interfere with functions such as eating and drinking. It is typically bilateral and symmetric but may begin on one side and remain asymmetric. The differential diagnosis includes dystonic tremor or parkinsons disease. PD can usually be differentiated from ET because the former stops at the onset of a voluntary action and is typically associated with bradykinesia with progressive slowing of sequential movements (sequence effect), rigidity, gait and postural instability, and other parkinsonian features. Beta blockers and primidone are the standard drug therapies for ET Propranolol is usually effective at relatively low doses, but higher doses may be needed in some patients. The drug is contraindicated in patients with bradycardia or asthma. Ref Harrison 20th edition page 3132,3133 ### End" @@ -6387,6 +11419,13 @@ The patient is suffering from essential tremors and drug of choice is propranolo Answer the following medical question: World Health Organization 2010 criteria for morphology (strict criteria) for semen analysis includes -, with the following options: A: >15% normal forms, B: >=4% normal forms, C: >=25% normal forms, D: >=32% normal forms +### Response: +","Normal Semen Analysis: World Health Organization 2010 Guideline Volume >=1.5 mL Sperm concentration >=15 million/mL Total sperm number >= 39 million/ ejaculate Sperm motility >40%motile, >32%progressive Morphology >=4% normal forms (kruger's strict criteria) Vitality 58 % White blood cells <1 million/mL Immunobead/Mixed antiglobulin Reaction <50% coated with antibodies reaction","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: World Health Organization 2010 criteria for morphology (strict criteria) for semen analysis includes -, with the following options: A: >15% normal forms, B: >=4% normal forms, C: >=25% normal forms, D: >=32% normal forms + ### Response: Normal Semen Analysis: World Health Organization 2010 Guideline Volume >=1.5 mL Sperm concentration >=15 million/mL Total sperm number >= 39 million/ ejaculate Sperm motility >40%motile, >32%progressive Morphology >=4% normal forms (kruger's strict criteria) Vitality 58 % White blood cells <1 million/mL Immunobead/Mixed antiglobulin Reaction <50% coated with antibodies reaction ### End" @@ -6396,6 +11435,13 @@ Normal Semen Analysis: World Health Organization 2010 Guideline Volume >=1.5 mL Answer the following medical question: Infamous conduct comprises of all, except: Delhi 11, with the following options: A: Adultery, B: Adveising, C: Procuring criminal aboion, D: Examining a patient without consent +### Response: +",Ans. Examining a patient without consent,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Infamous conduct comprises of all, except: Delhi 11, with the following options: A: Adultery, B: Adveising, C: Procuring criminal aboion, D: Examining a patient without consent + ### Response: Ans. Examining a patient without consent ### End" @@ -6405,6 +11451,13 @@ Ans. Examining a patient without consent Answer the following medical question: Sputum from an asthma patient may show ?, with the following options: A: Numerous eosinophils, B: Curschmann's spirals, C: Charcot-Leyden crystals, D: All of the above +### Response: +","Ans. is 'd' i.e., All of the above","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Sputum from an asthma patient may show ?, with the following options: A: Numerous eosinophils, B: Curschmann's spirals, C: Charcot-Leyden crystals, D: All of the above + ### Response: Ans. is 'd' i.e., All of the above ### End" @@ -6414,6 +11467,13 @@ Ans. is 'd' i.e., All of the above Answer the following medical question: Compared to round collimation, rectangular collimation ↓es exposure by:, with the following options: A: 60%, B: 50%, C: 40%, D: 30% +### Response: +","Compared to round collimation, rectangular collimation ↓es exposure by 60%","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Compared to round collimation, rectangular collimation ↓es exposure by:, with the following options: A: 60%, B: 50%, C: 40%, D: 30% + ### Response: Compared to round collimation, rectangular collimation ↓es exposure by 60% ### End" @@ -6423,6 +11483,13 @@ Compared to round collimation, rectangular collimation ↓es exposure by 60% Answer the following medical question: Acetazolamide decreases intraocular pressure by what mechanism: September 2010, with the following options: A: Decreases aqueous humor production, B: Decreases vitreous volume, C: Increased drainage of aqueous, D: None of the above +### Response: +","Ans. A: Decreases aqueous humor production Acetazolamide is a carbonic anhydrase inhibitor, which means that it forces the kidneys to excrete bicarbonate (HCO;), thus re-acidifying the blood. It also lowers intraocular tension by decreased formation of aqueous humour (It is rich in bicarbonate)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Acetazolamide decreases intraocular pressure by what mechanism: September 2010, with the following options: A: Decreases aqueous humor production, B: Decreases vitreous volume, C: Increased drainage of aqueous, D: None of the above + ### Response: Ans. A: Decreases aqueous humor production Acetazolamide is a carbonic anhydrase inhibitor, which means that it forces the kidneys to excrete bicarbonate (HCO;), thus re-acidifying the blood. It also lowers intraocular tension by decreased formation of aqueous humour (It is rich in bicarbonate) ### End" @@ -6432,6 +11499,13 @@ Ans. A: Decreases aqueous humor production Acetazolamide is a carbonic anhydrase Answer the following medical question: An old lady had a history of fall in bathroom once and couldn't move. Afterwards, she had leg in externally rotated position. There was tenderness in Scarpa's triangle and limb movement could not been done due to pain. No hip fracture was seen on X-Ray. Next step, with the following options: A: MRI, B: Repeat X-Ray after one week, C: Joint Aspiration, D: Give analgesic and Manipulate +### Response: +","Ans is 'a' i.e. MRI ""Impacted fractures may be extremely difficult to discern on plain x-ray. If there is a fracture it will show up on MRI or a bone scan after a few days. ""- ApleyHistory of fall, leg in externally rotated position and tenderness in Scarpa's triangle highly suggest fracture neck femur.An impacted, undisplaced fracture is likely to miss on an x-ray. An MRI or a bone scan would be needed to diagnose the lesion.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: An old lady had a history of fall in bathroom once and couldn't move. Afterwards, she had leg in externally rotated position. There was tenderness in Scarpa's triangle and limb movement could not been done due to pain. No hip fracture was seen on X-Ray. Next step, with the following options: A: MRI, B: Repeat X-Ray after one week, C: Joint Aspiration, D: Give analgesic and Manipulate + ### Response: Ans is 'a' i.e. MRI ""Impacted fractures may be extremely difficult to discern on plain x-ray. If there is a fracture it will show up on MRI or a bone scan after a few days. ""- ApleyHistory of fall, leg in externally rotated position and tenderness in Scarpa's triangle highly suggest fracture neck femur.An impacted, undisplaced fracture is likely to miss on an x-ray. An MRI or a bone scan would be needed to diagnose the lesion. ### End" @@ -6441,6 +11515,18 @@ Ans is 'a' i.e. MRI ""Impacted fractures may be extremely difficult to discern o Answer the following medical question: Radiological features of the osteosarcoma -a) New bone formationb) Sun ray appearancec) Codman's triangled) Soap bubble appearancee) Onion pool appearance, with the following options: A: ab, B: bc, C: abc, D: bcd +### Response: +","X-ray of a patient with osteosarcoma shows following features : - + +1)An area of irregular destruction in the metaphysis, sometimes overshadowed by the new bone formation. The cortex overlying the lesion is eroded. There is new bone formation in the matrix of the tumour. +2)Periosteal reaction : - As the tumor lifts the periosteum, it incites an intense periosteal reaction. The periosteal reaction in an osteosarcoma is irregular, unlike in osteomyelitis where it is smooth and in layers. +3)Codman's triangle : - A triangular area of subperiosteal new bone is seen at the tumour host cortex junction at the ends of the tumor. +4)Sun-ray appearance :- As the periosteum is unable to contain the tumour, the tumour grows into the overlying soft tissues. New bone is laid down along the blood vessels within the tumour growing centrifugally, giving rise to a ‘sur-ray appearance' on the X-ray.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Radiological features of the osteosarcoma -a) New bone formationb) Sun ray appearancec) Codman's triangled) Soap bubble appearancee) Onion pool appearance, with the following options: A: ab, B: bc, C: abc, D: bcd + ### Response: X-ray of a patient with osteosarcoma shows following features : - @@ -6455,6 +11541,13 @@ X-ray of a patient with osteosarcoma shows following features : - Answer the following medical question: Which of the following phospholipid has antigenic acitivity ?, with the following options: A: Plasmalogen, B: Cardiolipin, C: Phosphatidylcholine, D: Sphingomyelin +### Response: +","Ans. is 'b i.e., Cardiolipin Cardiolipin is the only human glycerophospholipid that possess antigenic propeies"" Cardiolipin is the major lipid of inner mitochondrial membrane.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following phospholipid has antigenic acitivity ?, with the following options: A: Plasmalogen, B: Cardiolipin, C: Phosphatidylcholine, D: Sphingomyelin + ### Response: Ans. is 'b i.e., Cardiolipin Cardiolipin is the only human glycerophospholipid that possess antigenic propeies"" Cardiolipin is the major lipid of inner mitochondrial membrane. ### End" @@ -6464,6 +11557,13 @@ Ans. is 'b i.e., Cardiolipin Cardiolipin is the only human glycerophospholipid t Answer the following medical question: Most common paraneoplastic syndrome in HCC is, with the following options: A: Hypoglycaemia, B: Hypeension, C: Hypercalcemia, D: Erythrocytosis +### Response: +",Paraneoplastic syndromes on HCC Hypercholesterolemia Hypoglycemia Erythrocytosis Hypercalcemia Hypercholesterolemia > Hypoglycemia > Erythrocytosis > Hypercalcemia Ref: Sabiston 20th edition Pgno : 1459,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common paraneoplastic syndrome in HCC is, with the following options: A: Hypoglycaemia, B: Hypeension, C: Hypercalcemia, D: Erythrocytosis + ### Response: Paraneoplastic syndromes on HCC Hypercholesterolemia Hypoglycemia Erythrocytosis Hypercalcemia Hypercholesterolemia > Hypoglycemia > Erythrocytosis > Hypercalcemia Ref: Sabiston 20th edition Pgno : 1459 ### End" @@ -6473,6 +11573,13 @@ Paraneoplastic syndromes on HCC Hypercholesterolemia Hypoglycemia Erythrocytosis Answer the following medical question: A 30-year-old male presented with hip pain for last 6 months. Hip X-ray is as shown below. What is the likely diagnosis?, with the following options: A: Giant cell tumor, B: Simple Bone Cyst, C: Adamantinoma, D: Ewing's sarcoma +### Response: +",Radiographic findings often are diagnostic. The characteristic x ray findings of GCT are: Eccentric Expansile Lobulated Lytic Metaphyseal NO matrix calcification of periosteal new bone formation,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 30-year-old male presented with hip pain for last 6 months. Hip X-ray is as shown below. What is the likely diagnosis?, with the following options: A: Giant cell tumor, B: Simple Bone Cyst, C: Adamantinoma, D: Ewing's sarcoma + ### Response: Radiographic findings often are diagnostic. The characteristic x ray findings of GCT are: Eccentric Expansile Lobulated Lytic Metaphyseal NO matrix calcification of periosteal new bone formation ### End" @@ -6482,6 +11589,13 @@ Radiographic findings often are diagnostic. The characteristic x ray findings of Answer the following medical question: Species of Anopheles causing malaria in Andamon & Nicobar island ?, with the following options: A: Anopheles stephensi, B: Anopheles dirus, C: Anopheles culicifacies, D: Anopheles epiroticus +### Response: +","Ans. is 'd' i.e., Anopheles epiroticus Vector for malaria is female anapheline mosquito.There are six primary vectors of malaria in India : ?An. culicifacies : - It is the main vector in rural and periurban areas.An. Stephensi : - Responsible for malaria in urban and industrial areas.An fluvitalis : - Main vector in hilly areas, forests and forests fringes, especially in the east.An. minimum : - Vector in the the foot hills of Noh-Eastern states.An. dirus : - Vector in the forest of Noh-East.An. epiroticus : - Restricted to Andaman and Nicobar Islands.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Species of Anopheles causing malaria in Andamon & Nicobar island ?, with the following options: A: Anopheles stephensi, B: Anopheles dirus, C: Anopheles culicifacies, D: Anopheles epiroticus + ### Response: Ans. is 'd' i.e., Anopheles epiroticus Vector for malaria is female anapheline mosquito.There are six primary vectors of malaria in India : ?An. culicifacies : - It is the main vector in rural and periurban areas.An. Stephensi : - Responsible for malaria in urban and industrial areas.An fluvitalis : - Main vector in hilly areas, forests and forests fringes, especially in the east.An. minimum : - Vector in the the foot hills of Noh-Eastern states.An. dirus : - Vector in the forest of Noh-East.An. epiroticus : - Restricted to Andaman and Nicobar Islands. ### End" @@ -6491,6 +11605,13 @@ Ans. is 'd' i.e., Anopheles epiroticus Vector for malaria is female anapheline m Answer the following medical question: Killer cells are associated with type ..... immunologic response -, with the following options: A: Type I, B: Type II, C: Type III, D: None +### Response: +","Ans. is D - 'None' . Killer cells are antibody dependent cytotoxic cells (ADCC) a type of Null cells. . ""The role of ADCC in hypersensitivity diseases is unceain"". Don't get confused between type II hypersensitivity and antibody dependent cellular cytotoxicity (ADCC). . Type II hypersensitivity is mediated by antibodies directed toward antigens present on cell surfaces or extracellular matrix. It involves opsonization i.e., complement and Fc receptor mediated phagocytosis. . Antibody-mediated destruction of cells may occur by another process called antibody dependent cellular cytotoxicity (ADCC). It is different from Type II hypersensitivity. It does not involve fixation of complement but instead requires the co-operation of leukocytes i.e., antibody dependent cytotoxic cells (ADCC). It is not a type II hypersensitivity.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Killer cells are associated with type ..... immunologic response -, with the following options: A: Type I, B: Type II, C: Type III, D: None + ### Response: Ans. is D - 'None' . Killer cells are antibody dependent cytotoxic cells (ADCC) a type of Null cells. . ""The role of ADCC in hypersensitivity diseases is unceain"". Don't get confused between type II hypersensitivity and antibody dependent cellular cytotoxicity (ADCC). . Type II hypersensitivity is mediated by antibodies directed toward antigens present on cell surfaces or extracellular matrix. It involves opsonization i.e., complement and Fc receptor mediated phagocytosis. . Antibody-mediated destruction of cells may occur by another process called antibody dependent cellular cytotoxicity (ADCC). It is different from Type II hypersensitivity. It does not involve fixation of complement but instead requires the co-operation of leukocytes i.e., antibody dependent cytotoxic cells (ADCC). It is not a type II hypersensitivity. ### End" @@ -6500,6 +11621,13 @@ Ans. is D - 'None' . Killer cells are antibody dependent cytotoxic cells (ADCC) Answer the following medical question: Disadvantage of radioactive iodine include the following except:, with the following options: A: Hypothyroidism, B: High chances of relapse, C: Delayed therapeutic effect, D: Development of thyroid carcinoma +### Response: +","Radioactive iodine emits beta particles that destroy some thyroid tissue and impair the ability of the remaining follicles to replicate; hence once the patient becomes euthyroid, chances of relapse are negligible. Though the amount of radioactive iodine to be administered is estimated by the size of the gland and its iodine uptake, about 40-60% of the patients may develop hypothyroidism. The beneficial effects take 3-4 weeks to become apparent. Neoplasms of the thyroid have been reported in children following treatment with it.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Disadvantage of radioactive iodine include the following except:, with the following options: A: Hypothyroidism, B: High chances of relapse, C: Delayed therapeutic effect, D: Development of thyroid carcinoma + ### Response: Radioactive iodine emits beta particles that destroy some thyroid tissue and impair the ability of the remaining follicles to replicate; hence once the patient becomes euthyroid, chances of relapse are negligible. Though the amount of radioactive iodine to be administered is estimated by the size of the gland and its iodine uptake, about 40-60% of the patients may develop hypothyroidism. The beneficial effects take 3-4 weeks to become apparent. Neoplasms of the thyroid have been reported in children following treatment with it. ### End" @@ -6509,6 +11637,13 @@ Radioactive iodine emits beta particles that destroy some thyroid tissue and imp Answer the following medical question: Drug of choice in phenothiazine-induced Dystonia is:, with the following options: A: Diphenhydramine, B: Metoclopramide, C: Trifluperamide, D: Benztropine +### Response: +","Answer is D (Benztropine): Central anticholinergics (eg. Benztropine) are the only drugs effective in phenothiazine /drug induced extrapyramidal symptoms' Central anticholinergics include Triherphenidyl : Most commonly used drug (Benzhexol) Procyclidine Biperidin Benztropine. All antipsychotics have potent dopamine blocking action. Dopaminergic blockage in basal ganglia results in deficiency of dopamine, which controls muscle tone and coordinates movements. This is turn shift the balance between the inhibitory dopaminergic system and excitatory cholinergic system, towards excitatory levels and results in dystonias. Balance can thus be restored by suppression of the unopposed excitatory cholinergic system (Administration of central anticholinergics).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Drug of choice in phenothiazine-induced Dystonia is:, with the following options: A: Diphenhydramine, B: Metoclopramide, C: Trifluperamide, D: Benztropine + ### Response: Answer is D (Benztropine): Central anticholinergics (eg. Benztropine) are the only drugs effective in phenothiazine /drug induced extrapyramidal symptoms' Central anticholinergics include Triherphenidyl : Most commonly used drug (Benzhexol) Procyclidine Biperidin Benztropine. All antipsychotics have potent dopamine blocking action. Dopaminergic blockage in basal ganglia results in deficiency of dopamine, which controls muscle tone and coordinates movements. This is turn shift the balance between the inhibitory dopaminergic system and excitatory cholinergic system, towards excitatory levels and results in dystonias. Balance can thus be restored by suppression of the unopposed excitatory cholinergic system (Administration of central anticholinergics). ### End" @@ -6518,6 +11653,13 @@ Answer is D (Benztropine): Central anticholinergics (eg. Benztropine) are the on Answer the following medical question: Erythroblastosis fetalis is an example of which type of hypersensitivity reaction -, with the following options: A: Type I, B: Type II, C: Type III, D: Type IV +### Response: +","Ans. is 'b' i.e., Type II HYPERSENSITIVITY'Tvpe I (IgE mediated)Tvpe II (IgG. IgM and comnlement mediated)o Wheal & Flare o Eczemao Blood transfusion reactionso Hay fevero Erythroblastosis fetaliso Asthmao Autoimmune hemolytic anemia or thrombocytopenia or agranulocytosiso Atopyo Urticariao Anaphylactic shocko Pemphigus vulgariso Acute dermatitiso Good pasture syndromeo Theobald smitho Bullous pemphigoidphenomenono Pernicious anemiao Prausnitz Kusntero Acute rheumatic fever(PK) reactiono Diabetes mellitus .o Cason i's testo Graves diseaseo Schultz-Daleo Myasthenia gravisphenomenon Type III (IgG IgM. complement and leucocyte mediated)Type IV (Cell mediated)o Local-Arthus reactiono Tuberculin testo Systemic-serum sicknesso Lepromin testo Schick testo Sarcoidosiso Polyarteritis nodosa (PAN)o Tuberculosiso Rheumatoid arthritiso Contact dermatitiso SLEo Granulomatous inflammationo Acute viral hepatitiso Type I lepra reactiono Penicillamine toxicityo Patch testo Hyperacute graft rejectiono Temporal arteritiso Type 2 lepra reaction (ENL)o Jones mote reaction (cutaneous basophilic HSN)o Hypersensitivity pneumonitiso R.A.o Graft rejectiono Infective endocarditiso Fairleys testo Henoch schonlein purpurao Frie's test","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Erythroblastosis fetalis is an example of which type of hypersensitivity reaction -, with the following options: A: Type I, B: Type II, C: Type III, D: Type IV + ### Response: Ans. is 'b' i.e., Type II HYPERSENSITIVITY'Tvpe I (IgE mediated)Tvpe II (IgG. IgM and comnlement mediated)o Wheal & Flare o Eczemao Blood transfusion reactionso Hay fevero Erythroblastosis fetaliso Asthmao Autoimmune hemolytic anemia or thrombocytopenia or agranulocytosiso Atopyo Urticariao Anaphylactic shocko Pemphigus vulgariso Acute dermatitiso Good pasture syndromeo Theobald smitho Bullous pemphigoidphenomenono Pernicious anemiao Prausnitz Kusntero Acute rheumatic fever(PK) reactiono Diabetes mellitus .o Cason i's testo Graves diseaseo Schultz-Daleo Myasthenia gravisphenomenon Type III (IgG IgM. complement and leucocyte mediated)Type IV (Cell mediated)o Local-Arthus reactiono Tuberculin testo Systemic-serum sicknesso Lepromin testo Schick testo Sarcoidosiso Polyarteritis nodosa (PAN)o Tuberculosiso Rheumatoid arthritiso Contact dermatitiso SLEo Granulomatous inflammationo Acute viral hepatitiso Type I lepra reactiono Penicillamine toxicityo Patch testo Hyperacute graft rejectiono Temporal arteritiso Type 2 lepra reaction (ENL)o Jones mote reaction (cutaneous basophilic HSN)o Hypersensitivity pneumonitiso R.A.o Graft rejectiono Infective endocarditiso Fairleys testo Henoch schonlein purpurao Frie's test ### End" @@ -6527,6 +11669,13 @@ Ans. is 'b' i.e., Type II HYPERSENSITIVITY'Tvpe I (IgE mediated)Tvpe II (IgG. Ig Answer the following medical question: Declaration of Oslo deals with, with the following options: A: Human experimentation, B: Therapeutic aboion, C: Euthnasia, D: Hunger strikers +### Response: +","Ans. is 'b' i.e., Therapeutic aboion","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Declaration of Oslo deals with, with the following options: A: Human experimentation, B: Therapeutic aboion, C: Euthnasia, D: Hunger strikers + ### Response: Ans. is 'b' i.e., Therapeutic aboion ### End" @@ -6536,6 +11685,14 @@ Ans. is 'b' i.e., Therapeutic aboion Answer the following medical question: A boy with ASOM undrgoing treatment with penicillin therapy for 7 days now presents with subsidence of pain and persistence of deafness, diagnosis is -, with the following options: A: Ototoxicity, B: Secretory otitis media, C: Adhesive otitis media, D: Tympanosclerosis +### Response: +","Inadequate antibiotic treatment of acute suppurative otitis media may inactivate infection but fail to resolve it completely. +Low grade infection lingers on which acts as a stimulus for the mucosa to secrete more mucus which leads to development of serous/secretory otitis media.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A boy with ASOM undrgoing treatment with penicillin therapy for 7 days now presents with subsidence of pain and persistence of deafness, diagnosis is -, with the following options: A: Ototoxicity, B: Secretory otitis media, C: Adhesive otitis media, D: Tympanosclerosis + ### Response: Inadequate antibiotic treatment of acute suppurative otitis media may inactivate infection but fail to resolve it completely. Low grade infection lingers on which acts as a stimulus for the mucosa to secrete more mucus which leads to development of serous/secretory otitis media. @@ -6546,6 +11703,13 @@ Low grade infection lingers on which acts as a stimulus for the mucosa to secret Answer the following medical question: Most common cause of hemolytic uremic syndrome is:, with the following options: A: E. coli, B: Shigella, C: Salmonella, D: Pseudomonas +### Response: +","a. E. coli(Ref: Nelson's 20/e p 2508-2510, Ghai 8/e p 492-493)Etiology of HUS: HUS usually follows an episode of acute gastroenteritis (less commonly, upper respiratory infection).The organisms responsible for HUS are:E. coli (most common) esp EHEC (shiga toxin producing)Salmonella; Shigella dysenteriaeStreptococcus pneumoniaeBartonella; CampylobacterViruses (Coxsackie virus, echovirus, influenza, varicella, HIV, EBV)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common cause of hemolytic uremic syndrome is:, with the following options: A: E. coli, B: Shigella, C: Salmonella, D: Pseudomonas + ### Response: a. E. coli(Ref: Nelson's 20/e p 2508-2510, Ghai 8/e p 492-493)Etiology of HUS: HUS usually follows an episode of acute gastroenteritis (less commonly, upper respiratory infection).The organisms responsible for HUS are:E. coli (most common) esp EHEC (shiga toxin producing)Salmonella; Shigella dysenteriaeStreptococcus pneumoniaeBartonella; CampylobacterViruses (Coxsackie virus, echovirus, influenza, varicella, HIV, EBV) ### End" @@ -6555,6 +11719,13 @@ a. E. coli(Ref: Nelson's 20/e p 2508-2510, Ghai 8/e p 492-493)Etiology of HUS: H Answer the following medical question: Blood transfusion is indicated in following conditions associated with sickle cell anemia:, with the following options: A: Frequent sickling episodes, B: Twin pregnancy, C: Poor obstetrical outcome, D: All of the above +### Response: +","Ans. is d, i.e. All of the aboveRef. Fernando Arias 4/e, p 238Prophylactic blood transfusions are not routinely advocated in all pregnant females with sickle cell anemia.Indications:1. Frequent severe sickling episodes.2. Low hematocrit levels.3. Twin pregnancy.4. Poor past obstetrical history.Target: HbS levels becomes <20%.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Blood transfusion is indicated in following conditions associated with sickle cell anemia:, with the following options: A: Frequent sickling episodes, B: Twin pregnancy, C: Poor obstetrical outcome, D: All of the above + ### Response: Ans. is d, i.e. All of the aboveRef. Fernando Arias 4/e, p 238Prophylactic blood transfusions are not routinely advocated in all pregnant females with sickle cell anemia.Indications:1. Frequent severe sickling episodes.2. Low hematocrit levels.3. Twin pregnancy.4. Poor past obstetrical history.Target: HbS levels becomes <20%. ### End" @@ -6564,6 +11735,13 @@ Ans. is d, i.e. All of the aboveRef. Fernando Arias 4/e, p 238Prophylactic blood Answer the following medical question: Which vasculitis affects both aerial and venous system, with the following options: A: Wegeners granulomatosus, B: PAN, C: Behcets disease, D: Kawsaki disease +### Response: +","Small vessel vasculitis affects aerioles, capillaries and venules. Of the options given, the only small vessel vasculitis is Wegener granulomatosis. (Ref: Robbins 8/e p511)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which vasculitis affects both aerial and venous system, with the following options: A: Wegeners granulomatosus, B: PAN, C: Behcets disease, D: Kawsaki disease + ### Response: Small vessel vasculitis affects aerioles, capillaries and venules. Of the options given, the only small vessel vasculitis is Wegener granulomatosis. (Ref: Robbins 8/e p511) ### End" @@ -6573,6 +11751,14 @@ Small vessel vasculitis affects aerioles, capillaries and venules. Of the option Answer the following medical question: True regarding galactosemia, with the following options: A: Mental retardation occurs, B: Defect in epimerase, C: Defect in galactose 1PO4 uridyl transferase, D: All the above +### Response: +","Inability to metabolise galactose occurs in galactosemia which may be caused by deficiency of galactose-1-phosphate uridyl transferase,UDP-Galactose-4-Epirnerase and galactokinase. +Out of three, most common is Galactose =1-phosphate uridyl transferase deficiency.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True regarding galactosemia, with the following options: A: Mental retardation occurs, B: Defect in epimerase, C: Defect in galactose 1PO4 uridyl transferase, D: All the above + ### Response: Inability to metabolise galactose occurs in galactosemia which may be caused by deficiency of galactose-1-phosphate uridyl transferase,UDP-Galactose-4-Epirnerase and galactokinase. Out of three, most common is Galactose =1-phosphate uridyl transferase deficiency. @@ -6583,6 +11769,13 @@ Out of three, most common is Galactose =1-phosphate uridyl transferase deficienc Answer the following medical question: Number of bacteria in urine sample (per ml) to label it as significant bacteriuria is: March 2011, September 2012, with the following options: A: 100/ ml, B: 1,000/ ml, C: 10,000/ ml, D: 100,000/ ml +### Response: +","Ans. D: 100,000/ ml Kass and other investigators have established that in the presence of active infection in the urinary tract, the urine will contain 1,00,000 bacteria or more per ml. This level is therefore considered to represent significant bacteriuria Significant bacteriuria In quantitative cultures, midstream urine samples will give a biphasic distribution of colonies, most specimens containing either less than 10,000 or more than 100,000 bacteria or more per ml. Kass and other investigators have established that in the presence of active infection in the urinary tract, the urine will contain 100,000 bacteria or more per ml. This level is therefore considered to represent significant bacteriuria Count of 10,000 bacteria or less per ml are due to contamination during voiding and are of no significance In patients on antibacterial or diuretic drugs and with some bacteria like Staph. Aureus, even low counts ma be significant.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Number of bacteria in urine sample (per ml) to label it as significant bacteriuria is: March 2011, September 2012, with the following options: A: 100/ ml, B: 1,000/ ml, C: 10,000/ ml, D: 100,000/ ml + ### Response: Ans. D: 100,000/ ml Kass and other investigators have established that in the presence of active infection in the urinary tract, the urine will contain 1,00,000 bacteria or more per ml. This level is therefore considered to represent significant bacteriuria Significant bacteriuria In quantitative cultures, midstream urine samples will give a biphasic distribution of colonies, most specimens containing either less than 10,000 or more than 100,000 bacteria or more per ml. Kass and other investigators have established that in the presence of active infection in the urinary tract, the urine will contain 100,000 bacteria or more per ml. This level is therefore considered to represent significant bacteriuria Count of 10,000 bacteria or less per ml are due to contamination during voiding and are of no significance In patients on antibacterial or diuretic drugs and with some bacteria like Staph. Aureus, even low counts ma be significant. ### End" @@ -6592,6 +11785,14 @@ Ans. D: 100,000/ ml Kass and other investigators have established that in the pr Answer the following medical question: Stress relaxation in denture base resins generally produces, with the following options: A: Sagging, B: Crazing, C: Creeping, D: Fracture lines +### Response: +","Stress relaxation can produce small surface flaws that may adversely affect the esthetic and physical properties of a denture. The production of such flaws, or microcracks, is termed as crazing. +Phillip’s 12th edition page 490","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Stress relaxation in denture base resins generally produces, with the following options: A: Sagging, B: Crazing, C: Creeping, D: Fracture lines + ### Response: Stress relaxation can produce small surface flaws that may adversely affect the esthetic and physical properties of a denture. The production of such flaws, or microcracks, is termed as crazing. Phillip’s 12th edition page 490 @@ -6602,6 +11803,13 @@ Phillip’s 12th edition page 490 Answer the following medical question: The formation of 25-hydroxycholecalciferol takes place in the-, with the following options: A: Liver, B: Kidney, C: Intestines, D: Pancreas +### Response: +","In response to ultraviolet radiation of the skin, a photochemical cleavage results in the formation of vitamin D from 7-dehydrocholesterol. Vitamin D enters the circulation, whether absorbed from the intestine or synthesized cutaneously, bound to vitamin D-binding protein, an a-globulin synthesized in the liver. Vitamin D is subsequently 25-hydroxylated in the liver by cytochrome P450-like enzymes in the mitochondria and microsomes. 25-hydroxyvitamin D (25D), is the major circulating and storage form of vitamin D. The second hydroxylation, required for the formation of the mature hormone, occurs in the kidney. Reference : page 2463-64 Harrison's Principles of Internal Medicine 19th edition","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The formation of 25-hydroxycholecalciferol takes place in the-, with the following options: A: Liver, B: Kidney, C: Intestines, D: Pancreas + ### Response: In response to ultraviolet radiation of the skin, a photochemical cleavage results in the formation of vitamin D from 7-dehydrocholesterol. Vitamin D enters the circulation, whether absorbed from the intestine or synthesized cutaneously, bound to vitamin D-binding protein, an a-globulin synthesized in the liver. Vitamin D is subsequently 25-hydroxylated in the liver by cytochrome P450-like enzymes in the mitochondria and microsomes. 25-hydroxyvitamin D (25D), is the major circulating and storage form of vitamin D. The second hydroxylation, required for the formation of the mature hormone, occurs in the kidney. Reference : page 2463-64 Harrison's Principles of Internal Medicine 19th edition ### End" @@ -6611,6 +11819,13 @@ In response to ultraviolet radiation of the skin, a photochemical cleavage resul Answer the following medical question: Age from teeth can be determined by all methods except, with the following options: A: Gustafson method, B: Mile method, C: Boyde method, D: Frame method +### Response: +","A) Gustafsons method: Age can be determined by attrition, peridontosis, secondary dentin, cementum apposition, root resorption and transparency of root. B) The method developed by Miles permits within group assessment of age based on dental attrition. It requires a subadult sample as baseline.The upper and lower scales show ages in years from bih, with different scales for each of the molars (representing separate functional ages of the teeth). The first molars are marked at 6 year intervals, the second at 6.5 and the third at 7 year intervals. C)Boyde's method: Cross strations develop in the enamel of teeth, till the complete formation of enamel. They represent daily incremental lines. The age of an individual can be calculated in terms of days by counting the number of lines from the neonatal line onwards. Ref: K.S.Naryan Reddy's synopsis of Forensic Medicine and Toxicology, 29 th edition, Chapter 4, page 40 & 41.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Age from teeth can be determined by all methods except, with the following options: A: Gustafson method, B: Mile method, C: Boyde method, D: Frame method + ### Response: A) Gustafsons method: Age can be determined by attrition, peridontosis, secondary dentin, cementum apposition, root resorption and transparency of root. B) The method developed by Miles permits within group assessment of age based on dental attrition. It requires a subadult sample as baseline.The upper and lower scales show ages in years from bih, with different scales for each of the molars (representing separate functional ages of the teeth). The first molars are marked at 6 year intervals, the second at 6.5 and the third at 7 year intervals. C)Boyde's method: Cross strations develop in the enamel of teeth, till the complete formation of enamel. They represent daily incremental lines. The age of an individual can be calculated in terms of days by counting the number of lines from the neonatal line onwards. Ref: K.S.Naryan Reddy's synopsis of Forensic Medicine and Toxicology, 29 th edition, Chapter 4, page 40 & 41. ### End" @@ -6620,6 +11835,13 @@ A) Gustafsons method: Age can be determined by attrition, peridontosis, secondar Answer the following medical question: Peripheral resistance is best indicated by:, with the following options: A: Diastolic blood pressure, B: Pulse pressure, C: Systolic resistance in aoa as it increases in its length, D: Mean aerial pressure, which is responsible for blood flow to an organ +### Response: +","Ans. a. Diastolic blood pressure Aerial hypeension is the result of abnormal flow/resistance relationships. Resistance to outflow consists of different components: the systolic component is the one generated by conductance vessels, whereas the diastolic component consists of peripheral resistance, which regulates peripheral blood supply due to the run-off of conductance vessels during left ventricular diastole. Thus, an increase in systemic resistance results in a rise in diastolic blood pressure. If the elasticity of conductance vessels decreases, diastolic run-off also decreases and diastolic blood pressure goes down. When this loss of elasticity occurs, the ejection force cannot be anymore offset by aerial distension, the pulse wave velocity increases and reflex waves to the hea arrive earlier, causing the systolic blood pressure to augment. Such an augmentation, together with decreasing diastolic blood pressure results in an enhancement of the pulse pressure. When the stroke volume is normal, an increase in pulse pressure is, therefore, a marker of altered conductance. However, if, due to loss of elasticity of the conductance aeries diastolic blood pressure goes down, increasing systolic pressure also protects against a decrease in mean pressure. Indeed, in conditions of elevated pulse pressure, the mean pressure can be normal or high, indicating that when evaluating blood pressure all components should be taken into consideration. A high systolic blood pressure associated with a normal mean blood pressure is suggestive of a normal peripheral resistance.'Diastolic PressureSystolic pressure is peak pressure reached during systole, similarly, diastolic pressure refers to lowest pressure during diastole.Diastolic blood pressure is an index to peripheral resistance.Elasticity of aoa and large aeries is mainly responsible for origin and maintenance of diastolic pressure (by Windkessel elastic recoil effect).Because the elasticity is higher in younger subjects, diastolic pressure is maintained and pulse pressure is narrow.Because the elasticity is lower in old persons, diastolic pressure is decreased and pulse pressure is widened.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Peripheral resistance is best indicated by:, with the following options: A: Diastolic blood pressure, B: Pulse pressure, C: Systolic resistance in aoa as it increases in its length, D: Mean aerial pressure, which is responsible for blood flow to an organ + ### Response: Ans. a. Diastolic blood pressure Aerial hypeension is the result of abnormal flow/resistance relationships. Resistance to outflow consists of different components: the systolic component is the one generated by conductance vessels, whereas the diastolic component consists of peripheral resistance, which regulates peripheral blood supply due to the run-off of conductance vessels during left ventricular diastole. Thus, an increase in systemic resistance results in a rise in diastolic blood pressure. If the elasticity of conductance vessels decreases, diastolic run-off also decreases and diastolic blood pressure goes down. When this loss of elasticity occurs, the ejection force cannot be anymore offset by aerial distension, the pulse wave velocity increases and reflex waves to the hea arrive earlier, causing the systolic blood pressure to augment. Such an augmentation, together with decreasing diastolic blood pressure results in an enhancement of the pulse pressure. When the stroke volume is normal, an increase in pulse pressure is, therefore, a marker of altered conductance. However, if, due to loss of elasticity of the conductance aeries diastolic blood pressure goes down, increasing systolic pressure also protects against a decrease in mean pressure. Indeed, in conditions of elevated pulse pressure, the mean pressure can be normal or high, indicating that when evaluating blood pressure all components should be taken into consideration. A high systolic blood pressure associated with a normal mean blood pressure is suggestive of a normal peripheral resistance.'Diastolic PressureSystolic pressure is peak pressure reached during systole, similarly, diastolic pressure refers to lowest pressure during diastole.Diastolic blood pressure is an index to peripheral resistance.Elasticity of aoa and large aeries is mainly responsible for origin and maintenance of diastolic pressure (by Windkessel elastic recoil effect).Because the elasticity is higher in younger subjects, diastolic pressure is maintained and pulse pressure is narrow.Because the elasticity is lower in old persons, diastolic pressure is decreased and pulse pressure is widened. ### End" @@ -6629,6 +11851,13 @@ Ans. a. Diastolic blood pressure Aerial hypeension is the result of abnormal flo Answer the following medical question: Choroidal neurovascularization is seen in all except -, with the following options: A: Trauma, B: Angiod streak, C: Myopia, D: Hypermetropia +### Response: +","Brushfield spots are small, white or grayish/brown spots on the periphery of the iris in the human eye due to aggregation of connective tissue, a normal constituent of theiris stroma. Hypermetropia is a long sightedness Ref khurana 6/e","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Choroidal neurovascularization is seen in all except -, with the following options: A: Trauma, B: Angiod streak, C: Myopia, D: Hypermetropia + ### Response: Brushfield spots are small, white or grayish/brown spots on the periphery of the iris in the human eye due to aggregation of connective tissue, a normal constituent of theiris stroma. Hypermetropia is a long sightedness Ref khurana 6/e ### End" @@ -6638,6 +11867,13 @@ Brushfield spots are small, white or grayish/brown spots on the periphery of the Answer the following medical question: Which of the following is true regarding HPV vaccine strains? Current WHO recommendations for HPV vaccination is:, with the following options: A: Bivalent vaccine 6,11 strains, B: Quadrivalent vaccine 6,11,16,58 strains, C: single dose to girls if initiated prior to 15 years of age, D: 2 doses recommended irrespective of age, gender, type of vaccine +### Response: +","2 doses of HPV vaccine are recommended irrespective of age, gender, type of vaccine. Option 1: Bivalent vaccine- serotype 16,18 (cervarix). Option 2: Quadrivalent vaccine- serotype 6,11,16,18 (Gardasil,Merck). Option 3, 4: The first dose is recommended for most persons before 15 years of age and the second dose should be given 6 to 12 months after the first dose. A 3-dose schedule is recommended for people who get the first dose on or after 15 years of age, and for people with ceain immunocompromising conditions.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is true regarding HPV vaccine strains? Current WHO recommendations for HPV vaccination is:, with the following options: A: Bivalent vaccine 6,11 strains, B: Quadrivalent vaccine 6,11,16,58 strains, C: single dose to girls if initiated prior to 15 years of age, D: 2 doses recommended irrespective of age, gender, type of vaccine + ### Response: 2 doses of HPV vaccine are recommended irrespective of age, gender, type of vaccine. Option 1: Bivalent vaccine- serotype 16,18 (cervarix). Option 2: Quadrivalent vaccine- serotype 6,11,16,18 (Gardasil,Merck). Option 3, 4: The first dose is recommended for most persons before 15 years of age and the second dose should be given 6 to 12 months after the first dose. A 3-dose schedule is recommended for people who get the first dose on or after 15 years of age, and for people with ceain immunocompromising conditions. ### End" @@ -6647,6 +11883,13 @@ Answer the following medical question: Which of the following is true regarding Answer the following medical question: Early age of sex is risk factor for -, with the following options: A: Carcinoma Cervix, B: Carcinoma vulva, C: Carcinoma vagina, D: Carcinoma ovary +### Response: +","Ans. is 'a' i.e., Carcinoma cervix [Ref: Williams Gynaec 2nd/e p.)o Having sex with multiple sexual partners and early age of first sexual intercourse are the risk factors for the develop- ment of carcinoma cervix.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Early age of sex is risk factor for -, with the following options: A: Carcinoma Cervix, B: Carcinoma vulva, C: Carcinoma vagina, D: Carcinoma ovary + ### Response: Ans. is 'a' i.e., Carcinoma cervix [Ref: Williams Gynaec 2nd/e p.)o Having sex with multiple sexual partners and early age of first sexual intercourse are the risk factors for the develop- ment of carcinoma cervix. ### End" @@ -6656,6 +11899,13 @@ Ans. is 'a' i.e., Carcinoma cervix [Ref: Williams Gynaec 2nd/e p.)o Having sex w Answer the following medical question: Which of the following local anaesthetics are not vasodilators, with the following options: A: Lignocaine, B: Bupivacaine, C: Benzocaine, D: Tetracaine +### Response: +",Lignocaine has no vasogenic action.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following local anaesthetics are not vasodilators, with the following options: A: Lignocaine, B: Bupivacaine, C: Benzocaine, D: Tetracaine + ### Response: Lignocaine has no vasogenic action. ### End" @@ -6665,6 +11915,13 @@ Lignocaine has no vasogenic action. Answer the following medical question: HPV vaccine is -, with the following options: A: Monovalent, B: Bivalent, C: Quadrivalent, D: Both bivalent and quadrivalent +### Response: +","HPV vaccine containing anyigen from6,11,16&18 REF:MICROBIOLOGY ANANTHA NARAYANAN NINTH EDITION PAGE.553","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: HPV vaccine is -, with the following options: A: Monovalent, B: Bivalent, C: Quadrivalent, D: Both bivalent and quadrivalent + ### Response: HPV vaccine containing anyigen from6,11,16&18 REF:MICROBIOLOGY ANANTHA NARAYANAN NINTH EDITION PAGE.553 ### End" @@ -6674,6 +11931,13 @@ HPV vaccine containing anyigen from6,11,16&18 REF:MICROBIOLOGY ANANTHA NARAYANAN Answer the following medical question: Bones contain which type of collagen ?, with the following options: A: I, B: II, C: III, D: IV +### Response: +","Ans. is 'a' i.e., I","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Bones contain which type of collagen ?, with the following options: A: I, B: II, C: III, D: IV + ### Response: Ans. is 'a' i.e., I ### End" @@ -6683,6 +11947,13 @@ Ans. is 'a' i.e., I Answer the following medical question: Liquid enamel is:, with the following options: A: Plaque, B: GIC, C: Saliva, D: Pellicle +### Response: +","Saliva is also called 'Liquid enamel' as it is a rich source of various minerals. The amount of saliva secreted normally is 5 ml/ 5 min i.e. 700-800 ml/ day. The quantity of saliva may influence caries incidence as is especially evident in cases of salivary gland and xerostomia in which salivary flow may be entirely lacking, with rampant caries as the typical result. The average unstimulated flow rate of saliva is about 0.3 ml per minute.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Liquid enamel is:, with the following options: A: Plaque, B: GIC, C: Saliva, D: Pellicle + ### Response: Saliva is also called 'Liquid enamel' as it is a rich source of various minerals. The amount of saliva secreted normally is 5 ml/ 5 min i.e. 700-800 ml/ day. The quantity of saliva may influence caries incidence as is especially evident in cases of salivary gland and xerostomia in which salivary flow may be entirely lacking, with rampant caries as the typical result. The average unstimulated flow rate of saliva is about 0.3 ml per minute. ### End" @@ -6692,6 +11963,13 @@ Saliva is also called 'Liquid enamel' as it is a rich source of various minerals Answer the following medical question: Reducing equivalents produced in glycolysis are transpoed from cytosol to mitochondria by, with the following options: A: Carnitine, B: Creatine, C: Malate shuttle, D: Glutamate shuttle +### Response: +","Malate-Aspaate Shuttle Mitochondrial membrane is impermeable to NADH. The NADH equivalents generated in glycolysis are therefore to be transpoed from the cytoplasm to mitochondria for oxidation. This is achieved by malate-aspaate shuttle or malate shuttle, which operates mainly in the liver, kidney, and hea. The cycle is operated with the help of enzymes malate dehydrogenase (MDH) and aspaate aminotransferase. From one molecule of NADH in the mitochondria, 2 1/2 ATP molecules are generated.Ref: DM Vasudevan, 7th edition, page no: 260","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Reducing equivalents produced in glycolysis are transpoed from cytosol to mitochondria by, with the following options: A: Carnitine, B: Creatine, C: Malate shuttle, D: Glutamate shuttle + ### Response: Malate-Aspaate Shuttle Mitochondrial membrane is impermeable to NADH. The NADH equivalents generated in glycolysis are therefore to be transpoed from the cytoplasm to mitochondria for oxidation. This is achieved by malate-aspaate shuttle or malate shuttle, which operates mainly in the liver, kidney, and hea. The cycle is operated with the help of enzymes malate dehydrogenase (MDH) and aspaate aminotransferase. From one molecule of NADH in the mitochondria, 2 1/2 ATP molecules are generated.Ref: DM Vasudevan, 7th edition, page no: 260 ### End" @@ -6701,6 +11979,13 @@ Malate-Aspaate Shuttle Mitochondrial membrane is impermeable to NADH. The NADH e Answer the following medical question: Pulmonary surfactant is secreted by ?, with the following options: A: Type I pneumocytes, B: Type II pneumocytes, C: Clara cells, D: Bronchial epithelial cells +### Response: +","Ans. is 'b' i.e., Type II PneumocytesSurfactant Surfactant is a Soap-like substance secreted by the type-II pneumocytes of the alveolar epithelium.It is a mixture of dipalmitoyl-phosphatidycholine (dipalmitoyl-lecithin), phosphatidylglycerol, other phospholipids, neutral lipids, Surfactant proteins A, B, C and D (SP-A, SP-B, SP-C and SP-D), and carbohydrates.Surfactant reduces the alveolar surface tension. This has three impoant physiological consequences : ?1) t reduces the collapsing tendency of lungs.2) It reduces the natural tendency of the smaller alveoli to collapse and empty into the larger ones. This is called alveolar stabilization.3) It reduces the tendency of the alveolar interstitial fluid to transudate out into the alveolar space.Dipalmitoyl-phosphatidylcholine (dipalmitoyl-lecithin) is the main surface tension lowering phospholipid in surfactant.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pulmonary surfactant is secreted by ?, with the following options: A: Type I pneumocytes, B: Type II pneumocytes, C: Clara cells, D: Bronchial epithelial cells + ### Response: Ans. is 'b' i.e., Type II PneumocytesSurfactant Surfactant is a Soap-like substance secreted by the type-II pneumocytes of the alveolar epithelium.It is a mixture of dipalmitoyl-phosphatidycholine (dipalmitoyl-lecithin), phosphatidylglycerol, other phospholipids, neutral lipids, Surfactant proteins A, B, C and D (SP-A, SP-B, SP-C and SP-D), and carbohydrates.Surfactant reduces the alveolar surface tension. This has three impoant physiological consequences : ?1) t reduces the collapsing tendency of lungs.2) It reduces the natural tendency of the smaller alveoli to collapse and empty into the larger ones. This is called alveolar stabilization.3) It reduces the tendency of the alveolar interstitial fluid to transudate out into the alveolar space.Dipalmitoyl-phosphatidylcholine (dipalmitoyl-lecithin) is the main surface tension lowering phospholipid in surfactant. ### End" @@ -6710,6 +11995,13 @@ Ans. is 'b' i.e., Type II PneumocytesSurfactant Surfactant is a Soap-like substa Answer the following medical question: Which is wrong about Crigler-Najjar syndrome Type - 1, with the following options: A: Very high level of unconjugated bilirubin occurs in Neonatal period, B: Kernicterus is usual, C: It responds well to phenobarbitone, D: Hepatic histology is normal +### Response: +","Criggler Najjar syndrome Feature Type 1 Type 2 Total serum bilirubin (mg/dl) 18-45(usually >20)) 6-25(usually 20) Routine liver tests normal Normal Response to phenobarbitone None Decreases bilirubin by >25% Kernicterus Usual Rare Hepatic histology Normal Normal Bile characteristics. Color Pale or colorless pigmented Bilirubin fractions >90% unconjugated Largest fraction (mean:57%) monoconjugates Bilirubin UDP-glucuronosyl transferase activity Typically absent, traces in some patients Markedly reduced :0-10% of normal Inheritance Recessive Predominantly recessive (AR>AD)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which is wrong about Crigler-Najjar syndrome Type - 1, with the following options: A: Very high level of unconjugated bilirubin occurs in Neonatal period, B: Kernicterus is usual, C: It responds well to phenobarbitone, D: Hepatic histology is normal + ### Response: Criggler Najjar syndrome Feature Type 1 Type 2 Total serum bilirubin (mg/dl) 18-45(usually >20)) 6-25(usually 20) Routine liver tests normal Normal Response to phenobarbitone None Decreases bilirubin by >25% Kernicterus Usual Rare Hepatic histology Normal Normal Bile characteristics. Color Pale or colorless pigmented Bilirubin fractions >90% unconjugated Largest fraction (mean:57%) monoconjugates Bilirubin UDP-glucuronosyl transferase activity Typically absent, traces in some patients Markedly reduced :0-10% of normal Inheritance Recessive Predominantly recessive (AR>AD) ### End" @@ -6719,6 +12011,13 @@ Criggler Najjar syndrome Feature Type 1 Type 2 Total serum bilirubin (mg/dl) 18- Answer the following medical question: Which of the following is not a benign tumor?, with the following options: A: Lipoma, B: Leiomyoma, C: Hepatoma, D: Chondroma +### Response: +","Ans. c (Hepatoma). (Ref. Robbin, Pathology, 7th ed., 273)BENIGN TUMORS# Fibroma,Lipoma,Chondroma# Osteoma,HemangiomaMeningioma# Leiomyoma,Rhabdomyoma,Squamous cell papilloma# Liver cell adenoma,AdenomaPapilloma# CystadenomaBronchial adenomaRenal tubular adenomaEducational Points:# An ectopic rest of normal tissue--choristoma.Q# Aberrant differentiation may produce mass of disorganized but mature specialized cells or tissue indigenous to particular site--Hamartoma.# Hepatoma is malignant tumor (A misnomer).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is not a benign tumor?, with the following options: A: Lipoma, B: Leiomyoma, C: Hepatoma, D: Chondroma + ### Response: Ans. c (Hepatoma). (Ref. Robbin, Pathology, 7th ed., 273)BENIGN TUMORS# Fibroma,Lipoma,Chondroma# Osteoma,HemangiomaMeningioma# Leiomyoma,Rhabdomyoma,Squamous cell papilloma# Liver cell adenoma,AdenomaPapilloma# CystadenomaBronchial adenomaRenal tubular adenomaEducational Points:# An ectopic rest of normal tissue--choristoma.Q# Aberrant differentiation may produce mass of disorganized but mature specialized cells or tissue indigenous to particular site--Hamartoma.# Hepatoma is malignant tumor (A misnomer). ### End" @@ -6728,6 +12027,13 @@ Ans. c (Hepatoma). (Ref. Robbin, Pathology, 7th ed., 273)BENIGN TUMORS# Fibroma, Answer the following medical question: Median nerve injury at the wrist causes-, with the following options: A: Claw hand, B: Loss of opposition of thumb, C: Policeman's tip deformity, D: Saturday night palsy +### Response: +","In median nerve injury at wrist, low median nerve injury is what occurs. That means only the thenar muscles are affected. The features shown in this condition includes- pen test for abductor pollicis brevis paralysis, opposition and abduction of thumb is lost, ape thumb deformity may be shown and loss of sensation of lateral 2/3rd of palm and lateral three and half fingers may be seen.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Median nerve injury at the wrist causes-, with the following options: A: Claw hand, B: Loss of opposition of thumb, C: Policeman's tip deformity, D: Saturday night palsy + ### Response: In median nerve injury at wrist, low median nerve injury is what occurs. That means only the thenar muscles are affected. The features shown in this condition includes- pen test for abductor pollicis brevis paralysis, opposition and abduction of thumb is lost, ape thumb deformity may be shown and loss of sensation of lateral 2/3rd of palm and lateral three and half fingers may be seen. ### End" @@ -6737,6 +12043,13 @@ In median nerve injury at wrist, low median nerve injury is what occurs. That me Answer the following medical question: Which is the most common location of the tumor glioblastoma multiforma?, with the following options: A: Brainstem, B: CP angle, C: Frontal lobe, D: Temporal lobe +### Response: +",Frontal lobe is the most common and classical location of Glioblastoma multiforme.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which is the most common location of the tumor glioblastoma multiforma?, with the following options: A: Brainstem, B: CP angle, C: Frontal lobe, D: Temporal lobe + ### Response: Frontal lobe is the most common and classical location of Glioblastoma multiforme. ### End" @@ -6746,6 +12059,16 @@ Frontal lobe is the most common and classical location of Glioblastoma multiform Answer the following medical question: Vomiting on the first day of baby's life may be caused by all of the following except –, with the following options: A: Pyloric stenosis, B: Oesophageal atersia, C: Aerophagy, D: Amniotic gastritis +### Response: +","A large number of normal babies vomit on first day due to irritation of stomach by swallowed amniotic fluid +The regurgitation / vomiting in a neonate is due to -> faulty feeding techniques or, aerophagy +Eosophageal atresia may present with vomiting on the first day. +In hypertrophic pyloric stenosis vomiting characteristically occurs after 2 weeks of age. (2-3 weeks).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Vomiting on the first day of baby's life may be caused by all of the following except –, with the following options: A: Pyloric stenosis, B: Oesophageal atersia, C: Aerophagy, D: Amniotic gastritis + ### Response: A large number of normal babies vomit on first day due to irritation of stomach by swallowed amniotic fluid The regurgitation / vomiting in a neonate is due to -> faulty feeding techniques or, aerophagy @@ -6758,6 +12081,13 @@ In hypertrophic pyloric stenosis vomiting characteristically occurs after 2 week Answer the following medical question: Autopsy in a new-born is done by opening first, with the following options: A: Head, B: Chest, C: Abdomen, D: Back +### Response: +",- Autopsy in a new-born is done by opening first the abdomen and the highest point of diaphragm is noted,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Autopsy in a new-born is done by opening first, with the following options: A: Head, B: Chest, C: Abdomen, D: Back + ### Response: - Autopsy in a new-born is done by opening first the abdomen and the highest point of diaphragm is noted ### End" @@ -6767,6 +12097,13 @@ Answer the following medical question: Autopsy in a new-born is done by opening Answer the following medical question: All the following are adverse outcomes associated with threatened aboion except, with the following options: A: Placenta pre, B: Preterm bih, C: Manual removal of placenta, D: Fetal macrosomia +### Response: +",Adverse Outcomes That are Increased in Women with Threatened AboionMaternalPerinatalPlacenta prePlacental abruptionManual removal of placentaCesarean deliveryPROMPreterm bihLow-bihweightFetal growth restrictionFetal and neonatal deathReference: William's Obstetrics; 25th edition; Chapter 18; Aboion,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All the following are adverse outcomes associated with threatened aboion except, with the following options: A: Placenta pre, B: Preterm bih, C: Manual removal of placenta, D: Fetal macrosomia + ### Response: Adverse Outcomes That are Increased in Women with Threatened AboionMaternalPerinatalPlacenta prePlacental abruptionManual removal of placentaCesarean deliveryPROMPreterm bihLow-bihweightFetal growth restrictionFetal and neonatal deathReference: William's Obstetrics; 25th edition; Chapter 18; Aboion ### End" @@ -6776,6 +12113,13 @@ Adverse Outcomes That are Increased in Women with Threatened AboionMaternalPerin Answer the following medical question: A 2-year-old boy bleeds excessively from minor injuries and has previously had bleeding gums. The maternal grandfather has a bleeding disorder. The child's physical examination shows slight tenderness of his knee with fluid accumulation in the knee joint. You suspect this patient is deficient in which coagulation factor?, with the following options: A: Prothrombin activator, B: Factor II, C: Factor VIII, D: Factor X +### Response: +","A young man with a bleeding disorder and a history of bleeding disorders in the males of his family would lead one to suspect hemophilia A (a deficiency of factor VIII.) The physical examination suggests bleeding into the knee joint, which is frequently seen in hemophilia A.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 2-year-old boy bleeds excessively from minor injuries and has previously had bleeding gums. The maternal grandfather has a bleeding disorder. The child's physical examination shows slight tenderness of his knee with fluid accumulation in the knee joint. You suspect this patient is deficient in which coagulation factor?, with the following options: A: Prothrombin activator, B: Factor II, C: Factor VIII, D: Factor X + ### Response: A young man with a bleeding disorder and a history of bleeding disorders in the males of his family would lead one to suspect hemophilia A (a deficiency of factor VIII.) The physical examination suggests bleeding into the knee joint, which is frequently seen in hemophilia A. ### End" @@ -6785,6 +12129,13 @@ A young man with a bleeding disorder and a history of bleeding disorders in the Answer the following medical question: The commonest sign of nail psoriasis is:, with the following options: A: Pitting, B: Pterygium, C: Oil drop sign, D: Onycholysis +### Response: +",Nail changes in psoriasis - Most common - Nail pitting/Thimble pitting Most characteristic - oil drop sign/ salmon patch Onycholysis Leukonychia Subungual hyperkeratosis Nail tunnel,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The commonest sign of nail psoriasis is:, with the following options: A: Pitting, B: Pterygium, C: Oil drop sign, D: Onycholysis + ### Response: Nail changes in psoriasis - Most common - Nail pitting/Thimble pitting Most characteristic - oil drop sign/ salmon patch Onycholysis Leukonychia Subungual hyperkeratosis Nail tunnel ### End" @@ -6794,6 +12145,13 @@ Nail changes in psoriasis - Most common - Nail pitting/Thimble pitting Most char Answer the following medical question: Which of the following drug is contraindicated in case of bilateral renal artery stenosis, with the following options: A: Hydralazine, B: Enalapril, C: Methyldopa, D: Dopamine +### Response: +","Enalaparil is a ACE inhibitor (Angiotensin converting enzyme inhibitor). All ACE inhibitors lead to decrease in GFR. Hence, they are contraindicated in Bilateral renal artery stenosis to prevent further decrease in GFR.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following drug is contraindicated in case of bilateral renal artery stenosis, with the following options: A: Hydralazine, B: Enalapril, C: Methyldopa, D: Dopamine + ### Response: Enalaparil is a ACE inhibitor (Angiotensin converting enzyme inhibitor). All ACE inhibitors lead to decrease in GFR. Hence, they are contraindicated in Bilateral renal artery stenosis to prevent further decrease in GFR. ### End" @@ -6803,6 +12161,38 @@ Enalaparil is a ACE inhibitor (Angiotensin converting enzyme inhibitor). All ACE Answer the following medical question: All the following antimicrobial agents are used topically except –, with the following options: A: Clotrimazole, B: Griseofulvin, C: Nystatin, D: Miconazole +### Response: +","Griseofulvin is used systemically for dermatophytosis. It is ineffective topically. +Polyene + +Amphotericin B → Topically as well as systemically (oral, iv intrathecally. +Nystatin, Hamycin, Natamycin (Pimaricin) → Topically. + +Hetrocyclic benzofuran + +Griseofulvin → Systemically (oral) + +Imidazoles + +Clotrimazole, econazole, miconozole, oxiconazole → Topical. +Ketoconazole Systemically (oral) and topically. + +Triazoles + +Fluconazole, voriconazole → systemically (iv., oral) and itraconozole → systemically (orally). + +Allylamine + +Terbinafine → Systemically (oral) and topically. + +Note + +Amphotericin B, ketoconazole and terbinafine are used systemically as well as topically.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All the following antimicrobial agents are used topically except –, with the following options: A: Clotrimazole, B: Griseofulvin, C: Nystatin, D: Miconazole + ### Response: Griseofulvin is used systemically for dermatophytosis. It is ineffective topically. Polyene @@ -6837,6 +12227,13 @@ Amphotericin B, ketoconazole and terbinafine are used systemically as well as to Answer the following medical question: All are true regarding direct ophthalmoscopy except: March 2008, with the following options: A: Image is erect, B: Magnification is more than indirect ophthalmoscopy, C: Wide area of fundus with least magnification can be seen in hypermetropics, D: It has a large field of view. +### Response: +","Ans. D: It has a large field of view Direct ophthalmoscopy allows visualization of the posterior pole of retina upto the equator. In comparison to this, indirect ophthalmoscopy has large field of view. The image is erect and magnified about 15 times (more magnified than that of indirect ophthalmoscopy) The area of the fundus which can be seen by the direct method varies with the distance of the observer from the eye and with the refraction. It increases as the eye is approached, is greatest in hypermetropia, least in myopia and intermediate in emmetropia. Thus the largest area, least magnified, is seen in hypermetropia, and the least area, most magnified, in myopia.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are true regarding direct ophthalmoscopy except: March 2008, with the following options: A: Image is erect, B: Magnification is more than indirect ophthalmoscopy, C: Wide area of fundus with least magnification can be seen in hypermetropics, D: It has a large field of view. + ### Response: Ans. D: It has a large field of view Direct ophthalmoscopy allows visualization of the posterior pole of retina upto the equator. In comparison to this, indirect ophthalmoscopy has large field of view. The image is erect and magnified about 15 times (more magnified than that of indirect ophthalmoscopy) The area of the fundus which can be seen by the direct method varies with the distance of the observer from the eye and with the refraction. It increases as the eye is approached, is greatest in hypermetropia, least in myopia and intermediate in emmetropia. Thus the largest area, least magnified, is seen in hypermetropia, and the least area, most magnified, in myopia. ### End" @@ -6846,6 +12243,13 @@ Ans. D: It has a large field of view Direct ophthalmoscopy allows visualization Answer the following medical question: All of the following hormones stimulate cAMP, EXCEPT:, with the following options: A: Glucagon, B: Follicle stimulating hormone, C: Luteinizing hormone, D: Acetylcholine +### Response: +","Hormones that Stimulate Adenylyl Cyclase: ACTH ADH-Adrenergics Calcitonin CRH FSH Glucagon hCG LH MSH PTH TSH Hormones that Inhibit Adenylyl Cyclase: Acetylcholine 2-Adrenergics Angiotensin II Somatostatin Ref: Weil P. (2011). Chapter 42. Hormone Action & Signal Transduction. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following hormones stimulate cAMP, EXCEPT:, with the following options: A: Glucagon, B: Follicle stimulating hormone, C: Luteinizing hormone, D: Acetylcholine + ### Response: Hormones that Stimulate Adenylyl Cyclase: ACTH ADH-Adrenergics Calcitonin CRH FSH Glucagon hCG LH MSH PTH TSH Hormones that Inhibit Adenylyl Cyclase: Acetylcholine 2-Adrenergics Angiotensin II Somatostatin Ref: Weil P. (2011). Chapter 42. Hormone Action & Signal Transduction. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e. ### End" @@ -6855,6 +12259,13 @@ Hormones that Stimulate Adenylyl Cyclase: ACTH ADH-Adrenergics Calcitonin CRH FS Answer the following medical question: 35 year old lady with post coital bleeding, Management is :, with the following options: A: Clinical examination and Pap smear, B: Visual examination with Lugol iodine, C: Visual examination with acetic acid, D: Colposcopy +### Response: +","Post coital bleeding is the typical symptom of Cervical cancer It is managed by colposcopy and abnormal areas are biopsied Reference : Textbook of Gynaecology; Sheila balakrishnan; 2nd edition; Pg no: 299, 302","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: 35 year old lady with post coital bleeding, Management is :, with the following options: A: Clinical examination and Pap smear, B: Visual examination with Lugol iodine, C: Visual examination with acetic acid, D: Colposcopy + ### Response: Post coital bleeding is the typical symptom of Cervical cancer It is managed by colposcopy and abnormal areas are biopsied Reference : Textbook of Gynaecology; Sheila balakrishnan; 2nd edition; Pg no: 299, 302 ### End" @@ -6864,6 +12275,13 @@ Post coital bleeding is the typical symptom of Cervical cancer It is managed by Answer the following medical question: Thiamin is a co-enzyme for, with the following options: A: Transketolase, B: Alanine transferase, C: ALA synthase, D: Cystathionine synthase +### Response: +","Ans. a (Transketolase) (Ref. Harper's Biochemistry-27th ed. 498).# Transketolase is a thiamine-requiring enzyme involved in the HMP shunt.# Other enzymes requiring Thiamine are n Pyruvate dehydrogenase & n a - ketoglutarate dehydrogenase.# Transketolase transfers the two-carbon unit comprising carbons 1 and 2 of a ketose onto the aldehyde carbon of an aldose sugar. It therefore effects the conversion of a ketose sugar into an aldose with two carbons less and simultaneously converts an aldose sugar into a ketose with two carbons more.# The reaction requires Mg2+ and thiamine diphosphate (vitamin B,) as coenzyme.# Measurement of erythrocyte transketolase and its activation by thiamine diphosphate is used to assess thiamine nutritional status.0# Transaldolase allows the transfer of a three-carbon dihydroxyacetone moiety (carbons 1-3) from the ketose sedohep- tulose 7-phosphate onto the aldose glyceraldehyde 3-phosphate to form the ketose fructose 6-phosphate and the four-carbon aldose erythrose 4-phosphate.VitaminFunctionsDeficiency diseaseARetinol, b-caroteneVisual pigments in the retina; regulation of gene expression and cell differentiation; b-carotene is an antioxidantNight blindness, xerophthalmia; keratinization of skinDCalciferolMaintenance of calcium balance; enhances intestinal absorption of Ca2+ and mobilizes bone mineralRickets = poor minertialization of bone; osteomalacia = bone de-mineraizationETocopherols, tocotrienolsAntioxidant, especially in cell membranesExtremely rare - serious neurologic dysfunctionKPhylloquinone, menaquinonesCoenzyme in formation of g-carboxyglutamate in enzymes of blood clotting and bone matrix diseaseImpaired blood clotting, hemorrhagic diseaseB1ThiaminCoenzyme in pyruvate and a-ketoglutarate, dehydrogenases, and transketolase; poorly defined function in nerve conductionPeripheral nerve damage (beriberi) or central nervous system lesions (Wernicke-Korsakoff syndrome)B2RiboflavinCoenzyme in oxidation and reduction reactions; prosthetic group of flavoproteinsLeisons of corner of mouth, lips, and tongue; seborrheic dermatitis Niacin, Nicotinic acid, nicotinamideCoenzyme in oxidation and reduction reaction, functional part of NAD and NADPPellagra-photosensitive dermatitis, depressive psychosisB6Pyridoxine, pyridoxal, PyridoxamineCoenzyme in transamination and decarboxylation of amino acids and glycogen phosphorylase; role in steroid hormone actionDisorders of amino acids metabolism, convulsions Folic acidCoenzyme in transfer of one-carbon fragmentsMegaloblastic anemiaB12 CobalaminCoenzyme in transfer of one-carbon fragments and metabolism of folic acidPernicious anemia = megaloblastic anemia with degeneration of the spinal cordPantothenic acidFunctional part of CoA and acyl carrier protein, fatty acid synthesis and metabolism HBiotinCoenzyme in carboxylation reactions in gluconeogenesis and fatty acids synthesisImpaired and carbohydrate metabolism, dermatitisCAscorbic acidCoenzyme in hydroxylation of proline and lysine in collagen synthesis; antioxidant; enhances absorption of ironScurvy - impaired wound healingLoss of dental cement, subcutaneous hemorrhagePentose phosphate pathway (HMP shunt).Produces NADPH, which is required for fatty acid and steroid biosynthesis and for glutathione reduction insideRBCs. All reactions of this pathway occur in the cytoplasm. No ATP is used or produced. Sites- lactating mammary glands, liver, adrenal cortex (sites of fatty acid or steroid synthesis), and RBCs.ReactionsKey enzymesProductsOxidative (irreversible)Glucose-6-phosphate dehydrogenaseNADPH (for fatty acid and steroid synthesis, glutathione reduction, and cytochrome P-450).Nonoxidative (reversible)Transketolases (require thiamine)Ribose-5-phosphate (for nucleotide synthesis), G3P, F6P (glycolytic intermediates)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Thiamin is a co-enzyme for, with the following options: A: Transketolase, B: Alanine transferase, C: ALA synthase, D: Cystathionine synthase + ### Response: Ans. a (Transketolase) (Ref. Harper's Biochemistry-27th ed. 498).# Transketolase is a thiamine-requiring enzyme involved in the HMP shunt.# Other enzymes requiring Thiamine are n Pyruvate dehydrogenase & n a - ketoglutarate dehydrogenase.# Transketolase transfers the two-carbon unit comprising carbons 1 and 2 of a ketose onto the aldehyde carbon of an aldose sugar. It therefore effects the conversion of a ketose sugar into an aldose with two carbons less and simultaneously converts an aldose sugar into a ketose with two carbons more.# The reaction requires Mg2+ and thiamine diphosphate (vitamin B,) as coenzyme.# Measurement of erythrocyte transketolase and its activation by thiamine diphosphate is used to assess thiamine nutritional status.0# Transaldolase allows the transfer of a three-carbon dihydroxyacetone moiety (carbons 1-3) from the ketose sedohep- tulose 7-phosphate onto the aldose glyceraldehyde 3-phosphate to form the ketose fructose 6-phosphate and the four-carbon aldose erythrose 4-phosphate.VitaminFunctionsDeficiency diseaseARetinol, b-caroteneVisual pigments in the retina; regulation of gene expression and cell differentiation; b-carotene is an antioxidantNight blindness, xerophthalmia; keratinization of skinDCalciferolMaintenance of calcium balance; enhances intestinal absorption of Ca2+ and mobilizes bone mineralRickets = poor minertialization of bone; osteomalacia = bone de-mineraizationETocopherols, tocotrienolsAntioxidant, especially in cell membranesExtremely rare - serious neurologic dysfunctionKPhylloquinone, menaquinonesCoenzyme in formation of g-carboxyglutamate in enzymes of blood clotting and bone matrix diseaseImpaired blood clotting, hemorrhagic diseaseB1ThiaminCoenzyme in pyruvate and a-ketoglutarate, dehydrogenases, and transketolase; poorly defined function in nerve conductionPeripheral nerve damage (beriberi) or central nervous system lesions (Wernicke-Korsakoff syndrome)B2RiboflavinCoenzyme in oxidation and reduction reactions; prosthetic group of flavoproteinsLeisons of corner of mouth, lips, and tongue; seborrheic dermatitis Niacin, Nicotinic acid, nicotinamideCoenzyme in oxidation and reduction reaction, functional part of NAD and NADPPellagra-photosensitive dermatitis, depressive psychosisB6Pyridoxine, pyridoxal, PyridoxamineCoenzyme in transamination and decarboxylation of amino acids and glycogen phosphorylase; role in steroid hormone actionDisorders of amino acids metabolism, convulsions Folic acidCoenzyme in transfer of one-carbon fragmentsMegaloblastic anemiaB12 CobalaminCoenzyme in transfer of one-carbon fragments and metabolism of folic acidPernicious anemia = megaloblastic anemia with degeneration of the spinal cordPantothenic acidFunctional part of CoA and acyl carrier protein, fatty acid synthesis and metabolism HBiotinCoenzyme in carboxylation reactions in gluconeogenesis and fatty acids synthesisImpaired and carbohydrate metabolism, dermatitisCAscorbic acidCoenzyme in hydroxylation of proline and lysine in collagen synthesis; antioxidant; enhances absorption of ironScurvy - impaired wound healingLoss of dental cement, subcutaneous hemorrhagePentose phosphate pathway (HMP shunt).Produces NADPH, which is required for fatty acid and steroid biosynthesis and for glutathione reduction insideRBCs. All reactions of this pathway occur in the cytoplasm. No ATP is used or produced. Sites- lactating mammary glands, liver, adrenal cortex (sites of fatty acid or steroid synthesis), and RBCs.ReactionsKey enzymesProductsOxidative (irreversible)Glucose-6-phosphate dehydrogenaseNADPH (for fatty acid and steroid synthesis, glutathione reduction, and cytochrome P-450).Nonoxidative (reversible)Transketolases (require thiamine)Ribose-5-phosphate (for nucleotide synthesis), G3P, F6P (glycolytic intermediates) ### End" @@ -6873,6 +12291,27 @@ Ans. a (Transketolase) (Ref. Harper's Biochemistry-27th ed. 498).# Transketolase Answer the following medical question: A 2 weeks old infant presents with excessive tearing in left eye, overflow of tears in the lower eyelid and frequent appearance of mucoid material for the last 1 week. The baby was delivered at home to a multigravida mother who had regular antenatal visits. There was no maternal or fetal complications perinatally. Most appropriate next step in management is:, with the following options: A: Nasolacrimal sac massaging, B: Probing of nasolacrimal duct, C: Application of erythromycin drops, D: Instillation of steroid drops +### Response: +","Refer: Kanski s Clinical Ophthalmology: A Systematic Approach 8th edition pg 301 , AK KHURANA COMPREHENSIVE OPHTHALMOLOGY 6TH EDITION pg. No369 +CONGENITAL DACRYOCYSTITIS +It is an inflammation of the lacrimal sac occurring in newborn infants +Treatment +It depends upon the age at which the child is brought. + +Massage over the lacrimal sac area and topical antibiotics - up to 6-8 weeks of age, 4 times a day to be followed by instillation of antibiotic drops. +Lacrimal syringing (irrigation) with normal saline and antibiotic solution. It should be added + to the conservative treatment if the condition is not cured up to the age of 2 months, once or twice a week. +Probing of NLD with Bowman’s probe. It should be performed, in case the condition is not cured + by the age of 3-4 months, under general anaesthesia; may be repeated after an interval of 3- + 4 weeks. +Intubations with silicone tube may be performed if repeated probings are failure. +Dacryocystorhinostomy (DCR) operations: When the child is brought very late or repeated probing + is a failure, after 4 years of age","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 2 weeks old infant presents with excessive tearing in left eye, overflow of tears in the lower eyelid and frequent appearance of mucoid material for the last 1 week. The baby was delivered at home to a multigravida mother who had regular antenatal visits. There was no maternal or fetal complications perinatally. Most appropriate next step in management is:, with the following options: A: Nasolacrimal sac massaging, B: Probing of nasolacrimal duct, C: Application of erythromycin drops, D: Instillation of steroid drops + ### Response: Refer: Kanski s Clinical Ophthalmology: A Systematic Approach 8th edition pg 301 , AK KHURANA COMPREHENSIVE OPHTHALMOLOGY 6TH EDITION pg. No369 CONGENITAL DACRYOCYSTITIS @@ -6896,6 +12335,13 @@ Dacryocystorhinostomy (DCR) operations: When the child is brought very late or r Answer the following medical question: A patient presents with tachycardia, BP of less than 100 mm systolic and postural hypotension. Diagnosis is: September 2012, with the following options: A: Vasovagal attack, B: Diabetic neuropathy, C: Shy Drager syndrome, D: Bleeding peptic ulcer +### Response: +","Ans: D i.e. Bleeding peptic ulcer GI ulcers (from surgery) MC site of duodenal ulcer: Duodenal cap Curling's ulcer: GI ulcers in severe burns Site of bleeding in duodenal ulcer: Gastroduodenal aery Treatment of perforated peptic ulcer: - Exploratory laparotomy, Nasogastric suction, - Acid suppression, - Antibiotics etc. Management of duodenal ulcer: - Highly selective vagotomy (least chances of diarrhea/ dumping syndrome) - Truncal vagotomy and antrectomy (lowest chances of recurrence) Cause of early dumping syndrome: Due to rapid emptying of hyperosmolar gastric contents into the small intestine","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A patient presents with tachycardia, BP of less than 100 mm systolic and postural hypotension. Diagnosis is: September 2012, with the following options: A: Vasovagal attack, B: Diabetic neuropathy, C: Shy Drager syndrome, D: Bleeding peptic ulcer + ### Response: Ans: D i.e. Bleeding peptic ulcer GI ulcers (from surgery) MC site of duodenal ulcer: Duodenal cap Curling's ulcer: GI ulcers in severe burns Site of bleeding in duodenal ulcer: Gastroduodenal aery Treatment of perforated peptic ulcer: - Exploratory laparotomy, Nasogastric suction, - Acid suppression, - Antibiotics etc. Management of duodenal ulcer: - Highly selective vagotomy (least chances of diarrhea/ dumping syndrome) - Truncal vagotomy and antrectomy (lowest chances of recurrence) Cause of early dumping syndrome: Due to rapid emptying of hyperosmolar gastric contents into the small intestine ### End" @@ -6905,6 +12351,13 @@ Ans: D i.e. Bleeding peptic ulcer GI ulcers (from surgery) MC site of duodenal u Answer the following medical question: LDH 5 is seen in ?, with the following options: A: Kidney, B: Hea, C: Liver, D: Prostate +### Response: +","LDH is an enzyme present in the cytoplasm of cells. LDH is present in the hea, liver, RBCs, kidney, skeletal muscles, lung and brain. When there is an injury to the cells LDH spells into the bloodstream. Five isoenzymes make the total LDH. These are; LDH 1 is present in the cardiac muscle and RBCs. LDH 2 is present in the cardiac muscle and RBCs. LDH 3 is present mainly in the lung and other tissues. LDH 4 is present in the kidneys, pancreas, and placenta. LDH 5 is present in the skeletal muscles and liver.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: LDH 5 is seen in ?, with the following options: A: Kidney, B: Hea, C: Liver, D: Prostate + ### Response: LDH is an enzyme present in the cytoplasm of cells. LDH is present in the hea, liver, RBCs, kidney, skeletal muscles, lung and brain. When there is an injury to the cells LDH spells into the bloodstream. Five isoenzymes make the total LDH. These are; LDH 1 is present in the cardiac muscle and RBCs. LDH 2 is present in the cardiac muscle and RBCs. LDH 3 is present mainly in the lung and other tissues. LDH 4 is present in the kidneys, pancreas, and placenta. LDH 5 is present in the skeletal muscles and liver. ### End" @@ -6914,6 +12367,13 @@ LDH is an enzyme present in the cytoplasm of cells. LDH is present in the hea, l Answer the following medical question: Lactic acidosis is not seen in, with the following options: A: Methanol poisoning, B: Respiratory failure, C: Circulatory failure, D: Tolbutamide +### Response: +","Answer is D (Tolbutamide) : Oral hypoglycemics of the biguanide group (Metformin & Phettfelrmin) are known to cause Lactic acidosis. It is not a complication of sulfonylureas such as Tolbutamide, Chlorpropamide etc. Lactic acidosis Lactic acid is produced from pyruvate when oxidative metabolism is reduced and glycolysis is increased. Lactic acidosis occurs when the rate of production of lactic acid from pyruvate in muscle, skin brain and erythrocytes exceeds the rate of removal by liver and kidney. The ingestion of methanol (wood alcohol) causes metabolic acidosis and its metabolites formaldehyde and formic acid cause severe optic nerve and central nervous system damage. Lactic acide, Aceto-acids and other unidentified organic acids contribute to the acidosis.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Lactic acidosis is not seen in, with the following options: A: Methanol poisoning, B: Respiratory failure, C: Circulatory failure, D: Tolbutamide + ### Response: Answer is D (Tolbutamide) : Oral hypoglycemics of the biguanide group (Metformin & Phettfelrmin) are known to cause Lactic acidosis. It is not a complication of sulfonylureas such as Tolbutamide, Chlorpropamide etc. Lactic acidosis Lactic acid is produced from pyruvate when oxidative metabolism is reduced and glycolysis is increased. Lactic acidosis occurs when the rate of production of lactic acid from pyruvate in muscle, skin brain and erythrocytes exceeds the rate of removal by liver and kidney. The ingestion of methanol (wood alcohol) causes metabolic acidosis and its metabolites formaldehyde and formic acid cause severe optic nerve and central nervous system damage. Lactic acide, Aceto-acids and other unidentified organic acids contribute to the acidosis. ### End" @@ -6923,6 +12383,13 @@ Answer is D (Tolbutamide) : Oral hypoglycemics of the biguanide group (Metformin Answer the following medical question: Beta blockers used in all except (Kerala 2007 repeat), with the following options: A: Peripheral vascular disease, B: Angina, C: Hypertension, D: Anxiety +### Response: +","Ans) a (Peripheral vascular disease) Ref Goodman & Gilman 11th edition, KDT 7th ed, Katzung 11th edEvery kerala exam there will be 3-5 questions concerning the beta and alpha selectivity and action beta antagonists, its uses and contraindication.Thesame question was asked in 2007 kerala examThe use of beta blockers will cause worsening of peripheral vascular disease.USES1) Hypertension -They are one of the first choice drugs used in treatment of hypertension.2) Angina pectoris- Beta-blockers reduce the frequency of anginal episodes and improve exercise toler- ance in many patients with angina3) Cardiac arrhythmias- Beta antagonists are often effective in the treatment of both supraventricular and ventricular arrhythmias.4) Myocardial infarction- Beta antagonists are strongly indicated in the acute phase of a myocardial infarction. In this setting, relative contraindications include brady cardia, hypotension, moderate or severe left ventricular failure, shock, heart block, and active airways disease.5) Congestive heart failure6) Dissecting aortic aneurysm7) Pheochromocytoma8) Thyrotoxicosis -controls the sympathetic symptoms without affecting thyroid status.9) Migraine -Propranolol is the most effective drug for prophylaxis of migraine10) Anxiety11) Essential tremor12) Glaucoma13) Hypertrophic obstructive cardiomyopathy14) Beta-receptor antagonists have been found to diminish portal vein pressure in patients with cirrhosis and prevent variceal bleedingAdverse effects1) Central nervous system effects include sedation, sleep disturbances, and depression. Rarely, psychotic reactions may occur.2) Worsens pre existing asthma and COPD3) Worsening of peripheral vascular disease4) Beta-receptor blockade depresses myocardial contractility and excitability., caution must be exercised in starting a beta receptor antagonist in patients with compensated heart failure5) Beta blockers may interact with the calcium antagonist verapamil causing severe hypotension, bradycardia, heart failure, and cardiac conduction abnormalities.6) Exacerbates variant(prinzmetars) angina.7) The incidence of hypoglycemic episodes in diabetics that are exacerbated.They also can cause impaired carbohydrate tolerance.8) Plasma lipid profile is altered.Total triglycerides and LDL cholesterol tend to increase while HDL cholesterol decreases.ENFUVIRTIDEEnfuvirtide is a synthetic 36-amino-acid peptide fusion inhibitor that blocks entry HIV genome into the cell.Enfuvirtide, binds to the gp41 subunit of the viral envelope glycoprotein, preventing the conformational changes required for the fusion of the viral and cellular membranes. It has no activity against HIV-2. Enfuvirtide must be administered by subcutaneous injection. Metabolism appears to be by proteolytic hydrolysis without involvement of the CYP450 system. Elimination half-life is 3.8 hours.Classification of antiretroviral drugs 1.Nucleoside reverse transcriptase inhibitor 4. Protease inhibitors* Zidovudine* Didanosine* Zalcitabine* Stavudine* Lamivudine* Emtricitabine* Abacavir* Saquinavir* Ritonavir* Indinavir* Nelfinavir* Amprenavir* Atazanavir* Lopinavir2. Non nucleoside reverse transcriptase inhibitors* Efavirenz* Nevirapine* Delavirdine* Etravirine5.Fusion inhibitors* Enfuvirtide* Maraviroc6. Integrase inhibitor* Raltegravir3.Nucleotide analogues* Tenofovir* Adefovir","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Beta blockers used in all except (Kerala 2007 repeat), with the following options: A: Peripheral vascular disease, B: Angina, C: Hypertension, D: Anxiety + ### Response: Ans) a (Peripheral vascular disease) Ref Goodman & Gilman 11th edition, KDT 7th ed, Katzung 11th edEvery kerala exam there will be 3-5 questions concerning the beta and alpha selectivity and action beta antagonists, its uses and contraindication.Thesame question was asked in 2007 kerala examThe use of beta blockers will cause worsening of peripheral vascular disease.USES1) Hypertension -They are one of the first choice drugs used in treatment of hypertension.2) Angina pectoris- Beta-blockers reduce the frequency of anginal episodes and improve exercise toler- ance in many patients with angina3) Cardiac arrhythmias- Beta antagonists are often effective in the treatment of both supraventricular and ventricular arrhythmias.4) Myocardial infarction- Beta antagonists are strongly indicated in the acute phase of a myocardial infarction. In this setting, relative contraindications include brady cardia, hypotension, moderate or severe left ventricular failure, shock, heart block, and active airways disease.5) Congestive heart failure6) Dissecting aortic aneurysm7) Pheochromocytoma8) Thyrotoxicosis -controls the sympathetic symptoms without affecting thyroid status.9) Migraine -Propranolol is the most effective drug for prophylaxis of migraine10) Anxiety11) Essential tremor12) Glaucoma13) Hypertrophic obstructive cardiomyopathy14) Beta-receptor antagonists have been found to diminish portal vein pressure in patients with cirrhosis and prevent variceal bleedingAdverse effects1) Central nervous system effects include sedation, sleep disturbances, and depression. Rarely, psychotic reactions may occur.2) Worsens pre existing asthma and COPD3) Worsening of peripheral vascular disease4) Beta-receptor blockade depresses myocardial contractility and excitability., caution must be exercised in starting a beta receptor antagonist in patients with compensated heart failure5) Beta blockers may interact with the calcium antagonist verapamil causing severe hypotension, bradycardia, heart failure, and cardiac conduction abnormalities.6) Exacerbates variant(prinzmetars) angina.7) The incidence of hypoglycemic episodes in diabetics that are exacerbated.They also can cause impaired carbohydrate tolerance.8) Plasma lipid profile is altered.Total triglycerides and LDL cholesterol tend to increase while HDL cholesterol decreases.ENFUVIRTIDEEnfuvirtide is a synthetic 36-amino-acid peptide fusion inhibitor that blocks entry HIV genome into the cell.Enfuvirtide, binds to the gp41 subunit of the viral envelope glycoprotein, preventing the conformational changes required for the fusion of the viral and cellular membranes. It has no activity against HIV-2. Enfuvirtide must be administered by subcutaneous injection. Metabolism appears to be by proteolytic hydrolysis without involvement of the CYP450 system. Elimination half-life is 3.8 hours.Classification of antiretroviral drugs 1.Nucleoside reverse transcriptase inhibitor 4. Protease inhibitors* Zidovudine* Didanosine* Zalcitabine* Stavudine* Lamivudine* Emtricitabine* Abacavir* Saquinavir* Ritonavir* Indinavir* Nelfinavir* Amprenavir* Atazanavir* Lopinavir2. Non nucleoside reverse transcriptase inhibitors* Efavirenz* Nevirapine* Delavirdine* Etravirine5.Fusion inhibitors* Enfuvirtide* Maraviroc6. Integrase inhibitor* Raltegravir3.Nucleotide analogues* Tenofovir* Adefovir ### End" @@ -6932,6 +12399,16 @@ Ans) a (Peripheral vascular disease) Ref Goodman & Gilman 11th edition, KDT 7th Answer the following medical question: Malignant pustules occurs in:, with the following options: A: Anthrax infection, B: Epithelioma, C: Melanoma, D: Tetanus +### Response: +","Pulmonary anthrax (wool-sorters’ disease): +Occurs due to inhalation of spores of B. anthracis in infectious aerosols results in rapid development of malignant pustule in the bronchus.  +This is followed by development of primary extensive necrotising pneumonia and haemorrhagic mediastinitis which is invariably fatal. +Mohan H. Textbook of pathology. Jaypee Brothers Medical Publishers; 2015. Edition 7. Page 169","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Malignant pustules occurs in:, with the following options: A: Anthrax infection, B: Epithelioma, C: Melanoma, D: Tetanus + ### Response: Pulmonary anthrax (wool-sorters’ disease): Occurs due to inhalation of spores of B. anthracis in infectious aerosols results in rapid development of malignant pustule in the bronchus.  @@ -6944,6 +12421,13 @@ Mohan H. Textbook of pathology. Jaypee Brothers Medical Publishers; 2015. Editio Answer the following medical question: All of the following are used in organophosphorus poisoning except, with the following options: A: Pralidoxime, B: Atropine, C: Activated charcoal, D: Naltrexone +### Response: +","Refer kDT 7/e p 110,111 Pharmacologic Treatment Atropine - The endpoint for atropine is dried pulmonary secretions and adequate oxygenation. Tachycardia and mydriasis must not be used to limit or to stop subsequent doses of atropine. The main concern with OP toxicity is respiratory failure from excessive airway secretions. Sta with a 1-2 mg IV bolus, repeat q3-5min prn for desire effects (drying of pulmonary secretions and adequate oxygenation). Consider doubling each subsequent dose for rapid control of patients in severe respiratory distress. An atropine drip titrated to the above endpoints can be initiated until the patient's condition is stabilized. Pralidoxime - Nucleophilic agent that reactivates the phosphorylated AChE by binding to the OP molecule. Used as an antidote to reverse muscle paralysis resulting from OP AChE pesticide poisoning but is not effective once the OP compound has bound AChE irreversibly (aged). Current recommendation is administration within 48 h of OP poisoning. Because it does not significantly relieve depression of respiratory center or decrease muscarinic effects of AChE poisoning, administer atropine concomitantly to block these effects of OP poisoning. Sta with 1-2 g (20-40 mg/kg) IV in 100 mL isotonic sodium chloride over 15-30 min; repeat in 1 h if muscle weakness is not relieved; then repeat q3-8h if signs of poisoning recur; other dosing regimens have been used, including continuous drip.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following are used in organophosphorus poisoning except, with the following options: A: Pralidoxime, B: Atropine, C: Activated charcoal, D: Naltrexone + ### Response: Refer kDT 7/e p 110,111 Pharmacologic Treatment Atropine - The endpoint for atropine is dried pulmonary secretions and adequate oxygenation. Tachycardia and mydriasis must not be used to limit or to stop subsequent doses of atropine. The main concern with OP toxicity is respiratory failure from excessive airway secretions. Sta with a 1-2 mg IV bolus, repeat q3-5min prn for desire effects (drying of pulmonary secretions and adequate oxygenation). Consider doubling each subsequent dose for rapid control of patients in severe respiratory distress. An atropine drip titrated to the above endpoints can be initiated until the patient's condition is stabilized. Pralidoxime - Nucleophilic agent that reactivates the phosphorylated AChE by binding to the OP molecule. Used as an antidote to reverse muscle paralysis resulting from OP AChE pesticide poisoning but is not effective once the OP compound has bound AChE irreversibly (aged). Current recommendation is administration within 48 h of OP poisoning. Because it does not significantly relieve depression of respiratory center or decrease muscarinic effects of AChE poisoning, administer atropine concomitantly to block these effects of OP poisoning. Sta with 1-2 g (20-40 mg/kg) IV in 100 mL isotonic sodium chloride over 15-30 min; repeat in 1 h if muscle weakness is not relieved; then repeat q3-8h if signs of poisoning recur; other dosing regimens have been used, including continuous drip. ### End" @@ -6953,6 +12437,13 @@ Refer kDT 7/e p 110,111 Pharmacologic Treatment Atropine - The endpoint for atro Answer the following medical question: Gene silencing RNA ?, with the following options: A: rRNA, B: tRNA, C: miRNA, D: None +### Response: +","Ans. is 'c' i.e., miRNA According to recent sudies a very large number of genes do not encode proteins. Instead, their products play impoant regulatory functions. The most recently discovered among this class of genes are that encode for gene-silencing RNAs, i.e. RNAs that do not encode proteins but instead inhibit gene expression (unlike classical RNAs which encode for proteins) Two gene-silencing RNAs are: Micro RNAs (miRNAs) Small interfering RNAs (siRNAs) 1. Micro RNA (miRNAs) Because of their profound influence on gene regulation, miRNAs are assuming central impoance in understanding normal developmental pathways, as well as pathologic conditions, such as cancer. o By current estimates there are approximately 1000 genes in humons that encodes miRNAs. Transcription of miRNA gene produces primary miRNA transcripts, which is processed within the nucleus to form another structure, called pre-miRNA. Pre-miRNA is transpoed to cytoplasm by a transpoor (Expo) protein. Dicer (an enzyme) does the additional cutting of this pre-miRNA that are about 21-30 nucleotide in length (hence called ""micro""). At this stage mRNA is still double stranded. Next, the miRNA unwinds, and single strands of this duplex are incorporated into a multiprotein complex called RNA-induced silencing complex (RISC). Base-pairing between the miRNA strand and it target mRNA (messenger RNA) directs RISC to either cause mRNA cleavage or repress its translation. In this way, the gene from which the target was derived is silenced (at a post-transcription level). A single miRNA can silence many target genes. 2. Small interfering RNAs (siRNAs) siRNAs work in similar manner as miRNA Unlike miRNA, siRNA precursors are introduced by investigators into cells. siRNA are becoming powerful tools for studying gene function and may in the future be used therapeutically to silence specific genes, such as oncogenes, whose products are involved in neoplastic transformation.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Gene silencing RNA ?, with the following options: A: rRNA, B: tRNA, C: miRNA, D: None + ### Response: Ans. is 'c' i.e., miRNA According to recent sudies a very large number of genes do not encode proteins. Instead, their products play impoant regulatory functions. The most recently discovered among this class of genes are that encode for gene-silencing RNAs, i.e. RNAs that do not encode proteins but instead inhibit gene expression (unlike classical RNAs which encode for proteins) Two gene-silencing RNAs are: Micro RNAs (miRNAs) Small interfering RNAs (siRNAs) 1. Micro RNA (miRNAs) Because of their profound influence on gene regulation, miRNAs are assuming central impoance in understanding normal developmental pathways, as well as pathologic conditions, such as cancer. o By current estimates there are approximately 1000 genes in humons that encodes miRNAs. Transcription of miRNA gene produces primary miRNA transcripts, which is processed within the nucleus to form another structure, called pre-miRNA. Pre-miRNA is transpoed to cytoplasm by a transpoor (Expo) protein. Dicer (an enzyme) does the additional cutting of this pre-miRNA that are about 21-30 nucleotide in length (hence called ""micro""). At this stage mRNA is still double stranded. Next, the miRNA unwinds, and single strands of this duplex are incorporated into a multiprotein complex called RNA-induced silencing complex (RISC). Base-pairing between the miRNA strand and it target mRNA (messenger RNA) directs RISC to either cause mRNA cleavage or repress its translation. In this way, the gene from which the target was derived is silenced (at a post-transcription level). A single miRNA can silence many target genes. 2. Small interfering RNAs (siRNAs) siRNAs work in similar manner as miRNA Unlike miRNA, siRNA precursors are introduced by investigators into cells. siRNA are becoming powerful tools for studying gene function and may in the future be used therapeutically to silence specific genes, such as oncogenes, whose products are involved in neoplastic transformation. ### End" @@ -6962,6 +12453,13 @@ Ans. is 'c' i.e., miRNA According to recent sudies a very large number of genes Answer the following medical question: Finger printing method was first used in:, with the following options: A: India, B: Japan, C: China, D: None of the above +### Response: +","Ans: a (India) Ref: Reddy, 27th ed, p. 76Finger printing method was first used in India in 1858 by Sir William HerschelIt was systematized by Galton in 1892Commonest type is - Loop > WhorlLeast common is composite.DN A fingerprinting was discovered by Alec Jeffreys","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Finger printing method was first used in:, with the following options: A: India, B: Japan, C: China, D: None of the above + ### Response: Ans: a (India) Ref: Reddy, 27th ed, p. 76Finger printing method was first used in India in 1858 by Sir William HerschelIt was systematized by Galton in 1892Commonest type is - Loop > WhorlLeast common is composite.DN A fingerprinting was discovered by Alec Jeffreys ### End" @@ -6971,6 +12469,13 @@ Ans: a (India) Ref: Reddy, 27th ed, p. 76Finger printing method was first used i Answer the following medical question: Most fatal amoebic encephalitis is caused by -, with the following options: A: E.histolytica, B: Naeglaria, C: E.dispar, D: Acanthamoeba +### Response: +",The parasite invades the cribriform plate and travels along the olfactory nerves to brain leading to a rapidly fatal infection known as primary amoebic meningoencephalitis.It occurs in young adults and children with a recent history of swimming in fresh water (refer pgno:25 baveja 3 rd edition),"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most fatal amoebic encephalitis is caused by -, with the following options: A: E.histolytica, B: Naeglaria, C: E.dispar, D: Acanthamoeba + ### Response: The parasite invades the cribriform plate and travels along the olfactory nerves to brain leading to a rapidly fatal infection known as primary amoebic meningoencephalitis.It occurs in young adults and children with a recent history of swimming in fresh water (refer pgno:25 baveja 3 rd edition) ### End" @@ -6980,6 +12485,13 @@ The parasite invades the cribriform plate and travels along the olfactory nerves Answer the following medical question: Echoencephalography is most useful in detecting:, with the following options: A: Ventricular dilatation, B: Midline shift, C: Epilepsy, D: Vascular lesions +### Response: +",Ans. Ventricular dilatation,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Echoencephalography is most useful in detecting:, with the following options: A: Ventricular dilatation, B: Midline shift, C: Epilepsy, D: Vascular lesions + ### Response: Ans. Ventricular dilatation ### End" @@ -6989,6 +12501,13 @@ Ans. Ventricular dilatation Answer the following medical question: Contraindication of rota virus vaccine is -, with the following options: A: SC1D, B: Intussusception, C: Severe allergic raction, D: All of above +### Response: +","Ans. is 'd' i.e., All of aboveGuide to Contraindications1 and Precautions to Commonly Used VaccinesVaccineContraindicationsPrecautionsHepatitis B (HepB)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Moderate or severe acute illness with or without fevero Infant weighing less than 2000 grams (4 lbs, 6.4 oz)Rotavirus(RV5 RV1 )o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Severe combined immunodeficiency (SCID)o History of intussusceptiono Moderate or severe acute illness with or without fevero Altered immunocompetence other than SCIDo Chronic gastrointestinal diseaseo Spina bifida or bladder exstrophyDiphtheria,tetanus, pertussis(DTaP)Tetanus,diphtheria,pertussis (Tdap)Tetanus,diphtheria (DT, Td)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento For pertussis-containing vaccines: encephalopathy (e.g., coma, decreased level of consc iousness, prolonged seizures) not attributable to another identifiable cause within 7 days of administration of a previous dose of DTP or DTaP (for DTaP); or of previous dose of DTP, DTaP, or Tdap (for Tdap)o Moderate or severe acute illness with or without fevero Guillain-Barre syndrome (GBS) within 6 weeks after a previous dose of tetanus toxoid-containing vaccineo Historyr of arthus-type hypersensitivity reactions after a previous dose of tetanus or diphtheria toxoid-containing vaccine; defer vaccination until at least 10 years have elapsed since the last tetanus-toxoid containing vaccineo For pertussis-containing vaccines: progressive or unstable neurologic disorder (including infantile spasms for DTaP), uncontrolled seizures, or progressive encephalopathy until a treatment regimen has been established and the condition has stabilizedFor DTaP only:o Temperature of 105c F or higher (40.5degC or higher) within 48 hours after vaccination with a previous dose of DTP/DTaPo Collapse or shock-like state (i.e., hypotonic hyporesponsive episode) within 48 hours after receiving a previous dose of DTP/DTaP o Seizure within 3 days after receiving a previous dose of DTP.'DTaPo Persistent, inconsolable crying lasting 3 or more hours within 48 hours after receiving a previous dose of DTP/DTaPHaemophilusinfluenzae type b(Hib)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Age younger than 6 weekso Moderate or severe acute illness with or without feverInactivatedpoliovirus vaccine(IPV)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Moderate or severe acute illness with or without fevero PregnancyPneumococcal (PCVI3 orPPSV23)o For PCV13, severe allergic reaction (e.g., anaphylaxis) after a previous dose of PCV7 or PCV13 or to a vaccine component, including to any vaccine containing diphtheria toxoido For PPSV23, severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Moderate or severe acute illness with or without feverMeasles, mumps,rubella (MMR)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Known severe immunodeficiency (e.g.. from hematologic and solid tumors, receipt of chemotherapy, congenital immunodeficiency, or long-term immunosuppressive therapyS or patients with human immunodeficiency virus infection who are severely i mmunocompromi sed) o Pregnancyo Moderate or severe acute illness with or without fevero Recent (within 11 months) receipt of antibody-containing blood product (specific interval depends on product)o Histoiy of thrombocytopenia or thrombocytopenic purpurao Need for tuberculin skin testingY'aricella (Var)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Known severe immunodeficiency (e.g., from hematologic and solid tumors, receipt of chemotherapy, primary or acquired immunodeficiency, or long-term immunosuppressive therapy5 or patients with HIV infection who are severely immunocomprom i sed)o Pregnancyo Moderate or severe acute illness with or without fevero Recent (within 11 months) receipt of antibody-containing blood product (specific interval depends on product)o Receipt of specific antivirals (i.e., acyclovir, famciclovir, or valaevclo- vir) 24 hours before vaccination; avoid use of these antiviral drugs for 14 days after vaccinationHepatitis A(HepA)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Moderate or severe acute illness with or without feverInfluenza, inactivatedinjectable (IIV)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose of any IIV or LAIV or to a vaccine component, including egg proteino Moderate or severe acute illness with or without fevero Histoiy of GBS within 6 weeks of previous influenza vaccinationo Persons who experience only hives with exposure to eggs may receive RIV (if age 18-49) or, with additional safety precautions, IIV.Influenza,recombinant (Riffo Severe allergic reaction (e.g., anaphylaxis) after a previous dose of RIV or to a vaccine component. RIV does not contain any egg proteino Moderate or severe acute illness with or without fevero History of GBS within 6 weeks of previous influenza vaccinationInfluenza, liveattenuated(LAIV)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose of IIV or LAIV or to a vaccine component, including egg proteino Conditions for which the ACIP recommend, against use, but which are not contraindications in vaccine package insert: immune suppression, certain chronic medical conditions such as asthma, diabetes, heart or kidney disease, and pregnancyo Moderate or severe acute illness with or without fever o History of GBS within 6 weeks of > previous influenza vaccination o Receipt of specific antivirals (i.e., amantadine, rimantadine, zanamivir, or oseltamivir) 48 hours before vaccination. Avoid use of these antiviral drugs for 14 days after vaccinationHumanPapillomavirus(HPV)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Moderate or severe acute illness with or without fevero PregnancyMen ingococcal: conjugate (MCV4), polysacch aride (MPSV4)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Moderate or severe acute illness with or without feverZoster (HZV)o Severe allergic reaction (e.g., anaphylaxis) to a vaccine componento Known severe immunodeficiency (e.g., from hematologic and solid tumors, receipt of chemotherapy, or long-term immunosuppressive therapy5 or patients with HIV infection who are severely immunocompromised),o Pregnancyo Moderate or severe acute illness with or without fevero Receipt of specific antivirals (i.e., acyclovir, famciclovir, or valacyclovir) 24 hours before vaccination; avoid use of these antiviral drugs for 14 days after vaccination.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Contraindication of rota virus vaccine is -, with the following options: A: SC1D, B: Intussusception, C: Severe allergic raction, D: All of above + ### Response: Ans. is 'd' i.e., All of aboveGuide to Contraindications1 and Precautions to Commonly Used VaccinesVaccineContraindicationsPrecautionsHepatitis B (HepB)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Moderate or severe acute illness with or without fevero Infant weighing less than 2000 grams (4 lbs, 6.4 oz)Rotavirus(RV5 RV1 )o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Severe combined immunodeficiency (SCID)o History of intussusceptiono Moderate or severe acute illness with or without fevero Altered immunocompetence other than SCIDo Chronic gastrointestinal diseaseo Spina bifida or bladder exstrophyDiphtheria,tetanus, pertussis(DTaP)Tetanus,diphtheria,pertussis (Tdap)Tetanus,diphtheria (DT, Td)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento For pertussis-containing vaccines: encephalopathy (e.g., coma, decreased level of consc iousness, prolonged seizures) not attributable to another identifiable cause within 7 days of administration of a previous dose of DTP or DTaP (for DTaP); or of previous dose of DTP, DTaP, or Tdap (for Tdap)o Moderate or severe acute illness with or without fevero Guillain-Barre syndrome (GBS) within 6 weeks after a previous dose of tetanus toxoid-containing vaccineo Historyr of arthus-type hypersensitivity reactions after a previous dose of tetanus or diphtheria toxoid-containing vaccine; defer vaccination until at least 10 years have elapsed since the last tetanus-toxoid containing vaccineo For pertussis-containing vaccines: progressive or unstable neurologic disorder (including infantile spasms for DTaP), uncontrolled seizures, or progressive encephalopathy until a treatment regimen has been established and the condition has stabilizedFor DTaP only:o Temperature of 105c F or higher (40.5degC or higher) within 48 hours after vaccination with a previous dose of DTP/DTaPo Collapse or shock-like state (i.e., hypotonic hyporesponsive episode) within 48 hours after receiving a previous dose of DTP/DTaP o Seizure within 3 days after receiving a previous dose of DTP.'DTaPo Persistent, inconsolable crying lasting 3 or more hours within 48 hours after receiving a previous dose of DTP/DTaPHaemophilusinfluenzae type b(Hib)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Age younger than 6 weekso Moderate or severe acute illness with or without feverInactivatedpoliovirus vaccine(IPV)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Moderate or severe acute illness with or without fevero PregnancyPneumococcal (PCVI3 orPPSV23)o For PCV13, severe allergic reaction (e.g., anaphylaxis) after a previous dose of PCV7 or PCV13 or to a vaccine component, including to any vaccine containing diphtheria toxoido For PPSV23, severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Moderate or severe acute illness with or without feverMeasles, mumps,rubella (MMR)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Known severe immunodeficiency (e.g.. from hematologic and solid tumors, receipt of chemotherapy, congenital immunodeficiency, or long-term immunosuppressive therapyS or patients with human immunodeficiency virus infection who are severely i mmunocompromi sed) o Pregnancyo Moderate or severe acute illness with or without fevero Recent (within 11 months) receipt of antibody-containing blood product (specific interval depends on product)o Histoiy of thrombocytopenia or thrombocytopenic purpurao Need for tuberculin skin testingY'aricella (Var)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Known severe immunodeficiency (e.g., from hematologic and solid tumors, receipt of chemotherapy, primary or acquired immunodeficiency, or long-term immunosuppressive therapy5 or patients with HIV infection who are severely immunocomprom i sed)o Pregnancyo Moderate or severe acute illness with or without fevero Recent (within 11 months) receipt of antibody-containing blood product (specific interval depends on product)o Receipt of specific antivirals (i.e., acyclovir, famciclovir, or valaevclo- vir) 24 hours before vaccination; avoid use of these antiviral drugs for 14 days after vaccinationHepatitis A(HepA)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Moderate or severe acute illness with or without feverInfluenza, inactivatedinjectable (IIV)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose of any IIV or LAIV or to a vaccine component, including egg proteino Moderate or severe acute illness with or without fevero Histoiy of GBS within 6 weeks of previous influenza vaccinationo Persons who experience only hives with exposure to eggs may receive RIV (if age 18-49) or, with additional safety precautions, IIV.Influenza,recombinant (Riffo Severe allergic reaction (e.g., anaphylaxis) after a previous dose of RIV or to a vaccine component. RIV does not contain any egg proteino Moderate or severe acute illness with or without fevero History of GBS within 6 weeks of previous influenza vaccinationInfluenza, liveattenuated(LAIV)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose of IIV or LAIV or to a vaccine component, including egg proteino Conditions for which the ACIP recommend, against use, but which are not contraindications in vaccine package insert: immune suppression, certain chronic medical conditions such as asthma, diabetes, heart or kidney disease, and pregnancyo Moderate or severe acute illness with or without fever o History of GBS within 6 weeks of > previous influenza vaccination o Receipt of specific antivirals (i.e., amantadine, rimantadine, zanamivir, or oseltamivir) 48 hours before vaccination. Avoid use of these antiviral drugs for 14 days after vaccinationHumanPapillomavirus(HPV)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Moderate or severe acute illness with or without fevero PregnancyMen ingococcal: conjugate (MCV4), polysacch aride (MPSV4)o Severe allergic reaction (e.g., anaphylaxis) after a previous dose or to a vaccine componento Moderate or severe acute illness with or without feverZoster (HZV)o Severe allergic reaction (e.g., anaphylaxis) to a vaccine componento Known severe immunodeficiency (e.g., from hematologic and solid tumors, receipt of chemotherapy, or long-term immunosuppressive therapy5 or patients with HIV infection who are severely immunocompromised),o Pregnancyo Moderate or severe acute illness with or without fevero Receipt of specific antivirals (i.e., acyclovir, famciclovir, or valacyclovir) 24 hours before vaccination; avoid use of these antiviral drugs for 14 days after vaccination. ### End" @@ -6998,6 +12517,13 @@ Ans. is 'd' i.e., All of aboveGuide to Contraindications1 and Precautions to Com Answer the following medical question: A primigravida at 10 weeks with ove diabetes on insulin has been hospitalised for ketoacidosis. Which could have been the most probable cause for her ketoacidosis?, with the following options: A: Infection, B: Hyperemesis gravidarum, C: Not taking regular folic acid, D: Pancreatitis +### Response: +","Diabetic ketoacidosis in a pregnant diabetic patient may occur as a result of Hyperemesis gravidarum Use of sympathomimetic drugs for tocolysis Infections Use of coicosteroids to induce fetal lung maturation. Non compliance with Insulin Therapy Since patient is in her first trimester and there is no history suggestive of infection in the question, hyperemesis would be the answer of choice here. Pancreatitis causing Ketoacidosis ( Called 'Kabadi' Syndrome ) is seen in 15 % cases of Acute Pancreatitis... not the likely cause here.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A primigravida at 10 weeks with ove diabetes on insulin has been hospitalised for ketoacidosis. Which could have been the most probable cause for her ketoacidosis?, with the following options: A: Infection, B: Hyperemesis gravidarum, C: Not taking regular folic acid, D: Pancreatitis + ### Response: Diabetic ketoacidosis in a pregnant diabetic patient may occur as a result of Hyperemesis gravidarum Use of sympathomimetic drugs for tocolysis Infections Use of coicosteroids to induce fetal lung maturation. Non compliance with Insulin Therapy Since patient is in her first trimester and there is no history suggestive of infection in the question, hyperemesis would be the answer of choice here. Pancreatitis causing Ketoacidosis ( Called 'Kabadi' Syndrome ) is seen in 15 % cases of Acute Pancreatitis... not the likely cause here. ### End" @@ -7007,6 +12533,13 @@ Diabetic ketoacidosis in a pregnant diabetic patient may occur as a result of Hy Answer the following medical question: School health examination must be done:-, with the following options: A: Every quaerly, B: Every 6 months, C: Annually, D: Every 2 years +### Response: +",Newer recommendation: NRHM recommends medical examination of children 'at the time of entry' and thereafter biannually( once every 6 months). Older recommendation: Rennuka Roy school health committee in India recommended medical examination of children ' at the time of entry' and thereafter every 4 years.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: School health examination must be done:-, with the following options: A: Every quaerly, B: Every 6 months, C: Annually, D: Every 2 years + ### Response: Newer recommendation: NRHM recommends medical examination of children 'at the time of entry' and thereafter biannually( once every 6 months). Older recommendation: Rennuka Roy school health committee in India recommended medical examination of children ' at the time of entry' and thereafter every 4 years. ### End" @@ -7016,6 +12549,13 @@ Newer recommendation: NRHM recommends medical examination of children 'at the ti Answer the following medical question: Anti-parietal cell antibodies are found in patients with?, with the following options: A: Good-pasture syndrome., B: Primary biliary cirrhosis, C: Wegener granulomatosis., D: Pernicious anemia +### Response: +","Ans. (d) Pernicious anemiaRef: Robbin's pathology 9th ed. /764* Anti-parietal cell antibodies are found in patients with the autoimmune disease known as pernicious anemia.* The anti-neutrophilic cytoplasmic antibodies are found in patients with Wegener granulomatosis.* Wegener granulomatosis may also present with pulmonary and renal involvement but will have associated upper respiratory tract findings, e.g, sinusitis and sinus abscesses.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Anti-parietal cell antibodies are found in patients with?, with the following options: A: Good-pasture syndrome., B: Primary biliary cirrhosis, C: Wegener granulomatosis., D: Pernicious anemia + ### Response: Ans. (d) Pernicious anemiaRef: Robbin's pathology 9th ed. /764* Anti-parietal cell antibodies are found in patients with the autoimmune disease known as pernicious anemia.* The anti-neutrophilic cytoplasmic antibodies are found in patients with Wegener granulomatosis.* Wegener granulomatosis may also present with pulmonary and renal involvement but will have associated upper respiratory tract findings, e.g, sinusitis and sinus abscesses. ### End" @@ -7025,6 +12565,13 @@ Ans. (d) Pernicious anemiaRef: Robbin's pathology 9th ed. /764* Anti-parietal ce Answer the following medical question: A head injury patient was brought to casualty. On examination, opens eyes to pinching finger tip, makes moaning sounds but does not talk or say anything and patient lies in normal flexion attitude. What is the GCS?, with the following options: A: 7, B: 8, C: 9, D: 10 +### Response: +","Eye openingCriterionRatingScoreOpen before stimulusSpontaneous4After spoken or shouted requestTo sound3After finger tip stimulusTo pressure2No opening at any time, no interfering factorNone1Closed by local factor(Ex orbital )Non testableNTVerbal responseCriterionRatingScoreCorrectly gives name, place and dateOrientated5Not oriented but communication coherentlyConfused4Intelligible single wordsWords3Only moans/groansSounds2No audible response, no interfering factorNone1Factor interfering with communication (Ex: ET tube)Non testableNTBest motor responseCriterionRatingScoreObey 2-pa requestObeys commands6Brings hand above clavicle to stimulus on head neckLocalising5Bends arm at elbow rapidly but features not predominantly abnormalNormal flexion4Bends arm at elbow, features clearly predominantly abnormalAbnormal flexion3Extends arm at elbowExtension2No movement in arms/legs, no None1Paralysed or other limiting factorNon testableNT","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A head injury patient was brought to casualty. On examination, opens eyes to pinching finger tip, makes moaning sounds but does not talk or say anything and patient lies in normal flexion attitude. What is the GCS?, with the following options: A: 7, B: 8, C: 9, D: 10 + ### Response: Eye openingCriterionRatingScoreOpen before stimulusSpontaneous4After spoken or shouted requestTo sound3After finger tip stimulusTo pressure2No opening at any time, no interfering factorNone1Closed by local factor(Ex orbital )Non testableNTVerbal responseCriterionRatingScoreCorrectly gives name, place and dateOrientated5Not oriented but communication coherentlyConfused4Intelligible single wordsWords3Only moans/groansSounds2No audible response, no interfering factorNone1Factor interfering with communication (Ex: ET tube)Non testableNTBest motor responseCriterionRatingScoreObey 2-pa requestObeys commands6Brings hand above clavicle to stimulus on head neckLocalising5Bends arm at elbow rapidly but features not predominantly abnormalNormal flexion4Bends arm at elbow, features clearly predominantly abnormalAbnormal flexion3Extends arm at elbowExtension2No movement in arms/legs, no None1Paralysed or other limiting factorNon testableNT ### End" @@ -7034,6 +12581,17 @@ Eye openingCriterionRatingScoreOpen before stimulusSpontaneous4After spoken or s Answer the following medical question: Rhinophyma is associated with which of the following?, with the following options: A: Infection of hair follicles, B: Hypertrophy of sebaceous gland, C: Congenital deformity of the nose, D: Hypertrophy of sweat gland +### Response: +","RHINOPHYMA / POTATO NOSE / RUM NOSE / COPPER'S NOSE / TOPPER'S NOSE / BRANDY NOSE +• Benign tumor due to hypertrophy of sebaceous glands of tip of nose. +• Seen in cases of long-standing acne rosacea. +• Precipitated by: Spicy food, Heat, Alcohol +• Treatment: Laser (CO2) Excision with skin grafting and Avoidance of alcohol.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Rhinophyma is associated with which of the following?, with the following options: A: Infection of hair follicles, B: Hypertrophy of sebaceous gland, C: Congenital deformity of the nose, D: Hypertrophy of sweat gland + ### Response: RHINOPHYMA / POTATO NOSE / RUM NOSE / COPPER'S NOSE / TOPPER'S NOSE / BRANDY NOSE • Benign tumor due to hypertrophy of sebaceous glands of tip of nose. @@ -7047,6 +12605,14 @@ RHINOPHYMA / POTATO NOSE / RUM NOSE / COPPER'S NOSE / TOPPER'S NOSE / BRANDY NOS Answer the following medical question: Which of the following tuberculids is characterized by involvement of sweat glands, and hair follicles with noncaseating epithelioid granuloma ?, with the following options: A: Lichen scrofulosorum, B: Miliary tuberculosis, C: Papulonecrotic type, D: Lupus vulgaris +### Response: +","In Lichen scrfulosorum ,hallmark feature is  superficial epitheloid dermal granulomas that surround hair follicles and sweat ducts and may occupy several dermal papillae. +Caseous necrosis is usually not seen.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following tuberculids is characterized by involvement of sweat glands, and hair follicles with noncaseating epithelioid granuloma ?, with the following options: A: Lichen scrofulosorum, B: Miliary tuberculosis, C: Papulonecrotic type, D: Lupus vulgaris + ### Response: In Lichen scrfulosorum ,hallmark feature is  superficial epitheloid dermal granulomas that surround hair follicles and sweat ducts and may occupy several dermal papillae. Caseous necrosis is usually not seen. @@ -7057,6 +12623,13 @@ Caseous necrosis is usually not seen. Answer the following medical question: Hypersecretory glaucoma is seen in-, with the following options: A: Epidemic dropsy, B: Marfan's syndrome, C: Hypeension, D: Diabetes +### Response: +","""In epidemic dropsy, the aqueous shows raised level of histamine, prostaglandin and protein suggestion that the glaucoma is hypersecretory"". Ref: pediatric Ophthalmology by PK Mukharjee 4th/e p.370","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hypersecretory glaucoma is seen in-, with the following options: A: Epidemic dropsy, B: Marfan's syndrome, C: Hypeension, D: Diabetes + ### Response: ""In epidemic dropsy, the aqueous shows raised level of histamine, prostaglandin and protein suggestion that the glaucoma is hypersecretory"". Ref: pediatric Ophthalmology by PK Mukharjee 4th/e p.370 ### End" @@ -7066,6 +12639,13 @@ Answer the following medical question: Hypersecretory glaucoma is seen in-, with Answer the following medical question: In multiparous women, sho labor is defined as a rate of cervical dilatation of, with the following options: A: 3cm/hr, B: 5cm/hr, C: 8cm/hr, D: 10cm/hr +### Response: +","Sho labors were defined as a rate of cervical dilatation of 5 cm/hr or faster for nulliparas and 10cm/hr for multiparas. Such sho labors were more common in multiparas who typically had contractions at intervals less than 2 minutes and were associated with placental abruption, meconium, postpaum hemorrhage, cocaine abuse, and low Apgar scores.Precipitous labor terminates in the expulsion of the fetus in < 3 hours.Ref: William&;s obstetrics; 24th edition; Chapter: 23","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In multiparous women, sho labor is defined as a rate of cervical dilatation of, with the following options: A: 3cm/hr, B: 5cm/hr, C: 8cm/hr, D: 10cm/hr + ### Response: Sho labors were defined as a rate of cervical dilatation of 5 cm/hr or faster for nulliparas and 10cm/hr for multiparas. Such sho labors were more common in multiparas who typically had contractions at intervals less than 2 minutes and were associated with placental abruption, meconium, postpaum hemorrhage, cocaine abuse, and low Apgar scores.Precipitous labor terminates in the expulsion of the fetus in < 3 hours.Ref: William&;s obstetrics; 24th edition; Chapter: 23 ### End" @@ -7075,6 +12655,18 @@ Sho labors were defined as a rate of cervical dilatation of 5 cm/hr or faster fo Answer the following medical question: A 3 year graduate MBBS programme was suggested by which committee?, with the following options: A: Sundar Committee, B: Expert Level Committee on Universal Health Coverage, C: Srivastava Committee, D: Krishnan Committee +### Response: +","HLEG Recommendations + +High Level Expert Group (HLEG, Planning Commission, GOI) on Universal health Coverage has suggested 3½ year MBBS course for serving rural population +HLEG was developed for XII Five Year Plan +Rural doctors will be called as ‘Community Health Officers’ +3½ Degree given: B.Sc. Community Health","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 3 year graduate MBBS programme was suggested by which committee?, with the following options: A: Sundar Committee, B: Expert Level Committee on Universal Health Coverage, C: Srivastava Committee, D: Krishnan Committee + ### Response: HLEG Recommendations @@ -7089,6 +12681,13 @@ Rural doctors will be called as ‘Community Health Officers’ Answer the following medical question: Reed sternberg cells are found in?, with the following options: A: Hodkin's disease, B: Sickle cell anaemia, C: Thalassemia, D: CML +### Response: +","Ans. is 'a' i.e., Hodgkin's disease o Pathologically, Hodgkins disease is distinguished from other lymphomas by the presence of Reed Sternberg cells. o Reed sternberg cells are not absolutely specific for Hodgkins disease and have also been noticed in cases of infectious mononucleosis and other malignancies including lymphoma, carcinoma and sarcomas. o Therefore, Reed-Sternberg, cells are not sufficient to establish the diagnosis of Hodgkins disease. o The diagnosis of hodgkins' lymphoma requires the presence of both the characteristic Reed-Sternberg cells and the characteristics cellular environment comprising of lymphocytes, histiocytes, granulocytes, eosinophils and plasma cells. o One more method which can be useful in the diagnosis is invio in for CD-15 and CD-30. The neoplastic cells of Hodgkins disease, both classic Reed-sternberg cell and Reed-sterberg variants, tend to stain positively with these antibodies. o In addition R.S. cells of lymphocytic predominant cells are also positive for CD20. o Atypical cells can be seen in some types of Hodgkins disease, but they are not diagnostic.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Reed sternberg cells are found in?, with the following options: A: Hodkin's disease, B: Sickle cell anaemia, C: Thalassemia, D: CML + ### Response: Ans. is 'a' i.e., Hodgkin's disease o Pathologically, Hodgkins disease is distinguished from other lymphomas by the presence of Reed Sternberg cells. o Reed sternberg cells are not absolutely specific for Hodgkins disease and have also been noticed in cases of infectious mononucleosis and other malignancies including lymphoma, carcinoma and sarcomas. o Therefore, Reed-Sternberg, cells are not sufficient to establish the diagnosis of Hodgkins disease. o The diagnosis of hodgkins' lymphoma requires the presence of both the characteristic Reed-Sternberg cells and the characteristics cellular environment comprising of lymphocytes, histiocytes, granulocytes, eosinophils and plasma cells. o One more method which can be useful in the diagnosis is invio in for CD-15 and CD-30. The neoplastic cells of Hodgkins disease, both classic Reed-sternberg cell and Reed-sterberg variants, tend to stain positively with these antibodies. o In addition R.S. cells of lymphocytic predominant cells are also positive for CD20. o Atypical cells can be seen in some types of Hodgkins disease, but they are not diagnostic. ### End" @@ -7098,6 +12697,14 @@ Ans. is 'a' i.e., Hodgkin's disease o Pathologically, Hodgkins disease is distin Answer the following medical question: All are tests done on blood except -, with the following options: A: Acid phosphatase test, B: Benzidine test, C: Hemochromogen test, D: Teichmann's test +### Response: +","Acid phosphatase test is used for semen. + Other three options arc tests for blood Stain.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are tests done on blood except -, with the following options: A: Acid phosphatase test, B: Benzidine test, C: Hemochromogen test, D: Teichmann's test + ### Response: Acid phosphatase test is used for semen.  Other three options arc tests for blood Stain. @@ -7108,6 +12715,13 @@ Acid phosphatase test is used for semen. Answer the following medical question: Which one of the following conditions may lead to exudative pleural effusion, with the following options: A: Cirrhosis, B: Nephrotic syndrome, C: Congestive hea failure, D: Bronchogenic carcinoma +### Response: +","Answer is D (Bronchogenic Carcinoma): Malignant pleural of fissions secondary to metastatic disease are exudative in nature. The three tumors that cause approx. 75% of all malignant pleural effusions are lung carcinoma, breast carcinoma, and Lymphoma. Exudative pleural effusion Transudative pleural effusion Exudative pleural effusion occurs when local factors that influence the formation Transudative pleural effusion occurs when and absorbtion of pleural fluid are altered. systemic factors that influence the formation and absorbtion of pleural fluid are altered. Distinguishing Laboratory features : * Total serum protein > 3 gm /dL * Pleural fluid protein /Serum protein > 0.5 * Pleural fluid LDH/Serum LDH > 0.6 * Pleural fluid LDH >2/3 upper limit of serum Total serum protein < 3 gm /dL Pleural fluid protein /Serum protein < 0.5 Pleural fluid LDH/Serum LDH < 0.6 Pleural fluid LDH<2/3 upper limit of serum Causes of Exudative Pleural Effusion: Causes of Tansuda ive Pleural Effusion: * Neoplastic diseases * Gastrointestinal disease * Pulmonary embolism 1. Congestive hea failure Metastatic disease Esophageal perforation * Sarcoidosis 2. Cirrhosis Mesothelioma Pancreatic disease * Uremia 3. Pulmonary embolization * Infectious diseases Intraabdominal abscesses * Asbestos exposure 4. Hephrotic syndrome Bacterial infections Diaphragmatic hernia * Meig's syndrome 5.Peritoneal dialysis Tuberculosis After abdominal surgery * Yellow nail 6. Superior vena cava obstruction Fungal infections Endoscopy variceal syndrome 7. Myxedema Tuberculosis sclerotherapy * Trapped lung 8.Urinothorax Viral infections * After liver transplant * Radiation therapy Parasitic infections * Post-coronary aery bypass * Post-cardiac injury * Collagen-vascular surgery syndrome diseases * Drug-induced pleural disease * Hemothorax Rheumatoid pleuritis Nitrofurantoin * latrogenic injury SLE Dantrolene * Ovarian Drug-induced lupus Methylsergide hyperstimulation Sjogren's syndrome Bromocriptine syndrome Wegner's Procarbazine * Pericardial disease granulomatosis Amiodarone * Chylothorax Churg-Strauss syndrome","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which one of the following conditions may lead to exudative pleural effusion, with the following options: A: Cirrhosis, B: Nephrotic syndrome, C: Congestive hea failure, D: Bronchogenic carcinoma + ### Response: Answer is D (Bronchogenic Carcinoma): Malignant pleural of fissions secondary to metastatic disease are exudative in nature. The three tumors that cause approx. 75% of all malignant pleural effusions are lung carcinoma, breast carcinoma, and Lymphoma. Exudative pleural effusion Transudative pleural effusion Exudative pleural effusion occurs when local factors that influence the formation Transudative pleural effusion occurs when and absorbtion of pleural fluid are altered. systemic factors that influence the formation and absorbtion of pleural fluid are altered. Distinguishing Laboratory features : * Total serum protein > 3 gm /dL * Pleural fluid protein /Serum protein > 0.5 * Pleural fluid LDH/Serum LDH > 0.6 * Pleural fluid LDH >2/3 upper limit of serum Total serum protein < 3 gm /dL Pleural fluid protein /Serum protein < 0.5 Pleural fluid LDH/Serum LDH < 0.6 Pleural fluid LDH<2/3 upper limit of serum Causes of Exudative Pleural Effusion: Causes of Tansuda ive Pleural Effusion: * Neoplastic diseases * Gastrointestinal disease * Pulmonary embolism 1. Congestive hea failure Metastatic disease Esophageal perforation * Sarcoidosis 2. Cirrhosis Mesothelioma Pancreatic disease * Uremia 3. Pulmonary embolization * Infectious diseases Intraabdominal abscesses * Asbestos exposure 4. Hephrotic syndrome Bacterial infections Diaphragmatic hernia * Meig's syndrome 5.Peritoneal dialysis Tuberculosis After abdominal surgery * Yellow nail 6. Superior vena cava obstruction Fungal infections Endoscopy variceal syndrome 7. Myxedema Tuberculosis sclerotherapy * Trapped lung 8.Urinothorax Viral infections * After liver transplant * Radiation therapy Parasitic infections * Post-coronary aery bypass * Post-cardiac injury * Collagen-vascular surgery syndrome diseases * Drug-induced pleural disease * Hemothorax Rheumatoid pleuritis Nitrofurantoin * latrogenic injury SLE Dantrolene * Ovarian Drug-induced lupus Methylsergide hyperstimulation Sjogren's syndrome Bromocriptine syndrome Wegner's Procarbazine * Pericardial disease granulomatosis Amiodarone * Chylothorax Churg-Strauss syndrome ### End" @@ -7117,6 +12731,13 @@ Answer is D (Bronchogenic Carcinoma): Malignant pleural of fissions secondary to Answer the following medical question: Most Common infection in Contact Lens user is, with the following options: A: Acanthamoeba, B: Pneumococcus, C: Pseudomonas, D: Staphylococcus aureus +### Response: +",Most Common infection in Contact Lens user is Pseudomonas,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most Common infection in Contact Lens user is, with the following options: A: Acanthamoeba, B: Pneumococcus, C: Pseudomonas, D: Staphylococcus aureus + ### Response: Most Common infection in Contact Lens user is Pseudomonas ### End" @@ -7126,6 +12747,19 @@ Most Common infection in Contact Lens user is Pseudomonas Answer the following medical question: Treatment of squamous cell carcinoma of anal canal is, with the following options: A: Cisplastin based chemotherapy followed by radical radiotherapy, B: Abdomino perineal resection, C: Radical radiotherapy, D: Radical radiotherapy followed by mitomycin-c based chemotherapy. +### Response: +","Cancers of the anal canal can be divided into those affecting the anal margin (distal to the dentate line) and those affecting the anal canal (proximal to the dentate line) +Treatment of Anal Epidermoid or squamous cell Ca + +Ca of anal margin is treated in similar way to the squamous cell ca of the skin in other locations because adequate surgical margins can usually be achieved without resecting the anal sphincter → wide local excision is adequate. +Epidermoid cancer occurring in the anal canal cannot be excised locally without destroying the sphincter so the first line therapy is → chemoradiotherapy (Nigro protocol) +More than 80% are cured by chemoradiation. If any residual tumor is left behind after chemo radiation or recurrence occurs →an abdominoperineal excision is performed. +Chemotherapy used is combination of 5FU (5-fluorouracil) and mitomycin C","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Treatment of squamous cell carcinoma of anal canal is, with the following options: A: Cisplastin based chemotherapy followed by radical radiotherapy, B: Abdomino perineal resection, C: Radical radiotherapy, D: Radical radiotherapy followed by mitomycin-c based chemotherapy. + ### Response: Cancers of the anal canal can be divided into those affecting the anal margin (distal to the dentate line) and those affecting the anal canal (proximal to the dentate line) Treatment of Anal Epidermoid or squamous cell Ca @@ -7141,6 +12775,13 @@ Chemotherapy used is combination of 5FU (5-fluorouracil) and mitomycin C Answer the following medical question: Collecting tubules of kidney develop from :, with the following options: A: Uretric bud, B: Mesonephric duct, C: Paramesonephric duct, D: Wolffian duct +### Response: +",A. i.e. Ureteric bud,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Collecting tubules of kidney develop from :, with the following options: A: Uretric bud, B: Mesonephric duct, C: Paramesonephric duct, D: Wolffian duct + ### Response: A. i.e. Ureteric bud ### End" @@ -7150,6 +12791,13 @@ A. i.e. Ureteric bud Answer the following medical question: Which of the following statements about Wilson's disease is true:, with the following options: A: Low serum ceruloplasmin and low urinary copper, B: Low serum ceruloplasmin and high urinary copper, C: High serum ceruloplasmin and low urinary copper, D: High serum ceruloplasmin and high urinary copper +### Response: +","Answer is B (Low serum ceruloplasmin and high urinary copper) Wilson's disease is associated with low levels of serum ceruloplasmin and high urinary copper excretion The basic defect in Wilson's disease is reduced biliaiy excretion of copper due to a mutation of gene on chromosome 13 which promotes copper excretion. This leads to accumulation of copper initially in the liver and subsequently in plasma and other systems once liver is saturated. Serum ceruloplasmin is the main copper binding protein in the blood and once excess copper spills into the blood, levels of free ceruloplasmin are decreased. Also excess copper is eventually excreted in urine and hence urinary copper levels are increased or high.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following statements about Wilson's disease is true:, with the following options: A: Low serum ceruloplasmin and low urinary copper, B: Low serum ceruloplasmin and high urinary copper, C: High serum ceruloplasmin and low urinary copper, D: High serum ceruloplasmin and high urinary copper + ### Response: Answer is B (Low serum ceruloplasmin and high urinary copper) Wilson's disease is associated with low levels of serum ceruloplasmin and high urinary copper excretion The basic defect in Wilson's disease is reduced biliaiy excretion of copper due to a mutation of gene on chromosome 13 which promotes copper excretion. This leads to accumulation of copper initially in the liver and subsequently in plasma and other systems once liver is saturated. Serum ceruloplasmin is the main copper binding protein in the blood and once excess copper spills into the blood, levels of free ceruloplasmin are decreased. Also excess copper is eventually excreted in urine and hence urinary copper levels are increased or high. ### End" @@ -7159,6 +12807,13 @@ Answer is B (Low serum ceruloplasmin and high urinary copper) Wilson's disease i Answer the following medical question: Ovarian function after hysterectomy :, with the following options: A: Increases, B: Decreases within 2 - 3 years, C: Remains the same, D: Decreases after 5 years +### Response: +",Decreases after 5 years,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ovarian function after hysterectomy :, with the following options: A: Increases, B: Decreases within 2 - 3 years, C: Remains the same, D: Decreases after 5 years + ### Response: Decreases after 5 years ### End" @@ -7168,6 +12823,13 @@ Decreases after 5 years Answer the following medical question: Pulmonary capillary pressure is:, with the following options: A: 5 mm Hg, B: 10 mm Hg, C: 20 mm Hg, D: 32 mm Hg +### Response: +",The average pulmonary capillary pressure is 10 mm Hg. Pulmonary capillary wedge pressure (which reflects LA pressure) is 5 mm Hg.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pulmonary capillary pressure is:, with the following options: A: 5 mm Hg, B: 10 mm Hg, C: 20 mm Hg, D: 32 mm Hg + ### Response: The average pulmonary capillary pressure is 10 mm Hg. Pulmonary capillary wedge pressure (which reflects LA pressure) is 5 mm Hg. ### End" @@ -7177,6 +12839,13 @@ The average pulmonary capillary pressure is 10 mm Hg. Pulmonary capillary wedge Answer the following medical question: The main reservoir for Entamoeba histolytica is -, with the following options: A: Man, B: Diy water, C: Soil, D: Ponds +### Response: +","The main reservoir for Entamoeba histolytica is man. Other options can be the modes of transmission ie. faeco oral through contaminated water. Option 1, 2, 3, 4 E. histolytica: Habitat: Large intestine Morphology-3 stages: Trophozoites, Pre-cyst and cyst. Host: Humans are the only host and reservoir. Infective form: Mature quadrinucleate cyst. Mode of transmission: Faeco-oral route and rarely sexual transmission (20-30% in homosexuals).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The main reservoir for Entamoeba histolytica is -, with the following options: A: Man, B: Diy water, C: Soil, D: Ponds + ### Response: The main reservoir for Entamoeba histolytica is man. Other options can be the modes of transmission ie. faeco oral through contaminated water. Option 1, 2, 3, 4 E. histolytica: Habitat: Large intestine Morphology-3 stages: Trophozoites, Pre-cyst and cyst. Host: Humans are the only host and reservoir. Infective form: Mature quadrinucleate cyst. Mode of transmission: Faeco-oral route and rarely sexual transmission (20-30% in homosexuals). ### End" @@ -7186,6 +12855,13 @@ The main reservoir for Entamoeba histolytica is man. Other options can be the mo Answer the following medical question: Which of the following childhood disorder improves with increase in age -, with the following options: A: Conduct disorder, B: Emotional problems, C: Temper tantrum, D: Sleep disorder +### Response: +","Ans. is 'c' i.e., Temper tantrum Temper tantrum reaches its peak point during second and third year of life and gradually subsides in between 3 to 6 years as the child learns to control his negativism and complies to the requests of others.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following childhood disorder improves with increase in age -, with the following options: A: Conduct disorder, B: Emotional problems, C: Temper tantrum, D: Sleep disorder + ### Response: Ans. is 'c' i.e., Temper tantrum Temper tantrum reaches its peak point during second and third year of life and gradually subsides in between 3 to 6 years as the child learns to control his negativism and complies to the requests of others. ### End" @@ -7195,6 +12871,13 @@ Ans. is 'c' i.e., Temper tantrum Temper tantrum reaches its peak point during se Answer the following medical question: In a snake envenomation, antivenom is staed by giving a dose of ?, with the following options: A: 2 ls, B: 4 ls, C: 10 ls, D: 20 ls +### Response: +","Ans. is 'c' i.e., 10 ls Polyvalent antisnake venom is useful when given within four hours of snake bite. It is of less value if delayed for eight hours and is of doubtful value after 24 hours. Each l of polyvalent antisnake venom neutralize about 6-8 mg of venom. Initial dose depends upon symptoms : Minimal (local swelling, no systemic symptoms) --) 5 vails. Moderate (swelling progressing beyond site of bite with systemic reaction)- 10 vails. Severe (markeld local reaction, severe systemic symptoms) - 10-15 vails. In neurotoxic poisoning, a second dose of 10 ls should be given after 1 hour.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In a snake envenomation, antivenom is staed by giving a dose of ?, with the following options: A: 2 ls, B: 4 ls, C: 10 ls, D: 20 ls + ### Response: Ans. is 'c' i.e., 10 ls Polyvalent antisnake venom is useful when given within four hours of snake bite. It is of less value if delayed for eight hours and is of doubtful value after 24 hours. Each l of polyvalent antisnake venom neutralize about 6-8 mg of venom. Initial dose depends upon symptoms : Minimal (local swelling, no systemic symptoms) --) 5 vails. Moderate (swelling progressing beyond site of bite with systemic reaction)- 10 vails. Severe (markeld local reaction, severe systemic symptoms) - 10-15 vails. In neurotoxic poisoning, a second dose of 10 ls should be given after 1 hour. ### End" @@ -7204,6 +12887,13 @@ Ans. is 'c' i.e., 10 ls Polyvalent antisnake venom is useful when given within f Answer the following medical question: Axillary nerve is a branch of which part of brachial plexus -, with the following options: A: Trunk, B: Medial cord, C: Lateral cord, D: Posterior cord +### Response: +","Ans. is 'd' i.e., Posterior cord Supraclavicular branches of brachial plexuso Branches of brachial plexus which are above the clavicle are called supraclavicular branches,o These arise from roots and trunks.Supraclavicular branches of brachial plexusFrom roots1. Nerves to scaleni and longus colli2. Branch to phrenic nerve3. Dorsal scapular nerve4. Long thoracic nerveC5,6,7,8C5C5C5,6(7)From trunks1. Nerve to subclavius2. Suprascapular nerveC5,6C5,6Infraclavicular branches of brachial plexuso Branches of brachial plexus which are below the clavicle are called infraclavicular branches,o These arise from cords.Infra clavicular branches of brachial plexusLateral cordLateral pectoralC5.6,7MusculocutaneousC5,6,7Lateral root of medianC(5), 6,7Medial cordMedial pectoralC8,T1Medial cutaneous of forearmC8.T1Medial cutaneous of armC8,T1Medial root of medianC8.T1UlnarC(7), 8,T1Posterior cordUpper subscaputarC5t6Lowrer subscapularC5.6Thoracodorsal (Nerve to latissimus dorsi, middle subscapular nerve)C6,7,8AxillaryC5,6RadialC5,6,7,8, (Tl)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Axillary nerve is a branch of which part of brachial plexus -, with the following options: A: Trunk, B: Medial cord, C: Lateral cord, D: Posterior cord + ### Response: Ans. is 'd' i.e., Posterior cord Supraclavicular branches of brachial plexuso Branches of brachial plexus which are above the clavicle are called supraclavicular branches,o These arise from roots and trunks.Supraclavicular branches of brachial plexusFrom roots1. Nerves to scaleni and longus colli2. Branch to phrenic nerve3. Dorsal scapular nerve4. Long thoracic nerveC5,6,7,8C5C5C5,6(7)From trunks1. Nerve to subclavius2. Suprascapular nerveC5,6C5,6Infraclavicular branches of brachial plexuso Branches of brachial plexus which are below the clavicle are called infraclavicular branches,o These arise from cords.Infra clavicular branches of brachial plexusLateral cordLateral pectoralC5.6,7MusculocutaneousC5,6,7Lateral root of medianC(5), 6,7Medial cordMedial pectoralC8,T1Medial cutaneous of forearmC8.T1Medial cutaneous of armC8,T1Medial root of medianC8.T1UlnarC(7), 8,T1Posterior cordUpper subscaputarC5t6Lowrer subscapularC5.6Thoracodorsal (Nerve to latissimus dorsi, middle subscapular nerve)C6,7,8AxillaryC5,6RadialC5,6,7,8, (Tl) ### End" @@ -7213,6 +12903,13 @@ Ans. is 'd' i.e., Posterior cord Supraclavicular branches of brachial plexuso Br Answer the following medical question: Spring catarrh is which type of hypersensitivity reaction -, with the following options: A: type I, B: type II, C: type II & III, D: All +### Response: +","Ans. is 'a' i.e., Type I . Vernal keratoconjuctivitis is a recurrent, bilateral, external ocular inflammation primarily affecting boys and young adults living in warm, dry climates. . It is an allergic disorder in which IgE (type I) and cell mediated immune mechanisms (type IV) play an impoant role.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Spring catarrh is which type of hypersensitivity reaction -, with the following options: A: type I, B: type II, C: type II & III, D: All + ### Response: Ans. is 'a' i.e., Type I . Vernal keratoconjuctivitis is a recurrent, bilateral, external ocular inflammation primarily affecting boys and young adults living in warm, dry climates. . It is an allergic disorder in which IgE (type I) and cell mediated immune mechanisms (type IV) play an impoant role. ### End" @@ -7222,6 +12919,13 @@ Ans. is 'a' i.e., Type I . Vernal keratoconjuctivitis is a recurrent, bilateral, Answer the following medical question: All of the following aeries are common sites of occlusion by a thrombus except:, with the following options: A: Anterior intervetricular, B: Posterior interventricular, C: Cirucumflex, D: Marginal +### Response: +","D i.e. Marginal Nodal, Acute Marginal & Posterior Descending (interventricular) aeryQ are branches of Right Coronary aery; whereas Circumflex, Diagonal, Obtuse Marginal & Anterior Descending (interventricular) aeryQ are branches of Left Coronary Aery. LAD, RCA and LCX are common whereas as marginal branches are uncommon site of thrombosis.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following aeries are common sites of occlusion by a thrombus except:, with the following options: A: Anterior intervetricular, B: Posterior interventricular, C: Cirucumflex, D: Marginal + ### Response: D i.e. Marginal Nodal, Acute Marginal & Posterior Descending (interventricular) aeryQ are branches of Right Coronary aery; whereas Circumflex, Diagonal, Obtuse Marginal & Anterior Descending (interventricular) aeryQ are branches of Left Coronary Aery. LAD, RCA and LCX are common whereas as marginal branches are uncommon site of thrombosis. ### End" @@ -7231,6 +12935,13 @@ D i.e. Marginal Nodal, Acute Marginal & Posterior Descending (interventricular) Answer the following medical question: All of the following agents are used for prophylaxis of migraine, Except -, with the following options: A: Propanalol, B: Valproate, C: Topiramate, D: Ethosuxamide +### Response: +","Ans. is 'd' i.e., Ethosuxamide Propanolol is the most commonly used drug for migraine prophylaxis. Anticonvulsants used for migraine prophylaxis are valproate, Gabapentine and topiramate (not ethosuxamide).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following agents are used for prophylaxis of migraine, Except -, with the following options: A: Propanalol, B: Valproate, C: Topiramate, D: Ethosuxamide + ### Response: Ans. is 'd' i.e., Ethosuxamide Propanolol is the most commonly used drug for migraine prophylaxis. Anticonvulsants used for migraine prophylaxis are valproate, Gabapentine and topiramate (not ethosuxamide). ### End" @@ -7240,6 +12951,13 @@ Ans. is 'd' i.e., Ethosuxamide Propanolol is the most commonly used drug for mig Answer the following medical question: Pyrazinamide acts on, with the following options: A: Interfering folic acid biosynthesis of mycobacteria, B: Bacteriostatic activity on growing organisms, C: Tuberculous bacilli in macrophages, D: Tuberculous bacilli in blood stream +### Response: +","(C) Tuberculous bacilli in macrophages # PYRAZINAMIDE A derivative of nicotinic acid, pyrazinamide is an important bactericidal drug used in short-course therapy for tuberculosis.> Mechanism of action: Pyrazinamide is similar to isoniazid in its narrow spectrum of antibacterial activity, which essentially includes only M.tuberculosis. The drug is bactericidal to slowly metabolizing organisms located within the acidic environment of the phagocyte or caseous granuloma; it is active only at a pH of <6.0. Pyrazinamide is considered a prodrug and is converted by the tubercle bacillus to the active form pyrazinoic acid. The target for this compound is thought to be a fatty acid synthase gene. Susceptible strains of M. tuberculosis are inhibited by 20p g/mL.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pyrazinamide acts on, with the following options: A: Interfering folic acid biosynthesis of mycobacteria, B: Bacteriostatic activity on growing organisms, C: Tuberculous bacilli in macrophages, D: Tuberculous bacilli in blood stream + ### Response: (C) Tuberculous bacilli in macrophages # PYRAZINAMIDE A derivative of nicotinic acid, pyrazinamide is an important bactericidal drug used in short-course therapy for tuberculosis.> Mechanism of action: Pyrazinamide is similar to isoniazid in its narrow spectrum of antibacterial activity, which essentially includes only M.tuberculosis. The drug is bactericidal to slowly metabolizing organisms located within the acidic environment of the phagocyte or caseous granuloma; it is active only at a pH of <6.0. Pyrazinamide is considered a prodrug and is converted by the tubercle bacillus to the active form pyrazinoic acid. The target for this compound is thought to be a fatty acid synthase gene. Susceptible strains of M. tuberculosis are inhibited by 20p g/mL. ### End" @@ -7249,6 +12967,13 @@ Answer the following medical question: Pyrazinamide acts on, with the following Answer the following medical question: Village health guide scheme was staed in ?, with the following options: A: 1974, B: 1977, C: 1986, D: 1989 +### Response: +","Ans. is 'b' i.e., 1977","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Village health guide scheme was staed in ?, with the following options: A: 1974, B: 1977, C: 1986, D: 1989 + ### Response: Ans. is 'b' i.e., 1977 ### End" @@ -7258,6 +12983,13 @@ Ans. is 'b' i.e., 1977 Answer the following medical question: Antigen antibody precipitation is maximally seenin which of the following?, with the following options: A: Excess of antibody, B: Excess of antigen, C: Equivalence of antibody and antigen, D: Antigen Hapten interaction +### Response: +","Equivalence of antibody and antigen Precipitation reaction It is a type of antigen antibody reaction - When a soluble antigen combines with its antibody in the presence of electrolytes (NaCI) at a suitable temperature and pH, the antigen antibody complex forms an isoluble precipitate. . The amount of precipitate formed is greatly influenced by the relative propoions of antigens and antibodies. - Precipitation occurs most rapidly and abundantly in the zone of equivalence in which the antigen and antibody are present in optimal propoions. . If increasing quantities of antigens are added to the same amount of antiserum in different tubes and the amounts of precipitate in different tubes are plotted on a graph, the resulting curve will have three phases:","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Antigen antibody precipitation is maximally seenin which of the following?, with the following options: A: Excess of antibody, B: Excess of antigen, C: Equivalence of antibody and antigen, D: Antigen Hapten interaction + ### Response: Equivalence of antibody and antigen Precipitation reaction It is a type of antigen antibody reaction - When a soluble antigen combines with its antibody in the presence of electrolytes (NaCI) at a suitable temperature and pH, the antigen antibody complex forms an isoluble precipitate. . The amount of precipitate formed is greatly influenced by the relative propoions of antigens and antibodies. - Precipitation occurs most rapidly and abundantly in the zone of equivalence in which the antigen and antibody are present in optimal propoions. . If increasing quantities of antigens are added to the same amount of antiserum in different tubes and the amounts of precipitate in different tubes are plotted on a graph, the resulting curve will have three phases: ### End" @@ -7267,6 +12999,13 @@ Equivalence of antibody and antigen Precipitation reaction It is a type of antig Answer the following medical question: Colipase acts with:, with the following options: A: Lipoprotein lipase, B: Pancreatic lipase, C: Gastric lipase, D: Salivary lipase +### Response: +","Pancreatic juice contains lipase, colipase, phospholipase A & B Colipase: Facilitates the action of lipase Prevents inactivation of lipase by bile salts","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Colipase acts with:, with the following options: A: Lipoprotein lipase, B: Pancreatic lipase, C: Gastric lipase, D: Salivary lipase + ### Response: Pancreatic juice contains lipase, colipase, phospholipase A & B Colipase: Facilitates the action of lipase Prevents inactivation of lipase by bile salts ### End" @@ -7276,6 +13015,13 @@ Pancreatic juice contains lipase, colipase, phospholipase A & B Colipase: Facili Answer the following medical question: Very low bih weight babies are, with the following options: A: < 2500 gm of bih weight, B: < 1500 gm of bih weight, C: <1000 gm of bih weight, D: Between 2500-300 gm of bih weight +### Response: +",Low bih weight (LBW) neonate- A neonate weighing less than 2500g at bih irrespective of the gestational age. Very low bihweight (VLBW) neonate- A neonate weighing leas than 1500g at bih irrespective of the gestational age. Extremely low bih weight (ELBW) neonate- A neonate weighing leas than 1000g at bih irrespective of the gestational age. Reference : page 125 Ghai Essential Pediatrics 8th edition,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Very low bih weight babies are, with the following options: A: < 2500 gm of bih weight, B: < 1500 gm of bih weight, C: <1000 gm of bih weight, D: Between 2500-300 gm of bih weight + ### Response: Low bih weight (LBW) neonate- A neonate weighing less than 2500g at bih irrespective of the gestational age. Very low bihweight (VLBW) neonate- A neonate weighing leas than 1500g at bih irrespective of the gestational age. Extremely low bih weight (ELBW) neonate- A neonate weighing leas than 1000g at bih irrespective of the gestational age. Reference : page 125 Ghai Essential Pediatrics 8th edition ### End" @@ -7285,6 +13031,13 @@ Low bih weight (LBW) neonate- A neonate weighing less than 2500g at bih irrespec Answer the following medical question: Transfer of the graft of different species are called as:, with the following options: A: Isograft, B: Allograft, C: Homograft, D: Xenograft +### Response: +",Isograft: Is a graft from a different individual genetically identical with recipient e.g. identical twin Autograft: Is to self Allograft: Graft from same species but different genotype (from one human to another human) Xenograft: Graft from different species (from animal to human),"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Transfer of the graft of different species are called as:, with the following options: A: Isograft, B: Allograft, C: Homograft, D: Xenograft + ### Response: Isograft: Is a graft from a different individual genetically identical with recipient e.g. identical twin Autograft: Is to self Allograft: Graft from same species but different genotype (from one human to another human) Xenograft: Graft from different species (from animal to human) ### End" @@ -7294,6 +13047,13 @@ Isograft: Is a graft from a different individual genetically identical with reci Answer the following medical question: True statement about Right coronary aery (RCA), with the following options: A: Diameter less than LCA, B: RCA arises from the aoa above the aoic valve, C: RCA supplies major pa of right atrium and right ventricle, D: RCA gives rise to circumflex coronary branch +### Response: +","Right coronary aery arises from anterior aoic sinus of ascending aoa.It is smaller than the left coronary aery. Branches A.Large branches 1.Marginal 2.Posterior interventricular B.Small branches 1.Nodal in 60%cases 2.Right atrial 3.Infundibular 4.Terminal AREA OF DISTRIBUTION 1.Right atrium 2.Ventricles-Greater pa of the right ventricle,except the area adjoining the anterior interventricular groove -A small pa of the left ventricle adjoining the posterior interventricular groove 3.Posterior pa of the interventricular septum 4.Whole of the conducting system of the hea except a pa of the left branch of the AV bundle.The SA node is supplied by the left coronary aery in about 40% of cases. REF.B D Chaurasia's human anatomy vol1.fifth edition","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True statement about Right coronary aery (RCA), with the following options: A: Diameter less than LCA, B: RCA arises from the aoa above the aoic valve, C: RCA supplies major pa of right atrium and right ventricle, D: RCA gives rise to circumflex coronary branch + ### Response: Right coronary aery arises from anterior aoic sinus of ascending aoa.It is smaller than the left coronary aery. Branches A.Large branches 1.Marginal 2.Posterior interventricular B.Small branches 1.Nodal in 60%cases 2.Right atrial 3.Infundibular 4.Terminal AREA OF DISTRIBUTION 1.Right atrium 2.Ventricles-Greater pa of the right ventricle,except the area adjoining the anterior interventricular groove -A small pa of the left ventricle adjoining the posterior interventricular groove 3.Posterior pa of the interventricular septum 4.Whole of the conducting system of the hea except a pa of the left branch of the AV bundle.The SA node is supplied by the left coronary aery in about 40% of cases. REF.B D Chaurasia's human anatomy vol1.fifth edition ### End" @@ -7303,6 +13063,13 @@ Right coronary aery arises from anterior aoic sinus of ascending aoa.It is small Answer the following medical question: Which of the following agents is used for day care surgery?, with the following options: A: Propofol, B: Thiopentone, C: Diazepam, D: Ketamine +### Response: +","Propofol produces quick induction(30 sec) and rapid recovery(4 min)from a single dose. Because of rapid recovery it is preferred for day cases. Thiopentone duration of action is 4-7min. And ketamine10-15min but amnesia lasts for 1-2 hours. From padmaja 4th edition Page no 194, 195, 196","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following agents is used for day care surgery?, with the following options: A: Propofol, B: Thiopentone, C: Diazepam, D: Ketamine + ### Response: Propofol produces quick induction(30 sec) and rapid recovery(4 min)from a single dose. Because of rapid recovery it is preferred for day cases. Thiopentone duration of action is 4-7min. And ketamine10-15min but amnesia lasts for 1-2 hours. From padmaja 4th edition Page no 194, 195, 196 ### End" @@ -7312,6 +13079,13 @@ Propofol produces quick induction(30 sec) and rapid recovery(4 min)from a single Answer the following medical question: Most common site of injury in under water blast: NEET 15, with the following options: A: Tympanic membrane, B: GIT, C: Liver, D: Lung +### Response: +",Ans. GIT,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common site of injury in under water blast: NEET 15, with the following options: A: Tympanic membrane, B: GIT, C: Liver, D: Lung + ### Response: Ans. GIT ### End" @@ -7322,9 +13096,23 @@ Ans. GIT Answer the following medical question: The nitrogen of the body is supplied by:, with the following options: A: Triacyl glycerol, B: Proteins, C: Glucose, D: Lipids ### Response: -Proteins are polymers of amino acid. Proteins contain carbon, hydrogen, oxygen and nitrogen as the major components. Nitrogen is characteristic of protein. On an average, the nitrogen content of ordinary proteins is 16% by weight. -### End" -772,"Below is an instruction that describes a task. Write a response that appropriately completes the request. +","Proteins are polymers of amino acid. Proteins contain carbon, hydrogen, oxygen and nitrogen as the major components. Nitrogen is characteristic of protein. On an average, the nitrogen content of ordinary proteins is 16% by weight.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The nitrogen of the body is supplied by:, with the following options: A: Triacyl glycerol, B: Proteins, C: Glucose, D: Lipids + +### Response: +Proteins are polymers of amino acid. Proteins contain carbon, hydrogen, oxygen and nitrogen as the major components. Nitrogen is characteristic of protein. On an average, the nitrogen content of ordinary proteins is 16% by weight. +### End" +772,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Level of hardness in soft water, with the following options: A: < 1meq/L, B: 1-3meq/L, C: 3-6meq/L, D: >6meq/L + +### Response: +",Soft water: < 1 mEq/LModerately hard: 1-3 mEq/LHard water: 3-6 mEq/LVery hard water: >6 mEq/LPark 23e pg: 727,"Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: @@ -7339,6 +13127,14 @@ Soft water: < 1 mEq/LModerately hard: 1-3 mEq/LHard water: 3-6 mEq/LVery hard wa Answer the following medical question: The impression material with lowest viscosity is, with the following options: A: Plaster of paris, B: Agar-agar, C: Zinc oxide eugenol, D: Elastomers +### Response: +","Impression plaster is a β-calcium sulfate hemihydrate used at a water/powder ratio of approximately 0.5 to 0.6. Its fluidity makes it suitable for making impressions of soft tissues in the uncompressed state, a characteristic of mucostatic impression material. +Ref: Phillips 12 ed page no 177","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The impression material with lowest viscosity is, with the following options: A: Plaster of paris, B: Agar-agar, C: Zinc oxide eugenol, D: Elastomers + ### Response: Impression plaster is a β-calcium sulfate hemihydrate used at a water/powder ratio of approximately 0.5 to 0.6. Its fluidity makes it suitable for making impressions of soft tissues in the uncompressed state, a characteristic of mucostatic impression material. Ref: Phillips 12 ed page no 177 @@ -7349,6 +13145,13 @@ Ref: Phillips 12 ed page no 177 Answer the following medical question: reversible lens granular deposits is caused by, with the following options: A: chlorpromazine, B: risperidone, C: paliperidone, D: olanzapine +### Response: +","chlorpromazine is a typical anti psychotic that has lot of mentioned side effects namely Blue grey discolouration of skin reverse lens granular deposits obstructive jaundice retrograde ejaculation REf. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no 925","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: reversible lens granular deposits is caused by, with the following options: A: chlorpromazine, B: risperidone, C: paliperidone, D: olanzapine + ### Response: chlorpromazine is a typical anti psychotic that has lot of mentioned side effects namely Blue grey discolouration of skin reverse lens granular deposits obstructive jaundice retrograde ejaculation REf. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no 925 ### End" @@ -7358,6 +13161,13 @@ chlorpromazine is a typical anti psychotic that has lot of mentioned side effect Answer the following medical question: Which of the following investigation is not needed during evaluation following 1st episode of urinary tract infection on a 7 month old boy?, with the following options: A: DMSA scan, B: Ultrasound of kidney and urinary tract, C: DTPA scan, D: Micturating cystourethogram (MCU) +### Response: +","Evaluation following the first episode of urinary tract infection: Age < 1 yr --> USG, MCU, DMSA scan Age 1-5 yr --> USG, DMSA scan (if USG or DMSA scan is abnormal --> MCU) Age > 5 yr --> USG (if USG abnormal --> MCU & DMSA scan)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following investigation is not needed during evaluation following 1st episode of urinary tract infection on a 7 month old boy?, with the following options: A: DMSA scan, B: Ultrasound of kidney and urinary tract, C: DTPA scan, D: Micturating cystourethogram (MCU) + ### Response: Evaluation following the first episode of urinary tract infection: Age < 1 yr --> USG, MCU, DMSA scan Age 1-5 yr --> USG, DMSA scan (if USG or DMSA scan is abnormal --> MCU) Age > 5 yr --> USG (if USG abnormal --> MCU & DMSA scan) ### End" @@ -7367,6 +13177,13 @@ Evaluation following the first episode of urinary tract infection: Age < 1 yr -- Answer the following medical question: Most commonly injured nerve in Incision shown, with the following options: A: Ilioinguinal nerve, B: Iliohypogastric nerve, C: Subcostal nerve, D: 11th Thoracic nerve +### Response: +",Ilia hypogastric nerve (McBumey's incision),"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most commonly injured nerve in Incision shown, with the following options: A: Ilioinguinal nerve, B: Iliohypogastric nerve, C: Subcostal nerve, D: 11th Thoracic nerve + ### Response: Ilia hypogastric nerve (McBumey's incision) ### End" @@ -7376,6 +13193,13 @@ Ilia hypogastric nerve (McBumey's incision) Answer the following medical question: Imidazole ring is present in, with the following options: A: Tryptophan, B: Arginine, C: Histidine, D: Tyrosine +### Response: +","Ans. is 'c' i.e.,Histidine Some amino acids contain a special functional group in their side chain which provide some specific functions to that amino acids. These are : Hydroxyl group in serine and threonine - Indole ring in tryptophanAmide group in aspargine and glutamine - (3-Carboxyl in glutamic acidThioether in methionine - Imidazole in histidineSulphydryl in cysteine - Phenol in tyrosiney-carboxyl in glutamic acid - Pyrrolidine in prolineGuanidinium in arginine - c-amino in lysine","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Imidazole ring is present in, with the following options: A: Tryptophan, B: Arginine, C: Histidine, D: Tyrosine + ### Response: Ans. is 'c' i.e.,Histidine Some amino acids contain a special functional group in their side chain which provide some specific functions to that amino acids. These are : Hydroxyl group in serine and threonine - Indole ring in tryptophanAmide group in aspargine and glutamine - (3-Carboxyl in glutamic acidThioether in methionine - Imidazole in histidineSulphydryl in cysteine - Phenol in tyrosiney-carboxyl in glutamic acid - Pyrrolidine in prolineGuanidinium in arginine - c-amino in lysine ### End" @@ -7385,6 +13209,16 @@ Ans. is 'c' i.e.,Histidine Some amino acids contain a special functional group i Answer the following medical question: All of the following are seen in psoriasis except –, with the following options: A: Auspitz sign present, B: 10% associated with arthritis, C: It is premalignant disease, D: Worsening of disease during winter +### Response: +","Psoriasis is not a premalignant condition. +Psoriatic lesions may worsen during winter. +Arthritis occurs in 5-10% of patients. +Auspitz sign is characteristic of Psoriasis","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following are seen in psoriasis except –, with the following options: A: Auspitz sign present, B: 10% associated with arthritis, C: It is premalignant disease, D: Worsening of disease during winter + ### Response: Psoriasis is not a premalignant condition. Psoriatic lesions may worsen during winter. @@ -7397,6 +13231,13 @@ Auspitz sign is characteristic of Psoriasis Answer the following medical question: Moeller's glossitis is due to a, with the following options: A: pernicious anemia, B: Riboflavin deficiency, C: Acute monocytic leukemia, D: Late acquired syphilis +### Response: +","Atrophic glossitis. Atrophic glossitis, also known as bald tongue, smooth tongue, Hunter glossitis, Moeller glossitis, or Moller-Hunter glossitis, is a condition characterized by a smooth glossy tongue that is often tender/painful, caused by complete atrophy of the lingual papillae Ref Davidson 23rd edition pg 1036","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Moeller's glossitis is due to a, with the following options: A: pernicious anemia, B: Riboflavin deficiency, C: Acute monocytic leukemia, D: Late acquired syphilis + ### Response: Atrophic glossitis. Atrophic glossitis, also known as bald tongue, smooth tongue, Hunter glossitis, Moeller glossitis, or Moller-Hunter glossitis, is a condition characterized by a smooth glossy tongue that is often tender/painful, caused by complete atrophy of the lingual papillae Ref Davidson 23rd edition pg 1036 ### End" @@ -7406,6 +13247,13 @@ Atrophic glossitis. Atrophic glossitis, also known as bald tongue, smooth tongue Answer the following medical question: A 30 year old male patient presents with urethritis. All of the following can be the causative agent except-, with the following options: A: Neisseria gonorrhoeae, B: Chlamydia trachomatis, C: Trichomonas vaginalis, D: Haemophilus ducreyi +### Response: +",Hemophilus ducreyi can cause genital ulcer but not urethritis,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 30 year old male patient presents with urethritis. All of the following can be the causative agent except-, with the following options: A: Neisseria gonorrhoeae, B: Chlamydia trachomatis, C: Trichomonas vaginalis, D: Haemophilus ducreyi + ### Response: Hemophilus ducreyi can cause genital ulcer but not urethritis ### End" @@ -7415,6 +13263,13 @@ Hemophilus ducreyi can cause genital ulcer but not urethritis Answer the following medical question: Delayed removal or absorption of amniotic fluid from pulmonary system results in, with the following options: A: Respiratory distress syndrome, B: Transient trachypnea of newborn, C: Meconium aspiration syndrome, D: None of the above +### Response: +",Delay in amniotic fluid removal from alveoli results in transient tachypnea of newborn.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Delayed removal or absorption of amniotic fluid from pulmonary system results in, with the following options: A: Respiratory distress syndrome, B: Transient trachypnea of newborn, C: Meconium aspiration syndrome, D: None of the above + ### Response: Delay in amniotic fluid removal from alveoli results in transient tachypnea of newborn. ### End" @@ -7424,6 +13279,13 @@ Delay in amniotic fluid removal from alveoli results in transient tachypnea of n Answer the following medical question: A pt. with Ca tongue is found to have lymph nodes in the lower neck. The t/t of choice for the lymph nodes is, with the following options: A: Lower cervical neck dissection, B: Suprahyoid neck dissection, C: Radiotherapy, D: Radical neck dissection +### Response: +","Surgical management can be of 3 types: Radical neck dissection (RND), Modified radical neck dissection (MRND) & Selective neck dissection (SND) Radical neck dissection - is the traditional gold standard for control of cervical metastasis. - RND involves removal of levels I to V of the cervical lymph nodes + Sternocleidomastoid, IJV and the spinal accessory nerve (CN XI). Modified radical neck dissection is modification of RND that preserves nonlymphatic structures i.e. CN XI, SCM and IJV. MRND has been found to be equally effective in controlling neck disease as RND with superior functional outcome. Selective neck dissection Preservation of any of the levels I through V during neck dissection is known as Selective neck dissection. The principle behind preservation of ceain nodal groups is that specific primary sites preferentially drain their lymphatics in a predictable pattern. Types of SND include the supraomohyoid neck dissection, the lateral neck dissection, and the posterolateral neck dissection.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A pt. with Ca tongue is found to have lymph nodes in the lower neck. The t/t of choice for the lymph nodes is, with the following options: A: Lower cervical neck dissection, B: Suprahyoid neck dissection, C: Radiotherapy, D: Radical neck dissection + ### Response: Surgical management can be of 3 types: Radical neck dissection (RND), Modified radical neck dissection (MRND) & Selective neck dissection (SND) Radical neck dissection - is the traditional gold standard for control of cervical metastasis. - RND involves removal of levels I to V of the cervical lymph nodes + Sternocleidomastoid, IJV and the spinal accessory nerve (CN XI). Modified radical neck dissection is modification of RND that preserves nonlymphatic structures i.e. CN XI, SCM and IJV. MRND has been found to be equally effective in controlling neck disease as RND with superior functional outcome. Selective neck dissection Preservation of any of the levels I through V during neck dissection is known as Selective neck dissection. The principle behind preservation of ceain nodal groups is that specific primary sites preferentially drain their lymphatics in a predictable pattern. Types of SND include the supraomohyoid neck dissection, the lateral neck dissection, and the posterolateral neck dissection. ### End" @@ -7433,6 +13295,13 @@ Surgical management can be of 3 types: Radical neck dissection (RND), Modified r Answer the following medical question: A 23 yr old nulliparous woman complains of painful coitus and informs that pain is located at the vaginal introitus. This is also accompanied by painful involuntary contraction of the pelvic muscles. The pelvic examination is normal. No obviouos local pathology could be seen. Of the following, what is the most common cause of this condition?, with the following options: A: Endometriosis, B: Psychological causes, C: Baholin's gland abscess, D: Vulvar atrophy +### Response: +","This patient has vaginismus. Genito-Pelvic Penetration Pain Disorder: GPPPD Dyspareunia : Persistent or recurrent pain with attempted or complete vaginal entry and/or penile vaginal intercourse. This is frequently associated with pelvic pathology such as endometriosis, pelvic adhesions, or ovarian neoplasms. Vaginismus: Persistent or recurrent difficulty to allow vaginal entry of a penis or other object, often with phobic avoidance,anticipation/fear/experience of pain, plus variable and involuntary pelvic muscle contraction. Involuntary reflexive contraction of pelvic muscles and often thighs, abdomen, buttocks, and even jaw, fists, and other muscle groups. The term was only correct when no local or pelvic pathology was present. The diagnosis of vaginismus was provisional until a very careful introital and vaginal examination was done. It may be generalized--the woman is unable to place anything in her vagina, even her own finger or a tampon It may be situational, maybe she can use a tampon and can tolerate a pelvic examination but cannot have intercourse These 2 terms, Dysparunia and Vaginismus, are now combined as mentioned above and called GPPPD. Treatment of vaginismus is graded Psychotherapy. This involves gradual assistance in making the patient aware of her anatomy and encouragement to allow self examination for a few days first and then examination by a gynecologist. Intercourse is not an option till the patient is comfoable with a pelvic examination.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 23 yr old nulliparous woman complains of painful coitus and informs that pain is located at the vaginal introitus. This is also accompanied by painful involuntary contraction of the pelvic muscles. The pelvic examination is normal. No obviouos local pathology could be seen. Of the following, what is the most common cause of this condition?, with the following options: A: Endometriosis, B: Psychological causes, C: Baholin's gland abscess, D: Vulvar atrophy + ### Response: This patient has vaginismus. Genito-Pelvic Penetration Pain Disorder: GPPPD Dyspareunia : Persistent or recurrent pain with attempted or complete vaginal entry and/or penile vaginal intercourse. This is frequently associated with pelvic pathology such as endometriosis, pelvic adhesions, or ovarian neoplasms. Vaginismus: Persistent or recurrent difficulty to allow vaginal entry of a penis or other object, often with phobic avoidance,anticipation/fear/experience of pain, plus variable and involuntary pelvic muscle contraction. Involuntary reflexive contraction of pelvic muscles and often thighs, abdomen, buttocks, and even jaw, fists, and other muscle groups. The term was only correct when no local or pelvic pathology was present. The diagnosis of vaginismus was provisional until a very careful introital and vaginal examination was done. It may be generalized--the woman is unable to place anything in her vagina, even her own finger or a tampon It may be situational, maybe she can use a tampon and can tolerate a pelvic examination but cannot have intercourse These 2 terms, Dysparunia and Vaginismus, are now combined as mentioned above and called GPPPD. Treatment of vaginismus is graded Psychotherapy. This involves gradual assistance in making the patient aware of her anatomy and encouragement to allow self examination for a few days first and then examination by a gynecologist. Intercourse is not an option till the patient is comfoable with a pelvic examination. ### End" @@ -7442,6 +13311,13 @@ This patient has vaginismus. Genito-Pelvic Penetration Pain Disorder: GPPPD Dysp Answer the following medical question: M.C. type of cutaneous T.B. is:, with the following options: A: Lupus vulgaris, B: Scrofuloderma, C: TIB, verruca cutis, D: Erythema induratum +### Response: +",A (Lupus vulgaris) Lupus vulgaris is the most commonly found form of cutaneous T.B. in adults in a recently published series from India and South Africa and the second most prevalent after Scrofuloderma in a series from U.K. Most common skm tuberculosis | | |Lupus vulgarisScrofuloderma||In adultsIn childrenSccrofuloderma is the commonest form of cutaneous T.B. in childhood in a large series from India and in another series from U.K.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: M.C. type of cutaneous T.B. is:, with the following options: A: Lupus vulgaris, B: Scrofuloderma, C: TIB, verruca cutis, D: Erythema induratum + ### Response: A (Lupus vulgaris) Lupus vulgaris is the most commonly found form of cutaneous T.B. in adults in a recently published series from India and South Africa and the second most prevalent after Scrofuloderma in a series from U.K. Most common skm tuberculosis | | |Lupus vulgarisScrofuloderma||In adultsIn childrenSccrofuloderma is the commonest form of cutaneous T.B. in childhood in a large series from India and in another series from U.K. ### End" @@ -7451,6 +13327,13 @@ A (Lupus vulgaris) Lupus vulgaris is the most commonly found form of cutaneous T Answer the following medical question: Pancreatic Cancer is caused by:, with the following options: A: Fasciola, B: Clonorchis, C: Paragonimus, D: None +### Response: +","Clonorchis infection causes the bile duct and pancreatic cancer. Ref: Harrison's Principles of Internal Medicine, 15th Edition, Page 591, 1247 ; CMDT, 2002, Page 1504","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pancreatic Cancer is caused by:, with the following options: A: Fasciola, B: Clonorchis, C: Paragonimus, D: None + ### Response: Clonorchis infection causes the bile duct and pancreatic cancer. Ref: Harrison's Principles of Internal Medicine, 15th Edition, Page 591, 1247 ; CMDT, 2002, Page 1504 ### End" @@ -7460,6 +13343,39 @@ Clonorchis infection causes the bile duct and pancreatic cancer. Ref: Harrison's Answer the following medical question: Objectives of National Mental Health programme are all accept –, with the following options: A: Promote community participation, B: Promote application of mental health knowledge, C: Provides free antipsychotic drugs to all, D: Provide accessibility of mental health care +### Response: +","National Mental Health Programme (NMHP) + +The Government of India has launched the National Mental Health Programme in 1982, with the following objectives: + + +To ensure availability and accessibility of minimum mental healthcare for all in the foreseeable future, particularly to the most vulnerable and underprivileged section of the population. +To encourage the application of mental health knowledge in general healthcare and in social development. +To promote community participation in the mental health service development. + + +The District Mental Health Programme (DMHP) was launched under NMHP in the year 1996, which was based on `Bellary Model' with the following components. + + +Early detection and treatment. +Training of general physicians and health workers. +IEC : Public awareness generation. +Monitoring (for simple record keeping). + + +The NMHP was re-strategized in year 2003 with following components:- + + +Extension of DMHP to 100 districts. +Up gradation of psychiatric wing in medical colleges/General hospitals. +Modernization of state mental hospitals. +IEC +Monitoring and evaluation.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Objectives of National Mental Health programme are all accept –, with the following options: A: Promote community participation, B: Promote application of mental health knowledge, C: Provides free antipsychotic drugs to all, D: Provide accessibility of mental health care + ### Response: National Mental Health Programme (NMHP) @@ -7495,6 +13411,13 @@ Monitoring and evaluation. Answer the following medical question: Splanchnic nerves are, with the following options: A: Preganglionic Sympathetic nerves, B: Postganglionic Sympathetic nerves, C: Preganglionic parasympathetic nerves, D: Postganglionic parasympathetic nerves +### Response: +",Splanchnic nerves are preganglionic Sympathetic nerves,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Splanchnic nerves are, with the following options: A: Preganglionic Sympathetic nerves, B: Postganglionic Sympathetic nerves, C: Preganglionic parasympathetic nerves, D: Postganglionic parasympathetic nerves + ### Response: Splanchnic nerves are preganglionic Sympathetic nerves ### End" @@ -7504,6 +13427,13 @@ Splanchnic nerves are preganglionic Sympathetic nerves Answer the following medical question: A highly ionized drug:, with the following options: A: Is excreted mainly by the kidney, B: Can cross the placental barrier easily, C: Is well absorbed from the intestine, D: Accumulates in the cellular lipids +### Response: +","Ans. (A) Is excreted mainly by the kidneys(Ref: KDT 8th/e p36)Ionized molecules cannot cross the biological membranes. Therefore, these are less likely to be absorbed. Entry of these molecules through blood brain barrier and blood placental barrier is also restricted. These drugs cannot be reabsorbed in the nephron, thus are excreted by the kidneys.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A highly ionized drug:, with the following options: A: Is excreted mainly by the kidney, B: Can cross the placental barrier easily, C: Is well absorbed from the intestine, D: Accumulates in the cellular lipids + ### Response: Ans. (A) Is excreted mainly by the kidneys(Ref: KDT 8th/e p36)Ionized molecules cannot cross the biological membranes. Therefore, these are less likely to be absorbed. Entry of these molecules through blood brain barrier and blood placental barrier is also restricted. These drugs cannot be reabsorbed in the nephron, thus are excreted by the kidneys. ### End" @@ -7513,6 +13443,14 @@ Ans. (A) Is excreted mainly by the kidneys(Ref: KDT 8th/e p36)Ionized molecules Answer the following medical question: Irreversible pulpitis leads to:, with the following options: A: Coagulative necrosis., B: Liquefaction necrosis., C: Caseous necrosis., D: All of the above. +### Response: +","Pulpal Necrosis +As stated before, pulp is encased in rigid walls, it has no collateral blood circulation, and its venules and lymphatics collapse under increased tissue pressure. Therefore irreversible pulpitis leads to liquefaction necrosis","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Irreversible pulpitis leads to:, with the following options: A: Coagulative necrosis., B: Liquefaction necrosis., C: Caseous necrosis., D: All of the above. + ### Response: Pulpal Necrosis As stated before, pulp is encased in rigid walls, it has no collateral blood circulation, and its venules and lymphatics collapse under increased tissue pressure. Therefore irreversible pulpitis leads to liquefaction necrosis @@ -7523,6 +13461,13 @@ As stated before, pulp is encased in rigid walls, it has no collateral blood cir Answer the following medical question: Haascheiben cells in epidermis are responsible for ?, with the following options: A: Temperature, B: Proprioception, C: Pressure, D: Touch +### Response: +","Merkel cells or Haascheiben cells are located amongst basal keratinocytes and are mainly found in hairy skin, tactile areas of glabrous skin, taste buds, anal canal, labial epithelium and eccrine sweat glands, all regions of high tactile acuity. Merkel cells are easily identifiable on transmission electron microscopy. They are oval with a long axis of approximately 15 mm, orientated parallel to the basement membrane.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Haascheiben cells in epidermis are responsible for ?, with the following options: A: Temperature, B: Proprioception, C: Pressure, D: Touch + ### Response: Merkel cells or Haascheiben cells are located amongst basal keratinocytes and are mainly found in hairy skin, tactile areas of glabrous skin, taste buds, anal canal, labial epithelium and eccrine sweat glands, all regions of high tactile acuity. Merkel cells are easily identifiable on transmission electron microscopy. They are oval with a long axis of approximately 15 mm, orientated parallel to the basement membrane. ### End" @@ -7532,6 +13477,13 @@ Merkel cells or Haascheiben cells are located amongst basal keratinocytes and ar Answer the following medical question: One Village Health Guide is for population of:, with the following options: A: 1000, B: 5000, C: 10000, D: 50000 +### Response: +",1000,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: One Village Health Guide is for population of:, with the following options: A: 1000, B: 5000, C: 10000, D: 50000 + ### Response: 1000 ### End" @@ -7541,6 +13493,13 @@ Answer the following medical question: One Village Health Guide is for populatio Answer the following medical question: Number of doses of HDCV vaccine required for preexposure prophylaxis ?, with the following options: A: 7, B: 5, C: 3, D: 1 +### Response: +","Ans. is 'c' i.e., 3 Pre-exposure prophylaxis . Persons who run a high risk of repeated exposure such as laboratory staff working with rabies virus, veterinarian, animal handlers and wild -life officers should be protected by pre-exposure immunization. . Cell-culture vaccine given on days 0, 7 and 28 (Total 3 doses) . Fuher booster should be given at intervals of 2 years.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Number of doses of HDCV vaccine required for preexposure prophylaxis ?, with the following options: A: 7, B: 5, C: 3, D: 1 + ### Response: Ans. is 'c' i.e., 3 Pre-exposure prophylaxis . Persons who run a high risk of repeated exposure such as laboratory staff working with rabies virus, veterinarian, animal handlers and wild -life officers should be protected by pre-exposure immunization. . Cell-culture vaccine given on days 0, 7 and 28 (Total 3 doses) . Fuher booster should be given at intervals of 2 years. ### End" @@ -7550,6 +13509,13 @@ Ans. is 'c' i.e., 3 Pre-exposure prophylaxis . Persons who run a high risk of re Answer the following medical question: Drug of choice for exo-erythrocystic stage of malaria is ?, with the following options: A: Chloroquine, B: Primaquine, C: Proguanil, D: Mefloquine +### Response: +","Ans. is 'b' i.e., Primaquine","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Drug of choice for exo-erythrocystic stage of malaria is ?, with the following options: A: Chloroquine, B: Primaquine, C: Proguanil, D: Mefloquine + ### Response: Ans. is 'b' i.e., Primaquine ### End" @@ -7559,6 +13525,13 @@ Ans. is 'b' i.e., Primaquine Answer the following medical question: Ayoung lady presentwith symptoms ofUrinary TVact Infection. All of the following findings on a midstream urine sample suppo the diagnosis of 'UncomplicatedAcute Cystitis', Except -, with the following options: A: Positive Nitrite Test, B: CFU count < 1000/ml, C: Detection of one bacteria/ field on Gram stain, D: )>10WBC/HPF +### Response: +","Acute uncomplicated cystitis in women is defined as an uncomplicated lower UTI in a pre-menopausal, non-pregnant woman with no known urological abnormalities or comorbidities. Classical lower urinary tract symptoms include dysuria, urinary frequency, urgency and sometimes haematuria . Ref Harrison20th edition pg 233","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ayoung lady presentwith symptoms ofUrinary TVact Infection. All of the following findings on a midstream urine sample suppo the diagnosis of 'UncomplicatedAcute Cystitis', Except -, with the following options: A: Positive Nitrite Test, B: CFU count < 1000/ml, C: Detection of one bacteria/ field on Gram stain, D: )>10WBC/HPF + ### Response: Acute uncomplicated cystitis in women is defined as an uncomplicated lower UTI in a pre-menopausal, non-pregnant woman with no known urological abnormalities or comorbidities. Classical lower urinary tract symptoms include dysuria, urinary frequency, urgency and sometimes haematuria . Ref Harrison20th edition pg 233 ### End" @@ -7568,6 +13541,13 @@ Acute uncomplicated cystitis in women is defined as an uncomplicated lower UTI i Answer the following medical question: What is the most likely diagnosis in this patient who was having difficulty swallowing?, with the following options: A: Amyloidosis, B: Amyotrophic lateral sclerosis, C: Pellagra, D: Pernicious anemia +### Response: +","Answer B. Amyotrophic lateral sclerosisWith his difficulty swallowing, the patient's tongue atrophy represents a bulbar symptom, and is most consistent with a diagnosis of amyotrophic lateral sclerosis (ALS). The patient also had clinical and neurophysiological evidence of upper-motor-neuron and lower-motor-neuron involvement, which supported the diagnosis. ALS is associated with dysarthria, hypophonia, dysphagia, and sialorrhea in addition to relentlessly progressive disability.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What is the most likely diagnosis in this patient who was having difficulty swallowing?, with the following options: A: Amyloidosis, B: Amyotrophic lateral sclerosis, C: Pellagra, D: Pernicious anemia + ### Response: Answer B. Amyotrophic lateral sclerosisWith his difficulty swallowing, the patient's tongue atrophy represents a bulbar symptom, and is most consistent with a diagnosis of amyotrophic lateral sclerosis (ALS). The patient also had clinical and neurophysiological evidence of upper-motor-neuron and lower-motor-neuron involvement, which supported the diagnosis. ALS is associated with dysarthria, hypophonia, dysphagia, and sialorrhea in addition to relentlessly progressive disability. ### End" @@ -7577,6 +13557,13 @@ Answer B. Amyotrophic lateral sclerosisWith his difficulty swallowing, the patie Answer the following medical question: Angle of humeral torsion is ___ degrees?, with the following options: A: 15, B: 35, C: 135, D: 164 +### Response: +","Ans. D 164Ref: Vishram Singh, vol-1: 2nd ed. pg. 22* Angle of humeral torsion is 164 degrees in contrast to femoral torsion of 15 degrees.* The angle of humeral torsion is due to angulation between the long axis of articular surface of the upper and lower ends of humerus. This is because the upper end appears to have rotated laterally","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Angle of humeral torsion is ___ degrees?, with the following options: A: 15, B: 35, C: 135, D: 164 + ### Response: Ans. D 164Ref: Vishram Singh, vol-1: 2nd ed. pg. 22* Angle of humeral torsion is 164 degrees in contrast to femoral torsion of 15 degrees.* The angle of humeral torsion is due to angulation between the long axis of articular surface of the upper and lower ends of humerus. This is because the upper end appears to have rotated laterally ### End" @@ -7586,6 +13573,13 @@ Ans. D 164Ref: Vishram Singh, vol-1: 2nd ed. pg. 22* Angle of humeral torsion is Answer the following medical question: RS cells are seen in?, with the following options: A: Hodgkin's disease, B: Sickle cell anaemia, C: Thalasemia, D: CML +### Response: +","Ans. is 'a' i.e., Hodgkin's disease * Hodgkin's disease is characterized by presence of Reed-sternberg cells (Classical Reed-sternberg cells) and its variants. RS cells are derived from B-cells of germinal center and induce accumulation of reactive, lymphocytes, histiocytes (macrophages) and granulocytes.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: RS cells are seen in?, with the following options: A: Hodgkin's disease, B: Sickle cell anaemia, C: Thalasemia, D: CML + ### Response: Ans. is 'a' i.e., Hodgkin's disease * Hodgkin's disease is characterized by presence of Reed-sternberg cells (Classical Reed-sternberg cells) and its variants. RS cells are derived from B-cells of germinal center and induce accumulation of reactive, lymphocytes, histiocytes (macrophages) and granulocytes. ### End" @@ -7595,6 +13589,13 @@ Ans. is 'a' i.e., Hodgkin's disease * Hodgkin's disease is characterized by pres Answer the following medical question: Tokyo guidelines are used to assess severity of which condition, with the following options: A: Peptic ulcer disease, B: GERD, C: Cholecystitis, D: IBD +### Response: +","Tokyo guidelines are used in diagnosing, assessing severity and treatment of cholecystitis and cholangitis.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Tokyo guidelines are used to assess severity of which condition, with the following options: A: Peptic ulcer disease, B: GERD, C: Cholecystitis, D: IBD + ### Response: Tokyo guidelines are used in diagnosing, assessing severity and treatment of cholecystitis and cholangitis. ### End" @@ -7604,6 +13605,13 @@ Tokyo guidelines are used in diagnosing, assessing severity and treatment of cho Answer the following medical question: Treatment of choice for antrochoanal polyp -, with the following options: A: Caldwell Luc operation, B: Intranasal polypectomy, C: Endoscopic removal, D: None of the above +### Response: +","Ans. is 'c' i.e., Endoscopic removal Treatment of antrochoanal polyp o There is no medical treatment for antrochoanal polyp. The treatment of choice is complete surgical removal of polyp along with removal of lining of maxillary sinus to prevent the recurrence. Surgeries for antrochoanal polyp include Avulsion of a polyp The stalk of the polyp is grasped and gently moved around to tease out the antral lining. Most of the time, avulsion fails to remove the polyp and antral lining completely. I ntranasal polypectomy It was the treatment of choice for all age groups prior to the advent of endoscopic sinus surgery and is still the treatment of choice in those setups where endoscopic surgery is not practised. Caldwell Luc operation It is indicated if there is a recurrence and the age of the patient is more than 17 years. Now a days with FESS available - Caldwell luc operation is avoided. Functional endoscopic sinus surgery (FESS) This is the treatment of choice for all polyps, whenever available and has superceded other methods of polyp removal.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Treatment of choice for antrochoanal polyp -, with the following options: A: Caldwell Luc operation, B: Intranasal polypectomy, C: Endoscopic removal, D: None of the above + ### Response: Ans. is 'c' i.e., Endoscopic removal Treatment of antrochoanal polyp o There is no medical treatment for antrochoanal polyp. The treatment of choice is complete surgical removal of polyp along with removal of lining of maxillary sinus to prevent the recurrence. Surgeries for antrochoanal polyp include Avulsion of a polyp The stalk of the polyp is grasped and gently moved around to tease out the antral lining. Most of the time, avulsion fails to remove the polyp and antral lining completely. I ntranasal polypectomy It was the treatment of choice for all age groups prior to the advent of endoscopic sinus surgery and is still the treatment of choice in those setups where endoscopic surgery is not practised. Caldwell Luc operation It is indicated if there is a recurrence and the age of the patient is more than 17 years. Now a days with FESS available - Caldwell luc operation is avoided. Functional endoscopic sinus surgery (FESS) This is the treatment of choice for all polyps, whenever available and has superceded other methods of polyp removal. ### End" @@ -7613,6 +13621,13 @@ Ans. is 'c' i.e., Endoscopic removal Treatment of antrochoanal polyp o There is Answer the following medical question: Kallu, a 22 year old male had an outing with his friends and developed fever of 38.5 degree C, diarrhoea and vomiting following eating chicken salad. 24 hours back. Two of his friends developed the same symptoms. The diagnosis is -, with the following options: A: Salmonella enteritis poisoning, B: Bacillus cereus, C: Staphylococcus aureus, D: Vibrio cholera +### Response: +","Ans. is 'a' i.e., Salmonella enteritis poisoning o Food poisoning in this child has following features : - i) IP --> 24 hours ii) Fever present iii) Diarrhea present iv) Vomiting present o Amongst the given options, only salmonella food poisoning can produce these features : o Commonly asked bacterial food poisoning. Organism Symptoms Food soure Incubation period 1. Staph aureus Diarrhea, Vomiting, No fever Meat, dairy & poultry product 1-6 hrs 2. Bacillus cereus Vomiting, diarrhea, No fever Fried rice (emetic type) Incubation period 8-16 hrs 1. Bacillus cereus (diarrheal type) Diarrhea, no vomiting, no fever wide range --> meat vegetables, cereals 2. Cl. perfringens Diarrhea, no vomiting, no fever Beef, poultry, legumes Incubation period 1. V. cholerae Diarrhea, vomiting, No fever wide range of food > 16 hrs 2. V. Parahemolyticus Diarrhea, vomiting, fever Sae food 3. Salmonella species Diarrhea, fever, rarely vomiting Beef, Paultry, eggs, dairy products 4. Shigella species Diarrhea, fever rarely vomiting Potato or egg salad, raw vegetables 5. Campylobacter jejuni Diarrhea, fever, no vomiting Paultry raw milk","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Kallu, a 22 year old male had an outing with his friends and developed fever of 38.5 degree C, diarrhoea and vomiting following eating chicken salad. 24 hours back. Two of his friends developed the same symptoms. The diagnosis is -, with the following options: A: Salmonella enteritis poisoning, B: Bacillus cereus, C: Staphylococcus aureus, D: Vibrio cholera + ### Response: Ans. is 'a' i.e., Salmonella enteritis poisoning o Food poisoning in this child has following features : - i) IP --> 24 hours ii) Fever present iii) Diarrhea present iv) Vomiting present o Amongst the given options, only salmonella food poisoning can produce these features : o Commonly asked bacterial food poisoning. Organism Symptoms Food soure Incubation period 1. Staph aureus Diarrhea, Vomiting, No fever Meat, dairy & poultry product 1-6 hrs 2. Bacillus cereus Vomiting, diarrhea, No fever Fried rice (emetic type) Incubation period 8-16 hrs 1. Bacillus cereus (diarrheal type) Diarrhea, no vomiting, no fever wide range --> meat vegetables, cereals 2. Cl. perfringens Diarrhea, no vomiting, no fever Beef, poultry, legumes Incubation period 1. V. cholerae Diarrhea, vomiting, No fever wide range of food > 16 hrs 2. V. Parahemolyticus Diarrhea, vomiting, fever Sae food 3. Salmonella species Diarrhea, fever, rarely vomiting Beef, Paultry, eggs, dairy products 4. Shigella species Diarrhea, fever rarely vomiting Potato or egg salad, raw vegetables 5. Campylobacter jejuni Diarrhea, fever, no vomiting Paultry raw milk ### End" @@ -7622,6 +13637,13 @@ Ans. is 'a' i.e., Salmonella enteritis poisoning o Food poisoning in this child Answer the following medical question: A neonate presents with features of hea failure. On examination anterior fontanelle was found to be bulging. On auscultation, a cranial bruit was heard. A CT angiography done showed the following: Which vessel is mainly involved in this abnormality?, with the following options: A: Median prosencephalic vein, B: Vein of Galen, C: Entire circle of willis, D: Choroid plexus +### Response: +","- History of features of hea failure, bulging anterior fontanelle, cranial bruit & image given suggests the diagnosis of VEIN OF GALEN MALFORMATION - Vessel involved is - Median prosencephalic vein of markowsky (precursor of vein of Galen) - Onset - 11-13 weeks of gestation","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A neonate presents with features of hea failure. On examination anterior fontanelle was found to be bulging. On auscultation, a cranial bruit was heard. A CT angiography done showed the following: Which vessel is mainly involved in this abnormality?, with the following options: A: Median prosencephalic vein, B: Vein of Galen, C: Entire circle of willis, D: Choroid plexus + ### Response: - History of features of hea failure, bulging anterior fontanelle, cranial bruit & image given suggests the diagnosis of VEIN OF GALEN MALFORMATION - Vessel involved is - Median prosencephalic vein of markowsky (precursor of vein of Galen) - Onset - 11-13 weeks of gestation ### End" @@ -7631,6 +13653,13 @@ Answer the following medical question: A neonate presents with features of hea f Answer the following medical question: Polyglandular syndrome (Schmidt syndrome) is associated with adrenocortical deficiency and which of the following conditions?, with the following options: A: Graves disease, B: Hypoparathyroidism, C: Hashimoto's thyroiditis, D: Islet cell adenoma +### Response: +","Ref: Harrison's Principles of Internal Medicine, IHed; Harrison's Online > Chapter 351. Disorders Affecting Multiple Endocrine Systems.Explanation:Immunologic Syndromes Affecting Multiple Endocrine OrgansWhen immune dysfunction affects two or more endocrine glands and other nonendocrine immune disorders are present, the polyglandular autoimmune (PGA) syndromes should be considered.The PGA syndromes are classified as two main types:Type I syndrome starts in childhood and is characterized by mucocutaneous candidiasis. hypoparathyroidism, and adrenal insufficiencyType II, or Schmidt syndrome is more likely to present in adults and most commonly includes adrenal insufficiency, thyroiditis, or type / diabetes mellitus & Graves diseaseFeatures of Polyglandular Autoimmune (PGA) SyndromesPGA I syndromePGA II syndrome (Schmidt syndrome)EpidemiologyAutosomal recessivePolvaenic inheritanceMutations in APECED geneHLA-DR3 and HLA-DR4 associatedChildhood onsetAdult onsetEqual male: female ratioFemale predominanceDisease Associations Mucocutaneous candidiasisAdrenal insufficiencyHypoparathyroidismHypothyroidismAdrenal insufficiencyGraves' diseaseHypogonadismAlopeciaType 1 diabetes HypoqonadnsmHypothyroidismHypophysitisDental enamel hypoplasiaMyasthenia gravisMalabsorptionVitiligoChronic active hepatitisAlopeciaVitiligoPernicious anemiaPernicious anemiaCeNac diseaseAPECED - Autoimmune polyendocrinopathy- candidiasis-ectodermal dystrophy.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Polyglandular syndrome (Schmidt syndrome) is associated with adrenocortical deficiency and which of the following conditions?, with the following options: A: Graves disease, B: Hypoparathyroidism, C: Hashimoto's thyroiditis, D: Islet cell adenoma + ### Response: Ref: Harrison's Principles of Internal Medicine, IHed; Harrison's Online > Chapter 351. Disorders Affecting Multiple Endocrine Systems.Explanation:Immunologic Syndromes Affecting Multiple Endocrine OrgansWhen immune dysfunction affects two or more endocrine glands and other nonendocrine immune disorders are present, the polyglandular autoimmune (PGA) syndromes should be considered.The PGA syndromes are classified as two main types:Type I syndrome starts in childhood and is characterized by mucocutaneous candidiasis. hypoparathyroidism, and adrenal insufficiencyType II, or Schmidt syndrome is more likely to present in adults and most commonly includes adrenal insufficiency, thyroiditis, or type / diabetes mellitus & Graves diseaseFeatures of Polyglandular Autoimmune (PGA) SyndromesPGA I syndromePGA II syndrome (Schmidt syndrome)EpidemiologyAutosomal recessivePolvaenic inheritanceMutations in APECED geneHLA-DR3 and HLA-DR4 associatedChildhood onsetAdult onsetEqual male: female ratioFemale predominanceDisease Associations Mucocutaneous candidiasisAdrenal insufficiencyHypoparathyroidismHypothyroidismAdrenal insufficiencyGraves' diseaseHypogonadismAlopeciaType 1 diabetes HypoqonadnsmHypothyroidismHypophysitisDental enamel hypoplasiaMyasthenia gravisMalabsorptionVitiligoChronic active hepatitisAlopeciaVitiligoPernicious anemiaPernicious anemiaCeNac diseaseAPECED - Autoimmune polyendocrinopathy- candidiasis-ectodermal dystrophy. ### End" @@ -7640,6 +13669,13 @@ Ref: Harrison's Principles of Internal Medicine, IHed; Harrison's Online > Chapt Answer the following medical question: A fifty-year-old man presents to his practitioner complaining that he often feels as if the room is spinning when he gets up from a recumbent position or turns his head. He has not lost consciousness and has had no chest pain. He has no cardiac history and a recent treadmill test showed no abnormalities. On examination, the sensation can be produced by rapidly turning the head. It can be reproduced many times, but it eventually ceases. Nystagmus is elicited. Hearing is normal. Which of the following is the most likely diagnosis?, with the following options: A: Benign paroxysmal positional veigo, B: Brain stem tumor, C: Meniere's disease, D: Syncope +### Response: +","Benign paroxysmal positional veigo (BPPV) is veigo that is precipitated by head position. It can be precipitated by trauma, but often no precipitating factor is identified. It generally abates after weeks to months. On exam, patients display nystagmus and the symptoms can be reproduced by head movement. In addition, the symptoms show latency, fatigability and habituation. Brain stem tumor and veebrobasilar TIA are causes of central causes of veigo, but would often be associated with other neurologic findings. Meniere disease displays the classic triad of unilateral tinnitus, unilateral deafness, and paroxysmal veigo. Since the patient has normal hearing, this is unlikely to be Meniere syndrome, although hearing loss may not manifest until later stages of the disease. Syncope is defined as transient loss of consciousness of cardiovascular origin. Thus since the patient has a lack of other cardiovascular symptoms and has not lost consciousness, this is not syncope.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A fifty-year-old man presents to his practitioner complaining that he often feels as if the room is spinning when he gets up from a recumbent position or turns his head. He has not lost consciousness and has had no chest pain. He has no cardiac history and a recent treadmill test showed no abnormalities. On examination, the sensation can be produced by rapidly turning the head. It can be reproduced many times, but it eventually ceases. Nystagmus is elicited. Hearing is normal. Which of the following is the most likely diagnosis?, with the following options: A: Benign paroxysmal positional veigo, B: Brain stem tumor, C: Meniere's disease, D: Syncope + ### Response: Benign paroxysmal positional veigo (BPPV) is veigo that is precipitated by head position. It can be precipitated by trauma, but often no precipitating factor is identified. It generally abates after weeks to months. On exam, patients display nystagmus and the symptoms can be reproduced by head movement. In addition, the symptoms show latency, fatigability and habituation. Brain stem tumor and veebrobasilar TIA are causes of central causes of veigo, but would often be associated with other neurologic findings. Meniere disease displays the classic triad of unilateral tinnitus, unilateral deafness, and paroxysmal veigo. Since the patient has normal hearing, this is unlikely to be Meniere syndrome, although hearing loss may not manifest until later stages of the disease. Syncope is defined as transient loss of consciousness of cardiovascular origin. Thus since the patient has a lack of other cardiovascular symptoms and has not lost consciousness, this is not syncope. ### End" @@ -7649,19 +13685,61 @@ Benign paroxysmal positional veigo (BPPV) is veigo that is precipitated by head Answer the following medical question: Maraviroc acts as:, with the following options: A: Reverse transcriptase inhibitor, B: Protease inhibitor, C: Entry inhibitor, D: None of the above +### Response: +","Maraviroc binds specifically and selectively to CCR5, one of two coreceptors necessary for entrance of HIV into CD4+ cells, thus blocking entry of CCR5-tropic HIV into these cells. Ref: Katzung 11th edition Chapter 49.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Maraviroc acts as:, with the following options: A: Reverse transcriptase inhibitor, B: Protease inhibitor, C: Entry inhibitor, D: None of the above + ### Response: Maraviroc binds specifically and selectively to CCR5, one of two coreceptors necessary for entrance of HIV into CD4+ cells, thus blocking entry of CCR5-tropic HIV into these cells. Ref: Katzung 11th edition Chapter 49. ### End" 805,"Below is an instruction that describes a task. Write a response that appropriately completes the request. -### Instruction: +### Instruction: + +Answer the following medical question: A 28 year old boy met with on accident and sustained severe crush injury. He is most likely to develop:, with the following options: A: Acute Renal Failure, B: Hypophosphatemia, C: Hypercalcemia, D: Acute Myocardial Infarction + +### Response: +",Answer is A (Acute Renal Failure): Acute Renal failure is an established complication of crush syndrome. Acute Renal Failure is usually caused by a combination of hypovolemia and release of nephrotoxic substances into the circulation such as myoglobin Crush syndrome is associated with hvpocalcemia and hvperphosphatemia Note Crush syndrome is associated with Hypocalcemia and not hypercalcemia. of calcium into muscle calls through leaky sarcolemmal membranes.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 28 year old boy met with on accident and sustained severe crush injury. He is most likely to develop:, with the following options: A: Acute Renal Failure, B: Hypophosphatemia, C: Hypercalcemia, D: Acute Myocardial Infarction + +### Response: +Answer is A (Acute Renal Failure): Acute Renal failure is an established complication of crush syndrome. Acute Renal Failure is usually caused by a combination of hypovolemia and release of nephrotoxic substances into the circulation such as myoglobin Crush syndrome is associated with hvpocalcemia and hvperphosphatemia Note Crush syndrome is associated with Hypocalcemia and not hypercalcemia. of calcium into muscle calls through leaky sarcolemmal membranes. +### End" +806,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: According to Rule of Nine , burns involving perineum are, with the following options: A: 1%, B: 9%, C: 18%, D: 27% + +### Response: +","BURNS in % BSA + +Determination of burn size estimates the extent of injury. +Burn size is assessed by Wallace rule of nines (By Alfred Russel Wallace) + +Wallace Rule of Nines + +In adults: + +- Each upper extremity: 9% +- Head and neck: 9% +- Lower extremities: 18% +- Anterior and posterior aspects of the trunk: 18% +- Perineum and genitalia: 1% + +Children have a relatively larger proportion of body surface area in their head and neck, which is compensated by a relatively smaller surface area in the lower extremities. -Answer the following medical question: A 28 year old boy met with on accident and sustained severe crush injury. He is most likely to develop:, with the following options: A: Acute Renal Failure, B: Hypophosphatemia, C: Hypercalcemia, D: Acute Myocardial Infarction +- In infants: Head and neck- 21%; Each leg-13% -### Response: -Answer is A (Acute Renal Failure): Acute Renal failure is an established complication of crush syndrome. Acute Renal Failure is usually caused by a combination of hypovolemia and release of nephrotoxic substances into the circulation such as myoglobin Crush syndrome is associated with hvpocalcemia and hvperphosphatemia Note Crush syndrome is associated with Hypocalcemia and not hypercalcemia. of calcium into muscle calls through leaky sarcolemmal membranes. -### End" -806,"Below is an instruction that describes a task. Write a response that appropriately completes the request. +Berkow formula is used to accurately determine burn size in children. +For estimating smaller burns: Area of open hand (including palm and extended fingers) of the patient is approximately 1% of TBSA. +This method is helpful in evaluating splash burns and burns of mixed distribution.","Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: @@ -7697,6 +13775,13 @@ This method is helpful in evaluating splash burns and burns of mixed distributio Answer the following medical question: A patient has normal anterior chamber and hazy cornea in one eye and shallow ant chamber and miotic pupil in fellow eye. the diagnosis is :, with the following options: A: Endopthalmitis, B: Acute congestive glaucoma, C: Chronic simple glaucoma, D: Acute anterior uveitis +### Response: +",D i.e. Acute anterior uveitis,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A patient has normal anterior chamber and hazy cornea in one eye and shallow ant chamber and miotic pupil in fellow eye. the diagnosis is :, with the following options: A: Endopthalmitis, B: Acute congestive glaucoma, C: Chronic simple glaucoma, D: Acute anterior uveitis + ### Response: D i.e. Acute anterior uveitis ### End" @@ -7706,6 +13791,13 @@ D i.e. Acute anterior uveitis Answer the following medical question: All of the following shows antigen virulence factor EXCEPT, with the following options: A: Corynebacterium diphtheriae, B: Inflarial parasites, C: Borrelia species, D: Malarial parasites +### Response: +","i.e. (C-diphtheriae):ANTIGENIC VARIATION* It is the process by which an infectious organism alters its surface proteins in order to evade a host immune response* Antigenic variation enables viruses to cross the species barrier eg H5N1 virus 'Jumping' from birds to then infect humans* Antigenic variation can occur through three broadly defined genetic processes: gene mutation, recombination and switching(I) Bacteria - best demonstrated by - species of the genus Neisseria N. meningitidis and N. gonorrhoeal, the gonococcus) Borrelia recurrentis that causes relapsing fever, species of the genus streptococcus and the Myeoplasma(II) Virus - best demonstrated : by HIV, Influenza virus and Hepatitis C virus, rhinovirus and entero viruses(III) Protozoa is best demonstrated by species of Plasmodium Trypanosomes (T. cruzi causes chagas disease and T. brucei gambience and T. brucei rhodesiense causes African Sleeping Sickness)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following shows antigen virulence factor EXCEPT, with the following options: A: Corynebacterium diphtheriae, B: Inflarial parasites, C: Borrelia species, D: Malarial parasites + ### Response: i.e. (C-diphtheriae):ANTIGENIC VARIATION* It is the process by which an infectious organism alters its surface proteins in order to evade a host immune response* Antigenic variation enables viruses to cross the species barrier eg H5N1 virus 'Jumping' from birds to then infect humans* Antigenic variation can occur through three broadly defined genetic processes: gene mutation, recombination and switching(I) Bacteria - best demonstrated by - species of the genus Neisseria N. meningitidis and N. gonorrhoeal, the gonococcus) Borrelia recurrentis that causes relapsing fever, species of the genus streptococcus and the Myeoplasma(II) Virus - best demonstrated : by HIV, Influenza virus and Hepatitis C virus, rhinovirus and entero viruses(III) Protozoa is best demonstrated by species of Plasmodium Trypanosomes (T. cruzi causes chagas disease and T. brucei gambience and T. brucei rhodesiense causes African Sleeping Sickness) ### End" @@ -7715,6 +13807,13 @@ i.e. (C-diphtheriae):ANTIGENIC VARIATION* It is the process by which an infectio Answer the following medical question: Young operation is used in?, with the following options: A: Allergic rhinitis, B: Vasomotor rhinitis, C: Atropic rhinitis, D: Lupus vulgaris +### Response: +","Ans. is 'c' i.e., Atropic rhinitis Treatment of Atrophic rhinitis It may be medical or surgical Medical treatment Nasal irrigation and removal of crusts by warm normal saline or warm nasal alkaline douche made up of sodium bicarbonate, sodium biborate and sodium chloride in water. 25 % glucose in glycerine : Following removal of the crust the nose is painted with 25% glucose in glycerine. Glucose-Inhibits proteolytic organisms, Glycerine is a hygroscopic agent. Other local antibiotics : Kemicetine antiozaena solution : 1 ml contains chloramphenicol (90 mg), estradiol dipropionate (0.64 mg), vit D2 (900 IU) and propylene glycol. o Potassium iodide : By mouth to increase the nasal secretion. Human placental extract is given in the form of submucosal injections. Other drugs : Rifampicin, Streptomycin to decreases the odour and crusts. Oestradiol spray to Tvascularity of nasal mucosa. Placental extract injected submucosally. Surgical treatment 1. Young's operation Closure of both the nostril following elevation of the nasal vestibular folds. They are opened after 6 months. 2. Modified Young's operation Paial closure of the nostril leaving behind a 3 mm hole. This remains for a period of 2 years. 3. Narrowing of the nasal cavity by (Lautenslagers operation) ? Submucosal injection of teflon paste Inseion of fat, cailage, bone or teflon strips under the mucoperiosteum of floor & lateral wall of nose. Section and medial displacement of lateral wall of nose. 4. Lautenslagers operation Surgical procedures aimed at medializing the lateral nasal wall using substances like : Paraffin, teflon, Polythere cailage.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Young operation is used in?, with the following options: A: Allergic rhinitis, B: Vasomotor rhinitis, C: Atropic rhinitis, D: Lupus vulgaris + ### Response: Ans. is 'c' i.e., Atropic rhinitis Treatment of Atrophic rhinitis It may be medical or surgical Medical treatment Nasal irrigation and removal of crusts by warm normal saline or warm nasal alkaline douche made up of sodium bicarbonate, sodium biborate and sodium chloride in water. 25 % glucose in glycerine : Following removal of the crust the nose is painted with 25% glucose in glycerine. Glucose-Inhibits proteolytic organisms, Glycerine is a hygroscopic agent. Other local antibiotics : Kemicetine antiozaena solution : 1 ml contains chloramphenicol (90 mg), estradiol dipropionate (0.64 mg), vit D2 (900 IU) and propylene glycol. o Potassium iodide : By mouth to increase the nasal secretion. Human placental extract is given in the form of submucosal injections. Other drugs : Rifampicin, Streptomycin to decreases the odour and crusts. Oestradiol spray to Tvascularity of nasal mucosa. Placental extract injected submucosally. Surgical treatment 1. Young's operation Closure of both the nostril following elevation of the nasal vestibular folds. They are opened after 6 months. 2. Modified Young's operation Paial closure of the nostril leaving behind a 3 mm hole. This remains for a period of 2 years. 3. Narrowing of the nasal cavity by (Lautenslagers operation) ? Submucosal injection of teflon paste Inseion of fat, cailage, bone or teflon strips under the mucoperiosteum of floor & lateral wall of nose. Section and medial displacement of lateral wall of nose. 4. Lautenslagers operation Surgical procedures aimed at medializing the lateral nasal wall using substances like : Paraffin, teflon, Polythere cailage. ### End" @@ -7724,6 +13823,13 @@ Ans. is 'c' i.e., Atropic rhinitis Treatment of Atrophic rhinitis It may be medi Answer the following medical question: Acanthosis nigricans is seen in ?, with the following options: A: Diabetes, B: GIT cancer, C: Hypothyroidism, D: All of the above +### Response: +","Ans. is 'd' i.e., All of the above Acanthosis nigricans Acanthosis nigricans is a brown to black, velvety hyperpigmentation of the skin. It is usually found in body folds, such as posterior & lateral folds of neck, axilla, groin, umblicus, forehead. It typically occurs in individuals younger than 40 years of age. Histopathologically papillomatosis is characteristically seen; however, there is no hypermelanosis and there is only mild acanthosis, if present. It is associated with Obesity (most common) Endocrinopathies --> Hypothyroidism, hypehyroidism, insuline resistance diabetes, Cushing's disease, PCOD, Bloom syndrome. Internal malignancy --> Gastric adenocarcinoma","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Acanthosis nigricans is seen in ?, with the following options: A: Diabetes, B: GIT cancer, C: Hypothyroidism, D: All of the above + ### Response: Ans. is 'd' i.e., All of the above Acanthosis nigricans Acanthosis nigricans is a brown to black, velvety hyperpigmentation of the skin. It is usually found in body folds, such as posterior & lateral folds of neck, axilla, groin, umblicus, forehead. It typically occurs in individuals younger than 40 years of age. Histopathologically papillomatosis is characteristically seen; however, there is no hypermelanosis and there is only mild acanthosis, if present. It is associated with Obesity (most common) Endocrinopathies --> Hypothyroidism, hypehyroidism, insuline resistance diabetes, Cushing's disease, PCOD, Bloom syndrome. Internal malignancy --> Gastric adenocarcinoma ### End" @@ -7733,6 +13839,13 @@ Ans. is 'd' i.e., All of the above Acanthosis nigricans Acanthosis nigricans is Answer the following medical question: Which of the following drugs is to treat postoperative shivering?, with the following options: A: Ondansetron, B: Diclofenac Sodium, C: Pethidine, D: Paracetamol +### Response: +","Ans. is 'c' i.e., Pethidine ""Unlike other opioid agonists, meperidine (pethidine) frequently terminates shivering regardless of the cause"". - MorganPost - anaesthesia shiveringo Shivering is a protective mechanism against heat loss caused by anaesthesia. As shivering is controlled by hypothalamus, it can be abolished by inhibition of hypothalamus.o Shivering increases metabolic rate and increases O2 consumption to 100-200% (1-2 times).o Post - anaesthesia shivering occurs most commonly with halothane ie. Halothane shakes.o Treatment:- Opioid agonist mepridine (pethidine) frequently terminates the shivering regardless of the cause. Chlorpromazine and butorphanol are also effective. Other drugs which can be used are clonidine, ketanserin, tramadol, physostigmine, nefopam, dexmedetamidine & Magnesium sulfate. These agents have specific action on thermoregulatory center in the hypothalamus. As oxygen consumption increases during shivering, supplemental oxygen therapy (high FiO2) is mandatory.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following drugs is to treat postoperative shivering?, with the following options: A: Ondansetron, B: Diclofenac Sodium, C: Pethidine, D: Paracetamol + ### Response: Ans. is 'c' i.e., Pethidine ""Unlike other opioid agonists, meperidine (pethidine) frequently terminates shivering regardless of the cause"". - MorganPost - anaesthesia shiveringo Shivering is a protective mechanism against heat loss caused by anaesthesia. As shivering is controlled by hypothalamus, it can be abolished by inhibition of hypothalamus.o Shivering increases metabolic rate and increases O2 consumption to 100-200% (1-2 times).o Post - anaesthesia shivering occurs most commonly with halothane ie. Halothane shakes.o Treatment:- Opioid agonist mepridine (pethidine) frequently terminates the shivering regardless of the cause. Chlorpromazine and butorphanol are also effective. Other drugs which can be used are clonidine, ketanserin, tramadol, physostigmine, nefopam, dexmedetamidine & Magnesium sulfate. These agents have specific action on thermoregulatory center in the hypothalamus. As oxygen consumption increases during shivering, supplemental oxygen therapy (high FiO2) is mandatory. ### End" @@ -7742,6 +13855,13 @@ Ans. is 'c' i.e., Pethidine ""Unlike other opioid agonists, meperidine (pethidin Answer the following medical question: Randomized controlled trials are -, with the following options: A: Clinical trials, B: Preventive trials, C: Before and after comparison studies, D: Evaluation of Health Services +### Response: +","Ans. is 'a' i.e., Clincial trials","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Randomized controlled trials are -, with the following options: A: Clinical trials, B: Preventive trials, C: Before and after comparison studies, D: Evaluation of Health Services + ### Response: Ans. is 'a' i.e., Clincial trials ### End" @@ -7755,6 +13875,21 @@ Answer the following medical question: Type (s) of Inflammatory bowel disease is (C)Toxic Coltis (D)Amoebic coltis, with the following options: A: AB, B: CD, C: CE, D: DA +### Response: +","""'Inflammatory bowel disease (IBD) Q is an immune-mediated chronic intestinal condition. +Ulcerative colitis (UC) and Crohn's disease (CD) are the two major types of IBD""- Harrison 17th/1886 Forms of Inflammatory bowel disease disease +The main forms of IBD are Crohn’s disease and ulcerative colitis (UC). +Accounting for far fewer cases are other forms of IBD, +which are not always classified as typical IBD: Collagenous colitis Lymphocytic colitis Ischaemic colitis Diversion colitis Behcet’s disease indeterminate","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Type (s) of Inflammatory bowel disease is/are: +(A)Crohn's disease +(B)Ulcerave Coltis +(C)Toxic Coltis +(D)Amoebic coltis, with the following options: A: AB, B: CD, C: CE, D: DA + ### Response: ""'Inflammatory bowel disease (IBD) Q is an immune-mediated chronic intestinal condition. Ulcerative colitis (UC) and Crohn's disease (CD) are the two major types of IBD""- Harrison 17th/1886 Forms of Inflammatory bowel disease disease @@ -7768,6 +13903,13 @@ which are not always classified as typical IBD: Collagenous colitis Lymphocytic Answer the following medical question: A person who is running, the main source of energy he will be using in 1st min is:, with the following options: A: Glucose, B: Glycogen, C: Fat, D: Phosphagen +### Response: +","""The major sources of energy in the 100-m sprint are creatine phosphate (first 4-5 sec) and then anaerobic glycolysis using muscle glycogen as the source of glucose.""","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A person who is running, the main source of energy he will be using in 1st min is:, with the following options: A: Glucose, B: Glycogen, C: Fat, D: Phosphagen + ### Response: ""The major sources of energy in the 100-m sprint are creatine phosphate (first 4-5 sec) and then anaerobic glycolysis using muscle glycogen as the source of glucose."" ### End" @@ -7777,6 +13919,13 @@ Answer the following medical question: A person who is running, the main source Answer the following medical question: Which of the following electrolyte abnormalities can be seen after brain injury?, with the following options: A: Hyponatremia, B: Hyperkalemia, C: Hypomagnesemia, D: All the above +### Response: +","Ans. is 'd' i.e., All the above Electrolyte abnormalities seen in brain injury* Electrolyte abnormalities occur in 60% of the patients with head injury.* Hyponatremia is the most common electrolyte abnormality seen and is often secondary to SIADH.* Other Electrolyte disorders including hypernatremia, hypokalemia, hyperkalemia, hypophosphatemia and hypomagnesemia are also common after acquired brain injury.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following electrolyte abnormalities can be seen after brain injury?, with the following options: A: Hyponatremia, B: Hyperkalemia, C: Hypomagnesemia, D: All the above + ### Response: Ans. is 'd' i.e., All the above Electrolyte abnormalities seen in brain injury* Electrolyte abnormalities occur in 60% of the patients with head injury.* Hyponatremia is the most common electrolyte abnormality seen and is often secondary to SIADH.* Other Electrolyte disorders including hypernatremia, hypokalemia, hyperkalemia, hypophosphatemia and hypomagnesemia are also common after acquired brain injury. ### End" @@ -7786,6 +13935,13 @@ Ans. is 'd' i.e., All the above Electrolyte abnormalities seen in brain injury* Answer the following medical question: Strongest stimulus of lactation is by :, with the following options: A: Metoclopramide, B: Post paum hemorrhage, C: Bromocripti ne, D: Suckling +### Response: +",Suckling,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Strongest stimulus of lactation is by :, with the following options: A: Metoclopramide, B: Post paum hemorrhage, C: Bromocripti ne, D: Suckling + ### Response: Suckling ### End" @@ -7795,6 +13951,48 @@ Suckling Answer the following medical question: Type 2 lepra reaction is an example of which type of hypersensitivity reaction?, with the following options: A: Type 1 hypersensitivity reaction, B: Type 2 hypersensitivity reaction, C: Type 3 hypersensitivity reaction, D: Type 4 hypersensitivity reaction +### Response: +","Please Remember +Type of Lepra Reaction + Type of Hypersensitivity Reaction = 5 +Type 1 Lepra Reaction is Type IV Hypersensitivity Reaction ic Cell Mediated Immunity (1 +4 = 5) +Type II Lepra Reaction is Type III Hypersensitivity Reaction ie Immune Complexes (2 + 3 = 5) +Type I Lepra Reactions (Downgrading and Reversal Reactions) + +Patients with borderline forms of leprosy hut not in patients with pure lepromatous disease. +It is Gell and Coombs type IV hypersensitivity reaction +Manifestations include classic signs of inflammation within previously involved macules, papules, and plaques and. on occasion, the appearance of new skin lesions, neuritis, and (less commonly j fever-—generally low-grade. +The nerve trunk most commonly involved in this process is the ulnar nerve at the elbow, which may be painful and exquisitely tender. +The most dramatic manifestation is foot dr op, which occurs when the peroneal nerve is involved. +When type 1 lepra reactions precede the initiation of appropriate antimicrobial therapy, they are termed downgrading reactions. and the case becomes histologically more lepromatous: when they occur after the initiation of therapy, they are termed reversal reactions, and the case becomes more tuberculoid. +Reversal reactions often occur in the first months or years after the initiation of therapy but may also develop several years thereafter. +Edema is the most characteristic microscopic feature of type 1 lepra lesions, whose diagnosis is primarily clinical. + +Type 2 lepra reaction (Erythema nodosum leprosum ) + +It is an immune complex mediated hypersensitivity reaction +It is Gell and Coombs type III hypersensitivity reaction +In patients with polar lepromatous or borderline lepromatous leprosy and follows initiation of leprosy treatment +Crops of erythematous, palpable, tender, papular, nodular or plaque lesions distributed bilaterally symmetrically, on face and extensor aspect of extremities. +Skin biopsy - vasculitis or pannieulitis. lymphocytes with polymorphonuclear infiltrates +Elevated levels of circulating TNF-α +Fever and systemic manifestations like polyarthritis, lymphadenopathy, immune complex glomerulonephritis, epididymoorchitis and iridocyclitis. +Risk factors are Multidrug therapy for leprosy, intercurrent infections, pregnancy, trauma, surgery,physical and mental stress +Corticosteroids (prednisolone-0.5 to 1 mg/kg/ day] are the first line drugs +Clofazimine and thalidomide are second line drugs +Thalidomide is contraindicated in pregnancy as it is teratogenic. + +Lucio's Phenomenon + +It is an unusual reaction seen exclusively in patients from the Caribbean and Mexico. +Patients with untreated diffuse lepromatosis form of lepromatous leprosy. +Recurrent crops of large, sharply marginated. ulcerative lesions on the lower extremities. +Secondary infection and septic bacteremia can be fatal. +Histologically, the lesions are characterized by ischemic necrosis of the epidermis and superficial dermis,heavy parasitism of endothelial cells with AFB. and endothelial proliferation and thrombus formation in the larger vessels of the deeper dermis.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Type 2 lepra reaction is an example of which type of hypersensitivity reaction?, with the following options: A: Type 1 hypersensitivity reaction, B: Type 2 hypersensitivity reaction, C: Type 3 hypersensitivity reaction, D: Type 4 hypersensitivity reaction + ### Response: Please Remember Type of Lepra Reaction + Type of Hypersensitivity Reaction = 5 @@ -7839,6 +14037,13 @@ Histologically, the lesions are characterized by ischemic necrosis of the epider Answer the following medical question: All are true about Gilbe's syndrome except ?, with the following options: A: Mild conjugated hyperbilirubinemia, B: Autosomal dominant, C: Nonnal liver histology, D: Almost normal liver function tests +### Response: +","Ans. is 'a' i.e., Mild conjugated hyperbilirubinemia Gilbe syndrome o Gilbe syndrome is a type of congenital unconjugated hyperbilirubinemia. It is autosomal dominant. o Hepatic biochemical tests are normal There is normal hepatic histology, but in some patients increased lipofuscin pigment may occur. There is mild increase in unconjugated bilirubin --> No kernicterus o Defect is ? a) Decreased hepatic uptake of bilirubin b) Decreased activity of UDP G transferase o Phenobarbitone decreases the level of unconjugated bilirubin by increasing its conjugation --> Phenobarbitone induces UDPG transferase activity. o Hemolysis may be seen. o The disposition of most xenobiotics metabolized by glucronidation appears to be normal except for antitumor drug irinotecan.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are true about Gilbe's syndrome except ?, with the following options: A: Mild conjugated hyperbilirubinemia, B: Autosomal dominant, C: Nonnal liver histology, D: Almost normal liver function tests + ### Response: Ans. is 'a' i.e., Mild conjugated hyperbilirubinemia Gilbe syndrome o Gilbe syndrome is a type of congenital unconjugated hyperbilirubinemia. It is autosomal dominant. o Hepatic biochemical tests are normal There is normal hepatic histology, but in some patients increased lipofuscin pigment may occur. There is mild increase in unconjugated bilirubin --> No kernicterus o Defect is ? a) Decreased hepatic uptake of bilirubin b) Decreased activity of UDP G transferase o Phenobarbitone decreases the level of unconjugated bilirubin by increasing its conjugation --> Phenobarbitone induces UDPG transferase activity. o Hemolysis may be seen. o The disposition of most xenobiotics metabolized by glucronidation appears to be normal except for antitumor drug irinotecan. ### End" @@ -7848,6 +14053,13 @@ Ans. is 'a' i.e., Mild conjugated hyperbilirubinemia Gilbe syndrome o Gilbe synd Answer the following medical question: Most impoant from of carbon-dioxide transpo in the blood, with the following options: A: It is mostly transpoed as carboxy hemoglobin, B: As dissolved CO2, C: As bicarbonates, D: Due to CO2 molecules attached to hemoglobin +### Response: +","The route by which most of the carbon dioxide is carried in the bloodstream. Once dissolved in the blood plasma, carbon dioxide combines with water to form carbonic acid, which immediately ionizes into hydrogen and bicarbonate ions. The bicarbonate ions serve as pa of the alkaline reserve.Ref: Ganong&;s Review of Medical Physiology; 24th edition; page no: 644","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most impoant from of carbon-dioxide transpo in the blood, with the following options: A: It is mostly transpoed as carboxy hemoglobin, B: As dissolved CO2, C: As bicarbonates, D: Due to CO2 molecules attached to hemoglobin + ### Response: The route by which most of the carbon dioxide is carried in the bloodstream. Once dissolved in the blood plasma, carbon dioxide combines with water to form carbonic acid, which immediately ionizes into hydrogen and bicarbonate ions. The bicarbonate ions serve as pa of the alkaline reserve.Ref: Ganong&;s Review of Medical Physiology; 24th edition; page no: 644 ### End" @@ -7857,6 +14069,13 @@ The route by which most of the carbon dioxide is carried in the bloodstream. Onc Answer the following medical question: Refraction at anterior surface cornea is maximum because, with the following options: A: Anterior surface of cornea has smaller curvature, B: There is greater difference between refractive indices of air & cornea, C: It is avascular transparent tissue, D: All of the above +### Response: +",.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Refraction at anterior surface cornea is maximum because, with the following options: A: Anterior surface of cornea has smaller curvature, B: There is greater difference between refractive indices of air & cornea, C: It is avascular transparent tissue, D: All of the above + ### Response: . ### End" @@ -7866,6 +14085,13 @@ Answer the following medical question: Refraction at anterior surface cornea is Answer the following medical question: Voriconazole is not effective against, with the following options: A: Aspergillosis, B: Mucormyocosis, C: Candida albicans, D: Candida tropicalis +### Response: +","Mucormycosis Voriconazole Voriconazole is recent systemic antifungal agent belonging to the azole chemical .family. It is a broad spectrum azole that has been approved for t/t by F.D.A. in 2002. As with other triazoles voriconazole impairs the biosynthesis of ergosterols by inhibiting the p450 enzyme 14a sterol demethylase. Voriconazole is administered by i.v. and oral routes. It is formulated as lyophilized powder ,for solution for i.v. infusion as well as tablets and powder for suspension for oral administration. Uses of Voriconazole Varoconazole is a broad spectrum azole. It can be used in all diseases where azoles are effective. It is especially used for ? Invasive aspergillosisQ In patients with invasive aspergillosis, initial therapy with voriconazole led to better responses and improved survival and resulted in.fewer side effects than the standard approach of initial therapy with amphotericin B. Emerging fungal pathogensQ Voriconazole is used in the primary treatment of amphotericin B and fluconazole resistant fungal infections e.g., Fusarium, Scendosporium. Patients with neutropenia and feverQ Pts with neutropenia and fever are often treated empirically with AMB or liposomal AMB to prevent invasive fungal infections. Voriconazole is a suitable alternative to AMB preparation for empirical antifungal therapy in patients with neutropenia and persistent fever. Those with Fluconazole resistant candida infection Voriconazole is a broad spectrum antifungal showing in vitro activity against candida species uncluding fluconazole resistant candida albicans2 and candida krusei2. Some impoant adverse effect of Voriconazole : ? Teratogenecity - Voriconazole is teratogenic in animals and contraindicated in pregnancy (class 0) QTc prolongation and arrhythmias - Voriconazole like some other azoles causes a prolongation of the QTc intervals which can become significant in patient with other risk factors for Torsades-de-points.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Voriconazole is not effective against, with the following options: A: Aspergillosis, B: Mucormyocosis, C: Candida albicans, D: Candida tropicalis + ### Response: Mucormycosis Voriconazole Voriconazole is recent systemic antifungal agent belonging to the azole chemical .family. It is a broad spectrum azole that has been approved for t/t by F.D.A. in 2002. As with other triazoles voriconazole impairs the biosynthesis of ergosterols by inhibiting the p450 enzyme 14a sterol demethylase. Voriconazole is administered by i.v. and oral routes. It is formulated as lyophilized powder ,for solution for i.v. infusion as well as tablets and powder for suspension for oral administration. Uses of Voriconazole Varoconazole is a broad spectrum azole. It can be used in all diseases where azoles are effective. It is especially used for ? Invasive aspergillosisQ In patients with invasive aspergillosis, initial therapy with voriconazole led to better responses and improved survival and resulted in.fewer side effects than the standard approach of initial therapy with amphotericin B. Emerging fungal pathogensQ Voriconazole is used in the primary treatment of amphotericin B and fluconazole resistant fungal infections e.g., Fusarium, Scendosporium. Patients with neutropenia and feverQ Pts with neutropenia and fever are often treated empirically with AMB or liposomal AMB to prevent invasive fungal infections. Voriconazole is a suitable alternative to AMB preparation for empirical antifungal therapy in patients with neutropenia and persistent fever. Those with Fluconazole resistant candida infection Voriconazole is a broad spectrum antifungal showing in vitro activity against candida species uncluding fluconazole resistant candida albicans2 and candida krusei2. Some impoant adverse effect of Voriconazole : ? Teratogenecity - Voriconazole is teratogenic in animals and contraindicated in pregnancy (class 0) QTc prolongation and arrhythmias - Voriconazole like some other azoles causes a prolongation of the QTc intervals which can become significant in patient with other risk factors for Torsades-de-points. ### End" @@ -7875,6 +14101,13 @@ Mucormycosis Voriconazole Voriconazole is recent systemic antifungal agent belon Answer the following medical question: Lacy white lesion in mouth with pterygium is seen in –, with the following options: A: Psoriasis, B: Ptirysis alba, C: Lichen planus, D: Leprosy +### Response: +","Mucosal lesions that present as a white net like eruption, i.e. lacy pattern and pterygium of nails is suggestive of Lichen planus.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Lacy white lesion in mouth with pterygium is seen in –, with the following options: A: Psoriasis, B: Ptirysis alba, C: Lichen planus, D: Leprosy + ### Response: Mucosal lesions that present as a white net like eruption, i.e. lacy pattern and pterygium of nails is suggestive of Lichen planus. ### End" @@ -7884,6 +14117,13 @@ Mucosal lesions that present as a white net like eruption, i.e. lacy pattern and Answer the following medical question: The drug of choice in scleroderma induced hypeensive crisis is, with the following options: A: ACE inhibitor, B: Thiazides, C: Beta blockers, D: Sodium nitroprusside +### Response: +","Refer kDT 7/e p 505 Blood pressure control is the mainstay of therapy in sclerodermarenal crisis. ... An ACE inhibitor is the agent of choice, leading to an improvement in blood pressure in up to 90% of patients by reversing the angiotensin II-inducedvasoconstriction.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The drug of choice in scleroderma induced hypeensive crisis is, with the following options: A: ACE inhibitor, B: Thiazides, C: Beta blockers, D: Sodium nitroprusside + ### Response: Refer kDT 7/e p 505 Blood pressure control is the mainstay of therapy in sclerodermarenal crisis. ... An ACE inhibitor is the agent of choice, leading to an improvement in blood pressure in up to 90% of patients by reversing the angiotensin II-inducedvasoconstriction. ### End" @@ -7893,6 +14133,13 @@ Refer kDT 7/e p 505 Blood pressure control is the mainstay of therapy in sclerod Answer the following medical question: Fasting hyperglycemia is almost always seen in, with the following options: A: Gastric carcinoma, B: Pheochromocytoma, C: Adrenal tumour, D: Carcinoid tumour +### Response: +","fasting glucose levels greater than or equal to 7.0 mmol/l, is frequently present in patients with phaeochromocytoma (24% in the present study) and the diabetes is reversed by removal of the tumour(pheochromocytoma). Ref - Harrison20th edition pg 99","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Fasting hyperglycemia is almost always seen in, with the following options: A: Gastric carcinoma, B: Pheochromocytoma, C: Adrenal tumour, D: Carcinoid tumour + ### Response: fasting glucose levels greater than or equal to 7.0 mmol/l, is frequently present in patients with phaeochromocytoma (24% in the present study) and the diabetes is reversed by removal of the tumour(pheochromocytoma). Ref - Harrison20th edition pg 99 ### End" @@ -7902,6 +14149,13 @@ fasting glucose levels greater than or equal to 7.0 mmol/l, is frequently presen Answer the following medical question: Congenital Wilson's disease is characterized by, with the following options: A: KF ring is present at bih, B: May present as acute hepatitis, C: Decreased Urinary copper excretion, D: Decreased hapatic copper concentration +### Response: +","Ans. is 'b' i.e., May present as acute hepatitis o KF ring develop after sometime due to deposition of copper in cornea. o It may present as acute or chronic liver disease. o Hepatic copper concentration and urinary excretion of copper are incerased.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Congenital Wilson's disease is characterized by, with the following options: A: KF ring is present at bih, B: May present as acute hepatitis, C: Decreased Urinary copper excretion, D: Decreased hapatic copper concentration + ### Response: Ans. is 'b' i.e., May present as acute hepatitis o KF ring develop after sometime due to deposition of copper in cornea. o It may present as acute or chronic liver disease. o Hepatic copper concentration and urinary excretion of copper are incerased. ### End" @@ -7911,6 +14165,13 @@ Ans. is 'b' i.e., May present as acute hepatitis o KF ring develop after sometim Answer the following medical question: Transamination reaction requires which vitamin?, with the following options: A: Thiamine, B: Pyridoxin, C: Riboflavin, D: Pentothenic acid +### Response: +",Pyridoxal phosphate (active form of vitamin B6) is the coenzyme for transamination reactions.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Transamination reaction requires which vitamin?, with the following options: A: Thiamine, B: Pyridoxin, C: Riboflavin, D: Pentothenic acid + ### Response: Pyridoxal phosphate (active form of vitamin B6) is the coenzyme for transamination reactions. ### End" @@ -7920,6 +14181,14 @@ Pyridoxal phosphate (active form of vitamin B6) is the coenzyme for transaminati Answer the following medical question: Paint brush appearance is a feature of, with the following options: A: Hydronephrosis, B: PCKD, C: Medullary sponge kidney, D: Papillary necrosis +### Response: +","Paint brush appearance - Medullary sponge kidney. +Egg in CUP appearance  - Papillary necrosis.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Paint brush appearance is a feature of, with the following options: A: Hydronephrosis, B: PCKD, C: Medullary sponge kidney, D: Papillary necrosis + ### Response: Paint brush appearance - Medullary sponge kidney. Egg in CUP appearance  - Papillary necrosis. @@ -7930,6 +14199,13 @@ Egg in CUP appearance  - Papillary necrosis. Answer the following medical question: Olopatidine acts as an:-, with the following options: A: Antihistaminic, B: Anti-inflammatory, C: Anti-emetic, D: Anti-psychotic +### Response: +",Olopatadine is a topical second generation anti-histaminic drugs It is used for allergic conjunctivitis as eye drops. ANTIHISTAMINIC DRUGS FIRST GENERATION SECOND GENERATION Promethazine Terfendaine (withdrawn now) Diphenhydramine Astemizole (withdrawan) Dimenhydrinate Fexofenadine Pheniramine Loratidine Chlorpheniramine Cetirizine Cinnarizine Levocetirizine Meclizine Mizolastine Cyclizine Azelastine Hydroxyzine Olopatadine Mepyramine Ebastine Buclizine Desloratidine,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Olopatidine acts as an:-, with the following options: A: Antihistaminic, B: Anti-inflammatory, C: Anti-emetic, D: Anti-psychotic + ### Response: Olopatadine is a topical second generation anti-histaminic drugs It is used for allergic conjunctivitis as eye drops. ANTIHISTAMINIC DRUGS FIRST GENERATION SECOND GENERATION Promethazine Terfendaine (withdrawn now) Diphenhydramine Astemizole (withdrawan) Dimenhydrinate Fexofenadine Pheniramine Loratidine Chlorpheniramine Cetirizine Cinnarizine Levocetirizine Meclizine Mizolastine Cyclizine Azelastine Hydroxyzine Olopatadine Mepyramine Ebastine Buclizine Desloratidine ### End" @@ -7939,6 +14215,13 @@ Olopatadine is a topical second generation anti-histaminic drugs It is used for Answer the following medical question: Which of the following anesthetize mucosa is snot Primarily used anesthetize mucosa, with the following options: A: Benzocaine, B: Lidocaine, C: Bupivacaine, D: Tetracaine +### Response: +",Bupivacaine cannot be used as surface anesthetic agent Bupivacaine is contraindicated in intravenous regional anesthesia due to fear of cardiac arrhythmia,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following anesthetize mucosa is snot Primarily used anesthetize mucosa, with the following options: A: Benzocaine, B: Lidocaine, C: Bupivacaine, D: Tetracaine + ### Response: Bupivacaine cannot be used as surface anesthetic agent Bupivacaine is contraindicated in intravenous regional anesthesia due to fear of cardiac arrhythmia ### End" @@ -7948,6 +14231,13 @@ Bupivacaine cannot be used as surface anesthetic agent Bupivacaine is contraindi Answer the following medical question: Gitter cells are, with the following options: A: Microglia, B: Modified macrophages, C: Astrocytes, D: Neutrophils +### Response: +","Microglia are a type of neuroglia (glial cell) located throughout the brain and spinal cord. Microglia account for 10-15% of all cells found within the brain. As the resident macrophage cells, they act as the first and main form of active immune defense in the central nervous system (CNS). Microglia (and other neuroglia including astrocytes) are distributed in large non-overlapping regions throughout the CNS. Microglia are key cells in overall brain maintenance--they are constantly scavenging the CNS for plaques, damaged or unnecessary neurons and synapses, and infectious agents. Since these processes must be efficient to prevent potentially fatal damage, microglia are extremely sensitive to even small pathological changes in the CNS. This sensitivity is achieved in pa by the presence of unique K+ channels that respond to even small changes in extracellular potassium. Ref - Wikipedia.org","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Gitter cells are, with the following options: A: Microglia, B: Modified macrophages, C: Astrocytes, D: Neutrophils + ### Response: Microglia are a type of neuroglia (glial cell) located throughout the brain and spinal cord. Microglia account for 10-15% of all cells found within the brain. As the resident macrophage cells, they act as the first and main form of active immune defense in the central nervous system (CNS). Microglia (and other neuroglia including astrocytes) are distributed in large non-overlapping regions throughout the CNS. Microglia are key cells in overall brain maintenance--they are constantly scavenging the CNS for plaques, damaged or unnecessary neurons and synapses, and infectious agents. Since these processes must be efficient to prevent potentially fatal damage, microglia are extremely sensitive to even small pathological changes in the CNS. This sensitivity is achieved in pa by the presence of unique K+ channels that respond to even small changes in extracellular potassium. Ref - Wikipedia.org ### End" @@ -7957,6 +14247,13 @@ Microglia are a type of neuroglia (glial cell) located throughout the brain and Answer the following medical question: The most common form of PSVT?, with the following options: A: Tachycardia originating from the atrium, B: AV nodal reentry tachycardia, C: WPW syndrome, D: Focal atrial tachycardia +### Response: +","Pathologic supraventricular tachycardia A. Tachycardia originating from the atriumDefining feature: tachycardia may continue despite beats that fail to conduct to the ventricles, indicating that the AV node is not paicipating in the tachycardia circuitB. AV nodal reentry tachycardiaDefining feature: paroxysmal regular tachycardia with P waves visible at the end of the QRS complex or not visible at allThe most common paroxysmal sustained tachycardia in healthy young adults; more common in womenC. Tachycardias associated with accessory atrioventricular pathwaysDefining feature: paroxysmal sustained tachycardia similar to AV nodal reentry; during sinus rhythm, evidence of ventricular preexcitation may be present (Wolff-Parkinson-White syndrome) or absent (concealed accessory pathway)Harrison 19e pg: 1476","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The most common form of PSVT?, with the following options: A: Tachycardia originating from the atrium, B: AV nodal reentry tachycardia, C: WPW syndrome, D: Focal atrial tachycardia + ### Response: Pathologic supraventricular tachycardia A. Tachycardia originating from the atriumDefining feature: tachycardia may continue despite beats that fail to conduct to the ventricles, indicating that the AV node is not paicipating in the tachycardia circuitB. AV nodal reentry tachycardiaDefining feature: paroxysmal regular tachycardia with P waves visible at the end of the QRS complex or not visible at allThe most common paroxysmal sustained tachycardia in healthy young adults; more common in womenC. Tachycardias associated with accessory atrioventricular pathwaysDefining feature: paroxysmal sustained tachycardia similar to AV nodal reentry; during sinus rhythm, evidence of ventricular preexcitation may be present (Wolff-Parkinson-White syndrome) or absent (concealed accessory pathway)Harrison 19e pg: 1476 ### End" @@ -7966,6 +14263,13 @@ Pathologic supraventricular tachycardia A. Tachycardia originating from the atri Answer the following medical question: Volume of ICF in body, with the following options: A: 0.2*body wt, B: 0.4*body wt, C: 0.6*body wt, D: 0.8*body wt +### Response: +","In a 70 kg man 60 % of body weight is due to water Of that water 2/3 rd is present intra cellularly Ref:Guyton and Hall textbook of medical physiology 12th edition,page number: 45,46,47","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Volume of ICF in body, with the following options: A: 0.2*body wt, B: 0.4*body wt, C: 0.6*body wt, D: 0.8*body wt + ### Response: In a 70 kg man 60 % of body weight is due to water Of that water 2/3 rd is present intra cellularly Ref:Guyton and Hall textbook of medical physiology 12th edition,page number: 45,46,47 ### End" @@ -7975,6 +14279,13 @@ In a 70 kg man 60 % of body weight is due to water Of that water 2/3 rd is prese Answer the following medical question: Which is a not an essential criteria according to WHO for normal semen analysis, with the following options: A: Sperm count > 20 million/ml, B: Volume > 1 ml, C: Sperm with normal morphology (strict criteria) > 15%, D: Motility > 25% with rapidly progressive motility +### Response: +","Volume > 1 ml THE W.H.O. RECOMMENDS THE FOLLOWING NORMAL VALUES Volume Sperm Total sperm number Percent mobility Forward progression Normal morphology Round cells Sperm agglutination > 2 ml concentration > 20 million / ml or more > 40 million/ejaculate > 50% with forward progression > 25% with rapid linear progression > 2 (scale 0-4) > 30% normal (W.H.O. criteria) > 14% normal (Kruger and strict criteria) < 5 million/rnl < 2 (scale 0-3),w.b.c fewer than I x106 / ml The normal sperm morphology is currently being reassessed by W.H.O In the interim the propoion of normal forms accepted by the laboratories in the U.K is either the earlier W.H.O limits of 30 or 15% based on strict morphological criteria.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which is a not an essential criteria according to WHO for normal semen analysis, with the following options: A: Sperm count > 20 million/ml, B: Volume > 1 ml, C: Sperm with normal morphology (strict criteria) > 15%, D: Motility > 25% with rapidly progressive motility + ### Response: Volume > 1 ml THE W.H.O. RECOMMENDS THE FOLLOWING NORMAL VALUES Volume Sperm Total sperm number Percent mobility Forward progression Normal morphology Round cells Sperm agglutination > 2 ml concentration > 20 million / ml or more > 40 million/ejaculate > 50% with forward progression > 25% with rapid linear progression > 2 (scale 0-4) > 30% normal (W.H.O. criteria) > 14% normal (Kruger and strict criteria) < 5 million/rnl < 2 (scale 0-3),w.b.c fewer than I x106 / ml The normal sperm morphology is currently being reassessed by W.H.O In the interim the propoion of normal forms accepted by the laboratories in the U.K is either the earlier W.H.O limits of 30 or 15% based on strict morphological criteria. ### End" @@ -7984,6 +14295,13 @@ Volume > 1 ml THE W.H.O. RECOMMENDS THE FOLLOWING NORMAL VALUES Volume Sperm Tot Answer the following medical question: Testosterone is produced in Leydig cells in fetus due to, with the following options: A: FSH, B: ssHCG, C: Coisol, D: Estrogen +### Response: +","Testosterone is the principal male sex hormone (androgen) that is produced by Leydig&;s cells of the testes in response to luteinizing hormone secreted by the pituitary gland. It is also produced by the adrenal coex in both males and females. Its chief function is to stimulate the development of the male reproductive organs, including the prostate, and the secondary sexcharacters, such as the beard. It encourages growth of bone and muscle and helps maintain muscle strength.Ref: Ganong&;s review of medical physiology;24th edition; page no:-423","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Testosterone is produced in Leydig cells in fetus due to, with the following options: A: FSH, B: ssHCG, C: Coisol, D: Estrogen + ### Response: Testosterone is the principal male sex hormone (androgen) that is produced by Leydig&;s cells of the testes in response to luteinizing hormone secreted by the pituitary gland. It is also produced by the adrenal coex in both males and females. Its chief function is to stimulate the development of the male reproductive organs, including the prostate, and the secondary sexcharacters, such as the beard. It encourages growth of bone and muscle and helps maintain muscle strength.Ref: Ganong&;s review of medical physiology;24th edition; page no:-423 ### End" @@ -7993,6 +14311,16 @@ Testosterone is the principal male sex hormone (androgen) that is produced by Le Answer the following medical question: A 36 year old male presents with weakness, pallor and bleeding gums. His HB was 7g %, total leukocyte count 1,10,000 cumm with many immature WBCs, which are positive for MPO and Platelet count 22,000/cumm, with the following options: A: AML, B: CML, C: ALL, D: CLL +### Response: +","Leuocyte - 1,10,000/ cumm +Peripheral smear contains immature WBCs +MPO test is positive +Recause of all three reasons patient is suffering from AML.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 36 year old male presents with weakness, pallor and bleeding gums. His HB was 7g %, total leukocyte count 1,10,000 cumm with many immature WBCs, which are positive for MPO and Platelet count 22,000/cumm, with the following options: A: AML, B: CML, C: ALL, D: CLL + ### Response: Leuocyte - 1,10,000/ cumm Peripheral smear contains immature WBCs @@ -8005,6 +14333,13 @@ Recause of all three reasons patient is suffering from AML. Answer the following medical question: False about lacerated wound is :, with the following options: A: Profuse hemorrhage, B: Vessels crushed, C: Hair bulb damaged, D: Irregular margins +### Response: +","Laceration - is the tearing of skin or muscles or mucous membrane caused by a shearing or a crushing force, and produced by application of a blunt force to a broad area of the body. - If the blunt force produces extensive bruising and laceration of deeper tissue, it is called crush injury. Features : Margins -Ragged, irregular and uneven Site -most commonly over bony prominences Bruising and abrasion - is seen around the margin Hair bulbs - are crushed Hemorrhage - is less, because the aeries are crushed and torn irregularly , they retract and blood clots readily","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: False about lacerated wound is :, with the following options: A: Profuse hemorrhage, B: Vessels crushed, C: Hair bulb damaged, D: Irregular margins + ### Response: Laceration - is the tearing of skin or muscles or mucous membrane caused by a shearing or a crushing force, and produced by application of a blunt force to a broad area of the body. - If the blunt force produces extensive bruising and laceration of deeper tissue, it is called crush injury. Features : Margins -Ragged, irregular and uneven Site -most commonly over bony prominences Bruising and abrasion - is seen around the margin Hair bulbs - are crushed Hemorrhage - is less, because the aeries are crushed and torn irregularly , they retract and blood clots readily ### End" @@ -8014,6 +14349,13 @@ Laceration - is the tearing of skin or muscles or mucous membrane caused by a sh Answer the following medical question: Mitochondria of a sperm is seen in ?, with the following options: A: Head, B: Neck, C: Body, D: Tail +### Response: +","Mitochondrial granules are seen enveloping the spiral threads around the axial filament present in the body of the sperm. Sperm: The human sperm possesses a head, a neck, a connecting piece or body, and a tail.Head is oval or elliptical, but flattened,its anterior two-thirds are covered by a layer of modified protoplasm, which is named the head-cap, which probably facilitates the, entrance of the spermatozoon into the ovum. The head contains a mass of chromatin, regarded as the nucleus of the cell surrounded by a thin envelope.Neck contains the anterior centriole, it is situated at the junction of the head and neck.Connecting piece or body is rod-like. The posterior centriole is placed at the junction of the body and neck, from this centriole an axial filament runs backward through the body and tail. The sheath of the axial filament is encircled by a spiral thread, around which is an envelope containing mitochondrial granules, and termed the mitochondrial sheath.Tail is of great length, and consists of the axial thread or filament, surrounded by its sheath, but mitochondria is absent.Ref: Gray's Anatomy of the Human Body, 20th Edition, Page 756","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mitochondria of a sperm is seen in ?, with the following options: A: Head, B: Neck, C: Body, D: Tail + ### Response: Mitochondrial granules are seen enveloping the spiral threads around the axial filament present in the body of the sperm. Sperm: The human sperm possesses a head, a neck, a connecting piece or body, and a tail.Head is oval or elliptical, but flattened,its anterior two-thirds are covered by a layer of modified protoplasm, which is named the head-cap, which probably facilitates the, entrance of the spermatozoon into the ovum. The head contains a mass of chromatin, regarded as the nucleus of the cell surrounded by a thin envelope.Neck contains the anterior centriole, it is situated at the junction of the head and neck.Connecting piece or body is rod-like. The posterior centriole is placed at the junction of the body and neck, from this centriole an axial filament runs backward through the body and tail. The sheath of the axial filament is encircled by a spiral thread, around which is an envelope containing mitochondrial granules, and termed the mitochondrial sheath.Tail is of great length, and consists of the axial thread or filament, surrounded by its sheath, but mitochondria is absent.Ref: Gray's Anatomy of the Human Body, 20th Edition, Page 756 ### End" @@ -8023,6 +14365,13 @@ Mitochondrial granules are seen enveloping the spiral threads around the axial f Answer the following medical question: A 58-year-old woman undergoes routine colonoscopy. A 2-cm submucosal nodule is identified in the appendix. Biopsy of the nodule shows nests of cells with round, uniform nuclei. Electron microscopy reveals numerous neuroendocrine granules in the cytoplasm. This patient's neoplastic disease is associated with which of the following clinical features?, with the following options: A: Congestive hea failure, B: Flushing and wheezing, C: Muscular dystrophy, D: Progressive systemic sclerosis +### Response: +","Patient is having carcinoid syndrome Carcinoid syndrome is a systemic paraneoplastic disease caused by the release of hormones from carcinoid tumors ( neuroendocrine granules) into venous blood. M/c site : GIT > Bronchus Symptoms:- Flushing Bronchial wheezing Watery diarrhea Abdominal colic are caused by the release of serotonin, bradykinin, and histamine. Histology : nests of cells with round, uniform nuclei Immunohistochemical (IHC) markers for carcinoid tumors: Neuron-specific enolase Synaptophysin Chromogranin A Leu 7 The other choices are not associated with this paraneoplastic syndrome.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 58-year-old woman undergoes routine colonoscopy. A 2-cm submucosal nodule is identified in the appendix. Biopsy of the nodule shows nests of cells with round, uniform nuclei. Electron microscopy reveals numerous neuroendocrine granules in the cytoplasm. This patient's neoplastic disease is associated with which of the following clinical features?, with the following options: A: Congestive hea failure, B: Flushing and wheezing, C: Muscular dystrophy, D: Progressive systemic sclerosis + ### Response: Patient is having carcinoid syndrome Carcinoid syndrome is a systemic paraneoplastic disease caused by the release of hormones from carcinoid tumors ( neuroendocrine granules) into venous blood. M/c site : GIT > Bronchus Symptoms:- Flushing Bronchial wheezing Watery diarrhea Abdominal colic are caused by the release of serotonin, bradykinin, and histamine. Histology : nests of cells with round, uniform nuclei Immunohistochemical (IHC) markers for carcinoid tumors: Neuron-specific enolase Synaptophysin Chromogranin A Leu 7 The other choices are not associated with this paraneoplastic syndrome. ### End" @@ -8032,6 +14381,13 @@ Patient is having carcinoid syndrome Carcinoid syndrome is a systemic paraneopla Answer the following medical question: Acute silicosis clinical manifestation is -, with the following options: A: silico-tuberculosis, B: Hypersensitivity pneumonitis, C: Hypersensitivity pneumonia, D: Forms nodules and casues pneumoconiosis +### Response: +","Silicosis is progressive and silicotics are prone to pulmonary tuberculosis ,a condition called silico-tuberculosis (Ref.PARK 'S tectbook of preventive and social medicine 21st edition page no 747)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Acute silicosis clinical manifestation is -, with the following options: A: silico-tuberculosis, B: Hypersensitivity pneumonitis, C: Hypersensitivity pneumonia, D: Forms nodules and casues pneumoconiosis + ### Response: Silicosis is progressive and silicotics are prone to pulmonary tuberculosis ,a condition called silico-tuberculosis (Ref.PARK 'S tectbook of preventive and social medicine 21st edition page no 747) ### End" @@ -8041,6 +14397,13 @@ Silicosis is progressive and silicotics are prone to pulmonary tuberculosis ,a c Answer the following medical question: Rx of dendritic ulcer –a) Acyclovirb) Ganciclovirc) Idoxuridine.d) vidarabinee) Trichophyton cains, with the following options: A: ac, B: a, C: abcde, D: bc +### Response: +","Antivirals used for HSV keratitis are Acyclovir, Ganciclovir, Triflurothymidine, vidarabine, Idoxuridine.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Rx of dendritic ulcer –a) Acyclovirb) Ganciclovirc) Idoxuridine.d) vidarabinee) Trichophyton cains, with the following options: A: ac, B: a, C: abcde, D: bc + ### Response: Antivirals used for HSV keratitis are Acyclovir, Ganciclovir, Triflurothymidine, vidarabine, Idoxuridine. ### End" @@ -8050,6 +14413,13 @@ Antivirals used for HSV keratitis are Acyclovir, Ganciclovir, Triflurothymidine, Answer the following medical question: All the following are true for mitral valve prolapse except, with the following options: A: Transmission may be as an autosomal dominant trait, B: Majority of the case present with features of mitral regurgitation, C: The valve leaflets characteristically show myxomatous, D: The disease is one of the common cardiovascular manifestations og Marfan's syndrome +### Response: +","Ref Harrison 19 th ed pg 1546 Most patients are asymptomatic and remain so for their entire lives. However, in Noh America, MVP is now the most common cause of isolated severe MR requiring surgical treatment. Arrhythmias, most commonly ventricular premature contractions and paroxysmal supraventricular and ventricular tachycardia, as well as AF, have been repoed and may cause palpitations, light-headedness, and syncope.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All the following are true for mitral valve prolapse except, with the following options: A: Transmission may be as an autosomal dominant trait, B: Majority of the case present with features of mitral regurgitation, C: The valve leaflets characteristically show myxomatous, D: The disease is one of the common cardiovascular manifestations og Marfan's syndrome + ### Response: Ref Harrison 19 th ed pg 1546 Most patients are asymptomatic and remain so for their entire lives. However, in Noh America, MVP is now the most common cause of isolated severe MR requiring surgical treatment. Arrhythmias, most commonly ventricular premature contractions and paroxysmal supraventricular and ventricular tachycardia, as well as AF, have been repoed and may cause palpitations, light-headedness, and syncope. ### End" @@ -8059,6 +14429,13 @@ Ref Harrison 19 th ed pg 1546 Most patients are asymptomatic and remain so for t Answer the following medical question: Retinal nervefibres most sensitive to glaucomatous damage are:, with the following options: A: Superior and inferior arcuate fibres, B: Macular fibres, C: Superior radiating fibres, D: Inferior radiating fibres +### Response: +",Ans. Superior and inferior arcuate fibres,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Retinal nervefibres most sensitive to glaucomatous damage are:, with the following options: A: Superior and inferior arcuate fibres, B: Macular fibres, C: Superior radiating fibres, D: Inferior radiating fibres + ### Response: Ans. Superior and inferior arcuate fibres ### End" @@ -8068,6 +14445,13 @@ Ans. Superior and inferior arcuate fibres Answer the following medical question: HLA typing is useful in, with the following options: A: Disputed paternity, B: Thanotology, C: Organ transplant, D: Dactylography +### Response: +","Also used in organ transplant Ref Robbins 9/e p195 ,215 DNA paternity testing is the use of DNA profiles to determine whether an individual is the biologicalparent of another individual. Paternity testing can be especially impoant when the rights and duties of the father are in issue and a child's paternity is in doubt. Tests can also determine the likelihood of someone being a biological grandparent. Though genetic testing is the most reliable standard, older methods also exist, including ABO blood group typing, analysis of various other proteins and enzymes, or using human leukocyte antigen antigens. The current techniques for paternity testing are using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). Paternity testing can now also be performed while the woman is still pregnant from a blood drawn","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: HLA typing is useful in, with the following options: A: Disputed paternity, B: Thanotology, C: Organ transplant, D: Dactylography + ### Response: Also used in organ transplant Ref Robbins 9/e p195 ,215 DNA paternity testing is the use of DNA profiles to determine whether an individual is the biologicalparent of another individual. Paternity testing can be especially impoant when the rights and duties of the father are in issue and a child's paternity is in doubt. Tests can also determine the likelihood of someone being a biological grandparent. Though genetic testing is the most reliable standard, older methods also exist, including ABO blood group typing, analysis of various other proteins and enzymes, or using human leukocyte antigen antigens. The current techniques for paternity testing are using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). Paternity testing can now also be performed while the woman is still pregnant from a blood drawn ### End" @@ -8077,6 +14461,13 @@ Also used in organ transplant Ref Robbins 9/e p195 ,215 DNA paternity testing is Answer the following medical question: In which of the following conditions, Aniridia and Hemihyperophy are most likely present ?, with the following options: A: Neuroblastoma, B: Wilms' tumour, C: Non-Hodgkin's lymphoma, D: Germ cell tumour +### Response: +","Ans. is 'b' i.e.,Wilm's tumour Wilm's tumour is associated with three groups of congenital malformations. o The risk of Wilm's tumour is increased in these conditions. o These are ? WAGR syndrome - It consists of o Aniridia o Mental retardation o Genital anomalies The risk of Wilm's tumour is increased by 33% in this syndrome. Denys - Drash syndrome - It consists of o Gonadal dysgenesis (male pseudohermaphroditism) o Nephropathy leading to renal failure. Majority of patients with this syndrome have ranal failure. Beckwith - Wiedeman syndrome - It consists of o Enlargement of body organs o Renal medullary cysts. o Hemihyperophy o Abnormal large cells in adrenal coex.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In which of the following conditions, Aniridia and Hemihyperophy are most likely present ?, with the following options: A: Neuroblastoma, B: Wilms' tumour, C: Non-Hodgkin's lymphoma, D: Germ cell tumour + ### Response: Ans. is 'b' i.e.,Wilm's tumour Wilm's tumour is associated with three groups of congenital malformations. o The risk of Wilm's tumour is increased in these conditions. o These are ? WAGR syndrome - It consists of o Aniridia o Mental retardation o Genital anomalies The risk of Wilm's tumour is increased by 33% in this syndrome. Denys - Drash syndrome - It consists of o Gonadal dysgenesis (male pseudohermaphroditism) o Nephropathy leading to renal failure. Majority of patients with this syndrome have ranal failure. Beckwith - Wiedeman syndrome - It consists of o Enlargement of body organs o Renal medullary cysts. o Hemihyperophy o Abnormal large cells in adrenal coex. ### End" @@ -8086,6 +14477,13 @@ Ans. is 'b' i.e.,Wilm's tumour Wilm's tumour is associated with three groups of Answer the following medical question: Fregoli's Syndrome is?, with the following options: A: Delusion of Doubles, B: Delusion of persecution, C: Delusion of twins, D: Delusion of parasites +### Response: +","Ans. is'a'i.e., Delusion of Doubles[Ref.: Kaplan 6 Saddock IF/e Chap. I4The Fregoli delusion, or the delusion of doubles, is a rare disorder in which a person holds a delusional belief that different people are in fact a single person who changes appearance or is in disguise.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Fregoli's Syndrome is?, with the following options: A: Delusion of Doubles, B: Delusion of persecution, C: Delusion of twins, D: Delusion of parasites + ### Response: Ans. is'a'i.e., Delusion of Doubles[Ref.: Kaplan 6 Saddock IF/e Chap. I4The Fregoli delusion, or the delusion of doubles, is a rare disorder in which a person holds a delusional belief that different people are in fact a single person who changes appearance or is in disguise. ### End" @@ -8095,6 +14493,13 @@ Ans. is'a'i.e., Delusion of Doubles[Ref.: Kaplan 6 Saddock IF/e Chap. I4The Freg Answer the following medical question: Phenytoin pharmacokinetics is highlighted by which of the following characteristics?, with the following options: A: High first pass metabolism, B: Nonsaturation kinetics of metabolism, C: Capacity limited metabolism saturating at higher therapeutic concentration range, D: Extrahepatic metabolism +### Response: +",(Ref: KDT 6/e p404) Phenytoin follows zero order kinetics at high plasma concentration due to saturation of metabolic pathways.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Phenytoin pharmacokinetics is highlighted by which of the following characteristics?, with the following options: A: High first pass metabolism, B: Nonsaturation kinetics of metabolism, C: Capacity limited metabolism saturating at higher therapeutic concentration range, D: Extrahepatic metabolism + ### Response: (Ref: KDT 6/e p404) Phenytoin follows zero order kinetics at high plasma concentration due to saturation of metabolic pathways. ### End" @@ -8104,6 +14509,13 @@ Answer the following medical question: Phenytoin pharmacokinetics is highlighted Answer the following medical question: Isocitrate dehydrogenase is linked to, with the following options: A: NAD, B: FAD, C: NADP, D: FMN +### Response: +","There are three isoenzymes of isocitrate dehydrogenase. One, which uses NAD+, is found only in mitochondria. The other two use NADP+ and are found in mitochondria and the cytosol. Respiratory-chain-linked oxidation of isocitrate occurs through the NAD+-dependent enzyme. Reference: Harper; 30th edition; Page no: 163","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Isocitrate dehydrogenase is linked to, with the following options: A: NAD, B: FAD, C: NADP, D: FMN + ### Response: There are three isoenzymes of isocitrate dehydrogenase. One, which uses NAD+, is found only in mitochondria. The other two use NADP+ and are found in mitochondria and the cytosol. Respiratory-chain-linked oxidation of isocitrate occurs through the NAD+-dependent enzyme. Reference: Harper; 30th edition; Page no: 163 ### End" @@ -8113,6 +14525,13 @@ There are three isoenzymes of isocitrate dehydrogenase. One, which uses NAD+, is Answer the following medical question: Which of the following can be used as vector for Gene therapy, with the following options: A: Viruses, B: Liposomes, C: Plasmids, D: All of these +### Response: +",Vectors used for gene delivery : Viral Vectors Non-viral Vectors Retroviruses Liposomes Adenoviruses Plasmids Herpes simplex viruses Physical methods,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following can be used as vector for Gene therapy, with the following options: A: Viruses, B: Liposomes, C: Plasmids, D: All of these + ### Response: Vectors used for gene delivery : Viral Vectors Non-viral Vectors Retroviruses Liposomes Adenoviruses Plasmids Herpes simplex viruses Physical methods ### End" @@ -8122,6 +14541,13 @@ Vectors used for gene delivery : Viral Vectors Non-viral Vectors Retroviruses Li Answer the following medical question: Key symptom in alcohol withdrawal syndrome is:, with the following options: A: Sleep disturbance, B: Visual hallucinations, C: Tremors, D: Delirium +### Response: +","Ans: C. TremorsKey symptom - Tremor.Withdrawal SyndromesSubstanceFeaturesOpioidYawningdeg, Insomnia, Dysphoric moodWater loss from different orificesdeg (Lacrimationdeg, sweatingdeg, diarrheadeg, vomiting, Increased vitalsdeg (BP, Pulse, RR, Temperature)degPupillary dilation, piloerectiondegAlcoholHang over (MC)degHallucinationsdeg (usually auditory) and illusionsdegInsomniadegTremors/Seizures (Alcoholic seizures/Rum fits): Classic signDelirium tremens:Occurs within 5 daysdeg of complete or significant abstinencedeg from heavy alcohol Recovery occurs within 7 daysCharacteristic features are clouding of consciousnessdeg, disorientationdeg, hallucinations (mostly visual and auditory)deg, illusiondeg, autonomic disturbancesdeg, agitationdeg and insomniadeg.CocaineIncreased or decreased Sleep (hypersomniadeg or insomnia) Psychomotor activityVivid unpleasant dreamsdegIncreased apetite and fatigue","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Key symptom in alcohol withdrawal syndrome is:, with the following options: A: Sleep disturbance, B: Visual hallucinations, C: Tremors, D: Delirium + ### Response: Ans: C. TremorsKey symptom - Tremor.Withdrawal SyndromesSubstanceFeaturesOpioidYawningdeg, Insomnia, Dysphoric moodWater loss from different orificesdeg (Lacrimationdeg, sweatingdeg, diarrheadeg, vomiting, Increased vitalsdeg (BP, Pulse, RR, Temperature)degPupillary dilation, piloerectiondegAlcoholHang over (MC)degHallucinationsdeg (usually auditory) and illusionsdegInsomniadegTremors/Seizures (Alcoholic seizures/Rum fits): Classic signDelirium tremens:Occurs within 5 daysdeg of complete or significant abstinencedeg from heavy alcohol Recovery occurs within 7 daysCharacteristic features are clouding of consciousnessdeg, disorientationdeg, hallucinations (mostly visual and auditory)deg, illusiondeg, autonomic disturbancesdeg, agitationdeg and insomniadeg.CocaineIncreased or decreased Sleep (hypersomniadeg or insomnia) Psychomotor activityVivid unpleasant dreamsdegIncreased apetite and fatigue ### End" @@ -8131,6 +14557,13 @@ Ans: C. TremorsKey symptom - Tremor.Withdrawal SyndromesSubstanceFeaturesOpioidY Answer the following medical question: Relative Afferent Pupillary defect (RAPD) occur due to damage to which of the following structures?, with the following options: A: Optic Tract, B: Optic nerve, C: Occulomotor Nerve, D: Lateral geniculate body +### Response: +","Marcus Gunn Pupil indicates relative afferent pupillary defect (RAPD) and it is caused by incomplete optic nerve lesions or severe retinal diseases. Marcus Gunn Pupil may be present as early as someone with complete vision in optic nerve disease. Ref: Ophthalmology By A.K Khurana, 4th Edition, Page 292; Textbook of Ophthalmology By Sunita Agarwal, Athiya Agarwal, David J Apple, 2002, Page 303, 304","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Relative Afferent Pupillary defect (RAPD) occur due to damage to which of the following structures?, with the following options: A: Optic Tract, B: Optic nerve, C: Occulomotor Nerve, D: Lateral geniculate body + ### Response: Marcus Gunn Pupil indicates relative afferent pupillary defect (RAPD) and it is caused by incomplete optic nerve lesions or severe retinal diseases. Marcus Gunn Pupil may be present as early as someone with complete vision in optic nerve disease. Ref: Ophthalmology By A.K Khurana, 4th Edition, Page 292; Textbook of Ophthalmology By Sunita Agarwal, Athiya Agarwal, David J Apple, 2002, Page 303, 304 ### End" @@ -8140,6 +14573,13 @@ Marcus Gunn Pupil indicates relative afferent pupillary defect (RAPD) and it is Answer the following medical question: Minimal ascites can be best detected by –, with the following options: A: USG, B: Plain X-ray abdomen, C: MRI, D: CT scan +### Response: +",Minimal ascites is detected best by USG.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Minimal ascites can be best detected by –, with the following options: A: USG, B: Plain X-ray abdomen, C: MRI, D: CT scan + ### Response: Minimal ascites is detected best by USG. ### End" @@ -8149,6 +14589,13 @@ Minimal ascites is detected best by USG. Answer the following medical question: As compared to unfractionated heparin, low molecular weight heparins, with the following options: A: Are absorbed more uniformly when given subcutaneously, B: Require more frequent laboratory monitoring, C: Cannot be given to patients with heparin induced thrombocytopenia, D: Predispose to a higher risk of osteopenia +### Response: +","Low molecular weight heparin has higher subcutaneous bioavailability. Lab monitoring is not required unlike heparin. LMWH has lower risk of osteoporosis and lower incidence of thrombocytopenia. From medical pharmacology padmaja 4th edition Page no 337, 339","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: As compared to unfractionated heparin, low molecular weight heparins, with the following options: A: Are absorbed more uniformly when given subcutaneously, B: Require more frequent laboratory monitoring, C: Cannot be given to patients with heparin induced thrombocytopenia, D: Predispose to a higher risk of osteopenia + ### Response: Low molecular weight heparin has higher subcutaneous bioavailability. Lab monitoring is not required unlike heparin. LMWH has lower risk of osteoporosis and lower incidence of thrombocytopenia. From medical pharmacology padmaja 4th edition Page no 337, 339 ### End" @@ -8158,6 +14605,24 @@ Low molecular weight heparin has higher subcutaneous bioavailability. Lab monito Answer the following medical question: The cardiac output can be determined by all except, with the following options: A: Fick's principle, B: V/Q ratio, C: Echocardiography, D: Thermodilution +### Response: +","Methods to determine the Cardiac output + +Flowmeter +Cardiometer + +-        Indirect method- Used in humans + +Fick’s principle method +Indicator dilution method +Thermodilution method +Doppler echocardiography +Cineradiography","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The cardiac output can be determined by all except, with the following options: A: Fick's principle, B: V/Q ratio, C: Echocardiography, D: Thermodilution + ### Response: Methods to determine the Cardiac output @@ -8178,6 +14643,13 @@ Cineradiography Answer the following medical question: A 32 years old patient develops vomiting 3-4 hours after eating a meal. What is the most likely cause?, with the following options: A: Staphylococcus aureus, B: Salmonella enteritidis, C: Clostridium botulinum, D: Clostridium perfirengens +### Response: +",Incubation period of staphylococcal food poisoning is 1-6 hours. Food Poisoning Organism Incubation period Staphylococcal 1-6 hours Salmonella 12-24 hours Botulism 12-36 hours Clostridium perfringens 6-24 hours Bacillus cereus 1-6 hours E.coli 8-72 hours,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 32 years old patient develops vomiting 3-4 hours after eating a meal. What is the most likely cause?, with the following options: A: Staphylococcus aureus, B: Salmonella enteritidis, C: Clostridium botulinum, D: Clostridium perfirengens + ### Response: Incubation period of staphylococcal food poisoning is 1-6 hours. Food Poisoning Organism Incubation period Staphylococcal 1-6 hours Salmonella 12-24 hours Botulism 12-36 hours Clostridium perfringens 6-24 hours Bacillus cereus 1-6 hours E.coli 8-72 hours ### End" @@ -8187,6 +14659,13 @@ Incubation period of staphylococcal food poisoning is 1-6 hours. Food Poisoning Answer the following medical question: Ferritin an inactive form of iron is stored in:, with the following options: A: Gut, B: Spleen, C: Liver, D: All of the above +### Response: +","Ans. C. LiverHemosiderosis is due to excessive iron in the body. It is commonly observed in patients receiving repeated blood transfusions. Bantu-siderosis is due to food cooked in iron pots.Hemochromatosis is a rare disease in which iron is directly deposited in the tissues.Bronzed pigmentation of skin, cirrhosis of liver, and pancreatic fibrosis are the manifestations of this disorder.Pancreatic fibrosis may be associated with a condition known as Bronze diabetes.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ferritin an inactive form of iron is stored in:, with the following options: A: Gut, B: Spleen, C: Liver, D: All of the above + ### Response: Ans. C. LiverHemosiderosis is due to excessive iron in the body. It is commonly observed in patients receiving repeated blood transfusions. Bantu-siderosis is due to food cooked in iron pots.Hemochromatosis is a rare disease in which iron is directly deposited in the tissues.Bronzed pigmentation of skin, cirrhosis of liver, and pancreatic fibrosis are the manifestations of this disorder.Pancreatic fibrosis may be associated with a condition known as Bronze diabetes. ### End" @@ -8196,6 +14675,13 @@ Ans. C. LiverHemosiderosis is due to excessive iron in the body. It is commonly Answer the following medical question: Myelomeningocele most commonly involves which region of spine:, with the following options: A: Cervico-dorsal, B: Dorsolumbar, C: Lumbosacral, D: Sacro-coccygeal +### Response: +","c. Lumbosacral(Ref: Nelson's 20/e p 2802-2803)Myelomeningocele involves lumbosacral region (75% of cases)Appearance: a sac-like cystic structure with remnants of neural tissue visible beneath the membrane, which occasionally ruptures and leaks CSF or an exposed flat neural placodeHydrocephalus with a type II Chiari malformation develops in 80% of patients with MMCThe lower the deformity in the neuraxis, the less likely is the risk of hydrocephalus.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Myelomeningocele most commonly involves which region of spine:, with the following options: A: Cervico-dorsal, B: Dorsolumbar, C: Lumbosacral, D: Sacro-coccygeal + ### Response: c. Lumbosacral(Ref: Nelson's 20/e p 2802-2803)Myelomeningocele involves lumbosacral region (75% of cases)Appearance: a sac-like cystic structure with remnants of neural tissue visible beneath the membrane, which occasionally ruptures and leaks CSF or an exposed flat neural placodeHydrocephalus with a type II Chiari malformation develops in 80% of patients with MMCThe lower the deformity in the neuraxis, the less likely is the risk of hydrocephalus. ### End" @@ -8205,6 +14691,13 @@ c. Lumbosacral(Ref: Nelson's 20/e p 2802-2803)Myelomeningocele involves lumbosac Answer the following medical question: Thrombolytics can provide relative morality reduction in the treatment of acute myocardial infarction if patient comes within, with the following options: A: 6 hrs, B: 12 hrs, C: 18 hrs, D: 24 hrs +### Response: +",Thrombolytic drugs should be given within 12 hours after onset of acute MI and within 3 hours of acute stroke Refer Harrison 18/e p2027,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Thrombolytics can provide relative morality reduction in the treatment of acute myocardial infarction if patient comes within, with the following options: A: 6 hrs, B: 12 hrs, C: 18 hrs, D: 24 hrs + ### Response: Thrombolytic drugs should be given within 12 hours after onset of acute MI and within 3 hours of acute stroke Refer Harrison 18/e p2027 ### End" @@ -8214,6 +14707,13 @@ Thrombolytic drugs should be given within 12 hours after onset of acute MI and w Answer the following medical question: What is extrapleural pneumonectomy -, with the following options: A: Removal one lobe of lung, B: Removal of a complete lung, C: Removal of pleura of one lung, D: Removal of an affected lung with its pleura and pa of diagphragm +### Response: +","Answer- D. Removal of an affected lung with its pleura and pa of diagphragmExtrapleural pneumonectomy (EPP): removal of the affected lung, plus pa of the diaphragm, the parietal pleura (lining of the chest) and the pericardium (lining of the hea) on that side.The linings are replaced by Gore-Tex in this radical and painfrrl surgery that is used primarily for treatment of malignant mesothelioma.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What is extrapleural pneumonectomy -, with the following options: A: Removal one lobe of lung, B: Removal of a complete lung, C: Removal of pleura of one lung, D: Removal of an affected lung with its pleura and pa of diagphragm + ### Response: Answer- D. Removal of an affected lung with its pleura and pa of diagphragmExtrapleural pneumonectomy (EPP): removal of the affected lung, plus pa of the diaphragm, the parietal pleura (lining of the chest) and the pericardium (lining of the hea) on that side.The linings are replaced by Gore-Tex in this radical and painfrrl surgery that is used primarily for treatment of malignant mesothelioma. ### End" @@ -8223,6 +14723,13 @@ Answer- D. Removal of an affected lung with its pleura and pa of diagphragmExtra Answer the following medical question: Leydig cells secrete-, with the following options: A: Inhibin, B: MIS, C: Testosterone, D: Androgen binding protein +### Response: +","Ans. is 'c' i.e., Testosterone Thyroido Thyroxine (T4) & Triiodothyronine (T3) by follicular cells,o Calcitonin by parafollicular cells.Parathyroido Parathormone (PTH)Pancreaso Insulin & amylin by b-cells (B - cells),o Glucagon by a-cells (A - cells),o Somatostatin by d-cells (D - cells),o pancreatic polypeptide by F - cells.Gonadso Testis* Androgens (testosterone & others) by Leydig cells.* ABP, inhibin activin and MIS by sertoli cells,o Ovary* Estrogen by granulosa cells.* Progesterone by theca cells.* Inhibin is secreted by granulosa cells and corpus luteum.* Activin is secreted by granulosa cells.* Relaxin is secreted by granulosa cells.Hypothalamuso Oxytocin by paraventricular nucleus,o ADH by supraoptic nucleus.o GHRH, CRH, TRH, GnRH and prolactin inhibiting hormone.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Leydig cells secrete-, with the following options: A: Inhibin, B: MIS, C: Testosterone, D: Androgen binding protein + ### Response: Ans. is 'c' i.e., Testosterone Thyroido Thyroxine (T4) & Triiodothyronine (T3) by follicular cells,o Calcitonin by parafollicular cells.Parathyroido Parathormone (PTH)Pancreaso Insulin & amylin by b-cells (B - cells),o Glucagon by a-cells (A - cells),o Somatostatin by d-cells (D - cells),o pancreatic polypeptide by F - cells.Gonadso Testis* Androgens (testosterone & others) by Leydig cells.* ABP, inhibin activin and MIS by sertoli cells,o Ovary* Estrogen by granulosa cells.* Progesterone by theca cells.* Inhibin is secreted by granulosa cells and corpus luteum.* Activin is secreted by granulosa cells.* Relaxin is secreted by granulosa cells.Hypothalamuso Oxytocin by paraventricular nucleus,o ADH by supraoptic nucleus.o GHRH, CRH, TRH, GnRH and prolactin inhibiting hormone. ### End" @@ -8232,6 +14739,13 @@ Ans. is 'c' i.e., Testosterone Thyroido Thyroxine (T4) & Triiodothyronine (T3) b Answer the following medical question: All of the following causes relaxation of mesangial cells except, with the following options: A: CAMP, B: Dopamine, C: PGF2, D: ANP +### Response: +","PGE2,ANP,CAMP,Dopamine cause relaxation of mesangial cells.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following causes relaxation of mesangial cells except, with the following options: A: CAMP, B: Dopamine, C: PGF2, D: ANP + ### Response: PGE2,ANP,CAMP,Dopamine cause relaxation of mesangial cells. ### End" @@ -8241,6 +14755,13 @@ PGE2,ANP,CAMP,Dopamine cause relaxation of mesangial cells. Answer the following medical question: False about bochdalek hernia is -, with the following options: A: The defect is posterolateral, B: more common on right side, C: May lead to pulmonary hypoplasia and respiratory distress, D: Can be diagnosed prenataily +### Response: +","Ans. is 'b' i.e., More common on right side Congenital diaphragmatic herniao It is the herniation of abdominal contents into the thoracic cavity through the diaphragmatic defecto The defect may be# Posterolateral (Bochdalek hernia)# Retrosternal (Morgagni hernia)# At the esophageal hiatus (hiatal hernia)# Adjacent to the hiatus (paresophageal hernia)o Although all these defects are congenital, the term congenital diaphragmatic hernia is generally used for Bochdalek hernia.Bochdalek herniao Most Bochdalek hernia are on the left side (-80%) and may rarely be bilateral.o Compression of the lung results in pulmonary hypoplasia, involving both the lungs (ipsilateral > contralateral)o Pulmonary vasculature is also abnormal leading to pulmonary hypertension.o Thus the two main factors that affect morbidity and mortality are pulmonary hypoplasia and pulmonary hypertensiono The most frequent clinical presentation of CDH is respiratory distress due to severe hypoxemiao The anteroposterior diameter of the chest may be large along with a scaphoid abdomeno The diagnosis of CDH can be made prenatally by ultrasound.o The postnatal diagnosis is relatively straightforward because a plain chest radiograph demonstrates the gastric air bubbles or loops of bowel within the chest. There may also be a mediastinal shift away from the side of the hernia.o Historically, the surgical repair of a CDH was considered to be a surgical emergency because it was believed that the abdominal viscera within the chest prevented the ability to ventilate. More recently with the recognition of the role of pulmnary hypertension and pulmonary hypoplasia and the adverse effects of early operative repair on the pulmonary function has caused a policy of delayed repair. Thus most pediatric surgeons wait for a variable period (24 to 72 hrs) to allow for stabilization of the infant before doing surgical repair.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: False about bochdalek hernia is -, with the following options: A: The defect is posterolateral, B: more common on right side, C: May lead to pulmonary hypoplasia and respiratory distress, D: Can be diagnosed prenataily + ### Response: Ans. is 'b' i.e., More common on right side Congenital diaphragmatic herniao It is the herniation of abdominal contents into the thoracic cavity through the diaphragmatic defecto The defect may be# Posterolateral (Bochdalek hernia)# Retrosternal (Morgagni hernia)# At the esophageal hiatus (hiatal hernia)# Adjacent to the hiatus (paresophageal hernia)o Although all these defects are congenital, the term congenital diaphragmatic hernia is generally used for Bochdalek hernia.Bochdalek herniao Most Bochdalek hernia are on the left side (-80%) and may rarely be bilateral.o Compression of the lung results in pulmonary hypoplasia, involving both the lungs (ipsilateral > contralateral)o Pulmonary vasculature is also abnormal leading to pulmonary hypertension.o Thus the two main factors that affect morbidity and mortality are pulmonary hypoplasia and pulmonary hypertensiono The most frequent clinical presentation of CDH is respiratory distress due to severe hypoxemiao The anteroposterior diameter of the chest may be large along with a scaphoid abdomeno The diagnosis of CDH can be made prenatally by ultrasound.o The postnatal diagnosis is relatively straightforward because a plain chest radiograph demonstrates the gastric air bubbles or loops of bowel within the chest. There may also be a mediastinal shift away from the side of the hernia.o Historically, the surgical repair of a CDH was considered to be a surgical emergency because it was believed that the abdominal viscera within the chest prevented the ability to ventilate. More recently with the recognition of the role of pulmnary hypertension and pulmonary hypoplasia and the adverse effects of early operative repair on the pulmonary function has caused a policy of delayed repair. Thus most pediatric surgeons wait for a variable period (24 to 72 hrs) to allow for stabilization of the infant before doing surgical repair. ### End" @@ -8250,6 +14771,13 @@ Ans. is 'b' i.e., More common on right side Congenital diaphragmatic herniao It Answer the following medical question: Patterns of Inter-relationships between persons in a society is ?, with the following options: A: Social structure, B: Social psychology, C: Herd structure, D: Social science +### Response: +","Ans. is 'a' i.e., Social structure Patterns of inter-relationships between persons in a society is called social structure. Note - Study of human inter-relationship is called sociology.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Patterns of Inter-relationships between persons in a society is ?, with the following options: A: Social structure, B: Social psychology, C: Herd structure, D: Social science + ### Response: Ans. is 'a' i.e., Social structure Patterns of inter-relationships between persons in a society is called social structure. Note - Study of human inter-relationship is called sociology. ### End" @@ -8259,6 +14787,13 @@ Ans. is 'a' i.e., Social structure Patterns of inter-relationships between perso Answer the following medical question: Division of zygote took place on 5th day after fertilization. What is the type of twinning:, with the following options: A: Monochorionic, Monoamniotic, B: Monochorionic, Diamniotic, C: Dichorionic, Diamniotic, D: Dichorionic, Monoamniotic +### Response: +","Ans. (b) Monochorionic, DiamnioticRef: Dutta 8th ed. 233Division of zygote and types of TwinningDivision of Zygote on/ afterTypes of Twining72 hours/3 daysDichorionic, DiamnioticBetween 4-8 daysMonochorionic, DiamnioticBetween 8-12 daysMonochorionic, Monoamniotic> DaysSiamese, Conjoined TwinsAlso Know* Most common type of twinning is dizygotic twins: 69%* Monozygotic twins in: 31%* MC TYPE OF TWIN GESTATION: Diamniotic Monochorionic (70-75%)* Least common type of twin gestation: Conjoined twins (<1%)* Hellin rule is associated with multiple pregnancyas per which chance of twins is al in 80 pregnancies, triplets 1 in 802 and so on. It can result in complications;* Prematurity is the commonest fetal complication* Post partumhemorrhage is the commonest maternal complication.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Division of zygote took place on 5th day after fertilization. What is the type of twinning:, with the following options: A: Monochorionic, Monoamniotic, B: Monochorionic, Diamniotic, C: Dichorionic, Diamniotic, D: Dichorionic, Monoamniotic + ### Response: Ans. (b) Monochorionic, DiamnioticRef: Dutta 8th ed. 233Division of zygote and types of TwinningDivision of Zygote on/ afterTypes of Twining72 hours/3 daysDichorionic, DiamnioticBetween 4-8 daysMonochorionic, DiamnioticBetween 8-12 daysMonochorionic, Monoamniotic> DaysSiamese, Conjoined TwinsAlso Know* Most common type of twinning is dizygotic twins: 69%* Monozygotic twins in: 31%* MC TYPE OF TWIN GESTATION: Diamniotic Monochorionic (70-75%)* Least common type of twin gestation: Conjoined twins (<1%)* Hellin rule is associated with multiple pregnancyas per which chance of twins is al in 80 pregnancies, triplets 1 in 802 and so on. It can result in complications;* Prematurity is the commonest fetal complication* Post partumhemorrhage is the commonest maternal complication. ### End" @@ -8268,6 +14803,13 @@ Ans. (b) Monochorionic, DiamnioticRef: Dutta 8th ed. 233Division of zygote and t Answer the following medical question: Pain rating index is provided by, with the following options: A: Faces scale, B: Visual analogue scale, C: Mc Gill questionniare, D: CHEOP scale +### Response: +",C i.e. Mc Gill questionnaire,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pain rating index is provided by, with the following options: A: Faces scale, B: Visual analogue scale, C: Mc Gill questionniare, D: CHEOP scale + ### Response: C i.e. Mc Gill questionnaire ### End" @@ -8277,6 +14819,13 @@ C i.e. Mc Gill questionnaire Answer the following medical question: Hyperchloremic acidosis with hypokalemia is a feature of, with the following options: A: Renal tubular acidosis, B: Addison's disease, C: Pyloric stenosis, D: Primary hyperaldosteronism +### Response: +","Ans. a (Renal tubular acidosis). (Ref. Harrison's Medicine 16th/pg. 265, 1702)METABOLIC ACIDOSIS: There are two major categories of clinical metabolic acidosis:# High anion-gap (AG) and# Normal-AG, or hyperchloremic acidosis:Hyperchloremic (nongap) metabolic acidosis# Alkali can be lost from the gastrointestinal tract in diarrhea or from the kidneys (renal tubular acidosis, RTA). In these disorders, reciprocal changes in and result in a normal AG.# In pure hyperchloremic acidosis, therefore, the increase in above the normal value approximates the decrease in . The absence of such a relationship suggests a mixed disturbance.# Metabolic acidosis due to gastrointestinal losses with a high urine pH can be differentiated from RTA because urinary NH4 excretion is typically low in RTA and high with diarrhea.# Urinary NH4 -levels can be estimated by calculating the urine anion gap (UAG):- UAG = -.# When > , and the urine gap is negative, the urine ammonium level is appropriately increased, suggesting an extrarenal cause of the acidosis.# Conversely, when the urine anion gap is positive, urine ammonium level is low, sugg. renal acidosis.The typical findings in classic distal RTA (type 1 RTA) include:# Hypokalemia,# Hyperchloremic acidosis,# Low urinary NH4""# Excretion (positive uag, low urine [NH4U, and# Inappropriately high urine pH (pH -5.5).# Most have hypocitraturia and hypercalciuria, so nephrolithiasis, nephrocalcinosis, bone ds common.# Proximal RTA (type 2 RTA) is most often due to generalized proximal tubular dysfunction manifested by glycosuria, generalized aminoaciduria, and phosphaturia (Fanconi syndrome).# In type 4 RTA, hyperkalemia is disproportionate to the reduction in GFR because of coexisting dysfunction of potassium and acid secretion.FindingType 1 RTAType 2 RTAType 4 RTAGI Bicarbonate LossNormal anion-gap acidosisYesYesYesYesMinimum urine pH>5.5<5.5<5.55 to 6% Filtered bicarbonate excreted<10>15<10<10Serum potassiumLowLowHighLowFanconi syndromeNoYesNoNoStones/nephrocalcinosisYesNoNoNoDaily acid excretionLowNormalLowHighUrine anion gapPositiveNegativePositiveNegativeDaily bicarbonate replacement needs<4 mmol/kg>4 mmol/kg<4 mmol/kgVariableTable: COMPARISON OF NORMAL ANION-GAP ACIDOSISAlso remember:FUNCTIONAL CONSEQUENCES OF TUBULOINTERSTITIAL DISEASEDefectCause(s)1Reduced GFRObliteration of microvasculature and obstruction of tubules2Fanconi syndromeDamage to proximal tubular reabsorption of glucose, amino acids, phosphate, and bicarbonate3Hyperchloremic acidosis1. Reduced ammonia production2. Inability to acidify the collecting duct fluid (distal renal tubular acidosis).3. Proximal bicarbonate wasting4Tubular/small-molecular weight proteinuriaFailure of proximal tubule protein reabsorption5Polyuria, isothenuriaDamage to medullary tubules and vasculature6HyperkalemiaPotassium secretory defects including aldosterone resistance7Salt wastingDistal tubular damage with impaired sodium reabsorptionPRIMARY HYPERALDOSTERONISM (Conn's syndrome)# Conn's adenoma is very sensitive to ACTH as is glucocorticoid suppressible hyperaldosteronism, hence morning levels of ACTH and aldosterone are low.# Idiopathic bilateral adrenal hyperplasia is common than adrenal adenoma,# K+ levels are normal in 70% cases.# Increased plasma and urinary aldosterone.# Decreased plasma renin activity.6# Its dexamethasone suppressive hyperaldosteronism.# 18 OH cortisol levels are very high in Conn's adenoma and glucocorticoid suppressible hyperplasia.# Spironolactone is drug of choice.Secondary hyperaldosteronism results from:# Nephritic syndrome,# Cirrhosis,# Heart failure and# Barter's syndrome.'Spirolactone bodies' are seen in ATCH secreting adrenal adenomas treated with Spironolactone.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hyperchloremic acidosis with hypokalemia is a feature of, with the following options: A: Renal tubular acidosis, B: Addison's disease, C: Pyloric stenosis, D: Primary hyperaldosteronism + ### Response: Ans. a (Renal tubular acidosis). (Ref. Harrison's Medicine 16th/pg. 265, 1702)METABOLIC ACIDOSIS: There are two major categories of clinical metabolic acidosis:# High anion-gap (AG) and# Normal-AG, or hyperchloremic acidosis:Hyperchloremic (nongap) metabolic acidosis# Alkali can be lost from the gastrointestinal tract in diarrhea or from the kidneys (renal tubular acidosis, RTA). In these disorders, reciprocal changes in and result in a normal AG.# In pure hyperchloremic acidosis, therefore, the increase in above the normal value approximates the decrease in . The absence of such a relationship suggests a mixed disturbance.# Metabolic acidosis due to gastrointestinal losses with a high urine pH can be differentiated from RTA because urinary NH4 excretion is typically low in RTA and high with diarrhea.# Urinary NH4 -levels can be estimated by calculating the urine anion gap (UAG):- UAG = -.# When > , and the urine gap is negative, the urine ammonium level is appropriately increased, suggesting an extrarenal cause of the acidosis.# Conversely, when the urine anion gap is positive, urine ammonium level is low, sugg. renal acidosis.The typical findings in classic distal RTA (type 1 RTA) include:# Hypokalemia,# Hyperchloremic acidosis,# Low urinary NH4""# Excretion (positive uag, low urine [NH4U, and# Inappropriately high urine pH (pH -5.5).# Most have hypocitraturia and hypercalciuria, so nephrolithiasis, nephrocalcinosis, bone ds common.# Proximal RTA (type 2 RTA) is most often due to generalized proximal tubular dysfunction manifested by glycosuria, generalized aminoaciduria, and phosphaturia (Fanconi syndrome).# In type 4 RTA, hyperkalemia is disproportionate to the reduction in GFR because of coexisting dysfunction of potassium and acid secretion.FindingType 1 RTAType 2 RTAType 4 RTAGI Bicarbonate LossNormal anion-gap acidosisYesYesYesYesMinimum urine pH>5.5<5.5<5.55 to 6% Filtered bicarbonate excreted<10>15<10<10Serum potassiumLowLowHighLowFanconi syndromeNoYesNoNoStones/nephrocalcinosisYesNoNoNoDaily acid excretionLowNormalLowHighUrine anion gapPositiveNegativePositiveNegativeDaily bicarbonate replacement needs<4 mmol/kg>4 mmol/kg<4 mmol/kgVariableTable: COMPARISON OF NORMAL ANION-GAP ACIDOSISAlso remember:FUNCTIONAL CONSEQUENCES OF TUBULOINTERSTITIAL DISEASEDefectCause(s)1Reduced GFRObliteration of microvasculature and obstruction of tubules2Fanconi syndromeDamage to proximal tubular reabsorption of glucose, amino acids, phosphate, and bicarbonate3Hyperchloremic acidosis1. Reduced ammonia production2. Inability to acidify the collecting duct fluid (distal renal tubular acidosis).3. Proximal bicarbonate wasting4Tubular/small-molecular weight proteinuriaFailure of proximal tubule protein reabsorption5Polyuria, isothenuriaDamage to medullary tubules and vasculature6HyperkalemiaPotassium secretory defects including aldosterone resistance7Salt wastingDistal tubular damage with impaired sodium reabsorptionPRIMARY HYPERALDOSTERONISM (Conn's syndrome)# Conn's adenoma is very sensitive to ACTH as is glucocorticoid suppressible hyperaldosteronism, hence morning levels of ACTH and aldosterone are low.# Idiopathic bilateral adrenal hyperplasia is common than adrenal adenoma,# K+ levels are normal in 70% cases.# Increased plasma and urinary aldosterone.# Decreased plasma renin activity.6# Its dexamethasone suppressive hyperaldosteronism.# 18 OH cortisol levels are very high in Conn's adenoma and glucocorticoid suppressible hyperplasia.# Spironolactone is drug of choice.Secondary hyperaldosteronism results from:# Nephritic syndrome,# Cirrhosis,# Heart failure and# Barter's syndrome.'Spirolactone bodies' are seen in ATCH secreting adrenal adenomas treated with Spironolactone. ### End" @@ -8286,6 +14835,13 @@ Ans. a (Renal tubular acidosis). (Ref. Harrison's Medicine 16th/pg. 265, 1702)ME Answer the following medical question: True about SCID in children is:, with the following options: A: It is due to adenosine deaminase deficiency, B: Humoral immunity is predominantly affected, C: Child should receive double dose of all vaccines, D: Patients with SCID have normal thymus +### Response: +",SCID: It is due to adenosine deaminase deficiency SCID- combined antibody and cellular defect Live vaccines are contraindicated in SCID Patients with SCID have very small thymus; tonsils & adenoids are also absent or underdeveloped,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about SCID in children is:, with the following options: A: It is due to adenosine deaminase deficiency, B: Humoral immunity is predominantly affected, C: Child should receive double dose of all vaccines, D: Patients with SCID have normal thymus + ### Response: SCID: It is due to adenosine deaminase deficiency SCID- combined antibody and cellular defect Live vaccines are contraindicated in SCID Patients with SCID have very small thymus; tonsils & adenoids are also absent or underdeveloped ### End" @@ -8295,6 +14851,13 @@ SCID: It is due to adenosine deaminase deficiency SCID- combined antibody and ce Answer the following medical question: The enzyme, 5a-reductase is responsible for:, with the following options: A: Conversion of cholesterol to pregnenolone and enhancing steroidogenesis, B: Conversion of testosterone to dihydrotestosterone, C: Aromatization of testosterone to estradiol, D: Increasing the synthesis of LH +### Response: +","Ans. B. Conversion of testosterone to dihydrotestosterone5 a -Reductase is the enzyme that converts testosterone to dihydrotestosterone. 5 a -Reductase is associated with increasing the most potent androgen, dihydrotestosterone, and reducing LH secretion. Estrogens are associated with female secondary sex characteristics, although some androgens regulate pubic hair development.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The enzyme, 5a-reductase is responsible for:, with the following options: A: Conversion of cholesterol to pregnenolone and enhancing steroidogenesis, B: Conversion of testosterone to dihydrotestosterone, C: Aromatization of testosterone to estradiol, D: Increasing the synthesis of LH + ### Response: Ans. B. Conversion of testosterone to dihydrotestosterone5 a -Reductase is the enzyme that converts testosterone to dihydrotestosterone. 5 a -Reductase is associated with increasing the most potent androgen, dihydrotestosterone, and reducing LH secretion. Estrogens are associated with female secondary sex characteristics, although some androgens regulate pubic hair development. ### End" @@ -8304,6 +14867,13 @@ Ans. B. Conversion of testosterone to dihydrotestosterone5 a -Reductase is the e Answer the following medical question: Modified amstredam criteria is used for diagnosis of, with the following options: A: Peutz jegher, B: HNPCC, C: Turcot, D: FAP +### Response: +",HNPCC / lynch is diagnosed bt modified emstredam eciteria.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Modified amstredam criteria is used for diagnosis of, with the following options: A: Peutz jegher, B: HNPCC, C: Turcot, D: FAP + ### Response: HNPCC / lynch is diagnosed bt modified emstredam eciteria. ### End" @@ -8313,6 +14883,13 @@ HNPCC / lynch is diagnosed bt modified emstredam eciteria. Answer the following medical question: All are complication of tonsillitis EXCEPT:, with the following options: A: Otitis media, B: Abscess, C: Malignant change, D: Subacute Bacterial Endocarditis +### Response: +","Ans. (c) Malignant changeRef: DhingrcTs ENT 5th ed. / 272-273* Acute tonsillitis often affects school-going children, but it can also affect adults.Cause:* MCC: Group A Beta Hemolytic streptococcus* Acute infections of tonsil may involve these components and are thus classified as:# Acute catarrhal or superficial tonsillitis: generalized pharyngitis and is mostly seen in viral infections.# Acute follicular tonsillitis: Infection spreads into the crypts which become filled with purulent material.# Acute parenchymatous tonsillitis: uniformly enlarged and red tonsil.# Acute membranous tonsillitis: It is a stage ahead of acute follicular tonsillitis. In this, exudation from the crypts coalesces to form a membrane on the surface of tonsil.Symptoms* Sore throat, Difficulty in swallowing, Fever, Eearache, odynophagia, dysphagia* Constitutional symptoms# Headache, general body aches, malaise and constipation.Treatment* Patient is put to bed and encouraged to take plenty of fluids.* Analgesics* Antimicrobial therapy (DOC: Penicillin)Complications* Chronic tonsillitis with recurrent acute attacks. This due to incomplete resolution of acute infection.* Peritonsillar abscess.* Parapharyngeal abscess.* Cervical abscess due to suppuration of jugulodigastric lymph nodes.* Acute otitis media.* Rheumatic fever.* Acute glomerulonephritis.* Subacute bacterial endocarditis.NOTE: Malignancy is never a complication of tonsilittis.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are complication of tonsillitis EXCEPT:, with the following options: A: Otitis media, B: Abscess, C: Malignant change, D: Subacute Bacterial Endocarditis + ### Response: Ans. (c) Malignant changeRef: DhingrcTs ENT 5th ed. / 272-273* Acute tonsillitis often affects school-going children, but it can also affect adults.Cause:* MCC: Group A Beta Hemolytic streptococcus* Acute infections of tonsil may involve these components and are thus classified as:# Acute catarrhal or superficial tonsillitis: generalized pharyngitis and is mostly seen in viral infections.# Acute follicular tonsillitis: Infection spreads into the crypts which become filled with purulent material.# Acute parenchymatous tonsillitis: uniformly enlarged and red tonsil.# Acute membranous tonsillitis: It is a stage ahead of acute follicular tonsillitis. In this, exudation from the crypts coalesces to form a membrane on the surface of tonsil.Symptoms* Sore throat, Difficulty in swallowing, Fever, Eearache, odynophagia, dysphagia* Constitutional symptoms# Headache, general body aches, malaise and constipation.Treatment* Patient is put to bed and encouraged to take plenty of fluids.* Analgesics* Antimicrobial therapy (DOC: Penicillin)Complications* Chronic tonsillitis with recurrent acute attacks. This due to incomplete resolution of acute infection.* Peritonsillar abscess.* Parapharyngeal abscess.* Cervical abscess due to suppuration of jugulodigastric lymph nodes.* Acute otitis media.* Rheumatic fever.* Acute glomerulonephritis.* Subacute bacterial endocarditis.NOTE: Malignancy is never a complication of tonsilittis. ### End" @@ -8322,6 +14899,13 @@ Ans. (c) Malignant changeRef: DhingrcTs ENT 5th ed. / 272-273* Acute tonsillitis Answer the following medical question: Induction of aboion is best by :, with the following options: A: Oxytocin, B: PGE2 gel, C: Stripping of membrane, D: Oestrogen +### Response: +",PGE2 gel,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Induction of aboion is best by :, with the following options: A: Oxytocin, B: PGE2 gel, C: Stripping of membrane, D: Oestrogen + ### Response: PGE2 gel ### End" @@ -8331,6 +14915,13 @@ PGE2 gel Answer the following medical question: A patient of acute myocardial infarction being treated in intensive care unit developed left ventricular failure with raised central venous pressure. It was decided to use nitroglycerine. Which route of administration would be most suitable?, with the following options: A: Sublingual, B: Oral, C: Intravenous bolus injection, D: Slow intravenous infusion +### Response: +",(Ref: KDT 6/e p527) Nitrates can be used in acute LVF by slow i.v. infusion.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A patient of acute myocardial infarction being treated in intensive care unit developed left ventricular failure with raised central venous pressure. It was decided to use nitroglycerine. Which route of administration would be most suitable?, with the following options: A: Sublingual, B: Oral, C: Intravenous bolus injection, D: Slow intravenous infusion + ### Response: (Ref: KDT 6/e p527) Nitrates can be used in acute LVF by slow i.v. infusion. ### End" @@ -8340,6 +14931,13 @@ Answer the following medical question: A patient of acute myocardial infarction Answer the following medical question: CSF pressure is mainly regulated by:, with the following options: A: Rate of CSF formation, B: Rate of CSF absorption, C: Cerebral blood flow, D: Venous pressure +### Response: +",B i.e. Rate of CSF absorption,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: CSF pressure is mainly regulated by:, with the following options: A: Rate of CSF formation, B: Rate of CSF absorption, C: Cerebral blood flow, D: Venous pressure + ### Response: B i.e. Rate of CSF absorption ### End" @@ -8349,6 +14947,13 @@ B i.e. Rate of CSF absorption Answer the following medical question: Cystic hygromas are associated with:, with the following options: A: Down's syndrome, B: Angel man syndrome, C: Marfan syndrome, D: Turner's syndrome +### Response: +",Cystic hygromas are multiloculated cysts which arise because of sequestration of Lymphatic system.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cystic hygromas are associated with:, with the following options: A: Down's syndrome, B: Angel man syndrome, C: Marfan syndrome, D: Turner's syndrome + ### Response: Cystic hygromas are multiloculated cysts which arise because of sequestration of Lymphatic system. ### End" @@ -8358,6 +14963,13 @@ Cystic hygromas are multiloculated cysts which arise because of sequestration of Answer the following medical question: Typical.JVP finding; in cardiac tamponade -, with the following options: A: absent 'Y' descent, B: Prominant 'a' wave, C: Absent 'a' wave, D: Prominent 'Y* wave +### Response: +","The accumulation of fluid in the pericardial space in a quantity sufficient to cause serious obstruction to the inflow of blood to the ventricles results in cardiac tamponade. This complication may be fatal if it is not recognized and treated promptly. The three most common causes of tamponade are neoplastic disease, idiopathic pericarditis, and renal failure. The three principal features of tamponade ( Beck's triad ) are hypotension, soft or absent hea sounds, and jugular venous distention with a prominent x descent but an absent y descent. ref : ( Harrison&;s principle of internal medicine,20 edition,pg no. 1572)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Typical.JVP finding; in cardiac tamponade -, with the following options: A: absent 'Y' descent, B: Prominant 'a' wave, C: Absent 'a' wave, D: Prominent 'Y* wave + ### Response: The accumulation of fluid in the pericardial space in a quantity sufficient to cause serious obstruction to the inflow of blood to the ventricles results in cardiac tamponade. This complication may be fatal if it is not recognized and treated promptly. The three most common causes of tamponade are neoplastic disease, idiopathic pericarditis, and renal failure. The three principal features of tamponade ( Beck's triad ) are hypotension, soft or absent hea sounds, and jugular venous distention with a prominent x descent but an absent y descent. ref : ( Harrison&;s principle of internal medicine,20 edition,pg no. 1572) ### End" @@ -8367,6 +14979,13 @@ The accumulation of fluid in the pericardial space in a quantity sufficient to c Answer the following medical question: CT Scan of head showing a 'Tram track5 appearance in, with the following options: A: Neurofibroma, B: Tuberous sclerosis, C: Von Hippel Lindau disease, D: Sturge weber syndrome +### Response: +","Ans. is 'd' i.e.,. Sturge Weber Syndrome. Sturge-Weber syndrome is characterized by -A large unilateral cutaneous angioma* (.Port wine stain*) of the faceA cerebral angioma involving the ipsilateral* cerebral hemisphere and meninges.Adrenal pheochromocytoma*.Cerebral angioma leads to cortical atrophy and epilepsy*.Characteristic tram track calcification* is seen on x-ray and CT head.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: CT Scan of head showing a 'Tram track5 appearance in, with the following options: A: Neurofibroma, B: Tuberous sclerosis, C: Von Hippel Lindau disease, D: Sturge weber syndrome + ### Response: Ans. is 'd' i.e.,. Sturge Weber Syndrome. Sturge-Weber syndrome is characterized by -A large unilateral cutaneous angioma* (.Port wine stain*) of the faceA cerebral angioma involving the ipsilateral* cerebral hemisphere and meninges.Adrenal pheochromocytoma*.Cerebral angioma leads to cortical atrophy and epilepsy*.Characteristic tram track calcification* is seen on x-ray and CT head. ### End" @@ -8376,6 +14995,13 @@ Ans. is 'd' i.e.,. Sturge Weber Syndrome. Sturge-Weber syndrome is characterized Answer the following medical question: Not true regarding treatment of bacterial corneal ulcer:, with the following options: A: Foified Antibiotic eye drops, B: Cycloplegic & Mydriatic to relieve pain, C: Cyanoacrylate glue is also indicated in treatment of small perforation., D: Steroids are given usually in persistent epithelial defects +### Response: +","Steroids should not be used in persistent epithelial defects Treatment Bacterial corneal ulcer Foified Antibiotic eye drops Cycloplegic & Mydriatic to relieve pain and give rest to ciliary body. Cyanoacrylate glue is also indicated in treatment of small perforation. In case of rise of intra-ocular pressure aqueous suppressant are used to reduce IOP. In case of Leucomatous corneal opacity, penetrating keratoplasty may be needed.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Not true regarding treatment of bacterial corneal ulcer:, with the following options: A: Foified Antibiotic eye drops, B: Cycloplegic & Mydriatic to relieve pain, C: Cyanoacrylate glue is also indicated in treatment of small perforation., D: Steroids are given usually in persistent epithelial defects + ### Response: Steroids should not be used in persistent epithelial defects Treatment Bacterial corneal ulcer Foified Antibiotic eye drops Cycloplegic & Mydriatic to relieve pain and give rest to ciliary body. Cyanoacrylate glue is also indicated in treatment of small perforation. In case of rise of intra-ocular pressure aqueous suppressant are used to reduce IOP. In case of Leucomatous corneal opacity, penetrating keratoplasty may be needed. ### End" @@ -8385,6 +15011,13 @@ Steroids should not be used in persistent epithelial defects Treatment Bacterial Answer the following medical question: SARS is caused by novel variant of?, with the following options: A: Pox virus, B: Toga virus, C: Coronavirus, D: Lyssa virus +### Response: +","Severe acute respiratory syndrome is caused by coronavirus type. SARS C/F Severe lower respiratory tract infection; Characterized by muscle pain, headache, sore throat Fever followed by the onset of respiratory symptoms mainly cough, dyspnea and pneumonia. There are six coronaviruses that can infect humans: Alpha coronaviruses 229E and NL63 Beta coronaviruses OC43, HKU1, SARS-CoV and MERS-CoV","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: SARS is caused by novel variant of?, with the following options: A: Pox virus, B: Toga virus, C: Coronavirus, D: Lyssa virus + ### Response: Severe acute respiratory syndrome is caused by coronavirus type. SARS C/F Severe lower respiratory tract infection; Characterized by muscle pain, headache, sore throat Fever followed by the onset of respiratory symptoms mainly cough, dyspnea and pneumonia. There are six coronaviruses that can infect humans: Alpha coronaviruses 229E and NL63 Beta coronaviruses OC43, HKU1, SARS-CoV and MERS-CoV ### End" @@ -8394,6 +15027,13 @@ Severe acute respiratory syndrome is caused by coronavirus type. SARS C/F Severe Answer the following medical question: Glucose is reabsorbed in which pa ?, with the following options: A: Early PCT, B: Henle loop, C: Collecting duct, D: Distal convoluted tubule +### Response: +","option a - 100% Glucose is reabsorbed from PCT by secondary active transpo, with the help of SGLT (Sodium Dependent Glucose Transpoer).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Glucose is reabsorbed in which pa ?, with the following options: A: Early PCT, B: Henle loop, C: Collecting duct, D: Distal convoluted tubule + ### Response: option a - 100% Glucose is reabsorbed from PCT by secondary active transpo, with the help of SGLT (Sodium Dependent Glucose Transpoer). ### End" @@ -8403,6 +15043,25 @@ option a - 100% Glucose is reabsorbed from PCT by secondary active transpo, with Answer the following medical question: 30 years old primipara in labour with transverse lie.Treatment of choice is:, with the following options: A: Internal cephalic version, B: Emergency cesarean section, C: Wait and watch, D: External cephalic version +### Response: +","Patients in labour with transverse lie can be managed by external cephalic version followed by surgical rupture of the membrane. +But it is important to note that the patient is a primigravida with age 30 years, i.e. elderly primi, so ECV is contraindicated. +This patient requires an emergency cesarean section. + +Guidelines for the management of transverse lie +Antenatal +↓ +External cephalic version in all cases beyond 35 weeks +↓ +If version fails or is contraindicated +↓ +Cesarean section at 38 weeks +During labour","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: 30 years old primipara in labour with transverse lie.Treatment of choice is:, with the following options: A: Internal cephalic version, B: Emergency cesarean section, C: Wait and watch, D: External cephalic version + ### Response: Patients in labour with transverse lie can be managed by external cephalic version followed by surgical rupture of the membrane. But it is important to note that the patient is a primigravida with age 30 years, i.e. elderly primi, so ECV is contraindicated. @@ -8424,6 +15083,26 @@ During labour Answer the following medical question: Which of the following is not a part of Marzouk’s classification?, with the following options: A: Exploratory instruments, B: Non cutting instruments, C: Restoration instruments, D: Instruments to remove tooth structure +### Response: +","G.V. Black among his many contributions to modern dentistry, is credited with the first acceptable nomenclature for and classification of hand instruments. His classification system enabled both dentists and manufacturers to communicate more clearly and effectively in regard to instrument design and function. +Hand instruments used in the dental operatory may be categorized as: + +Cutting (excavators, chisels and others).  +Noncutting (amalgam condensers, mirrors, explorers, probes). + +Marzouk classified instruments of operative dentistry into: + +Those used for exploration. +Those used for removal of tooth structure. +Those used for restoration of teeth. + +Ref: Sturdevant's art and science of operative dentistry. 4th edition page 310 +       Operative dentistry modern theory and practice Marzouk page 57","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is not a part of Marzouk’s classification?, with the following options: A: Exploratory instruments, B: Non cutting instruments, C: Restoration instruments, D: Instruments to remove tooth structure + ### Response: G.V. Black among his many contributions to modern dentistry, is credited with the first acceptable nomenclature for and classification of hand instruments. His classification system enabled both dentists and manufacturers to communicate more clearly and effectively in regard to instrument design and function. Hand instruments used in the dental operatory may be categorized as: @@ -8446,6 +15125,16 @@ Ref: Sturdevant's art and science of operative dentistry. 4th edition page 310 Answer the following medical question: Which adhesion molecule is involved in morphogenesis?, with the following options: A: Osteopontin, B: Osteonectin SPARC, C: Tenascin, D: Thrombospondin +### Response: +","Various adhesive glycoproteins act as glue for the ECM and the cells. These consist of fibronectin, tenascin (cytotactin) and thrombospondin. +Tenascin or cytotactin is the glycoprotein associated with fibroblasts and appears in wound about 48 hours after injury. It disappears from mature scar tissue. + +Mohan H. Textbook of Pathology. Jaypee Brothers Medical Publishers; 2015. Edition 7. Page 160","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which adhesion molecule is involved in morphogenesis?, with the following options: A: Osteopontin, B: Osteonectin SPARC, C: Tenascin, D: Thrombospondin + ### Response: Various adhesive glycoproteins act as glue for the ECM and the cells. These consist of fibronectin, tenascin (cytotactin) and thrombospondin. Tenascin or cytotactin is the glycoprotein associated with fibroblasts and appears in wound about 48 hours after injury. It disappears from mature scar tissue. @@ -8458,6 +15147,17 @@ Mohan H. Textbook of Pathology. Jaypee Brothers Medical Publishers; 2015. Editio Answer the following medical question: All of the following muscles are paralyzed in trauma to median nerve at the, wrist except -, with the following options: A: Adductor pollicis, B: Abductor pollicis, C: First two lumbicals, D: Muscles of the Thenar eminence +### Response: +","Median nerve supply in hand +-        Flexor pollicis brevis +-        Opponens pollicis +-        Abductor pollicis brevis +-        First two lumbricals","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following muscles are paralyzed in trauma to median nerve at the, wrist except -, with the following options: A: Adductor pollicis, B: Abductor pollicis, C: First two lumbicals, D: Muscles of the Thenar eminence + ### Response: Median nerve supply in hand -        Flexor pollicis brevis @@ -8471,6 +15171,13 @@ Median nerve supply in hand Answer the following medical question: Rapid urease positive test is done in ?, with the following options: A: H. Pylori, B: S. Aureus, C: Klebsiella, D: Staphylococcus +### Response: +","Ans. is 'a' i.e., H. Pylori","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Rapid urease positive test is done in ?, with the following options: A: H. Pylori, B: S. Aureus, C: Klebsiella, D: Staphylococcus + ### Response: Ans. is 'a' i.e., H. Pylori ### End" @@ -8480,6 +15187,13 @@ Ans. is 'a' i.e., H. Pylori Answer the following medical question: Casper's dictum for rate of decomposition in air: water: buried bodies is: TN 09, with the following options: A: 8:04:01, B: 4:02:01, C: 1:02:04, D: 1:04:08 +### Response: +",Ans. 1:4:8,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Casper's dictum for rate of decomposition in air: water: buried bodies is: TN 09, with the following options: A: 8:04:01, B: 4:02:01, C: 1:02:04, D: 1:04:08 + ### Response: Ans. 1:4:8 ### End" @@ -8489,6 +15203,13 @@ Ans. 1:4:8 Answer the following medical question: Cavitation in pulmonary metastasis is commonly associated with?, with the following options: A: Squamous cell carcinoma, B: Adenocarcinoma, C: Chondrosarcoma, D: Osteosarcoma +### Response: +",Cavitation in pulmonary metastases is a feature of Squamous cell carcinoma. Calcification in pulmonary metastasis is a feature in Osteosarcoma and chondrosarcoma.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cavitation in pulmonary metastasis is commonly associated with?, with the following options: A: Squamous cell carcinoma, B: Adenocarcinoma, C: Chondrosarcoma, D: Osteosarcoma + ### Response: Cavitation in pulmonary metastases is a feature of Squamous cell carcinoma. Calcification in pulmonary metastasis is a feature in Osteosarcoma and chondrosarcoma. ### End" @@ -8498,6 +15219,13 @@ Cavitation in pulmonary metastases is a feature of Squamous cell carcinoma. Calc Answer the following medical question: A patient has oral ulcer and skin bullae, which are slow to heal. The lesion is:, with the following options: A: Intradermal, B: Suprabasal, C: Epidermal, D: Sub comeal +### Response: +","Ans. b. Suprabasal (Ref: Fitzpatrick 7/e p45-47, 349, 459-84, 1714, 1878, 1892; Rooks Textbook of Dermatology 8/e p40.3-40.64)Bulla on body and oral mucosa in a 50 years old male is suggestive of Pemphigus vulgaris.Pemphigus vulgaris:Characterized by cutaneous (thin walled, delicate and flaccid bullae)Q and mucosal blisters.Mucosal lesions are present in all patients, oral mucosa most frequently involved, painful erosions extend peripherally with shedding of mucosaQ.Bulla is intra-epidermalQ, the split being suprabasalQ.Presence of acantholytic cells (rounded keratinocytesQ present in the blister cavity and at the edge of the blister) with row of tombstone appearanceQ.A 30-year-old male presents with flaccid bullae on an erythematous base and erosions over the oral mucous membrane. The blisters developed painful erosions rupture. The clinical features point towards a diagnosis ofpermphigus vulgaris, which is characterized by fish net pattern of intraepidermal IgG deposition on immunofluorescence.DisorderImmunofluorescencePatternTarget antigenPemphigus vulgarisIntercellular, intraepidermalQIgG, fish netQDesmoglein 3QPemphigus foliaceusIntercellular, intraepidermalQIgG, fish netQDesmoglein 1QParaneoplastic pemphigusIntercellular and subepidermalQIgG, fish netQPlakins (desmoplakin, envoplakin, periplakin, BP 230)Bullous pemphigoidBasement membrane zoneQIgG, linearQBP230> BP180Herpes gestationalisBasement membrane zoneQIgG, linearQBP230 > BP 180Dermatitis herpetiformisDermal papillaeQIgA, granularQ(?) Epidermal tissue trnasgl utam inaseQLinear IgA diseaseBasement membrane zoneQIgA, linearQBP180PemphigusAutoimmune disease characterized by acantholysis induced by deposition oflgG antibodies in the intercellular area of epidermisQCommonest variant is Pemphigus vulgaris, seen in adults mainlyQMainly involve upper part of the bodyQCharacterized by cutaneous (thin walled, delicate and flaccid bullae)Q and mucosal blistersMucosal lesions are present in all patients, oral mucosa most frequently involved, painful erosions extend peripherally with shedding of mucosaQErosions are frequently secondarily infectedQ (by bacteria in skin and Candida in mucosa), extensive lesions are associated with water and electrolyte imbalanceQAssociated with Nikolsky signQ and Bulla spread sign or Asboe Hansen signQ.Histology (Biopsy is best taken from the edgeQ, from perilestonal skinQ)Bulla is intra-epidermalQ, the split being suprabasalQPresence of acantholytic cells (rounded keratinocytesQ present in the blister cavity and at the edge of the blister)Row of tombstone appearanceQDirect Immunofluorescence (DIF):Done on skin, shows intercellular deposits of IgG and C3 giving a fish net appearanceQTreatment:Systemic steroids and immunosuppressants.Types of BullaeIntra-EpidermalSub-Epidermal* PemphigusQ* Herpes simplex/zosterQ* Molluscum contagiosumQ* Variola/varicelia* Eczema* Darriers disease* Miliria rubra* Pompholyx* PemphigoidQ* Dermatitis herpetiformisQ* Herpes gestationalisQ* BurnsQ* Erythema multiformeQ* Epidermolysis bullosa* Lichen planus bullosa","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A patient has oral ulcer and skin bullae, which are slow to heal. The lesion is:, with the following options: A: Intradermal, B: Suprabasal, C: Epidermal, D: Sub comeal + ### Response: Ans. b. Suprabasal (Ref: Fitzpatrick 7/e p45-47, 349, 459-84, 1714, 1878, 1892; Rooks Textbook of Dermatology 8/e p40.3-40.64)Bulla on body and oral mucosa in a 50 years old male is suggestive of Pemphigus vulgaris.Pemphigus vulgaris:Characterized by cutaneous (thin walled, delicate and flaccid bullae)Q and mucosal blisters.Mucosal lesions are present in all patients, oral mucosa most frequently involved, painful erosions extend peripherally with shedding of mucosaQ.Bulla is intra-epidermalQ, the split being suprabasalQ.Presence of acantholytic cells (rounded keratinocytesQ present in the blister cavity and at the edge of the blister) with row of tombstone appearanceQ.A 30-year-old male presents with flaccid bullae on an erythematous base and erosions over the oral mucous membrane. The blisters developed painful erosions rupture. The clinical features point towards a diagnosis ofpermphigus vulgaris, which is characterized by fish net pattern of intraepidermal IgG deposition on immunofluorescence.DisorderImmunofluorescencePatternTarget antigenPemphigus vulgarisIntercellular, intraepidermalQIgG, fish netQDesmoglein 3QPemphigus foliaceusIntercellular, intraepidermalQIgG, fish netQDesmoglein 1QParaneoplastic pemphigusIntercellular and subepidermalQIgG, fish netQPlakins (desmoplakin, envoplakin, periplakin, BP 230)Bullous pemphigoidBasement membrane zoneQIgG, linearQBP230> BP180Herpes gestationalisBasement membrane zoneQIgG, linearQBP230 > BP 180Dermatitis herpetiformisDermal papillaeQIgA, granularQ(?) Epidermal tissue trnasgl utam inaseQLinear IgA diseaseBasement membrane zoneQIgA, linearQBP180PemphigusAutoimmune disease characterized by acantholysis induced by deposition oflgG antibodies in the intercellular area of epidermisQCommonest variant is Pemphigus vulgaris, seen in adults mainlyQMainly involve upper part of the bodyQCharacterized by cutaneous (thin walled, delicate and flaccid bullae)Q and mucosal blistersMucosal lesions are present in all patients, oral mucosa most frequently involved, painful erosions extend peripherally with shedding of mucosaQErosions are frequently secondarily infectedQ (by bacteria in skin and Candida in mucosa), extensive lesions are associated with water and electrolyte imbalanceQAssociated with Nikolsky signQ and Bulla spread sign or Asboe Hansen signQ.Histology (Biopsy is best taken from the edgeQ, from perilestonal skinQ)Bulla is intra-epidermalQ, the split being suprabasalQPresence of acantholytic cells (rounded keratinocytesQ present in the blister cavity and at the edge of the blister)Row of tombstone appearanceQDirect Immunofluorescence (DIF):Done on skin, shows intercellular deposits of IgG and C3 giving a fish net appearanceQTreatment:Systemic steroids and immunosuppressants.Types of BullaeIntra-EpidermalSub-Epidermal* PemphigusQ* Herpes simplex/zosterQ* Molluscum contagiosumQ* Variola/varicelia* Eczema* Darriers disease* Miliria rubra* Pompholyx* PemphigoidQ* Dermatitis herpetiformisQ* Herpes gestationalisQ* BurnsQ* Erythema multiformeQ* Epidermolysis bullosa* Lichen planus bullosa ### End" @@ -8507,6 +15235,13 @@ Ans. b. Suprabasal (Ref: Fitzpatrick 7/e p45-47, 349, 459-84, 1714, 1878, 1892; Answer the following medical question: Sternum attached to scapula, with the following options: A: Manubrium, B: Clavicle, C: First rib, D: Second rib +### Response: +","Sternum or chest bone is attached to scapula which is present on posterior surface with help of clavicle or collar bone so that weight of upper limb is transmitted to axial skeleton scapula,Clavicle and sternum","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Sternum attached to scapula, with the following options: A: Manubrium, B: Clavicle, C: First rib, D: Second rib + ### Response: Sternum or chest bone is attached to scapula which is present on posterior surface with help of clavicle or collar bone so that weight of upper limb is transmitted to axial skeleton scapula,Clavicle and sternum ### End" @@ -8516,6 +15251,13 @@ Sternum or chest bone is attached to scapula which is present on posterior surfa Answer the following medical question: All the following are true regarding cystic hygroma EXCEPT, with the following options: A: May be present at bih, B: Brilliantly transilluminant, C: Increases in size on coughing, D: Sclerotherapy may be beneficial +### Response: +","Cystic hygroma usually present in the neonate or in early infancy, and occasionally may present at bih and be so large as to obstruct labour. The cysts are filled with clear lymph and lined by a single layer of epithelium with a mosaic appearance. Swelling usually occurs in the neck and may involve the parotid, submandibular, tongue and floor of mouth areas. The swelling may be bilateral and is soft and paially compressible, visibly increasing in size when the child coughs or cries. The characteristic that distinguishes it from all other neck swellings is that it is brilliantly translucent. The cheek, axilla, groin and mediastinum are other less frequent sites for a cystic hygroma. The behaviour of cystic hygromas during infancy is unpredictable. Sometimes the cyst expands rapidly and occasionally respiratory difficulty ensues, requiring immediate aspiration andeven occasionally a tracheostomy. The cyst may become infected. Definitive treatment is complete excision of the cyst at an early stage. Injection of a sclerosing agent, for example picibanil (OK-432), may reduce the size of the cyst; however, they are commonly multicystic and if the injection is extracystic subsequent surgery may be more difficult Bailey & Love,25th,729.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All the following are true regarding cystic hygroma EXCEPT, with the following options: A: May be present at bih, B: Brilliantly transilluminant, C: Increases in size on coughing, D: Sclerotherapy may be beneficial + ### Response: Cystic hygroma usually present in the neonate or in early infancy, and occasionally may present at bih and be so large as to obstruct labour. The cysts are filled with clear lymph and lined by a single layer of epithelium with a mosaic appearance. Swelling usually occurs in the neck and may involve the parotid, submandibular, tongue and floor of mouth areas. The swelling may be bilateral and is soft and paially compressible, visibly increasing in size when the child coughs or cries. The characteristic that distinguishes it from all other neck swellings is that it is brilliantly translucent. The cheek, axilla, groin and mediastinum are other less frequent sites for a cystic hygroma. The behaviour of cystic hygromas during infancy is unpredictable. Sometimes the cyst expands rapidly and occasionally respiratory difficulty ensues, requiring immediate aspiration andeven occasionally a tracheostomy. The cyst may become infected. Definitive treatment is complete excision of the cyst at an early stage. Injection of a sclerosing agent, for example picibanil (OK-432), may reduce the size of the cyst; however, they are commonly multicystic and if the injection is extracystic subsequent surgery may be more difficult Bailey & Love,25th,729. ### End" @@ -8525,6 +15267,13 @@ Cystic hygroma usually present in the neonate or in early infancy, and occasiona Answer the following medical question: Hair cells baseline membrane potential O?, with the following options: A: 30mV, B: -50mV, C: -40mV, D: -60mV +### Response: +","Ans. is 'd' i.e., -60mVThe resting membrane potential of the hair cells is about -60 mV.When the stereocilia are pushed toward the kinocilium, the membrane potential is decreased to about -50 mV. When the bundle of processes is pushed in the opposite direction, the cell is hyperpolarized.Displacing the process in a direction perpendicular to this axis provides no change in membrane potenital, and displacing the processes in directions that are intermediate between these two directions produces depolarization or hyperpolarization that is propoional to the degree to which the direction is toward or away from the kinocilium.Thus, the hair processes provide a mechanism for generating changes in membrane potential propoional to the direction and distance the hair moves.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hair cells baseline membrane potential O?, with the following options: A: 30mV, B: -50mV, C: -40mV, D: -60mV + ### Response: Ans. is 'd' i.e., -60mVThe resting membrane potential of the hair cells is about -60 mV.When the stereocilia are pushed toward the kinocilium, the membrane potential is decreased to about -50 mV. When the bundle of processes is pushed in the opposite direction, the cell is hyperpolarized.Displacing the process in a direction perpendicular to this axis provides no change in membrane potenital, and displacing the processes in directions that are intermediate between these two directions produces depolarization or hyperpolarization that is propoional to the degree to which the direction is toward or away from the kinocilium.Thus, the hair processes provide a mechanism for generating changes in membrane potential propoional to the direction and distance the hair moves. ### End" @@ -8534,6 +15283,13 @@ Ans. is 'd' i.e., -60mVThe resting membrane potential of the hair cells is about Answer the following medical question: Antral sign is seen in -, with the following options: A: Juvenile angiofibroma, B: Otosclerosis, C: CSOM, D: Sinusitis +### Response: +",Antral sign or Holman-Miller sign (anterior bowing of posterior wall of maxillary sinus) on CT scan is pathognomic of JNA.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Antral sign is seen in -, with the following options: A: Juvenile angiofibroma, B: Otosclerosis, C: CSOM, D: Sinusitis + ### Response: Antral sign or Holman-Miller sign (anterior bowing of posterior wall of maxillary sinus) on CT scan is pathognomic of JNA. ### End" @@ -8543,6 +15299,13 @@ Antral sign or Holman-Miller sign (anterior bowing of posterior wall of maxillar Answer the following medical question: Treatment of early cases of vocal nodules is -, with the following options: A: Excision, B: Laser Ablation, C: Voice therapy, D: Tissue sampling followed by definitive therapy +### Response: +","Ans. is 'c' i.e., Voice therapy * Early cases of vocal nodules can be treated conservatively by educating the patient in proper use of voice. Many nodules especially in children, disappear with this treatment.* Surgery is required for large nodules or long standing nodules in adults. Microscopic (microlaryngoscopic) excision is the treatment of choice.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Treatment of early cases of vocal nodules is -, with the following options: A: Excision, B: Laser Ablation, C: Voice therapy, D: Tissue sampling followed by definitive therapy + ### Response: Ans. is 'c' i.e., Voice therapy * Early cases of vocal nodules can be treated conservatively by educating the patient in proper use of voice. Many nodules especially in children, disappear with this treatment.* Surgery is required for large nodules or long standing nodules in adults. Microscopic (microlaryngoscopic) excision is the treatment of choice. ### End" @@ -8552,6 +15315,13 @@ Ans. is 'c' i.e., Voice therapy * Early cases of vocal nodules can be treated co Answer the following medical question: Killian's dehisense is seen in:, with the following options: A: Oropharynx, B: Nasopharynx, C: Cricopharynx, D: Vocal cords +### Response: +","It is the area of weakness between the two pas of inferior constrictor muscle-subthyropharyngeus and cricopharyngeus. Since it is an area of weakness it is one of the sites of esophageal perforation duting instrumentation and scopy-hence also called gateway of tears. It is lined by stratified squamous epithelium. Ref Dhingra 5/e,p 253,6/e,p 238.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Killian's dehisense is seen in:, with the following options: A: Oropharynx, B: Nasopharynx, C: Cricopharynx, D: Vocal cords + ### Response: It is the area of weakness between the two pas of inferior constrictor muscle-subthyropharyngeus and cricopharyngeus. Since it is an area of weakness it is one of the sites of esophageal perforation duting instrumentation and scopy-hence also called gateway of tears. It is lined by stratified squamous epithelium. Ref Dhingra 5/e,p 253,6/e,p 238. ### End" @@ -8561,6 +15331,13 @@ It is the area of weakness between the two pas of inferior constrictor muscle-su Answer the following medical question: Twin pregnancy, but due to two different men cause is ?, with the following options: A: Superfactation, B: Superfecundation, C: Both of the above, D: Not a realistic situation +### Response: +","Ans. is 'c' i.e., Both of the above Superfecundation : Two ova are released in the same cycle get feilized, either during the same act of coitus or during the separate acts. There is a possibility of the twin having two fathers. Superfaetation : (i) During the continuation of development of fetus, another ova released in a subsequent cycle get feilized and stas developing as a second fetus. This can result in (a) Twin having two fathers, (b) Two children being born together with different stages of development, (c) Female may deliver twice within 1-3 months","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Twin pregnancy, but due to two different men cause is ?, with the following options: A: Superfactation, B: Superfecundation, C: Both of the above, D: Not a realistic situation + ### Response: Ans. is 'c' i.e., Both of the above Superfecundation : Two ova are released in the same cycle get feilized, either during the same act of coitus or during the separate acts. There is a possibility of the twin having two fathers. Superfaetation : (i) During the continuation of development of fetus, another ova released in a subsequent cycle get feilized and stas developing as a second fetus. This can result in (a) Twin having two fathers, (b) Two children being born together with different stages of development, (c) Female may deliver twice within 1-3 months ### End" @@ -8570,6 +15347,13 @@ Ans. is 'c' i.e., Both of the above Superfecundation : Two ova are released in t Answer the following medical question: What will be the effect on spirometry in case of lobectomy done for bronchogenic carcinoma?, with the following options: A: Increased residual volume, B: Increased vital capacity, C: Increased dead space ventilation, D: Increased closing volume +### Response: +","In case of lobectomy, since the remaining lung tissue is lesser, all parameters like vital capacity, residual volume and closing volume will reduce. Hence, due to hypoxic stimulus post-operative patients of lobectomy will take rapid shallow breaths. This will lead to increased Dead space ventilation.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What will be the effect on spirometry in case of lobectomy done for bronchogenic carcinoma?, with the following options: A: Increased residual volume, B: Increased vital capacity, C: Increased dead space ventilation, D: Increased closing volume + ### Response: In case of lobectomy, since the remaining lung tissue is lesser, all parameters like vital capacity, residual volume and closing volume will reduce. Hence, due to hypoxic stimulus post-operative patients of lobectomy will take rapid shallow breaths. This will lead to increased Dead space ventilation. ### End" @@ -8579,6 +15363,13 @@ In case of lobectomy, since the remaining lung tissue is lesser, all parameters Answer the following medical question: A person restricts himself to house and fears about trains, elevators, and shopping malls. It is a feature of, with the following options: A: Generalised Anxiety disorder, B: Agoraphobia, C: Claustrophobia, D: Acrophobia +### Response: +","(B) Agoraphobia # Agoraphobia is an anxiety disorder characterized by symptoms of anxiety in situations where the person perceives the environment to be unsafe with no easy way to get away.> These situations can include open spaces, public transit, shopping malls, or simply being outside the home. Being in these situations may result in a panic attack.> Symptoms occur nearly every time the situation is encountered and lasts for more than six months.> Those affected will go to great lengths to avoid these situations. In severe cases people may become unable to leave their homes.# Cause of agoraphobia is a combination of genetic and environmental factors. Condition often runs in families and stressful events such as the death of a parent or being attacked may be a trigger. In the DSM-5 agoraphobia is classified as a phobia along with specific phobias and social phobia. Other conditions that can produce similar symptoms include separation anxiety, posttraumatic stress disorder, and major depressive disorder. Those affected are at higher risk of depression and substance use disorder.> Treatment: Without treatment it is uncommon for agoraphobia to resolve. Treatment is typically with a type of counselling called cognitive behavioral therapy (CBT). CBT results in resolution for about half of people# Claustrophobia is the fear of having no escape and being in closed or small spaces or rooms.> It is typically classified as an anxiety disorder and often results in panic attack, and can be the result of many situations or stimuli, including elevators crowded to capacity, windowless rooms, and even tight-necked clothing.> Onset of claustrophobia has been attributed to many factors, including a reduction in the size of the amygdala, classical conditioning, or a genetic predisposition to fear small spaces.> Claustrophobia is typically thought to have two key symptoms: Fear of restriction Fear of suffocation> A typical claustrophobic will fear restriction in at least one, if not several, of the following areas: small rooms, locked rooms, cars, aeroplanes, trains, tunnels, cellars, elevators, caves.# Acrophobia is an extreme or irrational fear or phobia of heights, especially when one is not particularly high up.> It belongs to a category of specific phobias, called space and motion discomfort, that share both similar etiology and options for treatment.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A person restricts himself to house and fears about trains, elevators, and shopping malls. It is a feature of, with the following options: A: Generalised Anxiety disorder, B: Agoraphobia, C: Claustrophobia, D: Acrophobia + ### Response: (B) Agoraphobia # Agoraphobia is an anxiety disorder characterized by symptoms of anxiety in situations where the person perceives the environment to be unsafe with no easy way to get away.> These situations can include open spaces, public transit, shopping malls, or simply being outside the home. Being in these situations may result in a panic attack.> Symptoms occur nearly every time the situation is encountered and lasts for more than six months.> Those affected will go to great lengths to avoid these situations. In severe cases people may become unable to leave their homes.# Cause of agoraphobia is a combination of genetic and environmental factors. Condition often runs in families and stressful events such as the death of a parent or being attacked may be a trigger. In the DSM-5 agoraphobia is classified as a phobia along with specific phobias and social phobia. Other conditions that can produce similar symptoms include separation anxiety, posttraumatic stress disorder, and major depressive disorder. Those affected are at higher risk of depression and substance use disorder.> Treatment: Without treatment it is uncommon for agoraphobia to resolve. Treatment is typically with a type of counselling called cognitive behavioral therapy (CBT). CBT results in resolution for about half of people# Claustrophobia is the fear of having no escape and being in closed or small spaces or rooms.> It is typically classified as an anxiety disorder and often results in panic attack, and can be the result of many situations or stimuli, including elevators crowded to capacity, windowless rooms, and even tight-necked clothing.> Onset of claustrophobia has been attributed to many factors, including a reduction in the size of the amygdala, classical conditioning, or a genetic predisposition to fear small spaces.> Claustrophobia is typically thought to have two key symptoms: Fear of restriction Fear of suffocation> A typical claustrophobic will fear restriction in at least one, if not several, of the following areas: small rooms, locked rooms, cars, aeroplanes, trains, tunnels, cellars, elevators, caves.# Acrophobia is an extreme or irrational fear or phobia of heights, especially when one is not particularly high up.> It belongs to a category of specific phobias, called space and motion discomfort, that share both similar etiology and options for treatment. ### End" @@ -8588,6 +15379,13 @@ Answer the following medical question: A person restricts himself to house and f Answer the following medical question: Amount of ORS given in 4 KG children with diarrhoea, with the following options: A: 200 ml, B: 300 ml, C: 400 ml, D: 800 ml +### Response: +","The family should be provided with at least two days woh of ORS packets.WHO recommends, in addition to infants continued to be breastfed, that children older than six months be given some food before being sent home, which helps to emphasize to parents the impoance of continuing to feed the child during diarrhoea.Body wt = 4 kg.Requirements 75 ml/kg.So total requirements 75x4 = 200 ml.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Amount of ORS given in 4 KG children with diarrhoea, with the following options: A: 200 ml, B: 300 ml, C: 400 ml, D: 800 ml + ### Response: The family should be provided with at least two days woh of ORS packets.WHO recommends, in addition to infants continued to be breastfed, that children older than six months be given some food before being sent home, which helps to emphasize to parents the impoance of continuing to feed the child during diarrhoea.Body wt = 4 kg.Requirements 75 ml/kg.So total requirements 75x4 = 200 ml. ### End" @@ -8597,6 +15395,13 @@ The family should be provided with at least two days woh of ORS packets.WHO reco Answer the following medical question: Wood worker's associated sinus Ca is: (PGI Dec 2006), with the following options: A: Adeno Ca, B: Sq cell Ca, C: Anaplastic Ca, D: Melanoma +### Response: +","Ans: A (Adeno Ca) ""Workers of furniture industry develop Adenocarcinoma of the Ethmoids and upper nasal cavityQ-while those engaged in Nickel refining get squamos cell and anaplastic carcinomaQ- Dhingra 5th/219","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Wood worker's associated sinus Ca is: (PGI Dec 2006), with the following options: A: Adeno Ca, B: Sq cell Ca, C: Anaplastic Ca, D: Melanoma + ### Response: Ans: A (Adeno Ca) ""Workers of furniture industry develop Adenocarcinoma of the Ethmoids and upper nasal cavityQ-while those engaged in Nickel refining get squamos cell and anaplastic carcinomaQ- Dhingra 5th/219 ### End" @@ -8606,6 +15411,13 @@ Ans: A (Adeno Ca) ""Workers of furniture industry develop Adenocarcinoma of the Answer the following medical question: Most common cause of posterior staphyloma, with the following options: A: Trauma, B: Glaucoma, C: Myopia, D: Scleritis +### Response: +","POSTERIOR STAPHYLOMA It effects the posterior pole of the eye and is lined by the choroid. Degenerative high axial myopia is the most common cause. Indirect ophthalmoscopy shows a posterior outward curvature of the globe detected as a crescentric shadow in the macular region. The retinal vessels are seen to change direction, dipping down into the region. The staphylomatous region may appear pale due to degenerative changes in the retina, retinal pigment epithelium and choroid. Ref:- Parsons diseases of eye; pg num:-230","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common cause of posterior staphyloma, with the following options: A: Trauma, B: Glaucoma, C: Myopia, D: Scleritis + ### Response: POSTERIOR STAPHYLOMA It effects the posterior pole of the eye and is lined by the choroid. Degenerative high axial myopia is the most common cause. Indirect ophthalmoscopy shows a posterior outward curvature of the globe detected as a crescentric shadow in the macular region. The retinal vessels are seen to change direction, dipping down into the region. The staphylomatous region may appear pale due to degenerative changes in the retina, retinal pigment epithelium and choroid. Ref:- Parsons diseases of eye; pg num:-230 ### End" @@ -8615,6 +15427,13 @@ POSTERIOR STAPHYLOMA It effects the posterior pole of the eye and is lined by th Answer the following medical question: Fluoresciene stain is used in the eye to stain -, with the following options: A: Cornea, B: Retina, C: Choroid, D: Iris +### Response: +","Ans. is 'a' i.e., Cornea Important corneal examinationsUsed foro Keratometry, Corneal topography o Specular microscopyo Slit lampo Padiymetero Placido's disco Fluorescein. Alacian blue & Ben sal rose staino Window reflex, slit lamp biomicroscopy, Placidos' discCurvature of cornea Corneal endothelial densityCorneal opacity Thic kness of cornea Corneal sheen Corneal stainingCorneal surface","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Fluoresciene stain is used in the eye to stain -, with the following options: A: Cornea, B: Retina, C: Choroid, D: Iris + ### Response: Ans. is 'a' i.e., Cornea Important corneal examinationsUsed foro Keratometry, Corneal topography o Specular microscopyo Slit lampo Padiymetero Placido's disco Fluorescein. Alacian blue & Ben sal rose staino Window reflex, slit lamp biomicroscopy, Placidos' discCurvature of cornea Corneal endothelial densityCorneal opacity Thic kness of cornea Corneal sheen Corneal stainingCorneal surface ### End" @@ -8624,6 +15443,13 @@ Ans. is 'a' i.e., Cornea Important corneal examinationsUsed foro Keratometry, Co Answer the following medical question: TRUE/FALSE about pulmonary embolism: McConnell sign is seen in CT pulmonary angiography as a filling defect. Westermark sign is area of regional oligemia seen on x-ray. Polo mint sign is seen in echocardiography as regional motion abnormality. IOC in pregnant patient is V/Q scan. Chang sign is abrupt change in diameter of right descending pulmonary aery., with the following options: A: FTFTT, B: FTTFT, C: FTTTT, D: FFTFT +### Response: +","Pulmonary thromboembolism - Hampton hump sign- Peripheral wedge-shapedarea of infarction - Westermark sign - Pulmonary oligemia - Pallas sign - Prominence of descending right pulmonary aery - Fleischner sign- Prominence of main pulmonary aery - Chang sign - abrupt change in caliber of the descendingright pulmonary aery - IOC for Pulmonary thromboembolism - CT Angio (MDCT with contrast) - In iodine allergies and pregnancy IOC for pulmonary thromboembolism - V/Q Scan - Gold standard for PTE - Pulmonary Angiography POLO MINT SIGN - The polo mint sign is a description given to a venous thrombosis on contrast-enhanced CT imaging. When viewed in the axial plane, a thin rim of contrast persists around a central filling defect due to thrombus.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: TRUE/FALSE about pulmonary embolism: McConnell sign is seen in CT pulmonary angiography as a filling defect. Westermark sign is area of regional oligemia seen on x-ray. Polo mint sign is seen in echocardiography as regional motion abnormality. IOC in pregnant patient is V/Q scan. Chang sign is abrupt change in diameter of right descending pulmonary aery., with the following options: A: FTFTT, B: FTTFT, C: FTTTT, D: FFTFT + ### Response: Pulmonary thromboembolism - Hampton hump sign- Peripheral wedge-shapedarea of infarction - Westermark sign - Pulmonary oligemia - Pallas sign - Prominence of descending right pulmonary aery - Fleischner sign- Prominence of main pulmonary aery - Chang sign - abrupt change in caliber of the descendingright pulmonary aery - IOC for Pulmonary thromboembolism - CT Angio (MDCT with contrast) - In iodine allergies and pregnancy IOC for pulmonary thromboembolism - V/Q Scan - Gold standard for PTE - Pulmonary Angiography POLO MINT SIGN - The polo mint sign is a description given to a venous thrombosis on contrast-enhanced CT imaging. When viewed in the axial plane, a thin rim of contrast persists around a central filling defect due to thrombus. ### End" @@ -8633,6 +15459,13 @@ Pulmonary thromboembolism - Hampton hump sign- Peripheral wedge-shapedarea of in Answer the following medical question: All of the following are intravenous anesthetic induction agents except ?, with the following options: A: Thiopentone sodium, B: Ketamine, C: Etomidate, D: Bupivacaine +### Response: +","Ans. is 'd' i.e., Bupivacaine","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following are intravenous anesthetic induction agents except ?, with the following options: A: Thiopentone sodium, B: Ketamine, C: Etomidate, D: Bupivacaine + ### Response: Ans. is 'd' i.e., Bupivacaine ### End" @@ -8642,6 +15475,13 @@ Ans. is 'd' i.e., Bupivacaine Answer the following medical question: A 35 year old athlete has height 184 cm , arm span 194 cm, pulse rate 64/min , BP 148/64 mm Hg . Chest auscultation reveals long Diastolic murmur over right 2nd intercostal space on routine examination. The probable diagnosis is, with the following options: A: Aoic regurgitation, B: Atrial septal defect, C: Ebstein anomaly, D: Coarctation of aoa +### Response: +",Ref Harrison 19 th ed pg 1536 Arm span greater than height is suggestive of MarfansM syndrome. Aoic regurgitation is a feature associated with Marfan's as well as consistent with a diastolic murmur is second right intercostal space.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 35 year old athlete has height 184 cm , arm span 194 cm, pulse rate 64/min , BP 148/64 mm Hg . Chest auscultation reveals long Diastolic murmur over right 2nd intercostal space on routine examination. The probable diagnosis is, with the following options: A: Aoic regurgitation, B: Atrial septal defect, C: Ebstein anomaly, D: Coarctation of aoa + ### Response: Ref Harrison 19 th ed pg 1536 Arm span greater than height is suggestive of MarfansM syndrome. Aoic regurgitation is a feature associated with Marfan's as well as consistent with a diastolic murmur is second right intercostal space. ### End" @@ -8651,6 +15491,13 @@ Ref Harrison 19 th ed pg 1536 Arm span greater than height is suggestive of Marf Answer the following medical question: Tennis elbow is characterized by -, with the following options: A: Tenderness over the medial epicondyle, B: Tendinits of common extensor origin, C: Tendinitis of common flexor origin, D: Painful flexion and extension +### Response: +","Ans. is 'b' i.e., Tendinits of common extensor origin o Tennis elbow is extraarticular affection characterized by pain and acute tenderness at the origin of the extensor muscles of the forearm from the lateral epicondyle.o It is believed to be caused by strain of the forearm extensor muscles, particularly the extensor carpi radialishrevis, at the point of their origin from lateral epicondyle,","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Tennis elbow is characterized by -, with the following options: A: Tenderness over the medial epicondyle, B: Tendinits of common extensor origin, C: Tendinitis of common flexor origin, D: Painful flexion and extension + ### Response: Ans. is 'b' i.e., Tendinits of common extensor origin o Tennis elbow is extraarticular affection characterized by pain and acute tenderness at the origin of the extensor muscles of the forearm from the lateral epicondyle.o It is believed to be caused by strain of the forearm extensor muscles, particularly the extensor carpi radialishrevis, at the point of their origin from lateral epicondyle, ### End" @@ -8660,6 +15507,13 @@ Ans. is 'b' i.e., Tendinits of common extensor origin o Tennis elbow is extraart Answer the following medical question: Incision for drainage of parotid abscess is fashioned to avoid damage to which of the following structures?, with the following options: A: Facial nerve, B: Parotid duct, C: Retromandibular vein, D: Carotid artery +### Response: +","Ans. is 'a' i.e., Facial nerve * Surgical drainage under local or general anaesthesia is carried out by a pre - auricular incision as employed for parotidectomy. Skin flap is raised to expose surface of the gland, and the abscess or abscesses are bluntly opened working parallel to the branches of the VII nerve.* Contents of parotid space include parotid gland and its associated parotid lymph nodes, facial nerve, external carotid artery and retromandibular vein, however, facial nerve is the most superficial among these. Therefore, prevention of injury to the facial nerve is of utmost importance.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Incision for drainage of parotid abscess is fashioned to avoid damage to which of the following structures?, with the following options: A: Facial nerve, B: Parotid duct, C: Retromandibular vein, D: Carotid artery + ### Response: Ans. is 'a' i.e., Facial nerve * Surgical drainage under local or general anaesthesia is carried out by a pre - auricular incision as employed for parotidectomy. Skin flap is raised to expose surface of the gland, and the abscess or abscesses are bluntly opened working parallel to the branches of the VII nerve.* Contents of parotid space include parotid gland and its associated parotid lymph nodes, facial nerve, external carotid artery and retromandibular vein, however, facial nerve is the most superficial among these. Therefore, prevention of injury to the facial nerve is of utmost importance. ### End" @@ -8669,6 +15523,13 @@ Ans. is 'a' i.e., Facial nerve * Surgical drainage under local or general anaest Answer the following medical question: Best investigation for acute intestinal obstruction is:, with the following options: A: Barium studies, B: X-ray, C: USG, D: ERCP +### Response: +","Diagnosis - X-ray Abdomen: Confirm the clinical suspicion and define more accurately the site of obstruction (60% diagnostic accuracy) Supine radiographs: Dilated loops of small intestine without evidence of colonic distention, diagnose site and level of obstruction. Erect radiographs: Multiple air-fluid levels, which often layer in a step wise pattern Supine films are better than erect for diagnosis of intestinal obstruction CT SCAN Used in complex patients, in whom the diagnosis is not readily apparent Highly sensitive for diagnosing complete or high-grade obstruction of the small bowel and for determining the location and cause of obstruction. Less sensitive for paial small bowel obstruction. Useful for extrinsic cause of bowel obstruction (e.g. abdominal tumors, inflammatory disease, or abscess) and determining bowel strangulation. - Enteroclysis is investigation of choice in low-grade, intermittent SBO. - Barium studies: Precisely demonstrate the level of the obstruction and cause in ceain cases - Ultrasound: Useful in pregnant patients.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Best investigation for acute intestinal obstruction is:, with the following options: A: Barium studies, B: X-ray, C: USG, D: ERCP + ### Response: Diagnosis - X-ray Abdomen: Confirm the clinical suspicion and define more accurately the site of obstruction (60% diagnostic accuracy) Supine radiographs: Dilated loops of small intestine without evidence of colonic distention, diagnose site and level of obstruction. Erect radiographs: Multiple air-fluid levels, which often layer in a step wise pattern Supine films are better than erect for diagnosis of intestinal obstruction CT SCAN Used in complex patients, in whom the diagnosis is not readily apparent Highly sensitive for diagnosing complete or high-grade obstruction of the small bowel and for determining the location and cause of obstruction. Less sensitive for paial small bowel obstruction. Useful for extrinsic cause of bowel obstruction (e.g. abdominal tumors, inflammatory disease, or abscess) and determining bowel strangulation. - Enteroclysis is investigation of choice in low-grade, intermittent SBO. - Barium studies: Precisely demonstrate the level of the obstruction and cause in ceain cases - Ultrasound: Useful in pregnant patients. ### End" @@ -8678,6 +15539,13 @@ Diagnosis - X-ray Abdomen: Confirm the clinical suspicion and define more accura Answer the following medical question: Mantle cell Ca shows -, with the following options: A: CD5 +, CD25 -, B: CD 5 +, CD 10 +, C: CD 5+, CD23+, D: CD 5+, CD 23 - +### Response: +",Mantle cell lymphoma is CD5 positive and CD23 negative.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mantle cell Ca shows -, with the following options: A: CD5 +, CD25 -, B: CD 5 +, CD 10 +, C: CD 5+, CD23+, D: CD 5+, CD 23 - + ### Response: Mantle cell lymphoma is CD5 positive and CD23 negative. ### End" @@ -8687,6 +15555,15 @@ Mantle cell lymphoma is CD5 positive and CD23 negative. Answer the following medical question: TRUS in carcinoma prostate is most useful for?, with the following options: A: Seminal vesicle involvement, B: Measurement of prostatic volume, C: Guiding the Diagnostic biopsies, D: To detect focal area hypo echoic of malignancy +### Response: +","Transrectal ultrasound is indicated for prostate in early! +localized prostate carcinoma, as it is the most accurate method for staging the local disease and also guided biopsy +from suspicious areas of prostate (when S. PSA has been found to be elevated)..","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: TRUS in carcinoma prostate is most useful for?, with the following options: A: Seminal vesicle involvement, B: Measurement of prostatic volume, C: Guiding the Diagnostic biopsies, D: To detect focal area hypo echoic of malignancy + ### Response: Transrectal ultrasound is indicated for prostate in early! localized prostate carcinoma, as it is the most accurate method for staging the local disease and also guided biopsy @@ -8698,6 +15575,13 @@ from suspicious areas of prostate (when S. PSA has been found to be elevated).. Answer the following medical question: Tyrosine enters gluconeogenesis by forming which substrate, with the following options: A: Succinyl CoA, B: Alpha - ketoglutarate, C: Fumarate, D: Citrate +### Response: +","Sources of Gluconeogenesis uGluconeogenesis is the process by which glucose molecules are produced from non-carbohydrate precursors. uNon carbohydrate precursors include lactate, glucogenic amino acids, glycerol pa of fat and propionyl CoA derived from odd chain fatty acids. DM Vasudevan , Textbook of Biochemistry for Medical Students , 7th ed, page 119","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Tyrosine enters gluconeogenesis by forming which substrate, with the following options: A: Succinyl CoA, B: Alpha - ketoglutarate, C: Fumarate, D: Citrate + ### Response: Sources of Gluconeogenesis uGluconeogenesis is the process by which glucose molecules are produced from non-carbohydrate precursors. uNon carbohydrate precursors include lactate, glucogenic amino acids, glycerol pa of fat and propionyl CoA derived from odd chain fatty acids. DM Vasudevan , Textbook of Biochemistry for Medical Students , 7th ed, page 119 ### End" @@ -8707,6 +15591,13 @@ Sources of Gluconeogenesis uGluconeogenesis is the process by which glucose mole Answer the following medical question: Hostile witness is covered under IPC section ?, with the following options: A: 191, B: 192, C: 193, D: 194 +### Response: +","Ans. is 'A' i.e., 191. Hostility is one form of perjury. A hostile witness is one who's provided an eyewitness account of a criminal event or other information to help the prosecution build a case, but has later turned in cou, giving a different version of events or contradictory information. A witness is termed hostile, when he gives a ceain statement on his knowledge about commission of a crime before the police but refutes it when called as witness before the cou during trial. IPC 191 - Giving false evidence (Perjury)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hostile witness is covered under IPC section ?, with the following options: A: 191, B: 192, C: 193, D: 194 + ### Response: Ans. is 'A' i.e., 191. Hostility is one form of perjury. A hostile witness is one who's provided an eyewitness account of a criminal event or other information to help the prosecution build a case, but has later turned in cou, giving a different version of events or contradictory information. A witness is termed hostile, when he gives a ceain statement on his knowledge about commission of a crime before the police but refutes it when called as witness before the cou during trial. IPC 191 - Giving false evidence (Perjury) ### End" @@ -8716,6 +15607,13 @@ Ans. is 'A' i.e., 191. Hostility is one form of perjury. A hostile witness is on Answer the following medical question: Which of the following obstetric condition can be detected using a Paogram?, with the following options: A: Abruptio placentae, B: Obstructed labour, C: Incoordinate uterine action, D: PPH +### Response: +","A paogram is a graphic record of progress of labor that helps to detect whether labour is progressing normally or not, indicates when augmentation of labour is appropriate and assists in recognising cephalopelvic dispropoion long before labour becomes obstructed. Three impoant parameters plotted in it are cervical dilation, cervical effacement in centimeters and descent of the presenting pa in fifths palpable above the pelvic brim. The American College of Obstetricians and Gynecology Paogram consists of a latent phase of 8 hours and and an ale line staing at a cervical dilatation of 3cm and progressing at a rate of 1cm per hour. Action line lies 2 hours to the right and parallel to the ale line. Action is recommended with a delay in cervical dilatation of more than 2 hours or delay in descent of head more than 1 hour. Ref: The Paograph and How to Assess Labour By Anna Nolte page 1, Donald School Manual of Practical Problems in Obstetrics edited by Narendra Malhotra, page 489.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following obstetric condition can be detected using a Paogram?, with the following options: A: Abruptio placentae, B: Obstructed labour, C: Incoordinate uterine action, D: PPH + ### Response: A paogram is a graphic record of progress of labor that helps to detect whether labour is progressing normally or not, indicates when augmentation of labour is appropriate and assists in recognising cephalopelvic dispropoion long before labour becomes obstructed. Three impoant parameters plotted in it are cervical dilation, cervical effacement in centimeters and descent of the presenting pa in fifths palpable above the pelvic brim. The American College of Obstetricians and Gynecology Paogram consists of a latent phase of 8 hours and and an ale line staing at a cervical dilatation of 3cm and progressing at a rate of 1cm per hour. Action line lies 2 hours to the right and parallel to the ale line. Action is recommended with a delay in cervical dilatation of more than 2 hours or delay in descent of head more than 1 hour. Ref: The Paograph and How to Assess Labour By Anna Nolte page 1, Donald School Manual of Practical Problems in Obstetrics edited by Narendra Malhotra, page 489. ### End" @@ -8725,6 +15623,13 @@ A paogram is a graphic record of progress of labor that helps to detect whether Answer the following medical question: Zero dose of polio vaccine is given at:, with the following options: A: Before giving DPT, B: At bih, C: When child is having diarrhea, D: When child is having polio +### Response: +",- OPV zero dose: Given at bih / as early as possible within first 15 days of life. LATEST NATIONAL IMMUNIZATION SCHEDULE (NIS): 2019,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Zero dose of polio vaccine is given at:, with the following options: A: Before giving DPT, B: At bih, C: When child is having diarrhea, D: When child is having polio + ### Response: - OPV zero dose: Given at bih / as early as possible within first 15 days of life. LATEST NATIONAL IMMUNIZATION SCHEDULE (NIS): 2019 ### End" @@ -8734,6 +15639,13 @@ Answer the following medical question: Zero dose of polio vaccine is given at:, Answer the following medical question: Enzyme that protects the brain from free radical injury is -, with the following options: A: Myeloperoxidase, B: Superoxide dismutase, C: MAO, D: Hydroxylase +### Response: +","Ans. is 'b' i.e., Superoxide dismutase Antioxidant mechanisms Cells have multiple mechanisms to remove free radicals and there by minimize injury. There are several nonenzymatic and enzymatic systems that contribute to inactivation of free radical reactions. A. Non-enzymatic system o Antioxidants (Vit 'E', Vit A, Vit C, glutathione and Cysteine) block the initiation of free radical formation and inactivate free radicals. o Tissue proteins (transferrin, ferritin, lactoferrin, and ceruloplasmin). As already explained, iron and copper can catalyze the formation of free radicals, these transpo and storage proteins decrease the reactive free iron and copper, thereby minimizing the free radical formation. B. Enzymatic system o A series of enzymes acts as free radical-scavenging systems and breakdown hydrogen peroxide and superoxide anion. 1. Catalase o Present in peroxisomes and decomposes H202 2 H202__________ 02 + 2 H20 2. Superoxide desmutase (SOD) o Manganese - superoxide dismutase is present in mitochondria, while copper-zinc-superoxide dismutase is found in the cytosol. o It conves superoxide to H202 2 02- + 2 H SOD 2 H202+ 02 3. Glutathione peroxidase o Present in mitochondria & cytosol. o It catalyzes free radical breakdown. H202+2 G S H __ GSSG+2H20 20H+ 2 G SH _ > GSSG+2H20 o Intracellular ratio of oxidized glutathione (G S S G) to reduced glutathione (G S M) is a reflection of the oxidative state of the cell.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Enzyme that protects the brain from free radical injury is -, with the following options: A: Myeloperoxidase, B: Superoxide dismutase, C: MAO, D: Hydroxylase + ### Response: Ans. is 'b' i.e., Superoxide dismutase Antioxidant mechanisms Cells have multiple mechanisms to remove free radicals and there by minimize injury. There are several nonenzymatic and enzymatic systems that contribute to inactivation of free radical reactions. A. Non-enzymatic system o Antioxidants (Vit 'E', Vit A, Vit C, glutathione and Cysteine) block the initiation of free radical formation and inactivate free radicals. o Tissue proteins (transferrin, ferritin, lactoferrin, and ceruloplasmin). As already explained, iron and copper can catalyze the formation of free radicals, these transpo and storage proteins decrease the reactive free iron and copper, thereby minimizing the free radical formation. B. Enzymatic system o A series of enzymes acts as free radical-scavenging systems and breakdown hydrogen peroxide and superoxide anion. 1. Catalase o Present in peroxisomes and decomposes H202 2 H202__________ 02 + 2 H20 2. Superoxide desmutase (SOD) o Manganese - superoxide dismutase is present in mitochondria, while copper-zinc-superoxide dismutase is found in the cytosol. o It conves superoxide to H202 2 02- + 2 H SOD 2 H202+ 02 3. Glutathione peroxidase o Present in mitochondria & cytosol. o It catalyzes free radical breakdown. H202+2 G S H __ GSSG+2H20 20H+ 2 G SH _ > GSSG+2H20 o Intracellular ratio of oxidized glutathione (G S S G) to reduced glutathione (G S M) is a reflection of the oxidative state of the cell. ### End" @@ -8743,6 +15655,13 @@ Ans. is 'b' i.e., Superoxide dismutase Antioxidant mechanisms Cells have multipl Answer the following medical question: A 60 year old male was diagnosed as carcinoma right lung. On CECT chest there was tumour of 5 x 5 cm in upper lobe and another 2 x 2 cm size tumour nodule in middle lobe. The primary modality of treatment is, with the following options: A: Radiotherapy, B: Chemotherapy, C: Surgery, D: Suppoive treatment +### Response: +","Refer above table Treatment of operable NSCCL Stage IA, IB, IIA, IIB : Surgical resection Adjuvant chemotherapy is given in stage II Stage IIIA with minimal N2 involvement : Neoadjuvant chemotherapy followed by surgical resection with complete Mediastinal LN dissection Postoperative radiotherapy for patients found to have N2 disease Ref : Sabiston 20th edition Pgno : 1591","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 60 year old male was diagnosed as carcinoma right lung. On CECT chest there was tumour of 5 x 5 cm in upper lobe and another 2 x 2 cm size tumour nodule in middle lobe. The primary modality of treatment is, with the following options: A: Radiotherapy, B: Chemotherapy, C: Surgery, D: Suppoive treatment + ### Response: Refer above table Treatment of operable NSCCL Stage IA, IB, IIA, IIB : Surgical resection Adjuvant chemotherapy is given in stage II Stage IIIA with minimal N2 involvement : Neoadjuvant chemotherapy followed by surgical resection with complete Mediastinal LN dissection Postoperative radiotherapy for patients found to have N2 disease Ref : Sabiston 20th edition Pgno : 1591 ### End" @@ -8752,6 +15671,13 @@ Refer above table Treatment of operable NSCCL Stage IA, IB, IIA, IIB : Surgical Answer the following medical question: Which of the following is least likely to cause weight gain?, with the following options: A: Clozapine, B: Molindone, C: Perphenazine, D: Chlorpromazine +### Response: +","Pimozide and molindone are typical antipsychotic drugs. There is no significant difference in efficacy between these newer typical and the older typical antipsychotic drugs.The side effect profile of molindone is similar to that of other typical antipsychotics. Unlike most antipsychotics, molindone use is associated with weight loss.Ref: Harper&;s Biochemistry; 12th edition; Page no: 514","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is least likely to cause weight gain?, with the following options: A: Clozapine, B: Molindone, C: Perphenazine, D: Chlorpromazine + ### Response: Pimozide and molindone are typical antipsychotic drugs. There is no significant difference in efficacy between these newer typical and the older typical antipsychotic drugs.The side effect profile of molindone is similar to that of other typical antipsychotics. Unlike most antipsychotics, molindone use is associated with weight loss.Ref: Harper&;s Biochemistry; 12th edition; Page no: 514 ### End" @@ -8761,6 +15687,13 @@ Pimozide and molindone are typical antipsychotic drugs. There is no significant Answer the following medical question: Drug of choice for diabetic diarrhea:, with the following options: A: Duloxetine, B: Clonidine, C: Domperidone, D: Alosetron +### Response: +","(Ref: Sleisenger and Fordtran's Gastrointestinal and Liver Disease, Volume 1; P 575)Diabetic diarrhea is seen in middle aged type 1 poorly controlled diabetic patients and is characterized by intermittent, brown, watery and voluminous stools which is occasionally accompanied by tenesmus.In these patients, GI adrenergic function is impaired in autonomic neuropathy. Therefore, any adrenergic agonist may further stimulate the intestinal absorption of fluid and electrolytes.Drugs used areAlpha 2 adrenergic agonist: Clonidine. Acts as adrenergic antagonist which acts by reversing the peripheral adrenergic resorptive abnormalities.# Because of autonomic neuropathies, these patients will not experience postural hypotension.# Moreover, clonidine doesn't alter diabetic control or renal function.Somatostatin analogue: Octreotide. Useful in refractory diabetic diarrheaCodeine, Diphenoxylate with atropine, Loperamide:Used for symptomatic treatment.Anti-diarrheal agentsDrugsMain uses ;Tryptophan hydroxylaseinhibitor: Telotristat ethylSevere diarrhea due tocarcinoid tumorsEnkephalinase inhibitor-RacecadotrilAcute diarrheaSafe in childrenOctreotide* Severe secretory diarrhea due to GI tumors* Postgastrectomy dumping syndromeCrofelemer (plant derived)HIV/AIDS diarrheaAlosetron* Diarrhea-predominant IBS in womenBile acid sequestrants:Cholestyramine, Colesevelam, ColestipiolBile salt induced diarrheaClonidineDiabetic diarrheaMOR agonists* Diphenoxylate, difenoxin, LoperamideAcute diarrheaChronic diarrheaTraveler's diarrheaAntibiotics--empiric therapy* Fluoroquinolone* Ciprofloxacin* Levofloxacin* Norfloxacin* OfloxacinAlternative antibiotics* Azithromycin* Rifaximin* Acute diarrhea* Traveler's diarrhea* Azithromycin: Preferred treatment for children with traveler's diarrhea* Rifaxamin: Preferred for diarrhea predominant IBS","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Drug of choice for diabetic diarrhea:, with the following options: A: Duloxetine, B: Clonidine, C: Domperidone, D: Alosetron + ### Response: (Ref: Sleisenger and Fordtran's Gastrointestinal and Liver Disease, Volume 1; P 575)Diabetic diarrhea is seen in middle aged type 1 poorly controlled diabetic patients and is characterized by intermittent, brown, watery and voluminous stools which is occasionally accompanied by tenesmus.In these patients, GI adrenergic function is impaired in autonomic neuropathy. Therefore, any adrenergic agonist may further stimulate the intestinal absorption of fluid and electrolytes.Drugs used areAlpha 2 adrenergic agonist: Clonidine. Acts as adrenergic antagonist which acts by reversing the peripheral adrenergic resorptive abnormalities.# Because of autonomic neuropathies, these patients will not experience postural hypotension.# Moreover, clonidine doesn't alter diabetic control or renal function.Somatostatin analogue: Octreotide. Useful in refractory diabetic diarrheaCodeine, Diphenoxylate with atropine, Loperamide:Used for symptomatic treatment.Anti-diarrheal agentsDrugsMain uses ;Tryptophan hydroxylaseinhibitor: Telotristat ethylSevere diarrhea due tocarcinoid tumorsEnkephalinase inhibitor-RacecadotrilAcute diarrheaSafe in childrenOctreotide* Severe secretory diarrhea due to GI tumors* Postgastrectomy dumping syndromeCrofelemer (plant derived)HIV/AIDS diarrheaAlosetron* Diarrhea-predominant IBS in womenBile acid sequestrants:Cholestyramine, Colesevelam, ColestipiolBile salt induced diarrheaClonidineDiabetic diarrheaMOR agonists* Diphenoxylate, difenoxin, LoperamideAcute diarrheaChronic diarrheaTraveler's diarrheaAntibiotics--empiric therapy* Fluoroquinolone* Ciprofloxacin* Levofloxacin* Norfloxacin* OfloxacinAlternative antibiotics* Azithromycin* Rifaximin* Acute diarrhea* Traveler's diarrhea* Azithromycin: Preferred treatment for children with traveler's diarrhea* Rifaxamin: Preferred for diarrhea predominant IBS ### End" @@ -8770,6 +15703,13 @@ Answer the following medical question: Drug of choice for diabetic diarrhea:, wi Answer the following medical question: Most common cause of Pubey Menorrhagic :, with the following options: A: Anovulation, B: Malignancy, C: Endometriosis, D: Bleeding disorder +### Response: +",Ans. is a i.e. Anovulation Pubey menorrhagia is excessive cyclical regular bleeding occuring in adolescents. Most common cause of pubey menorrhagia is anovulation which results in excess of estrogen or unopposed estrogen in absence of progesterone. Ilnd most common cause is - Bleeding disorders - blood dyscrasias and coagulation disorders. Other causes of Abnormal bleeding in Adolescents. Pregnancy related bleeding Sexually transmitted-Infections - paicularly chlamydia Sexual abuse Exogenous hormones Other endocrine or systemic problems eg. ?Hepatic dysfunction Hyperprolactinemia ( it can cause either amenorrhea or irregular bleeding) PCOS - It can occur during adolescence also Hypothyroidism Anatomical causes - Paially obstructive genetic anomalies.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common cause of Pubey Menorrhagic :, with the following options: A: Anovulation, B: Malignancy, C: Endometriosis, D: Bleeding disorder + ### Response: Ans. is a i.e. Anovulation Pubey menorrhagia is excessive cyclical regular bleeding occuring in adolescents. Most common cause of pubey menorrhagia is anovulation which results in excess of estrogen or unopposed estrogen in absence of progesterone. Ilnd most common cause is - Bleeding disorders - blood dyscrasias and coagulation disorders. Other causes of Abnormal bleeding in Adolescents. Pregnancy related bleeding Sexually transmitted-Infections - paicularly chlamydia Sexual abuse Exogenous hormones Other endocrine or systemic problems eg. ?Hepatic dysfunction Hyperprolactinemia ( it can cause either amenorrhea or irregular bleeding) PCOS - It can occur during adolescence also Hypothyroidism Anatomical causes - Paially obstructive genetic anomalies. ### End" @@ -8780,9 +15720,24 @@ Ans. is a i.e. Anovulation Pubey menorrhagia is excessive cyclical regular bleed Answer the following medical question: A gastric biopsy is performed on a patient with suspected graft-versus-host disease following bone marrow transplantation. The biopsy demonstrates many isolated dying epithelial cells in crypts showing fragmented, hyperchromatic nuclei and small discrete blebs containing both cytoplasm and nuclear fragments. The biopsy demonstrates which of the following?, with the following options: A: Apoptosis, B: Caseous neurosis, C: Coagulative necrosis, D: Gangrenous necrosis ### Response: -The changes described are those of apoptosis, which is a form of programmed cell death. Apoptosis can be seen in a variety of settings. In this case, it is occurring in the context of graft-versus-host disease, which is mediated by CD8+ and CD4+ cells. Apoptosis also occurs during embryogenesis, during hormone-dependent involution in the adult (eg, during menstruation), during rapid proliferation of cell populations (eg, intestinal crypt epithelia), and in the immune system (e.g., in developing thymus). It can also occur after duct obstruction in organs such as pancreas and during some viral diseases. The hallmark of this programmed method of cell death is the fragmentation of the cell with formation of cytoplasmic blebs and apoptotic bodies that are phagocytized by other healthy cells. Caseous necrosis, such as is seen in tuberculosis, shows necrotic, amorphous granular debris surrounded by a granulomatous response. Coagulative necrosis, such as is seen in myocardial infarction, shows coagulated, anuclear cell ""ghosts."" Gangrenous necrosis is a commonly used surgical term (eg, in diabetic feet) that does not have a precise pathologic counterpa. Ref: Jan B.V., Lowry S.F. (2010). Chapter 2. Systemic Response to Injury and Metabolic Suppo. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e. -### End" -918,"Below is an instruction that describes a task. Write a response that appropriately completes the request. +","The changes described are those of apoptosis, which is a form of programmed cell death. Apoptosis can be seen in a variety of settings. In this case, it is occurring in the context of graft-versus-host disease, which is mediated by CD8+ and CD4+ cells. Apoptosis also occurs during embryogenesis, during hormone-dependent involution in the adult (eg, during menstruation), during rapid proliferation of cell populations (eg, intestinal crypt epithelia), and in the immune system (e.g., in developing thymus). It can also occur after duct obstruction in organs such as pancreas and during some viral diseases. The hallmark of this programmed method of cell death is the fragmentation of the cell with formation of cytoplasmic blebs and apoptotic bodies that are phagocytized by other healthy cells. Caseous necrosis, such as is seen in tuberculosis, shows necrotic, amorphous granular debris surrounded by a granulomatous response. Coagulative necrosis, such as is seen in myocardial infarction, shows coagulated, anuclear cell ""ghosts."" Gangrenous necrosis is a commonly used surgical term (eg, in diabetic feet) that does not have a precise pathologic counterpa. Ref: Jan B.V., Lowry S.F. (2010). Chapter 2. Systemic Response to Injury and Metabolic Suppo. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A gastric biopsy is performed on a patient with suspected graft-versus-host disease following bone marrow transplantation. The biopsy demonstrates many isolated dying epithelial cells in crypts showing fragmented, hyperchromatic nuclei and small discrete blebs containing both cytoplasm and nuclear fragments. The biopsy demonstrates which of the following?, with the following options: A: Apoptosis, B: Caseous neurosis, C: Coagulative necrosis, D: Gangrenous necrosis + +### Response: +The changes described are those of apoptosis, which is a form of programmed cell death. Apoptosis can be seen in a variety of settings. In this case, it is occurring in the context of graft-versus-host disease, which is mediated by CD8+ and CD4+ cells. Apoptosis also occurs during embryogenesis, during hormone-dependent involution in the adult (eg, during menstruation), during rapid proliferation of cell populations (eg, intestinal crypt epithelia), and in the immune system (e.g., in developing thymus). It can also occur after duct obstruction in organs such as pancreas and during some viral diseases. The hallmark of this programmed method of cell death is the fragmentation of the cell with formation of cytoplasmic blebs and apoptotic bodies that are phagocytized by other healthy cells. Caseous necrosis, such as is seen in tuberculosis, shows necrotic, amorphous granular debris surrounded by a granulomatous response. Coagulative necrosis, such as is seen in myocardial infarction, shows coagulated, anuclear cell ""ghosts."" Gangrenous necrosis is a commonly used surgical term (eg, in diabetic feet) that does not have a precise pathologic counterpa. Ref: Jan B.V., Lowry S.F. (2010). Chapter 2. Systemic Response to Injury and Metabolic Suppo. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e. +### End" +918,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: After overnight fasting, levels of Glucose transporters are reduced in, with the following options: A: Brain cells, B: Hepatocytes, C: Adipocytes, D: RBCs + +### Response: +","Overnight fasting causes insulin levels to fall. This decreases the number of glucose transporters which are insulin dependent. +Insulin-dependent glucose transporters are GLUT-4, present in adipocytes, skeletal and cardiac muscles. Rest of the glucose transporters are not insulin dependent.","Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: @@ -8798,6 +15753,13 @@ Insulin-dependent glucose transporters are GLUT-4, present in adipocytes, skelet Answer the following medical question: Tamoxifen increases the risk of which malignancy?, with the following options: A: Cervix, B: Vagina, C: Endometrium, D: Vulval +### Response: +","TAMOXIFEN Tamoxifen is a SERM that possess estrogen antagonistic activity in the breast and blood whereas agonistic activity in bone, uterus and liver. Its major indication is the treatment of breast carcinoma. It has beneficial effect on bone and lipid profile Tamoxifen can increase the risk of endometrial carcinoma and thromboembolism.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Tamoxifen increases the risk of which malignancy?, with the following options: A: Cervix, B: Vagina, C: Endometrium, D: Vulval + ### Response: TAMOXIFEN Tamoxifen is a SERM that possess estrogen antagonistic activity in the breast and blood whereas agonistic activity in bone, uterus and liver. Its major indication is the treatment of breast carcinoma. It has beneficial effect on bone and lipid profile Tamoxifen can increase the risk of endometrial carcinoma and thromboembolism. ### End" @@ -8807,6 +15769,13 @@ TAMOXIFEN Tamoxifen is a SERM that possess estrogen antagonistic activity in the Answer the following medical question: Physical dependence is not seen with, with the following options: A: Alcohol, B: Raw opium, C: Raw opium, D: Benzodiazepines +### Response: +","C i.e. Cannabis Physical dependence and withdrawl symptoms are absent in LSD and mild in cannabinoids (cannabis), amphetaminesQ, ectasy, psychedelics, cigarettes and caffeine. So symptomatic treatment is not required in withdrawl of LSD (1st) > cannabis (2nd answer)Q. Drug Physical dependence Psychic dependence Physical withdrawl problems Psychic withdraw( problems Opioids Severe Severe Strong Strong Alcohol Moderate Moderate Strong Moderate Barbiturates Moderate Moderate Strong Moderate Amphetamines Moderate Moderate Mild Mild Benzodiazepine Mild Mild Moderate Moderate Crack / Cocaine + (Probable) Moderate Moderate Severe Nicotine(cigarettes) Mild Moderate Mild Strong Caffeine Mild Moderate Mild Mild Phencyclidine + (Probable) Mild Mild None Ectasy - - Mild None Cannabinoids (Cannabis, marihuana) + (Probable / little) Moderate Mild Mild LSD (Lysergic acid diethylamide) Nonedeg Mild - * Amphetamine & cocaine are non addictive, or cause psychological but not physical dependence, but critics claim this of limited meaning now","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Physical dependence is not seen with, with the following options: A: Alcohol, B: Raw opium, C: Raw opium, D: Benzodiazepines + ### Response: C i.e. Cannabis Physical dependence and withdrawl symptoms are absent in LSD and mild in cannabinoids (cannabis), amphetaminesQ, ectasy, psychedelics, cigarettes and caffeine. So symptomatic treatment is not required in withdrawl of LSD (1st) > cannabis (2nd answer)Q. Drug Physical dependence Psychic dependence Physical withdrawl problems Psychic withdraw( problems Opioids Severe Severe Strong Strong Alcohol Moderate Moderate Strong Moderate Barbiturates Moderate Moderate Strong Moderate Amphetamines Moderate Moderate Mild Mild Benzodiazepine Mild Mild Moderate Moderate Crack / Cocaine + (Probable) Moderate Moderate Severe Nicotine(cigarettes) Mild Moderate Mild Strong Caffeine Mild Moderate Mild Mild Phencyclidine + (Probable) Mild Mild None Ectasy - - Mild None Cannabinoids (Cannabis, marihuana) + (Probable / little) Moderate Mild Mild LSD (Lysergic acid diethylamide) Nonedeg Mild - * Amphetamine & cocaine are non addictive, or cause psychological but not physical dependence, but critics claim this of limited meaning now ### End" @@ -8816,6 +15785,13 @@ C i.e. Cannabis Physical dependence and withdrawl symptoms are absent in LSD and Answer the following medical question: A patient with complete anosmia will still respond to inhalation of:, with the following options: A: Coffee, B: Ammonia, C: Vanilla, D: Garlic +### Response: +","Smell of coffee, vanilla and garlic is sensed by olfactory system. Vapours of ammonia are so strong that they stimulate somatic sensory fibres (V nerve). Ammonia is never used to test sense of smell.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A patient with complete anosmia will still respond to inhalation of:, with the following options: A: Coffee, B: Ammonia, C: Vanilla, D: Garlic + ### Response: Smell of coffee, vanilla and garlic is sensed by olfactory system. Vapours of ammonia are so strong that they stimulate somatic sensory fibres (V nerve). Ammonia is never used to test sense of smell. ### End" @@ -8825,6 +15801,13 @@ Smell of coffee, vanilla and garlic is sensed by olfactory system. Vapours of am Answer the following medical question: A 50 year old man with a history of smoking, hypeension, and chronic exeional angina develops several daily episodes of chest pain at rest compatible with cardiac ischemia. The patient is hospitalized. All the following would be pa of an appropriate management plan cxcept :, with the following options: A: Intravenous heparin, B: Aspirin, C: Intravenous nitroglycerin, D: Lidocaine by bolus infusion +### Response: +","Answer is D (Lidocaine by Bolus infusion) This patient with several risk factors for ischaemic hea disease and chronic exeional dyspnea now develops `several daily' episodes of chest pain and 'pain at rest' suggesting a diagnosis of U.A (or NSTEMI). While nitrate are recommended as the initial antiischaemic treatment, aspirin and heparin form pa of antithrombotic treatment. Lidocaine is not indicated.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 50 year old man with a history of smoking, hypeension, and chronic exeional angina develops several daily episodes of chest pain at rest compatible with cardiac ischemia. The patient is hospitalized. All the following would be pa of an appropriate management plan cxcept :, with the following options: A: Intravenous heparin, B: Aspirin, C: Intravenous nitroglycerin, D: Lidocaine by bolus infusion + ### Response: Answer is D (Lidocaine by Bolus infusion) This patient with several risk factors for ischaemic hea disease and chronic exeional dyspnea now develops `several daily' episodes of chest pain and 'pain at rest' suggesting a diagnosis of U.A (or NSTEMI). While nitrate are recommended as the initial antiischaemic treatment, aspirin and heparin form pa of antithrombotic treatment. Lidocaine is not indicated. ### End" @@ -8834,6 +15817,13 @@ Answer is D (Lidocaine by Bolus infusion) This patient with several risk factors Answer the following medical question: Osteonecrosis of femoral head seen in -a) Sickle cell diseaseb) Gaucher's diseasec) Polycythemiad) Hyperparathyroidisme) Fracture, with the following options: A: bcde, B: abcd, C: acde, D: abce +### Response: +",Sickle cell anemia and polycythemia can cause AVN.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Osteonecrosis of femoral head seen in -a) Sickle cell diseaseb) Gaucher's diseasec) Polycythemiad) Hyperparathyroidisme) Fracture, with the following options: A: bcde, B: abcd, C: acde, D: abce + ### Response: Sickle cell anemia and polycythemia can cause AVN. ### End" @@ -8843,6 +15833,13 @@ Sickle cell anemia and polycythemia can cause AVN. Answer the following medical question: Management in case of rupture of disc at L5, S1 is, with the following options: A: Emergency removal of disc, B: Joint fusion, C: Immobilization for 2 weeks with spinal brace, D: Traction +### Response: +",C i.e. Immobilization for 2 weeks with spinal brace,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Management in case of rupture of disc at L5, S1 is, with the following options: A: Emergency removal of disc, B: Joint fusion, C: Immobilization for 2 weeks with spinal brace, D: Traction + ### Response: C i.e. Immobilization for 2 weeks with spinal brace ### End" @@ -8852,6 +15849,13 @@ C i.e. Immobilization for 2 weeks with spinal brace Answer the following medical question: Husband having suspicion that his wife is having affair with another man, diagnosis is, with the following options: A: delusion, B: perception, C: hallucination, D: Amotivation +### Response: +","DELUSION - * false fixed firm belief, * subjective ceainity, * compelling counterargument, * impervious to other experiences and * outside socio cultural and educational background the delusion explained in the question is delusion of marital infedilty also called as Othello syndrome other name for othello syndrome is * JEALOUS TYPE of delusional disorder o ALSO KNOWN AS Conjugal paranoia * Othello syndrome * Marked jealousy * Pathological jealousy Morbid jealousy o It is more common among alcoholic males ,the possible explanation that is given is alcoholic males have sexual dysfunction and that these women may sta suspecting their spouses. Reference.Kaplon and Sadock, synopsis of psychiatry, 11 th edition, pg no.333","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Husband having suspicion that his wife is having affair with another man, diagnosis is, with the following options: A: delusion, B: perception, C: hallucination, D: Amotivation + ### Response: DELUSION - * false fixed firm belief, * subjective ceainity, * compelling counterargument, * impervious to other experiences and * outside socio cultural and educational background the delusion explained in the question is delusion of marital infedilty also called as Othello syndrome other name for othello syndrome is * JEALOUS TYPE of delusional disorder o ALSO KNOWN AS Conjugal paranoia * Othello syndrome * Marked jealousy * Pathological jealousy Morbid jealousy o It is more common among alcoholic males ,the possible explanation that is given is alcoholic males have sexual dysfunction and that these women may sta suspecting their spouses. Reference.Kaplon and Sadock, synopsis of psychiatry, 11 th edition, pg no.333 ### End" @@ -8861,6 +15865,13 @@ DELUSION - * false fixed firm belief, * subjective ceainity, * compelling counte Answer the following medical question: An ICU patient on atracurium infusion develops seizures after 2 days. The most probable cause is:, with the following options: A: Accumulation of landonosine, B: Allergy to drug, C: Due to prolong infusion, D: All +### Response: +",A i.e. Accumulation of laudanosine,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: An ICU patient on atracurium infusion develops seizures after 2 days. The most probable cause is:, with the following options: A: Accumulation of landonosine, B: Allergy to drug, C: Due to prolong infusion, D: All + ### Response: A i.e. Accumulation of laudanosine ### End" @@ -8870,6 +15881,13 @@ A i.e. Accumulation of laudanosine Answer the following medical question: Suprasellar calcification with polyuria seen in ?, with the following options: A: Langerhan cell histocytosis, B: Medulloblastoma, C: Pineal oma, D: Craniopharyngioma +### Response: +","Ans. is 'd' i.e. Craniopharyngioma A suprasellar calcification is typical of craniopharyngioma Polyuria is d/t diabetes insipidus caused d/t compression by the tumor over pituitary. (Schwaz 7/e p1629 writes -""Clinically, patients with suprasellar tumors typically present with diabetes insipidus, visual difficulties, or endocrinopathy."")","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Suprasellar calcification with polyuria seen in ?, with the following options: A: Langerhan cell histocytosis, B: Medulloblastoma, C: Pineal oma, D: Craniopharyngioma + ### Response: Ans. is 'd' i.e. Craniopharyngioma A suprasellar calcification is typical of craniopharyngioma Polyuria is d/t diabetes insipidus caused d/t compression by the tumor over pituitary. (Schwaz 7/e p1629 writes -""Clinically, patients with suprasellar tumors typically present with diabetes insipidus, visual difficulties, or endocrinopathy."") ### End" @@ -8879,6 +15897,13 @@ Ans. is 'd' i.e. Craniopharyngioma A suprasellar calcification is typical of cra Answer the following medical question: Production of Surfactant is by:, with the following options: A: Alveolar macrophages, B: Type I Pneumocytes, C: Type II Pneumocytes, D: Clara cells +### Response: +","Ans. C Type II PneumocytesRef: Guytotty 11th ed pg. 474,* The smaller type II pneumocytes are often more numerous than type I pneumocytes, but they contribute less than 10% of the surface area.* They are rounded cells which protrude from the alveolar surface, particularly at the angles between alveolar profiles.* In the human lung they are often associated with interalveolar pores of Kohn. Their cytoplasm contains numerous characteristic secretory lamellar bodies, which they can recycle.* Ultra structurally, the lamellar bodies are comprised of concentric whorls of phospholipid-rich membrane, the precursors of alveolar surfactant.* ""Surfactant is stored in lamellar bodies and secreted in the form of tubular myelin (unrelated to myelin of the nervous system) by type II pneumocytes. It is recycled by type II pneumocytes, or cleared (phagocytosed) by alveolar macrophages.* Clara cells of the bronchiolar epithelium serve as progenitor cells. They are non-ciliated cuboidal epithelial cells in terminal bronchioles.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Production of Surfactant is by:, with the following options: A: Alveolar macrophages, B: Type I Pneumocytes, C: Type II Pneumocytes, D: Clara cells + ### Response: Ans. C Type II PneumocytesRef: Guytotty 11th ed pg. 474,* The smaller type II pneumocytes are often more numerous than type I pneumocytes, but they contribute less than 10% of the surface area.* They are rounded cells which protrude from the alveolar surface, particularly at the angles between alveolar profiles.* In the human lung they are often associated with interalveolar pores of Kohn. Their cytoplasm contains numerous characteristic secretory lamellar bodies, which they can recycle.* Ultra structurally, the lamellar bodies are comprised of concentric whorls of phospholipid-rich membrane, the precursors of alveolar surfactant.* ""Surfactant is stored in lamellar bodies and secreted in the form of tubular myelin (unrelated to myelin of the nervous system) by type II pneumocytes. It is recycled by type II pneumocytes, or cleared (phagocytosed) by alveolar macrophages.* Clara cells of the bronchiolar epithelium serve as progenitor cells. They are non-ciliated cuboidal epithelial cells in terminal bronchioles. ### End" @@ -8888,6 +15913,13 @@ Ans. C Type II PneumocytesRef: Guytotty 11th ed pg. 474,* The smaller type II pn Answer the following medical question: Radiotherapy is treatment of choice in-, with the following options: A: Sarcoidosis, B: Tuberculosis, C: Monoclonal hypogammaglobulinemia, D: Sarcomas +### Response: +","Hypergammaglobulinemia results from an overproduction of immunoglobulins by plasma cells, either monoclonal and reflective of a plasma cell or lymphoproliferative disorder, or polyclonal and accompanying other disease states. IgG replacement therapy and theradiotheraphy aretreatment of choice for most primary immunodeficiency syndromes, including X-linked agammaglobulinemia (Bruton disease; XLA), common variable immunodeficiency (CVID), severe combined immunodeficiency (SCID), hyper-IgM, adenosine deaminase (ADA) deficiency, and Wiskott-Aldrich syndrome Ref Harrison20th edition pg 298","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Radiotherapy is treatment of choice in-, with the following options: A: Sarcoidosis, B: Tuberculosis, C: Monoclonal hypogammaglobulinemia, D: Sarcomas + ### Response: Hypergammaglobulinemia results from an overproduction of immunoglobulins by plasma cells, either monoclonal and reflective of a plasma cell or lymphoproliferative disorder, or polyclonal and accompanying other disease states. IgG replacement therapy and theradiotheraphy aretreatment of choice for most primary immunodeficiency syndromes, including X-linked agammaglobulinemia (Bruton disease; XLA), common variable immunodeficiency (CVID), severe combined immunodeficiency (SCID), hyper-IgM, adenosine deaminase (ADA) deficiency, and Wiskott-Aldrich syndrome Ref Harrison20th edition pg 298 ### End" @@ -8897,6 +15929,13 @@ Hypergammaglobulinemia results from an overproduction of immunoglobulins by plas Answer the following medical question: Causes of female pseudohermaphrodism ?, with the following options: A: 17-alpha hydroxylase deficiency, B: 21-alpha hydroxylase deficiency, C: Mixed gonadal dysgenesis, D: All of the above +### Response: +","Ans. is 'b' i.e., 21-alpha hydroxylase deficiency Ambiguous genitalia (Hermaphroditism) Ambiguous genitalia are defined as discrepancy between the external genitals and internal gonads. o They can be categorized : ? Female pseudohermaphroditism Male pseudohermaphroditism True hermaphroditism Female pseudohermaphroditism. Gentotype is XX Gonads are ovaries External genitalia are virilized (male differentiation). As there is no mullarian inhibiting factor, mullarian duct develops into uterus tubes and ovary. But due to presence of androgen external genitalia are virilized. Causes are: i) Maternal virilizing tumor -9 Arrhenoblastoma ii) 21 hydroxylase deficiency } Congenital adrenal hyperplasia iii) 11 beta hydroxylase deficiency iv) Maternal medications with androgen.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Causes of female pseudohermaphrodism ?, with the following options: A: 17-alpha hydroxylase deficiency, B: 21-alpha hydroxylase deficiency, C: Mixed gonadal dysgenesis, D: All of the above + ### Response: Ans. is 'b' i.e., 21-alpha hydroxylase deficiency Ambiguous genitalia (Hermaphroditism) Ambiguous genitalia are defined as discrepancy between the external genitals and internal gonads. o They can be categorized : ? Female pseudohermaphroditism Male pseudohermaphroditism True hermaphroditism Female pseudohermaphroditism. Gentotype is XX Gonads are ovaries External genitalia are virilized (male differentiation). As there is no mullarian inhibiting factor, mullarian duct develops into uterus tubes and ovary. But due to presence of androgen external genitalia are virilized. Causes are: i) Maternal virilizing tumor -9 Arrhenoblastoma ii) 21 hydroxylase deficiency } Congenital adrenal hyperplasia iii) 11 beta hydroxylase deficiency iv) Maternal medications with androgen. ### End" @@ -8906,6 +15945,29 @@ Ans. is 'b' i.e., 21-alpha hydroxylase deficiency Ambiguous genitalia (Hermaphro Answer the following medical question: Autoimmune hemolytic anemia is seen in -, with the following options: A: CML, B: CLL, C: ALL, D: AML +### Response: +","Clinical features of CLL + +Most patients present at ages over 50 with a male predominance +Patients with CLL are often asymptomatic. +When symptoms appear, they are nonspecific and include easy fatigability, weight loss and anorexia. + +Other symptoms are : - + +Hepatosplenomegaly              +Lymphadenopathy    +Hypogammaglobulinemia Increased susceptibility to infections.    +Autoimmune hemolytic anemia or thrombocytopenia           +CLL has a tendency to transform into more aggressive lymphoid neoplams : - + + +Prolymphocytic leukemia  → Characterized by worsening of cytopenia, marked splenomagaly and appearance of prolymphocytes in the peripheral blood. +Richter syndrome → CLL is transformed into diffuse large B-cell lymphoma.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Autoimmune hemolytic anemia is seen in -, with the following options: A: CML, B: CLL, C: ALL, D: AML + ### Response: Clinical features of CLL @@ -8931,6 +15993,13 @@ Richter syndrome → CLL is transformed into diffuse large B-cell lymphoma. Answer the following medical question: All of the following agents may be used in the management of Chronic Hypocalcemia, except:, with the following options: A: Etidronate, B: Thiazides, C: Elemental calcium, D: Vitamin D analogs +### Response: +","Answer is A (Etidronate): Etidronate is a first generation bisphosphonate, used for the management of Hypercalcemia (not used fir Hypocalcemia). `Treatment of Hypocalcemia includes Calcium replacement with Vitamin D analogs along with Thiazide diuretics to prevent excess calcium excretion besides replenishing any decreases in magnesium and phosphate restriction'.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All of the following agents may be used in the management of Chronic Hypocalcemia, except:, with the following options: A: Etidronate, B: Thiazides, C: Elemental calcium, D: Vitamin D analogs + ### Response: Answer is A (Etidronate): Etidronate is a first generation bisphosphonate, used for the management of Hypercalcemia (not used fir Hypocalcemia). `Treatment of Hypocalcemia includes Calcium replacement with Vitamin D analogs along with Thiazide diuretics to prevent excess calcium excretion besides replenishing any decreases in magnesium and phosphate restriction'. ### End" @@ -8940,6 +16009,13 @@ Answer is A (Etidronate): Etidronate is a first generation bisphosphonate, used Answer the following medical question: Which of the vaccine strain changed every year, with the following options: A: Measles, B: Mumps, C: Influenza, D: Polio +### Response: +",Influenza virus under goes antigenic shift and causes epidemics and pandemics. It requires vaccine strain also to be changed regularly Ref:- K Park 24th ed; pg num:- 164,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the vaccine strain changed every year, with the following options: A: Measles, B: Mumps, C: Influenza, D: Polio + ### Response: Influenza virus under goes antigenic shift and causes epidemics and pandemics. It requires vaccine strain also to be changed regularly Ref:- K Park 24th ed; pg num:- 164 ### End" @@ -8949,6 +16025,13 @@ Influenza virus under goes antigenic shift and causes epidemics and pandemics. I Answer the following medical question: Which of the following is the most efficacious triptan for rapid relief of acute migraine attack?, with the following options: A: Sumatriptan, B: Almotriptan, C: Rizatriptan, D: Naratriptan +### Response: +","Stimulation of 5-HT1B/1D receptors can stop an acute migraine attack. Ergotamine and dihydroergotamine are nonselective receptor agonists, whereas the triptans are selective 5-HT1B/1D receptor agonists. A variety of triptans--sumatriptan, almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, and zolmitriptan--are available for the treatment of migraine. Rizatriptan and eletriptan are, on a population basis, the most efficacious of the triptans currently available. Sumatriptan and zolmitriptan have similar rates of efficacy as well as time to onset, with an advantage of having multiple formulations, whereas almotriptan has a similar rate of efficacy to sumatriptan and is better tolerated, and frovatriptan and naratriptan are somewhat slower in onset and are also well tolerated Ref Harrison 20th edition page 3100","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is the most efficacious triptan for rapid relief of acute migraine attack?, with the following options: A: Sumatriptan, B: Almotriptan, C: Rizatriptan, D: Naratriptan + ### Response: Stimulation of 5-HT1B/1D receptors can stop an acute migraine attack. Ergotamine and dihydroergotamine are nonselective receptor agonists, whereas the triptans are selective 5-HT1B/1D receptor agonists. A variety of triptans--sumatriptan, almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, and zolmitriptan--are available for the treatment of migraine. Rizatriptan and eletriptan are, on a population basis, the most efficacious of the triptans currently available. Sumatriptan and zolmitriptan have similar rates of efficacy as well as time to onset, with an advantage of having multiple formulations, whereas almotriptan has a similar rate of efficacy to sumatriptan and is better tolerated, and frovatriptan and naratriptan are somewhat slower in onset and are also well tolerated Ref Harrison 20th edition page 3100 ### End" @@ -8958,6 +16041,13 @@ Stimulation of 5-HT1B/1D receptors can stop an acute migraine attack. Ergotamine Answer the following medical question: Telefona refers to?, with the following options: A: Pulling of hairs, B: Beating of soles, C: Beating on both ears, D: Beating on head +### Response: +",.Ans. (c) Beating on both earsRef: Reddy 5th ed. / 257,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Telefona refers to?, with the following options: A: Pulling of hairs, B: Beating of soles, C: Beating on both ears, D: Beating on head + ### Response: .Ans. (c) Beating on both earsRef: Reddy 5th ed. / 257 ### End" @@ -8967,6 +16057,13 @@ Answer the following medical question: Telefona refers to?, with the following o Answer the following medical question: Post pill amenorrhoea is treated by :, with the following options: A: Estrogens, B: Progesterone, C: Clonidine, D: Clomiphene +### Response: +",Clomiphene,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Post pill amenorrhoea is treated by :, with the following options: A: Estrogens, B: Progesterone, C: Clonidine, D: Clomiphene + ### Response: Clomiphene ### End" @@ -8976,6 +16073,13 @@ Clomiphene Answer the following medical question: In a child with itchy lesions over the groin and prepuce. Which of the following should not be advised?, with the following options: A: Bathe and apply scabicidal, B: Treat family, C: Boil the clothes, D: IV antibiotics +### Response: +","Child suffering from scabies : use scabicidal. Anti-scabetic agent applied to entire body sparing scalp and face. Preferably applied after a good scrub bath with soap and water. All the clothes worn should be washed, dried in hot sun & ironed. All the members if personal household and other intimates should be treated even if they do not have obvious symptoms or signs. Systemic antibiotics seldom required for mild secondary pyoderma seen in early stages of scabies. For severe pyoderma especially in debilitated patients a systemic antibiotic may be given.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In a child with itchy lesions over the groin and prepuce. Which of the following should not be advised?, with the following options: A: Bathe and apply scabicidal, B: Treat family, C: Boil the clothes, D: IV antibiotics + ### Response: Child suffering from scabies : use scabicidal. Anti-scabetic agent applied to entire body sparing scalp and face. Preferably applied after a good scrub bath with soap and water. All the clothes worn should be washed, dried in hot sun & ironed. All the members if personal household and other intimates should be treated even if they do not have obvious symptoms or signs. Systemic antibiotics seldom required for mild secondary pyoderma seen in early stages of scabies. For severe pyoderma especially in debilitated patients a systemic antibiotic may be given. ### End" @@ -8985,6 +16089,18 @@ Child suffering from scabies : use scabicidal. Anti-scabetic agent applied to en Answer the following medical question: Surgical staging is required in which of the following sex cord stromal tumor, with the following options: A: Granulosa cell tumor, B: Gynandroblastoma, C: Sertoli - leydig cell tumor (well differentiated), D: Thecoma +### Response: +","Surgical staging is required in + +Granulosa cell tumor +Fibrosarcoma  +Sertoli - Leydig cell tumor (intermediate and poorly differentiated) +Sex-cord stromal tumor with annular tubules (independent of peutz-Jeghers syndrome)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Surgical staging is required in which of the following sex cord stromal tumor, with the following options: A: Granulosa cell tumor, B: Gynandroblastoma, C: Sertoli - leydig cell tumor (well differentiated), D: Thecoma + ### Response: Surgical staging is required in @@ -8999,6 +16115,13 @@ Sex-cord stromal tumor with annular tubules (independent of peutz-Jeghers syndro Answer the following medical question: Sarcomatous change should be suspected in case of uterine fibroid when there occurs, with the following options: A: Increase in the size, B: Pain, C: Bleeding, D: All of the above +### Response: +","Ans. d (All of the above) (Ref. Shaw gynecology 14th/ 319)Sarcomatous change in fibroid is commonly seen in postmenopausal women when the tumor is noticed to grow suddenly, causing pain and postmenopausal bleeding.SARCOMATOUS CHANGE IN A MYOMA# Sarcomatous change in a myoma is extremely rare and the incidence is not more than 0.5% of all myomas.# Intramural: To start with most fibroids are intramural. There is a false capsule of connective tissue. It has a higher potential for sarcomatous change than subserous fibroid.# Important sign is nonencapsulation.Fibroids can undergo several types of degeneration:# Hyaline degeneration: this is the most common type of degeneration (can occur in -60%).# Cystic degeneration: -4 %.# Myxoid degeneration: generally considered uncommon although reported as high a 50% by some authors# Red - carneous degeneration: due to haemorrhagic infarction, which can occur particularly during pregnancy. Red degeneration of fibroid is common in pregnancy especially the third trimester.# Red degeneration presents almost exclusively in pregnancy with acute pain, fever and localized tenderness. It is due to aseptic inflammation and thrombosis. It is usually managed conservatively.Additional Educational Points:# Most common type of uterine myoma is intramural.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Sarcomatous change should be suspected in case of uterine fibroid when there occurs, with the following options: A: Increase in the size, B: Pain, C: Bleeding, D: All of the above + ### Response: Ans. d (All of the above) (Ref. Shaw gynecology 14th/ 319)Sarcomatous change in fibroid is commonly seen in postmenopausal women when the tumor is noticed to grow suddenly, causing pain and postmenopausal bleeding.SARCOMATOUS CHANGE IN A MYOMA# Sarcomatous change in a myoma is extremely rare and the incidence is not more than 0.5% of all myomas.# Intramural: To start with most fibroids are intramural. There is a false capsule of connective tissue. It has a higher potential for sarcomatous change than subserous fibroid.# Important sign is nonencapsulation.Fibroids can undergo several types of degeneration:# Hyaline degeneration: this is the most common type of degeneration (can occur in -60%).# Cystic degeneration: -4 %.# Myxoid degeneration: generally considered uncommon although reported as high a 50% by some authors# Red - carneous degeneration: due to haemorrhagic infarction, which can occur particularly during pregnancy. Red degeneration of fibroid is common in pregnancy especially the third trimester.# Red degeneration presents almost exclusively in pregnancy with acute pain, fever and localized tenderness. It is due to aseptic inflammation and thrombosis. It is usually managed conservatively.Additional Educational Points:# Most common type of uterine myoma is intramural. ### End" @@ -9008,6 +16131,13 @@ Ans. d (All of the above) (Ref. Shaw gynecology 14th/ 319)Sarcomatous change in Answer the following medical question: Which of the following markers is specific for gastrointestinal stromal tumor (GIST):, with the following options: A: CD 117, B: CD 34, C: CD123, D: S-100 +### Response: +",Ans. (a) CD 117(Ref: Robbins 9th/pg 775; 8th/pg 789)Most useful diagnostic marker is c-kit (CD117) detectable in 95% of the patients.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following markers is specific for gastrointestinal stromal tumor (GIST):, with the following options: A: CD 117, B: CD 34, C: CD123, D: S-100 + ### Response: Ans. (a) CD 117(Ref: Robbins 9th/pg 775; 8th/pg 789)Most useful diagnostic marker is c-kit (CD117) detectable in 95% of the patients. ### End" @@ -9017,6 +16147,13 @@ Ans. (a) CD 117(Ref: Robbins 9th/pg 775; 8th/pg 789)Most useful diagnostic marke Answer the following medical question: A 75-year-old woman is admitted to the hospital with anginal pain. ECG reveals myocardial infarction and a right bundle branch block. During physical examination the patient has a loud second heart sound. Which of the following heart valves are responsible for the production of the second heart sound?, with the following options: A: Aortic and pulmonary, B: Aortic and tricuspid, C: Tricuspid and mitral, D: Mitral and pulmonary +### Response: +",The second heart sound is caused by the closure of the aortic and pulmonary valves. The first sound by the heart is caused by the closure of the tricuspid and mitral valves.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 75-year-old woman is admitted to the hospital with anginal pain. ECG reveals myocardial infarction and a right bundle branch block. During physical examination the patient has a loud second heart sound. Which of the following heart valves are responsible for the production of the second heart sound?, with the following options: A: Aortic and pulmonary, B: Aortic and tricuspid, C: Tricuspid and mitral, D: Mitral and pulmonary + ### Response: The second heart sound is caused by the closure of the aortic and pulmonary valves. The first sound by the heart is caused by the closure of the tricuspid and mitral valves. ### End" @@ -9026,6 +16163,13 @@ The second heart sound is caused by the closure of the aortic and pulmonary valv Answer the following medical question: CSF is formed by -, with the following options: A: Arachnoid villi, B: Venous plexus, C: Choroid plexus, D: Subfornical nucleus +### Response: +","Ans. (c) Choroid plexus(Ref: Ganong, 25th ed/p.603)CSF is produced from choroid plexuses epithelial cells. It is absorbed through the arachnoid villi into veins","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: CSF is formed by -, with the following options: A: Arachnoid villi, B: Venous plexus, C: Choroid plexus, D: Subfornical nucleus + ### Response: Ans. (c) Choroid plexus(Ref: Ganong, 25th ed/p.603)CSF is produced from choroid plexuses epithelial cells. It is absorbed through the arachnoid villi into veins ### End" @@ -9035,6 +16179,13 @@ Ans. (c) Choroid plexus(Ref: Ganong, 25th ed/p.603)CSF is produced from choroid Answer the following medical question: 3 point symmetry is NOT disturbed in which fracture, with the following options: A: Fracture ulna only, B: Fracture radius only, C: Fracture of radius & ulna both bones of forearm, D: Weak posterior capsule +### Response: +",B i.e. Fracture radius only Weak posterior capsule may disrupt three point bony relation by promoting subluxation or dislocations of elbow. Fracture ulna on the upper end i.e. involving olecranon also disturb three point symmetry. But the radius has nothing to do with three point bony relationshipQ and so it will not disturb three point bony symmetry.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: 3 point symmetry is NOT disturbed in which fracture, with the following options: A: Fracture ulna only, B: Fracture radius only, C: Fracture of radius & ulna both bones of forearm, D: Weak posterior capsule + ### Response: B i.e. Fracture radius only Weak posterior capsule may disrupt three point bony relation by promoting subluxation or dislocations of elbow. Fracture ulna on the upper end i.e. involving olecranon also disturb three point symmetry. But the radius has nothing to do with three point bony relationshipQ and so it will not disturb three point bony symmetry. ### End" @@ -9044,6 +16195,13 @@ B i.e. Fracture radius only Weak posterior capsule may disrupt three point bony Answer the following medical question: The first permanent tooth to appear is:, with the following options: A: 1st molar, B: Lateral incisor, C: Upper canine, D: 1st premolar +### Response: +",Ans: A (1st molar) Ref: The Essentials of Forensic Medicine and Toxicology by KS Narayan Reddy. 29th edition. 2010.Explanation:Appearance of temporary teeth:Lower central incisor (6 mths)Upper central incisor (7 M)Upper lateral incisor (8 M)Lower lateral incisor (9 M)1 st molar ( 1 yr)Canine (1 1/2 yr)2nd molar (2 yr)Appearance of permanent teeth:1st molar (6 yr)Central incisors (7 yr)Lateral incisors (8 yr)1st premolar (9 vr)2nd premolar (10 yr)Canine (11 yr)2nd molar (12-14 yr)3rd molar (17-25 yr),"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The first permanent tooth to appear is:, with the following options: A: 1st molar, B: Lateral incisor, C: Upper canine, D: 1st premolar + ### Response: Ans: A (1st molar) Ref: The Essentials of Forensic Medicine and Toxicology by KS Narayan Reddy. 29th edition. 2010.Explanation:Appearance of temporary teeth:Lower central incisor (6 mths)Upper central incisor (7 M)Upper lateral incisor (8 M)Lower lateral incisor (9 M)1 st molar ( 1 yr)Canine (1 1/2 yr)2nd molar (2 yr)Appearance of permanent teeth:1st molar (6 yr)Central incisors (7 yr)Lateral incisors (8 yr)1st premolar (9 vr)2nd premolar (10 yr)Canine (11 yr)2nd molar (12-14 yr)3rd molar (17-25 yr) ### End" @@ -9053,6 +16211,13 @@ Ans: A (1st molar) Ref: The Essentials of Forensic Medicine and Toxicology by KS Answer the following medical question: Which of the following drugs is not used for the management of multiple myeloma, with the following options: A: Boezomib, B: Hydroxyurea, C: Melphelan, D: Cyclophosphamide +### Response: +","Answer is B (Hydroxyurea) Hydroxyurea is not recommended for the management of multiple myeloma Chemotherapeutic Agents Recommended in the management of multiple myeloma Boezomib Cyclophosphamide Doxorubicin Vincristine Lenalidomide Thalidomide Melphelan Dexamethasone / Prednisolone Interferon (Maintenance) The most commonly used chemotherapy agents in non-transplant and transplant candidates and in relapsed orrefractory myeloma, based on the 2007 National Comprehensive Cancer Network (NCCN) guidelines Primary Induction therapy for transplant candidates Primary Induction Therapy for non-transplant Candidates Boezomib/dexamethasone (category 1) * Boezomib/dexamethasone Boezomib/cyclophosphamide/dexamethasone * Dexamethasone (category 2B) Bonezomib/doxorubicin/dexamethasone (category I) * Lenalidomide/low-dose dexamethasone (category 1) Boezomib/enalidomideQ/dexamethasone (category 2B) * Liposomal doxorubicin/vincristine/dexamethasone (D VD) Boezomib/thalidomide/dexamethasone (category 1) (category 2B) Dexamethasone (category 2B) * Melphalan/prednisone (MP) Lenalidomide'/dexamethasone (category I) * Melphalan/prednisone/boezomib (MPB) (category I) Liposomal doxorubicin/vincristine/dexamethasone * Melphalan/prednisone/thalidomide (MPT) (category 1) (DVD) (category 2B) * Melphalan/prednisone/lenalidomide (MPL) Thalidomide/dexamethasone (category 2B) * Thalidomide/dexamethasone (category 2B) * Vincristine/doxorubicin/dexamethasone (VAD) (cateoory 2B) Maintenance Therapy Sal * Interferon (category 2B) * Repeat primary induction therapy (if relapse at > 6 mo) * Lenalidomide' * Bendamustine (category 2B) * Steroids (category 2B) * Boezomibg (category 1) * Thalidomide (category 1) +-prednisone (category 2B) * Boezomib/dexamethasone * Borlezomib/lenalidomide/dexamethasone (category 2B) * Boezomib/liposomal doxorubicing (category I) * Cyclophosphamide-VAD * Cyclophosphamide/boezomib/dexamethasoneh * Cyclophosphamide/lenalidomide/dexamethasoneh * Dexamethasone * Dexamethasone/cyclophasphamide/etoposide/cisplatin (DCEP) * Dexamethasone/thalidomide/cisplatin/doxorubicin/ cyclophosphamide/etoposide (DT-PACE) * High-dose cyclophosphamide * Lenalidomide/dexamethasone (category 1) * Lenalidomide * Thalidomide * Thalidomide/dexamethasone aSelected, but not inclusive of all regimens -->Thalidomide/dexamethasone bTreatments are listed alphabatically and do not imply preference. cRecommend herpes zoster prophylaxis for patients treated with boezomib dProphylactic anticoagulation recommended for patients receiving thalidomide-based therapy or lenalidomide with dexmethasone. fLenalidomide as maintenance has been evaluated in three independent randomized clinical trials. Results from each of these trials show improvements in TTP. The panel felt that this warranted inclusion: however, this recommendation remains Category 2A since these results have not undergone full peer review and safety/efficacy data are still preliminary. gBoezomib/liposomal doxorubicin is prefered to boezumib single agent hThese are representative regimens combining standard agents with novel agents Note: All recommendations are category 2A unless otherwise indicated. Clinical Trials: NCCN believes that the best management of any cancer patient is in a clinical trial. Paicipation in clinical tirals is especially encouraged.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following drugs is not used for the management of multiple myeloma, with the following options: A: Boezomib, B: Hydroxyurea, C: Melphelan, D: Cyclophosphamide + ### Response: Answer is B (Hydroxyurea) Hydroxyurea is not recommended for the management of multiple myeloma Chemotherapeutic Agents Recommended in the management of multiple myeloma Boezomib Cyclophosphamide Doxorubicin Vincristine Lenalidomide Thalidomide Melphelan Dexamethasone / Prednisolone Interferon (Maintenance) The most commonly used chemotherapy agents in non-transplant and transplant candidates and in relapsed orrefractory myeloma, based on the 2007 National Comprehensive Cancer Network (NCCN) guidelines Primary Induction therapy for transplant candidates Primary Induction Therapy for non-transplant Candidates Boezomib/dexamethasone (category 1) * Boezomib/dexamethasone Boezomib/cyclophosphamide/dexamethasone * Dexamethasone (category 2B) Bonezomib/doxorubicin/dexamethasone (category I) * Lenalidomide/low-dose dexamethasone (category 1) Boezomib/enalidomideQ/dexamethasone (category 2B) * Liposomal doxorubicin/vincristine/dexamethasone (D VD) Boezomib/thalidomide/dexamethasone (category 1) (category 2B) Dexamethasone (category 2B) * Melphalan/prednisone (MP) Lenalidomide'/dexamethasone (category I) * Melphalan/prednisone/boezomib (MPB) (category I) Liposomal doxorubicin/vincristine/dexamethasone * Melphalan/prednisone/thalidomide (MPT) (category 1) (DVD) (category 2B) * Melphalan/prednisone/lenalidomide (MPL) Thalidomide/dexamethasone (category 2B) * Thalidomide/dexamethasone (category 2B) * Vincristine/doxorubicin/dexamethasone (VAD) (cateoory 2B) Maintenance Therapy Sal * Interferon (category 2B) * Repeat primary induction therapy (if relapse at > 6 mo) * Lenalidomide' * Bendamustine (category 2B) * Steroids (category 2B) * Boezomibg (category 1) * Thalidomide (category 1) +-prednisone (category 2B) * Boezomib/dexamethasone * Borlezomib/lenalidomide/dexamethasone (category 2B) * Boezomib/liposomal doxorubicing (category I) * Cyclophosphamide-VAD * Cyclophosphamide/boezomib/dexamethasoneh * Cyclophosphamide/lenalidomide/dexamethasoneh * Dexamethasone * Dexamethasone/cyclophasphamide/etoposide/cisplatin (DCEP) * Dexamethasone/thalidomide/cisplatin/doxorubicin/ cyclophosphamide/etoposide (DT-PACE) * High-dose cyclophosphamide * Lenalidomide/dexamethasone (category 1) * Lenalidomide * Thalidomide * Thalidomide/dexamethasone aSelected, but not inclusive of all regimens -->Thalidomide/dexamethasone bTreatments are listed alphabatically and do not imply preference. cRecommend herpes zoster prophylaxis for patients treated with boezomib dProphylactic anticoagulation recommended for patients receiving thalidomide-based therapy or lenalidomide with dexmethasone. fLenalidomide as maintenance has been evaluated in three independent randomized clinical trials. Results from each of these trials show improvements in TTP. The panel felt that this warranted inclusion: however, this recommendation remains Category 2A since these results have not undergone full peer review and safety/efficacy data are still preliminary. gBoezomib/liposomal doxorubicin is prefered to boezumib single agent hThese are representative regimens combining standard agents with novel agents Note: All recommendations are category 2A unless otherwise indicated. Clinical Trials: NCCN believes that the best management of any cancer patient is in a clinical trial. Paicipation in clinical tirals is especially encouraged. ### End" @@ -9062,6 +16227,13 @@ Answer is B (Hydroxyurea) Hydroxyurea is not recommended for the management of m Answer the following medical question: T - 10 Protocol' for treatment of osteosarcoma includes all of the following, EXCEPT:, with the following options: A: High Dose Methotrexate, B: Bleomycin, Cyclophosphamide, Doxorubicin (BCD), C: Vincristine, D: Etoposide +### Response: +","Both Etoposide and Vincristine is not included in the 'T-10' protocol for osteosarcoma. Since etoposide is included in modified protocol for treatment of osteosarcoma. Vincristine is the best answer. Ref: Principles and Practice of Pediatric Oncology, 5th Edition, Page 1102; Sma Study Series Ohopedics By Narender Rohilla, Page 155","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: T - 10 Protocol' for treatment of osteosarcoma includes all of the following, EXCEPT:, with the following options: A: High Dose Methotrexate, B: Bleomycin, Cyclophosphamide, Doxorubicin (BCD), C: Vincristine, D: Etoposide + ### Response: Both Etoposide and Vincristine is not included in the 'T-10' protocol for osteosarcoma. Since etoposide is included in modified protocol for treatment of osteosarcoma. Vincristine is the best answer. Ref: Principles and Practice of Pediatric Oncology, 5th Edition, Page 1102; Sma Study Series Ohopedics By Narender Rohilla, Page 155 ### End" @@ -9071,6 +16243,13 @@ Both Etoposide and Vincristine is not included in the 'T-10' protocol for osteos Answer the following medical question: Intravenous fluid of choice in management of diabetic ketoacidosis, with the following options: A: Normal saline, B: Colloids, C: 5% dextrose, D: Dextran - 70 +### Response: +","Answer-A. Normal salineTreatment of DKA1. InsulinA bolus of IV IM sho acting insulin (regular insulin) should be given immediately to reduce blood glucose level'Subsequent treatment should piovide continuous and adequate level ofcirculating insulin'2. IV fluidDue to vomiting, osmotic diuresis and hyperventilation, there is dehydration and Na. deficit in DKA which should be treated by iv saline infusion.Normal saline (0.9% saline) k the fluid of choice3. KCI4. Sodium bicarbonate5. Magnesium and phosphate","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Intravenous fluid of choice in management of diabetic ketoacidosis, with the following options: A: Normal saline, B: Colloids, C: 5% dextrose, D: Dextran - 70 + ### Response: Answer-A. Normal salineTreatment of DKA1. InsulinA bolus of IV IM sho acting insulin (regular insulin) should be given immediately to reduce blood glucose level'Subsequent treatment should piovide continuous and adequate level ofcirculating insulin'2. IV fluidDue to vomiting, osmotic diuresis and hyperventilation, there is dehydration and Na. deficit in DKA which should be treated by iv saline infusion.Normal saline (0.9% saline) k the fluid of choice3. KCI4. Sodium bicarbonate5. Magnesium and phosphate ### End" @@ -9080,6 +16259,13 @@ Answer-A. Normal salineTreatment of DKA1. InsulinA bolus of IV IM sho acting ins Answer the following medical question: Hepatic C is associated with all except:, with the following options: A: PAN, B: Dermatomyositis like syndrome, C: Lichen Planus, D: All +### Response: +","Answer is B (Dermatomyositis like syndrome) Dermatamyositis like syndrome has not been mentioned in association with Hepatitis C infection. Psoriasis has also not been linked to Hepatitis C virus directly although it may be seen in patients treated with Interferon a Lichen plaints and PAN are established associations of both, hepatitis B and hepatitis C. Dermatoses associated with Hepatitis B Dermatoses associated with Hepatitis C * Gianotti-Crosti syndrome * Lichen planus * B-cell lymphoma (lymphoplasmacytic lymphoma, Waldenstrom macroglobulinemia) associated with * Mixed cryoglobulinemia mixed cryoglobulinemia. * Erythema nodosum * Leukocytoclastic vasculitis * Pyoderma gangrenosum * Polyaeritis nodosa * Polyaeritis nodosa * Porphyria cutanea tarda * Uicaria * Lichen planus * Leukocytoclastic vasculitis * Uicaria * Serum sickness-like prodrometeinuria, or hematuria * Dermatomyositis-like syndrome *Many dermatoses formerly associated with HBV infection have turned out to be more often or exclusively associated with HCV. Thus, both of these lists should be viewed as working formulations.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hepatic C is associated with all except:, with the following options: A: PAN, B: Dermatomyositis like syndrome, C: Lichen Planus, D: All + ### Response: Answer is B (Dermatomyositis like syndrome) Dermatamyositis like syndrome has not been mentioned in association with Hepatitis C infection. Psoriasis has also not been linked to Hepatitis C virus directly although it may be seen in patients treated with Interferon a Lichen plaints and PAN are established associations of both, hepatitis B and hepatitis C. Dermatoses associated with Hepatitis B Dermatoses associated with Hepatitis C * Gianotti-Crosti syndrome * Lichen planus * B-cell lymphoma (lymphoplasmacytic lymphoma, Waldenstrom macroglobulinemia) associated with * Mixed cryoglobulinemia mixed cryoglobulinemia. * Erythema nodosum * Leukocytoclastic vasculitis * Pyoderma gangrenosum * Polyaeritis nodosa * Polyaeritis nodosa * Porphyria cutanea tarda * Uicaria * Lichen planus * Leukocytoclastic vasculitis * Uicaria * Serum sickness-like prodrometeinuria, or hematuria * Dermatomyositis-like syndrome *Many dermatoses formerly associated with HBV infection have turned out to be more often or exclusively associated with HCV. Thus, both of these lists should be viewed as working formulations. ### End" @@ -9089,6 +16275,13 @@ Answer is B (Dermatomyositis like syndrome) Dermatamyositis like syndrome has no Answer the following medical question: Right superior intercostal vein drains into, with the following options: A: Brachiocephalic vein, B: Azygos vein, C: Inferior venacava, D: Hemizygos vein +### Response: +","The right superior intercostal vein drains the 2nd, 3rd, and 4th posterior intercostal veins on the right side of the body. It flows into the azygos vein. The left superior intercostal veins drains the 2nd and 3rd posterior intercostal veins on the left side of the body. It drains into the left brachiocephalic vein B D CHOURASIAS HUMAN ANATOMY UPPER LIMB THORAX VOLUME, 1 SIXTH EDITION, page no,221","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Right superior intercostal vein drains into, with the following options: A: Brachiocephalic vein, B: Azygos vein, C: Inferior venacava, D: Hemizygos vein + ### Response: The right superior intercostal vein drains the 2nd, 3rd, and 4th posterior intercostal veins on the right side of the body. It flows into the azygos vein. The left superior intercostal veins drains the 2nd and 3rd posterior intercostal veins on the left side of the body. It drains into the left brachiocephalic vein B D CHOURASIAS HUMAN ANATOMY UPPER LIMB THORAX VOLUME, 1 SIXTH EDITION, page no,221 ### End" @@ -9098,6 +16291,13 @@ The right superior intercostal vein drains the 2nd, 3rd, and 4th posterior inter Answer the following medical question: DNA synthesis occurs in phase-, with the following options: A: G1, B: G2, C: S, D: M +### Response: +","Ans. is 'c' i.e., S o In the cell, the replication of the DNA occurs only at a specific time during the life of the cell. This period is referred to as the synthetic phase. The various phases of cell cycle are (in sequence) G0 - G1 - S - G2 - M. G1 : Presynthetic phase/interval. S : Synthetic phase (DNA synthesis). G2 : Post-synthetic phase/premitotic phase/interval. M : Mitotic phase: Cells are produced which either directly reenter next cycle or pass into non-proliferative G0 phase. G0 : the Quiescent state.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: DNA synthesis occurs in phase-, with the following options: A: G1, B: G2, C: S, D: M + ### Response: Ans. is 'c' i.e., S o In the cell, the replication of the DNA occurs only at a specific time during the life of the cell. This period is referred to as the synthetic phase. The various phases of cell cycle are (in sequence) G0 - G1 - S - G2 - M. G1 : Presynthetic phase/interval. S : Synthetic phase (DNA synthesis). G2 : Post-synthetic phase/premitotic phase/interval. M : Mitotic phase: Cells are produced which either directly reenter next cycle or pass into non-proliferative G0 phase. G0 : the Quiescent state. ### End" @@ -9107,6 +16307,13 @@ Ans. is 'c' i.e., S o In the cell, the replication of the DNA occurs only at a s Answer the following medical question: Double bubble sign is seen in -, with the following options: A: Ladd's band, B: Annular pancreas, C: Duodenal atresia, D: All of the above +### Response: +","Ans. is 'd' i.e., All of the above o Double bubble sign is seen in duodenal atresia, duodenal web, deudenal stenosis, Ladd's band, Annular pancreas, Malrotation of gut, preduodenal vein.Single Bubble signCongenita] hypertrophic pyloric stenosisDouble Bubble signDuodenal atresiaDuodenal webDuodena] stenosisLadd's bandAnnular pancreasMalrotation of gutPreduodenal veinTriple Bubble signJejunal or proximal ileum atresiaMultiple Bubble signIleal atresia","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Double bubble sign is seen in -, with the following options: A: Ladd's band, B: Annular pancreas, C: Duodenal atresia, D: All of the above + ### Response: Ans. is 'd' i.e., All of the above o Double bubble sign is seen in duodenal atresia, duodenal web, deudenal stenosis, Ladd's band, Annular pancreas, Malrotation of gut, preduodenal vein.Single Bubble signCongenita] hypertrophic pyloric stenosisDouble Bubble signDuodenal atresiaDuodenal webDuodena] stenosisLadd's bandAnnular pancreasMalrotation of gutPreduodenal veinTriple Bubble signJejunal or proximal ileum atresiaMultiple Bubble signIleal atresia ### End" @@ -9116,6 +16323,13 @@ Ans. is 'd' i.e., All of the above o Double bubble sign is seen in duodenal atre Answer the following medical question: Which of the following is NOT a ""Chemoattractant""., with the following options: A: Leukotriene B 4, B: IL8, C: C5a, D: C3 +### Response: +",C3,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is NOT a ""Chemoattractant""., with the following options: A: Leukotriene B 4, B: IL8, C: C5a, D: C3 + ### Response: C3 ### End" @@ -9125,6 +16339,13 @@ C3 Answer the following medical question: Which of the following type of cataract is seen in a person 1-2years following exposure to radiation?, with the following options: A: Lamellar cataract, B: Christmas tree cataract, C: Posterior polar cataract, D: Posterior subcapsular cataract +### Response: +","Radiation usually causes posterior subcapsular cataract which has their onset 1-2 years after completion of radiation therapy. A radiation dose of 15Gy is associated with a 50% risk of cataract formation. Christmas tree cataract is a rare form of age related cataract. In this type, the highly retractile multicolored needle shaped lenticular inclusions are seen within the deep perinuclear coex of the lens. Posterior polar cataract is a rare form of congenital cataract with a round, discoid opacity located in the central posterior pa of the lens adjacent to and merging with the posterior capsule. REF: Cataract Surgery from Routine to Complex: A Practical Guide By George J. C. Jin PAGE 21.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following type of cataract is seen in a person 1-2years following exposure to radiation?, with the following options: A: Lamellar cataract, B: Christmas tree cataract, C: Posterior polar cataract, D: Posterior subcapsular cataract + ### Response: Radiation usually causes posterior subcapsular cataract which has their onset 1-2 years after completion of radiation therapy. A radiation dose of 15Gy is associated with a 50% risk of cataract formation. Christmas tree cataract is a rare form of age related cataract. In this type, the highly retractile multicolored needle shaped lenticular inclusions are seen within the deep perinuclear coex of the lens. Posterior polar cataract is a rare form of congenital cataract with a round, discoid opacity located in the central posterior pa of the lens adjacent to and merging with the posterior capsule. REF: Cataract Surgery from Routine to Complex: A Practical Guide By George J. C. Jin PAGE 21. ### End" @@ -9134,6 +16355,13 @@ Radiation usually causes posterior subcapsular cataract which has their onset 1- Answer the following medical question: Treatment of choice of a 2cm thyroid nodule in a 50 year old man with FNAC revealing it to be a papillary carcinoma:, with the following options: A: Hemithyroidectomy, B: Subtotal thyroidectomy with modified neck dissection, C: Near total thyroidectomy with modified neck dissection, D: Hemithyroidectomy with modified neck dissection +### Response: +","Surgery, either near-total or total thyroidectomy, is the initial treatment of choice for patients with papillary carcinoma. Near-total thyroidectomy is performed for extensive unilateral tumors with local metastases. Total thyroidectomy is performed for patients with extensive multifocal disease with metastases to the cervical lymph nodes, contiguous neck structures, or distant sites. Ref: Current Medical Diagnosis and Treatment, 2012, Chapter 26; Hazzard's Geriatric Medicine and Gerontology, 6th Edition, Chapter 108","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Treatment of choice of a 2cm thyroid nodule in a 50 year old man with FNAC revealing it to be a papillary carcinoma:, with the following options: A: Hemithyroidectomy, B: Subtotal thyroidectomy with modified neck dissection, C: Near total thyroidectomy with modified neck dissection, D: Hemithyroidectomy with modified neck dissection + ### Response: Surgery, either near-total or total thyroidectomy, is the initial treatment of choice for patients with papillary carcinoma. Near-total thyroidectomy is performed for extensive unilateral tumors with local metastases. Total thyroidectomy is performed for patients with extensive multifocal disease with metastases to the cervical lymph nodes, contiguous neck structures, or distant sites. Ref: Current Medical Diagnosis and Treatment, 2012, Chapter 26; Hazzard's Geriatric Medicine and Gerontology, 6th Edition, Chapter 108 ### End" @@ -9143,6 +16371,13 @@ Surgery, either near-total or total thyroidectomy, is the initial treatment of c Answer the following medical question: In thin basement membrane disease, the defect is in, with the following options: A: a1 and a2 chains of type IV collagen, B: a3 and a4 chains of type IV collagen, C: a1 and a2 chains of type VI collagen, D: a3 and a4 chains of type VI collagen +### Response: +","TBM disease (also known as benign familial hematuria and thin basement membrane nephropathy) is, along with IgA nephropathy, the most common cause of blood in the urine without any other symptoms. The only abnormal finding in this diseaseis a thinning of the basement membrane of the glomeruli (filters) in the kidneys. Refer robbins 9/e","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In thin basement membrane disease, the defect is in, with the following options: A: a1 and a2 chains of type IV collagen, B: a3 and a4 chains of type IV collagen, C: a1 and a2 chains of type VI collagen, D: a3 and a4 chains of type VI collagen + ### Response: TBM disease (also known as benign familial hematuria and thin basement membrane nephropathy) is, along with IgA nephropathy, the most common cause of blood in the urine without any other symptoms. The only abnormal finding in this diseaseis a thinning of the basement membrane of the glomeruli (filters) in the kidneys. Refer robbins 9/e ### End" @@ -9152,6 +16387,13 @@ TBM disease (also known as benign familial hematuria and thin basement membrane Answer the following medical question: Most common intraocular tumour of childhood is:, with the following options: A: Malignant Melanoma, B: Retinoblastoma, C: Haemangioma, D: Rhabdomyoma +### Response: +","Ans: b (Retinoblastoma) Ref: AK Khurana, 4th ed, p. 280 * Retinoblastoma is the most common intraocular tumour occurring in 1 in 20000 live births * Arises from the neurosensory layer of retinalneuroectodermal) * Sporadic 94% Familial 6% * Bilateral 30-40% Unilateral 60-70% *Heritable 40% (All familial + l/3rd of sporadic) Nonheritable 60% - Rb gene is a tumour suppressor gene on Ch 13 long arm. Loss or inactivation of both the normal allele lead to Rb. - Histopathology: - Flexner wintersteiner rosettes (highly specific) - Homer wright rosettes - Pseudorosettes - Necrosis & calcification C/F:- 1. Leukocoria (Amaurotic cats eye reflex)- M.C. manifestation 2. Squint(2nd MC) 3. Secondary glaucoma 4. Nystagmus Inv: A. On Ophthalmoscopy 2 appearances 1. Endophytic retinoblastoma with calcification- Cottage cheese appearance 2. Exophytic Rb with appearance of exudative retinal detachment B. USG C. CT Scan Both detects calcification D. MRI - to study optic nerve & sellar & parasellar regions of brain Treatment: Small tumours (<4 mm diameter < 2 mm thickness) 1. Laser photocoagulation 2. cryotherapy (anterior to equator) 3. transpupillary thermotherapy Medium sized tumours (< 12 mm dia < 6 mm thickness) 1. Brachyterapy using episcleral plaque applicator 2. Chemoreduction - agents vincristine, carboplatin & etoposide Large tumours 1. Enucleation 2. Chemoreduction Extracranial ext. -- external beam radiotherapy Recurrent/ metastasis-- chemotherapy Prognosis: Reese Elsworth system Indications of enucleation 1. No chance of preserving useful vision 2. Tumour involving half of globe 3. Optic nerve involvement 4. Glaucoma or AC involvement 5. Gross vitreous seedings","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common intraocular tumour of childhood is:, with the following options: A: Malignant Melanoma, B: Retinoblastoma, C: Haemangioma, D: Rhabdomyoma + ### Response: Ans: b (Retinoblastoma) Ref: AK Khurana, 4th ed, p. 280 * Retinoblastoma is the most common intraocular tumour occurring in 1 in 20000 live births * Arises from the neurosensory layer of retinalneuroectodermal) * Sporadic 94% Familial 6% * Bilateral 30-40% Unilateral 60-70% *Heritable 40% (All familial + l/3rd of sporadic) Nonheritable 60% - Rb gene is a tumour suppressor gene on Ch 13 long arm. Loss or inactivation of both the normal allele lead to Rb. - Histopathology: - Flexner wintersteiner rosettes (highly specific) - Homer wright rosettes - Pseudorosettes - Necrosis & calcification C/F:- 1. Leukocoria (Amaurotic cats eye reflex)- M.C. manifestation 2. Squint(2nd MC) 3. Secondary glaucoma 4. Nystagmus Inv: A. On Ophthalmoscopy 2 appearances 1. Endophytic retinoblastoma with calcification- Cottage cheese appearance 2. Exophytic Rb with appearance of exudative retinal detachment B. USG C. CT Scan Both detects calcification D. MRI - to study optic nerve & sellar & parasellar regions of brain Treatment: Small tumours (<4 mm diameter < 2 mm thickness) 1. Laser photocoagulation 2. cryotherapy (anterior to equator) 3. transpupillary thermotherapy Medium sized tumours (< 12 mm dia < 6 mm thickness) 1. Brachyterapy using episcleral plaque applicator 2. Chemoreduction - agents vincristine, carboplatin & etoposide Large tumours 1. Enucleation 2. Chemoreduction Extracranial ext. -- external beam radiotherapy Recurrent/ metastasis-- chemotherapy Prognosis: Reese Elsworth system Indications of enucleation 1. No chance of preserving useful vision 2. Tumour involving half of globe 3. Optic nerve involvement 4. Glaucoma or AC involvement 5. Gross vitreous seedings ### End" @@ -9161,6 +16403,17 @@ Ans: b (Retinoblastoma) Ref: AK Khurana, 4th ed, p. 280 * Retinoblastoma is the Answer the following medical question: Main drawback of Be in Ni-Cr alloys, with the following options: A: Health hazard, B: Increase flow of alloy, C: Reduce fusion temp, D: Refine grain bending +### Response: +","Although beryllium is known to be highly toxic, it is used in some Ni-Cr alloys in concentrations of 1% to 2% by weight (approximately 5.5% to 11% atomic content) to increase the castability of these alloys and lower their melting range. It also tends to form thin adherent oxides that are required to promote atomic bonding of porcelain.  +Base metal alloys containing both beryllium and nickel exhibit high beryllium release rates, which may pose a health risk. +Beryllium-containing particles that are inhaled and reach the alveoli of the lungs may cause a chronic inflammatory condition called berylliosis.  +Berylliosis occurs only in individuals with a hypersensitivity to beryllium and may occur from inhalation of beryllium dusts (from grinding or polishing alloys), salts, or fumes such as those encountered in casting beryllium-containing alloys. Thus, dental lab technicians would presumably be at the highest risk of adverse effects from exposure to beryllium dusts and vapors. +Ref: Phillip’s 12th edition page 128.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Main drawback of Be in Ni-Cr alloys, with the following options: A: Health hazard, B: Increase flow of alloy, C: Reduce fusion temp, D: Refine grain bending + ### Response: Although beryllium is known to be highly toxic, it is used in some Ni-Cr alloys in concentrations of 1% to 2% by weight (approximately 5.5% to 11% atomic content) to increase the castability of these alloys and lower their melting range. It also tends to form thin adherent oxides that are required to promote atomic bonding of porcelain.  Base metal alloys containing both beryllium and nickel exhibit high beryllium release rates, which may pose a health risk. @@ -9174,6 +16427,13 @@ Ref: Phillip’s 12th edition page 128. Answer the following medical question: Eye lash infestation by pediculosis is caused by:, with the following options: A: Pediculosis Capitis, B: Pediculosis corporis, C: Phthiriasis pubis, D: Hymenoptera +### Response: +",Lice: Head lice Body lice Pubic lice Pediculosis capitis Pediculosis corporis Phthiriasis pubis Phthriasis palpebrarum - -rare eyelid infestation -cause: Phthiriasis pubis,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Eye lash infestation by pediculosis is caused by:, with the following options: A: Pediculosis Capitis, B: Pediculosis corporis, C: Phthiriasis pubis, D: Hymenoptera + ### Response: Lice: Head lice Body lice Pubic lice Pediculosis capitis Pediculosis corporis Phthiriasis pubis Phthriasis palpebrarum - -rare eyelid infestation -cause: Phthiriasis pubis ### End" @@ -9183,6 +16443,13 @@ Lice: Head lice Body lice Pubic lice Pediculosis capitis Pediculosis corporis Ph Answer the following medical question: A 6.5-month-old infant presented with complaints altered behavior, cyanosis, weak cry, drooling, diminished feeding and constipation for 1 week. On examination, Shallow respiration Generalized flaccidity Absent DTRs Drooping eyelids There was no past history of fever, cough or coryza. The prenatal and antenatal period was uncomplicated. There was normal progression of the developmental milestones. The child was recently staed on pureed foods along with small amounts of honey. Lab studies and CSF studies were normal. SERS based immunoassay revealed a positive test. The motility of the above organism is due to which type of flagella: -, with the following options: A: , B: , C: , D: +### Response: +","This is a case of infant botulism. Presents as: - Acute flaccid paralysis Toxin inhibits presynaptic release of Acetylcholine History of honey ingestion Honey contains spores of C. botulinum Risk is higher in infants As the gut flora has not matured in infants C. botulinum Gram positive bacillus 5 x 1 micrometer Non capsulated Peritrichous flagella Produces subterminal, bulging, oval spores Option A is monotrichous flagella Option B is Lophotrichous flagella Option D is Amphitrichous flagella","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 6.5-month-old infant presented with complaints altered behavior, cyanosis, weak cry, drooling, diminished feeding and constipation for 1 week. On examination, Shallow respiration Generalized flaccidity Absent DTRs Drooping eyelids There was no past history of fever, cough or coryza. The prenatal and antenatal period was uncomplicated. There was normal progression of the developmental milestones. The child was recently staed on pureed foods along with small amounts of honey. Lab studies and CSF studies were normal. SERS based immunoassay revealed a positive test. The motility of the above organism is due to which type of flagella: -, with the following options: A: , B: , C: , D: + ### Response: This is a case of infant botulism. Presents as: - Acute flaccid paralysis Toxin inhibits presynaptic release of Acetylcholine History of honey ingestion Honey contains spores of C. botulinum Risk is higher in infants As the gut flora has not matured in infants C. botulinum Gram positive bacillus 5 x 1 micrometer Non capsulated Peritrichous flagella Produces subterminal, bulging, oval spores Option A is monotrichous flagella Option B is Lophotrichous flagella Option D is Amphitrichous flagella ### End" @@ -9192,6 +16459,14 @@ This is a case of infant botulism. Presents as: - Acute flaccid paralysis Toxin Answer the following medical question: Increased density in skull vault is seen in -a) Hyperparathyroidismb) Multiple myelomac) Fluorosisd) Renal osteodystrophy, with the following options: A: acd, B: ad, C: bc, D: bde +### Response: +","All the causes of generalized increased in bone density can cause increased density of skull vault — Practical imaging 2nd /e 73 +Fluorosis and secondary hyperparathyroidism (renal osteodystrophy) cause increased density of skull vault.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Increased density in skull vault is seen in -a) Hyperparathyroidismb) Multiple myelomac) Fluorosisd) Renal osteodystrophy, with the following options: A: acd, B: ad, C: bc, D: bde + ### Response: All the causes of generalized increased in bone density can cause increased density of skull vault — Practical imaging 2nd /e 73 Fluorosis and secondary hyperparathyroidism (renal osteodystrophy) cause increased density of skull vault. @@ -9202,6 +16477,13 @@ Fluorosis and secondary hyperparathyroidism (renal osteodystrophy) cause increas Answer the following medical question: Which water soluble vitamin is synthesized in our body -, with the following options: A: Niacin, B: Folic acid, C: Cobalamine, D: Pyridoxine +### Response: +","Ans. is 'a' i.e., Niacin o This question is confusing one (Read text below)o Niacin (Vitamin B3) is synthesized from tryptophan inside the bodo Some vitamins are also formed by bacterial activity in coloni) Vitamin Kii) Vitamin B12Thiamin (Vitamin Bl)iv) Riboflavin (Vitamin B2)v) Biotin (Vitamin B7)o Thus, options a, b & d all are correct here. But best answer among these is niacin as it is the only vitamin which is synthesized by proper anabolic metabolism.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which water soluble vitamin is synthesized in our body -, with the following options: A: Niacin, B: Folic acid, C: Cobalamine, D: Pyridoxine + ### Response: Ans. is 'a' i.e., Niacin o This question is confusing one (Read text below)o Niacin (Vitamin B3) is synthesized from tryptophan inside the bodo Some vitamins are also formed by bacterial activity in coloni) Vitamin Kii) Vitamin B12Thiamin (Vitamin Bl)iv) Riboflavin (Vitamin B2)v) Biotin (Vitamin B7)o Thus, options a, b & d all are correct here. But best answer among these is niacin as it is the only vitamin which is synthesized by proper anabolic metabolism. ### End" @@ -9211,6 +16493,13 @@ Ans. is 'a' i.e., Niacin o This question is confusing one (Read text below)o Nia Answer the following medical question: Most common malignancy in AIDS is: March 2011, with the following options: A: Kaposi sarcoma, B: Hodgkins lymphoma, C: Leukemia, D: Multiple myeloma +### Response: +",Ans. A: Kaposi sarcoma The neoplastic diseases clearly seen with an increased frequency in patients with HIV infection are Kaposi sarcoma and non-Hodgkin's lymphoma,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common malignancy in AIDS is: March 2011, with the following options: A: Kaposi sarcoma, B: Hodgkins lymphoma, C: Leukemia, D: Multiple myeloma + ### Response: Ans. A: Kaposi sarcoma The neoplastic diseases clearly seen with an increased frequency in patients with HIV infection are Kaposi sarcoma and non-Hodgkin's lymphoma ### End" @@ -9220,6 +16509,13 @@ Ans. A: Kaposi sarcoma The neoplastic diseases clearly seen with an increased fr Answer the following medical question: Brown atrophy occurs due to:, with the following options: A: Melanin, B: Hemosiderin, C: Bilirubin, D: Lipofuscin +### Response: +","Lipofuscin is an insoluble pigment,also known as Lipochrome or wear and tear pigment. -Its a sign of free radical injury and lipid peroxidation. -In sectioned tissue it appears as yellow-brown,finley granular cytoplasmic,often perinuclear pigment. -It is seen in the aging cells and is paicularly prominent in the liver and hea of aging patients. -Also seen in patients with severe malnutrition and cancer cachexia. Brown atrophy of the hea","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Brown atrophy occurs due to:, with the following options: A: Melanin, B: Hemosiderin, C: Bilirubin, D: Lipofuscin + ### Response: Lipofuscin is an insoluble pigment,also known as Lipochrome or wear and tear pigment. -Its a sign of free radical injury and lipid peroxidation. -In sectioned tissue it appears as yellow-brown,finley granular cytoplasmic,often perinuclear pigment. -It is seen in the aging cells and is paicularly prominent in the liver and hea of aging patients. -Also seen in patients with severe malnutrition and cancer cachexia. Brown atrophy of the hea ### End" @@ -9229,6 +16525,13 @@ Lipofuscin is an insoluble pigment,also known as Lipochrome or wear and tear pig Answer the following medical question: Anaphylaxis refers to, with the following options: A: The severe reaction following primary injection of protein solutions, B: The state of immunity developed by repeated injections of any foreign substance, C: The severe reaction resulting from sensitive to common allergens, D: The severe reaction following re-injection of protein solution in a sensitized animal +### Response: +","The general mechanism of immediate hypersensitivity involves a series of steps. An antigen induces the formation of IgE antibody, which binds firmly by its Fc poion to high-affinity IgE receptors on mast cells, basophils, and possibly eosinophils.Sometime later, an individual experiences a second exposure to the same antigen. This second exposure results in the cross-linking of the cell-bound IgE molecules and the release of pharmacologically active mediators.Jawetz 27e pg: 145","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Anaphylaxis refers to, with the following options: A: The severe reaction following primary injection of protein solutions, B: The state of immunity developed by repeated injections of any foreign substance, C: The severe reaction resulting from sensitive to common allergens, D: The severe reaction following re-injection of protein solution in a sensitized animal + ### Response: The general mechanism of immediate hypersensitivity involves a series of steps. An antigen induces the formation of IgE antibody, which binds firmly by its Fc poion to high-affinity IgE receptors on mast cells, basophils, and possibly eosinophils.Sometime later, an individual experiences a second exposure to the same antigen. This second exposure results in the cross-linking of the cell-bound IgE molecules and the release of pharmacologically active mediators.Jawetz 27e pg: 145 ### End" @@ -9238,6 +16541,13 @@ The general mechanism of immediate hypersensitivity involves a series of steps. Answer the following medical question: Normal vision with absence of direct & consensual light reflex, which nerve is involved -, with the following options: A: Optic, B: Oculomotor, C: Trigeminal, D: Abducens +### Response: +","Ans. is 'b' i.e., Oculomotor o This question can be solved by simple basic knowledge :-Among the given options only optic nerve and occulomotor nerves are related to light reflex.In optic nerve injury, vision is also impaired (vision is normal in the question).Thus answer is oculomotor nerve.o When light is shone to one (e.g. left) eye, left optic nerve carries afferent impulse to brain and from brain efferent impulse to ipsiplateral (left) eye comes through ipsilateral (left) occulomotor nerve (for direct light reflex) and efferent for contralateral (right) eye comes through contralateral (right) occulmotor nerve for consensual light reflex. When light is shone to other (right) eye, right optic nerve carries afferent impulse to brain and from brain, efferent impulse to right eye (for direct light reflex) comes through right occulmotor nerve and efferent for left eye (for consensual light reflex) comes through left occulomotor nerve. So :-Optic nerve is responsible for direct light reflex in ipsilateral eye and consensual light reflex for contralateral eye. (In above example, afferent for right sided direct and left sided consensual light reflex is through right optic nerve; and afferent for left sided direct and right sided consensual light reflex is through left optic nerve).Occulomotor nerve is responsible for direct and consensual light reflex in the same eye. (In above example, efferent for right sided direct as well as consensual light reflex is through right occulmotor nerve and efferent for left sided direct as well as consensual light reflex is through left occulomotor nerve).In complete optic nerve lesion of one side (Amaurosis light reflex or total afferent pupillary defect)o The ipsilateral direct reflex is losto The ipsilateral consensual reflex is intacto The contralateral direct reflex is intacto The contralateral consensual reflex is lostIn occulomotor nerve lesion of one side (efferent pupillary defect)o The ipsilateral direct reflex is losto The ipsilateral consensual reflex is losto The contralateral direct reflex is intacto The contralateral consensual reflex is intact","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Normal vision with absence of direct & consensual light reflex, which nerve is involved -, with the following options: A: Optic, B: Oculomotor, C: Trigeminal, D: Abducens + ### Response: Ans. is 'b' i.e., Oculomotor o This question can be solved by simple basic knowledge :-Among the given options only optic nerve and occulomotor nerves are related to light reflex.In optic nerve injury, vision is also impaired (vision is normal in the question).Thus answer is oculomotor nerve.o When light is shone to one (e.g. left) eye, left optic nerve carries afferent impulse to brain and from brain efferent impulse to ipsiplateral (left) eye comes through ipsilateral (left) occulomotor nerve (for direct light reflex) and efferent for contralateral (right) eye comes through contralateral (right) occulmotor nerve for consensual light reflex. When light is shone to other (right) eye, right optic nerve carries afferent impulse to brain and from brain, efferent impulse to right eye (for direct light reflex) comes through right occulmotor nerve and efferent for left eye (for consensual light reflex) comes through left occulomotor nerve. So :-Optic nerve is responsible for direct light reflex in ipsilateral eye and consensual light reflex for contralateral eye. (In above example, afferent for right sided direct and left sided consensual light reflex is through right optic nerve; and afferent for left sided direct and right sided consensual light reflex is through left optic nerve).Occulomotor nerve is responsible for direct and consensual light reflex in the same eye. (In above example, efferent for right sided direct as well as consensual light reflex is through right occulmotor nerve and efferent for left sided direct as well as consensual light reflex is through left occulomotor nerve).In complete optic nerve lesion of one side (Amaurosis light reflex or total afferent pupillary defect)o The ipsilateral direct reflex is losto The ipsilateral consensual reflex is intacto The contralateral direct reflex is intacto The contralateral consensual reflex is lostIn occulomotor nerve lesion of one side (efferent pupillary defect)o The ipsilateral direct reflex is losto The ipsilateral consensual reflex is losto The contralateral direct reflex is intacto The contralateral consensual reflex is intact ### End" @@ -9247,6 +16557,13 @@ Ans. is 'b' i.e., Oculomotor o This question can be solved by simple basic knowl Answer the following medical question: A 68-year-old man complains of pain upon urination. A CT scan and a biopsy provide evidence of an enlarged, cancerous prostate gland. Subsequently, he undergoes a radical prostatectomy. Postoperatively, he suffers from urinary incontinence because of paralysis of the external urethral sphincter. Which of the following nerves was injured during the operation?, with the following options: A: Pelvic splanchnic, B: Sacral splanchnic, C: Pudendal, D: Superior gluteal +### Response: +","The perineal branch of the pudendal nerve is responsible for the innervation of the external urethral sphincter, and injury to this nerve can result in paralysis of the sphincter and urinary incontinence. Pelvic splanchnic and sacral splanchnic nerves are autonomic nerves that do not supply skeletal muscles in the urogenital region. The gluteal nerves innervate gluteal muscles.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 68-year-old man complains of pain upon urination. A CT scan and a biopsy provide evidence of an enlarged, cancerous prostate gland. Subsequently, he undergoes a radical prostatectomy. Postoperatively, he suffers from urinary incontinence because of paralysis of the external urethral sphincter. Which of the following nerves was injured during the operation?, with the following options: A: Pelvic splanchnic, B: Sacral splanchnic, C: Pudendal, D: Superior gluteal + ### Response: The perineal branch of the pudendal nerve is responsible for the innervation of the external urethral sphincter, and injury to this nerve can result in paralysis of the sphincter and urinary incontinence. Pelvic splanchnic and sacral splanchnic nerves are autonomic nerves that do not supply skeletal muscles in the urogenital region. The gluteal nerves innervate gluteal muscles. ### End" @@ -9256,6 +16573,13 @@ The perineal branch of the pudendal nerve is responsible for the innervation of Answer the following medical question: The gold standard for diagnosis of gastroesophageal reflux disease (GERD) is not related-surgery, with the following options: A: Endoscopy, B: Barium swallow, C: Esophageal manometry, D: 24-hours pH monitoring +### Response: +",.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The gold standard for diagnosis of gastroesophageal reflux disease (GERD) is not related-surgery, with the following options: A: Endoscopy, B: Barium swallow, C: Esophageal manometry, D: 24-hours pH monitoring + ### Response: . ### End" @@ -9265,6 +16589,13 @@ Answer the following medical question: The gold standard for diagnosis of gastro Answer the following medical question: The X-linked dominant one is, with the following options: A: Fragile X syndrome, B: Vitamin D resistant rickets, C: Duchenne muscular dystrophy, D: Myotonic dystrophy +### Response: +",(B) Vitamin D resistant rickets # X-linked Dominant:; Amelogenesis imperfects; Bipolar depressive psychosis; Goltz's syndrome; hypophosphatemia; Oral-facial- digital syndrome; Vitamin D resistant rickets.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The X-linked dominant one is, with the following options: A: Fragile X syndrome, B: Vitamin D resistant rickets, C: Duchenne muscular dystrophy, D: Myotonic dystrophy + ### Response: (B) Vitamin D resistant rickets # X-linked Dominant:; Amelogenesis imperfects; Bipolar depressive psychosis; Goltz's syndrome; hypophosphatemia; Oral-facial- digital syndrome; Vitamin D resistant rickets. ### End" @@ -9274,6 +16605,13 @@ Answer the following medical question: The X-linked dominant one is, with the fo Answer the following medical question: End-tidal CO2 is increased to maximum level in :, with the following options: A: Pul. embolism, B: Malignant hypehermia, C: Extubation, D: Blockage of secretion +### Response: +","B i.e. Malignant hypehermia Unilateral absence (or decrease) of breath sounds over one lung (especially left) after a speedy intubation suggests a diagnosis of inadveent endobronchial intubation. End tidal CO2 may be low, normal or raised after an endotracheal intubation. Tlie presence of high end tidal CO2 however excludes a diagnosis of esophageal intubation which is associated with reduced or absent end tidal CO2. Malignant hypehermia show marked rise in ETCO2.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: End-tidal CO2 is increased to maximum level in :, with the following options: A: Pul. embolism, B: Malignant hypehermia, C: Extubation, D: Blockage of secretion + ### Response: B i.e. Malignant hypehermia Unilateral absence (or decrease) of breath sounds over one lung (especially left) after a speedy intubation suggests a diagnosis of inadveent endobronchial intubation. End tidal CO2 may be low, normal or raised after an endotracheal intubation. Tlie presence of high end tidal CO2 however excludes a diagnosis of esophageal intubation which is associated with reduced or absent end tidal CO2. Malignant hypehermia show marked rise in ETCO2. ### End" @@ -9283,6 +16621,13 @@ B i.e. Malignant hypehermia Unilateral absence (or decrease) of breath sounds ov Answer the following medical question: The gene that regulates normal morphogenesis during development is -, with the following options: A: FMR-1 gene, B: Homeobox gene., C: P-16, D: PTEN. +### Response: +","Ans. is 'b' i.e., Homeobox geneHomeobox geneo is associated with normal morphogenesis.o Their expression results in the production of localized cellular condensation of primitive mesenchyme in the sites of future bones.o They play an impoant role in patterning of limbs, veebrae and craniofacial structures.o Mutations in Homeobox gene produces an extra digit between 3rd and fouh fingers as well as some degree of syndactyly.About other options :?o FMR gene : It is familial mental retardation gene mutation in this gene causes Fragile-X- syndromeo PTEN : It is phosphatase and tensin homologue. It is frequently deleted in many human cancers such as Glioblastomas, Prostate cancers, Endometrial cancers and Breast cancer.o P-16 : It is a tumour suppressor gene.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The gene that regulates normal morphogenesis during development is -, with the following options: A: FMR-1 gene, B: Homeobox gene., C: P-16, D: PTEN. + ### Response: Ans. is 'b' i.e., Homeobox geneHomeobox geneo is associated with normal morphogenesis.o Their expression results in the production of localized cellular condensation of primitive mesenchyme in the sites of future bones.o They play an impoant role in patterning of limbs, veebrae and craniofacial structures.o Mutations in Homeobox gene produces an extra digit between 3rd and fouh fingers as well as some degree of syndactyly.About other options :?o FMR gene : It is familial mental retardation gene mutation in this gene causes Fragile-X- syndromeo PTEN : It is phosphatase and tensin homologue. It is frequently deleted in many human cancers such as Glioblastomas, Prostate cancers, Endometrial cancers and Breast cancer.o P-16 : It is a tumour suppressor gene. ### End" @@ -9292,6 +16637,13 @@ Ans. is 'b' i.e., Homeobox geneHomeobox geneo is associated with normal morphoge Answer the following medical question: The drug imatinib acts by inhibiting which of the following enzyme?, with the following options: A: Tyrosine kinase, B: Glutathione reductase, C: Thymidine synthase, D: Protein kinase +### Response: +","Imatinib is a tyrosine kinase inhibitor domain of BCR-ABL oncoprotein and prevents phosphorylation of the kinase substrate by ATP. It is indicated for the treatment of chronic myelogenous leukemia and gastrointestinal stromal tumors. 5 Fluorouracil inhibits thymidylate synthase thereby interfering with synthesis of DNA to lesser extent RNA. Its effect is more marked on atypical, rapidly proliferating cells. It is used topically for the treatment of multiple actinic keratoses. Ref: Chu E., Saorelli A.C. (2012). Chapter 54. Cancer Chemotherapy. In B.G. Katzung, S.B. Masters, A.J. Trevor (Eds), Basic & Clinical Pharmacology, 12e.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The drug imatinib acts by inhibiting which of the following enzyme?, with the following options: A: Tyrosine kinase, B: Glutathione reductase, C: Thymidine synthase, D: Protein kinase + ### Response: Imatinib is a tyrosine kinase inhibitor domain of BCR-ABL oncoprotein and prevents phosphorylation of the kinase substrate by ATP. It is indicated for the treatment of chronic myelogenous leukemia and gastrointestinal stromal tumors. 5 Fluorouracil inhibits thymidylate synthase thereby interfering with synthesis of DNA to lesser extent RNA. Its effect is more marked on atypical, rapidly proliferating cells. It is used topically for the treatment of multiple actinic keratoses. Ref: Chu E., Saorelli A.C. (2012). Chapter 54. Cancer Chemotherapy. In B.G. Katzung, S.B. Masters, A.J. Trevor (Eds), Basic & Clinical Pharmacology, 12e. ### End" @@ -9301,6 +16653,13 @@ Imatinib is a tyrosine kinase inhibitor domain of BCR-ABL oncoprotein and preven Answer the following medical question: 45 X, chromosomal compliment associated with:, with the following options: A: Turner 's syndrome, B: Edward syndrome, C: Patau syndrome, D: Klinefelter syndrome +### Response: +","(Turner syndrome): Ref: 2216 - H (2341-H17th) Disorder Common chromosomal compliment Gonad External Genitalia Internal Genitalia Breast development * Klinefelter syndrome 47, XXY or 46 XY, 47 XXY Hyalinized testes Male Male Gynecomastia * Turner syndrome 45, X or 46 XX/ 45, X Streak gonad or immature ovary Female Hypoplastic female Immature female * Mixed gonadal dysgenesis 46 XY/45X Testis or streak gonad Variable usually ambiguous Variable Usually male * True hermaphroditism 46XY/46XX Testis & ovary or ovotestis Variable usually ambiguous Variable Gynecomastia","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: 45 X, chromosomal compliment associated with:, with the following options: A: Turner 's syndrome, B: Edward syndrome, C: Patau syndrome, D: Klinefelter syndrome + ### Response: (Turner syndrome): Ref: 2216 - H (2341-H17th) Disorder Common chromosomal compliment Gonad External Genitalia Internal Genitalia Breast development * Klinefelter syndrome 47, XXY or 46 XY, 47 XXY Hyalinized testes Male Male Gynecomastia * Turner syndrome 45, X or 46 XX/ 45, X Streak gonad or immature ovary Female Hypoplastic female Immature female * Mixed gonadal dysgenesis 46 XY/45X Testis or streak gonad Variable usually ambiguous Variable Usually male * True hermaphroditism 46XY/46XX Testis & ovary or ovotestis Variable usually ambiguous Variable Gynecomastia ### End" @@ -9310,6 +16669,13 @@ Answer the following medical question: 45 X, chromosomal compliment associated w Answer the following medical question: A person hears voices before Jailing asleep, history of falls in day time sleep attacks. The probable diagnosis is (* NIMHANS Post MBBS 2017; NIMHANS 2014; NIMHANS 2007), with the following options: A: Narcolepsy, B: Schizophrenia, C: Delusion, D: Insomnia +### Response: +","(A) Narcolepsy# NARCOLEPSY:> It is a long-term neurological disorder that involves a decreased ability to regulate sleep-wake cycles.> Symptoms are periods of excessive daytime sleepiness that usually last from seconds to minutes and may occur at any time.> 70% of Narcolepsy people experience episodes of sudden loss of muscle strength (cataplexy).> Spells can be brought on by strong emotions.> Less commonly there may be inability to move or vivid hallucinations while falling asleep or waking up.> Narcolepsy people tend to sleep about the same number of hours per day as people without, but the quality of sleep tends to be worse.# ""Tetrad of Narcolepsy: 1. 1. Cataplexy, 2. Sleep paralysis, 3. Hypnagogic hallucinations, and 4. Excessive daytime sleepiness.> Other symptoms: automatic behaviors and night-time wakefulness.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A person hears voices before Jailing asleep, history of falls in day time sleep attacks. The probable diagnosis is (* NIMHANS Post MBBS 2017; NIMHANS 2014; NIMHANS 2007), with the following options: A: Narcolepsy, B: Schizophrenia, C: Delusion, D: Insomnia + ### Response: (A) Narcolepsy# NARCOLEPSY:> It is a long-term neurological disorder that involves a decreased ability to regulate sleep-wake cycles.> Symptoms are periods of excessive daytime sleepiness that usually last from seconds to minutes and may occur at any time.> 70% of Narcolepsy people experience episodes of sudden loss of muscle strength (cataplexy).> Spells can be brought on by strong emotions.> Less commonly there may be inability to move or vivid hallucinations while falling asleep or waking up.> Narcolepsy people tend to sleep about the same number of hours per day as people without, but the quality of sleep tends to be worse.# ""Tetrad of Narcolepsy: 1. 1. Cataplexy, 2. Sleep paralysis, 3. Hypnagogic hallucinations, and 4. Excessive daytime sleepiness.> Other symptoms: automatic behaviors and night-time wakefulness. ### End" @@ -9319,6 +16685,13 @@ Answer the following medical question: A person hears voices before Jailing asle Answer the following medical question: Hand foot mouth syndrome is caused by -, with the following options: A: Parvovirus 6, B: Parvovirus 19, C: Coxsackie virus A 16, D: Coxsackie virus A 19 +### Response: +","HFMD id caused by coxsackie virus A16,A9,B1-3 REF:ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.491","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hand foot mouth syndrome is caused by -, with the following options: A: Parvovirus 6, B: Parvovirus 19, C: Coxsackie virus A 16, D: Coxsackie virus A 19 + ### Response: HFMD id caused by coxsackie virus A16,A9,B1-3 REF:ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.491 ### End" @@ -9328,6 +16701,13 @@ HFMD id caused by coxsackie virus A16,A9,B1-3 REF:ANATHANARAYANAN MICROBIOLOGY N Answer the following medical question: An elderly multiparous woman with intrauterine foetal death was admitted with strong labour pains The patient suddenly goes in shock with cyanosis respiratory disturbances and pulmonary oedema The most likely clinical diagnosis is;, with the following options: A: Rupture of uterus, B: Congestive hea failure, C: Amniotic fluid embolism, D: Concealed accidental hemorrhage +### Response: +","

Amniotic fluid enter the maternal circulation and sets up a DIC,leading to consumptive coagulopathy. Classically a woman in late labour gasps for air,has bronchospasm,become cyanotic and undergoes immediate collapse and cardiorespiratory arrest,usually accompanied by hemorrhage. Reference: Textbook of obstetrics,Sheila Balakrishnan,2nd edition,page no;408 <\p>","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: An elderly multiparous woman with intrauterine foetal death was admitted with strong labour pains The patient suddenly goes in shock with cyanosis respiratory disturbances and pulmonary oedema The most likely clinical diagnosis is;, with the following options: A: Rupture of uterus, B: Congestive hea failure, C: Amniotic fluid embolism, D: Concealed accidental hemorrhage + ### Response:

Amniotic fluid enter the maternal circulation and sets up a DIC,leading to consumptive coagulopathy. Classically a woman in late labour gasps for air,has bronchospasm,become cyanotic and undergoes immediate collapse and cardiorespiratory arrest,usually accompanied by hemorrhage. Reference: Textbook of obstetrics,Sheila Balakrishnan,2nd edition,page no;408 <\p> ### End" @@ -9337,6 +16717,13 @@ Answer the following medical question: An elderly multiparous woman with intraut Answer the following medical question: Most common type of gastric polyp is ?, with the following options: A: Hyperplastic polyp, B: Hamaomatous polyp, C: Malignant polyp, D: Malignant polyp +### Response: +","Ans. is 'a' i.e., Hyperplastic polypo Polyps are nodule or mass that project above the level of the surrounding mucosa.o Gastric polyps are of following types ?Hyperplastic polypo It is the most common gastric polyp o It is non neoplastico It has no malignant potential o Most common site is antrum2. Adenomatous polyp (Adenoma) o Adenoma contains proliferative dysplastic epithelium and thereby has malignant potential.o Most common site is the antrum.3. Other rare type of polyps are --> Fundic gland polyps, Peutz - Jegher polyps, Juvenile polyp, and Inflammatory fibroid polyp (eosinophlic granuloma).Following information have been added in Pie of Robbins o Hyperplastic polyps are also referred to as inflammatory polyps as they develop in association with chronic gastritis, which initiates the injury and reactive hyperplasia that leads to polyp growth.o Hypeplastic polyp occurs between 50-60 years of age.o Among individuals with H.Pylori gastrititis, polyp may regress after bacterial eradication.o Because the risk of dysplasia correlates with size, polyps larger than 1.5 cm should be resected and examined histologically.o The prevelance offundic gland polyps has increased markedly in recent years as a result of proton pump inhibitor therapy. This likely reflects increased gastrin secretion in response to reduced gastric acidity and the resulting glandular hyperplasia.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common type of gastric polyp is ?, with the following options: A: Hyperplastic polyp, B: Hamaomatous polyp, C: Malignant polyp, D: Malignant polyp + ### Response: Ans. is 'a' i.e., Hyperplastic polypo Polyps are nodule or mass that project above the level of the surrounding mucosa.o Gastric polyps are of following types ?Hyperplastic polypo It is the most common gastric polyp o It is non neoplastico It has no malignant potential o Most common site is antrum2. Adenomatous polyp (Adenoma) o Adenoma contains proliferative dysplastic epithelium and thereby has malignant potential.o Most common site is the antrum.3. Other rare type of polyps are --> Fundic gland polyps, Peutz - Jegher polyps, Juvenile polyp, and Inflammatory fibroid polyp (eosinophlic granuloma).Following information have been added in Pie of Robbins o Hyperplastic polyps are also referred to as inflammatory polyps as they develop in association with chronic gastritis, which initiates the injury and reactive hyperplasia that leads to polyp growth.o Hypeplastic polyp occurs between 50-60 years of age.o Among individuals with H.Pylori gastrititis, polyp may regress after bacterial eradication.o Because the risk of dysplasia correlates with size, polyps larger than 1.5 cm should be resected and examined histologically.o The prevelance offundic gland polyps has increased markedly in recent years as a result of proton pump inhibitor therapy. This likely reflects increased gastrin secretion in response to reduced gastric acidity and the resulting glandular hyperplasia. ### End" @@ -9346,6 +16733,13 @@ Ans. is 'a' i.e., Hyperplastic polypo Polyps are nodule or mass that project abo Answer the following medical question: A 25 year old infeile male underwent semen analysis. Results show : sperm count - 15 million/ml ; pH - 7.5 ; volume - 2 ml ; no agglutination is seen. Morphology shows 60% normal and 60% motile sperms. Most likely diagnosis is :, with the following options: A: Normospermia, B: Oligospermia, C: Azoospermia, D: Aspermia +### Response: +","Oligospermia The Semen Analysis of the patient shows : Sperm count is 15 million/ml. PH = 7.5 Volume = 2 ml Morphology = 60% normal Normal should be at least 20 million/ml i.e. this patient is oligospermic (N = > 7.2) N = at least 2 ml N = 50% Normal Morphology So, all criteria are normal except sperm count (to be specific sperm concentration) which is less than normal and therefore most likely diagnosis is oligospermia.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 25 year old infeile male underwent semen analysis. Results show : sperm count - 15 million/ml ; pH - 7.5 ; volume - 2 ml ; no agglutination is seen. Morphology shows 60% normal and 60% motile sperms. Most likely diagnosis is :, with the following options: A: Normospermia, B: Oligospermia, C: Azoospermia, D: Aspermia + ### Response: Oligospermia The Semen Analysis of the patient shows : Sperm count is 15 million/ml. PH = 7.5 Volume = 2 ml Morphology = 60% normal Normal should be at least 20 million/ml i.e. this patient is oligospermic (N = > 7.2) N = at least 2 ml N = 50% Normal Morphology So, all criteria are normal except sperm count (to be specific sperm concentration) which is less than normal and therefore most likely diagnosis is oligospermia. ### End" @@ -9355,6 +16749,13 @@ Oligospermia The Semen Analysis of the patient shows : Sperm count is 15 million Answer the following medical question: The selective MAO-B inhibitor out of the following is:, with the following options: A: Selegiline, B: Clorgyline, C: Moclebemide, D: Tranylcypromine +### Response: +",-Selegiline and rasagiline Also called as Deprenyl Irreversible and selective MAO-B inhibitors Inhibits MAO-A at higher doses only It has neuroprotective and antiapoptotic effects Use: Oral dose is used in on- off phenomenon in Parkinsonism Transdermal patch is used for depression Incidence of cheese reaction is minimal Causes insomnia so used in morning and afternoon -Moclebemide is selective reversible MAO-A inhibitor for depression. Whereas clorgyline is irreversible MAO-A inhibitor -Tranylcypromine is a non-selective MAO inhibitor.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The selective MAO-B inhibitor out of the following is:, with the following options: A: Selegiline, B: Clorgyline, C: Moclebemide, D: Tranylcypromine + ### Response: -Selegiline and rasagiline Also called as Deprenyl Irreversible and selective MAO-B inhibitors Inhibits MAO-A at higher doses only It has neuroprotective and antiapoptotic effects Use: Oral dose is used in on- off phenomenon in Parkinsonism Transdermal patch is used for depression Incidence of cheese reaction is minimal Causes insomnia so used in morning and afternoon -Moclebemide is selective reversible MAO-A inhibitor for depression. Whereas clorgyline is irreversible MAO-A inhibitor -Tranylcypromine is a non-selective MAO inhibitor. ### End" @@ -9364,6 +16765,13 @@ Answer the following medical question: The selective MAO-B inhibitor out of the Answer the following medical question: At what time is the crown completed for the tooth indicated?, with the following options: A: Primary maxillary central incisor, 3 weeks., B: Permanent maxillary central incisor, 2 to 3 years., C: Primary maxillary lateral incisor, 2 to 3 months., D: Permanent maxillary lateral incisor, 2 to 3 years. +### Response: +","The correct answer for A would be about 1.5 months or 6 weeks; B, About 4 to 5 years; C, About 2.5 months or 10 weeks; D, About 4 to 5 years.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: At what time is the crown completed for the tooth indicated?, with the following options: A: Primary maxillary central incisor, 3 weeks., B: Permanent maxillary central incisor, 2 to 3 years., C: Primary maxillary lateral incisor, 2 to 3 months., D: Permanent maxillary lateral incisor, 2 to 3 years. + ### Response: The correct answer for A would be about 1.5 months or 6 weeks; B, About 4 to 5 years; C, About 2.5 months or 10 weeks; D, About 4 to 5 years. ### End" @@ -9373,6 +16781,13 @@ The correct answer for A would be about 1.5 months or 6 weeks; B, About 4 to 5 y Answer the following medical question: Embryonic hemoglobin is:, with the following options: A: Alpha 2 Beta 2, B: Alpha 2,Gamma 2, C: Alpha 2 Delta 2, D: Alpha 2 +### Response: +","Normal mammalian hemoglobins contain two pairs of unlike polypeptide chains: one chain of each pair is or -like and the other is non- (, , or ). The -chains of all human hemoglobins encountered after early embryogenesis are the same. The non- chains include the -chain of normal adult hemoglobin (Hb A ), the -chain of fetal hemoglobin (Hb F ), and the -chain of Hb A2 (Hb A2 ), the minor component, which accounts for 2.5 percent of the hemoglobin of normal adults.The -chain of fetal hemoglobin (Hb F) differs from the -chain by 39 residues. Ref: Natarajan K., Townes T.M., Kutlar A. (2010). Chapter 48. Disorders of Hemoglobin Structure: Sickle Cell Anemia and Related Abnormalities. In J.T. Prchal, K. Kaushansky, M.A. Lichtman, T.J. Kipps, U. Seligsohn (Eds), Williams Hematology, 8e.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Embryonic hemoglobin is:, with the following options: A: Alpha 2 Beta 2, B: Alpha 2,Gamma 2, C: Alpha 2 Delta 2, D: Alpha 2 + ### Response: Normal mammalian hemoglobins contain two pairs of unlike polypeptide chains: one chain of each pair is or -like and the other is non- (, , or ). The -chains of all human hemoglobins encountered after early embryogenesis are the same. The non- chains include the -chain of normal adult hemoglobin (Hb A ), the -chain of fetal hemoglobin (Hb F ), and the -chain of Hb A2 (Hb A2 ), the minor component, which accounts for 2.5 percent of the hemoglobin of normal adults.The -chain of fetal hemoglobin (Hb F) differs from the -chain by 39 residues. Ref: Natarajan K., Townes T.M., Kutlar A. (2010). Chapter 48. Disorders of Hemoglobin Structure: Sickle Cell Anemia and Related Abnormalities. In J.T. Prchal, K. Kaushansky, M.A. Lichtman, T.J. Kipps, U. Seligsohn (Eds), Williams Hematology, 8e. ### End" @@ -9382,6 +16797,13 @@ Normal mammalian hemoglobins contain two pairs of unlike polypeptide chains: one Answer the following medical question: Size of diameter of mosquito net holes -, with the following options: A: 0[?]02 inch, B: 0[?]0475 inch, C: 0[?]5 inch, D: 0[?]1 inch +### Response: +","Ans. is 'b' i.e., 0.0475 inch o The best pattern of mosquito net is the rectangular net.o There should not be a single rent in the net.o The Size of openings in the net is of utmost importance, the size should not exceed 0.0475 inch in any diameter.o The number of holes in one square inch in usually 150.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Size of diameter of mosquito net holes -, with the following options: A: 0[?]02 inch, B: 0[?]0475 inch, C: 0[?]5 inch, D: 0[?]1 inch + ### Response: Ans. is 'b' i.e., 0.0475 inch o The best pattern of mosquito net is the rectangular net.o There should not be a single rent in the net.o The Size of openings in the net is of utmost importance, the size should not exceed 0.0475 inch in any diameter.o The number of holes in one square inch in usually 150. ### End" @@ -9391,6 +16813,13 @@ Ans. is 'b' i.e., 0.0475 inch o The best pattern of mosquito net is the rectangu Answer the following medical question: A patient comes to you after visiting the hair dresser. What will you do to confirm the diagnosis:, with the following options: A: VDRL, B: Allergy Test, C: S IgE, D: Patch Test +### Response: +",Ans. D. Patch TestPatient is having swelling of face most probably due to allergy to some cosmetic product. Patch test will identify the cause of allergic reaction.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A patient comes to you after visiting the hair dresser. What will you do to confirm the diagnosis:, with the following options: A: VDRL, B: Allergy Test, C: S IgE, D: Patch Test + ### Response: Ans. D. Patch TestPatient is having swelling of face most probably due to allergy to some cosmetic product. Patch test will identify the cause of allergic reaction. ### End" @@ -9400,6 +16829,13 @@ Ans. D. Patch TestPatient is having swelling of face most probably due to allerg Answer the following medical question: Sympathetic stimulation causes, with the following options: A: Pupillary constriction, B: Contraction of bladder detrusor, C: Bronchial smooth muscle contraction, D: Vasoconstriction of skin and mucus membranes +### Response: +","Sympathetic stimulation causes vasoconstriction in all blood vessels except those in skeletal muscles. And causes pupillary dilatation, bronchial smooth muscle dilation, relaxation of detrussor muscle of bladder Ref: Ganong&;s review of medical physiology; 23rd edition; pg:556","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Sympathetic stimulation causes, with the following options: A: Pupillary constriction, B: Contraction of bladder detrusor, C: Bronchial smooth muscle contraction, D: Vasoconstriction of skin and mucus membranes + ### Response: Sympathetic stimulation causes vasoconstriction in all blood vessels except those in skeletal muscles. And causes pupillary dilatation, bronchial smooth muscle dilation, relaxation of detrussor muscle of bladder Ref: Ganong&;s review of medical physiology; 23rd edition; pg:556 ### End" @@ -9409,6 +16845,13 @@ Sympathetic stimulation causes vasoconstriction in all blood vessels except thos Answer the following medical question: Dose of anti D immunoglobin is -, with the following options: A: 300 mgm, B: 200mgm, C: 30mgm, D: 3mgm +### Response: +","Ans. is 'a' i.e., 300 mgm o Has been explained in previous sessions","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Dose of anti D immunoglobin is -, with the following options: A: 300 mgm, B: 200mgm, C: 30mgm, D: 3mgm + ### Response: Ans. is 'a' i.e., 300 mgm o Has been explained in previous sessions ### End" @@ -9418,6 +16861,13 @@ Ans. is 'a' i.e., 300 mgm o Has been explained in previous sessions Answer the following medical question: In a patient, corneal scraping reveals narrow angled septate hyphae. Which of the following is the likely etiologic agent?, with the following options: A: Mucor, B: Candida, C: Aspergillus, D: Histoplasma +### Response: +","Aspergillus is a mould with narrow angled septate hyphae. Asexual conidia are arranged in chain, carried on elongated cells called sterigmata borne on expanded ends of conidiophores. Aspergillus fumigatus is the common cause of aspergillosis. Histoplasma is a dimorphic fungi. Mucor is a broad nonseptate hyphae present in tissues. Candida is characterized by the presence of pseudohyphae. Ref: Essentials of Clinical Mycology By Carol A. Kaufmann, 2nd Edition, Pages 248-53","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In a patient, corneal scraping reveals narrow angled septate hyphae. Which of the following is the likely etiologic agent?, with the following options: A: Mucor, B: Candida, C: Aspergillus, D: Histoplasma + ### Response: Aspergillus is a mould with narrow angled septate hyphae. Asexual conidia are arranged in chain, carried on elongated cells called sterigmata borne on expanded ends of conidiophores. Aspergillus fumigatus is the common cause of aspergillosis. Histoplasma is a dimorphic fungi. Mucor is a broad nonseptate hyphae present in tissues. Candida is characterized by the presence of pseudohyphae. Ref: Essentials of Clinical Mycology By Carol A. Kaufmann, 2nd Edition, Pages 248-53 ### End" @@ -9427,6 +16877,13 @@ Aspergillus is a mould with narrow angled septate hyphae. Asexual conidia are ar Answer the following medical question: Which of the following play most impoant role in memory:, with the following options: A: Synaptic network, B: Electric conduction network, C: Conductivity circuit, D: Conductivity network +### Response: +","Ans: a. Synaptic Net.Synaptic network s single best answer ""Long-term memory involves changes in the structure of neurons including growth of new processes and synapses.So, to the extent that you remember anything about this material on memory tomorrow, or next week, or next year, it will be because structural changes in synapses are beginning in your brains.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following play most impoant role in memory:, with the following options: A: Synaptic network, B: Electric conduction network, C: Conductivity circuit, D: Conductivity network + ### Response: Ans: a. Synaptic Net.Synaptic network s single best answer ""Long-term memory involves changes in the structure of neurons including growth of new processes and synapses.So, to the extent that you remember anything about this material on memory tomorrow, or next week, or next year, it will be because structural changes in synapses are beginning in your brains. ### End" @@ -9436,6 +16893,13 @@ Ans: a. Synaptic Net.Synaptic network s single best answer ""Long-term memory in Answer the following medical question: Chronic urethral obstruction due to benign prostatic hyperplasia can lead to the following change in kidney parenchyma:, with the following options: A: Hyperplasia, B: Hyperophy, C: Atrophy, D: Dysplasia +### Response: +","Chronic urethral obstruction because of urinary calculi, prostatic hyperophy, tumors, normal pregnancy, uterine prolapse or functional disorders cause hydronephrosis which by definition is used to describe dilatation of renal pelvis and calyces associated with progressive atrophy of the kidney due to obstruction to the outflow of urine.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Chronic urethral obstruction due to benign prostatic hyperplasia can lead to the following change in kidney parenchyma:, with the following options: A: Hyperplasia, B: Hyperophy, C: Atrophy, D: Dysplasia + ### Response: Chronic urethral obstruction because of urinary calculi, prostatic hyperophy, tumors, normal pregnancy, uterine prolapse or functional disorders cause hydronephrosis which by definition is used to describe dilatation of renal pelvis and calyces associated with progressive atrophy of the kidney due to obstruction to the outflow of urine. ### End" @@ -9445,6 +16909,15 @@ Chronic urethral obstruction because of urinary calculi, prostatic hyperophy, tu Answer the following medical question: The most important property in determining the induction of a general anaesthetic agent:, with the following options: A: Alveolar exchange, B: Pulmonary ventilation, C: Solubility of anaesthetic in blood, D: Solubility of anaesthetic in tissue +### Response: +","INTRAVENOUS ANAESTHETICS are generally used for induction because of rapidity of onset of action. Except in children, they have largely replaced inhalational anaesthetics for induction. Anaesthesia is then usually maintained by an inhalational agent. They also serve to reduce the amount of maintenance anaesthetic. Supplemented with analgesics and muscle relaxants, they can also be used as the sole anaesthetic. +The most important property in determining the induction of a general anaesthetic agent is solubility of anaesthetic in blood. +Reference: Essentials of Medical Pharmacology Eighth Edition KD TRIPATHI page no 408","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The most important property in determining the induction of a general anaesthetic agent:, with the following options: A: Alveolar exchange, B: Pulmonary ventilation, C: Solubility of anaesthetic in blood, D: Solubility of anaesthetic in tissue + ### Response: INTRAVENOUS ANAESTHETICS are generally used for induction because of rapidity of onset of action. Except in children, they have largely replaced inhalational anaesthetics for induction. Anaesthesia is then usually maintained by an inhalational agent. They also serve to reduce the amount of maintenance anaesthetic. Supplemented with analgesics and muscle relaxants, they can also be used as the sole anaesthetic. The most important property in determining the induction of a general anaesthetic agent is solubility of anaesthetic in blood. @@ -9456,6 +16929,13 @@ Reference: Essentials of Medical Pharmacology Eighth Edition KD TRIPATHI page Answer the following medical question: Which of the following is not true about bulimia nervosa, with the following options: A: Invariable weight loss with endocrine disorders, B: Occurrence of both binge eating and inappropriate compensatory behavior at least twice weekly, on an average, for 3 months, C: Recurrent episodes of eating binges, D: Recurrent self - induced vomiting +### Response: +","Bulimia Nervosa Bulimia nervosa is an eating disorder characterised by the following clinical features: 1. Bulimia nervosa usually has an onset in early teens or adolescence. 2. There is an intense fear of becoming obese. There may be an earlier history of anorexia nervosa. 3. There is usually body-image disturbance and the person is unable to perceive own body size accurately. 4. There is a persistent preoccupation with eating and an irresistible craving for food. There are episodes of overeating in which large amounts of food are consumed within sho periods of time (eating binges). 5. There are attempts to 'counteract' the effects of overeating by one or more of the following: self-induced vomiting, purgative abuse, periods of starvation, and/or use of drugs such as appetite suppressants. 6. No known medical illness is present which can account for the disorder. 7. An absence of any other primary psychiatric disorder. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no.144","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following is not true about bulimia nervosa, with the following options: A: Invariable weight loss with endocrine disorders, B: Occurrence of both binge eating and inappropriate compensatory behavior at least twice weekly, on an average, for 3 months, C: Recurrent episodes of eating binges, D: Recurrent self - induced vomiting + ### Response: Bulimia Nervosa Bulimia nervosa is an eating disorder characterised by the following clinical features: 1. Bulimia nervosa usually has an onset in early teens or adolescence. 2. There is an intense fear of becoming obese. There may be an earlier history of anorexia nervosa. 3. There is usually body-image disturbance and the person is unable to perceive own body size accurately. 4. There is a persistent preoccupation with eating and an irresistible craving for food. There are episodes of overeating in which large amounts of food are consumed within sho periods of time (eating binges). 5. There are attempts to 'counteract' the effects of overeating by one or more of the following: self-induced vomiting, purgative abuse, periods of starvation, and/or use of drugs such as appetite suppressants. 6. No known medical illness is present which can account for the disorder. 7. An absence of any other primary psychiatric disorder. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no.144 ### End" @@ -9465,6 +16945,13 @@ Bulimia Nervosa Bulimia nervosa is an eating disorder characterised by the follo Answer the following medical question: In the lungs bronchial aeries supply the bronchopulmonary tree, with the following options: A: Till teiary bronchi, B: Till segmental bronchi, C: Till respiratory bronchioles, D: Till alveolar sacs +### Response: +",Bronchial aery supplies the bronchial tree till respiratory bronchiole. BD CHAURASIA'S HUMAN ANATOMY VOLUME 1. 6TH EDITION.page no.242 fig 16.9,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In the lungs bronchial aeries supply the bronchopulmonary tree, with the following options: A: Till teiary bronchi, B: Till segmental bronchi, C: Till respiratory bronchioles, D: Till alveolar sacs + ### Response: Bronchial aery supplies the bronchial tree till respiratory bronchiole. BD CHAURASIA'S HUMAN ANATOMY VOLUME 1. 6TH EDITION.page no.242 fig 16.9 ### End" @@ -9474,6 +16961,13 @@ Bronchial aery supplies the bronchial tree till respiratory bronchiole. BD CHAUR Answer the following medical question: All the following are causes of hyperthermia except:, with the following options: A: Hypothyroidism, B: Cerebral hemorrhage, C: Succinyl Choline, D: Pheochromocytoma +### Response: +","Ans: A (Hypothyroidism) Ref: Harrison's principles of Internal Medicine. 18th edition. 2012. Chapter 16. Pg.143Causes of HyperthermiaHeat StrokeExertional: Exercise in higher than normal heat and humidityNonexertional: Anticholinergics, antiparkinsonian drugs: diuretics: ohenothiazinesDrug-Induced HyperthermiaAmphetamines, cocaine, phencyclidine (PCP), lysergic acid diethylamide (LSD), salicylates, lithium, anticholinergicsNeuroleptic Malignant SyndromePhenothiazines; butyrophenones, haloperidol and bromperidol: fluoxetine; loxapine; tncyclic dibenzodiazepines; metoclopramide; dom peri done; thiothixene; molindone.Serotonin SyndromeSelective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), tricyclic antidepressantsMalignant HyperthermiaInhalational anesthetics, succinyicholine EndocrinopathyThyrotoxicosis, pheochromocytoma Central Nervous System DamageCerebral hemorrhage, status epiiepticus, hypothalamic injury","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All the following are causes of hyperthermia except:, with the following options: A: Hypothyroidism, B: Cerebral hemorrhage, C: Succinyl Choline, D: Pheochromocytoma + ### Response: Ans: A (Hypothyroidism) Ref: Harrison's principles of Internal Medicine. 18th edition. 2012. Chapter 16. Pg.143Causes of HyperthermiaHeat StrokeExertional: Exercise in higher than normal heat and humidityNonexertional: Anticholinergics, antiparkinsonian drugs: diuretics: ohenothiazinesDrug-Induced HyperthermiaAmphetamines, cocaine, phencyclidine (PCP), lysergic acid diethylamide (LSD), salicylates, lithium, anticholinergicsNeuroleptic Malignant SyndromePhenothiazines; butyrophenones, haloperidol and bromperidol: fluoxetine; loxapine; tncyclic dibenzodiazepines; metoclopramide; dom peri done; thiothixene; molindone.Serotonin SyndromeSelective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), tricyclic antidepressantsMalignant HyperthermiaInhalational anesthetics, succinyicholine EndocrinopathyThyrotoxicosis, pheochromocytoma Central Nervous System DamageCerebral hemorrhage, status epiiepticus, hypothalamic injury ### End" @@ -9483,6 +16977,13 @@ Ans: A (Hypothyroidism) Ref: Harrison's principles of Internal Medicine. 18th ed Answer the following medical question: Following cells are responsible for acid secretion in kidney, with the following options: A: I cells, B: P cells, C: Mesangial cells, D: Pericytes +### Response: +",.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Following cells are responsible for acid secretion in kidney, with the following options: A: I cells, B: P cells, C: Mesangial cells, D: Pericytes + ### Response: . ### End" @@ -9492,6 +16993,13 @@ Answer the following medical question: Following cells are responsible for acid Answer the following medical question: Which of the following OPV vials are usable?, with the following options: A: Only 1, B: Only 1,2, C: Only 1,2, 3, D: Only 3, 4 +### Response: +","(b) Only 1, 2Rules for VVM use in India* Rule 1: If the inner square is lighter than the outer circle, the vaccine may be used (Vials 1, 2)* Rule 2: If the inner square is the same colour as, or darker than, the outer circle, the vaccine must not be used (Vials 3,4).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which of the following OPV vials are usable?, with the following options: A: Only 1, B: Only 1,2, C: Only 1,2, 3, D: Only 3, 4 + ### Response: (b) Only 1, 2Rules for VVM use in India* Rule 1: If the inner square is lighter than the outer circle, the vaccine may be used (Vials 1, 2)* Rule 2: If the inner square is the same colour as, or darker than, the outer circle, the vaccine must not be used (Vials 3,4). ### End" @@ -9501,6 +17009,13 @@ Answer the following medical question: Which of the following OPV vials are usab Answer the following medical question: Pea-soup stool is characteristically seen in ?, with the following options: A: Cholera, B: Typhoid, C: Botolism, D: Polio +### Response: +","Ans. is 'b' i.e., Typhoid Pea - soup stool It is khaki - green, slimy stools typically occurs in the 3' week of typhoid fever, at which point the patients are in toxic state and at greatest risk for the intestinal perforation and hemorrhage. Similar stools occur in enteropathogenic E. coli infection of infants.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pea-soup stool is characteristically seen in ?, with the following options: A: Cholera, B: Typhoid, C: Botolism, D: Polio + ### Response: Ans. is 'b' i.e., Typhoid Pea - soup stool It is khaki - green, slimy stools typically occurs in the 3' week of typhoid fever, at which point the patients are in toxic state and at greatest risk for the intestinal perforation and hemorrhage. Similar stools occur in enteropathogenic E. coli infection of infants. ### End" @@ -9510,6 +17025,13 @@ Ans. is 'b' i.e., Typhoid Pea - soup stool It is khaki - green, slimy stools typ Answer the following medical question: Phossy jaw is seen in which poisoning?, with the following options: A: Mercury, B: Yellow phosphorous, C: Red phosphorous, D: Tetanus +### Response: +","ANSWER: (B) Yellow phosphorousREF: Textbook of Forensic Medicine and Toxicology by Nagesh Kumar Rao - Page 371Phossy jaw is a type of osteomyelitis of jaws observed in chronic cases of phosphorus poisoning. Incidence is common among the workers of phosphorus industries linked to ""yellow phosphorous,"" the key ingredient in ""strike-anywhere"" matches, who are exposed to phosphorus fumes. The process starts in a carious tooth and then spreads, causing severe necrosis of the lower jawNote: Yellow phosphorous is also known as white phosphorous","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Phossy jaw is seen in which poisoning?, with the following options: A: Mercury, B: Yellow phosphorous, C: Red phosphorous, D: Tetanus + ### Response: ANSWER: (B) Yellow phosphorousREF: Textbook of Forensic Medicine and Toxicology by Nagesh Kumar Rao - Page 371Phossy jaw is a type of osteomyelitis of jaws observed in chronic cases of phosphorus poisoning. Incidence is common among the workers of phosphorus industries linked to ""yellow phosphorous,"" the key ingredient in ""strike-anywhere"" matches, who are exposed to phosphorus fumes. The process starts in a carious tooth and then spreads, causing severe necrosis of the lower jawNote: Yellow phosphorous is also known as white phosphorous ### End" @@ -9519,6 +17041,13 @@ ANSWER: (B) Yellow phosphorousREF: Textbook of Forensic Medicine and Toxicology Answer the following medical question: Components of Neonatal Resuscitation , except _____________, with the following options: A: Maintenance of temperature, B: Maintenance of respiration, C: Maintenance of circulation, D: Chest compression +### Response: +","Initial breaths and assisted ventilation: Inflation breaths are used in newborn resuscitation, to facilitate the aeration of the fluid-filled lungs, by applying a higher airway pressure for a prolonged period of time. The primary measure of adequate initial ventilation is the prompt improvement in hea rate. Reference: GHAI Essential pediatrics, 8th edition","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Components of Neonatal Resuscitation , except _____________, with the following options: A: Maintenance of temperature, B: Maintenance of respiration, C: Maintenance of circulation, D: Chest compression + ### Response: Initial breaths and assisted ventilation: Inflation breaths are used in newborn resuscitation, to facilitate the aeration of the fluid-filled lungs, by applying a higher airway pressure for a prolonged period of time. The primary measure of adequate initial ventilation is the prompt improvement in hea rate. Reference: GHAI Essential pediatrics, 8th edition ### End" @@ -9528,6 +17057,13 @@ Initial breaths and assisted ventilation: Inflation breaths are used in newborn Answer the following medical question: All are causes of chronic granulomatous uveitis EXCEPT:, with the following options: A: Sarcoidosis, B: Tuberculosis, C: Brucellosis, D: Fuchs heterochromic iridocyclitis +### Response: +","(Fuch's heterochromic iridocyclitis) (220-Parson 20th)* Causes of chronic granulomatous uveitis - Sarcoidosis, Herpes simplex, herpes zoster, varicella, syphilis,Tuberculosis, leprosy, brucellosis phacoanaphylactic* Causes chronic - non granulomatous uveitis - Juvenile, chronic arthritis, chronic iridocyclitis of children,Fuch's heterochromic iridocyclitis.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are causes of chronic granulomatous uveitis EXCEPT:, with the following options: A: Sarcoidosis, B: Tuberculosis, C: Brucellosis, D: Fuchs heterochromic iridocyclitis + ### Response: (Fuch's heterochromic iridocyclitis) (220-Parson 20th)* Causes of chronic granulomatous uveitis - Sarcoidosis, Herpes simplex, herpes zoster, varicella, syphilis,Tuberculosis, leprosy, brucellosis phacoanaphylactic* Causes chronic - non granulomatous uveitis - Juvenile, chronic arthritis, chronic iridocyclitis of children,Fuch's heterochromic iridocyclitis. ### End" @@ -9537,6 +17073,13 @@ Answer the following medical question: All are causes of chronic granulomatous u Answer the following medical question: Pigment production by staphylococcus aureus occurs in?, with the following options: A: Erythrasma, B: Bullous impetigo, C: Buruli ulcer, D: Food poisoning +### Response: +","Ans. is 'b' i.e., Bullous impetigo I am not able to understand this question. As most of the isolates of virulent staph aureus produce golden yellow pigment in culture. It is not disease specific. In Bullous impetigo, there may be postinflammatory pigmentation, especially in dark-skinned patients (But this is not due to pigment produced by staph aureus. Pigment is produced in culture). Among the given options a & c are not caused by staph aureus. So, I will go for option b.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pigment production by staphylococcus aureus occurs in?, with the following options: A: Erythrasma, B: Bullous impetigo, C: Buruli ulcer, D: Food poisoning + ### Response: Ans. is 'b' i.e., Bullous impetigo I am not able to understand this question. As most of the isolates of virulent staph aureus produce golden yellow pigment in culture. It is not disease specific. In Bullous impetigo, there may be postinflammatory pigmentation, especially in dark-skinned patients (But this is not due to pigment produced by staph aureus. Pigment is produced in culture). Among the given options a & c are not caused by staph aureus. So, I will go for option b. ### End" @@ -9546,6 +17089,13 @@ Ans. is 'b' i.e., Bullous impetigo I am not able to understand this question. As Answer the following medical question: Marker for carcinoma colon is: September 2005, March 2013, with the following options: A: AFP, B: CA-125, C: CEA, D: HCG +### Response: +",Ans. C: CEA,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Marker for carcinoma colon is: September 2005, March 2013, with the following options: A: AFP, B: CA-125, C: CEA, D: HCG + ### Response: Ans. C: CEA ### End"