Essential fatty acids: Those that cannot be synthesised by humans.They can be derived from food only. The most impoant essential fatty acid is linoleic acid, which serves as the basis for production of other essential fatty acids( linolenic and arachidonic acid) . Not all PUFA are essential fatty acids. Linoleic acid:- dietary source and per cent content . Safflower oil- 73 Corn oil- 57 Sunflower oil-56 Soyabean oil-51 Sesame oil-40 Ground nut oil-39 Mustard oil -15 Palmoil- 9 Coconut oil- 2 Eichosapentanoic acid: Fish oil: 10 % present. Linolenic acid : Soyabean oil-7 {Reference: Park&;s textbook of community medicine 23 rd edition, pg no. 611}","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Amongst the following fats and oils, highest propoion of poly unsaturated fatty acids (PUFA) is found in -, with the following options: A: Groundnut oil, B: Coconut oil, C: Safflower oil, D: Butter + +### Response: +
Essential fatty acids: Those that cannot be synthesised by humans.They can be derived from food only. The most impoant essential fatty acid is linoleic acid, which serves as the basis for production of other essential fatty acids( linolenic and arachidonic acid) . Not all PUFA are essential fatty acids. Linoleic acid:- dietary source and per cent content . Safflower oil- 73 Corn oil- 57 Sunflower oil-56 Soyabean oil-51 Sesame oil-40 Ground nut oil-39 Mustard oil -15 Palmoil- 9 Coconut oil- 2 Eichosapentanoic acid: Fish oil: 10 % present. Linolenic acid : Soyabean oil-7 {Reference: Park&;s textbook of community medicine 23 rd edition, pg no. 611}
+### End"
+279,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The industry, with the highest accidental death rate and long held to be the most dangerous occupation is –, with the following options: A: Agriculture, B: Construction, C: Mining and quarrying, D: Trade
+
+### Response:
+","Accidents are a common features in most industries.
+In fact, some industries are known for accidents, eg: coal and other mining industries, quarrying, construction work.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The industry, with the highest accidental death rate and long held to be the most dangerous occupation is –, with the following options: A: Agriculture, B: Construction, C: Mining and quarrying, D: Trade
+
+### Response:
+Accidents are a common features in most industries.
+In fact, some industries are known for accidents, eg: coal and other mining industries, quarrying, construction work.
+### End"
+280,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A female patient presented with a firm mass of 2 x 2 ems in the upper outer quadrant of the breast. She gives a family history of ovarian carcinoma. The investigation that needs to be done to assess for mutation is -, with the following options: A: p53, B: BRCA-2, C: Her 2/Neu gene, D: C-myc gene
+
+### Response:
+",""" In women with hereditary breast - ovarian cancer, two susceptibility loci have been identified:
+
+BRCA -1 → located on chromosome 17 and
+BRCA - 2 → located on chromosome 13
+
+""About 25% of familial cancers (or around 3% of all breast cancer) can be attributed to two highly penetrant autosomal dominant genes BRCA1 and BRCA2""
+Coming to the question
+
+This woman is suffering from familial breast carcinoma as (family history positive for ovarian cancer)
+The most common gene associated with familial breast cancer is BRCA-1 (52%) followed by BRCA-2 (32% of all familial cancers).
+BRAC-1 and BRAC-2 are associated with ovarian cancer, so a family history of ovarian carcinoma may be positive.
+
+Remember
+
+The most common gene involved in famiilial breast cancer → BRCA-1
+The most common gene involved in sporadic breast cancer → p53
+Most common gene involved overall (Hereditary plus sporadic) → p53
+The maximum increase in susceptibility to breast cancer is seen with → p53 mutation (>90%) whether it is sporadic or Hereditary.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A female patient presented with a firm mass of 2 x 2 ems in the upper outer quadrant of the breast. She gives a family history of ovarian carcinoma. The investigation that needs to be done to assess for mutation is -, with the following options: A: p53, B: BRCA-2, C: Her 2/Neu gene, D: C-myc gene
+
+### Response:
+"" In women with hereditary breast - ovarian cancer, two susceptibility loci have been identified:
+
+BRCA -1 → located on chromosome 17 and
+BRCA - 2 → located on chromosome 13
+
+""About 25% of familial cancers (or around 3% of all breast cancer) can be attributed to two highly penetrant autosomal dominant genes BRCA1 and BRCA2""
+Coming to the question
+
+This woman is suffering from familial breast carcinoma as (family history positive for ovarian cancer)
+The most common gene associated with familial breast cancer is BRCA-1 (52%) followed by BRCA-2 (32% of all familial cancers).
+BRAC-1 and BRAC-2 are associated with ovarian cancer, so a family history of ovarian carcinoma may be positive.
+
+Remember
+
+The most common gene involved in famiilial breast cancer → BRCA-1
+The most common gene involved in sporadic breast cancer → p53
+Most common gene involved overall (Hereditary plus sporadic) → p53
+The maximum increase in susceptibility to breast cancer is seen with → p53 mutation (>90%) whether it is sporadic or Hereditary.
+### End"
+281,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Do the embryological first pharyngeal arches remain?, with the following options: A: Sphenomandibular ligament, B: Stylohyoid ligament, C: Stylomandibular ligament, D: Styloid ligament
+
+### Response:
+","The pa of the cailage extending from the region of the middle ear to the mandible disappears, but it's sheath forms the anterior ligament of the malleus and the sphenomandibular ligament Ref: Human Embryology, Inderbir Singh, 10th edition, page no: 131","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Do the embryological first pharyngeal arches remain?, with the following options: A: Sphenomandibular ligament, B: Stylohyoid ligament, C: Stylomandibular ligament, D: Styloid ligament
+
+### Response:
+The pa of the cailage extending from the region of the middle ear to the mandible disappears, but it's sheath forms the anterior ligament of the malleus and the sphenomandibular ligament Ref: Human Embryology, Inderbir Singh, 10th edition, page no: 131
+### End"
+282,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: 10 month old child can not do -, with the following options: A: Change cube from one hand to another, B: Can build a cube of six, C: Can pull and stand, D: All
+
+### Response:
+","Ans. is 'b' i.e., Can build a cube of six o A child can transfer the objects from one hand to another by 5-7 months. o A child can build a tower of 6 cubes by 21 months ( see above question). o A child can pull himself up by the age of 10 months. o A child makes a simple sentence first time by the age of 2 years. o Pincer grasp develops by 9 months.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: 10 month old child can not do -, with the following options: A: Change cube from one hand to another, B: Can build a cube of six, C: Can pull and stand, D: All
+
+### Response:
+Ans. is 'b' i.e., Can build a cube of six o A child can transfer the objects from one hand to another by 5-7 months. o A child can build a tower of 6 cubes by 21 months ( see above question). o A child can pull himself up by the age of 10 months. o A child makes a simple sentence first time by the age of 2 years. o Pincer grasp develops by 9 months.
+### End"
+283,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A newborn has his leg inveed and the dorsum of his foot does not touch the front of tibia. What is the diagnosis of this condition?, with the following options: A: Congenital veical talus, B: Congenital talipes equino varus, C: Cerebral palsy, D: Poliomyelitis
+
+### Response:
+","Congenital clubfoot (equinovarus foot; talipes equinovarus): It is characterized by fixed ankle plantar flexion (equinus), inversion and axial internal rotation of the subtalar (talocalcaneal) joint (varus), and medial subluxation of the talonavicular and calcaneocuboid joints (adductus). The typical radiographic findings of incompletely treated clubfoot include the following features: Presence of hind foot plantar flexion; Lack of the normal angular relationship between the talus and calcaneus (so-called parallelism of talus and calcaneus); and Residual medial subluxation or displacement of the navicular on the talus and the cuboid on the calcaneus. Ref: Rab G.T. (2006). Chapter 11. Pediatric Ohopedic Surgery. In H.B. Skinner (Ed), CURRENT Diagnosis & Treatment in Ohopedics, 4e.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A newborn has his leg inveed and the dorsum of his foot does not touch the front of tibia. What is the diagnosis of this condition?, with the following options: A: Congenital veical talus, B: Congenital talipes equino varus, C: Cerebral palsy, D: Poliomyelitis
+
+### Response:
+Congenital clubfoot (equinovarus foot; talipes equinovarus): It is characterized by fixed ankle plantar flexion (equinus), inversion and axial internal rotation of the subtalar (talocalcaneal) joint (varus), and medial subluxation of the talonavicular and calcaneocuboid joints (adductus). The typical radiographic findings of incompletely treated clubfoot include the following features: Presence of hind foot plantar flexion; Lack of the normal angular relationship between the talus and calcaneus (so-called parallelism of talus and calcaneus); and Residual medial subluxation or displacement of the navicular on the talus and the cuboid on the calcaneus. Ref: Rab G.T. (2006). Chapter 11. Pediatric Ohopedic Surgery. In H.B. Skinner (Ed), CURRENT Diagnosis & Treatment in Ohopedics, 4e.
+### End"
+284,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Von Herick angle grade '3' of anterior chamber denotes, with the following options: A: Wide open angle, B: Moderately open angle, C: Moderately narrow angle, D: Closed angle
+
+### Response:
+","Ans. is 'b' i.e., Moderately open angle","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Von Herick angle grade '3' of anterior chamber denotes, with the following options: A: Wide open angle, B: Moderately open angle, C: Moderately narrow angle, D: Closed angle
+
+### Response:
+Ans. is 'b' i.e., Moderately open angle
+### End"
+285,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: During setting of alginate impression materials:, with the following options: A: Trisodium phosphate reacts with sodium alginate, B: Trisodium phosphate reacts with calcium sulphate, C: Colloidal gel changes to sol, D: Material in contact with soft tissues sets last
+
+### Response:
+","Gelation Process
+The typical sol-gel reaction can be described simply as a reaction of soluble alginate with calcium ions from calcium sulfate and the formation of an insoluble calcium alginate.
+Structurally, calcium ions replace the sodium or potassium ions of two adjacent molecules to produce a cross-linked complex or polymer network. The production of the calcium alginate is so rapid that it does not allow sufficient working time. A water-soluble phosphate salt (e.g., trisodium phosphate) is added to the composition as a retarder to extend the working time. The strategy is that the calcium ions will react preferentially with the phosphate ions in the solution. Thus, the rapid reaction between calcium ions and the soluble alginate is deferred until phosphate ions from trisodium phosphate are exhausted. The amount of retarder is adjusted to provide the proper setting time. A similar gelation process is expected with the modified alginate product.
+Reference: PHILLIPS’ SCIENCE OF DENTAL MATERIALS, 12th ed page no 172","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: During setting of alginate impression materials:, with the following options: A: Trisodium phosphate reacts with sodium alginate, B: Trisodium phosphate reacts with calcium sulphate, C: Colloidal gel changes to sol, D: Material in contact with soft tissues sets last
+
+### Response:
+Gelation Process
+The typical sol-gel reaction can be described simply as a reaction of soluble alginate with calcium ions from calcium sulfate and the formation of an insoluble calcium alginate.
+Structurally, calcium ions replace the sodium or potassium ions of two adjacent molecules to produce a cross-linked complex or polymer network. The production of the calcium alginate is so rapid that it does not allow sufficient working time. A water-soluble phosphate salt (e.g., trisodium phosphate) is added to the composition as a retarder to extend the working time. The strategy is that the calcium ions will react preferentially with the phosphate ions in the solution. Thus, the rapid reaction between calcium ions and the soluble alginate is deferred until phosphate ions from trisodium phosphate are exhausted. The amount of retarder is adjusted to provide the proper setting time. A similar gelation process is expected with the modified alginate product.
+Reference: PHILLIPS’ SCIENCE OF DENTAL MATERIALS, 12th ed page no 172
+### End"
+286,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Cholecystokinin causes all of the following except:-, with the following options: A: Gall bladder contraction, B: Pancreatic enzyme secretion, C: Increases gastrin secretion, D: Increases small intestinal motility
+
+### Response:
+","Cholecystokinin: - Stimuli for secretion Site of secretion Actions Protein, Fat, Acid -I cells of duodenum, jejunum and ileum Stimulates- Pancreatic enzyme secretions Pancreatic bicarbonate secretions Gallbladder contraction Growth of exocrine pancreas Inhibits- Gastric emptying","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Cholecystokinin causes all of the following except:-, with the following options: A: Gall bladder contraction, B: Pancreatic enzyme secretion, C: Increases gastrin secretion, D: Increases small intestinal motility
+
+### Response:
+Cholecystokinin: - Stimuli for secretion Site of secretion Actions Protein, Fat, Acid -I cells of duodenum, jejunum and ileum Stimulates- Pancreatic enzyme secretions Pancreatic bicarbonate secretions Gallbladder contraction Growth of exocrine pancreas Inhibits- Gastric emptying
+### End"
+287,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Delusion is a disorder of:, with the following options: A: Thinking, B: Memory, C: Perception, D: Intellect
+
+### Response:
+",Ans. is 'a' Thinking Cognition (Thought) Disorders are -Schizophrenia*Obsessive compulsive neurosis*Delusions* & phobias*Also rememberHallucinations are disorder of - perception*,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Delusion is a disorder of:, with the following options: A: Thinking, B: Memory, C: Perception, D: Intellect
+
+### Response:
+Ans. is 'a' Thinking Cognition (Thought) Disorders are -Schizophrenia*Obsessive compulsive neurosis*Delusions* & phobias*Also rememberHallucinations are disorder of - perception*
+### End"
+288,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Investigation of choice for spinal tuberculosis -, with the following options: A: X-ray, B: CT-Scan, C: Open biopsy, D: MRI
+
+### Response:
+","Ans. is 'd' i.e., MRIInvestigations in musculoskeletal systemo Investigation of choice for AVN Hip - MRIo Best initial test for osteomyelitis - Plain x-rayo Best second line test for osteomyelitis (if there is high clinical suspician and x-ray is negative) - MRIo Most accurate diagnostic test for osteomyelitis - Bone biopsy and culture,o Best view for scaphoid fracture - Oblique (scaphoid) view of wrist,o Best view for C1-C2 vertebrae & junction - Open mouth odontoid (Pegs) view,o Investigation of choice for ACL & PCL injury - MRIo Investigation of choice to detect calcification - CT scano Investigation of choice for prolapsed intervertebral disc - MRIo Investigation of choice for spinal tuberculosis - MRIo Investigation of choice for traumatic paraplagia -MRIo Gold standard and investigation of choice for osteoporosis - Dual energy x-ray absorptiometry (DEXA).","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Investigation of choice for spinal tuberculosis -, with the following options: A: X-ray, B: CT-Scan, C: Open biopsy, D: MRI
+
+### Response:
+Ans. is 'd' i.e., MRIInvestigations in musculoskeletal systemo Investigation of choice for AVN Hip - MRIo Best initial test for osteomyelitis - Plain x-rayo Best second line test for osteomyelitis (if there is high clinical suspician and x-ray is negative) - MRIo Most accurate diagnostic test for osteomyelitis - Bone biopsy and culture,o Best view for scaphoid fracture - Oblique (scaphoid) view of wrist,o Best view for C1-C2 vertebrae & junction - Open mouth odontoid (Pegs) view,o Investigation of choice for ACL & PCL injury - MRIo Investigation of choice to detect calcification - CT scano Investigation of choice for prolapsed intervertebral disc - MRIo Investigation of choice for spinal tuberculosis - MRIo Investigation of choice for traumatic paraplagia -MRIo Gold standard and investigation of choice for osteoporosis - Dual energy x-ray absorptiometry (DEXA).
+### End"
+289,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Barrett's esophagus shows:, with the following options: A: Intestinal dysplasia, B: Intestinal metaplasia, C: Squamous cell metaplasia, D: Columnar cell metaplasia
+
+### Response:
+","Intestinal metaplasia Repeat from Nov 06 Schwaz writes - ""The definition of Barrett's esophagus (BE), has evolved considerably over the past decade. Traditionally, BE was identified by the presence of columnar mucosa extending at least 3 cm into the esophagus. It is now recognized that the specialized intestinal type epithelium found in the Barrett's mucosa is the only tissue predisposed to malignant degeneration. Consequently, the diagnosis of Barrett's esophagus is presently made given any length of endoscopically identifiable columnar mucosa that proves on biopsy to show intestinal metaplasia. While long segments of columnar mucosa without metaplasia do occur, they are uncommon and are probably congenital in origin. The hallmark of intestinal metaplasia is the presence of intestinal goblet cells.""","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Barrett's esophagus shows:, with the following options: A: Intestinal dysplasia, B: Intestinal metaplasia, C: Squamous cell metaplasia, D: Columnar cell metaplasia
+
+### Response:
+Intestinal metaplasia Repeat from Nov 06 Schwaz writes - ""The definition of Barrett's esophagus (BE), has evolved considerably over the past decade. Traditionally, BE was identified by the presence of columnar mucosa extending at least 3 cm into the esophagus. It is now recognized that the specialized intestinal type epithelium found in the Barrett's mucosa is the only tissue predisposed to malignant degeneration. Consequently, the diagnosis of Barrett's esophagus is presently made given any length of endoscopically identifiable columnar mucosa that proves on biopsy to show intestinal metaplasia. While long segments of columnar mucosa without metaplasia do occur, they are uncommon and are probably congenital in origin. The hallmark of intestinal metaplasia is the presence of intestinal goblet cells.""
+### End"
+290,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: All are used for schizophrenia Except, with the following options: A: Chlorpromazine, B: Clozapine, C: Risperidone, D: Venlafaxine
+
+### Response:
+","Selective serotonin-norepinephrine reuptake inhibitors (SNRIs) include venlafaxine, its metabolite desvenlafaxine, and duloxetine. In addition to their use in major depression, other applications of the SNRIs include the treatment of pain disorders including neuropathies and fibromyalgia. SNRIs are also used in the treatment of generalized anxiety, stress urinary incontinence, and vasomotor symptoms of menopause. chlorpromazine is a type of typical antipsychotic introduced by Delay and Denniker Risperidone is a atypical antipsychotic Clozapine is a second generation antipsychotic used for treatment resistant schizophrenia Clozapine, risperidone are atypical antipsychotic drugs chlorpromazine is a phenothiazine antipsychotic, can be used in schizophrenia Reference: Kaplon and sadock, 11 th edition, synopsis of psychiatry, 11 th edition, pg no. 1010","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: All are used for schizophrenia Except, with the following options: A: Chlorpromazine, B: Clozapine, C: Risperidone, D: Venlafaxine
+
+### Response:
+Selective serotonin-norepinephrine reuptake inhibitors (SNRIs) include venlafaxine, its metabolite desvenlafaxine, and duloxetine. In addition to their use in major depression, other applications of the SNRIs include the treatment of pain disorders including neuropathies and fibromyalgia. SNRIs are also used in the treatment of generalized anxiety, stress urinary incontinence, and vasomotor symptoms of menopause. chlorpromazine is a type of typical antipsychotic introduced by Delay and Denniker Risperidone is a atypical antipsychotic Clozapine is a second generation antipsychotic used for treatment resistant schizophrenia Clozapine, risperidone are atypical antipsychotic drugs chlorpromazine is a phenothiazine antipsychotic, can be used in schizophrenia Reference: Kaplon and sadock, 11 th edition, synopsis of psychiatry, 11 th edition, pg no. 1010
+### End"
+291,"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 man presents with coughing up blood and sputum. He gives a history of recurrent pneumonias and a chronic cough productive of foul-smelling purulent sputum. He has no other past medical history and is a lifetime nonsmoker. On physical examination, there are no oral lesions, heart sounds are normal, and wet inspiratory crackles are heard at the lung bases posteriorly. He also has clubbing of his fingers, but there is no hepatosplenomegaly or any palpable lymph nodes. CXR show fibrosis and pulmonary infiltrates in the right lower lung. Which of the following is the most appropriate initial diagnostic test?, with the following options: A: chest CT scan, B: bronchoscopy, C: bronchography, D: open thoracotomy
+
+### Response:
+","Bronchography has been superseded by a CT scan in defining the extent of bronchiectasis. Occasionally, advanced cases of saccular bronchiectasis can be diagnosed by routine CXR. The use of high-resolution CT scanning, in which the images are 1.5 mm thick, has resulted in excellent diagnostic accuracy.","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 man presents with coughing up blood and sputum. He gives a history of recurrent pneumonias and a chronic cough productive of foul-smelling purulent sputum. He has no other past medical history and is a lifetime nonsmoker. On physical examination, there are no oral lesions, heart sounds are normal, and wet inspiratory crackles are heard at the lung bases posteriorly. He also has clubbing of his fingers, but there is no hepatosplenomegaly or any palpable lymph nodes. CXR show fibrosis and pulmonary infiltrates in the right lower lung. Which of the following is the most appropriate initial diagnostic test?, with the following options: A: chest CT scan, B: bronchoscopy, C: bronchography, D: open thoracotomy
+
+### Response:
+Bronchography has been superseded by a CT scan in defining the extent of bronchiectasis. Occasionally, advanced cases of saccular bronchiectasis can be diagnosed by routine CXR. The use of high-resolution CT scanning, in which the images are 1.5 mm thick, has resulted in excellent diagnostic accuracy.
+### End"
+292,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: RPD can be classified as which level of prevention?, with the following options: A: Primary level, B: Secondary level, C: Tertiary level, D: Support adjacent mobile teeth with clasp
+
+### Response:
+","Primary Prevention
+Primary prevention aims to avoid the development of a disease or disability in healthy individuals. Most population-based health promotion activities, such as encouraging less consumption of sugars to reduce caries risk, are primary preventive measures. Other examples of primary prevention in medicine and dentistry include the use of fluoridated toothpaste, and vaccinations for infectious diseases like measles, mumps, rubella, and polio.
+Secondary Prevention
+The focus of secondary prevention is early disease detection, making it possible to prevent the worsening of the disease and the emergence of symptoms, or to minimize complications and limit disabilities before the disease becomes severe. Secondary prevention also includes the detection of disease in asymptomatic patients, with screening or diagnostic testing and preventing the spread of communicable diseases. Examples in dentistry and medicine include screening for caries, periodontal screening and recording for periodontal disease, and screening for breast and cervical cancer.
+Tertiary Prevention
+The goal of tertiary prevention is to reduce the negative impact of an already-established disease by restoring function and reducing disease-related complications.
+Tertiary prevention also aims to improve the quality of life for people with disease. In medicine and dentistry, tertiary prevention measures include the use of amalgam and composite fillings for dental caries, replacement of missing teeth with bridges, implants, or dentures, or insulin therapy for Type II diabetes.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: RPD can be classified as which level of prevention?, with the following options: A: Primary level, B: Secondary level, C: Tertiary level, D: Support adjacent mobile teeth with clasp
+
+### Response:
+Primary Prevention
+Primary prevention aims to avoid the development of a disease or disability in healthy individuals. Most population-based health promotion activities, such as encouraging less consumption of sugars to reduce caries risk, are primary preventive measures. Other examples of primary prevention in medicine and dentistry include the use of fluoridated toothpaste, and vaccinations for infectious diseases like measles, mumps, rubella, and polio.
+Secondary Prevention
+The focus of secondary prevention is early disease detection, making it possible to prevent the worsening of the disease and the emergence of symptoms, or to minimize complications and limit disabilities before the disease becomes severe. Secondary prevention also includes the detection of disease in asymptomatic patients, with screening or diagnostic testing and preventing the spread of communicable diseases. Examples in dentistry and medicine include screening for caries, periodontal screening and recording for periodontal disease, and screening for breast and cervical cancer.
+Tertiary Prevention
+The goal of tertiary prevention is to reduce the negative impact of an already-established disease by restoring function and reducing disease-related complications.
+Tertiary prevention also aims to improve the quality of life for people with disease. In medicine and dentistry, tertiary prevention measures include the use of amalgam and composite fillings for dental caries, replacement of missing teeth with bridges, implants, or dentures, or insulin therapy for Type II diabetes.
+### End"
+293,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Significant titres of IHA is seen in all types of amoebiasis except-, with the following options: A: Acute amoebic dysentery, B: Brain abscess, C: Liver abscess, D: Cyst passers
+
+### Response:
+","Infection with E. histolytica does not necessarily lead to disease. Infact, in most cases it remains within the lumen of the large intestine, feeding on the colonic contents and mucus as a commensal without causing any ill effects. Such persons become carriers or asymptomatic cyst passers, as their stool contains cysts. They are responsible for the maintenance and spread of infection in the community. The infection may get spontaneously eliminated in many of them. Sometimes, the infection may be activated and clinical disease ensues. Such latency and reactivation are characteristic of amoebiasis. TEXTBOOK OF MEDICAL PARASITOLOGY,CKJ PANIKER,6TH EDITION,PAGE NO 17","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Significant titres of IHA is seen in all types of amoebiasis except-, with the following options: A: Acute amoebic dysentery, B: Brain abscess, C: Liver abscess, D: Cyst passers
+
+### Response:
+Infection with E. histolytica does not necessarily lead to disease. Infact, in most cases it remains within the lumen of the large intestine, feeding on the colonic contents and mucus as a commensal without causing any ill effects. Such persons become carriers or asymptomatic cyst passers, as their stool contains cysts. They are responsible for the maintenance and spread of infection in the community. The infection may get spontaneously eliminated in many of them. Sometimes, the infection may be activated and clinical disease ensues. Such latency and reactivation are characteristic of amoebiasis. TEXTBOOK OF MEDICAL PARASITOLOGY,CKJ PANIKER,6TH EDITION,PAGE NO 17
+### End"
+294,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: All are side effects of steroids except, with the following options: A: Skin atrophy, B: Telangiectasia, C: Folliculitis, D: Photosentivity
+
+### Response:
+",Refer KDT 6/e p 855 Steroids are used for treatment of Photosentivity Other effects like skin atrophy Telangiectasia Folkiculitis Can be caused by steroids,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: All are side effects of steroids except, with the following options: A: Skin atrophy, B: Telangiectasia, C: Folliculitis, D: Photosentivity
+
+### Response:
+Refer KDT 6/e p 855 Steroids are used for treatment of Photosentivity Other effects like skin atrophy Telangiectasia Folkiculitis Can be caused by steroids
+### End"
+295,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The termination of Descemet&;s membrane is, with the following options: A: Schwalbe's line, B: Sclera's spur, C: Schlemm's canal, D: Tubercular meshwork
+
+### Response:
+",Descement's membrane The Descement's membrane is a strong homogeneous basement membrane of the corneal endothelium It consists of collagen and glycoproteins. Unlike Bowman's membrane it can regenerate. In the periphery it appears to end at the anterior limit of trabecular meshwork as Schwalbe's line (ring) Reference: A.K.Khurana; 6th edition; Page no:96,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The termination of Descemet&;s membrane is, with the following options: A: Schwalbe's line, B: Sclera's spur, C: Schlemm's canal, D: Tubercular meshwork
+
+### Response:
+Descement's membrane The Descement's membrane is a strong homogeneous basement membrane of the corneal endothelium It consists of collagen and glycoproteins. Unlike Bowman's membrane it can regenerate. In the periphery it appears to end at the anterior limit of trabecular meshwork as Schwalbe's line (ring) Reference: A.K.Khurana; 6th edition; Page no:96
+### End"
+296,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: All are Type-III hypersensitivity reaction except:, with the following options: A: Polyaeritis nodosa, B: Post- streptococcal glomerulonephritis, C: Epstein barr virus infections, D: Pemphigus vulgaris
+
+### Response:
+",Pemphigus vulgaris is type 2 hypersensitivity reaction. examples of various hypersensitivity reaction are given in attached treasure.,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: All are Type-III hypersensitivity reaction except:, with the following options: A: Polyaeritis nodosa, B: Post- streptococcal glomerulonephritis, C: Epstein barr virus infections, D: Pemphigus vulgaris
+
+### Response:
+Pemphigus vulgaris is type 2 hypersensitivity reaction. examples of various hypersensitivity reaction are given in attached treasure.
+### End"
+297,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Both soft and hard exudates are seen in, with the following options: A: Hypeension, B: Diabetes, C: Eale's disease, D: All of the above
+
+### Response:
+","Ref khurana 6th edition pg 567 Differential Diagnosis for Hard exudates Differential Diagnosis for soft exudates i. Diabetic retinopathy ii. HTN retinopathy iii. BRVO iv. CRVO v. Coats' disease vi. Retinal aery macro aneurysm vii. Radiation retinopathy viii. Eales' disease Retinopathy of toxemia of pregnancy _ Diabetic retinopathy _ Anaemic retinopathy _ LE, PAN, and scleroderma _ Leukaemic retinopathy _ Retinopathy of AIDS - Hypeensive retinopathy - Eales' disease","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Both soft and hard exudates are seen in, with the following options: A: Hypeension, B: Diabetes, C: Eale's disease, D: All of the above
+
+### Response:
+Ref khurana 6th edition pg 567 Differential Diagnosis for Hard exudates Differential Diagnosis for soft exudates i. Diabetic retinopathy ii. HTN retinopathy iii. BRVO iv. CRVO v. Coats' disease vi. Retinal aery macro aneurysm vii. Radiation retinopathy viii. Eales' disease Retinopathy of toxemia of pregnancy _ Diabetic retinopathy _ Anaemic retinopathy _ LE, PAN, and scleroderma _ Leukaemic retinopathy _ Retinopathy of AIDS - Hypeensive retinopathy - Eales' disease
+### End"
+298,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Dicrotic nature of aoic notch is lost in?, with the following options: A: Aoic Stenosis, B: Aoic Regurgitation, C: PDA, D: Aeriosclerosis
+
+### Response:
+","Aoic Stenosis REF: Harrison's 17th ed chapter 220 Anacrotic pulse with a slow initial upstroke, the peak is close to S2; these features suggest fixed left ventricular outflow obstruction, such as occurs with valvular aoic stenosis","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Dicrotic nature of aoic notch is lost in?, with the following options: A: Aoic Stenosis, B: Aoic Regurgitation, C: PDA, D: Aeriosclerosis
+
+### Response:
+Aoic Stenosis REF: Harrison's 17th ed chapter 220 Anacrotic pulse with a slow initial upstroke, the peak is close to S2; these features suggest fixed left ventricular outflow obstruction, such as occurs with valvular aoic stenosis
+### End"
+299,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: For post-exposure prophylaxis of HIV is:-, with the following options: A: Tenoir + Lamivudine for 4 weeks, B: Lamivudine + Ritonavir for 4 weeks, C: Zidovudine + Lamivudine + Indinavir for 4 weeks, D: Single dose Zidovudine + Lamivudine + Indinavir
+
+### Response:
+",New post-exposure guidelines for HIV for adolescents and adults: Preferred backbone regimen: Tenofovir + Lamivudine for 4 weeks. Preferred third drug: Lopinavir / Ritonavir or Atazanavir / Ritonavir.,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: For post-exposure prophylaxis of HIV is:-, with the following options: A: Tenoir + Lamivudine for 4 weeks, B: Lamivudine + Ritonavir for 4 weeks, C: Zidovudine + Lamivudine + Indinavir for 4 weeks, D: Single dose Zidovudine + Lamivudine + Indinavir
+
+### Response:
+New post-exposure guidelines for HIV for adolescents and adults: Preferred backbone regimen: Tenofovir + Lamivudine for 4 weeks. Preferred third drug: Lopinavir / Ritonavir or Atazanavir / Ritonavir.
+### End"
+300,"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 treatment of psoriasis involving <10% of BSA (body surface area) is, with the following options: A: Methotrexate, B: Oral steroids, C: Topical steroids, D: Topical calcipotriol
+
+### Response:
+",Topical steroids & topical calcipotriol can be used for treating psoriatic lesions involving <10% body surface area & calcipotriol is the drug of choice.,"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 treatment of psoriasis involving <10% of BSA (body surface area) is, with the following options: A: Methotrexate, B: Oral steroids, C: Topical steroids, D: Topical calcipotriol
+
+### Response:
+Topical steroids & topical calcipotriol can be used for treating psoriatic lesions involving <10% body surface area & calcipotriol is the drug of choice.
+### End"
+301,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: True about dashboard injury:, with the following options: A: Lower pole of patella fracture, B: Posterior dislocation of hip, C: Fracture lateral condyle femur, D: Fracture of head of femur
+
+### Response:
+","Ans. :B > A (Lower pole of patella fracture); B (Posterior dislocation of hip C (Fracture lateral condyle femur); D(Fracture of head of femur) ""In motor accident, the occupant of car is thrown forwards & his knee stikes against the dashboard; & the force is transmitted up the shaft, resulting in posterior dislocation of the hip. It is therefore, also known as dashboard injury""- Maheshwari 3rd/111POSTERIOR DISLOCATION AND FRACTURE- DISLOCATION Campbell's Operative Orthopaedics, 11th ed.Patients with a posterior dislocation of the hip generally present with a shortened, internally rotated, adducted limb in slight flexion. This position can be altered if the femoral head is impaled on a fractured posterior acetabular wall.This injury typically occurs from a longitudinally directed force applied through the femur to a flexed hip, often when a patient's knee strikes the dashboard in an automobile head- on collision. If the hip is adducted at the time of injury, a pure dislocation occurs, whereas a neutral position or abduction leads to dislocation associated with a fracture of the femoral head or acetabulum""The fracture of patella may result from dashboard injury- Orthopaedics Illustrated by R.K.Gupta lst/83""Posterior Dislocation of hip: Usually this occurs in a road accident as a result of dash board injury""- Orthopaedics Illustrated by R-K-Gupta 1st/83Dash board injury loadf20Ql-2fQ6-manfredmi-massar.pdfUnicondylar fractures of the femur are charac-terized by avulsion of one femoral condyle whilethe other intact condyle remains in continuity withthe femoral metaphysis . Accounting for only0.65% of all femoral fractures , they havenever been reviewed extensively in the orthopedicliterature, in particular as a class of fracture. Theyhave almost always been included in the genericgroup of distal-third femoral fractures.Unicondylar femoral fractures represent a diagnostic problem, as they are often overlooked owing to their frequent association with other fractures of the same limb or in other regions. Moreover, they show great anatomical variability, resulting in difficult radiologic evaluation and in a controversial therapeutic approach . They occur followingdirect impact, avulsion or action of shear forces onthe knee, generally in sports activities or traffkaccidents, particularly dashboard traumaThe critical point is represented by thetrochlear-condylar groove, located at the junction between the trochlea and the medial and lateralcondyles ; starting from this typical site, the fracture line may be frontal, sagittal or oblique in eachcondvle. The lateral condyle is involved three times as often as the medial onePOSTERIOR DISLOCATION - AXIAL LOAD ON FEMUR THROUGH KNEE (DASHBOARD INJURY) http://www.ncbi. nlm.nih.gov/pmcf/articles/There are reports in the medical literature of ipsilateral fractures of the femoral neck and intertrochanteric- pertrochanteric region,In this the patient sustained a dashboard injury which initially caused the reverse oblique trochanteric fracture, and the continued movement of the distal fragment impacted the femoral neck and caused the femora! neck fracture which was minimally displaced.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: True about dashboard injury:, with the following options: A: Lower pole of patella fracture, B: Posterior dislocation of hip, C: Fracture lateral condyle femur, D: Fracture of head of femur
+
+### Response:
+Ans. :B > A (Lower pole of patella fracture); B (Posterior dislocation of hip C (Fracture lateral condyle femur); D(Fracture of head of femur) ""In motor accident, the occupant of car is thrown forwards & his knee stikes against the dashboard; & the force is transmitted up the shaft, resulting in posterior dislocation of the hip. It is therefore, also known as dashboard injury""- Maheshwari 3rd/111POSTERIOR DISLOCATION AND FRACTURE- DISLOCATION Campbell's Operative Orthopaedics, 11th ed.Patients with a posterior dislocation of the hip generally present with a shortened, internally rotated, adducted limb in slight flexion. This position can be altered if the femoral head is impaled on a fractured posterior acetabular wall.This injury typically occurs from a longitudinally directed force applied through the femur to a flexed hip, often when a patient's knee strikes the dashboard in an automobile head- on collision. If the hip is adducted at the time of injury, a pure dislocation occurs, whereas a neutral position or abduction leads to dislocation associated with a fracture of the femoral head or acetabulum""The fracture of patella may result from dashboard injury- Orthopaedics Illustrated by R.K.Gupta lst/83""Posterior Dislocation of hip: Usually this occurs in a road accident as a result of dash board injury""- Orthopaedics Illustrated by R-K-Gupta 1st/83Dash board injury loadf20Ql-2fQ6-manfredmi-massar.pdfUnicondylar fractures of the femur are charac-terized by avulsion of one femoral condyle whilethe other intact condyle remains in continuity withthe femoral metaphysis . Accounting for only0.65% of all femoral fractures , they havenever been reviewed extensively in the orthopedicliterature, in particular as a class of fracture. Theyhave almost always been included in the genericgroup of distal-third femoral fractures.Unicondylar femoral fractures represent a diagnostic problem, as they are often overlooked owing to their frequent association with other fractures of the same limb or in other regions. Moreover, they show great anatomical variability, resulting in difficult radiologic evaluation and in a controversial therapeutic approach . They occur followingdirect impact, avulsion or action of shear forces onthe knee, generally in sports activities or traffkaccidents, particularly dashboard traumaThe critical point is represented by thetrochlear-condylar groove, located at the junction between the trochlea and the medial and lateralcondyles ; starting from this typical site, the fracture line may be frontal, sagittal or oblique in eachcondvle. The lateral condyle is involved three times as often as the medial onePOSTERIOR DISLOCATION - AXIAL LOAD ON FEMUR THROUGH KNEE (DASHBOARD INJURY) http://www.ncbi. nlm.nih.gov/pmcf/articles/There are reports in the medical literature of ipsilateral fractures of the femoral neck and intertrochanteric- pertrochanteric region,In this the patient sustained a dashboard injury which initially caused the reverse oblique trochanteric fracture, and the continued movement of the distal fragment impacted the femoral neck and caused the femora! neck fracture which was minimally displaced.
+### End"
+302,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Screening is not recommended if -, with the following options: A: Prevalence of disease is high, B: Life expectancy can be prolonged by early diagnosis, C: Diagnostic test should be available, D: Diseases with no latent period
+
+### Response:
+","Ans. is 'd' i.e., Disease with no latent period o The disease to be screened should fulfil the following criteria before it is considered suitable for screening:-The condition sougth should be an important health problem (in general, prevalence should be high).There should be a recognizable latent or early asymptomatic stage.The natural history of the conti ti on, including development from latent to declared disease, should be adequately understood (so that we ean know at what stage the process ceases to be reversible).There is a test that can detect the disease prior to the onset of signs and symptoms.Facilities should be available for confirmation of the diagnosis.There is an effective treatment.There should be an agreed-on policy concerning whom to treat as patients (e.g., lower ranges of blood pressure; border-line diabetes).There is good evidence that early detection and treatment reduces morbidity and mortality.The expected benefits (e.g., the number of lives saved) of early detection exceed the risks and costs.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Screening is not recommended if -, with the following options: A: Prevalence of disease is high, B: Life expectancy can be prolonged by early diagnosis, C: Diagnostic test should be available, D: Diseases with no latent period
+
+### Response:
+Ans. is 'd' i.e., Disease with no latent period o The disease to be screened should fulfil the following criteria before it is considered suitable for screening:-The condition sougth should be an important health problem (in general, prevalence should be high).There should be a recognizable latent or early asymptomatic stage.The natural history of the conti ti on, including development from latent to declared disease, should be adequately understood (so that we ean know at what stage the process ceases to be reversible).There is a test that can detect the disease prior to the onset of signs and symptoms.Facilities should be available for confirmation of the diagnosis.There is an effective treatment.There should be an agreed-on policy concerning whom to treat as patients (e.g., lower ranges of blood pressure; border-line diabetes).There is good evidence that early detection and treatment reduces morbidity and mortality.The expected benefits (e.g., the number of lives saved) of early detection exceed the risks and costs.
+### End"
+303,"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 psoriasis except, with the following options: A: Acanthosis, B: Koebner phenomenon, C: Auspitz sign, D: Civatte bodies
+
+### Response:
+","Civatte bodies ( apoptotic bodies derived from keratinocytes at dermal-epidermal junction) are seen in lichen planus. Acanthosis (epidermal skin thickening), Auspitz's sign (Scaling that bleeds when removed), Koebner's phenomenon (new lesions at sight of minor injury) are seen in psoriasis. Koebner's phenomenon also seen in True Koebner response Psoriasis Vitiligo Halo naevus Lichen planus Pseudo-Koebner response (characterised by the appearance of similar skin lesions at the site of injury in infective lesions) Molluscum contagiosum Pyoderma gangrenosum Was Ref Harrison 20th edition pg 1123","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 psoriasis except, with the following options: A: Acanthosis, B: Koebner phenomenon, C: Auspitz sign, D: Civatte bodies
+
+### Response:
+Civatte bodies ( apoptotic bodies derived from keratinocytes at dermal-epidermal junction) are seen in lichen planus. Acanthosis (epidermal skin thickening), Auspitz's sign (Scaling that bleeds when removed), Koebner's phenomenon (new lesions at sight of minor injury) are seen in psoriasis. Koebner's phenomenon also seen in True Koebner response Psoriasis Vitiligo Halo naevus Lichen planus Pseudo-Koebner response (characterised by the appearance of similar skin lesions at the site of injury in infective lesions) Molluscum contagiosum Pyoderma gangrenosum Was Ref Harrison 20th edition pg 1123
+### End"
+304,"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 'target lesion' in stomach is:, with the following options: A: Melanoma, B: Carcinoid, C: Lymphoma, D: Fibroma
+
+### Response:
+",Ans. 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 cause of 'target lesion' in stomach is:, with the following options: A: Melanoma, B: Carcinoid, C: Lymphoma, D: Fibroma
+
+### Response:
+Ans. Melanoma
+### End"
+305,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Feature of delirium -, with the following options: A: Altered sleep, B: Diorientation, C: Autonomicdisturbanes, D: All of the above
+
+### Response:
+","Clinical features of delirium
+
+ Delirium has an acute onset and rapid progress. The clinical features of delirium are : -
+
+1. Abnormalities of consciousness: - The most conspicuous feature is a clouding of consciousness which ranges from mild dulling to deep coma.
+2. Cognitive impairment: - Confusion or disorientation particularly to me and next to place and occasionally to person. Poor concentration, intention, altered sensorium and disturbances of memory are seen. There is impairment of immediate and recent memory, remote memory is normal.
+3. Perceptual anomalies : - Delirium is the most common cause of illusion. Hallucination, particularly visual are common.
+4. Emotional disturbances: - Most commonly it is fear, followed by anxiety. Less commonly euphoria, apathy or depression may occur. Mood constantly fluctuates, i.e., labile mood.
+5. Language disturbances: - Museum as well as rambling and incoherent speech.
+6. Psychomotor disturbances: - Hypo or hyperactivity, agitation.
+7. Disorder of sleep: - Sleep-wake rhythm is usually altered. Sleep is fragmented and disturbed by nightmares. Diurnal variation with sedation in the day me and restlessness at night (Sundowning) is common.
+8. Autonomic disturbances: - Tachycardia, sweating, tremors.
+9. Neurological signs : - Tremor, seizure, choreiform movements.
+10. Electroencephalography (EEG) : - The most typical finding is diffuse (generalized) slowing. Low voltage fast activity is seen if the delirium is due to the withdrawal of sedative drugs or alcohol.
+
+ All symptoms fluctuate in severity and rapidly with apparently normal periods (lucid intervals) in between.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Feature of delirium -, with the following options: A: Altered sleep, B: Diorientation, C: Autonomicdisturbanes, D: All of the above
+
+### Response:
+Clinical features of delirium
+
+ Delirium has an acute onset and rapid progress. The clinical features of delirium are : -
+
+1. Abnormalities of consciousness: - The most conspicuous feature is a clouding of consciousness which ranges from mild dulling to deep coma.
+2. Cognitive impairment: - Confusion or disorientation particularly to me and next to place and occasionally to person. Poor concentration, intention, altered sensorium and disturbances of memory are seen. There is impairment of immediate and recent memory, remote memory is normal.
+3. Perceptual anomalies : - Delirium is the most common cause of illusion. Hallucination, particularly visual are common.
+4. Emotional disturbances: - Most commonly it is fear, followed by anxiety. Less commonly euphoria, apathy or depression may occur. Mood constantly fluctuates, i.e., labile mood.
+5. Language disturbances: - Museum as well as rambling and incoherent speech.
+6. Psychomotor disturbances: - Hypo or hyperactivity, agitation.
+7. Disorder of sleep: - Sleep-wake rhythm is usually altered. Sleep is fragmented and disturbed by nightmares. Diurnal variation with sedation in the day me and restlessness at night (Sundowning) is common.
+8. Autonomic disturbances: - Tachycardia, sweating, tremors.
+9. Neurological signs : - Tremor, seizure, choreiform movements.
+10. Electroencephalography (EEG) : - The most typical finding is diffuse (generalized) slowing. Low voltage fast activity is seen if the delirium is due to the withdrawal of sedative drugs or alcohol.
+
+ All symptoms fluctuate in severity and rapidly with apparently normal periods (lucid intervals) in between.
+### End"
+306,"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 prognostic factor for acute pancreatitis?, with the following options: A: Hypocalcemia, B: Hyperglycemia, C: AST elevation, D: Increased serum amylase
+
+### Response:
+","The prognostic factors considered for predicting the severity of acute pancreatitis are : Aerial PaO2 less than 60 mmHg LDH more than 600 IU/L AST more than 200 IU/L WBC more than 15,000/mm3 Serum albumin less than 3.2gm/dl Serum calcium less than 8 mg/dl Blood glucose more than 180 mg/dl Blood urea more than 45 mg/dl Ref: Grading and Staging in Gastroenterology By Guido N. J. Tytgat, page 300.","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 prognostic factor for acute pancreatitis?, with the following options: A: Hypocalcemia, B: Hyperglycemia, C: AST elevation, D: Increased serum amylase
+
+### Response:
+The prognostic factors considered for predicting the severity of acute pancreatitis are : Aerial PaO2 less than 60 mmHg LDH more than 600 IU/L AST more than 200 IU/L WBC more than 15,000/mm3 Serum albumin less than 3.2gm/dl Serum calcium less than 8 mg/dl Blood glucose more than 180 mg/dl Blood urea more than 45 mg/dl Ref: Grading and Staging in Gastroenterology By Guido N. J. Tytgat, page 300.
+### End"
+307,"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 old girl with normal developmental milestones except that she staed speaking by the age of four. She does not play with other children and wants to eat, play and sleep in her own way. She often has temper tantrums related to any new changes. What is the likely diagnosis?, with the following options: A: ADHD, B: Autism, C: Specific learning disorder, D: Mental retardation
+
+### Response:
+","Autism is charecterised by a developmental delay in speech, communication difficulties, lack of social skills, difficulty in coping with change, rigid preferences and routines which is pervasive and persistent from childhood.","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 old girl with normal developmental milestones except that she staed speaking by the age of four. She does not play with other children and wants to eat, play and sleep in her own way. She often has temper tantrums related to any new changes. What is the likely diagnosis?, with the following options: A: ADHD, B: Autism, C: Specific learning disorder, D: Mental retardation
+
+### Response:
+Autism is charecterised by a developmental delay in speech, communication difficulties, lack of social skills, difficulty in coping with change, rigid preferences and routines which is pervasive and persistent from childhood.
+### End"
+308,"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 contaminant in a positive blood culture?, with the following options: A: Staphylococcus epidermidis, B: Bacteriodes, C: Candida, D: E.coli
+
+### Response:
+","Among the options provided common contaminant in positive blood culture is Staphylococcus epidermidis (Coagulase negative staphylococcus- CONS) followed by other normal skin flora (other bacteria like Propionibacterium spp) and Candida species.Ref: Ananthanarayan 9th edition, p 622","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 contaminant in a positive blood culture?, with the following options: A: Staphylococcus epidermidis, B: Bacteriodes, C: Candida, D: E.coli
+
+### Response:
+Among the options provided common contaminant in positive blood culture is Staphylococcus epidermidis (Coagulase negative staphylococcus- CONS) followed by other normal skin flora (other bacteria like Propionibacterium spp) and Candida species.Ref: Ananthanarayan 9th edition, p 622
+### End"
+309,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A female having carcinoma cervix stage IIIb. What is the treatment:-, with the following options: A: Weheims hysterectomy, B: Schauta's radical vaginal hysterectomy, C: Chemotherapy, D: Intracavitary brachytherapy with external beam radiotherapy
+
+### Response:
+","Rx of Cervical cancer NOTE: THERE IS NO ROLE OF SURGERY IN TREATMENT OF STAGE IIB AND ABOVE - Stage I - IIA - Surgical management: Radical Hysterectomy (aka type 3 hysterectomy) - Structures removed in radical hysterectomy are : Uterus, cervix, upper 1/3 - 1/2 of vagina, entire parametrium, uterine aery ligated at its origin from internal iliac aery, uterosacral ligament at most distal attachment (rectum) - Stage >= IIB - Chemoradiation - Radiotherapy alone is effective Rx in all stages. - Maximum radiation given at Point A 2cm above and 2 cm lateral to external os Ureter crosses the uterine aery (bridge over water) here ureter is under the uterine aery Parametrium seen here Upto 7500 to 8000 RADs given here Point B 3cm lateral to point B Obturator lymph nodes at the pelvis side walls Obturator lymph nodes -sentinel group of LN Upto 6000 RADS given here.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A female having carcinoma cervix stage IIIb. What is the treatment:-, with the following options: A: Weheims hysterectomy, B: Schauta's radical vaginal hysterectomy, C: Chemotherapy, D: Intracavitary brachytherapy with external beam radiotherapy
+
+### Response:
+Rx of Cervical cancer NOTE: THERE IS NO ROLE OF SURGERY IN TREATMENT OF STAGE IIB AND ABOVE - Stage I - IIA - Surgical management: Radical Hysterectomy (aka type 3 hysterectomy) - Structures removed in radical hysterectomy are : Uterus, cervix, upper 1/3 - 1/2 of vagina, entire parametrium, uterine aery ligated at its origin from internal iliac aery, uterosacral ligament at most distal attachment (rectum) - Stage >= IIB - Chemoradiation - Radiotherapy alone is effective Rx in all stages. - Maximum radiation given at Point A 2cm above and 2 cm lateral to external os Ureter crosses the uterine aery (bridge over water) here ureter is under the uterine aery Parametrium seen here Upto 7500 to 8000 RADs given here Point B 3cm lateral to point B Obturator lymph nodes at the pelvis side walls Obturator lymph nodes -sentinel group of LN Upto 6000 RADS given here.
+### End"
+310,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The differentiating feature b/w Ectopic ACTH secretion and Cushing syndrome is -, with the following options: A: Hypokalemic alkalosis, B: Clinical features of cushing syndrome, C: Hyperpigmentation, D: Hypeension
+
+### Response:
+",ectopic ACTH has no typical Cushing's signs & symptoms and hypokalemic alkalosis is the predominant manifestation ( Harrison 17 pg 2255),"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The differentiating feature b/w Ectopic ACTH secretion and Cushing syndrome is -, with the following options: A: Hypokalemic alkalosis, B: Clinical features of cushing syndrome, C: Hyperpigmentation, D: Hypeension
+
+### Response:
+ectopic ACTH has no typical Cushing's signs & symptoms and hypokalemic alkalosis is the predominant manifestation ( Harrison 17 pg 2255)
+### End"
+311,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: True about Bidutamide is?, with the following options: A: Binds to androgen receptor, B: Causes gynecomastia, C: It can be given as monotherapy in prostatic carcinoma, D: All are true
+
+### Response:
+","ANSWER: (D) All are trueREF: Cancer Chemotherapy and Biotherapy: Principles and Practice by bruce A. Chabner, Dan L. Longo Page 679, Goodman Gillman's 11th ed p. 1021ANDROGEN RECEPTOR ANTAGONISTS(Flutamide, Bicalutamide, and Nilutamide)* Bicalutamide is an oral non-steroidal anti-androgen used in the treatment of prostate cancer and hirsutism.It was first launched as a combination treatment (with surgical or medical castration) for advanced prostate cancer and subsequently launched as monotherapy for the treatment of earlier stages of the disease.Bicalutamide is a teratogen and must not be handled by females who are or may become pregnantAdverse reactions include reproductive system and breast disorders, breast tenderness, gynecomastia, hot flushes, gastrointestinal disorders, diarrhea, nausea, hepatic changes (elevated levels of transaminases, jaundice), asthenia and pruritus","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: True about Bidutamide is?, with the following options: A: Binds to androgen receptor, B: Causes gynecomastia, C: It can be given as monotherapy in prostatic carcinoma, D: All are true
+
+### Response:
+ANSWER: (D) All are trueREF: Cancer Chemotherapy and Biotherapy: Principles and Practice by bruce A. Chabner, Dan L. Longo Page 679, Goodman Gillman's 11th ed p. 1021ANDROGEN RECEPTOR ANTAGONISTS(Flutamide, Bicalutamide, and Nilutamide)* Bicalutamide is an oral non-steroidal anti-androgen used in the treatment of prostate cancer and hirsutism.It was first launched as a combination treatment (with surgical or medical castration) for advanced prostate cancer and subsequently launched as monotherapy for the treatment of earlier stages of the disease.Bicalutamide is a teratogen and must not be handled by females who are or may become pregnantAdverse reactions include reproductive system and breast disorders, breast tenderness, gynecomastia, hot flushes, gastrointestinal disorders, diarrhea, nausea, hepatic changes (elevated levels of transaminases, jaundice), asthenia and pruritus
+### End"
+312,"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 a cavitatory lesion in right upper lobe of lung. The best investigation is:, with the following options: A: Bronchoscopy, lavage and brushing, B: CT scan, C: X-ray, D: FNAC
+
+### Response:
+","Uses of bronchoscopy Diagnostic Confirmation of disease Carcinoma of the bronchus Inflammatory and infective process Investigative Tissue biopsy Preoperative assessment Before lung resection Before esophageal resection Persistent hemoptysis Therapeutic Removal of secretions Removal of foreign bodies Stent placement, endobronchial resection","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 a cavitatory lesion in right upper lobe of lung. The best investigation is:, with the following options: A: Bronchoscopy, lavage and brushing, B: CT scan, C: X-ray, D: FNAC
+
+### Response:
+Uses of bronchoscopy Diagnostic Confirmation of disease Carcinoma of the bronchus Inflammatory and infective process Investigative Tissue biopsy Preoperative assessment Before lung resection Before esophageal resection Persistent hemoptysis Therapeutic Removal of secretions Removal of foreign bodies Stent placement, endobronchial resection
+### End"
+313,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Right heart border is mainly formed by, with the following options: A: Right atrium, B: Superior vena cava, C: Right ventricle, D: Inferior vena cava
+
+### Response:
+","Right heart border: SVC, Rightatrium, Ivc mainly by Right atrium.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Right heart border is mainly formed by, with the following options: A: Right atrium, B: Superior vena cava, C: Right ventricle, D: Inferior vena cava
+
+### Response:
+Right heart border: SVC, Rightatrium, Ivc mainly by Right atrium.
+### End"
+314,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Not a cause of Gynaecomastia:, with the following options: A: INH, B: Cimetidine, C: Digitalis, D: Pyrazinamide
+
+### Response:
+",Pyrazinamide,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Not a cause of Gynaecomastia:, with the following options: A: INH, B: Cimetidine, C: Digitalis, D: Pyrazinamide
+
+### Response:
+Pyrazinamide
+### End"
+315,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Zero order kinetics occur in which of the following drug with high doses?, with the following options: A: Phenytoin and Propranolol, B: Digoxin and Propranolol, C: Amiloride and Probenecid, D: Lithium and Theophylline
+
+### Response:
+","When high doses of ceain drugs are given their mechanism of elimination gets saturated and elimination kinetics changes from first order to zero order. Examples of such drugs are phenytoin, propranolol, theophylline, salicylates, and tolbutamide. Drugs that obey zero order kinetics are phenytoin, salicylates, ethanol, furosemide and indomethacin. In zero order kinetics only a constant amount of drug is excreted rather than a constant percentage or propoion. For drugs exhibiting zero order kinetics small increments in dose may cause dispropoionately large increase in serum concentration. Clearance and t1/2 of the drug varies with concentration of the drug. I st order kinetics: In this type of elimination, a fixed fraction of the drug present in the body is eliminated in unit time. Most of the drugs follow this type of kinetics. It works within physiological limits until elimination mechanisms are saturated. Ref: Pharmacology ReCap 2.0 for Bachelor of Dentistry Students By Dr. J. G. Buch page 25. Pediatric Critical Care Medicine: Basic Science And Clinical Evidence edited by Derek S. Wheeler, page 163.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Zero order kinetics occur in which of the following drug with high doses?, with the following options: A: Phenytoin and Propranolol, B: Digoxin and Propranolol, C: Amiloride and Probenecid, D: Lithium and Theophylline
+
+### Response:
+When high doses of ceain drugs are given their mechanism of elimination gets saturated and elimination kinetics changes from first order to zero order. Examples of such drugs are phenytoin, propranolol, theophylline, salicylates, and tolbutamide. Drugs that obey zero order kinetics are phenytoin, salicylates, ethanol, furosemide and indomethacin. In zero order kinetics only a constant amount of drug is excreted rather than a constant percentage or propoion. For drugs exhibiting zero order kinetics small increments in dose may cause dispropoionately large increase in serum concentration. Clearance and t1/2 of the drug varies with concentration of the drug. I st order kinetics: In this type of elimination, a fixed fraction of the drug present in the body is eliminated in unit time. Most of the drugs follow this type of kinetics. It works within physiological limits until elimination mechanisms are saturated. Ref: Pharmacology ReCap 2.0 for Bachelor of Dentistry Students By Dr. J. G. Buch page 25. Pediatric Critical Care Medicine: Basic Science And Clinical Evidence edited by Derek S. Wheeler, page 163.
+### End"
+316,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: H pylori resists acidity of gastric content due to -, with the following options: A: Urease, B: Vacuolating cytotoxin, C: Secretion of alkaline contents, D: Cagpai
+
+### Response:
+","Ans. is 'a' i.e., Urease * H. pylori produces an exceptionally powerful urease, almost 100 times more active than that of proteus vulgaris, which is vital to its survival in the stomach.* Urease acts on urea to generate ammonia, which neutralizes acid around bacteria.Virulence and pathogenesis* Most H. Pylori colonized persons do not develop clinical sequelae. H. pylori is noninvasive, living in gastric mucus. Gastric antrum is the most common site of colonization.* H Pylori colonises stomach of half of human population in world: 30% in developed countries, and > 80% in developing countries (more prevalent in developing countries).* Following virulence factors have been identified1) Vacuolating cytotoxin (Vac A): It is associated with peptic ulcer.2) Cag Pal (cytotoxic associated gene or Cagpathogenicity island) : It encodes Cag A which is associated with peptic ulcer and gastric adenocarcinoma.3) Bab A: It is an adhesin and associated with increased gastric inflammation.4) Urease: H pylori splits urea rapidly to produce ammonia to survive.* Colonization of gastric antrum leads to depletion of somatostatin producing 'D' cells. This results in loss of inhibition of gastrin release and hypergastrinemia (normally somatostatin inhibits gastrin secretion).","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: H pylori resists acidity of gastric content due to -, with the following options: A: Urease, B: Vacuolating cytotoxin, C: Secretion of alkaline contents, D: Cagpai
+
+### Response:
+Ans. is 'a' i.e., Urease * H. pylori produces an exceptionally powerful urease, almost 100 times more active than that of proteus vulgaris, which is vital to its survival in the stomach.* Urease acts on urea to generate ammonia, which neutralizes acid around bacteria.Virulence and pathogenesis* Most H. Pylori colonized persons do not develop clinical sequelae. H. pylori is noninvasive, living in gastric mucus. Gastric antrum is the most common site of colonization.* H Pylori colonises stomach of half of human population in world: 30% in developed countries, and > 80% in developing countries (more prevalent in developing countries).* Following virulence factors have been identified1) Vacuolating cytotoxin (Vac A): It is associated with peptic ulcer.2) Cag Pal (cytotoxic associated gene or Cagpathogenicity island) : It encodes Cag A which is associated with peptic ulcer and gastric adenocarcinoma.3) Bab A: It is an adhesin and associated with increased gastric inflammation.4) Urease: H pylori splits urea rapidly to produce ammonia to survive.* Colonization of gastric antrum leads to depletion of somatostatin producing 'D' cells. This results in loss of inhibition of gastrin release and hypergastrinemia (normally somatostatin inhibits gastrin secretion).
+### End"
+317,"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 AIDS defining illness?, with the following options: A: Oropharynx candidiasis, B: CMV retinitis, C: Primary CNS lymphoma, D: Kaposi's sarcoma
+
+### Response:
+","Ans. (a) Orpharynx candidiasis Candidiasis of bronchi, trachea, lung, oesophagus comes under AIDS defining criteria. Infections listed in the AIDS surveillance case definition Candidiasis of bronchi, trachea, lungs, oesophagus Coccidioidomycosis, disseminated or extrapulmonary Cryptococcosis, extrapulmonary Cryptosporidiosis, chronic, intestinal (> 1 month's duration) Cytomegalovirus disease (other than liver, spleen, or nodes) Cytomegalovirus retinitis (with loss of vision) Encephalopathy, HIV-related Herpes simplex: chronic ulcer(s) (> 1 month's duration); orbronchitis, pneumonia, or esophagitis Disseminated or extrapulmonary histoplasmosis Isosporiasts, chronic intestinal (> 1 month's duration) Mycobacterium avium complex or M.kansosil, disseminated or extrapulmonary Mycobacterium tuberculosis, any site (pulmonarya or extrapulmonary) Mycobacterium, other species or unidentitled species, disseminated or extrapulmonary. Pneumonocystis jiroved pneumonia Salmonella septicemia, recurrent Toxoplasmosis of brain Wasting syndrome due to HIV","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 AIDS defining illness?, with the following options: A: Oropharynx candidiasis, B: CMV retinitis, C: Primary CNS lymphoma, D: Kaposi's sarcoma
+
+### Response:
+Ans. (a) Orpharynx candidiasis Candidiasis of bronchi, trachea, lung, oesophagus comes under AIDS defining criteria. Infections listed in the AIDS surveillance case definition Candidiasis of bronchi, trachea, lungs, oesophagus Coccidioidomycosis, disseminated or extrapulmonary Cryptococcosis, extrapulmonary Cryptosporidiosis, chronic, intestinal (> 1 month's duration) Cytomegalovirus disease (other than liver, spleen, or nodes) Cytomegalovirus retinitis (with loss of vision) Encephalopathy, HIV-related Herpes simplex: chronic ulcer(s) (> 1 month's duration); orbronchitis, pneumonia, or esophagitis Disseminated or extrapulmonary histoplasmosis Isosporiasts, chronic intestinal (> 1 month's duration) Mycobacterium avium complex or M.kansosil, disseminated or extrapulmonary Mycobacterium tuberculosis, any site (pulmonarya or extrapulmonary) Mycobacterium, other species or unidentitled species, disseminated or extrapulmonary. Pneumonocystis jiroved pneumonia Salmonella septicemia, recurrent Toxoplasmosis of brain Wasting syndrome due to HIV
+### End"
+318,"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 an elevated plasma thyroxine (T4) concentration, a low plasma TSH concentration, and her thyroid gland is smaller than normal. What is the most likely explanation for these findings?, with the following options: A: A lesion in the anterior pituitary that prevents TSH secretion, B: Graves' disease, C: The patient is taking propylthiouracil, D: The patient is taking thyroid extract
+
+### Response:
+","Regulation of Thyroid hormone synthesis: Option A: Decreased TSH will lead to decreased T4 Option B: in Grave's disease there is formation of thyroid-stimulating immunoglobulin (TSI), also known as long-acting thyroid stimulator (LATS), which is not subject to negative-feedback inhibition by thyroid hormone. Thus, T4 will be increased that will cause negative feedback inhibition of TSH (i.e. TSH will be decreased). Due to continuous stimulation of thyroid gland by LATS there will glandular hyperophy or goitre. Option C: Antithyroid substances (PTU = propylthiouracil; MMI= Methimazole) Propylthiouracil will decrease T4 concentration. Option D: Thyroid extract means patient is taking exogenous T3 and T4 hence increased T4 Increased T4 causes feedback inhibition of TSH hence decreased TSH which causes hypoplasia of gland . This is known as Wolff Chaikoff effect .","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 an elevated plasma thyroxine (T4) concentration, a low plasma TSH concentration, and her thyroid gland is smaller than normal. What is the most likely explanation for these findings?, with the following options: A: A lesion in the anterior pituitary that prevents TSH secretion, B: Graves' disease, C: The patient is taking propylthiouracil, D: The patient is taking thyroid extract
+
+### Response:
+Regulation of Thyroid hormone synthesis: Option A: Decreased TSH will lead to decreased T4 Option B: in Grave's disease there is formation of thyroid-stimulating immunoglobulin (TSI), also known as long-acting thyroid stimulator (LATS), which is not subject to negative-feedback inhibition by thyroid hormone. Thus, T4 will be increased that will cause negative feedback inhibition of TSH (i.e. TSH will be decreased). Due to continuous stimulation of thyroid gland by LATS there will glandular hyperophy or goitre. Option C: Antithyroid substances (PTU = propylthiouracil; MMI= Methimazole) Propylthiouracil will decrease T4 concentration. Option D: Thyroid extract means patient is taking exogenous T3 and T4 hence increased T4 Increased T4 causes feedback inhibition of TSH hence decreased TSH which causes hypoplasia of gland . This is known as Wolff Chaikoff effect .
+### End"
+319,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A multiparous woman delivered by a village dai (midwife) presents on the 22nd postnatal day with bleeding per vaginam with clost. On examination, the uterus is 14-16 weeks, the internal os is open, and there is bleeding through the os. The likely cause of this bleeding is -, with the following options: A: Excessive postnatal physical work, B: Perineal tears, C: Retained bits of placenta and membranes, D: None of the above
+
+### Response:
+",Ans-C,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A multiparous woman delivered by a village dai (midwife) presents on the 22nd postnatal day with bleeding per vaginam with clost. On examination, the uterus is 14-16 weeks, the internal os is open, and there is bleeding through the os. The likely cause of this bleeding is -, with the following options: A: Excessive postnatal physical work, B: Perineal tears, C: Retained bits of placenta and membranes, D: None of the above
+
+### Response:
+Ans-C
+### End"
+320,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: High or low fistula is ano is termed according to its internal opening present with reference to, with the following options: A: Anal canal, B: Dentate line, C: Anorectal ring, D: Sacral promontary
+
+### Response:
+","The anorectal ring marks the junction between the rectum and the anal canal. It is formed by the joining of the puborectalis muscle. the deep external sphincter, conjoined longitudinal muscle and the highest pa of the internal sphincter. The anorectal ring can be clearly felt digitally, especially on its posterior and lateral aspects. Ref: Bailey & Love&;s Sho Practice of Surgery,E25,Page-1240","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: High or low fistula is ano is termed according to its internal opening present with reference to, with the following options: A: Anal canal, B: Dentate line, C: Anorectal ring, D: Sacral promontary
+
+### Response:
+The anorectal ring marks the junction between the rectum and the anal canal. It is formed by the joining of the puborectalis muscle. the deep external sphincter, conjoined longitudinal muscle and the highest pa of the internal sphincter. The anorectal ring can be clearly felt digitally, especially on its posterior and lateral aspects. Ref: Bailey & Love&;s Sho Practice of Surgery,E25,Page-1240
+### End"
+321,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Characteristic symptom of asthma -, with the following options: A: Clubbing, B: Wheezing, C: Stridor, D: Bradycardia
+
+### Response:
+","Ans. is 'b' i.e., Wheezing Clinical manifestations of asthma Wheezing --> Mast characteristic of asthma Flaring of nostrils Fatigue Hyper-resonant chest In chronic cases chest becomes barrel shaped Cough Cyanosis Tachycardia Dysnea Apprension, restlessness Pulsus paradoxus Cardiac arrhythmias due to sever hypoxemia Intercostal and suprasternal retraction --> Excessive use of accessory muscles of respiration.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Characteristic symptom of asthma -, with the following options: A: Clubbing, B: Wheezing, C: Stridor, D: Bradycardia
+
+### Response:
+Ans. is 'b' i.e., Wheezing Clinical manifestations of asthma Wheezing --> Mast characteristic of asthma Flaring of nostrils Fatigue Hyper-resonant chest In chronic cases chest becomes barrel shaped Cough Cyanosis Tachycardia Dysnea Apprension, restlessness Pulsus paradoxus Cardiac arrhythmias due to sever hypoxemia Intercostal and suprasternal retraction --> Excessive use of accessory muscles of respiration.
+### End"
+322,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The most reliable fetal parameter for estimation of gestational age in first trimester is:, with the following options: A: Femur length, B: G sac diameter, C: CRL, D: BPD
+
+### Response:
+","Ans. C. CRLGestational age (GA) in the first trimester is usually calculated from the fetal crown-rump length (CRL). This is the longest demonstrable length of the embryo or fetus, excluding the limbs and the yolk sac. The correlation between CRL and GA is excellent until approximately 12 weeks. No sex or race differences are appreciable, but maternal characteristics, such as age and smoking, may have a significant effect beyond 10-week gestation. The GA estimate has a 95% confidence interval of plus or minus 6 days, and it is most accurate between 7 and 10 weeks of pregnancy. Transabdominal ultrasonography may underestimate gestational age by an average of 1.6 days compared with transvaginal ultrasonography.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The most reliable fetal parameter for estimation of gestational age in first trimester is:, with the following options: A: Femur length, B: G sac diameter, C: CRL, D: BPD
+
+### Response:
+Ans. C. CRLGestational age (GA) in the first trimester is usually calculated from the fetal crown-rump length (CRL). This is the longest demonstrable length of the embryo or fetus, excluding the limbs and the yolk sac. The correlation between CRL and GA is excellent until approximately 12 weeks. No sex or race differences are appreciable, but maternal characteristics, such as age and smoking, may have a significant effect beyond 10-week gestation. The GA estimate has a 95% confidence interval of plus or minus 6 days, and it is most accurate between 7 and 10 weeks of pregnancy. Transabdominal ultrasonography may underestimate gestational age by an average of 1.6 days compared with transvaginal ultrasonography.
+### End"
+323,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Paraxial mesoderm develops into, with the following options: A: Somites, B: Mesonephric duct, C: Notochord, D: All of the above
+
+### Response:
+","Human embryology Tenth edition Inderbier Singh Page no 62At first, the cells of paraxial mesoderm are homogeneously arranged later the mesoderm get segmented The segment are two categories somitomeres and somites","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Paraxial mesoderm develops into, with the following options: A: Somites, B: Mesonephric duct, C: Notochord, D: All of the above
+
+### Response:
+Human embryology Tenth edition Inderbier Singh Page no 62At first, the cells of paraxial mesoderm are homogeneously arranged later the mesoderm get segmented The segment are two categories somitomeres and somites
+### End"
+324,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: In near vision what is the change?, with the following options: A: Power of lens decreases, B: Depth of focus increases, C: Lateral recti contraction, D: Zonular tension increases
+
+### Response:
+","Ans. b. Depth of focus increasesThe most common problems developed in adults between ages 41 to 60 may to seeing clearly at close distances, especially when reading and working on the computer.This normal change in the eyes focusing ability, called presbyopia.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: In near vision what is the change?, with the following options: A: Power of lens decreases, B: Depth of focus increases, C: Lateral recti contraction, D: Zonular tension increases
+
+### Response:
+Ans. b. Depth of focus increasesThe most common problems developed in adults between ages 41 to 60 may to seeing clearly at close distances, especially when reading and working on the computer.This normal change in the eyes focusing ability, called presbyopia.
+### End"
+325,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The following drug is not helpful in the treatment of ectopic pregnancy:, with the following options: A: Methotrexate, B: Misoprostol, C: Actinomycin-D, D: RU486
+
+### Response:
+","Misoprostol (PGE1) has been used for cervical ripening which is used for induction of labour. It doesn't have any role in management of ectopic pregnancy. Ref:Text Book of Obstetrics By Dutta, 6th Edition, Pages 175, 189, 505","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The following drug is not helpful in the treatment of ectopic pregnancy:, with the following options: A: Methotrexate, B: Misoprostol, C: Actinomycin-D, D: RU486
+
+### Response:
+Misoprostol (PGE1) has been used for cervical ripening which is used for induction of labour. It doesn't have any role in management of ectopic pregnancy. Ref:Text Book of Obstetrics By Dutta, 6th Edition, Pages 175, 189, 505
+### End"
+326,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: An eleven year old boy is having Tinea capitis on his scalp. Which of the following is the most appropriate line of treatment of this condition?, with the following options: A: Shaving of the scalp, B: Oral griseofulvin therapy, C: Topical griseofulvin therapy, D: Selenium sulphide shampoo
+
+### Response:
+","Tinea capitis is the infection of skin of scalp and hair by fungi. Microsporium and Trichophyton tonsurans are the most common causative organisms. Oral Griseofulvin is the drug of choice for Tinea capitis. Other oral drugs which are useful includes ketoconazole, itraconazole and tebinafine. Ref: Oski's Essential Pediatrics By Michael Crocetti, 2nd Edition","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: An eleven year old boy is having Tinea capitis on his scalp. Which of the following is the most appropriate line of treatment of this condition?, with the following options: A: Shaving of the scalp, B: Oral griseofulvin therapy, C: Topical griseofulvin therapy, D: Selenium sulphide shampoo
+
+### Response:
+Tinea capitis is the infection of skin of scalp and hair by fungi. Microsporium and Trichophyton tonsurans are the most common causative organisms. Oral Griseofulvin is the drug of choice for Tinea capitis. Other oral drugs which are useful includes ketoconazole, itraconazole and tebinafine. Ref: Oski's Essential Pediatrics By Michael Crocetti, 2nd Edition
+### End"
+327,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Tyrosinosis is caused due to deficiency of which enzyme?, with the following options: A: Fumaryl acetoacetate hydrolase, B: p-hydroxy phenyl pyruvate dehydrogenase, C: Tyrosine transaminase, D: Tyrosine ligase
+
+### Response:
+","There are 3 Types of Tyrosinemia Disease Enzyme deficient / deficiency features Tyrosinemia type I or Tyrosinosis/ Hepatic renal Tyrosinemia/ Hereditary Tyrosinemia Fumaryl Aceto Acetate Hydrolase Most common Tyrosinemia Type II or Richner Hanha Syndrome aka occulo cutaneous Tyrosinemia Tyrosine Transminase Eyes and skin are involved. Tyrosinemia Type III or Neonatal Tyrosinemia Complete deficiency of PHPP (Para Hydroxy - Phenyl Pyruvate) Hydroxylase Paial deficiency, of PHPP Hydroxylase is called as Hawkinson Urea CATABOLISM OF PHENYL-ALANINE AND TYROSINE","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Tyrosinosis is caused due to deficiency of which enzyme?, with the following options: A: Fumaryl acetoacetate hydrolase, B: p-hydroxy phenyl pyruvate dehydrogenase, C: Tyrosine transaminase, D: Tyrosine ligase
+
+### Response:
+There are 3 Types of Tyrosinemia Disease Enzyme deficient / deficiency features Tyrosinemia type I or Tyrosinosis/ Hepatic renal Tyrosinemia/ Hereditary Tyrosinemia Fumaryl Aceto Acetate Hydrolase Most common Tyrosinemia Type II or Richner Hanha Syndrome aka occulo cutaneous Tyrosinemia Tyrosine Transminase Eyes and skin are involved. Tyrosinemia Type III or Neonatal Tyrosinemia Complete deficiency of PHPP (Para Hydroxy - Phenyl Pyruvate) Hydroxylase Paial deficiency, of PHPP Hydroxylase is called as Hawkinson Urea CATABOLISM OF PHENYL-ALANINE AND TYROSINE
+### End"
+328,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The nerve affected in carpal tunnel syndrome is -, with the following options: A: Radial nerve, B: Anterior Interosseus nerve, C: Superficial palmar branch of radial nerve, D: Median Nerve
+
+### Response:
+","Ans. is 'd' i.e., Median Nerve Entrapment neuropathiesi) Carpal tunnel:- Median nerve (carpal tunnel syndrome)ii) Cubital tunnel:- Ulnar nerve (cubital tunnel syndrome)iii) Guyon's canal:- Ulnar nerve (Guyan's canal syndrome)iv) Tarsal tunnel:- Posterior tibial nerve (Tarsal tunnel syndrome)v) Inguinal ligament:- Lateral cutaneous nerve of thigh (meralgia paraesthetica).vi) Suprascapular notch:- Suprascapular nervevii) Neck of fibula:- Common peroneal nerveviii) Fascial tunnel of superficial peroneal nerve:- Superficial peroneal nerveix) Arcase of Frohse:- Posterior interosseous syndromex) Thoracicoutlet:- Lower trunk of brachial plexusxi) Compression in the foot:- Digital nerve (Morten's metatarsalgia)","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The nerve affected in carpal tunnel syndrome is -, with the following options: A: Radial nerve, B: Anterior Interosseus nerve, C: Superficial palmar branch of radial nerve, D: Median Nerve
+
+### Response:
+Ans. is 'd' i.e., Median Nerve Entrapment neuropathiesi) Carpal tunnel:- Median nerve (carpal tunnel syndrome)ii) Cubital tunnel:- Ulnar nerve (cubital tunnel syndrome)iii) Guyon's canal:- Ulnar nerve (Guyan's canal syndrome)iv) Tarsal tunnel:- Posterior tibial nerve (Tarsal tunnel syndrome)v) Inguinal ligament:- Lateral cutaneous nerve of thigh (meralgia paraesthetica).vi) Suprascapular notch:- Suprascapular nervevii) Neck of fibula:- Common peroneal nerveviii) Fascial tunnel of superficial peroneal nerve:- Superficial peroneal nerveix) Arcase of Frohse:- Posterior interosseous syndromex) Thoracicoutlet:- Lower trunk of brachial plexusxi) Compression in the foot:- Digital nerve (Morten's metatarsalgia)
+### End"
+329,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Earliest phenotypic manifestation of Idiopathic hereditary hemochromatosis is :, with the following options: A: Post prandial increase in serum iron concentration, B: Elevated serum ferritin level, C: Slate grey pigmentation of skin, D: Increased transferrin saturation
+
+### Response:
+","Increased transferrin saturation Elevation in transferrin saturation is the earliest phenotypic manifestation of idiopathic hereditary hemochromatosisQ. Hereditary hemochromatosis is a common inherited single gene disorder. It is characterized by increased intestinal absorption of iron, with deposition of iron in multiple organs. Persons with hereditary hemochromatosis absorb only a few milligrams of iron each day in excess of need. Therefore, clinical manifestations often occur only after 40 years of age, when body iron stores have reached 15-40g (normally, the body stores approximately 4g of iron). In the past hereditary hemochromatosis was usually diagnosed at an advanced stage. The classical description was : ? - Cutaneous hyperpigmentation. - Diabetes mellitus - Cirrhosis Currently, most patients with newly diagnosed hereditary hemochromatosis are asymptomatic i.e., diagnosed at an early state when the patient is still asymptomatic. The shift towards earlier diagnosis is probably the result of including serum iron indices in the diagnosis. Such as : Serum iron - Serum iron binding capacity - % transferrin saturation and serum ferritin These are elevated in hemochromatosis long before the symptoms of hemochromatosis have developed. Therefore serum iron indices are used as screening test for the diagnosis of Heruochromatosis. A.Percent transferrin saturation Percent transferrin saturation is the earliest phenotypic marker of hereditary hemoehromatosisQ. ""It is the best screening test used for the diagnosis of hereditary hemochromatosis."" Biron binding capacity Now days iron binding capacity is being increasingly used as the screening test for the diagnosis of hereditary hemochromatosis. Many trials have proved that : Iron binding capacity is better than % transferrin saturation as a screening test, but its wide scale use has not been staed till now. C.Serum Ferritin Serum ferritin concentration is usually a good index of body iron stores. Serum ferritin is increased in most untreated patients with hemochromatosis. Asymptomatic or symptomatic family members with the disease have increased serum ferritin. But serum ferritin is not used as screening marker because its act as acute phase reactant and its level is increased in various inflammatory conditions. Besides that its level is also increased in alcoholic liver disease and other hepatocellular injury due to increased release from tissues. Confirmatory testing of hereditary hemochromatosis : Is done by genetic analysis, which is more reliable than determining iron content in liver biopsies. Hereditary hemochromatosis is associated with mutations in the HFE genee. Between 60-93 percent of patients with this disorder are homozygous for mutation designated C282Ye. Liver biopsy is also done to assess if liver fibrosis is present or not.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Earliest phenotypic manifestation of Idiopathic hereditary hemochromatosis is :, with the following options: A: Post prandial increase in serum iron concentration, B: Elevated serum ferritin level, C: Slate grey pigmentation of skin, D: Increased transferrin saturation
+
+### Response:
+Increased transferrin saturation Elevation in transferrin saturation is the earliest phenotypic manifestation of idiopathic hereditary hemochromatosisQ. Hereditary hemochromatosis is a common inherited single gene disorder. It is characterized by increased intestinal absorption of iron, with deposition of iron in multiple organs. Persons with hereditary hemochromatosis absorb only a few milligrams of iron each day in excess of need. Therefore, clinical manifestations often occur only after 40 years of age, when body iron stores have reached 15-40g (normally, the body stores approximately 4g of iron). In the past hereditary hemochromatosis was usually diagnosed at an advanced stage. The classical description was : ? - Cutaneous hyperpigmentation. - Diabetes mellitus - Cirrhosis Currently, most patients with newly diagnosed hereditary hemochromatosis are asymptomatic i.e., diagnosed at an early state when the patient is still asymptomatic. The shift towards earlier diagnosis is probably the result of including serum iron indices in the diagnosis. Such as : Serum iron - Serum iron binding capacity - % transferrin saturation and serum ferritin These are elevated in hemochromatosis long before the symptoms of hemochromatosis have developed. Therefore serum iron indices are used as screening test for the diagnosis of Heruochromatosis. A.Percent transferrin saturation Percent transferrin saturation is the earliest phenotypic marker of hereditary hemoehromatosisQ. ""It is the best screening test used for the diagnosis of hereditary hemochromatosis."" Biron binding capacity Now days iron binding capacity is being increasingly used as the screening test for the diagnosis of hereditary hemochromatosis. Many trials have proved that : Iron binding capacity is better than % transferrin saturation as a screening test, but its wide scale use has not been staed till now. C.Serum Ferritin Serum ferritin concentration is usually a good index of body iron stores. Serum ferritin is increased in most untreated patients with hemochromatosis. Asymptomatic or symptomatic family members with the disease have increased serum ferritin. But serum ferritin is not used as screening marker because its act as acute phase reactant and its level is increased in various inflammatory conditions. Besides that its level is also increased in alcoholic liver disease and other hepatocellular injury due to increased release from tissues. Confirmatory testing of hereditary hemochromatosis : Is done by genetic analysis, which is more reliable than determining iron content in liver biopsies. Hereditary hemochromatosis is associated with mutations in the HFE genee. Between 60-93 percent of patients with this disorder are homozygous for mutation designated C282Ye. Liver biopsy is also done to assess if liver fibrosis is present or not.
+### End"
+330,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: For hysteroscopy, following are/is used, with the following options: A: Distilled Water, B: Air, C: Glycine, D: O2
+
+### Response:
+","Distending Media Uterine cavity is distended with a media to seperate the uterine walls and have a panoramic view during hysteroscopy CO2: Commonly used for diagnostic purposes. It is solouble in blood and is safe Glycine1.5%: Excellent visualisation, hyperosmolar Mannitol 5%+ Glycine 2.2% Normal saline D.C.DUTTA&;S TEXTBOOK OF GYNECOLOGY; 6th edition; Pg no:620","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: For hysteroscopy, following are/is used, with the following options: A: Distilled Water, B: Air, C: Glycine, D: O2
+
+### Response:
+Distending Media Uterine cavity is distended with a media to seperate the uterine walls and have a panoramic view during hysteroscopy CO2: Commonly used for diagnostic purposes. It is solouble in blood and is safe Glycine1.5%: Excellent visualisation, hyperosmolar Mannitol 5%+ Glycine 2.2% Normal saline D.C.DUTTA&;S TEXTBOOK OF GYNECOLOGY; 6th edition; Pg no:620
+### End"
+331,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The intercostal drainage tube is inseed in the, with the following options: A: 5th intercostal space in the midaxillary line, B: 3rd intercostal space in the midaxillary line, C: 4th intercostal space in the anterior axillary line, D: 9th intercostal space in the midclavicular line
+
+### Response:
+","Answer- A. 5th intercostal space in the midaxillary lineSafe triangle of icd inseionAnterior border of latissimus dorsi.Lateral border ofpectoralis major.Horizontal line superior to the nipple.Horizontal line inferior to axilla.More specifcally, the tube is inseed into the 46 or 5th intercostal space slightly anterior to the mid axillary line","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The intercostal drainage tube is inseed in the, with the following options: A: 5th intercostal space in the midaxillary line, B: 3rd intercostal space in the midaxillary line, C: 4th intercostal space in the anterior axillary line, D: 9th intercostal space in the midclavicular line
+
+### Response:
+Answer- A. 5th intercostal space in the midaxillary lineSafe triangle of icd inseionAnterior border of latissimus dorsi.Lateral border ofpectoralis major.Horizontal line superior to the nipple.Horizontal line inferior to axilla.More specifcally, the tube is inseed into the 46 or 5th intercostal space slightly anterior to the mid axillary line
+### End"
+332,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Abdominal surgery under LA, patient suddenly felt pain due to, with the following options: A: Liver, B: Gut, C: Parietal peritoneum, D: Visceralperitoneum
+
+### Response:
+",".pas of peritoneum mainly includes 1. Parietal peritoneum: It lines the inner surface of the abdominal wall, under surface of diaphragm and pelvic wall. It is loosely attached to the overlying walls and can be easily stripped off. It is innervated by the somatic nerves, so pain sensitive. Anterior peritoneum is most sensitive when compared to pelvic peritoneum. 2. Visceral peritoneum: It lines the outer surface of the abdominal viscera, firmly adherent, cannot be stripped off. It is innervated by autonomic nervous system; hence not pain sensitive. ref:SRB&;s manual of surgery,ed 3,pg no 498","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Abdominal surgery under LA, patient suddenly felt pain due to, with the following options: A: Liver, B: Gut, C: Parietal peritoneum, D: Visceralperitoneum
+
+### Response:
+.pas of peritoneum mainly includes 1. Parietal peritoneum: It lines the inner surface of the abdominal wall, under surface of diaphragm and pelvic wall. It is loosely attached to the overlying walls and can be easily stripped off. It is innervated by the somatic nerves, so pain sensitive. Anterior peritoneum is most sensitive when compared to pelvic peritoneum. 2. Visceral peritoneum: It lines the outer surface of the abdominal viscera, firmly adherent, cannot be stripped off. It is innervated by autonomic nervous system; hence not pain sensitive. ref:SRB&;s manual of surgery,ed 3,pg no 498
+### End"
+333,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: FAD-linked dehydrogenase is, with the following options: A: Isocitrate dehydrogenase, B: Pyruvate dehydrogenase, C: Succinate dehydrogenase, D: Enoyl reductase
+
+### Response:
+","Succinate dehydrogenase or succinate-coenzyme Q reductase (SQR) or respiratory Complex II is an enzyme complex, found in many bacterial cells and in the inner mitochondrial membrane of mammalian mitochondria. It is the only enzyme that paicipates in both the citric acid cycle and the electron transpo together. In step 6 of the citric acid cycle, SQR catalyzes the oxidation of succinate to fumarate with the reduction of ubiquinone to ubiquinol. This occurs in the inner mitochondrial membrane by coupling the two reactions together. Little is known about the exact succinate oxidation mechanism. However, the crystal structure shows that FAD, Glu255, Arg286, and His242 of subunit A are good candidates for the initial deprotonation step. Thereafter, there are two possible elimination mechanisms: E2 or E1cb. In the E2 elimination, the mechanism is conceed. The basic residue or cofactor deprotonates the alpha carbon, and FAD accepts the hydride from the beta carbon, oxidizing the bound succinate to fumarate--refer to image 6. In E1cb, an enolate intermediate is formed, shown in image 7, before FAD accepts the hydride. Fuher research is required to determine which elimination mechanism succinate undergoes in Succinate Dehydrogenase. Oxidized fumarate, now loosely bound to the active site, is free to exit the protein.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: FAD-linked dehydrogenase is, with the following options: A: Isocitrate dehydrogenase, B: Pyruvate dehydrogenase, C: Succinate dehydrogenase, D: Enoyl reductase
+
+### Response:
+Succinate dehydrogenase or succinate-coenzyme Q reductase (SQR) or respiratory Complex II is an enzyme complex, found in many bacterial cells and in the inner mitochondrial membrane of mammalian mitochondria. It is the only enzyme that paicipates in both the citric acid cycle and the electron transpo together. In step 6 of the citric acid cycle, SQR catalyzes the oxidation of succinate to fumarate with the reduction of ubiquinone to ubiquinol. This occurs in the inner mitochondrial membrane by coupling the two reactions together. Little is known about the exact succinate oxidation mechanism. However, the crystal structure shows that FAD, Glu255, Arg286, and His242 of subunit A are good candidates for the initial deprotonation step. Thereafter, there are two possible elimination mechanisms: E2 or E1cb. In the E2 elimination, the mechanism is conceed. The basic residue or cofactor deprotonates the alpha carbon, and FAD accepts the hydride from the beta carbon, oxidizing the bound succinate to fumarate--refer to image 6. In E1cb, an enolate intermediate is formed, shown in image 7, before FAD accepts the hydride. Fuher research is required to determine which elimination mechanism succinate undergoes in Succinate Dehydrogenase. Oxidized fumarate, now loosely bound to the active site, is free to exit the protein.
+### End"
+334,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Binswanger disease is a form of?, with the following options: A: Hypertensive retinopathy, B: Hypertensive nephropathy, C: Hypertensive encephalopathy, D: subcortical leukoencephalopathy
+
+### Response:
+","Ans. (d) Subcortical leukoencephalopathy(Ref: International Neurology textbook pg 12)Binswanger's disease (also known as subcortical leukoencephalopathy), also called subcortical vascular dementia, is a type of dementia caused by widespread, microscopic areas of damage to the deep layers of white matter in the brain Hypertension and old age are risk factors.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Binswanger disease is a form of?, with the following options: A: Hypertensive retinopathy, B: Hypertensive nephropathy, C: Hypertensive encephalopathy, D: subcortical leukoencephalopathy
+
+### Response:
+Ans. (d) Subcortical leukoencephalopathy(Ref: International Neurology textbook pg 12)Binswanger's disease (also known as subcortical leukoencephalopathy), also called subcortical vascular dementia, is a type of dementia caused by widespread, microscopic areas of damage to the deep layers of white matter in the brain Hypertension and old age are risk factors.
+### End"
+335,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Commonest type of ca breast is :, with the following options: A: Papillary ca, B: Pagets disease, C: Fibrasorcoma, D: Infiltrative ductal ca
+
+### Response:
+","Ans. is 'd' ie Infiltrative Ductal ca Almost all breast malignancies are adenocarcinomas, all other types (i.e. squamous cell Ca, phylloides tumors, sarcomas, and lymphomas are rareThey are divided into two types ductal and lobular types each of which are further two types carcinoma in situ & invasive type.Ductal carcinomas arise from epithelium lining the ducts and lobular arises from the epithelium of the acini forming lobules.Infiltrative ductal Ca is the most common type of breast Ca.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Commonest type of ca breast is :, with the following options: A: Papillary ca, B: Pagets disease, C: Fibrasorcoma, D: Infiltrative ductal ca
+
+### Response:
+Ans. is 'd' ie Infiltrative Ductal ca Almost all breast malignancies are adenocarcinomas, all other types (i.e. squamous cell Ca, phylloides tumors, sarcomas, and lymphomas are rareThey are divided into two types ductal and lobular types each of which are further two types carcinoma in situ & invasive type.Ductal carcinomas arise from epithelium lining the ducts and lobular arises from the epithelium of the acini forming lobules.Infiltrative ductal Ca is the most common type of breast Ca.
+### End"
+336,"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 Histoplasma capsulatum ?, with the following options: A: Dimorphic fungus, B: May mimic TB, C: Capsulated, D: Mostly asymptomic
+
+### Response:
+","Ans. is 'c' i.e., Capsulated Histoplasma capsulatum A dimorphic fungus Non encapsulated - The only medically impoant capsulated fungus is cryptococcus. Infection is acquired by inhalation of microconidia (small spores) in dust contaminated with bird or bat dropping. It causes intracellular infection of reticuloendothelial system. Clinical manifestations - Majority of patients are asymptomatic","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 Histoplasma capsulatum ?, with the following options: A: Dimorphic fungus, B: May mimic TB, C: Capsulated, D: Mostly asymptomic
+
+### Response:
+Ans. is 'c' i.e., Capsulated Histoplasma capsulatum A dimorphic fungus Non encapsulated - The only medically impoant capsulated fungus is cryptococcus. Infection is acquired by inhalation of microconidia (small spores) in dust contaminated with bird or bat dropping. It causes intracellular infection of reticuloendothelial system. Clinical manifestations - Majority of patients are asymptomatic
+### End"
+337,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A 23-year-old woman undergoes total thyroidectomy for carcinoma of the thyroid gland. On the second postoperative day, she begins to complain of a tingling sensation in her hands. She appears quite anxious and later complains of muscle cramps. Which of the following is the most appropriate initial management strategy?, with the following options: A: 10 mL of 10% magnesium sulfate intravenously, B: Oral vitamin D, C: 100 mg oral Synthroid, D: Continuous infusion of calcium gluconate
+
+### Response:
+","Intravenous calcium infusion is the treatment for severe, symptomatic hypocalcemia, although, typically, oral calcium supplementation (up to 1-2 g every 4 hours) is sufficient in patients with mild symptoms. Since postthyroidectomy hypocalcemia is usually due to transient ischemia of the parathyroid glands and is self-limited, in most cases the problem is resolved in several days. In cases of persistent hypocalcemia, vitamin D preparations may be necessary. There is no role for thyroid hormone replacement or magnesium sulfate in the treatment of hypocalcemia.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A 23-year-old woman undergoes total thyroidectomy for carcinoma of the thyroid gland. On the second postoperative day, she begins to complain of a tingling sensation in her hands. She appears quite anxious and later complains of muscle cramps. Which of the following is the most appropriate initial management strategy?, with the following options: A: 10 mL of 10% magnesium sulfate intravenously, B: Oral vitamin D, C: 100 mg oral Synthroid, D: Continuous infusion of calcium gluconate
+
+### Response:
+Intravenous calcium infusion is the treatment for severe, symptomatic hypocalcemia, although, typically, oral calcium supplementation (up to 1-2 g every 4 hours) is sufficient in patients with mild symptoms. Since postthyroidectomy hypocalcemia is usually due to transient ischemia of the parathyroid glands and is self-limited, in most cases the problem is resolved in several days. In cases of persistent hypocalcemia, vitamin D preparations may be necessary. There is no role for thyroid hormone replacement or magnesium sulfate in the treatment of hypocalcemia.
+### End"
+338,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A 32-year-old male basketball player comes down hard on his ankle. He is admitted to the outpatient clinic, and radiographic examination reveals a Pott's fracture. What ligament is most likely injured?, with the following options: A: Calcaneofibular ligament, B: Deltoid ligament, C: Spring ligament, D: Plantar ligament
+
+### Response:
+","Pott's fracture is a rather archaic term for a fracture of the fibula at the ankle. The term is often used to indicate a bimalleolar fracture of fibula and tibia, perhaps with a tear in the medial collateral ligament, allowing the foot to be deviated laterally. (The medial malleolus will often break before the deltoid ligament tears.) This fracture is also known as Dupuytren's fracture. The fracture results from abduction and lateral rotation of the foot in extreme eversion. There can also be breaking of the posterior aspect of the distal tibia. The spring ligament, also known as the plantar calcaneonavicular ligament, extends from the calcaneus to the navicular bone and is a part of the medial longitudinal arch. This ligament would not be affected in eversion or inversion of the ankle. The plantar ligament, which is composed of the long and short plantar ligaments, supports the lateral longitudinal arch of the foot and would therefore not be affected by inversion or eversion of the foot. The calcaneofibular ligament runs from the calcaneus to the fibula. It would be injured during inversion of the foot, not in eversion, as is the case in a Pott fracture.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A 32-year-old male basketball player comes down hard on his ankle. He is admitted to the outpatient clinic, and radiographic examination reveals a Pott's fracture. What ligament is most likely injured?, with the following options: A: Calcaneofibular ligament, B: Deltoid ligament, C: Spring ligament, D: Plantar ligament
+
+### Response:
+Pott's fracture is a rather archaic term for a fracture of the fibula at the ankle. The term is often used to indicate a bimalleolar fracture of fibula and tibia, perhaps with a tear in the medial collateral ligament, allowing the foot to be deviated laterally. (The medial malleolus will often break before the deltoid ligament tears.) This fracture is also known as Dupuytren's fracture. The fracture results from abduction and lateral rotation of the foot in extreme eversion. There can also be breaking of the posterior aspect of the distal tibia. The spring ligament, also known as the plantar calcaneonavicular ligament, extends from the calcaneus to the navicular bone and is a part of the medial longitudinal arch. This ligament would not be affected in eversion or inversion of the ankle. The plantar ligament, which is composed of the long and short plantar ligaments, supports the lateral longitudinal arch of the foot and would therefore not be affected by inversion or eversion of the foot. The calcaneofibular ligament runs from the calcaneus to the fibula. It would be injured during inversion of the foot, not in eversion, as is the case in a Pott fracture.
+### End"
+339,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Corpus luteum secretes, with the following options: A: Progesterone, B: Oestrogen, C: Inhibin, D: All of the above
+
+### Response:
+","D. i.e. (All of the above) (80 - Dutta 4th) (28 - 29- Shaw14th)* Predominantly progesterone is secreted by the corpus luteum to support the endometrium of the luteal phase. There is also secretion of oestrogen, inhibin and relaxin*** Progesterone along with oestrogen from corpus luteum maintains the growth of the fertilized ovum* Corpus luteum reaches maximum maturity by the 22nd day of the normal cycle (2 cm or more)* Corpus luteal fluid contains - Phospholipids, cholesterol and carotene (yellow colour - Lutein) *** The regression is attributed to fall in LH and rise in the level of oestrogen and PGF2 a**Corpus luteum of pregnancy* There is surge of hyperplasia of all the layers between 23rd to 28th day due to chorionic gonadotrophin, hCG like LH will stimulate corpus luteum to secrete progesterone* The corpus luteum of pregnancy is functionally active upto the 10 to 12th week in human beings**","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Corpus luteum secretes, with the following options: A: Progesterone, B: Oestrogen, C: Inhibin, D: All of the above
+
+### Response:
+D. i.e. (All of the above) (80 - Dutta 4th) (28 - 29- Shaw14th)* Predominantly progesterone is secreted by the corpus luteum to support the endometrium of the luteal phase. There is also secretion of oestrogen, inhibin and relaxin*** Progesterone along with oestrogen from corpus luteum maintains the growth of the fertilized ovum* Corpus luteum reaches maximum maturity by the 22nd day of the normal cycle (2 cm or more)* Corpus luteal fluid contains - Phospholipids, cholesterol and carotene (yellow colour - Lutein) *** The regression is attributed to fall in LH and rise in the level of oestrogen and PGF2 a**Corpus luteum of pregnancy* There is surge of hyperplasia of all the layers between 23rd to 28th day due to chorionic gonadotrophin, hCG like LH will stimulate corpus luteum to secrete progesterone* The corpus luteum of pregnancy is functionally active upto the 10 to 12th week in human beings**
+### End"
+340,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Most common muscle damaged in rotator cuff is, with the following options: A: Supraspinatus, B: Infraspinatus, C: Subsacapularis, D: Teres minor
+
+### Response:
+","Refer Williams Vil 1.p 330 The tendons of the rotator cuff, not the muscle are most commonly involved and of the four, The supraspinatus us effected most frequently as it passes below the acromian","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Most common muscle damaged in rotator cuff is, with the following options: A: Supraspinatus, B: Infraspinatus, C: Subsacapularis, D: Teres minor
+
+### Response:
+Refer Williams Vil 1.p 330 The tendons of the rotator cuff, not the muscle are most commonly involved and of the four, The supraspinatus us effected most frequently as it passes below the acromian
+### End"
+341,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Cataract is caused by al! except:, with the following options: A: Ultraviolet radiation, B: M RI, C: Infrared radiation, D: Microwave radiation
+
+### Response:
+",Ans. M RI,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Cataract is caused by al! except:, with the following options: A: Ultraviolet radiation, B: M RI, C: Infrared radiation, D: Microwave radiation
+
+### Response:
+Ans. M RI
+### End"
+342,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Cerebral blood flow is depend on, with the following options: A: O2 concentration, B: CO2 concentration, C: K+ concentration, D: Cl- concentration
+
+### Response:
+","i.e. (CO2 concentration): (441- Lee's) (376-77-AK-Jain 4th/anaesthesia 12th)Cerebral blood flow increases in linearity with rise in arterial PC02 (Direct effect)Cerebral blood flow (CBF) is the difference between mean arterial pressure and intracranial pressure or central venous pressure which ever is higher.It is 50 mi/100 gm of brain tissueSince ions are not able to cross the blood brain barrier as easily as O2, O2 and lipid soluble substances (such as most anaesthetics) the ions have little effects on cerebral blood flowFactors affecting cerebral blood flow (CBF)A. Cerebral metabolism - cerebral blood flow varies directly with metabolic activity, various studies have shown that regional CBF parallels metabolic activity for eg motor activity of a limb is associated with an increased in regional CBF of the corresponding motor cortex. Similarily, visual activity is associated with an increase in regional CBF of the corresponding occipital cortex.B. Cerebral Perfusion pressure: is the difference between mean arterial pressure (MAP) and intracranial pressure (ICP) or central venous pressure (CVP) which ever is greater CPP is normally 80-100 mm Hg. Because ICP is normally less than 10 mm Hg. CPP is primarily dependent on MAP. Autoregulation maintains a steady CBF as perfusion pressure varies between 60 and 160 mm Hg. Decrease in CPP results in cerebral vasodilation, where as elevations induce vasoconstriction.C. Arterial PCO2 - The most important extrinsic influences on CBF are respiratory gas tensions particularly arterial PCO2. CBF is directly proportional to arterial PCO2 between tensions of 20 and 80 mm of Hg. The effect is almost immediates and is thought to be secondary to changes in the PH of CSF and cerebral tissueD. Arterial PO2: only marked changes in arterial PO2 alter CBF whereas hypoxia may be associated with only minimal decrease (-10%) in CBF severe hypoxemia (arterial PO2 less than 50 mm Hg) profoundly increases CBFE. Temperature - CBF changes 5 - 7% 1degC change in temperature. Hypothermia decreases both cerebral metabolic rate and CBF. Whereas pyrexia has the reverse effect.F. Blood viscosity - CBF rises as viscosity falls and vise versaG. Autonomic system* Cerebral blood flow is maintained at constant levels (does not change) in response to moderate exercise)**** Mild to moderate decrease in perfusion pressure decreases driving forces for flow, resulting in CO2 accumulation, which by release of H+ produces cerebral vasodilation.* Most important factor for regulating cerebral blood flow under normal conditions is the rate of cerebral CO2formation.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Cerebral blood flow is depend on, with the following options: A: O2 concentration, B: CO2 concentration, C: K+ concentration, D: Cl- concentration
+
+### Response:
+i.e. (CO2 concentration): (441- Lee's) (376-77-AK-Jain 4th/anaesthesia 12th)Cerebral blood flow increases in linearity with rise in arterial PC02 (Direct effect)Cerebral blood flow (CBF) is the difference between mean arterial pressure and intracranial pressure or central venous pressure which ever is higher.It is 50 mi/100 gm of brain tissueSince ions are not able to cross the blood brain barrier as easily as O2, O2 and lipid soluble substances (such as most anaesthetics) the ions have little effects on cerebral blood flowFactors affecting cerebral blood flow (CBF)A. Cerebral metabolism - cerebral blood flow varies directly with metabolic activity, various studies have shown that regional CBF parallels metabolic activity for eg motor activity of a limb is associated with an increased in regional CBF of the corresponding motor cortex. Similarily, visual activity is associated with an increase in regional CBF of the corresponding occipital cortex.B. Cerebral Perfusion pressure: is the difference between mean arterial pressure (MAP) and intracranial pressure (ICP) or central venous pressure (CVP) which ever is greater CPP is normally 80-100 mm Hg. Because ICP is normally less than 10 mm Hg. CPP is primarily dependent on MAP. Autoregulation maintains a steady CBF as perfusion pressure varies between 60 and 160 mm Hg. Decrease in CPP results in cerebral vasodilation, where as elevations induce vasoconstriction.C. Arterial PCO2 - The most important extrinsic influences on CBF are respiratory gas tensions particularly arterial PCO2. CBF is directly proportional to arterial PCO2 between tensions of 20 and 80 mm of Hg. The effect is almost immediates and is thought to be secondary to changes in the PH of CSF and cerebral tissueD. Arterial PO2: only marked changes in arterial PO2 alter CBF whereas hypoxia may be associated with only minimal decrease (-10%) in CBF severe hypoxemia (arterial PO2 less than 50 mm Hg) profoundly increases CBFE. Temperature - CBF changes 5 - 7% 1degC change in temperature. Hypothermia decreases both cerebral metabolic rate and CBF. Whereas pyrexia has the reverse effect.F. Blood viscosity - CBF rises as viscosity falls and vise versaG. Autonomic system* Cerebral blood flow is maintained at constant levels (does not change) in response to moderate exercise)**** Mild to moderate decrease in perfusion pressure decreases driving forces for flow, resulting in CO2 accumulation, which by release of H+ produces cerebral vasodilation.* Most important factor for regulating cerebral blood flow under normal conditions is the rate of cerebral CO2formation.
+### End"
+343,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Not glucogenic is, with the following options: A: Acetyl CoA, B: Lactate, C: Glycerol, D: Oxaloacetate
+
+### Response:
+","CLASSIFICATION OF AMINO ACIDS BASED ON METABOLISM - A. Purely Ketogenic - Leucine is purely ketogenic because it is conveed to ketone bodies. B. Ketogenic and Glucogenic - Lysine, Isoleucine, Phenylalanine, Tyrosine and Tryptophan are paially ketogenic and paially glucogenic. How ever in humans lysine is predominantly ketogenic. During metabolism, pa of the carbon skeleton of these amino acids will enter the ketogenic pathway and the other pa to glucogenic pathway. C. Purely Glucogenic - All the remaining 14 amino acids are purely glucogenic as they enter only into the glucogenic pathway. the glucogenic amino acids are: Alanine Arginine Asparagine Aspaic acid Cysteine Glutamic acid Glutamine Glycine Histidine Methionine Proline Serine Valine. PNEMONIC TO REMEMBER ESSENTIAL AMINO ACIDS -""Any Help In Learning These Little Molecules Proves Truely Valuable"" This stands for Arginine, Histidine, Isoleucine, Leucine, Threonine, Lysine, Methionine, Phenylalanine, Tryptophan and Valine in that order. Arginine and Histidine are semi-essential amino acids; while others are essential. REF:DM VASUDEVAN TEXTBOOK OF BIOCHEMISTRY,EIGHTH EDITION,PG.NO.,26,27.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Not glucogenic is, with the following options: A: Acetyl CoA, B: Lactate, C: Glycerol, D: Oxaloacetate
+
+### Response:
+CLASSIFICATION OF AMINO ACIDS BASED ON METABOLISM - A. Purely Ketogenic - Leucine is purely ketogenic because it is conveed to ketone bodies. B. Ketogenic and Glucogenic - Lysine, Isoleucine, Phenylalanine, Tyrosine and Tryptophan are paially ketogenic and paially glucogenic. How ever in humans lysine is predominantly ketogenic. During metabolism, pa of the carbon skeleton of these amino acids will enter the ketogenic pathway and the other pa to glucogenic pathway. C. Purely Glucogenic - All the remaining 14 amino acids are purely glucogenic as they enter only into the glucogenic pathway. the glucogenic amino acids are: Alanine Arginine Asparagine Aspaic acid Cysteine Glutamic acid Glutamine Glycine Histidine Methionine Proline Serine Valine. PNEMONIC TO REMEMBER ESSENTIAL AMINO ACIDS -""Any Help In Learning These Little Molecules Proves Truely Valuable"" This stands for Arginine, Histidine, Isoleucine, Leucine, Threonine, Lysine, Methionine, Phenylalanine, Tryptophan and Valine in that order. Arginine and Histidine are semi-essential amino acids; while others are essential. REF:DM VASUDEVAN TEXTBOOK OF BIOCHEMISTRY,EIGHTH EDITION,PG.NO.,26,27.
+### End"
+344,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Widal test is a type of, with the following options: A: Slide agglutination test, B: Tube agglutination test, C: CFT, D: Ring precipitation test
+
+### Response:
+","Tube dilution agglutination test (Widal test): Serum agglutinins rise sharply during the second and third weeks of S serotype Typhi infection. The Widal test to detect these antibodies against the O and H antigens has been in use for decades. At least two serum specimens, obtained at intervals of 7-10 days, are needed to prove a rise in antibody titer. Serial dilutions of unknown sera are tested against antigens from representative salmonellae. The interpretive criteria when single serum specimens are tested vary, but a titer against the O antigen of greater than 1:320 and against the H antigen of greater than 1:640 is considered positive.Ref: Jawetz Medical Microbiology; Chapter15 Enteric Gram-Negative Rods (Enterobacteriaceae); Page no: 241","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Widal test is a type of, with the following options: A: Slide agglutination test, B: Tube agglutination test, C: CFT, D: Ring precipitation test
+
+### Response:
+Tube dilution agglutination test (Widal test): Serum agglutinins rise sharply during the second and third weeks of S serotype Typhi infection. The Widal test to detect these antibodies against the O and H antigens has been in use for decades. At least two serum specimens, obtained at intervals of 7-10 days, are needed to prove a rise in antibody titer. Serial dilutions of unknown sera are tested against antigens from representative salmonellae. The interpretive criteria when single serum specimens are tested vary, but a titer against the O antigen of greater than 1:320 and against the H antigen of greater than 1:640 is considered positive.Ref: Jawetz Medical Microbiology; Chapter15 Enteric Gram-Negative Rods (Enterobacteriaceae); Page no: 241
+### End"
+345,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Endemic ascitis is associated with the following aEUR', with the following options: A: Pyrrolizidine, B: Aflatoxin, C: Sanguinarine, D: Beta oxalylamino alanine (BOAA)
+
+### Response:
+","Pyrrolizidine Repeat from Nov 06 Endemic ascites is caused by a hepatotoxin - pyrrolizidine alkaloid found in weed seeds of Crotolaria (Jhunjhunia). These weed seeds of Jhunjhunia contaminate the millet seeds Panicum milare (locally k/a Gondhli) Endemic ascites presented in Sarguja district of Madhya Pradesh during 1973 & 1976 as outbreak of rapidly developing ascites and jaundice with high moality. Preventive measures - educating the people - deweeding of Jhunjhunia plants which grow along with the staple food-millet. - sieving to separate out the Jhunjhunia seeds from millet seeds. Other food toxicant diseases: Neurolathyrism - caused by toxin Beta oxalyl amino alanine (BOAA) found in seeds of pulse Lathyrus sativum (Khersari dal) Epidemic dropsy - caused by toxic alkaloid Sanguinarine found in argemone mexicana seeds. Argemone oil contaminates mustard oil. Aflatoxicosis is due to ingestion of aflatoxins produced by ceain fungi, Aspergillus flavus and A. parasiticus. Aflatoxins are hepatotoxins & also carcinogenic.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Endemic ascitis is associated with the following aEUR', with the following options: A: Pyrrolizidine, B: Aflatoxin, C: Sanguinarine, D: Beta oxalylamino alanine (BOAA)
+
+### Response:
+Pyrrolizidine Repeat from Nov 06 Endemic ascites is caused by a hepatotoxin - pyrrolizidine alkaloid found in weed seeds of Crotolaria (Jhunjhunia). These weed seeds of Jhunjhunia contaminate the millet seeds Panicum milare (locally k/a Gondhli) Endemic ascites presented in Sarguja district of Madhya Pradesh during 1973 & 1976 as outbreak of rapidly developing ascites and jaundice with high moality. Preventive measures - educating the people - deweeding of Jhunjhunia plants which grow along with the staple food-millet. - sieving to separate out the Jhunjhunia seeds from millet seeds. Other food toxicant diseases: Neurolathyrism - caused by toxin Beta oxalyl amino alanine (BOAA) found in seeds of pulse Lathyrus sativum (Khersari dal) Epidemic dropsy - caused by toxic alkaloid Sanguinarine found in argemone mexicana seeds. Argemone oil contaminates mustard oil. Aflatoxicosis is due to ingestion of aflatoxins produced by ceain fungi, Aspergillus flavus and A. parasiticus. Aflatoxins are hepatotoxins & also carcinogenic.
+### End"
+346,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: In aeep transverse arrest inu delivery of baby is conducted by :, with the following options: A: Cesarean section, B: Vacuum extraction, C: Keilland forcep and Manual rotation and forcep delivery both, D: All
+
+### Response:
+","Ans. is a, b, c and d i.e. Cesarean section; Vaccum extraction; Keilland forcep; and Manual rotation and forcep delivery In case of occipto posterior position if paial anterior rotation occurs the head is arrested with the sagittal suture in the transverse diameter at the level of the ischial spines, after full dilatation of the cervix in spite of good uterine contractions. This condition is called as Deep Transverse Arrest. It occurs more commonly in android pelvis. Ventouse Ideal in all cases Manual rotation & If the obstetrician is well versed with this technique manual rotation followed by forceps application forceps application can be done Forceps rotation & Under general anaesthesia Keilland's forceps are used for rotation and delivery delivery in deep transverse arrest. Cesarean section If the pelvis is android or there is CPD, cesarean section should be done. In modern obstetrics, traumatic vaginal delivery causing intracranial hemorrhage is to be avoided at all costs and so there is increasing use of cesarean section for deep transverse arrest. Craniotomy If the baby is dead. Note : In most centres now a days, either cesarean section or vaccum extraction is performed, due to lack of experience in forceps rotation and manual rotation. It is extremely impoant to remember that if vaccum or forceps fails, no attempt should be made to persist with vaginal delivery. The procedure should be abandoned and immediate cesarean section undeaken. In late and neglected cases if the fetus is dead, craniotomy is an option in experienced hands. However, now days most obstetricians would prefer to perform cesarean section in cases of obstructed labour, even when the fetus is dead.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: In aeep transverse arrest inu delivery of baby is conducted by :, with the following options: A: Cesarean section, B: Vacuum extraction, C: Keilland forcep and Manual rotation and forcep delivery both, D: All
+
+### Response:
+Ans. is a, b, c and d i.e. Cesarean section; Vaccum extraction; Keilland forcep; and Manual rotation and forcep delivery In case of occipto posterior position if paial anterior rotation occurs the head is arrested with the sagittal suture in the transverse diameter at the level of the ischial spines, after full dilatation of the cervix in spite of good uterine contractions. This condition is called as Deep Transverse Arrest. It occurs more commonly in android pelvis. Ventouse Ideal in all cases Manual rotation & If the obstetrician is well versed with this technique manual rotation followed by forceps application forceps application can be done Forceps rotation & Under general anaesthesia Keilland's forceps are used for rotation and delivery delivery in deep transverse arrest. Cesarean section If the pelvis is android or there is CPD, cesarean section should be done. In modern obstetrics, traumatic vaginal delivery causing intracranial hemorrhage is to be avoided at all costs and so there is increasing use of cesarean section for deep transverse arrest. Craniotomy If the baby is dead. Note : In most centres now a days, either cesarean section or vaccum extraction is performed, due to lack of experience in forceps rotation and manual rotation. It is extremely impoant to remember that if vaccum or forceps fails, no attempt should be made to persist with vaginal delivery. The procedure should be abandoned and immediate cesarean section undeaken. In late and neglected cases if the fetus is dead, craniotomy is an option in experienced hands. However, now days most obstetricians would prefer to perform cesarean section in cases of obstructed labour, even when the fetus is dead.
+### End"
+347,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Spiegel berg criteria is for -, with the following options: A: Cervix, B: Fallopian Tubes, C: Ovaries, D: Uterus
+
+### Response:
+","Ans. is 'c' i.e., Ovaries Spiegel berg criteria are used for the diagnosis of ovarian ectopic pregnancy. Criteria is as followso Tube on the affected side must be intacto Gestational sac must be in the position of ovary,o Gestational sac is connected to uterus by ovarian ligament,o The ovarian tissue must be found on its wall on histological examination.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Spiegel berg criteria is for -, with the following options: A: Cervix, B: Fallopian Tubes, C: Ovaries, D: Uterus
+
+### Response:
+Ans. is 'c' i.e., Ovaries Spiegel berg criteria are used for the diagnosis of ovarian ectopic pregnancy. Criteria is as followso Tube on the affected side must be intacto Gestational sac must be in the position of ovary,o Gestational sac is connected to uterus by ovarian ligament,o The ovarian tissue must be found on its wall on histological examination.
+### End"
+348,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Common organisms causinh sinusitis:, with the following options: A: pseudomonas, B: Moraxella catarrhalis, C: Streptococcus pneumoniae, D: H.influenza
+
+### Response:
+","according to scott Brown 7/e,p 1441 M/C Organism causing sinusitis in adults is also Streptococcus pneumoniae followed by H.influenza. In childreb M/C is streptococcus pnuemonia followef by both H.influenza and moraxella catarrhalis.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Common organisms causinh sinusitis:, with the following options: A: pseudomonas, B: Moraxella catarrhalis, C: Streptococcus pneumoniae, D: H.influenza
+
+### Response:
+according to scott Brown 7/e,p 1441 M/C Organism causing sinusitis in adults is also Streptococcus pneumoniae followed by H.influenza. In childreb M/C is streptococcus pnuemonia followef by both H.influenza and moraxella catarrhalis.
+### End"
+349,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Du Bois sign seen in syphilis is:, with the following options: A: Shortening of the little finger, B: Small patches are seen on the back, C: Tightening of the fingers, D: All of the above
+
+### Response:
+","According to the current literature, the term ""du Bois sign"" characterizes the condition of a shortened fifth finger as a symptom of congenital syphilis.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Du Bois sign seen in syphilis is:, with the following options: A: Shortening of the little finger, B: Small patches are seen on the back, C: Tightening of the fingers, D: All of the above
+
+### Response:
+According to the current literature, the term ""du Bois sign"" characterizes the condition of a shortened fifth finger as a symptom of congenital syphilis.
+### End"
+350,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Which drug is contraindicated in pregnancy ?, with the following options: A: Methyldopa, B: Hydralazine, C: Captopril, D: All of the above
+
+### Response:
+",Captopril,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Which drug is contraindicated in pregnancy ?, with the following options: A: Methyldopa, B: Hydralazine, C: Captopril, D: All of the above
+
+### Response:
+Captopril
+### End"
+351,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Function of UGA codon -, with the following options: A: Initiates transcription, B: Translates, C: Terminates protein synthesis, D: None
+
+### Response:
+","Ans. is 'c' i.e., Terminates protein synthesis o Termination (stop/nonsense) codons signal to terminate the translation. These are 3 stop codons UAA, UGA and UAGo Initiation codon - AUGo Stop codons (termination codons or nonsense codons) - UAA, UGA, UA G","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Function of UGA codon -, with the following options: A: Initiates transcription, B: Translates, C: Terminates protein synthesis, D: None
+
+### Response:
+Ans. is 'c' i.e., Terminates protein synthesis o Termination (stop/nonsense) codons signal to terminate the translation. These are 3 stop codons UAA, UGA and UAGo Initiation codon - AUGo Stop codons (termination codons or nonsense codons) - UAA, UGA, UA G
+### End"
+352,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: If anterior cruciate ligament is broken the tibia moves?, with the following options: A: Medial to femur, B: Lateral to femur, C: Forward on femur, D: Backward on femur
+
+### Response:
+","ANSWER: (C) Forward on femurREF: Snell's 8th ed ch:10Anterior Cruciate Ligament: The anterior cruciate ligament is attached to the anterior intercondylar area of the tibia and passes upward, backward, and laterally, to be attached to the posterior part of the medial surface of the lateral femoral condyle. The anterior cruciate ligament prevents posterior displacement of the femur on the tibia. With the knee joint flexed, the anterior cruciate ligament prevents the tibia from being pulled anteriorly.Posterior Cruciate Ligament: The posterior cruciate ligament is attached to the posterior intercondylar area of the tibia and passes upward, forward, and medially to be attached to the anterior part of the lateral surface of the medial femoral condyle. The posterior cruciate ligament prevents anterior displacement of the femur on the tibia. With the knee joint flexed, the posterior cruciate ligament prevents the tibia from being pulled posteriorly.Injury to the cruciate ligaments can occur when excessive force is applied to the knee joint.Tears of the anterior cruciate ligament are common : Examination of patients with a ruptured anterior cruciate ligament showrs that the tibia can be pulled excessively forward on the femurTears of the posterior cruciate ligament are rare. With rupture of the posterior cruciate ligament, the tibia can be made to move excessively backward on the femur","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: If anterior cruciate ligament is broken the tibia moves?, with the following options: A: Medial to femur, B: Lateral to femur, C: Forward on femur, D: Backward on femur
+
+### Response:
+ANSWER: (C) Forward on femurREF: Snell's 8th ed ch:10Anterior Cruciate Ligament: The anterior cruciate ligament is attached to the anterior intercondylar area of the tibia and passes upward, backward, and laterally, to be attached to the posterior part of the medial surface of the lateral femoral condyle. The anterior cruciate ligament prevents posterior displacement of the femur on the tibia. With the knee joint flexed, the anterior cruciate ligament prevents the tibia from being pulled anteriorly.Posterior Cruciate Ligament: The posterior cruciate ligament is attached to the posterior intercondylar area of the tibia and passes upward, forward, and medially to be attached to the anterior part of the lateral surface of the medial femoral condyle. The posterior cruciate ligament prevents anterior displacement of the femur on the tibia. With the knee joint flexed, the posterior cruciate ligament prevents the tibia from being pulled posteriorly.Injury to the cruciate ligaments can occur when excessive force is applied to the knee joint.Tears of the anterior cruciate ligament are common : Examination of patients with a ruptured anterior cruciate ligament showrs that the tibia can be pulled excessively forward on the femurTears of the posterior cruciate ligament are rare. With rupture of the posterior cruciate ligament, the tibia can be made to move excessively backward on the femur
+### End"
+353,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: b-blockers act in glaucoma by -, with the following options: A: Decreased aqueous production, B: Increased aqueous outflow, C: Reduce vitreous volume, D: None
+
+### Response:
+","Ans. is 'a' i.e., Decreased aqueous production Mechanism of action of pharmacological agents in POAGAgentMechanism of actiono b-blocker (Timolol. Betaxolol, levobunolol, carteolol)o Decreased aqueous secretion from ciliary epitheliumo Prostaglandins (latanoprost, bimatoprost, travoprost)o Increased uveosclerai aqueous outflowo Alpha agonists # Non-selective (Epinephrine, Dipivefrine)# Selective a-2 (Aprocionidine, Brimonidme)Increased uveosclerai aqueous outflow.Decreased aqueous secretiono Carbonic anhydrase inhibitors (Dorzolamide, Brinzolamide, Acetazolamide)o Decreased aqueous secretion due to lack of HCOt""o Cholinomimetics (Pilocarpine, physostigmine. carbachot, echothiphate)o Increased aqueous outflow due to opening of trabecular meshwork due to ciliary muscle contractiono Hyperosmotic agents (Mannitol, glycerol)o Reduce vitreous volume and deepen anterior chamber","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: b-blockers act in glaucoma by -, with the following options: A: Decreased aqueous production, B: Increased aqueous outflow, C: Reduce vitreous volume, D: None
+
+### Response:
+Ans. is 'a' i.e., Decreased aqueous production Mechanism of action of pharmacological agents in POAGAgentMechanism of actiono b-blocker (Timolol. Betaxolol, levobunolol, carteolol)o Decreased aqueous secretion from ciliary epitheliumo Prostaglandins (latanoprost, bimatoprost, travoprost)o Increased uveosclerai aqueous outflowo Alpha agonists # Non-selective (Epinephrine, Dipivefrine)# Selective a-2 (Aprocionidine, Brimonidme)Increased uveosclerai aqueous outflow.Decreased aqueous secretiono Carbonic anhydrase inhibitors (Dorzolamide, Brinzolamide, Acetazolamide)o Decreased aqueous secretion due to lack of HCOt""o Cholinomimetics (Pilocarpine, physostigmine. carbachot, echothiphate)o Increased aqueous outflow due to opening of trabecular meshwork due to ciliary muscle contractiono Hyperosmotic agents (Mannitol, glycerol)o Reduce vitreous volume and deepen anterior chamber
+### End"
+354,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Most impoant factor in the convergence of light rays on the retina is, with the following options: A: Length of eye ball, B: Dioptre power of lens, C: Centre of lens, D: Cornea
+
+### Response:
+",The total dioptric power of the eye is about +60 D out of which about +44 D is contributed by the cornea and +16 D by the crystalline lens. The human eye is spherical and its internal pas are transparent so that the maximum amount of light can reach the retina. The cornea surrounds and protects the eye. It is made of transparent gel-like material that helps converge light rays onto the retina. Khurana 4e pg: 26,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Most impoant factor in the convergence of light rays on the retina is, with the following options: A: Length of eye ball, B: Dioptre power of lens, C: Centre of lens, D: Cornea
+
+### Response:
+The total dioptric power of the eye is about +60 D out of which about +44 D is contributed by the cornea and +16 D by the crystalline lens. The human eye is spherical and its internal pas are transparent so that the maximum amount of light can reach the retina. The cornea surrounds and protects the eye. It is made of transparent gel-like material that helps converge light rays onto the retina. Khurana 4e pg: 26
+### End"
+355,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Which among the following drug is safest in a patient allergic to penicillin:, with the following options: A: Cephalexin, B: Imipennem, C: Cefepime, D: Aztreonam
+
+### Response:
+",Aztreonam,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Which among the following drug is safest in a patient allergic to penicillin:, with the following options: A: Cephalexin, B: Imipennem, C: Cefepime, D: Aztreonam
+
+### Response:
+Aztreonam
+### End"
+356,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A drug having 40% absorption and hepatic extraction ratio of 0.6. What is the bioavailability of that drug?, with the following options: A: 16%, B: 24%, C: 20%, D: 28%
+
+### Response:
+","Ans. is 'a' i.e., 16% Absoion of drug is 40% i. e. if 100 mg of drug is taken 40 mg will be absorbed. Hepatic extraction ratio is 0.6 i.e. out of the absorbed dose 60% will be removed by liver; so from the absorbed 40 mg 60% removed i. e. 24 mg removed. Thus finally the remaining 16 mg of the total dose taken reaches the systemic circulation. So bioavailability is 16% as 16mg of the total 100 mg finally reached the systemic circulation","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A drug having 40% absorption and hepatic extraction ratio of 0.6. What is the bioavailability of that drug?, with the following options: A: 16%, B: 24%, C: 20%, D: 28%
+
+### Response:
+Ans. is 'a' i.e., 16% Absoion of drug is 40% i. e. if 100 mg of drug is taken 40 mg will be absorbed. Hepatic extraction ratio is 0.6 i.e. out of the absorbed dose 60% will be removed by liver; so from the absorbed 40 mg 60% removed i. e. 24 mg removed. Thus finally the remaining 16 mg of the total dose taken reaches the systemic circulation. So bioavailability is 16% as 16mg of the total 100 mg finally reached the systemic circulation
+### End"
+357,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: All are opioid agonist - antagonist compounds except – a) Buprenorphineb) Nalbuphinec) Pentazocined) Nalmefenee) Papaverine, with the following options: A: ab, B: bc, C: cd, D: de
+
+### Response:
+","Agonist antagonist opioids Pentazocine, Nalbuphine, Nalorphine, Butorphanol, Levallorphan, Dezocine, Meptazinol, Buprenorphine.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: All are opioid agonist - antagonist compounds except – a) Buprenorphineb) Nalbuphinec) Pentazocined) Nalmefenee) Papaverine, with the following options: A: ab, B: bc, C: cd, D: de
+
+### Response:
+Agonist antagonist opioids Pentazocine, Nalbuphine, Nalorphine, Butorphanol, Levallorphan, Dezocine, Meptazinol, Buprenorphine.
+### End"
+358,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The enzyme deficient in Galactosemia is:-, with the following options: A: Sphingomyelinase, B: Hexosaminidase, C: Galactose 1- phosphate uridyl transferase, D: Glucocerebrosidase
+
+### Response:
+","Most Common Galactosemia is Galactose 1- phosphate uridyl transferase (GALT) deficiency Galactose (Diet- from milk/milk products) | Galactokinase Galactose - 1- Phosphate | GALT UDP - Galactose | Epimerase UDP- Glucose Deficiency of any of the enzyme in galactose metabolism will lead to galactosemia Galactokinase deficiency: Minor type galactosemia Substrate galactose gets accumulated Galactose later gets reduced to Galactitol which causes Oil Drop Cataract GALT (Galactose - 1 - phosphate Uridyl transferase) deficiency: More common Leads to Classical type galactosemia Substrate galactose - 1 - phosphate gets accumulated in Liver and Brain | Leading to | Jaundice Hepatomegaly Mental retardation Oil drop cataract also occurs here because galactose-1-phosphate when gets accumulated inhibits galactokinase which leads to galactose accumulation Sphingomyelinase, Hexosaminidase and Glucocerebrosidase are all deficient in Sphingolipidoses","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The enzyme deficient in Galactosemia is:-, with the following options: A: Sphingomyelinase, B: Hexosaminidase, C: Galactose 1- phosphate uridyl transferase, D: Glucocerebrosidase
+
+### Response:
+Most Common Galactosemia is Galactose 1- phosphate uridyl transferase (GALT) deficiency Galactose (Diet- from milk/milk products) | Galactokinase Galactose - 1- Phosphate | GALT UDP - Galactose | Epimerase UDP- Glucose Deficiency of any of the enzyme in galactose metabolism will lead to galactosemia Galactokinase deficiency: Minor type galactosemia Substrate galactose gets accumulated Galactose later gets reduced to Galactitol which causes Oil Drop Cataract GALT (Galactose - 1 - phosphate Uridyl transferase) deficiency: More common Leads to Classical type galactosemia Substrate galactose - 1 - phosphate gets accumulated in Liver and Brain | Leading to | Jaundice Hepatomegaly Mental retardation Oil drop cataract also occurs here because galactose-1-phosphate when gets accumulated inhibits galactokinase which leads to galactose accumulation Sphingomyelinase, Hexosaminidase and Glucocerebrosidase are all deficient in Sphingolipidoses
+### End"
+359,"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 patient complains of lower teeth irregularities and wants to undergo orthodontic treatment without undergoing extractions. On examination, moderate lower incisor crowding was noted. Bolton’s analysis reveals an overall mandibular excess of 4 mm and anterior mandibular excess of 2 mm. Which of the following teeth can be selected for interproximal reduction in this patient?, with the following options: A: Upper anteriors, B: Lower anteriors, C: Upper posteriors, D: Lower anteriors and posteriors
+
+### Response:
+","Bolton’s analysis considers the ratio of the tooth material of the maxillary arch to the mandibular arch. The combined and individual widths of maxillary and mandibular teeth have a pre-determined proportion to maintain normal occlusion relationship. An alteration in this balance would lead to unsatisfactory occlusion. If there is a maxillary tooth material excess, then it would lead to a large overjet, whereas if there is a mandibular excess, it will lead to crowding or negative overjet.
+Clinical Application:
+
+Overall excess of 4 mm in the lower arch with a lower anterior excess of 4mm indicates stripping in the lower 3-3 region.
+Overall excess of 4 mm in the lower arch with normal ant ratio indicates stripping in the lower posteriors.
+Overall excess of 4 mm in the lower arch with a lower anterior excess of 2 mm indicates interproximal reduction in all the lower teeth.","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 patient complains of lower teeth irregularities and wants to undergo orthodontic treatment without undergoing extractions. On examination, moderate lower incisor crowding was noted. Bolton’s analysis reveals an overall mandibular excess of 4 mm and anterior mandibular excess of 2 mm. Which of the following teeth can be selected for interproximal reduction in this patient?, with the following options: A: Upper anteriors, B: Lower anteriors, C: Upper posteriors, D: Lower anteriors and posteriors
+
+### Response:
+Bolton’s analysis considers the ratio of the tooth material of the maxillary arch to the mandibular arch. The combined and individual widths of maxillary and mandibular teeth have a pre-determined proportion to maintain normal occlusion relationship. An alteration in this balance would lead to unsatisfactory occlusion. If there is a maxillary tooth material excess, then it would lead to a large overjet, whereas if there is a mandibular excess, it will lead to crowding or negative overjet.
+Clinical Application:
+
+Overall excess of 4 mm in the lower arch with a lower anterior excess of 4mm indicates stripping in the lower 3-3 region.
+Overall excess of 4 mm in the lower arch with normal ant ratio indicates stripping in the lower posteriors.
+Overall excess of 4 mm in the lower arch with a lower anterior excess of 2 mm indicates interproximal reduction in all the lower teeth.
+### End"
+360,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Dry wine is:, with the following options: A: Methylated spirit, B: Methyl alcohol, C: Isopropyle alcohol, D: Chloral hydrate
+
+### Response:
+",D i.e. Chloral Hydrate,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Dry wine is:, with the following options: A: Methylated spirit, B: Methyl alcohol, C: Isopropyle alcohol, D: Chloral hydrate
+
+### Response:
+D i.e. Chloral Hydrate
+### End"
+361,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Calcium is absorbed from:, with the following options: A: Duodenum, B: Jejunum, C: Ileum, D: Colon
+
+### Response:
+","All the divalent cations, except Mg++ , are absorbed from duodenum. Mg++ is absorbed from ileum. Calcium is absorbed mainly in duodenum and upper jejunum, not whole of jejunum.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Calcium is absorbed from:, with the following options: A: Duodenum, B: Jejunum, C: Ileum, D: Colon
+
+### Response:
+All the divalent cations, except Mg++ , are absorbed from duodenum. Mg++ is absorbed from ileum. Calcium is absorbed mainly in duodenum and upper jejunum, not whole of jejunum.
+### End"
+362,"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 beta adrenergic agonist is used as an aerosol for treatment of bronchial asthma?, with the following options: A: Salbutamol, B: Ketotifen, C: Fluticasone, D: Monteleukast
+
+### Response:
+","Ans: a (Salbutamol) Ref: KDT, 5 ed, p. 217Salbutamol (albuterol) is a highly selective beta 2 agonist.Inhaled salbutamol produces bronchodilation within 5 min and the action lasts for 2-4 hours.Drugs used tor bronchial asthma:Bronchodilators:a. Sympathomimetic-AdrenalineEphedrineIsoprenalinesalbutamolterbutalineb. Methylxanthines-Theophyllineaminophyllinec. Anticholinergics-AtropineIpratropium bromideTiotropium bromideLeukotriene antagonist:MonteleukastzafirleukastMast cell stabilizers:Sodium cromoglycateNedocromil, ketotifenLipoxygenase inhibitors:ZileutonPhosphodiesterase III/ IV inhibitor:PiclamelastCorticosteroids:a. Systemic-HydrocortisonePrednisoloneb. Inhalational-Beclomethesone dipropionateBudesonideFluticasone propionateFlunisolide","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 beta adrenergic agonist is used as an aerosol for treatment of bronchial asthma?, with the following options: A: Salbutamol, B: Ketotifen, C: Fluticasone, D: Monteleukast
+
+### Response:
+Ans: a (Salbutamol) Ref: KDT, 5 ed, p. 217Salbutamol (albuterol) is a highly selective beta 2 agonist.Inhaled salbutamol produces bronchodilation within 5 min and the action lasts for 2-4 hours.Drugs used tor bronchial asthma:Bronchodilators:a. Sympathomimetic-AdrenalineEphedrineIsoprenalinesalbutamolterbutalineb. Methylxanthines-Theophyllineaminophyllinec. Anticholinergics-AtropineIpratropium bromideTiotropium bromideLeukotriene antagonist:MonteleukastzafirleukastMast cell stabilizers:Sodium cromoglycateNedocromil, ketotifenLipoxygenase inhibitors:ZileutonPhosphodiesterase III/ IV inhibitor:PiclamelastCorticosteroids:a. Systemic-HydrocortisonePrednisoloneb. Inhalational-Beclomethesone dipropionateBudesonideFluticasone propionateFlunisolide
+### End"
+363,"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 choriocarcinoma is:, with the following options: A: Chemotherapy, B: External beam radiotherapy, C: Hysterectomy, D: Intracavitary brachytherapy
+
+### Response:
+","Ans. A. Chemotherapy* The treatment of choice of choriocarcinoma is mainly chemotherapy both for local and distal metastasis. The drug of choice for the same is methotrexate. It is given orally 5mg five times a day for 5 days. Side effects of Methotrexate are ulcerative stomatitis, gastric hemorrhage, skin reaction, alopecia, bone marrow suppression, Liver and Kidney damage.","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 choriocarcinoma is:, with the following options: A: Chemotherapy, B: External beam radiotherapy, C: Hysterectomy, D: Intracavitary brachytherapy
+
+### Response:
+Ans. A. Chemotherapy* The treatment of choice of choriocarcinoma is mainly chemotherapy both for local and distal metastasis. The drug of choice for the same is methotrexate. It is given orally 5mg five times a day for 5 days. Side effects of Methotrexate are ulcerative stomatitis, gastric hemorrhage, skin reaction, alopecia, bone marrow suppression, Liver and Kidney damage.
+### End"
+364,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Immediate precursor of acetoacetate, with the following options: A: HMG CoA, B: Acetoacetyl CoA, C: Acetyl CoA, D: Malonyl CoA
+
+### Response:
+","Immediate precursor of acetoacetate (ketone body) is HMG CoA, not Acetoacetyl CoA.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Immediate precursor of acetoacetate, with the following options: A: HMG CoA, B: Acetoacetyl CoA, C: Acetyl CoA, D: Malonyl CoA
+
+### Response:
+Immediate precursor of acetoacetate (ketone body) is HMG CoA, not Acetoacetyl CoA.
+### End"
+365,"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 are true about Wiskott Aldrich syndrome except:, with the following options: A: It is an autosomal recessive disorder, B: There is failure of aggregation of platelets in response to agonists, C: Thrombocytopenia is seen, D: Patient presents with eczema
+
+### Response:
+","Wiskott-Aldrich syndrome X-linked disease characterized by thrombocytopenia, eczema, and a marked vulnerability to recurrent infection, resulting in early death. There is progressive loss of T-lymphocytes in the peripheral blood and in the T-cell zones (paracoical areas) of the lymph nodes, with variable defects in cellular immunity. Patients do not make antibodies to polysaccharide antigens, and the response to protein antigens is poor. IgM levels in the serum are low, but levels of IgG are usually normal. Paradoxically the levels of IgA and IgE are often elevated. Rx:- Allogeneic hematopoietic stem cell transplant","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 are true about Wiskott Aldrich syndrome except:, with the following options: A: It is an autosomal recessive disorder, B: There is failure of aggregation of platelets in response to agonists, C: Thrombocytopenia is seen, D: Patient presents with eczema
+
+### Response:
+Wiskott-Aldrich syndrome X-linked disease characterized by thrombocytopenia, eczema, and a marked vulnerability to recurrent infection, resulting in early death. There is progressive loss of T-lymphocytes in the peripheral blood and in the T-cell zones (paracoical areas) of the lymph nodes, with variable defects in cellular immunity. Patients do not make antibodies to polysaccharide antigens, and the response to protein antigens is poor. IgM levels in the serum are low, but levels of IgG are usually normal. Paradoxically the levels of IgA and IgE are often elevated. Rx:- Allogeneic hematopoietic stem cell transplant
+### End"
+366,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Ovulation in a female with 38 day cycle is :, with the following options: A: 14th day, B: 8th day, C: 24th day, D: 30th day
+
+### Response:
+",24th day,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Ovulation in a female with 38 day cycle is :, with the following options: A: 14th day, B: 8th day, C: 24th day, D: 30th day
+
+### Response:
+24th day
+### End"
+367,"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 personality trait?, with the following options: A: Sensation seeking, B: Neuroticism, C: Openness to experience, D: Problem solving
+
+### Response:
+","There are 5 Personality traits(parameters)-Mnemonics- OCEAN Openness to experience(novelty seeking, sensation seeking) Conscientiousness(disciplined ,dutiful and organized) Extraversion(outspoken) Agreeableness(cooperative to others) Neuroticism(Tendency to experience negative emotions,emotional instability) Sensation seeking is apa of ""openness to experience"". Problem solving is not a personality trait.","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 personality trait?, with the following options: A: Sensation seeking, B: Neuroticism, C: Openness to experience, D: Problem solving
+
+### Response:
+There are 5 Personality traits(parameters)-Mnemonics- OCEAN Openness to experience(novelty seeking, sensation seeking) Conscientiousness(disciplined ,dutiful and organized) Extraversion(outspoken) Agreeableness(cooperative to others) Neuroticism(Tendency to experience negative emotions,emotional instability) Sensation seeking is apa of ""openness to experience"". Problem solving is not a personality trait.
+### End"
+368,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Cyanosis is seen in: March 2013, with the following options: A: VSD, B: TAPVC, C: VSD, D: PDA
+
+### Response:
+",Ans. B i.e. TAPVC,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Cyanosis is seen in: March 2013, with the following options: A: VSD, B: TAPVC, C: VSD, D: PDA
+
+### Response:
+Ans. B i.e. TAPVC
+### End"
+369,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Most common congenital anomaly of the larynx is:, with the following options: A: Laryngomalacia, B: Subglottic stenosis, C: Laryngeal web, D: Subglottic haemangioma
+
+### Response:
+",Laryngomalacia is the most common congenital laryngeal anomaly.This is followed by:(i). congenital vocal cord paralysis and(ii). congenital subglottic stenosis.,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Most common congenital anomaly of the larynx is:, with the following options: A: Laryngomalacia, B: Subglottic stenosis, C: Laryngeal web, D: Subglottic haemangioma
+
+### Response:
+Laryngomalacia is the most common congenital laryngeal anomaly.This is followed by:(i). congenital vocal cord paralysis and(ii). congenital subglottic stenosis.
+### End"
+370,"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 malignancy?, with the following options: A: Fragile X syndrome, B: Fanconi's syndrome, C: Down's syndrome, D: Bloom syndrome
+
+### Response:
+","Ans:A.)Fragile X Syndrome. Fragile X syndrome It is inherited in an X-linked dominant pattern. Symptoms often include mild to moderate intellectual disability. Physical features may include a long and narrow face, large ears, flexible fingers, and large testicles. About a third of people have features of autism such as problems with social interactions and delayed speech. Hyperactivity is common and seizures occur in about 10%. Males are usually more affected than females. Fragile X syndrome is typically due to an expansion of the CGG triplet repeat within the Fragile X mental retardation 1 (FMR1) gene on the X chromosome","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 malignancy?, with the following options: A: Fragile X syndrome, B: Fanconi's syndrome, C: Down's syndrome, D: Bloom syndrome
+
+### Response:
+Ans:A.)Fragile X Syndrome. Fragile X syndrome It is inherited in an X-linked dominant pattern. Symptoms often include mild to moderate intellectual disability. Physical features may include a long and narrow face, large ears, flexible fingers, and large testicles. About a third of people have features of autism such as problems with social interactions and delayed speech. Hyperactivity is common and seizures occur in about 10%. Males are usually more affected than females. Fragile X syndrome is typically due to an expansion of the CGG triplet repeat within the Fragile X mental retardation 1 (FMR1) gene on the X chromosome
+### End"
+371,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The OHI was developed to measure :, with the following options: A: The variations in gingival inflammation in relation to the degree of mental retardation in children., B: The number of gingival units affected rather than the severity of the inflammation., C: The accumulation of supra gingival calculus on the gingival third of the tooth or, more specifically, supragingival calculus along the margin of the gingiva., D: The presence and extent of debris accumulation, for evaluating tooth-brushing efficacy.
+
+### Response:
+","The Oral Hygiene Index (OHI) was developed in 1960 by John C. Greene and Jack R. Vermillion to classify and assess oral hygiene status.
+This index was developed to study variations in gingival inflammation in relation to the degree of mental retardation in children. It was depicted as a sensitive, simple and rapid method for assessing group or individual oral hygiene quantitatively.
+The papillary - marginal - attachment index (PMA index) was developed by Maury Massler and Schour I. in 1944.
+The basic philosophy used in the development of the PMA index was very similar to the DMF index, i.e, the number of gingival units affected were counted rather than the severity of the inflammation.
+The Marginal Line Calculus Index (MLCI) was developed by Muhlemann H.R. and Villa R in 1967. MLCI, is another index that is frequently used in short-term clinical trials (i.e less than 6 weeks) of anticalculus agents.
+This index was developed to assess the accumulation of supra gingival calculus on the gingival third of the tooth or, more specifically, supragingival calculus along the margin of the gingiva.
+The Glass Index system was developed by Glass R.L. in 1965. This index assesses the presence and extent of debris accumulation, for evaluating tooth-brushing efficacy.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The OHI was developed to measure :, with the following options: A: The variations in gingival inflammation in relation to the degree of mental retardation in children., B: The number of gingival units affected rather than the severity of the inflammation., C: The accumulation of supra gingival calculus on the gingival third of the tooth or, more specifically, supragingival calculus along the margin of the gingiva., D: The presence and extent of debris accumulation, for evaluating tooth-brushing efficacy.
+
+### Response:
+The Oral Hygiene Index (OHI) was developed in 1960 by John C. Greene and Jack R. Vermillion to classify and assess oral hygiene status.
+This index was developed to study variations in gingival inflammation in relation to the degree of mental retardation in children. It was depicted as a sensitive, simple and rapid method for assessing group or individual oral hygiene quantitatively.
+The papillary - marginal - attachment index (PMA index) was developed by Maury Massler and Schour I. in 1944.
+The basic philosophy used in the development of the PMA index was very similar to the DMF index, i.e, the number of gingival units affected were counted rather than the severity of the inflammation.
+The Marginal Line Calculus Index (MLCI) was developed by Muhlemann H.R. and Villa R in 1967. MLCI, is another index that is frequently used in short-term clinical trials (i.e less than 6 weeks) of anticalculus agents.
+This index was developed to assess the accumulation of supra gingival calculus on the gingival third of the tooth or, more specifically, supragingival calculus along the margin of the gingiva.
+The Glass Index system was developed by Glass R.L. in 1965. This index assesses the presence and extent of debris accumulation, for evaluating tooth-brushing efficacy.
+### End"
+372,"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 veins crosses perpendicularly the superficial surface of the sternocleidomastoid surface directly beneath the platysma muscle?, with the following options: A: Retromandibular, B: Anterior jugular, C: Posterior auricular, D: External jugular
+
+### Response:
+",The external jugular vein crosses perpendicularly the superficial surface of the sternocleidomastoid muscle directly under the platysma muscle. The anterior jugular descends near the median line. The posterior auricular joints the retromandibular to form the external jugular. The internal jugular runs in the carotid sheath deep to the sternocleidomastoid muscle.,"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 veins crosses perpendicularly the superficial surface of the sternocleidomastoid surface directly beneath the platysma muscle?, with the following options: A: Retromandibular, B: Anterior jugular, C: Posterior auricular, D: External jugular
+
+### Response:
+The external jugular vein crosses perpendicularly the superficial surface of the sternocleidomastoid muscle directly under the platysma muscle. The anterior jugular descends near the median line. The posterior auricular joints the retromandibular to form the external jugular. The internal jugular runs in the carotid sheath deep to the sternocleidomastoid muscle.
+### End"
+373,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: In case of spasticity, the drug not used is:, with the following options: A: Diazepam, B: Baclofen, C: Tizanidine, D: Amitryptiline
+
+### Response:
+","Spasticity is a condition in which ceain muscles are continuously contracted. This contraction causes stiffness or tightness of the muscles and can interfere with normal movement, speech and gait.Spasticity is usually caused by damage to the poion of the brain or spinal cord that controls voluntary movement. Amitriptyline, sold under the brand name Elavil among others, is a medicine primarily used to treat a number of mental illnesses. These include major depressive disorder and anxiety disorders, and less commonly attention deficit hyperactivity disorder and bipolar disorder.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: In case of spasticity, the drug not used is:, with the following options: A: Diazepam, B: Baclofen, C: Tizanidine, D: Amitryptiline
+
+### Response:
+Spasticity is a condition in which ceain muscles are continuously contracted. This contraction causes stiffness or tightness of the muscles and can interfere with normal movement, speech and gait.Spasticity is usually caused by damage to the poion of the brain or spinal cord that controls voluntary movement. Amitriptyline, sold under the brand name Elavil among others, is a medicine primarily used to treat a number of mental illnesses. These include major depressive disorder and anxiety disorders, and less commonly attention deficit hyperactivity disorder and bipolar disorder.
+### End"
+374,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Human placenta is:, with the following options: A: Hemochorial, B: Endothen - esdothelima, C: Chorio - endothelial, D: Non-Discoidal
+
+### Response:
+","Ans-A (Hemochorial) Ref: DC Dutta's Textbook of Obstetrics, 7th edn, pg 28Explanation:Human placentaStarts developing at 6 weeks and completed by 12 weeksHuman placenta is discoid, hemochorial, deciduateDevelopment of placentaFetal part - chorion frondosumMaternal part - deciduas hasalisCleavage of placenta following delivery occurs through deciduas spongiosumNormal weight - 500 gmsFunctional unit of placenta - chorionic villiUmbilical artery has 2 arteries and one veinNitabuch's membrane is absent in placenta accretaBlood flow in feto placental unit at term 500 ml/ minOxygen saturation inUmbilical vein -70-80 %Umbilical artery - 50 -60 %Intervillous space is filled with maternal bloodVolume of blood in mature placenta - 500 ml","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Human placenta is:, with the following options: A: Hemochorial, B: Endothen - esdothelima, C: Chorio - endothelial, D: Non-Discoidal
+
+### Response:
+Ans-A (Hemochorial) Ref: DC Dutta's Textbook of Obstetrics, 7th edn, pg 28Explanation:Human placentaStarts developing at 6 weeks and completed by 12 weeksHuman placenta is discoid, hemochorial, deciduateDevelopment of placentaFetal part - chorion frondosumMaternal part - deciduas hasalisCleavage of placenta following delivery occurs through deciduas spongiosumNormal weight - 500 gmsFunctional unit of placenta - chorionic villiUmbilical artery has 2 arteries and one veinNitabuch's membrane is absent in placenta accretaBlood flow in feto placental unit at term 500 ml/ minOxygen saturation inUmbilical vein -70-80 %Umbilical artery - 50 -60 %Intervillous space is filled with maternal bloodVolume of blood in mature placenta - 500 ml
+### End"
+375,"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 constituent of mesorectum?, with the following options: A: Pararectal lymph nodes, B: Inferior rectal artery, C: Middle rectal vein, D: Inferior mesenteric plexus
+
+### Response:
+","(Refer: Gray’s Anatomy for Students, 1st edition, pg no: 418)
+Mesorectal Fascia
+ It contains:
+
+Superior rectal artery and its branches.
+Superior rectal vein and tributaries.
+Lymphatic vessels and nodes along the superior rectal artery.
+Branches from the inferior mesenteric plexus which descend to innervate the rectum.
+Loose adipose connective tissue.","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 constituent of mesorectum?, with the following options: A: Pararectal lymph nodes, B: Inferior rectal artery, C: Middle rectal vein, D: Inferior mesenteric plexus
+
+### Response:
+(Refer: Gray’s Anatomy for Students, 1st edition, pg no: 418)
+Mesorectal Fascia
+ It contains:
+
+Superior rectal artery and its branches.
+Superior rectal vein and tributaries.
+Lymphatic vessels and nodes along the superior rectal artery.
+Branches from the inferior mesenteric plexus which descend to innervate the rectum.
+Loose adipose connective tissue.
+### End"
+376,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The magnification obtained by direct ophthalmoscope is, with the following options: A: 5times, B: 10times, C: 15times, D: 20times
+
+### Response:
+","TECHNIQUE MAGNIFICATION FIELD OF VIEW CHARACTERISTICS Direct ophthalmoscopy 15X 5* Erect and viual Indirect ophthalmoscopy with +20D 3X 45* Inveed reversed and real Indirect ophthalmoscopy with +30D 2X 50* Inveed reversed and real Biomicroscopic examination with +78D 10X 30* Inveed reversed and real Biomicroscopic examination with +90D 7.5X 40* Inveed reversed and real Fundus camera 2.5X 30* Erect, viual, photo documentation Ref. : Khurana's Theory and Practice of Optics and Refraction; 2nd Ed; Pg. 386","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The magnification obtained by direct ophthalmoscope is, with the following options: A: 5times, B: 10times, C: 15times, D: 20times
+
+### Response:
+TECHNIQUE MAGNIFICATION FIELD OF VIEW CHARACTERISTICS Direct ophthalmoscopy 15X 5* Erect and viual Indirect ophthalmoscopy with +20D 3X 45* Inveed reversed and real Indirect ophthalmoscopy with +30D 2X 50* Inveed reversed and real Biomicroscopic examination with +78D 10X 30* Inveed reversed and real Biomicroscopic examination with +90D 7.5X 40* Inveed reversed and real Fundus camera 2.5X 30* Erect, viual, photo documentation Ref. : Khurana's Theory and Practice of Optics and Refraction; 2nd Ed; Pg. 386
+### End"
+377,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Black malarial pigment is seen in: September 2009, with the following options: A: P.vivax, B: P.falciparum, C: P.nialariae, D: P.ovlae
+
+### Response:
+","Ans. B: P.falciparum In well-stained preparations the nuclei of the parasites are always stained red and the cytoplasm blue. The presence of malaria pigment is very characteristic of the older stages of Plasmodium sp. P. falciparum often contains a single black dot. P. vivax often contains countless fine golden yellow/brown specks of malaria pigment. In P. ovale and P. malariae the pigment inclusions are many and brownish black. Countless fine red spots in the red blood cell (Schiiffner's dots) can be seen in P. vivax and P. ovale (the more mature the parasite, the more dots). In P. ovale the dots are sometimes called James's dots. Sometimes a few flecks can be observed in P. falciparum (Maurer's dots or clefts). P. malariae almost never exhibits dots (Ziemann's dots). The visibility of these dots depends to a great extent on the acidity (pH) with which the thin slide preparation is stained (slightly alkaline: pH = 8 is best). The acidity is impoant because blood smears are usually stained for haematological tests with a slightly acid pH.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Black malarial pigment is seen in: September 2009, with the following options: A: P.vivax, B: P.falciparum, C: P.nialariae, D: P.ovlae
+
+### Response:
+Ans. B: P.falciparum In well-stained preparations the nuclei of the parasites are always stained red and the cytoplasm blue. The presence of malaria pigment is very characteristic of the older stages of Plasmodium sp. P. falciparum often contains a single black dot. P. vivax often contains countless fine golden yellow/brown specks of malaria pigment. In P. ovale and P. malariae the pigment inclusions are many and brownish black. Countless fine red spots in the red blood cell (Schiiffner's dots) can be seen in P. vivax and P. ovale (the more mature the parasite, the more dots). In P. ovale the dots are sometimes called James's dots. Sometimes a few flecks can be observed in P. falciparum (Maurer's dots or clefts). P. malariae almost never exhibits dots (Ziemann's dots). The visibility of these dots depends to a great extent on the acidity (pH) with which the thin slide preparation is stained (slightly alkaline: pH = 8 is best). The acidity is impoant because blood smears are usually stained for haematological tests with a slightly acid pH.
+### End"
+378,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Key hole sign is seen in, with the following options: A: Hydronephrosis, B: Posterior urethral valve, C: Ectopic ureter, D: PCKD
+
+### Response:
+","Key hole sign - Posterior urethral valve.
+Crescent sign - Hydronephrosis.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Key hole sign is seen in, with the following options: A: Hydronephrosis, B: Posterior urethral valve, C: Ectopic ureter, D: PCKD
+
+### Response:
+Key hole sign - Posterior urethral valve.
+Crescent sign - Hydronephrosis.
+### End"
+379,"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 of Benign Ovarian tumour ?, with the following options: A: Torsion is uncommon, B: Capsule is Intact, C: Ascites can occur, D: Size less than 10 cm
+
+### Response:
+","Ans. is b' i.e., Capsule is intactCapsule remains intact in benign ovarian tumor.o Torsion is a common complication.o Ascites is a complication of malignant tumor.","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 of Benign Ovarian tumour ?, with the following options: A: Torsion is uncommon, B: Capsule is Intact, C: Ascites can occur, D: Size less than 10 cm
+
+### Response:
+Ans. is b' i.e., Capsule is intactCapsule remains intact in benign ovarian tumor.o Torsion is a common complication.o Ascites is a complication of malignant tumor.
+### End"
+380,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Site of action of vecuronium is –, with the following options: A: Cerebrum, B: Reticular formation, C: Motor neuron, D: Myoneural junction
+
+### Response:
+","Vecuronium, a non-depolarizing blocker, acts on nicotinic receptors at myoneural junction.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Site of action of vecuronium is –, with the following options: A: Cerebrum, B: Reticular formation, C: Motor neuron, D: Myoneural junction
+
+### Response:
+Vecuronium, a non-depolarizing blocker, acts on nicotinic receptors at myoneural junction.
+### End"
+381,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Run-Amok is a feature of :, with the following options: A: Opium, B: Dhatura, C: Cannabis, D: Alcohal
+
+### Response:
+","Ans. is 'c' ie Cannabis Run-amok: is a condition resulting from the continued use of cannabis or even its consumption for the first time.It is characterized by a frenzied desire to commit murders.A number of individuals are killed, the first ones being those against whom the assailant has some real or imaginary enmity, followed by others who are in the way, until the homicidal tendency lasts. The person may then commit suicide or surrender himself to the police.There are four important forms of cannabis used in India.They all are derived from different parts of the same plant:Bhang - derived from dried leaves & fruit shoots*Ganja - Consists of dried flowering tops*Charas - consists of resinous exudate from the leaves and stems of the plant* (also k/a hashish)Majun - its a sweetmeat made with bhang, flour, milk and butter.Active ingredient of cannabis * - Tetrahydrocannabinol (THC)*.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Run-Amok is a feature of :, with the following options: A: Opium, B: Dhatura, C: Cannabis, D: Alcohal
+
+### Response:
+Ans. is 'c' ie Cannabis Run-amok: is a condition resulting from the continued use of cannabis or even its consumption for the first time.It is characterized by a frenzied desire to commit murders.A number of individuals are killed, the first ones being those against whom the assailant has some real or imaginary enmity, followed by others who are in the way, until the homicidal tendency lasts. The person may then commit suicide or surrender himself to the police.There are four important forms of cannabis used in India.They all are derived from different parts of the same plant:Bhang - derived from dried leaves & fruit shoots*Ganja - Consists of dried flowering tops*Charas - consists of resinous exudate from the leaves and stems of the plant* (also k/a hashish)Majun - its a sweetmeat made with bhang, flour, milk and butter.Active ingredient of cannabis * - Tetrahydrocannabinol (THC)*.
+### End"
+382,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Platelate aggregation is caused by all, except ?, with the following options: A: Thromboxane A2, B: Serotonin, C: Prostacyclin (PGI2), D: Thrombin
+
+### Response:
+","Ans. is 'c' i.e., Prostacyclin (PGI2)Factors promoting platelet aggregation : ADP, TXA2 , epinephrine, serotonin, vWF, fibrinogen, collagen, immune complex, thrombin, thrombospondin.Factors inhibiting platelet aggregation : PGI2, NO, endothelin, bradykinin.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Platelate aggregation is caused by all, except ?, with the following options: A: Thromboxane A2, B: Serotonin, C: Prostacyclin (PGI2), D: Thrombin
+
+### Response:
+Ans. is 'c' i.e., Prostacyclin (PGI2)Factors promoting platelet aggregation : ADP, TXA2 , epinephrine, serotonin, vWF, fibrinogen, collagen, immune complex, thrombin, thrombospondin.Factors inhibiting platelet aggregation : PGI2, NO, endothelin, bradykinin.
+### End"
+383,"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 can be regarded as primary action of inhibin?, with the following options: A: It inhibits secretion of prolactin, B: It stimulates synthesis of estradiol, C: It stimulates secretion of TSH, D: It inhibits secretion of FSH
+
+### Response:
+","Follicle-stimulating hormone (FSH) one of the gonadotropins of the anterior pituitary, which stimulates the growth and maturity of graafian follicles in the ovary, and stimulates spermatogenesis in the male.Ref: Ganong&;s review of medical physiology; 24th edition; page no:-333","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 can be regarded as primary action of inhibin?, with the following options: A: It inhibits secretion of prolactin, B: It stimulates synthesis of estradiol, C: It stimulates secretion of TSH, D: It inhibits secretion of FSH
+
+### Response:
+Follicle-stimulating hormone (FSH) one of the gonadotropins of the anterior pituitary, which stimulates the growth and maturity of graafian follicles in the ovary, and stimulates spermatogenesis in the male.Ref: Ganong&;s review of medical physiology; 24th edition; page no:-333
+### End"
+384,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Which enzyme polymerizes Okazaki fragments?, with the following options: A: DNA polymerase I, B: DNA polymerase II, C: DNA polymerase III, D: RNA polymerase
+
+### Response:
+","DNA polymerase III holoenzyme is the enzyme primarily responsible for replicative DNA synthesis in E. coli. It carries out primer-initiated 5' to 3' polymerization of DNA on a single-stranded DNA template, as well as 3' to 5' exonucleolytic editing of mispaired nucleotides Ref-D.M.Vasudevan 7/e p538","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Which enzyme polymerizes Okazaki fragments?, with the following options: A: DNA polymerase I, B: DNA polymerase II, C: DNA polymerase III, D: RNA polymerase
+
+### Response:
+DNA polymerase III holoenzyme is the enzyme primarily responsible for replicative DNA synthesis in E. coli. It carries out primer-initiated 5' to 3' polymerization of DNA on a single-stranded DNA template, as well as 3' to 5' exonucleolytic editing of mispaired nucleotides Ref-D.M.Vasudevan 7/e p538
+### End"
+385,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Steroid with max mineralocoicoid activity ?, with the following options: A: Fludrocoisone, B: DOCA, C: Prednisolone, D: Triamsinolone
+
+### Response:
+","Ans. is 'a' i.e, Fludrocoisone","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Steroid with max mineralocoicoid activity ?, with the following options: A: Fludrocoisone, B: DOCA, C: Prednisolone, D: Triamsinolone
+
+### Response:
+Ans. is 'a' i.e, Fludrocoisone
+### End"
+386,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Ectopic pregnancy, characteristic finding in USG is -, with the following options: A: Absence of gestational sac in uterus, B: Complex adnexal mass, C: Resistance in colored Doppler, D: Free fluid in peritoneal cavity
+
+### Response:
+","""The Presence of a non - ovarian complex adnexal mass is the most sensitive and specific USG finding for ectopic pregnancy"".
+—USG in radiology
+""The presence of a fetal heart beat outside the uterine cavity is pathognomonic for an ectopic pregnancy"".
+—USG in radiology","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Ectopic pregnancy, characteristic finding in USG is -, with the following options: A: Absence of gestational sac in uterus, B: Complex adnexal mass, C: Resistance in colored Doppler, D: Free fluid in peritoneal cavity
+
+### Response:
+""The Presence of a non - ovarian complex adnexal mass is the most sensitive and specific USG finding for ectopic pregnancy"".
+—USG in radiology
+""The presence of a fetal heart beat outside the uterine cavity is pathognomonic for an ectopic pregnancy"".
+—USG in radiology
+### End"
+387,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The protein responsible for elasticity of the muscle is:, with the following options: A: Actin, B: Myosin, C: Titin, D: All
+
+### Response:
+","Titin is responsible for the elasticity of the muscle present in hea and skeletal muscle Actin and myosin are regarded as contractile proteins Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:86,87","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The protein responsible for elasticity of the muscle is:, with the following options: A: Actin, B: Myosin, C: Titin, D: All
+
+### Response:
+Titin is responsible for the elasticity of the muscle present in hea and skeletal muscle Actin and myosin are regarded as contractile proteins Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:86,87
+### End"
+388,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A person is not able to extend his metacarpophalangeal joint. This is due to injury to which nerve?, with the following options: A: Ulnar nerve, B: Radial nerve injury, C: Median nerve injury, D: Post. Introsseus nerve injury
+
+### Response:
+","Ans. is 'd > b' i.e., Post. Introsseus nerve injury > Radial nerve injury Extension of MP joint is caused by muscles supplied by posterior interosseus nerve. Posterior interosseus nerve is a branch of radial nerve, so radial nerve palsy also results in loss of ability to extend MP joint. However, for single answer, the best option is posterior interosseus nerve because the only finding in PIN palsy is inability to extend MP joint of thumb & fingers, and inability to do radial abduction of thumb. In radial nerve palsy other findings will also be there. Clinical features of radial nerve palsy Clinical features depend upon the site of lesion. 1. If lesion is high Wrist drop, thumb drop and finger drop. Inability to extend elbow, wrist, thumb & fingers (MP joint) Patient can extend interphalangeal joints due to action of lumbricals and interossei. Sensory loss over posterior surface of arm & forearm and lower lateral half of forearm. 2. If lesion is low A. Type 1 Wrist drop, thumb drop and finger drop. Elbow extension is preserved. Sensory loss over the dorsum of first web space. B. Type II Thumb drop and finger drop Elbow and wrist extension is preserved Sensory loss over the dorsum of first web space Clinical features of posterior interosseus nerve It is prone to be injured in injury & operations of radial head- neck. There is no sensory deficit as it is a pure motor nerve. Wrist extension is preserved (i.e. no wrist drop) due to spared extensor carpi radialis longus . Presents with loss of extension of metacarpophalangeal (MP) joints i.e., thumb & finger drop.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A person is not able to extend his metacarpophalangeal joint. This is due to injury to which nerve?, with the following options: A: Ulnar nerve, B: Radial nerve injury, C: Median nerve injury, D: Post. Introsseus nerve injury
+
+### Response:
+Ans. is 'd > b' i.e., Post. Introsseus nerve injury > Radial nerve injury Extension of MP joint is caused by muscles supplied by posterior interosseus nerve. Posterior interosseus nerve is a branch of radial nerve, so radial nerve palsy also results in loss of ability to extend MP joint. However, for single answer, the best option is posterior interosseus nerve because the only finding in PIN palsy is inability to extend MP joint of thumb & fingers, and inability to do radial abduction of thumb. In radial nerve palsy other findings will also be there. Clinical features of radial nerve palsy Clinical features depend upon the site of lesion. 1. If lesion is high Wrist drop, thumb drop and finger drop. Inability to extend elbow, wrist, thumb & fingers (MP joint) Patient can extend interphalangeal joints due to action of lumbricals and interossei. Sensory loss over posterior surface of arm & forearm and lower lateral half of forearm. 2. If lesion is low A. Type 1 Wrist drop, thumb drop and finger drop. Elbow extension is preserved. Sensory loss over the dorsum of first web space. B. Type II Thumb drop and finger drop Elbow and wrist extension is preserved Sensory loss over the dorsum of first web space Clinical features of posterior interosseus nerve It is prone to be injured in injury & operations of radial head- neck. There is no sensory deficit as it is a pure motor nerve. Wrist extension is preserved (i.e. no wrist drop) due to spared extensor carpi radialis longus . Presents with loss of extension of metacarpophalangeal (MP) joints i.e., thumb & finger drop.
+### End"
+389,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: In nephritic syndrome the following features indicate poor prognosis except -, with the following options: A: Selective proteinuria, B: Haematuria, C: Hypeension, D: Membrano proliferative histopathology
+
+### Response:
+","ACUTE NEPHRITIC SYNDROME. This is the acute onset of haematuria, proteinuria, hypeension, oedema and oliguria following an infective illness about 10 to 20 days earlier. 1. The haematuria is generally slight giving the urine smoky appearance and erythrocytes are detectable by microscopy or by chemical testing for haemoglobin. Appearance of red cell casts is another classical feature of acute nephritic syndrome. 2. The proteinuria is mild (less than 3 gm per 24 hrs) and is usually non-selective (nephritic range proteinuria). 3. Hypeension is variable depending upon the severity of the glomerular disease but is generally mild. 4. Oedema in nephritic syndrome is usually mild and results from sodium and water retention. 5. Oliguria is variable and reflects the severity of glomerular involvement. The underlying causes of acute nephritic syndrome may be primary glomerulonephritic diseases (classically acute glomerulonephritis and rapidly progressive glomerulonephritis) or ceain systemic diseases Ref: Harsh Mohan textbook of pathology 6th Ed. page 660","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: In nephritic syndrome the following features indicate poor prognosis except -, with the following options: A: Selective proteinuria, B: Haematuria, C: Hypeension, D: Membrano proliferative histopathology
+
+### Response:
+ACUTE NEPHRITIC SYNDROME. This is the acute onset of haematuria, proteinuria, hypeension, oedema and oliguria following an infective illness about 10 to 20 days earlier. 1. The haematuria is generally slight giving the urine smoky appearance and erythrocytes are detectable by microscopy or by chemical testing for haemoglobin. Appearance of red cell casts is another classical feature of acute nephritic syndrome. 2. The proteinuria is mild (less than 3 gm per 24 hrs) and is usually non-selective (nephritic range proteinuria). 3. Hypeension is variable depending upon the severity of the glomerular disease but is generally mild. 4. Oedema in nephritic syndrome is usually mild and results from sodium and water retention. 5. Oliguria is variable and reflects the severity of glomerular involvement. The underlying causes of acute nephritic syndrome may be primary glomerulonephritic diseases (classically acute glomerulonephritis and rapidly progressive glomerulonephritis) or ceain systemic diseases Ref: Harsh Mohan textbook of pathology 6th Ed. page 660
+### End"
+390,"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 fibroids are not suitable for uterine artery embolization, with the following options: A: Intramural fibroid, B: Subserosal fibroid, C: Cervical fibroid, D: pedunculated submucous fibroid
+
+### Response:
+",Pedunculated submucosal fibroids are not suitable for UAE because they can infarct and slough.,"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 fibroids are not suitable for uterine artery embolization, with the following options: A: Intramural fibroid, B: Subserosal fibroid, C: Cervical fibroid, D: pedunculated submucous fibroid
+
+### Response:
+Pedunculated submucosal fibroids are not suitable for UAE because they can infarct and slough.
+### End"
+391,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Styloid process is derived from, with the following options: A: First arch, B: Second arch, C: Third arch, D: Fouh arch
+
+### Response:
+","The styloid process,the stylohyoid ligament and muscle are derived from the second branchial arch. 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: Styloid process is derived from, with the following options: A: First arch, B: Second arch, C: Third arch, D: Fouh arch
+
+### Response:
+The styloid process,the stylohyoid ligament and muscle are derived from the second branchial arch. REF.BDC VOL.3,Fifth Edition,
+### End"
+392,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: In high myopia which of the following is seen?, with the following options: A: Uveitis, B: Chorioretinal degeneration, C: Papillitis, D: Retinal. Hemorrhages
+
+### Response:
+","Steroid-induced glaucoma Secondary open angle glaucoma TheoriesGlycosaminoglycans theory- Steroids inhibits the release of hydrolases -GAG in trabecular meshwork cannot depolymerize and retain water in ECS - narrowing of trabecular spaces and decrease in aqueous humor outflow Endothelial cell theory- Steroids suppress the phagocytic activity of endothelial cells - collection of debris in the trabecular meshwork - decreasing in aqueous outflow PG theory- Steroids inhibit the synthesis of PGE and PGF - decrease in aqueous outflow facility & increase in IOP Features - develops following weeks of topical therapy with strong steroids and months of therapy with weak steroids Treatment - discontinuation of steroids ; 0.5% timolol maleate ; filtration surgery (Refer: AH Khurana, Comprehensive Textbook of Ophthalmology,5thedition, pg no: 32-36)","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: In high myopia which of the following is seen?, with the following options: A: Uveitis, B: Chorioretinal degeneration, C: Papillitis, D: Retinal. Hemorrhages
+
+### Response:
+Steroid-induced glaucoma Secondary open angle glaucoma TheoriesGlycosaminoglycans theory- Steroids inhibits the release of hydrolases -GAG in trabecular meshwork cannot depolymerize and retain water in ECS - narrowing of trabecular spaces and decrease in aqueous humor outflow Endothelial cell theory- Steroids suppress the phagocytic activity of endothelial cells - collection of debris in the trabecular meshwork - decreasing in aqueous outflow PG theory- Steroids inhibit the synthesis of PGE and PGF - decrease in aqueous outflow facility & increase in IOP Features - develops following weeks of topical therapy with strong steroids and months of therapy with weak steroids Treatment - discontinuation of steroids ; 0.5% timolol maleate ; filtration surgery (Refer: AH Khurana, Comprehensive Textbook of Ophthalmology,5thedition, pg no: 32-36)
+### End"
+393,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Protein requirment in an adult male per day -, with the following options: A: 1 g/kg/day, B: 1.5g/kg/day, C: 2 g/kg/day, D: 5 g/kg/day
+
+### Response:
+","Ans. is 'a' i.e., 1g/kg/day Recommended protein allowancesGroupParticulars(g / kg / day)Mansedentary work (60 kg)moderate work1 heavy work Womansedentary work (55 kg)moderate work heavy work1Infants0 to 3 months1.16 3 to 6 months1.16 6 to 9 months1.69 9 to 12 months1.69Children1 to 3 years1.3 4 to 6 years1.12 7 to 9 years1.18AdolescentsMales 10 to 12 years1.16 13 to 15 years1.14 16 to 18 years1.11 Females 10 to 12 years1.15 13 to 15 years1.11 16 to 18 years1.06","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Protein requirment in an adult male per day -, with the following options: A: 1 g/kg/day, B: 1.5g/kg/day, C: 2 g/kg/day, D: 5 g/kg/day
+
+### Response:
+Ans. is 'a' i.e., 1g/kg/day Recommended protein allowancesGroupParticulars(g / kg / day)Mansedentary work (60 kg)moderate work1 heavy work Womansedentary work (55 kg)moderate work heavy work1Infants0 to 3 months1.16 3 to 6 months1.16 6 to 9 months1.69 9 to 12 months1.69Children1 to 3 years1.3 4 to 6 years1.12 7 to 9 years1.18AdolescentsMales 10 to 12 years1.16 13 to 15 years1.14 16 to 18 years1.11 Females 10 to 12 years1.15 13 to 15 years1.11 16 to 18 years1.06
+### End"
+394,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A patient complains of knee pain. Routine investigations are unremarkable and still, the patient is unsatisfied. Urine turns black on standing, what is the enzyme involved?, with the following options: A: Homogentisate oxidase, B: Xanthine oxidase, C: Methyl malonate oxidase, D: Phenyl pyruvate oxidase
+
+### Response:
+","Alkaptonuria - Due to deficiency of Homogentisate dioxygenase/ oxidase (requires Iron) Fresh urine is normal in colour On standing or on exposure to air - turns Black - Homogentisic acid accumulated - get oxidised - gives rise to Black urine - Homogentisic acid gets polymerized in body forming ALKAPTON BODIES, which gets accumulated in: Cailages - Nose, ear pinna, interveebral disc Connective tissue has bluish black colour. Patient develops ahralgia & ahritis. - This condition is known as Ochronosis. Ahritis is also known as ochronotic ahritis - Benedict 's test is positive due to homogentisic Acid, which is a Reducing substance - Treatment drug is NITISINONE","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A patient complains of knee pain. Routine investigations are unremarkable and still, the patient is unsatisfied. Urine turns black on standing, what is the enzyme involved?, with the following options: A: Homogentisate oxidase, B: Xanthine oxidase, C: Methyl malonate oxidase, D: Phenyl pyruvate oxidase
+
+### Response:
+Alkaptonuria - Due to deficiency of Homogentisate dioxygenase/ oxidase (requires Iron) Fresh urine is normal in colour On standing or on exposure to air - turns Black - Homogentisic acid accumulated - get oxidised - gives rise to Black urine - Homogentisic acid gets polymerized in body forming ALKAPTON BODIES, which gets accumulated in: Cailages - Nose, ear pinna, interveebral disc Connective tissue has bluish black colour. Patient develops ahralgia & ahritis. - This condition is known as Ochronosis. Ahritis is also known as ochronotic ahritis - Benedict 's test is positive due to homogentisic Acid, which is a Reducing substance - Treatment drug is NITISINONE
+### End"
+395,"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 Branchial cysts is true:, with the following options: A: 50-70% are seen in lungs, B: Most common site is mediastinum, C: They are premalignant lesions, D: Infection is uncommon in Pulmonary bronchogenic cysts
+
+### Response:
+",Most common site of bronchial/bronchogenic cysts is mediastinum. Only about 15% of bronchogenic cysts occur in the lungs (pulmonary bronchial cysts). Pulmonary bronchogenic cysts often become infected. Bronchogenic cysts are benign lesion and do not have malignant potential (not premalignant). Bronchial Cyst/Bronchogenic cysts: Review Bronchial cysts represent islands of bronchial tissue left behind during the branching of the airways during early fetal development. They arise due to abnormal budding of the tracheobronchial tree and foregut and are lined by bronchial epithelium. The most common site of bronchial cysts is mediastinum. The other site of bronchial cyst is within the pulmonary parenchyma (lung) (Less common site - 15%) Ref : Bailey and love surgery text book 27th Ed,"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 Branchial cysts is true:, with the following options: A: 50-70% are seen in lungs, B: Most common site is mediastinum, C: They are premalignant lesions, D: Infection is uncommon in Pulmonary bronchogenic cysts
+
+### Response:
+Most common site of bronchial/bronchogenic cysts is mediastinum. Only about 15% of bronchogenic cysts occur in the lungs (pulmonary bronchial cysts). Pulmonary bronchogenic cysts often become infected. Bronchogenic cysts are benign lesion and do not have malignant potential (not premalignant). Bronchial Cyst/Bronchogenic cysts: Review Bronchial cysts represent islands of bronchial tissue left behind during the branching of the airways during early fetal development. They arise due to abnormal budding of the tracheobronchial tree and foregut and are lined by bronchial epithelium. The most common site of bronchial cysts is mediastinum. The other site of bronchial cyst is within the pulmonary parenchyma (lung) (Less common site - 15%) Ref : Bailey and love surgery text book 27th Ed
+### End"
+396,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Virulence of a disease is indicated by, with the following options: A: Specific moality rate, B: Propoional moality rate, C: Amount of GDP spent on the disease, D: Case fatality ratio
+
+### Response:
+","CASE FATALITY RATIO Case fatality rate represents the killing power of a disease. It is simply the ratio of deaths to cases. The time interval is not specified. Case fatality rate is typically used in acute Infectious diseases (e.g., food poisoning, cholera, measles). Its usefulness for chronic diseases is limited, because the period from onset to death is long and variable. The case fatality rate for the same disease may vary in different epidemics because of changes in the agent, host and environmental factors. Case fatality is closely related to virulence. Ref: Park 25th edition Pgno : 66","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Virulence of a disease is indicated by, with the following options: A: Specific moality rate, B: Propoional moality rate, C: Amount of GDP spent on the disease, D: Case fatality ratio
+
+### Response:
+CASE FATALITY RATIO Case fatality rate represents the killing power of a disease. It is simply the ratio of deaths to cases. The time interval is not specified. Case fatality rate is typically used in acute Infectious diseases (e.g., food poisoning, cholera, measles). Its usefulness for chronic diseases is limited, because the period from onset to death is long and variable. The case fatality rate for the same disease may vary in different epidemics because of changes in the agent, host and environmental factors. Case fatality is closely related to virulence. Ref: Park 25th edition Pgno : 66
+### End"
+397,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Breast milk is known to transmit, with the following options: A: Tuberculosis, B: CMV, C: Varicella, D: Rubella
+
+### Response:
+",CMV has been demonstrated in breast milk. Approximately 2/3 of CMV-seronegative breast-fed infants may become infected with CMV. The risk is more in a preterm infant. Thus the use of fresh donor milk for feeding a preterm infant is contraindicated unless the milk is known to be CMV-negative.Ref: Page 215; Nelson textbook of pediatrics; 18th edition,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Breast milk is known to transmit, with the following options: A: Tuberculosis, B: CMV, C: Varicella, D: Rubella
+
+### Response:
+CMV has been demonstrated in breast milk. Approximately 2/3 of CMV-seronegative breast-fed infants may become infected with CMV. The risk is more in a preterm infant. Thus the use of fresh donor milk for feeding a preterm infant is contraindicated unless the milk is known to be CMV-negative.Ref: Page 215; Nelson textbook of pediatrics; 18th edition
+### End"
+398,"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 chest pain was brought to the hospital. He was diagnosed to be a case of myocardial infarction and was administered a thrombolytic immediately. However, his cardiac condition worsened and he died. He was diagnosed to be suffering from ""cardiac reperfusion injury"". Which of the following is an expected histological finding in his cardiac tissue?, with the following options: A: Presence of coagulative necrosis with neutrophilic infiltration, B: Deposition of granulation tissue, C: Presence of contraction bands, D: Fibrosis and scar formation
+
+### Response:
+","Restoration of blood flow to ischemic tissues can promote recovery of cells if they are reversibly injured. However, under ceain circumstances, when blood flow is restored to cells that have been ischemic but have not died, injury is paradoxically exacerbated and proceeds at an accelerated pace. This process is calledischemia-reperfusion injury. It is due to sudden influx of free radicals and Ca+2 Neutrophils are responsible for production of free radicals. Re-perfused blood is rich in calcium hence leads formation of contraction bands.","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 chest pain was brought to the hospital. He was diagnosed to be a case of myocardial infarction and was administered a thrombolytic immediately. However, his cardiac condition worsened and he died. He was diagnosed to be suffering from ""cardiac reperfusion injury"". Which of the following is an expected histological finding in his cardiac tissue?, with the following options: A: Presence of coagulative necrosis with neutrophilic infiltration, B: Deposition of granulation tissue, C: Presence of contraction bands, D: Fibrosis and scar formation
+
+### Response:
+Restoration of blood flow to ischemic tissues can promote recovery of cells if they are reversibly injured. However, under ceain circumstances, when blood flow is restored to cells that have been ischemic but have not died, injury is paradoxically exacerbated and proceeds at an accelerated pace. This process is calledischemia-reperfusion injury. It is due to sudden influx of free radicals and Ca+2 Neutrophils are responsible for production of free radicals. Re-perfused blood is rich in calcium hence leads formation of contraction bands.
+### End"
+399,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Marker for acute hepatitis B is:, with the following options: A: HBV DNA polymerase, B: IgG anti HBc, C: Core antgen (HbcAg), D: Anti-HbsAg
+
+### Response:
+","Ans. (a) HBV DNA polymerase DNA polymerase activity, HBV DNA and HBeAg which are representative of viremic stage of hepatitis B, appears early in the incubation period, concurrently or sholy after the first appearance of HBsAg. Thus, from these lines it is clear that DNA polymerase is a marker of HBV infection. However, it is elevated in both acute and chronic active hepatitis. As there is no other correct option, this can be taken as correct. Note Hepatitis core antigen never appears in serum as it remain inside hepatocyte (intrahepatic)","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Marker for acute hepatitis B is:, with the following options: A: HBV DNA polymerase, B: IgG anti HBc, C: Core antgen (HbcAg), D: Anti-HbsAg
+
+### Response:
+Ans. (a) HBV DNA polymerase DNA polymerase activity, HBV DNA and HBeAg which are representative of viremic stage of hepatitis B, appears early in the incubation period, concurrently or sholy after the first appearance of HBsAg. Thus, from these lines it is clear that DNA polymerase is a marker of HBV infection. However, it is elevated in both acute and chronic active hepatitis. As there is no other correct option, this can be taken as correct. Note Hepatitis core antigen never appears in serum as it remain inside hepatocyte (intrahepatic)
+### End"
+400,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Ganglion of hay fever is, with the following options: A: Otic ganglion, B: Ptery gopalatine ganglion, C: Submandibular ganglion, D: Geniculate ganglion
+
+### Response:
+","In hay fever, the allergen-reagin reaction occurs in the nose. Histamine released in response to the reaction causes local intranasal vascular dilation, with resultant increased capillary pressure and increased capillary permeability. Both these effects cause rapid fluid leakage into the nasal cavities and into associated deeper tissues of the nose, and the nasal linings become swollen and secretory. Pterygopalatine ganglion is also called as hay fever ganglion because it serves as a relay station for secretomotor fibres to the -lacrimal glands -mucous glands of nose -paranasal sinuses -palate -pharynx. Ref: guyton and hall textbook of medical physiology 12 edition page number: 671,672,673","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Ganglion of hay fever is, with the following options: A: Otic ganglion, B: Ptery gopalatine ganglion, C: Submandibular ganglion, D: Geniculate ganglion
+
+### Response:
+In hay fever, the allergen-reagin reaction occurs in the nose. Histamine released in response to the reaction causes local intranasal vascular dilation, with resultant increased capillary pressure and increased capillary permeability. Both these effects cause rapid fluid leakage into the nasal cavities and into associated deeper tissues of the nose, and the nasal linings become swollen and secretory. Pterygopalatine ganglion is also called as hay fever ganglion because it serves as a relay station for secretomotor fibres to the -lacrimal glands -mucous glands of nose -paranasal sinuses -palate -pharynx. Ref: guyton and hall textbook of medical physiology 12 edition page number: 671,672,673
+### End"
+401,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Most common pattern of fingerprints?, with the following options: A: Whorls, B: Loops, C: Arches, D: Composite
+
+### Response:
+",Study of fingerprints is called DACTYLOGRAPHY There are different types of patterns of fingerprints. They are ((Love Wife And Children.)) LOOPS WHORLS ARCH COMPOSITE Most common pattern of fingerprint - LOOPS Least common pattern of fingerprint - COMPOSITE,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Most common pattern of fingerprints?, with the following options: A: Whorls, B: Loops, C: Arches, D: Composite
+
+### Response:
+Study of fingerprints is called DACTYLOGRAPHY There are different types of patterns of fingerprints. They are ((Love Wife And Children.)) LOOPS WHORLS ARCH COMPOSITE Most common pattern of fingerprint - LOOPS Least common pattern of fingerprint - COMPOSITE
+### End"
+402,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: SMART caries vaccine is a form of:, with the following options: A: Genetically modified strain of S.mutans BCS3-L1 incapable of producing lactic acid, B: Synthetic Ab prepared from transgenic tobacco plant, C: Egg yolk antibody specific for GTPase, D: Unit of cholera toxin chemically conjugated to relevant antigen
+
+### Response:
+","SMART in Smart caries vaccine denotes ""S. Mutans and Replacement Therapy"".
+Jeffrey Hillman from the University of Florida developed a genetically modified strain of Streptococcus mutans called BCS5- L1 that is incapable of producing lactic acid - the acid that dissolves tooth enamel - and aggressively replaces native flora. In laboratory tests, rats that were given BCS311 were conferred with a lifetime of protection against S. mutans. BCS3-L1 colonizes the mouth and produces a small amount of a lantibiotic, called MU1140, which allows it to outcompete S. mutans. Hillman suggested that treatment with BCSL1 in humans could also provide a lifetime of protection, or, at worst, require occasional reapplications.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: SMART caries vaccine is a form of:, with the following options: A: Genetically modified strain of S.mutans BCS3-L1 incapable of producing lactic acid, B: Synthetic Ab prepared from transgenic tobacco plant, C: Egg yolk antibody specific for GTPase, D: Unit of cholera toxin chemically conjugated to relevant antigen
+
+### Response:
+SMART in Smart caries vaccine denotes ""S. Mutans and Replacement Therapy"".
+Jeffrey Hillman from the University of Florida developed a genetically modified strain of Streptococcus mutans called BCS5- L1 that is incapable of producing lactic acid - the acid that dissolves tooth enamel - and aggressively replaces native flora. In laboratory tests, rats that were given BCS311 were conferred with a lifetime of protection against S. mutans. BCS3-L1 colonizes the mouth and produces a small amount of a lantibiotic, called MU1140, which allows it to outcompete S. mutans. Hillman suggested that treatment with BCSL1 in humans could also provide a lifetime of protection, or, at worst, require occasional reapplications.
+### End"
+403,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: With regard to the malignant behavior of leimyosarcoma, the most impoant criterion is:, with the following options: A: Blood vessel penetration by tumor cells, B: Tumor cells in lymphatic channels, C: Lymphocyte infiltration, D: The number of mitoses per high power field
+
+### Response:
+","An impoant microscopic criterion for distinguishing leiomyosarcoma from leiomyoma is the number of mitoses present. Greater than 10 mitoses per10 high-power fields (hpf) is associated with frank malignancy (leiomyosarcoma). Ref: Robbin's Basics of Pathology , 7th Edition, Page I090; Oncology: An Evidence-Based Approach By Alfred E. Chang, 2006, Page 944.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: With regard to the malignant behavior of leimyosarcoma, the most impoant criterion is:, with the following options: A: Blood vessel penetration by tumor cells, B: Tumor cells in lymphatic channels, C: Lymphocyte infiltration, D: The number of mitoses per high power field
+
+### Response:
+An impoant microscopic criterion for distinguishing leiomyosarcoma from leiomyoma is the number of mitoses present. Greater than 10 mitoses per10 high-power fields (hpf) is associated with frank malignancy (leiomyosarcoma). Ref: Robbin's Basics of Pathology , 7th Edition, Page I090; Oncology: An Evidence-Based Approach By Alfred E. Chang, 2006, Page 944.
+### End"
+404,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Intermediate hosts for toxoplasma are all except?, with the following options: A: Human, B: Sheep, C: Cat, D: Pig
+
+### Response:
+","Ans. is 'c' i.e., Cat","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Intermediate hosts for toxoplasma are all except?, with the following options: A: Human, B: Sheep, C: Cat, D: Pig
+
+### Response:
+Ans. is 'c' i.e., Cat
+### End"
+405,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The cubitus-valgus deformity is a complication of -, with the following options: A: # Lateral condyle of humerus, B: # Intercondylar of humerus, C: It of the olecranon, D: # Head of the radius
+
+### Response:
+","Cubitus valgus is a common complication.
+It is caused by persistent upward displacement of the fractured condyle or by retardation of epiphyseal growth on the affected side from damage to the growing epiphyseal cartilage.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The cubitus-valgus deformity is a complication of -, with the following options: A: # Lateral condyle of humerus, B: # Intercondylar of humerus, C: It of the olecranon, D: # Head of the radius
+
+### Response:
+Cubitus valgus is a common complication.
+It is caused by persistent upward displacement of the fractured condyle or by retardation of epiphyseal growth on the affected side from damage to the growing epiphyseal cartilage.
+### End"
+406,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Endemic Disease' means that a disease -, with the following options: A: Occurs clearly in excess of normal expectancy, B: Is constantly present in a given population group, C: Exhibits seasonal pattern, D: Is prevalent among animals
+
+### Response:
+","Ans. is 'b' i.e., Is Consistantly present in a given population group Endemic disease o It refers to constant presence of a disease or infectious agent within a given geographic area or population group, without impoation from outsite.o In other words ""Endemicity is defined as the usual or expected frequency of the disease within a given geographic area or population group"".What does expected frequency (usual frequency) meano Expected frequency --> The number (range) of cases of a disease that one would expect to occur in a given popuation group if population and environmental conditions are stable.o Expected frequency (normal expectancy) is derived by looking at average of number of cases of the disease in previous 3 -- 5 years in that geographical area.Other terms related to endemic disease : -i) Hyperendemic -p The disease is constantly present at a high incidence and/or prevalence rate and effects all age group equally.ii) Haloendemic --> A high level of infection begining early in life and affecting most of the child population, leading to a state of equilibrium such that adult population shows evidence of disease much less commonly than to the children, as in case of malaria","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Endemic Disease' means that a disease -, with the following options: A: Occurs clearly in excess of normal expectancy, B: Is constantly present in a given population group, C: Exhibits seasonal pattern, D: Is prevalent among animals
+
+### Response:
+Ans. is 'b' i.e., Is Consistantly present in a given population group Endemic disease o It refers to constant presence of a disease or infectious agent within a given geographic area or population group, without impoation from outsite.o In other words ""Endemicity is defined as the usual or expected frequency of the disease within a given geographic area or population group"".What does expected frequency (usual frequency) meano Expected frequency --> The number (range) of cases of a disease that one would expect to occur in a given popuation group if population and environmental conditions are stable.o Expected frequency (normal expectancy) is derived by looking at average of number of cases of the disease in previous 3 -- 5 years in that geographical area.Other terms related to endemic disease : -i) Hyperendemic -p The disease is constantly present at a high incidence and/or prevalence rate and effects all age group equally.ii) Haloendemic --> A high level of infection begining early in life and affecting most of the child population, leading to a state of equilibrium such that adult population shows evidence of disease much less commonly than to the children, as in case of malaria
+### End"
+407,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Drum stick is characteristic of:, with the following options: A: Corynebacterium diphtheriae, B: Clostridium tetani, C: Neisseria meningitides, D: Strep Pneumoniae
+
+### Response:
+","Ans. (b) Clostridium tetaniRef: Microbiology by Ananthanarayan and Paniker 8th ed. 1249-54* There are species of Clostridium that bears terminal spores which appears as drumstick shaped under microscope.* Clostridium tetani is a gram positive obligate anaerobe which is the causative agent of tetanus, bears spores which are spherical, terminal and twice the diameter of vegetative cells. This gives it a drumstick appearance upon viewing under microscope.BacteriaAppearance* Clostridium tetaniDrumstick appearance* Corynebacterium diphtheriaChinese letter pattern* Neisseria meningitidesD- shaped* N. GonorrheaKidney shaped appearance* Strep PneumoniaeFlame shaped appearance","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Drum stick is characteristic of:, with the following options: A: Corynebacterium diphtheriae, B: Clostridium tetani, C: Neisseria meningitides, D: Strep Pneumoniae
+
+### Response:
+Ans. (b) Clostridium tetaniRef: Microbiology by Ananthanarayan and Paniker 8th ed. 1249-54* There are species of Clostridium that bears terminal spores which appears as drumstick shaped under microscope.* Clostridium tetani is a gram positive obligate anaerobe which is the causative agent of tetanus, bears spores which are spherical, terminal and twice the diameter of vegetative cells. This gives it a drumstick appearance upon viewing under microscope.BacteriaAppearance* Clostridium tetaniDrumstick appearance* Corynebacterium diphtheriaChinese letter pattern* Neisseria meningitidesD- shaped* N. GonorrheaKidney shaped appearance* Strep PneumoniaeFlame shaped appearance
+### End"
+408,"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 antilipidemic drug reduces cholesterol levels by reducing the cholesterol absorption in intestine by acting on NPC1L1 receptors?, with the following options: A: Fenofibrate, B: Nicotinic acid, C: Lovastatin, D: Ezetimibe
+
+### Response:
+",.,"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 antilipidemic drug reduces cholesterol levels by reducing the cholesterol absorption in intestine by acting on NPC1L1 receptors?, with the following options: A: Fenofibrate, B: Nicotinic acid, C: Lovastatin, D: Ezetimibe
+
+### Response:
+.
+### End"
+409,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: IOC for angiofibroma is, with the following options: A: Plain X-ray, B: CT scan, C: MRI, D: Angiography
+
+### Response:
+","NASOPHARYNGEAL FIBROMA (JUVENILE NASOPHARYNGEAL ANGIOFIBROMA) INVESTIGATIONS :- 1. Computed tomography (CT) scan of the head with contrast enhancement is now the investigation of choice. It has replaced conventional radiographs. It shows the extent of tumour, bony destruction or displacements. Anterior bowing of the posterior wall of maxillary sinus, often called antral sign or Holman-Miller sign, is pathognomic of angiofibroma. 2. Magnetic resonance imaging (MRI) is complementary to CT scans and shows any soft tissue extensions present intracranially in the infratemporal fossa or in the orbit. 3. Carotid angiography shows the extent of tumours, its vascularity and feeding vessels which mostly come from the external carotid system. In very large tumours or those with intracranial extension vessels may also come from internal carotid system. Embolization of vessels can be done at this time to decrease bleeding at operation. Feeders from only the external carotid system can be embolized. Resection of tumour should not be delayed beyond 24-48 h of embolization to avoid vascularization from the contralateral side. Ref:- Dhingra; pg num:-247,248","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: IOC for angiofibroma is, with the following options: A: Plain X-ray, B: CT scan, C: MRI, D: Angiography
+
+### Response:
+NASOPHARYNGEAL FIBROMA (JUVENILE NASOPHARYNGEAL ANGIOFIBROMA) INVESTIGATIONS :- 1. Computed tomography (CT) scan of the head with contrast enhancement is now the investigation of choice. It has replaced conventional radiographs. It shows the extent of tumour, bony destruction or displacements. Anterior bowing of the posterior wall of maxillary sinus, often called antral sign or Holman-Miller sign, is pathognomic of angiofibroma. 2. Magnetic resonance imaging (MRI) is complementary to CT scans and shows any soft tissue extensions present intracranially in the infratemporal fossa or in the orbit. 3. Carotid angiography shows the extent of tumours, its vascularity and feeding vessels which mostly come from the external carotid system. In very large tumours or those with intracranial extension vessels may also come from internal carotid system. Embolization of vessels can be done at this time to decrease bleeding at operation. Feeders from only the external carotid system can be embolized. Resection of tumour should not be delayed beyond 24-48 h of embolization to avoid vascularization from the contralateral side. Ref:- Dhingra; pg num:-247,248
+### End"
+410,"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 of CA head of pancreas, with the following options: A: Vomiting, B: Pain, C: Malabsorption, D: Jaundice
+
+### Response:
+",Jaundice is the most common symptom of Ca. Head of pancreas.,"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 of CA head of pancreas, with the following options: A: Vomiting, B: Pain, C: Malabsorption, D: Jaundice
+
+### Response:
+Jaundice is the most common symptom of Ca. Head of pancreas.
+### End"
+411,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: True about thiopentone-, with the following options: A: Long acting, B: Good analgesic action, C: Cerebroprotective, D: Good muscle relaxation
+
+### Response:
+","Barbiturate-induced reductions in oxygen requirements and cerebral metabolic activity are mirrored by changes in the electroencephalogram (EEG), which progress from low-voltage fast activity with small doses to high-voltage slow activity, burst suppression, and electrical silence with larger doses. Barbiturates may protect the brain from transient episodes of focal ischemia (eg, cerebral embolism) but probably do not protect from global ischemia (eg, cardiac arrest). With the reduction in CMRO2, a parallel reduction in cerebral perfusion occurs, as seen in decreased cerebral blood flow (CBF) and ICP. 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: True about thiopentone-, with the following options: A: Long acting, B: Good analgesic action, C: Cerebroprotective, D: Good muscle relaxation
+
+### Response:
+Barbiturate-induced reductions in oxygen requirements and cerebral metabolic activity are mirrored by changes in the electroencephalogram (EEG), which progress from low-voltage fast activity with small doses to high-voltage slow activity, burst suppression, and electrical silence with larger doses. Barbiturates may protect the brain from transient episodes of focal ischemia (eg, cerebral embolism) but probably do not protect from global ischemia (eg, cardiac arrest). With the reduction in CMRO2, a parallel reduction in cerebral perfusion occurs, as seen in decreased cerebral blood flow (CBF) and ICP. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e.
+### End"
+412,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Confidence limit includes:-, with the following options: A: Range and standard detion, B: Median and standard error, C: Mean and standard error, D: Mode and standard detion
+
+### Response:
+","- Confidence limit includes Mean and standard error. - Confidence limits are the upper and lower boundaries of a confidence interval. Confidence interval is the interval within which a parameter value is expected to lie with ceain confidence levels, as could be revealed by repeated samples. CI= Mean +/- (Z x Standard error), Where Z= critical value, and S.E. =Standard detion/ [?]sample size= S.D./[?]n","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Confidence limit includes:-, with the following options: A: Range and standard detion, B: Median and standard error, C: Mean and standard error, D: Mode and standard detion
+
+### Response:
+- Confidence limit includes Mean and standard error. - Confidence limits are the upper and lower boundaries of a confidence interval. Confidence interval is the interval within which a parameter value is expected to lie with ceain confidence levels, as could be revealed by repeated samples. CI= Mean +/- (Z x Standard error), Where Z= critical value, and S.E. =Standard detion/ [?]sample size= S.D./[?]n
+### End"
+413,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The index described by Brooke and Shaw to assess orthodontic treatment need from an anatomical and aesthetic perspective is:, with the following options: A: Orthodontic Treatment Priority Index (TPI), B: Index of Orthodontic Treatment Need (IOTN), C: Index of Complexity Outcome and Need (ICON), D: Dental Aesthetic Index (DAI)
+
+### Response:
+","INDEX OF ORTHODONTIC TREATMENT NEED (IOTN):
+The Index of Orthodontic Treatment Needs (IOTN) was described in 1989 by R H. Brook and W.C. Shaw to assess orthodontic treatment need from an anatomical and aesthetic perspective.
+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: The index described by Brooke and Shaw to assess orthodontic treatment need from an anatomical and aesthetic perspective is:, with the following options: A: Orthodontic Treatment Priority Index (TPI), B: Index of Orthodontic Treatment Need (IOTN), C: Index of Complexity Outcome and Need (ICON), D: Dental Aesthetic Index (DAI)
+
+### Response:
+INDEX OF ORTHODONTIC TREATMENT NEED (IOTN):
+The Index of Orthodontic Treatment Needs (IOTN) was described in 1989 by R H. Brook and W.C. Shaw to assess orthodontic treatment need from an anatomical and aesthetic perspective.
+Essentials of preventive and community dentistry
+Soben Peter
+5th edition
+### End"
+414,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Galagan formula for Flouride is:, with the following options: A: Ppm of F = - 0.038+0.0062 temperature in Fahrenheit, B: Ppm of F = 0.038+0.0062 temperature in Fahrenheit, C: Ppm of F = 0.038-0.062 temperature in Fahrenheit, D: None
+
+### Response:
+","Galagan formula for fluoride:
+This is usually calculated by the formula given by Galagan and Vermillion in 1957.
+Ppm of F‾ = - 0.038 +0.0062 t (temperature in Fahrenheit)
+‘E’ is the estimated daily water intake for children in ounces per pound of body weight.
+‘t’ is the yearly mean of the daily maximum temperature in Fahrenheit.
+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: Galagan formula for Flouride is:, with the following options: A: Ppm of F = - 0.038+0.0062 temperature in Fahrenheit, B: Ppm of F = 0.038+0.0062 temperature in Fahrenheit, C: Ppm of F = 0.038-0.062 temperature in Fahrenheit, D: None
+
+### Response:
+Galagan formula for fluoride:
+This is usually calculated by the formula given by Galagan and Vermillion in 1957.
+Ppm of F‾ = - 0.038 +0.0062 t (temperature in Fahrenheit)
+‘E’ is the estimated daily water intake for children in ounces per pound of body weight.
+‘t’ is the yearly mean of the daily maximum temperature in Fahrenheit.
+Essentials of preventive and community dentistry
+Soben Peter
+5th edition
+### End"
+415,"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 woman gave birth to a small for age newborn at 38 weeks of pregnancy. On examination, the newborn was found to have rhinitis, distended abdomen; wrinkled skin, and palmoplantar blisters. The woman had an earlier history of abortion and stillbirth. The most likely diagnosis is:, with the following options: A: Neonatal pemphigus, B: Scabies, C: Congenital syphilis, D: Congenital HIV infection
+
+### Response:
+","Ans. (c) Congenital syphilisRef: OP Ghai 8th ed./182y 273Early manifestations of congenital infection vary and involve multiple organ systems.* About 60% of infants born with congenital syphilis are asymptomatic at birth. Symptoms develop within the first 2 months of life. In symptomatic infants, the most common physical finding, reported in almost 100% of cases, is hepatomegaly; biochemical evidence of liver dysfunction is usually observed.* The other common findings are skeletal abnormalities, rash, and generalized lymphadenopathy. Radiographic abnormalities, periostitis or osteitis, involve multiple bones and are seen in the vast majority of symptomatic infants, but they also can be found in a fifth of infants with no symptoms or relevant findings on physical examination. Sometimes, the lesion is painful and an infant will favor an extremity (pseudopalsy).* The rash is maculopapular and may involve palms and soles. In contrast to acquired syphilis, a vesicular rash and bullae may develop. These lesions are also highly contagious.* Mucosal involvement may present as rhinitis (""snuffles""). Nasal secretions are highly contagious.* Hematological abnormalities include anemia and thrombocytopenia. Some infants have leukocytosis. Abnormal CSF examination is seen in a half of symptomatic infants but also can be found in 10% of those who are asymptomatic.* Late-onset congenital syphilis (diagnosed >2 y)* Scarring from the early systemic disease causes late manifestations of congenital syphilis. Manifestations include neurosyphilis and involvement of the teeth, bones, eyes, and the eighth cranial nerve, as follows:# Bone involvement - Saber shins, saddle nose# Teeth involvement - Notched, peg-shaped incisors (Hutchinson teeth)# Pigmentary involvement - Linear scars (rhagades) at the corners of the mouth# Interstitial keratitis - Presents in the first or second decade of life# Sensory-neural hearing loss (eighth cranial nerve deafness) - Presents between age 10 and 40 years.# Classic Hutchinson triad - (1) defective incisors, (2) interstitial keratitis, (3) eighth cranial nerve deafness.","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 woman gave birth to a small for age newborn at 38 weeks of pregnancy. On examination, the newborn was found to have rhinitis, distended abdomen; wrinkled skin, and palmoplantar blisters. The woman had an earlier history of abortion and stillbirth. The most likely diagnosis is:, with the following options: A: Neonatal pemphigus, B: Scabies, C: Congenital syphilis, D: Congenital HIV infection
+
+### Response:
+Ans. (c) Congenital syphilisRef: OP Ghai 8th ed./182y 273Early manifestations of congenital infection vary and involve multiple organ systems.* About 60% of infants born with congenital syphilis are asymptomatic at birth. Symptoms develop within the first 2 months of life. In symptomatic infants, the most common physical finding, reported in almost 100% of cases, is hepatomegaly; biochemical evidence of liver dysfunction is usually observed.* The other common findings are skeletal abnormalities, rash, and generalized lymphadenopathy. Radiographic abnormalities, periostitis or osteitis, involve multiple bones and are seen in the vast majority of symptomatic infants, but they also can be found in a fifth of infants with no symptoms or relevant findings on physical examination. Sometimes, the lesion is painful and an infant will favor an extremity (pseudopalsy).* The rash is maculopapular and may involve palms and soles. In contrast to acquired syphilis, a vesicular rash and bullae may develop. These lesions are also highly contagious.* Mucosal involvement may present as rhinitis (""snuffles""). Nasal secretions are highly contagious.* Hematological abnormalities include anemia and thrombocytopenia. Some infants have leukocytosis. Abnormal CSF examination is seen in a half of symptomatic infants but also can be found in 10% of those who are asymptomatic.* Late-onset congenital syphilis (diagnosed >2 y)* Scarring from the early systemic disease causes late manifestations of congenital syphilis. Manifestations include neurosyphilis and involvement of the teeth, bones, eyes, and the eighth cranial nerve, as follows:# Bone involvement - Saber shins, saddle nose# Teeth involvement - Notched, peg-shaped incisors (Hutchinson teeth)# Pigmentary involvement - Linear scars (rhagades) at the corners of the mouth# Interstitial keratitis - Presents in the first or second decade of life# Sensory-neural hearing loss (eighth cranial nerve deafness) - Presents between age 10 and 40 years.# Classic Hutchinson triad - (1) defective incisors, (2) interstitial keratitis, (3) eighth cranial nerve deafness.
+### End"
+416,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: All enveloped helical RNA viruses belong to one large group, which includes all of the following except:, with the following options: A: Influenza, B: Parainfluenza, C: Mumps, D: Herpes
+
+### Response:
+",Ans. d. Herpes,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: All enveloped helical RNA viruses belong to one large group, which includes all of the following except:, with the following options: A: Influenza, B: Parainfluenza, C: Mumps, D: Herpes
+
+### Response:
+Ans. d. Herpes
+### End"
+417,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Owl eye inclusion bodies are seen in?, with the following options: A: HSV, B: CMV, C: EBV, D: Hepatitis B
+
+### Response:
+",Ans. (b) CMV(Ref: Robbins 9th/pg 1266)Enlarged cells (cytomegaly) with intranuclear and intra- cytoplasmic inclusions are seen with cytomegalovirus infection. QThe intra nuclear inclusions appear like owl's eye inclusions in stained tissue sections,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Owl eye inclusion bodies are seen in?, with the following options: A: HSV, B: CMV, C: EBV, D: Hepatitis B
+
+### Response:
+Ans. (b) CMV(Ref: Robbins 9th/pg 1266)Enlarged cells (cytomegaly) with intranuclear and intra- cytoplasmic inclusions are seen with cytomegalovirus infection. QThe intra nuclear inclusions appear like owl's eye inclusions in stained tissue sections
+### End"
+418,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Mailgnant otitis externa is due to ?, with the following options: A: Wax impaction, B: Hypeesion, C: Diabetes, D: None of above
+
+### Response:
+","Malignant otitis externa Otitis externa is a common ear infection also known as swimmer's ear. It develops in the ear canal leading to the eardrum. In some cases, otitis externa can spread to surrounding tissue, including the bones of the jaw and face. This infection is known as malignant otitis externa. Although otitis externa is also known as swimmer's ear, malignant otitis externa isn't due to water remaining in the ear canal. Bacteria such as Pseudomonas aeruginosa and Staphylococcus aureus often cause malignant otitis externa. Over 90 percent of people who develop malignant otitis externa have diabetes. Malignant otitis externa is an aggressive infection rather than a malignancy, or cancer. An alternative name for malignant otitis externa is necrotizing external otitis. If it's not treated malignant otitis externa can be life-threatening. What causes malignant otitis externa? Malignant otitis externa isn't commonly a complication of swimmer's ear. Typically, the condition occurs when you have other health problems or you're receiving treatment that can weaken your immune system. These can include: diabetes chemotherapy HIV AIDS","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Mailgnant otitis externa is due to ?, with the following options: A: Wax impaction, B: Hypeesion, C: Diabetes, D: None of above
+
+### Response:
+Malignant otitis externa Otitis externa is a common ear infection also known as swimmer's ear. It develops in the ear canal leading to the eardrum. In some cases, otitis externa can spread to surrounding tissue, including the bones of the jaw and face. This infection is known as malignant otitis externa. Although otitis externa is also known as swimmer's ear, malignant otitis externa isn't due to water remaining in the ear canal. Bacteria such as Pseudomonas aeruginosa and Staphylococcus aureus often cause malignant otitis externa. Over 90 percent of people who develop malignant otitis externa have diabetes. Malignant otitis externa is an aggressive infection rather than a malignancy, or cancer. An alternative name for malignant otitis externa is necrotizing external otitis. If it's not treated malignant otitis externa can be life-threatening. What causes malignant otitis externa? Malignant otitis externa isn't commonly a complication of swimmer's ear. Typically, the condition occurs when you have other health problems or you're receiving treatment that can weaken your immune system. These can include: diabetes chemotherapy HIV AIDS
+### End"
+419,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Phagocytosis in brain is caused by ?, with the following options: A: Astrocytes, B: Microglia, C: Oligodendrocytes, D: Ependymal cells
+
+### Response:
+","Ans. is 'b' i.e., Microglia","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Phagocytosis in brain is caused by ?, with the following options: A: Astrocytes, B: Microglia, C: Oligodendrocytes, D: Ependymal cells
+
+### Response:
+Ans. is 'b' i.e., Microglia
+### End"
+420,"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 drugs act on cannabinoid receptors except, with the following options: A: Nabilone, B: Rimonabant, C: Mescaline, D: Dronabinol
+
+### Response:
+","Mescaline does not act on cannabinoid receptors. Dronabinol and nabilone increase appetite and act as antiemetics. Rimonabant is banned now(D/T increased suicides) Mescaline is a naturally occuring hallucinogenic drug. 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: All the following drugs act on cannabinoid receptors except, with the following options: A: Nabilone, B: Rimonabant, C: Mescaline, D: Dronabinol
+
+### Response:
+Mescaline does not act on cannabinoid receptors. Dronabinol and nabilone increase appetite and act as antiemetics. Rimonabant is banned now(D/T increased suicides) Mescaline is a naturally occuring hallucinogenic drug. Ref: KD Tripathi, 8th ed
+### End"
+421,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: LMN involves:, with the following options: A: Peripheral nerves, B: Anterior horn cell, C: Anterior nerve root, D: All
+
+### Response:
+",A i.e. Peripheral nerve; B i.e. Anterior horn cell; C i.e. Anterior nerve root,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: LMN involves:, with the following options: A: Peripheral nerves, B: Anterior horn cell, C: Anterior nerve root, D: All
+
+### Response:
+A i.e. Peripheral nerve; B i.e. Anterior horn cell; C i.e. Anterior nerve root
+### End"
+422,"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-, with the following options: A: High fibre diet, B: Cystic fibrosis, C: Hypothyroidism, D: All
+
+### Response:
+","Ans is 'a' i.e., High fibre diet Constipation in infants and children 3 Constipation is extremely common in pediatric population. o 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. o Organic causes of constipation are: (i) Intestinal: Hirschprung disease, Anal/rectal stenosis, Anal fissure, anteriorly displaced anal opening, strictures. (ii) Drugs: Narcotics, vincristine, Psychotropics. (iii) Metabolic/endocrine: Cystic fibrosis, hypothyroidism, Panhypopituitrism (iv) Neuromuscular: Cerebral palsy, Psychomotor retardation, spinal cord lesions, Myotonic dystophy, Neuropathy or myopathy of GIT (v) 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-, with the following options: A: High fibre diet, B: Cystic fibrosis, C: Hypothyroidism, D: All
+
+### Response:
+Ans is 'a' i.e., High fibre diet Constipation in infants and children 3 Constipation is extremely common in pediatric population. o 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. o Organic causes of constipation are: (i) Intestinal: Hirschprung disease, Anal/rectal stenosis, Anal fissure, anteriorly displaced anal opening, strictures. (ii) Drugs: Narcotics, vincristine, Psychotropics. (iii) Metabolic/endocrine: Cystic fibrosis, hypothyroidism, Panhypopituitrism (iv) Neuromuscular: Cerebral palsy, Psychomotor retardation, spinal cord lesions, Myotonic dystophy, Neuropathy or myopathy of GIT (v) Other causes: Low fibre diet, Milk protein allergy.
+### End"
+423,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Mad Cow disease (Bovine Spongioform Encephalopathy) is similar in man to -, with the following options: A: Alzheimer's Disease, B: Creutzfeldt Jacod Disease, C: Huntingtons Chorea, D: Picks Disease
+
+### Response:
+","CJD is a subacute preaenile encephalopathy with progressive incordination and dementia ending fatally in about a year.It is a prion disease. prion disease in animals include scrapie,mink encephalopathy,BSE madcow disease.These are caused by slow virus group B. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:556,557","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Mad Cow disease (Bovine Spongioform Encephalopathy) is similar in man to -, with the following options: A: Alzheimer's Disease, B: Creutzfeldt Jacod Disease, C: Huntingtons Chorea, D: Picks Disease
+
+### Response:
+CJD is a subacute preaenile encephalopathy with progressive incordination and dementia ending fatally in about a year.It is a prion disease. prion disease in animals include scrapie,mink encephalopathy,BSE madcow disease.These are caused by slow virus group B. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:556,557
+### End"
+424,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: True about lung compliance:, with the following options: A: Ratio of change in volume to pressure, B: Has inspiratory and expiratory component, C: Hysteresis exists, D: All
+
+### Response:
+","The difference between the inspiratory and expiratory component of the lung is hysteresis It is due to difference in compliance of lung during inspiration and expiration It is due to difference between concentration of surfactants during inspiration and expiration Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:319,320","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: True about lung compliance:, with the following options: A: Ratio of change in volume to pressure, B: Has inspiratory and expiratory component, C: Hysteresis exists, D: All
+
+### Response:
+The difference between the inspiratory and expiratory component of the lung is hysteresis It is due to difference in compliance of lung during inspiration and expiration It is due to difference between concentration of surfactants during inspiration and expiration Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:319,320
+### End"
+425,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Not intravenous Anasthetic agent, with the following options: A: Ketamine, B: Thiopantone, C: Etomidate, D: Cyclopropane
+
+### Response:
+",D i.e. Cyclopropane,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Not intravenous Anasthetic agent, with the following options: A: Ketamine, B: Thiopantone, C: Etomidate, D: Cyclopropane
+
+### Response:
+D i.e. Cyclopropane
+### End"
+426,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: BRCA 1 gene is located on-, with the following options: A: Chromosome 13, B: Chromosome 11, C: Chromosome 17, D: Chromosome 22
+
+### Response:
+",. Chromosome 17,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: BRCA 1 gene is located on-, with the following options: A: Chromosome 13, B: Chromosome 11, C: Chromosome 17, D: Chromosome 22
+
+### Response:
+. Chromosome 17
+### End"
+427,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Rider's bones are ossification of, with the following options: A: Adductor brevis, B: Adductor longus, C: Adductor magnus, D: Flexor digitorum superficialis
+
+### Response:
+","Rider's bone develops in the tendon of adductor longus in professional riders. It is a sesamoid bone.that has no periosteum and ossifies after bih. Reference: BD Chaurasia's handbook of general anatomy, 5th edition, pg 55","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Rider's bones are ossification of, with the following options: A: Adductor brevis, B: Adductor longus, C: Adductor magnus, D: Flexor digitorum superficialis
+
+### Response:
+Rider's bone develops in the tendon of adductor longus in professional riders. It is a sesamoid bone.that has no periosteum and ossifies after bih. Reference: BD Chaurasia's handbook of general anatomy, 5th edition, pg 55
+### End"
+428,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A 22-year-old lady died. The postmortem appearance that will indicate that she has had delivered a child are all, except -, with the following options: A: Walls of uterus are convex from inside, B: Cervix is irregular and external os is patulous, C: Body of uterus is twice the length of cervix, D: Uterus is bulky, large and heavy than nullipara.
+
+### Response:
+","Signs of remote delivery in a dead lady.
+
+
+Large, thicker and heavier uterus.
+Walls of the uterus are concave from inside.
+The body of the uterus is twice the length of the cervix (of the same length in virgin).
+Top of the fundus is convex and at a higher level than that of the broad ligament.
+The cervix is irregular in form, shortened and its edges show cicatrices.
+External os is enlarged and internal os is not so well defined.
+Mucosal folds are present in the canal of the cervix.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A 22-year-old lady died. The postmortem appearance that will indicate that she has had delivered a child are all, except -, with the following options: A: Walls of uterus are convex from inside, B: Cervix is irregular and external os is patulous, C: Body of uterus is twice the length of cervix, D: Uterus is bulky, large and heavy than nullipara.
+
+### Response:
+Signs of remote delivery in a dead lady.
+
+
+Large, thicker and heavier uterus.
+Walls of the uterus are concave from inside.
+The body of the uterus is twice the length of the cervix (of the same length in virgin).
+Top of the fundus is convex and at a higher level than that of the broad ligament.
+The cervix is irregular in form, shortened and its edges show cicatrices.
+External os is enlarged and internal os is not so well defined.
+Mucosal folds are present in the canal of the cervix.
+### End"
+429,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Principles of primary health care include all except: March 2011, with the following options: A: Treatment is done by a doctor, B: Equitable distribution, C: Intersectoral co-ordination, D: Appropriate technology
+
+### Response:
+","Ans. A: Treatment is done by doctor Principles of primary health care are equitable distribution, community paicipation, intersectoral coordination and appropriate technology Primary health care The Alma Ata Conference defines Primary Health Care as essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally, accessible to individuals and families in the community by means of acceptable to them, through their full paicipation and at a cost that community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination. It forms an integral pa of both the country's health system, of which it is the central function and the main focus and of the overall social and economic development of the community Goal The global goal as stated in the Alma Ata Declaration is Health for All by the year 2000 through self-reliance. - Health begins at home, in schools and in the workplace because it is there where people live and work that health is made or broken. - It also means that people will use better approaches than they do now for preventing diseases and alleting unavoidable disease and disability and have better ways of growing up, growing old and dying gracefully. - It also means that here will be even distribution among the population of whatever resources for health are available. - It means that essential health services will be accessible to all individuals and families in an acceptable and affordable way. Principles and Strategies: Accessibility, Availability, Affordability and Acceptability of Health Services Strategies: - Health services delivered where the people are - Use of indigenous/resident volunteer health worker as a health care provider with a ratio of one community health worker per 10-20 households - Use of traditional (herbal medicine) with essential drugs. Provision of quality, basic and essential health services Strategies: - Training design and curriculum based on community needs and priorities. - Attitudes, knowledge and skills developed are on promotive, preventive, curative and rehabilitative health care. - Regular monitoring and periodic evaluation of community health workers performance by the community and health staff. Community Paicipation Strategies: - Awareness, building and consciousness raising on health and health-related issues. - Planning, implementation, monitoring and evaluation done through small group meetings (10-20 households cluster) Selection of community health workers by the community. - Formation of health committees. Establishment of a community health organization at the parish or municipal level. - Mass health campaigns and mobilization to combat health problems. Self-reliance Strategies Community generates suppo (cash, labor) for health programs. - Use of local resources (human, financial, material) - Training of community in leadership and management skills. - Incorporation of income generating projects, cooperatives and small scale industries. Recognition of interrelationship of health and development Strategies: - Convergence of health, food, nutrition, water, sanitation and population services. Integration of PHC into national, regional, provincial, municipal and barangay development plans. - Coordination of activities with economic planning, education, agriculture, industry, housing, public works, communication and social services. Establishment of an effective health referral system. Social Mobilization Strategies - Establishment of an effective health referral system. - Multi-sectoral and interdisciplinary linkage. - Information, education, communication suppo using multi-media. - Collaboration between government and non-governmental organizations. Decentralization Strategies - Reallocation of budgetary resources. - Reorientation of health professional and PHC. Advocacy for political and suppo from the national leadership down to the barangay level. 8 Essential Health Services in Primary Health Care - E - Education for Health - L - Locally endemic disease control - C - Expanded program for immunization M - Maternal and Child Health including responsible parenthood - E - Essential drugs - N - Nutrition - T - Treatment of communicable and non-communicable diseases - S - Safe water and sanitation Remember ELEMENTS","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Principles of primary health care include all except: March 2011, with the following options: A: Treatment is done by a doctor, B: Equitable distribution, C: Intersectoral co-ordination, D: Appropriate technology
+
+### Response:
+Ans. A: Treatment is done by doctor Principles of primary health care are equitable distribution, community paicipation, intersectoral coordination and appropriate technology Primary health care The Alma Ata Conference defines Primary Health Care as essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally, accessible to individuals and families in the community by means of acceptable to them, through their full paicipation and at a cost that community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination. It forms an integral pa of both the country's health system, of which it is the central function and the main focus and of the overall social and economic development of the community Goal The global goal as stated in the Alma Ata Declaration is Health for All by the year 2000 through self-reliance. - Health begins at home, in schools and in the workplace because it is there where people live and work that health is made or broken. - It also means that people will use better approaches than they do now for preventing diseases and alleting unavoidable disease and disability and have better ways of growing up, growing old and dying gracefully. - It also means that here will be even distribution among the population of whatever resources for health are available. - It means that essential health services will be accessible to all individuals and families in an acceptable and affordable way. Principles and Strategies: Accessibility, Availability, Affordability and Acceptability of Health Services Strategies: - Health services delivered where the people are - Use of indigenous/resident volunteer health worker as a health care provider with a ratio of one community health worker per 10-20 households - Use of traditional (herbal medicine) with essential drugs. Provision of quality, basic and essential health services Strategies: - Training design and curriculum based on community needs and priorities. - Attitudes, knowledge and skills developed are on promotive, preventive, curative and rehabilitative health care. - Regular monitoring and periodic evaluation of community health workers performance by the community and health staff. Community Paicipation Strategies: - Awareness, building and consciousness raising on health and health-related issues. - Planning, implementation, monitoring and evaluation done through small group meetings (10-20 households cluster) Selection of community health workers by the community. - Formation of health committees. Establishment of a community health organization at the parish or municipal level. - Mass health campaigns and mobilization to combat health problems. Self-reliance Strategies Community generates suppo (cash, labor) for health programs. - Use of local resources (human, financial, material) - Training of community in leadership and management skills. - Incorporation of income generating projects, cooperatives and small scale industries. Recognition of interrelationship of health and development Strategies: - Convergence of health, food, nutrition, water, sanitation and population services. Integration of PHC into national, regional, provincial, municipal and barangay development plans. - Coordination of activities with economic planning, education, agriculture, industry, housing, public works, communication and social services. Establishment of an effective health referral system. Social Mobilization Strategies - Establishment of an effective health referral system. - Multi-sectoral and interdisciplinary linkage. - Information, education, communication suppo using multi-media. - Collaboration between government and non-governmental organizations. Decentralization Strategies - Reallocation of budgetary resources. - Reorientation of health professional and PHC. Advocacy for political and suppo from the national leadership down to the barangay level. 8 Essential Health Services in Primary Health Care - E - Education for Health - L - Locally endemic disease control - C - Expanded program for immunization M - Maternal and Child Health including responsible parenthood - E - Essential drugs - N - Nutrition - T - Treatment of communicable and non-communicable diseases - S - Safe water and sanitation Remember ELEMENTS
+### End"
+430,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Specific Tumor marker is seen in -, with the following options: A: Ca breast, B: Ca lung, C: Ca liver, D: Ca ovary
+
+### Response:
+"," Ref Harrison 20th edition pg 528","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Specific Tumor marker is seen in -, with the following options: A: Ca breast, B: Ca lung, C: Ca liver, D: Ca ovary
+
+### Response:
+
Ref Harrison 20th edition pg 528
+### End"
+431,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Child with h/o hypopigmented macule on back, infantile spasm and delayed milestone has, with the following options: A: NF, B: Sturge weber syndrome, C: Tuberous sclerosis, D: Nevus anemicus.
+
+### Response:
+",C i.e. Tuberous sclerosis,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Child with h/o hypopigmented macule on back, infantile spasm and delayed milestone has, with the following options: A: NF, B: Sturge weber syndrome, C: Tuberous sclerosis, D: Nevus anemicus.
+
+### Response:
+C i.e. Tuberous sclerosis
+### End"
+432,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Acute severe malnutrition diagnostic criteria include all except, with the following options: A: Weight for height below 2SD of WHO Growth Standards 2006, B: Visible severe wasting, C: Mid arm circumference below 115 mm, D: Bipedal edema
+
+### Response:
+","WHO & UNICEF’s Acute Malnutrition Criteria
+
+Presence of Bipedal edema
+Visible severe wasting
+Mid arm circumference below 115 mm
+Weight for height below 3SD of WHO Growth Standards 2006","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Acute severe malnutrition diagnostic criteria include all except, with the following options: A: Weight for height below 2SD of WHO Growth Standards 2006, B: Visible severe wasting, C: Mid arm circumference below 115 mm, D: Bipedal edema
+
+### Response:
+WHO & UNICEF’s Acute Malnutrition Criteria
+
+Presence of Bipedal edema
+Visible severe wasting
+Mid arm circumference below 115 mm
+Weight for height below 3SD of WHO Growth Standards 2006
+### End"
+433,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: In pyloric stenosis, the following changes are seen:March 2011, with the following options: A: Hypokalemic hyponatremic alkalosis, B: Hyperkalemia, C: Acidosis with hyponatremic alkalosis, D: Hyperchloremic acidosis
+
+### Response:
+","Ans. A: Hypokalemic hyponatremic alkalosisThe vomiting of hydrochloric acid results in hypochloraemic alkalosis but, initially sodium and potassium levels may be relatively normal, but later on bicarbonate is excreted along with sodium and so, with time, the patient becomes progressively hyponatremic and more profoundly dehydrated.Because of dehydration, a phase of sodium retention follows and potassium and hydrogen are excreted in preference. This results in the urine becoming paradoxically acidic and hypokalemia ensues","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: In pyloric stenosis, the following changes are seen:March 2011, with the following options: A: Hypokalemic hyponatremic alkalosis, B: Hyperkalemia, C: Acidosis with hyponatremic alkalosis, D: Hyperchloremic acidosis
+
+### Response:
+Ans. A: Hypokalemic hyponatremic alkalosisThe vomiting of hydrochloric acid results in hypochloraemic alkalosis but, initially sodium and potassium levels may be relatively normal, but later on bicarbonate is excreted along with sodium and so, with time, the patient becomes progressively hyponatremic and more profoundly dehydrated.Because of dehydration, a phase of sodium retention follows and potassium and hydrogen are excreted in preference. This results in the urine becoming paradoxically acidic and hypokalemia ensues
+### End"
+434,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A 45-year-old man presents with two painless beefy red ulcers in the inguinal region, a biopsy and Giemsa stain reveal Donovan bodies, these findings are most consistent with? SELECT ONE, with the following options: A: Behcet's syndrome, B: Glomus tumor, C: Renal agenesis, D: Granuloma inguinale
+
+### Response:
+","Granuloma inguinale is a lesion related to a contagious, sexually transmitted disease. Identification of Donovan bodies in tissue prepared with Giemsa stain establishes the diagnosis. Treatment is with tetracycline.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A 45-year-old man presents with two painless beefy red ulcers in the inguinal region, a biopsy and Giemsa stain reveal Donovan bodies, these findings are most consistent with? SELECT ONE, with the following options: A: Behcet's syndrome, B: Glomus tumor, C: Renal agenesis, D: Granuloma inguinale
+
+### Response:
+Granuloma inguinale is a lesion related to a contagious, sexually transmitted disease. Identification of Donovan bodies in tissue prepared with Giemsa stain establishes the diagnosis. Treatment is with tetracycline.
+### End"
+435,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: 5 YR old unvaccinated came to OPD with fever and red eyes on examination the following type of rash is seen. What is the most likely complication associated with this condition Caption, with the following options: A: Acute myocarditis, B: Acute nephritis, C: Acute pancreatitis, D: Acute orchits
+
+### Response:
+","In above case child is usually suffering from measles. Most likely complication associated with this condition among the above option is Acute myocarditis. Virus causing myocarditis- Common - Coxsackie A,B , Echovirus, HIV , Influenza Less common - Adenovirus, measles , HSV 1, Cytomegalovirus, Rubella and varicella zoster.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: 5 YR old unvaccinated came to OPD with fever and red eyes on examination the following type of rash is seen. What is the most likely complication associated with this condition Caption, with the following options: A: Acute myocarditis, B: Acute nephritis, C: Acute pancreatitis, D: Acute orchits
+
+### Response:
+In above case child is usually suffering from measles. Most likely complication associated with this condition among the above option is Acute myocarditis. Virus causing myocarditis- Common - Coxsackie A,B , Echovirus, HIV , Influenza Less common - Adenovirus, measles , HSV 1, Cytomegalovirus, Rubella and varicella zoster.
+### End"
+436,"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 man is admitted to the emergency department with a stab wound in the superior region of his neck. A radiographic examination reveals that the wound has not affected any major structures. Physical examination reveals that the patient has lost sensation from the skin over the angle of the jaw. Which of the following nerves is most likely injured?, with the following options: A: Supraclavicular, B: Transverse cervical, C: Great auricular, D: Greater occipital
+
+### Response:
+","Four nerves participate in providing cutaneous supply to the neck. The nerves are the supraclavicular, great auricular, transverse cervical, and the lesser occipital. The area over the angle of the jaw is innervated by the great auricular nerve. It ascends from spinal segments from C2 and C3 and innervates the skin over the angle of the jaw and posteroinferior to the auricle of the ear. The transverse cervical also originates from C2-3 spinal segments but passes anteriorly to innervate the anterior and lateral aspects of the neck. The lesser occipital nerve innervates skin in the area of the back of the neck and posterior occiput. The supraclavicular nerves originate from C3-4 and innervate the more inferior aspects of the neck, the upper deltoid region, and skin inferior to the clavicles.","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 man is admitted to the emergency department with a stab wound in the superior region of his neck. A radiographic examination reveals that the wound has not affected any major structures. Physical examination reveals that the patient has lost sensation from the skin over the angle of the jaw. Which of the following nerves is most likely injured?, with the following options: A: Supraclavicular, B: Transverse cervical, C: Great auricular, D: Greater occipital
+
+### Response:
+Four nerves participate in providing cutaneous supply to the neck. The nerves are the supraclavicular, great auricular, transverse cervical, and the lesser occipital. The area over the angle of the jaw is innervated by the great auricular nerve. It ascends from spinal segments from C2 and C3 and innervates the skin over the angle of the jaw and posteroinferior to the auricle of the ear. The transverse cervical also originates from C2-3 spinal segments but passes anteriorly to innervate the anterior and lateral aspects of the neck. The lesser occipital nerve innervates skin in the area of the back of the neck and posterior occiput. The supraclavicular nerves originate from C3-4 and innervate the more inferior aspects of the neck, the upper deltoid region, and skin inferior to the clavicles.
+### End"
+437,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Not an indication for percutaneous aspiration in amoebic liver abscess, with the following options: A: Radiographically unresolved lesion after 6 months after 6 months, B: Suspected diagnosis, C: Left lobe liver abscess, D: Compression or outflow obstruction of hepatic or poal vein
+
+### Response:
+","Amoebic liver abscess Although clinical improvement after adequate treatment with antiamoebic agents is the rule, radiologic resolution of the abscess cavity is usually delayed The average time to radiologic resolution is 3 to 9 months and can take as long as years in some patients Studies have shown that more than 90% of the visible lesions disappear radiologically, but a small percentage of patients are left with a clinically irrelevant residual lesion Ref: Sabiston 20th edition Pgno : 1452","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Not an indication for percutaneous aspiration in amoebic liver abscess, with the following options: A: Radiographically unresolved lesion after 6 months after 6 months, B: Suspected diagnosis, C: Left lobe liver abscess, D: Compression or outflow obstruction of hepatic or poal vein
+
+### Response:
+Amoebic liver abscess Although clinical improvement after adequate treatment with antiamoebic agents is the rule, radiologic resolution of the abscess cavity is usually delayed The average time to radiologic resolution is 3 to 9 months and can take as long as years in some patients Studies have shown that more than 90% of the visible lesions disappear radiologically, but a small percentage of patients are left with a clinically irrelevant residual lesion Ref: Sabiston 20th edition Pgno : 1452
+### End"
+438,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Independent risk factors for endometrial hyperplasia are all except, with the following options: A: Obesity, B: Diabetes, C: Hypertension, D: Tamoxifen
+
+### Response:
+",Hypertension is not independent risk factor for endometrial hyperplasia causing AUB.,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Independent risk factors for endometrial hyperplasia are all except, with the following options: A: Obesity, B: Diabetes, C: Hypertension, D: Tamoxifen
+
+### Response:
+Hypertension is not independent risk factor for endometrial hyperplasia causing AUB.
+### End"
+439,"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 eating disorder, with the following options: A: Enuresis, B: Bulimia nervosa, C: Encoparesis, D: Tourette disorder
+
+### Response:
+","Feeding and eating disorders: Pica, Rumination Disorder, Restrictive Food Intake Disorder, Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder.*Pica: the persistent eating of non-nutritive, non-food substances (>! Month)*Rumination Disorder: Repeated regurgitation of food rechewed, reswallowed, spit out(>1month)Restrictive Food Intake Disorder: failure to meet appropriate nutritional needs resulting in weight loss, nutritional deficiency, nutritional supplements*Anorexia Nervosa:Refusal to maintain body weight above normal weight for age and height the relentless drive for thinness and/or an intense fear of gaining weight --a psychopathologyself-induced starvation (restriction/ binge eating followed by purging)--a behavior.presence of medical signs and symptoms resulting from starvation:-Cachexia, amenorrhea, hypothermia, bradycardia, hypotension, lanugo hair, Leukopenia, Osteoporosis, hypokalemic alkalosis (repeated vomiting) E.*Bulimia Nervosa: clinical features(physical and psychological ) are milder compared to Anorexia nervosa the person has the goal of becoming thin but is not able to sustain prolonged periods of starvation, hunger. F: Binge Eating Disorder: Binge episodes are defined as repeated rapid and usually private episodes of overeating large quantities of food that is generally of dense caloric content, leading to guilt, anxiety about becoming fat, low self-esteem, and frequently gastric distressEncopresis*: Involuntary passage of feces, usually occurring at night or during sleep.Enuresis*: Incontinence of urine during sleep.Ref: P.329 section II Feeding And Eating Disorders(DSM-5) p.923 chap7.3 Signs and Symptoms in Psychiatry","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 eating disorder, with the following options: A: Enuresis, B: Bulimia nervosa, C: Encoparesis, D: Tourette disorder
+
+### Response:
+Feeding and eating disorders: Pica, Rumination Disorder, Restrictive Food Intake Disorder, Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder.*Pica: the persistent eating of non-nutritive, non-food substances (>! Month)*Rumination Disorder: Repeated regurgitation of food rechewed, reswallowed, spit out(>1month)Restrictive Food Intake Disorder: failure to meet appropriate nutritional needs resulting in weight loss, nutritional deficiency, nutritional supplements*Anorexia Nervosa:Refusal to maintain body weight above normal weight for age and height the relentless drive for thinness and/or an intense fear of gaining weight --a psychopathologyself-induced starvation (restriction/ binge eating followed by purging)--a behavior.presence of medical signs and symptoms resulting from starvation:-Cachexia, amenorrhea, hypothermia, bradycardia, hypotension, lanugo hair, Leukopenia, Osteoporosis, hypokalemic alkalosis (repeated vomiting) E.*Bulimia Nervosa: clinical features(physical and psychological ) are milder compared to Anorexia nervosa the person has the goal of becoming thin but is not able to sustain prolonged periods of starvation, hunger. F: Binge Eating Disorder: Binge episodes are defined as repeated rapid and usually private episodes of overeating large quantities of food that is generally of dense caloric content, leading to guilt, anxiety about becoming fat, low self-esteem, and frequently gastric distressEncopresis*: Involuntary passage of feces, usually occurring at night or during sleep.Enuresis*: Incontinence of urine during sleep.Ref: P.329 section II Feeding And Eating Disorders(DSM-5) p.923 chap7.3 Signs and Symptoms in Psychiatry
+### End"
+440,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: In vision 2020 of NPCB, center of excellence are-, with the following options: A: 20000, B: 2000, C: 200, D: 20
+
+### Response:
+","Ans. is 'd' i.e., 20 o 'Vision 2020: The Right to Sight', is a global initiative launched by WHO in 1999 in a broad coalition with a 'Task Force of International Non-Governmental Organisations (NGOs)' to combat the gigantic problem of blindness in the world.o Objective of vision 2020. Objective is to eliminate avoidable blindness by the year 2020 and to reduce the global burden of blindness.o Government of India has adopted 'Vision 2020: Right to Sight' under National Programme for Control of Blindness.o Based on the recommendations of WHO. there is need to develop the infrastructure pyramid wrhich includesPrimary level Vision CentresThere is a need to develop 20000 vision centres,y Each with one Ophthalmic Assistant or equivalent (Community based MLOP)y Covering a population of 50000.Service Centres.There is need to develop 2000 service centres at secondary# level.Each with two ophthalmologists and 8 paramedics (Hospital based MLOP), and one eye care manager,Covering a population of 5 lacs.Training CentresThere is a need to develop 200 ""Training Centres' for the training of Ophthalmologists.Covering a population of 50 lacs.Centre of Excellence (COE)There is need to develop 20 COE with well de\>eloped all sub specialities of Ophthalmology\Covering a population of 5 crores.The infrastructure for Vision 2020","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: In vision 2020 of NPCB, center of excellence are-, with the following options: A: 20000, B: 2000, C: 200, D: 20
+
+### Response:
+Ans. is 'd' i.e., 20 o 'Vision 2020: The Right to Sight', is a global initiative launched by WHO in 1999 in a broad coalition with a 'Task Force of International Non-Governmental Organisations (NGOs)' to combat the gigantic problem of blindness in the world.o Objective of vision 2020. Objective is to eliminate avoidable blindness by the year 2020 and to reduce the global burden of blindness.o Government of India has adopted 'Vision 2020: Right to Sight' under National Programme for Control of Blindness.o Based on the recommendations of WHO. there is need to develop the infrastructure pyramid wrhich includesPrimary level Vision CentresThere is a need to develop 20000 vision centres,y Each with one Ophthalmic Assistant or equivalent (Community based MLOP)y Covering a population of 50000.Service Centres.There is need to develop 2000 service centres at secondary# level.Each with two ophthalmologists and 8 paramedics (Hospital based MLOP), and one eye care manager,Covering a population of 5 lacs.Training CentresThere is a need to develop 200 ""Training Centres' for the training of Ophthalmologists.Covering a population of 50 lacs.Centre of Excellence (COE)There is need to develop 20 COE with well de\>eloped all sub specialities of Ophthalmology\Covering a population of 5 crores.The infrastructure for Vision 2020
+### End"
+441,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Structures present at the lateral wall of cavernous sinus are all EXCEPT:, with the following options: A: Maxillary nerve, B: Ophthalmic nerve, C: Trochlear nerve, D: Optic nerve
+
+### Response:
+","ANSWER: (D) Optic nerveREF: Grays anatomy 39m edition page 277 CAVERNOUS SINUS:The cavernous sinus is a large venous plexus that lies on both sides of the body of the sphenoid bone. The sinus extends from the superior orbital fissure to the apex of the petrous temporal bone, with an average length of 2 cm and width of 1 cm.i. Tributaries of the cavernous sinus are the superior ophthalmic vein, a branch from the inferior ophthalmic vein (or sometimes the wrhole vessel), the superficial middle cerebral vein, inferior cerebral veins and sphenoparietal sinus. The central retinal vein and frontal tributary of the middle meningeal vein sometimes drain into it.ii. Contents:* Carotid artery* Sympathetic chain* Abducens nerveiii. Lateral wall:* Uncus of the temporal lobe* Oculomotor nerve* Trochlear nerve* Ophthalmic nerve* Maxillary nerve","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Structures present at the lateral wall of cavernous sinus are all EXCEPT:, with the following options: A: Maxillary nerve, B: Ophthalmic nerve, C: Trochlear nerve, D: Optic nerve
+
+### Response:
+ANSWER: (D) Optic nerveREF: Grays anatomy 39m edition page 277 CAVERNOUS SINUS:The cavernous sinus is a large venous plexus that lies on both sides of the body of the sphenoid bone. The sinus extends from the superior orbital fissure to the apex of the petrous temporal bone, with an average length of 2 cm and width of 1 cm.i. Tributaries of the cavernous sinus are the superior ophthalmic vein, a branch from the inferior ophthalmic vein (or sometimes the wrhole vessel), the superficial middle cerebral vein, inferior cerebral veins and sphenoparietal sinus. The central retinal vein and frontal tributary of the middle meningeal vein sometimes drain into it.ii. Contents:* Carotid artery* Sympathetic chain* Abducens nerveiii. Lateral wall:* Uncus of the temporal lobe* Oculomotor nerve* Trochlear nerve* Ophthalmic nerve* Maxillary nerve
+### End"
+442,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The antiviral drug used for treatment of cytomeglovirus retinitis is:, with the following options: A: Acyclovir, B: Ganciclovir, C: Triflurothymidine, D: All of the above
+
+### Response:
+",Ans. Ganciclovir,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The antiviral drug used for treatment of cytomeglovirus retinitis is:, with the following options: A: Acyclovir, B: Ganciclovir, C: Triflurothymidine, D: All of the above
+
+### Response:
+Ans. Ganciclovir
+### End"
+443,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: In ICU setting patients suffering from which respiratory pathology are at risk of CO2 narcosis?, with the following options: A: Pneumonia, B: Asthma, C: Emphysema, D: Bronchieactasis
+
+### Response:
+","Ans. is 'c' i.e., Emphysema Metabolic causes of altered consciousness in ICU* In the ICU setting, several metabolic causes of an altered level of consciousness predominate.* Hypercarbic encephalopathy can present with headache, confusion, stupor, or coma.* Hypoventilation syndrome occurs most frequently in patients with a history of chronic CO2 retention who are receiving oxygen therapy for emphysema or chronic pulmonary disease.* The elevated Paco2 leading to CO2 narcosis may have a direct anesthetic effect, and cerebral vasodilation from increased PaCO2 can lead to increased ICP.* Hepatic encephalopathy is suggested by asterixis and can occur in chronic liver failure or acute fulminant hepatic failure.* Both hyperglycemia and hypoglycemia can cause encephalopathy, as can hypernatremia and hyponatremia.* Confusion, impairment of eye movements, and gait ataxia are the hallmarks of acute Wernicke's disease.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: In ICU setting patients suffering from which respiratory pathology are at risk of CO2 narcosis?, with the following options: A: Pneumonia, B: Asthma, C: Emphysema, D: Bronchieactasis
+
+### Response:
+Ans. is 'c' i.e., Emphysema Metabolic causes of altered consciousness in ICU* In the ICU setting, several metabolic causes of an altered level of consciousness predominate.* Hypercarbic encephalopathy can present with headache, confusion, stupor, or coma.* Hypoventilation syndrome occurs most frequently in patients with a history of chronic CO2 retention who are receiving oxygen therapy for emphysema or chronic pulmonary disease.* The elevated Paco2 leading to CO2 narcosis may have a direct anesthetic effect, and cerebral vasodilation from increased PaCO2 can lead to increased ICP.* Hepatic encephalopathy is suggested by asterixis and can occur in chronic liver failure or acute fulminant hepatic failure.* Both hyperglycemia and hypoglycemia can cause encephalopathy, as can hypernatremia and hyponatremia.* Confusion, impairment of eye movements, and gait ataxia are the hallmarks of acute Wernicke's disease.
+### End"
+444,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Root value of pudendal nerve -, with the following options: A: S1S2S3, B: S2S3S4, C: S3-S4, D: S2-S3
+
+### Response:
+","Ans. is 'b' i.e., S2S3S4 NerveRoot valveo Sciatic nervey Tibial nervey Common peroneal nerveL-4,5 S1,2,3L-4.5 S1,2,3L-4,5 S1,2o Superior gluteal nerveL-4,5 S1o Inferior gluteal nerveL5S1,2o The nerve to quadratus femorisL-4,5 S1o Nerve to obturatus internusL5S1,2o Superior gemellusL-4,5S1o Inferior gemellusL4,5 S1,2o The posterior cutaneous nerve of thighS1,2,3o Pudendal nerveS1, S3, S4o Perforating cutaneous nerveS2,3","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Root value of pudendal nerve -, with the following options: A: S1S2S3, B: S2S3S4, C: S3-S4, D: S2-S3
+
+### Response:
+Ans. is 'b' i.e., S2S3S4 NerveRoot valveo Sciatic nervey Tibial nervey Common peroneal nerveL-4,5 S1,2,3L-4.5 S1,2,3L-4,5 S1,2o Superior gluteal nerveL-4,5 S1o Inferior gluteal nerveL5S1,2o The nerve to quadratus femorisL-4,5 S1o Nerve to obturatus internusL5S1,2o Superior gemellusL-4,5S1o Inferior gemellusL4,5 S1,2o The posterior cutaneous nerve of thighS1,2,3o Pudendal nerveS1, S3, S4o Perforating cutaneous nerveS2,3
+### End"
+445,"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 alpha fetoprotein is raised in all of the following except., with the following options: A: Cirrohosis of liver., B: Hepatocellur carcinoma, C: Yolk sac tumor, D: Dysgerminoma
+
+### Response:
+",Ans. is 'd' i.e. Dysgerminoma Elevation of a feto protein is not seen in dysgerminoma. It may sometimes show elevation of bHCG.Raised a fetoprotein is seen in:Neoplastic conditions:Liver cancerGerm cell tumours of testis (non seminomatous)Yolk sac tumours*Embryonal carcinoma*Non neoplastic conditions:Cirrhosis*Pregnancy*,"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 alpha fetoprotein is raised in all of the following except., with the following options: A: Cirrohosis of liver., B: Hepatocellur carcinoma, C: Yolk sac tumor, D: Dysgerminoma
+
+### Response:
+Ans. is 'd' i.e. Dysgerminoma Elevation of a feto protein is not seen in dysgerminoma. It may sometimes show elevation of bHCG.Raised a fetoprotein is seen in:Neoplastic conditions:Liver cancerGerm cell tumours of testis (non seminomatous)Yolk sac tumours*Embryonal carcinoma*Non neoplastic conditions:Cirrhosis*Pregnancy*
+### End"
+446,"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 Lambda phage are true, EXCEPT:, with the following options: A: In Lysogenic phase it fuses with host chromosome and remains dormant, B: In Lytic phase it fuses with host chromosome and replicates, C: Both Lytic and Lysogenic phases occur together, D: In Lytic phase it causes cell lysis and releases virus paicles
+
+### Response:
+","In a lambda phage, lytic phase and lysogenic phase does not occur together.Primary event in the genetic switch between lysis and lysogeny is governed by the level of lambda encoded proteins required for the lytic pathway. If one set of lambda immediate early genes are transcribed, then the lytic pathway is ored. If a transcriptionally repressor protein encoded by lambda cl gene inhibits the transcription, lysogeny is ored. Ref: Introduction to Plant Biotechnology, 3rd Edition By Chawla, Page 238; Cell and Molecular Biology By S. C. Rastogi, Page 530","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 Lambda phage are true, EXCEPT:, with the following options: A: In Lysogenic phase it fuses with host chromosome and remains dormant, B: In Lytic phase it fuses with host chromosome and replicates, C: Both Lytic and Lysogenic phases occur together, D: In Lytic phase it causes cell lysis and releases virus paicles
+
+### Response:
+In a lambda phage, lytic phase and lysogenic phase does not occur together.Primary event in the genetic switch between lysis and lysogeny is governed by the level of lambda encoded proteins required for the lytic pathway. If one set of lambda immediate early genes are transcribed, then the lytic pathway is ored. If a transcriptionally repressor protein encoded by lambda cl gene inhibits the transcription, lysogeny is ored. Ref: Introduction to Plant Biotechnology, 3rd Edition By Chawla, Page 238; Cell and Molecular Biology By S. C. Rastogi, Page 530
+### End"
+447,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A one year old child presents with sho stature, lethargy, & constipation. Clinical examination shows a palpable goiter. Laboratory investigations revealed a low T4 and elevated TSH which of the following is the most likely diagnosis., with the following options: A: Thyroid Dyshormonogenesis, B: Thyroid Dysgenesis, C: Central Hypothyroidism, D: TSH Receptor Blocking Antibody
+
+### Response:
+","Child with presence of a palpable goitre ,along with clinical and laboratory features of hypothyroidism suggests a diagnosis of thyroid dyshormonogenesis from the options listed in the question. Ref: Pediatrics By Lloyd J. Brown, Lee Todd Miller page 168.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A one year old child presents with sho stature, lethargy, & constipation. Clinical examination shows a palpable goiter. Laboratory investigations revealed a low T4 and elevated TSH which of the following is the most likely diagnosis., with the following options: A: Thyroid Dyshormonogenesis, B: Thyroid Dysgenesis, C: Central Hypothyroidism, D: TSH Receptor Blocking Antibody
+
+### Response:
+Child with presence of a palpable goitre ,along with clinical and laboratory features of hypothyroidism suggests a diagnosis of thyroid dyshormonogenesis from the options listed in the question. Ref: Pediatrics By Lloyd J. Brown, Lee Todd Miller page 168.
+### End"
+448,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Black color in triage -, with the following options: A: Death, B: Transfer, C: High priority, D: Low priority
+
+### Response:
+","- triage consists of rapidly classifying the injured on the basis of severity of their injuries and the likelihood of their survival with prompt medical intervention. - black colour triage signals dead or moribund patients. Reference: Park's textbook of preventive and social medicine, 23rd edition, pg no: 796 <\p>","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Black color in triage -, with the following options: A: Death, B: Transfer, C: High priority, D: Low priority
+
+### Response:
+- triage consists of rapidly classifying the injured on the basis of severity of their injuries and the likelihood of their survival with prompt medical intervention. - black colour triage signals dead or moribund patients. Reference: Park's textbook of preventive and social medicine, 23rd edition, pg no: 796 <\p>
+### End"
+449,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A new born girl not passed meconium for 48 hrs, has abdominal distention and vomiting. Initial investigation of choice would be:, with the following options: A: Manometry, B: Genotyping for cystic fibrosis, C: Lower GI contrast study, D: Serum trypsin immunoblot
+
+### Response:
+","More than 90% of full term newborn infants pass meconium within the first 24 hrs. The possibility of intestinal obstruction is considered if an infant does not pass meconium for 24-36 hrs.
+Differential diagnosis would include causes of low intestinal obstruction.
+
+- Hirschsprung disease
+- Beal or colonic atresia/stenosis
+- Meconium ileus
+- Meconium plug syndrome
+- Neonatal small left colon syndrome
+
+The first investigation is always a plain abdominal radiograph (supine and left lateral decubitus view)
+Next investigation is a contrast enema also k/a lower GI series (presence of any perforation can be ruled out from plain X-rays)
+Barium can be used but water-soluble contrast agents are used commonly
+Contrast enema helps to some extent in differentiating among the causes of low intestinal obstructions.
+
+Hirschsprung's disease-
+
+Barium enema usually shows a transition zone between dilated proximal colon and a smaller-caliber obstructed distal colon caused by the nonrelaxation of the agaglionic bowel. However, a normal study does not exclude Hirschsprung's disease. Diagnosis is confirmed by rectal biopsy.
+
+Meconium ilens-
+
+Meconium ileus occurs when meconium becomes inspissated and obstructs the distal ileum.
+The condition is usually a manifestation of cystic fibrosis. Meconium ileus is usually taken to be synonymous with cystic fibrosis until proven otherwise, and meconium ileus is generally the earliest manifestation of the disease.
+Contrast enema study typically demonstrates microcolon, which is a reflection of underused bowel.
+
+Meconium plug syndrome
+
+Meconium plug syndrome, also termed functional immaturity of the colon, is a transient disorder of the newborn colon characterized by delayed passage (>24-48 h) of meconium and intestinal dilatation . Currently, meconium plug syndrome is understood as a transient functional disorder of the colon resulting from immaturity of the myenteric plexus nerve cells or their hormonal receptors.
+
+
+Contrast enema demonstrates the retained meconium as a filling defect or plug that produces a double-contrast effect.
+
+Usually, the colon is normal or may be mildly enlarged and filled with meconium. A change in the colon's diameter at the splenic flexure may be seen and is indistinguishable from that observed in Hirschsprung disease, although in the latter disorder the transition zone usually is in the rectosigmoid.
+Meconium plug syndrome is a diagnosis of exclusion. Contrast enema usually eliminates congenital small bowel obstruction and rare colon abnormalities such as atresia or duplication. The primary differential consideration is Hirschsprung disease, which is diagnosed eventually in approximately 10-30% of patients with apparent meconium plug syndrome
+
+Neonatal small left colon syndrome —
+
+Colonic obstruction with a characteristic caliber reduction in the sigmoid and descending colon unrelated to meconium inspissation or aganglionosis. This condition has a frequent association with maternal gestational diabetes mellitus and seldom requires surgical intervention.
+A contrast enema demonstrated a narrowed descending and sigmoid colon, with a caliber transition at the splenic flexure.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A new born girl not passed meconium for 48 hrs, has abdominal distention and vomiting. Initial investigation of choice would be:, with the following options: A: Manometry, B: Genotyping for cystic fibrosis, C: Lower GI contrast study, D: Serum trypsin immunoblot
+
+### Response:
+More than 90% of full term newborn infants pass meconium within the first 24 hrs. The possibility of intestinal obstruction is considered if an infant does not pass meconium for 24-36 hrs.
+Differential diagnosis would include causes of low intestinal obstruction.
+
+- Hirschsprung disease
+- Beal or colonic atresia/stenosis
+- Meconium ileus
+- Meconium plug syndrome
+- Neonatal small left colon syndrome
+
+The first investigation is always a plain abdominal radiograph (supine and left lateral decubitus view)
+Next investigation is a contrast enema also k/a lower GI series (presence of any perforation can be ruled out from plain X-rays)
+Barium can be used but water-soluble contrast agents are used commonly
+Contrast enema helps to some extent in differentiating among the causes of low intestinal obstructions.
+
+Hirschsprung's disease-
+
+Barium enema usually shows a transition zone between dilated proximal colon and a smaller-caliber obstructed distal colon caused by the nonrelaxation of the agaglionic bowel. However, a normal study does not exclude Hirschsprung's disease. Diagnosis is confirmed by rectal biopsy.
+
+Meconium ilens-
+
+Meconium ileus occurs when meconium becomes inspissated and obstructs the distal ileum.
+The condition is usually a manifestation of cystic fibrosis. Meconium ileus is usually taken to be synonymous with cystic fibrosis until proven otherwise, and meconium ileus is generally the earliest manifestation of the disease.
+Contrast enema study typically demonstrates microcolon, which is a reflection of underused bowel.
+
+Meconium plug syndrome
+
+Meconium plug syndrome, also termed functional immaturity of the colon, is a transient disorder of the newborn colon characterized by delayed passage (>24-48 h) of meconium and intestinal dilatation . Currently, meconium plug syndrome is understood as a transient functional disorder of the colon resulting from immaturity of the myenteric plexus nerve cells or their hormonal receptors.
+
+
+Contrast enema demonstrates the retained meconium as a filling defect or plug that produces a double-contrast effect.
+
+Usually, the colon is normal or may be mildly enlarged and filled with meconium. A change in the colon's diameter at the splenic flexure may be seen and is indistinguishable from that observed in Hirschsprung disease, although in the latter disorder the transition zone usually is in the rectosigmoid.
+Meconium plug syndrome is a diagnosis of exclusion. Contrast enema usually eliminates congenital small bowel obstruction and rare colon abnormalities such as atresia or duplication. The primary differential consideration is Hirschsprung disease, which is diagnosed eventually in approximately 10-30% of patients with apparent meconium plug syndrome
+
+Neonatal small left colon syndrome —
+
+Colonic obstruction with a characteristic caliber reduction in the sigmoid and descending colon unrelated to meconium inspissation or aganglionosis. This condition has a frequent association with maternal gestational diabetes mellitus and seldom requires surgical intervention.
+A contrast enema demonstrated a narrowed descending and sigmoid colon, with a caliber transition at the splenic flexure.
+### End"
+450,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: ROTA virus is diagnosed by -, with the following options: A: IgM specific antibody in stool, B: ELISA demonstrates antibody in stool, C: Immunoflorescene antigen in stool, D: Culture of rotavirus
+
+### Response:
+",for demonstration of the virus in stools are simple and and are sensitive.IgM andIgG antibodies can be demonstrated in the blood of infected children REF:ANANTHANARYANAN TEXT BOOK OF MICROBIOLOGY 9EDITION PGNO.561,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: ROTA virus is diagnosed by -, with the following options: A: IgM specific antibody in stool, B: ELISA demonstrates antibody in stool, C: Immunoflorescene antigen in stool, D: Culture of rotavirus
+
+### Response:
+for demonstration of the virus in stools are simple and and are sensitive.IgM andIgG antibodies can be demonstrated in the blood of infected children REF:ANANTHANARYANAN TEXT BOOK OF MICROBIOLOGY 9EDITION PGNO.561
+### End"
+451,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Postoperative ileus is most commonly seen in:, with the following options: A: Colon, B: Ileum, C: Duodenum, D: Stomach
+
+### Response:
+","Ans. a. Colon (Ref: Sabiston 19/e p1244; Schwartz 9/e p992-993; Bailey 26th/1197-1198, 25th/1261-1262: Shackelford 7/e p592-593)Post-operative ileus is most commonly seen in colon.Post-operative IleusFollowing most abdominal operations or injuries, the motility of the GI tract is transiently impaired.Proposed mechanisms responsible for this dysmotility are surgical stress-induced sympathetic reflexes, inflammatory response mediator release, and anesthetic/analgesic effectsQ; each of which can inhibit intestinal motility.Return of normal motility: Small intestineQ (within 24 hours) >Gastric (48 hours)Q > Colonic (3-5 days)Q.Post-operative ileus is most pronounced in colonQCharacteristic sequence of return of normal motility: Small intestinal motility returning to normal within the first 24 hours, gastric motility within 48 hours and colonic motility returning to normal 3 to 5 daysQ.Because small bowel motility is returned before colonic and gastric motility, listening for bowel sounds is not a reliable indicator that ileus has fully resolvedQ.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Postoperative ileus is most commonly seen in:, with the following options: A: Colon, B: Ileum, C: Duodenum, D: Stomach
+
+### Response:
+Ans. a. Colon (Ref: Sabiston 19/e p1244; Schwartz 9/e p992-993; Bailey 26th/1197-1198, 25th/1261-1262: Shackelford 7/e p592-593)Post-operative ileus is most commonly seen in colon.Post-operative IleusFollowing most abdominal operations or injuries, the motility of the GI tract is transiently impaired.Proposed mechanisms responsible for this dysmotility are surgical stress-induced sympathetic reflexes, inflammatory response mediator release, and anesthetic/analgesic effectsQ; each of which can inhibit intestinal motility.Return of normal motility: Small intestineQ (within 24 hours) >Gastric (48 hours)Q > Colonic (3-5 days)Q.Post-operative ileus is most pronounced in colonQCharacteristic sequence of return of normal motility: Small intestinal motility returning to normal within the first 24 hours, gastric motility within 48 hours and colonic motility returning to normal 3 to 5 daysQ.Because small bowel motility is returned before colonic and gastric motility, listening for bowel sounds is not a reliable indicator that ileus has fully resolvedQ.
+### End"
+452,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Major bacterial enzyme responsible for putrefaction: NEET 14, with the following options: A: Hyaluronidase, B: Lecithinase, C: Metalloproteinase, D: Collagenase
+
+### Response:
+",Ans. Lecithinase,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Major bacterial enzyme responsible for putrefaction: NEET 14, with the following options: A: Hyaluronidase, B: Lecithinase, C: Metalloproteinase, D: Collagenase
+
+### Response:
+Ans. Lecithinase
+### End"
+453,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: True about cleft palate are all except, with the following options: A: Surgery should be done at 1 year, B: 50% recover speech after operation, C: A/w hearing loss, D: A/w cleft lip in 45%
+
+### Response:
+","Cleft lip and palate Clefts of the lip, alveolus & hard and soft palate are the most common congenital abnormalities of the orofacial structures Frequently occur as isolated deformities but can be associated with other medical condition, paicularly congenital hea disease Incomplete clefts affect only a poion of the lip and contain a bridge of tissue connecting the central & lateral lip elements, referred to as Simon a's band Cleft lip is due to Non-fusion of maxillary process with medial nasal process Unilateral cleft lip is associated with posterior displacement of alar cailage Distribution In unilateral cleft lip the deformity affects the left side in 60% of cases Typical distribution of cleft types Cleft lip alone :15% CCleft lip & palate :45% (MC) Isolated cleft palate : 40% Etiology of cleft lip and palate Etiology of cleft lip & palate : Genetic Predisposition & a contributory environmental component Environmental factors : Maternal epilepsy & drugs (steroids, diazepam & phenytoin) Associated syndromes Although most cleft lip & palate occur as an isolated deformity, pierre Robin sequence remains the most common syndrome. Other associated syndromes : Stickler's (ophthalmic and musculoskeletal abnormalities), Shprintzen's (Cardiac anomalies), Down's, Ape's and Trecher-Collins' syndromes Types of cleft lip Types of cleft palate Unilateral cleft lip Bilateral cleft lip Incomplete : Cleft of the hard palate remains attached to the nasal septum and vomer Complete : Nadal septum and vomer are completely seperated from the palatine process Antenatal diagnosis All but isolated cleft palate can be diagnosed by ultrasound after 18 weeks gestation Problems immediately after bih All but isolated cleft palate can be diagnosed by ultrasound after 18 weeks gestation Problems immediately after bih Some babies are able to feed normally but some will need assistance Breathing problems in Pierre Robin sequence may be life threatening Management Surgical techniques are aimed at restoring normal anatomy Cleft lip: Repaired between 3 and 6 months of age Cleft palate : Repaired between 6 and 18 months of age Principles of surgery Cleft lip surgery attaches and reconnects the muscles around the oral sphincters Cleft palate surgery aims to bring together mucosa and muscles with minimal scaring Two-stage procedures attempt to minimize dissection Secondary management Following primary surgery, regular review by a multidisciplinary team is essential Many aspects of cleft care require long-term review : Hearing, speech, dental development, facial growth Ref: Sabiston 20th edition Pgno :1946-1947","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: True about cleft palate are all except, with the following options: A: Surgery should be done at 1 year, B: 50% recover speech after operation, C: A/w hearing loss, D: A/w cleft lip in 45%
+
+### Response:
+Cleft lip and palate Clefts of the lip, alveolus & hard and soft palate are the most common congenital abnormalities of the orofacial structures Frequently occur as isolated deformities but can be associated with other medical condition, paicularly congenital hea disease Incomplete clefts affect only a poion of the lip and contain a bridge of tissue connecting the central & lateral lip elements, referred to as Simon a's band Cleft lip is due to Non-fusion of maxillary process with medial nasal process Unilateral cleft lip is associated with posterior displacement of alar cailage Distribution In unilateral cleft lip the deformity affects the left side in 60% of cases Typical distribution of cleft types Cleft lip alone :15% CCleft lip & palate :45% (MC) Isolated cleft palate : 40% Etiology of cleft lip and palate Etiology of cleft lip & palate : Genetic Predisposition & a contributory environmental component Environmental factors : Maternal epilepsy & drugs (steroids, diazepam & phenytoin) Associated syndromes Although most cleft lip & palate occur as an isolated deformity, pierre Robin sequence remains the most common syndrome. Other associated syndromes : Stickler's (ophthalmic and musculoskeletal abnormalities), Shprintzen's (Cardiac anomalies), Down's, Ape's and Trecher-Collins' syndromes Types of cleft lip Types of cleft palate Unilateral cleft lip Bilateral cleft lip Incomplete : Cleft of the hard palate remains attached to the nasal septum and vomer Complete : Nadal septum and vomer are completely seperated from the palatine process Antenatal diagnosis All but isolated cleft palate can be diagnosed by ultrasound after 18 weeks gestation Problems immediately after bih All but isolated cleft palate can be diagnosed by ultrasound after 18 weeks gestation Problems immediately after bih Some babies are able to feed normally but some will need assistance Breathing problems in Pierre Robin sequence may be life threatening Management Surgical techniques are aimed at restoring normal anatomy Cleft lip: Repaired between 3 and 6 months of age Cleft palate : Repaired between 6 and 18 months of age Principles of surgery Cleft lip surgery attaches and reconnects the muscles around the oral sphincters Cleft palate surgery aims to bring together mucosa and muscles with minimal scaring Two-stage procedures attempt to minimize dissection Secondary management Following primary surgery, regular review by a multidisciplinary team is essential Many aspects of cleft care require long-term review : Hearing, speech, dental development, facial growth Ref: Sabiston 20th edition Pgno :1946-1947
+### End"
+454,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Apo B48 and apo B100 are expressed as two different apo-proteins because of difference in, with the following options: A: RNA editing, B: RNA splicing, C: Chromosomal loci, D: Apo-B gene
+
+### Response:
+","RNA editing
+
+Apo B-100 and apo B-48 are closely related polypeptides.
+Apo B-100, a single polypeptide of 4536 amino acids, is encoded by the same gene as apo B-48.
+Apo B-48 consists of the first 2152 amino acids of apo B-100, counting from N terminals. These (2152 amino acids) account for 48% of total amino acids (4536) of apo B-100. Therefore, it is called apo B-48.
+In the intestine, after synthesis of 2152 amino acids by their respective codons, the codon 2153 (CAA) acts as stop codon which terminates further synthesis.
+Therefore, in the intestine, translation stops at the 2153rd codon so that instead of a polypeptide chain of 4536 amino acids (i.e. apo B-100), a shorter polypeptide chain of 2152 amino acids (i.e. apo B-48) is synthesized.
+This is an example of tissue-specific editing of an RNA transcript.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Apo B48 and apo B100 are expressed as two different apo-proteins because of difference in, with the following options: A: RNA editing, B: RNA splicing, C: Chromosomal loci, D: Apo-B gene
+
+### Response:
+RNA editing
+
+Apo B-100 and apo B-48 are closely related polypeptides.
+Apo B-100, a single polypeptide of 4536 amino acids, is encoded by the same gene as apo B-48.
+Apo B-48 consists of the first 2152 amino acids of apo B-100, counting from N terminals. These (2152 amino acids) account for 48% of total amino acids (4536) of apo B-100. Therefore, it is called apo B-48.
+In the intestine, after synthesis of 2152 amino acids by their respective codons, the codon 2153 (CAA) acts as stop codon which terminates further synthesis.
+Therefore, in the intestine, translation stops at the 2153rd codon so that instead of a polypeptide chain of 4536 amino acids (i.e. apo B-100), a shorter polypeptide chain of 2152 amino acids (i.e. apo B-48) is synthesized.
+This is an example of tissue-specific editing of an RNA transcript.
+### End"
+455,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Shiga toxin acts by ?, with the following options: A: Activating adenylyl cyclase to increase cAMP, B: Activating guanylyl cyclase to increase cGMP, C: Inhibiting protein synthesis, D: Inhibiting DNA replication
+
+### Response:
+","Ans. is 'c' i.e., Inhibiting protein synthesis","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Shiga toxin acts by ?, with the following options: A: Activating adenylyl cyclase to increase cAMP, B: Activating guanylyl cyclase to increase cGMP, C: Inhibiting protein synthesis, D: Inhibiting DNA replication
+
+### Response:
+Ans. is 'c' i.e., Inhibiting protein synthesis
+### End"
+456,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: In pure tone audiogram the symbol X is used to mark, with the following options: A: No change in air conduction in right ear, B: Bone conduction in right ear, C: Air conduction in right ear, D: Air conduction in left ear
+
+### Response:
+",Ref:- Dhingra; pg num:-30,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: In pure tone audiogram the symbol X is used to mark, with the following options: A: No change in air conduction in right ear, B: Bone conduction in right ear, C: Air conduction in right ear, D: Air conduction in left ear
+
+### Response:
+Ref:- Dhingra; pg num:-30
+### End"
+457,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A newborn is found to have a defect in the central abdomen at bih. All of the following features are suggestive of Omphalocele as a diagnosis except that, with the following options: A: The defect is open, B: Associated with trisomy 13, C: Associated with other congenital anomalies, D: Umbilical cord is at the apex of membrane
+
+### Response:
+","Omphalocele- larger defect, covered by a membrane, Higher association with anomalies, bowel usually normal.CONGENITAL OMPHALOCELEAn omphalocele is a herniation or protrusion of the abdominal contents into the base of the umbilical cord. In contrast to the more common umbilical hernia, the sac is covered with peritoneum without overlying skin. Immediate surgical repair, before infection, has taken place and before the tissues have been damaged by drying (saline-soaked sterile dressings should be applied immediately) or by rupture of the sac, is essential for survival.The majority ([?]75%) of infants with omphalocele have associated congenital anomalies/syndromes, including Beckwith-Wiedemann syndrome (omphalocele, macrosomia, hypoglycemia), and other chromosomal (29%, including trisomies 13 and 18) and nonchromosomal (45%) multiple and isolated congenital anomalies (musculoskeletal, 24%; urogenital, 20%; cardiovascular, 15%; and central nervous system, 9%). The survival rate is approximately 80% overall, but in infants with isolated omphalocele, the survival rate is >90%.Ref: Nelson Textbook of Pediatrics; 20th edition; Page no: 890","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A newborn is found to have a defect in the central abdomen at bih. All of the following features are suggestive of Omphalocele as a diagnosis except that, with the following options: A: The defect is open, B: Associated with trisomy 13, C: Associated with other congenital anomalies, D: Umbilical cord is at the apex of membrane
+
+### Response:
+Omphalocele- larger defect, covered by a membrane, Higher association with anomalies, bowel usually normal.CONGENITAL OMPHALOCELEAn omphalocele is a herniation or protrusion of the abdominal contents into the base of the umbilical cord. In contrast to the more common umbilical hernia, the sac is covered with peritoneum without overlying skin. Immediate surgical repair, before infection, has taken place and before the tissues have been damaged by drying (saline-soaked sterile dressings should be applied immediately) or by rupture of the sac, is essential for survival.The majority ([?]75%) of infants with omphalocele have associated congenital anomalies/syndromes, including Beckwith-Wiedemann syndrome (omphalocele, macrosomia, hypoglycemia), and other chromosomal (29%, including trisomies 13 and 18) and nonchromosomal (45%) multiple and isolated congenital anomalies (musculoskeletal, 24%; urogenital, 20%; cardiovascular, 15%; and central nervous system, 9%). The survival rate is approximately 80% overall, but in infants with isolated omphalocele, the survival rate is >90%.Ref: Nelson Textbook of Pediatrics; 20th edition; Page no: 890
+### End"
+458,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A red cell with a volume of 100 cu.microns and intracellular osmolality of 300 mOsm was placed in a solution with an osmolality of 100 mOsm. What will be the final volume of this cell?, with the following options: A: 33.33 cu.microns, B: 50 cu.microns, C: 150 cu.microns, D: 300 cu.microns
+
+### Response:
+",pi Vi = pf Vf 100 x 300 = 100 x Vf Vf = 300 Pi - initial osmolality; Pf - final osmolality Vi - initial volume; Vf - final volume,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A red cell with a volume of 100 cu.microns and intracellular osmolality of 300 mOsm was placed in a solution with an osmolality of 100 mOsm. What will be the final volume of this cell?, with the following options: A: 33.33 cu.microns, B: 50 cu.microns, C: 150 cu.microns, D: 300 cu.microns
+
+### Response:
+pi Vi = pf Vf 100 x 300 = 100 x Vf Vf = 300 Pi - initial osmolality; Pf - final osmolality Vi - initial volume; Vf - final volume
+### End"
+459,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: 20-year-male presents with fever, fatigue, posterior cervical lymphadenopathy, palatal petechiae, and splenomegaly. Peripheral smear shows atypical lymphocytes and the heterophile antibody is positive. The likely diagnosis is, with the following options: A: Acute leukemia, B: Lymphocytic leukemia, C: Infectious mononucleosis, D: Chronic myeloid leukemia
+
+### Response:
+","The Epstein-Barr virus is the cause of heterophil positive infectious mononucleosisFeatures are fever, sore throat, lymphadenopathy most often affects posterior cervical nodes but may be generalized, splenomegaly and atypical lymphocytosisIt is usually a disease of young adultsRef: Davidson's 20/e p307, Harrison; 18/e p1467-1468","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: 20-year-male presents with fever, fatigue, posterior cervical lymphadenopathy, palatal petechiae, and splenomegaly. Peripheral smear shows atypical lymphocytes and the heterophile antibody is positive. The likely diagnosis is, with the following options: A: Acute leukemia, B: Lymphocytic leukemia, C: Infectious mononucleosis, D: Chronic myeloid leukemia
+
+### Response:
+The Epstein-Barr virus is the cause of heterophil positive infectious mononucleosisFeatures are fever, sore throat, lymphadenopathy most often affects posterior cervical nodes but may be generalized, splenomegaly and atypical lymphocytosisIt is usually a disease of young adultsRef: Davidson's 20/e p307, Harrison; 18/e p1467-1468
+### End"
+460,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A child has microcephaly, blue eyes, fair skin, and mental retardation; ferric chloride test is positive. What is the likely diagnosis?, with the following options: A: Phenylketonuria, B: Homocystinuria, C: Tyrosinosis, D: Alkaptonuria
+
+### Response:
+","-The given scenario suggests diagnosis of Phenylketonuria (PKU). -C/F of Phenylketonuria: Blonde hair, Blue iris, Fair skin Musty/ mousy body odour Microcephaly Intellectual disability due to toxic levels of Phenylalanine and insufficient tyrosine Growth Retardation Dental enamel changes Irritability , Tremors , Convulsions, Hypeonia -OTHER OPTIONS : Homocystinuria- seizures, marfanoid features, ectopia lentis, thromboembolism Tyrosinosis- hepatomegaly, peripheral neuropathy Alkaptonuria- ochronosis, urine turns black on standing, ahritis","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A child has microcephaly, blue eyes, fair skin, and mental retardation; ferric chloride test is positive. What is the likely diagnosis?, with the following options: A: Phenylketonuria, B: Homocystinuria, C: Tyrosinosis, D: Alkaptonuria
+
+### Response:
+-The given scenario suggests diagnosis of Phenylketonuria (PKU). -C/F of Phenylketonuria: Blonde hair, Blue iris, Fair skin Musty/ mousy body odour Microcephaly Intellectual disability due to toxic levels of Phenylalanine and insufficient tyrosine Growth Retardation Dental enamel changes Irritability , Tremors , Convulsions, Hypeonia -OTHER OPTIONS : Homocystinuria- seizures, marfanoid features, ectopia lentis, thromboembolism Tyrosinosis- hepatomegaly, peripheral neuropathy Alkaptonuria- ochronosis, urine turns black on standing, ahritis
+### End"
+461,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A child of phenyl ketonuria mother may develop –, with the following options: A: Microcephaly, mental retardation, congenital heart disease, B: Mental retardation, cataract, congenital heart disease, C: HydrocephaluS, cataract., D: Microcephaly, cataract, renal dysplasia.
+
+### Response:
+","Children born to phenyl ketonuria mothers have following features
+
+Mental retardation
+Microcephaly
+Growth retardation
+Congenital heart disease","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A child of phenyl ketonuria mother may develop –, with the following options: A: Microcephaly, mental retardation, congenital heart disease, B: Mental retardation, cataract, congenital heart disease, C: HydrocephaluS, cataract., D: Microcephaly, cataract, renal dysplasia.
+
+### Response:
+Children born to phenyl ketonuria mothers have following features
+
+Mental retardation
+Microcephaly
+Growth retardation
+Congenital heart disease
+### End"
+462,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: 'Dipstick test' for rapid diagnosis of Plasmodium falciparum is based on:-, with the following options: A: Arginine-rich protein, B: Histidine-rich protein, C: Tyrosine-rich protein, D: Serine-rich protein
+
+### Response:
+",'Dipstick test' is used for the rapid diagnosis of plasmodium falciparum: Is a 'rapid whole blood immunochromatographic test'. Uses 2 antibodies specific for 'Pf Histidine Rich Protein II antigen'. Is a 'antigen capture assay'. ALSO REMEMBER: Serological diagnosis of Kala Azar is based on: rk39 antigen. Serological diagnosis of Dengue is based on: NS-1 antigen.,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: 'Dipstick test' for rapid diagnosis of Plasmodium falciparum is based on:-, with the following options: A: Arginine-rich protein, B: Histidine-rich protein, C: Tyrosine-rich protein, D: Serine-rich protein
+
+### Response:
+'Dipstick test' is used for the rapid diagnosis of plasmodium falciparum: Is a 'rapid whole blood immunochromatographic test'. Uses 2 antibodies specific for 'Pf Histidine Rich Protein II antigen'. Is a 'antigen capture assay'. ALSO REMEMBER: Serological diagnosis of Kala Azar is based on: rk39 antigen. Serological diagnosis of Dengue is based on: NS-1 antigen.
+### End"
+463,"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 acts as lung surfactant:, with the following options: A: Sphingomyelin, B: Lysolecithin, C: Dipalmitoyl lecithin, D: Cephalin
+
+### Response:
+","C Harper, 26th ed, p. 202 & 25th ed, p. 265","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 acts as lung surfactant:, with the following options: A: Sphingomyelin, B: Lysolecithin, C: Dipalmitoyl lecithin, D: Cephalin
+
+### Response:
+C Harper, 26th ed, p. 202 & 25th ed, p. 265
+### End"
+464,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Most important amino acid for formation Neutrophilic extracellular trap (NET) is, with the following options: A: Leucine, B: Methionine, C: Citrulline, D: Valine
+
+### Response:
+",Conversion of arginine residues to Citrulline in the histones is an essential step in the formation of neutrophill extracillular traps.,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Most important amino acid for formation Neutrophilic extracellular trap (NET) is, with the following options: A: Leucine, B: Methionine, C: Citrulline, D: Valine
+
+### Response:
+Conversion of arginine residues to Citrulline in the histones is an essential step in the formation of neutrophill extracillular traps.
+### End"
+465,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Normal vital capacity in an adult is, with the following options: A: 1200 ml, B: 2500 ml, C: 3000 ml, D: 4700 ml
+
+### Response:
+",Vital capacity Amount of air that can be exhaled with maximum effo after maximum inspiration (ERV + TV + IRV); used to assess strength of thoracic muscles as well as pulmonary function. Around 4700mlRef: Ganong review of medical physiology 23rd edition Page no: 593,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Normal vital capacity in an adult is, with the following options: A: 1200 ml, B: 2500 ml, C: 3000 ml, D: 4700 ml
+
+### Response:
+Vital capacity Amount of air that can be exhaled with maximum effo after maximum inspiration (ERV + TV + IRV); used to assess strength of thoracic muscles as well as pulmonary function. Around 4700mlRef: Ganong review of medical physiology 23rd edition Page no: 593
+### End"
+466,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: CO2 content in aerial blood is, with the following options: A: 19ml/dl, B: 29ml/dl, C: 36ml/dl, D: 49 ml/dl
+
+### Response:
+",Approximately 49 mL of CO2 in each deciliter of aerial bloodRef: Ganong's Review of Medical Physiology Twenty-Third Edition Page No: 613,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: CO2 content in aerial blood is, with the following options: A: 19ml/dl, B: 29ml/dl, C: 36ml/dl, D: 49 ml/dl
+
+### Response:
+Approximately 49 mL of CO2 in each deciliter of aerial bloodRef: Ganong's Review of Medical Physiology Twenty-Third Edition Page No: 613
+### End"
+467,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Ichthyosis may be associated with: September 2003, with the following options: A: Carcinoma lung, B: Carcinoma breast, C: Leukemia, D: Lymphoma
+
+### Response:
+",Ans. D i.e. Lymphoma,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Ichthyosis may be associated with: September 2003, with the following options: A: Carcinoma lung, B: Carcinoma breast, C: Leukemia, D: Lymphoma
+
+### Response:
+Ans. D i.e. Lymphoma
+### End"
+468,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: What is prolotherapy which is used for the treatment of TMJ discoloration:, with the following options: A: Regeneration injection therapy., B: Injection to paralyze the lateral pterygoid muscle., C: Thickening of joint therapy., D: All of the above.
+
+### Response:
+","Prolotherapy
+Proliferation therapy
+Regeneration injection therapy.
+Principle:
+Stimulation of joint tissue.
+Organized | planned Microtrauma by Needle and By Chemicals .
+So as to produce growth Function which regenerate/Rejuvenate the Joint.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: What is prolotherapy which is used for the treatment of TMJ discoloration:, with the following options: A: Regeneration injection therapy., B: Injection to paralyze the lateral pterygoid muscle., C: Thickening of joint therapy., D: All of the above.
+
+### Response:
+Prolotherapy
+Proliferation therapy
+Regeneration injection therapy.
+Principle:
+Stimulation of joint tissue.
+Organized | planned Microtrauma by Needle and By Chemicals .
+So as to produce growth Function which regenerate/Rejuvenate the Joint.
+### End"
+469,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Hour glass deformity is seen in, with the following options: A: Carcinoma stomach, B: Peptic ulcer, C: Duodenal atresia, D: CHPS
+
+### Response:
+","COMPLICATIONS. Acute and subacute peptic ulcers usually heal without leaving any visible scar. However, healing of chronic, larger and deeper ulcers may result in complications like Obstruction. Development of fibrous scar at or near the pylorus results in pyloric stenosis. In the case of healed duodenal ulcer, it causes duodenal stenosis. Healed ulcers along the lesser curvatures may produce 'hourglass' deformity due to fibrosis and contraction TEXT BOOK OF HARSH MOHAN SIXTH EDITION PAGE.553. IMAGE REF:","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Hour glass deformity is seen in, with the following options: A: Carcinoma stomach, B: Peptic ulcer, C: Duodenal atresia, D: CHPS
+
+### Response:
+COMPLICATIONS. Acute and subacute peptic ulcers usually heal without leaving any visible scar. However, healing of chronic, larger and deeper ulcers may result in complications like Obstruction. Development of fibrous scar at or near the pylorus results in pyloric stenosis. In the case of healed duodenal ulcer, it causes duodenal stenosis. Healed ulcers along the lesser curvatures may produce 'hourglass' deformity due to fibrosis and contraction TEXT BOOK OF HARSH MOHAN SIXTH EDITION PAGE.553. IMAGE REF:
+### End"
+470,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Which toxin increases exocytosis of acetyl choline containing vesicles?, with the following options: A: Botulinum toxin, B: Tetrodoxin, C: Saxitoxin, D: Black widow spider toxin
+
+### Response:
+","Latrodectus mactans (Black Widow or Hourglass Spider) This is found all over the world. The female of the species is larger and more vicious. There is usually a red hourglass spot on the dorsal surface of its shiny black body. The venom is predominantly neurotoxic and therefore does not produce much local necrosis and some persons experience no other symptoms except a sharp pinprick. However, a-latrotoxin, the most active component of the venom, binds irreversibly to nerves and causes release and eventual depletion of acetylcholine, norepinephrine and other neurotransmitters from presynaptic terminals. Within an hour or so, painful cramps spread from the bite site to large muscles of the extremities and the trunk. Other features may include salivation, diaphoresis, vomiting, hypeension, tachycardia, laboured breathing, anxiety, headache, fasciculations, paraesthesia, hyper-reflexia, urinary retention, uterine contractions and premature labour. Rhabdomyolysis and renal failure have been repoed. Ref : Krishnan vij Textbook of Forensic medicine and Toxicology 5th edtion ; pg no - 487","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Which toxin increases exocytosis of acetyl choline containing vesicles?, with the following options: A: Botulinum toxin, B: Tetrodoxin, C: Saxitoxin, D: Black widow spider toxin
+
+### Response:
+Latrodectus mactans (Black Widow or Hourglass Spider) This is found all over the world. The female of the species is larger and more vicious. There is usually a red hourglass spot on the dorsal surface of its shiny black body. The venom is predominantly neurotoxic and therefore does not produce much local necrosis and some persons experience no other symptoms except a sharp pinprick. However, a-latrotoxin, the most active component of the venom, binds irreversibly to nerves and causes release and eventual depletion of acetylcholine, norepinephrine and other neurotransmitters from presynaptic terminals. Within an hour or so, painful cramps spread from the bite site to large muscles of the extremities and the trunk. Other features may include salivation, diaphoresis, vomiting, hypeension, tachycardia, laboured breathing, anxiety, headache, fasciculations, paraesthesia, hyper-reflexia, urinary retention, uterine contractions and premature labour. Rhabdomyolysis and renal failure have been repoed. Ref : Krishnan vij Textbook of Forensic medicine and Toxicology 5th edtion ; pg no - 487
+### End"
+471,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The use of combined oral contraceptive pill is associated with an increased incidence of:, with the following options: A: Bacterial vaginosis, B: Chlamydial endocervicitis, C: Vaginal was, D: Genital herpes
+
+### Response:
+","There is an overall reduction in the incidence of PID with OCPs but Chlamydial PID may increase. This is classically an indolent PID where the patient has no pain, no discharge.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: The use of combined oral contraceptive pill is associated with an increased incidence of:, with the following options: A: Bacterial vaginosis, B: Chlamydial endocervicitis, C: Vaginal was, D: Genital herpes
+
+### Response:
+There is an overall reduction in the incidence of PID with OCPs but Chlamydial PID may increase. This is classically an indolent PID where the patient has no pain, no discharge.
+### End"
+472,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Cyclic AMP increase the rate of glycogenolysis by, with the following options: A: Promoting the formation of phosphorylase, B: Acting as a cofactor for glycogen phosphorylase, C: Furnishing phosphate for the phosphorylysis of glycogen, D: Acting as a precursor of 5' AMP which is a cofactor for glycogen phosphorylase
+
+### Response:
+","The roles of cAMP and inorganic phosphate (Pi) in the regulation of muscle glycogenolysis during exercise have been investigated in humans using the needle biopsy technique. The fraction of phosphorylase a in resting muscle was as a mean 23%, but the rate of glycogenolysis was extremely low. Epinephrine infusion increased cAMP in muscle by 3-fold and transformed 80% of phosphorylase to the form","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Cyclic AMP increase the rate of glycogenolysis by, with the following options: A: Promoting the formation of phosphorylase, B: Acting as a cofactor for glycogen phosphorylase, C: Furnishing phosphate for the phosphorylysis of glycogen, D: Acting as a precursor of 5' AMP which is a cofactor for glycogen phosphorylase
+
+### Response:
+The roles of cAMP and inorganic phosphate (Pi) in the regulation of muscle glycogenolysis during exercise have been investigated in humans using the needle biopsy technique. The fraction of phosphorylase a in resting muscle was as a mean 23%, but the rate of glycogenolysis was extremely low. Epinephrine infusion increased cAMP in muscle by 3-fold and transformed 80% of phosphorylase to the form
+### End"
+473,"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 least extrapyramidal side effect:, with the following options: A: Haloperidol, B: Fluphenazine, C: Clozapine, D: Flupenthioxol
+
+### Response:
+",Ref: KDT 6/e p429 Clozapine is an atypical neuroleptic with least extrapyramidal side effects among all antipsychotics.,"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 least extrapyramidal side effect:, with the following options: A: Haloperidol, B: Fluphenazine, C: Clozapine, D: Flupenthioxol
+
+### Response:
+Ref: KDT 6/e p429 Clozapine is an atypical neuroleptic with least extrapyramidal side effects among all antipsychotics.
+### End"
+474,"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 a patient with diphtheria is ?, with the following options: A: Till cough subsides, B: Till patient is febrile, C: Life long, D: For 15 days after infection
+
+### Response:
+","Ans. is 'd' i.e., For 15 days after infection o The period of infectivity may vary from 14 to 28 days from the onset of the disease, but carriers may remain infective for much longer period. o A case or carrier may be considered non-communicable when at least 2 cultures properly obtained from nose and throat, 24 hours apa, are negative for diphtheria bacilli.","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 a patient with diphtheria is ?, with the following options: A: Till cough subsides, B: Till patient is febrile, C: Life long, D: For 15 days after infection
+
+### Response:
+Ans. is 'd' i.e., For 15 days after infection o The period of infectivity may vary from 14 to 28 days from the onset of the disease, but carriers may remain infective for much longer period. o A case or carrier may be considered non-communicable when at least 2 cultures properly obtained from nose and throat, 24 hours apa, are negative for diphtheria bacilli.
+### End"
+475,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Best mode of contraception for a newly married lady with rheumatic heart disease:, with the following options: A: Oral pills, B: Norplant, C: IUCD, D: Condom
+
+### Response:
+","Barrier contraceptives (diaphragm/condom) are the ideal contraceptives for patients with medical complications such as heart disease.
+“The primary advantage of the diaphragm is the almost total absence of risks and medical contraindications.”
+
+Combined oral contraceptive pills are contraindicated in a woman with cardiac disease.
+IUCD is carefully considered in a cardiac and diabetic woman because of the possibility of pelvic infection.
+Depoprovera (DMPA) a progesterone only injectable contraceptive also is not a preferred agent for patients with cardiac disease although it is not contraindicated.
+Sterilization should be considered with completion of family at the end of first week in the puerperium under local anesthesia through abdominal root by minilap technique.
+If the heart is not well compensated, the husband is advised for vasectomy.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Best mode of contraception for a newly married lady with rheumatic heart disease:, with the following options: A: Oral pills, B: Norplant, C: IUCD, D: Condom
+
+### Response:
+Barrier contraceptives (diaphragm/condom) are the ideal contraceptives for patients with medical complications such as heart disease.
+“The primary advantage of the diaphragm is the almost total absence of risks and medical contraindications.”
+
+Combined oral contraceptive pills are contraindicated in a woman with cardiac disease.
+IUCD is carefully considered in a cardiac and diabetic woman because of the possibility of pelvic infection.
+Depoprovera (DMPA) a progesterone only injectable contraceptive also is not a preferred agent for patients with cardiac disease although it is not contraindicated.
+Sterilization should be considered with completion of family at the end of first week in the puerperium under local anesthesia through abdominal root by minilap technique.
+If the heart is not well compensated, the husband is advised for vasectomy.
+### End"
+476,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Position of vocal cord in cadaver is:, with the following options: A: Median, B: Paramedian, C: Intermediate, D: Full Abduction
+
+### Response:
+",The vocal fold of the excised larynx is known to be located at an intermediate position(the so-called cadaver position).,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Position of vocal cord in cadaver is:, with the following options: A: Median, B: Paramedian, C: Intermediate, D: Full Abduction
+
+### Response:
+The vocal fold of the excised larynx is known to be located at an intermediate position(the so-called cadaver position).
+### End"
+477,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Increased radiolucency of one sided hemithorax may he caused by all the following except:, with the following options: A: Obstructive emphysema, B: Pneumothorax, C: Expiratory film, D: Rotation
+
+### Response:
+",Ans. Expiratory film,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Increased radiolucency of one sided hemithorax may he caused by all the following except:, with the following options: A: Obstructive emphysema, B: Pneumothorax, C: Expiratory film, D: Rotation
+
+### Response:
+Ans. Expiratory film
+### End"
+478,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A health care system which is appropriate to everyone whether the service is needed at all in relation to essential human needs, can be accessible to everyone, available to everyone as first level of health care and the cost can be affordable by everyone is:, with the following options: A: Primary health care, B: Secondary health care, C: Tertiary health care, D: Basic health care
+
+### Response:
+","Ans. (a) Primary health careRef : K. Park 23rd ed. / 891-92* PHC is Primary Health Care outlined by Alma Ata in 1978.* It is defined as essential health care, which is characterized by 4 As# Acceptable (it should be acceptable by everyone)# Accessible (it should be accessible by everyone)# Available (it should be available to everyone)# Affordable (it should be affordable to everyone)8 Elements of PHC (Primary Health Care) (remembered as ELEMENTS)EEssential drugsLLocally endemic disease prevention and controlEEPI (Expanded program of immunization)MMCH (Maternal and child Health care including family planning)EEducationNNutritionTTreatment of common ailmentsSSafe water supply and sanitation* Equity of distribution is NOT an element of PHC, but it is one of the principles/pillars of the PHC.* 4 Principles/Pillars of Primary Health Care:# Equitable distribution# Community participation# Intersectoral coordination# Appropriate technology.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: A health care system which is appropriate to everyone whether the service is needed at all in relation to essential human needs, can be accessible to everyone, available to everyone as first level of health care and the cost can be affordable by everyone is:, with the following options: A: Primary health care, B: Secondary health care, C: Tertiary health care, D: Basic health care
+
+### Response:
+Ans. (a) Primary health careRef : K. Park 23rd ed. / 891-92* PHC is Primary Health Care outlined by Alma Ata in 1978.* It is defined as essential health care, which is characterized by 4 As# Acceptable (it should be acceptable by everyone)# Accessible (it should be accessible by everyone)# Available (it should be available to everyone)# Affordable (it should be affordable to everyone)8 Elements of PHC (Primary Health Care) (remembered as ELEMENTS)EEssential drugsLLocally endemic disease prevention and controlEEPI (Expanded program of immunization)MMCH (Maternal and child Health care including family planning)EEducationNNutritionTTreatment of common ailmentsSSafe water supply and sanitation* Equity of distribution is NOT an element of PHC, but it is one of the principles/pillars of the PHC.* 4 Principles/Pillars of Primary Health Care:# Equitable distribution# Community participation# Intersectoral coordination# Appropriate technology.
+### End"
+479,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Internal jugular vein is the continuation of which of the following sinus, with the following options: A: Cavernous sinus, B: Sigmoid sinus, C: Inferior petrosal sinus, D: Superior petrosal sinus
+
+### Response:
+","Internal jugular vein is the direct continuation of the sigmoid sinusThe sigmoid sinuses:They are two areas beneath the brain which allow blood to drain inferiorly from the posterior center of the head.They drain from the transverse sinuses and converge with the inferior petrosal sinuses to form the internal jugular veinEach sigmoid sinus begins beneath the temporal bone and follows a touous course to the jugular foramen, at which point the sinus becomes continuous with the internal jugular veinThe internal jugular vein:It collects the blood from the brain, from the superficial pas of the face, and from the neck.It is directly continuous with the transverse sinus, and begins in the posterior compament of the jugular foramen, at the base of the skull.The thoracic duct on the left side and the right lymphatic duct on the right side open into the angle of union of the internal jugular and subclan veins.The external jugular vein:It is formed by the junction of the posterior division of the posterior facial with the posterior auricular vein.It commences in the substance of the parotid gland, on a level with the angle of the mandible.The anterior jugular vein:It begins near the hyoid bone by the confluence of several superficial veins from the submaxillary region.It descends between the median line and the anterior border of the Sternocleidomastoideus, and, at the lower pa of the neck, passes beneath that muscle to open into the termination of the external jugular, or, in some instances, into the subclan vein","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Internal jugular vein is the continuation of which of the following sinus, with the following options: A: Cavernous sinus, B: Sigmoid sinus, C: Inferior petrosal sinus, D: Superior petrosal sinus
+
+### Response:
+Internal jugular vein is the direct continuation of the sigmoid sinusThe sigmoid sinuses:They are two areas beneath the brain which allow blood to drain inferiorly from the posterior center of the head.They drain from the transverse sinuses and converge with the inferior petrosal sinuses to form the internal jugular veinEach sigmoid sinus begins beneath the temporal bone and follows a touous course to the jugular foramen, at which point the sinus becomes continuous with the internal jugular veinThe internal jugular vein:It collects the blood from the brain, from the superficial pas of the face, and from the neck.It is directly continuous with the transverse sinus, and begins in the posterior compament of the jugular foramen, at the base of the skull.The thoracic duct on the left side and the right lymphatic duct on the right side open into the angle of union of the internal jugular and subclan veins.The external jugular vein:It is formed by the junction of the posterior division of the posterior facial with the posterior auricular vein.It commences in the substance of the parotid gland, on a level with the angle of the mandible.The anterior jugular vein:It begins near the hyoid bone by the confluence of several superficial veins from the submaxillary region.It descends between the median line and the anterior border of the Sternocleidomastoideus, and, at the lower pa of the neck, passes beneath that muscle to open into the termination of the external jugular, or, in some instances, into the subclan vein
+### End"
+480,"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 WRONG regarding ophthalmic aery:-, with the following options: A: Present in dura along with optic nerve, B: Supplies anterior ethmoidal sinus, C: Aery to retina is end aery, D: Leaves orbit through inferior orbital fissure
+
+### Response:
+","Ophthalmic aery arises from Internal Carotid Aery as it emerges from the roof of the Cavernous Sinus, enters the Orbit through Optic canal inferolateral to the optic nerve, both lying in a common dural sheath. Gives central aery to retina (an end aery), and also supplies ethmoidal sinuses by giving ethmoidal aeries.","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 WRONG regarding ophthalmic aery:-, with the following options: A: Present in dura along with optic nerve, B: Supplies anterior ethmoidal sinus, C: Aery to retina is end aery, D: Leaves orbit through inferior orbital fissure
+
+### Response:
+Ophthalmic aery arises from Internal Carotid Aery as it emerges from the roof of the Cavernous Sinus, enters the Orbit through Optic canal inferolateral to the optic nerve, both lying in a common dural sheath. Gives central aery to retina (an end aery), and also supplies ethmoidal sinuses by giving ethmoidal aeries.
+### End"
+481,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Serum contains all the clotting factors, except, with the following options: A: Plasma thromboplastin, B: Labile factor, C: Hageman factor, D: Christmas factor
+
+### Response:
+","If whole blood is allowed to clot and the clot is removed, the remaining fluid is called serum. Serum has essentially the same composition as plasma, except that:
+
+Fibrinogen (factor I) and clotting factors II, V, and VIII have been removed and
+Has higher serotonin content, because of the breakdown of platelets during clotting.
+
+Also, know that factor 5 is called as labile factor.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Serum contains all the clotting factors, except, with the following options: A: Plasma thromboplastin, B: Labile factor, C: Hageman factor, D: Christmas factor
+
+### Response:
+If whole blood is allowed to clot and the clot is removed, the remaining fluid is called serum. Serum has essentially the same composition as plasma, except that:
+
+Fibrinogen (factor I) and clotting factors II, V, and VIII have been removed and
+Has higher serotonin content, because of the breakdown of platelets during clotting.
+
+Also, know that factor 5 is called as labile factor.
+### End"
+482,"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 is hit in the face with a baseball bat and presents to the emergency department with massive facial swelling, ecchymosis, and an elongated face. There is mobility of the middle third of the face on digital manipulation of the maxilla. What is the likely diagnosis?, with the following options: A: Lambdoid injury, B: Odontoid fracture, C: LeFort III fracture, D: Palatal split
+
+### Response:
+","The physical findings are characteristics of a Le Fort III fracture (Figure below). In this injury, the fracture passes through maxilla and nasal bones and above the zygomatic bone.Classic Le Fort fracture patterns","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 is hit in the face with a baseball bat and presents to the emergency department with massive facial swelling, ecchymosis, and an elongated face. There is mobility of the middle third of the face on digital manipulation of the maxilla. What is the likely diagnosis?, with the following options: A: Lambdoid injury, B: Odontoid fracture, C: LeFort III fracture, D: Palatal split
+
+### Response:
+The physical findings are characteristics of a Le Fort III fracture (Figure below). In this injury, the fracture passes through maxilla and nasal bones and above the zygomatic bone.Classic Le Fort fracture patterns
+### End"
+483,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Teeth with pulp chambers relatively small and have constriction of the pulp chamber approximately at the CEJ are called as:, with the following options: A: Microdont, B: Hypotaurodont., C: Cynodont., D: None of the above
+
+### Response:
+","Teeth with pulp chambers that are relatively small and have constriction of the pulp chamber approximately at the CEJ and are called as cynodonts. The term taurodontism was introduced by Sir Arthur Keith to describe a dental -anomaly where the body of the tooth is enlarged at the expense of the roots (bull —like teeth). The taurodontic teeth are identified by elongated pulp .chambers and apical displacement of bifurcation or trifurcation of the roots. Due to this, the chamber has a greater apicoocclusal height than in cynodont teeth and lacks the constriction at the level of the CEJ giving it a rectangular shape.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Teeth with pulp chambers relatively small and have constriction of the pulp chamber approximately at the CEJ are called as:, with the following options: A: Microdont, B: Hypotaurodont., C: Cynodont., D: None of the above
+
+### Response:
+Teeth with pulp chambers that are relatively small and have constriction of the pulp chamber approximately at the CEJ and are called as cynodonts. The term taurodontism was introduced by Sir Arthur Keith to describe a dental -anomaly where the body of the tooth is enlarged at the expense of the roots (bull —like teeth). The taurodontic teeth are identified by elongated pulp .chambers and apical displacement of bifurcation or trifurcation of the roots. Due to this, the chamber has a greater apicoocclusal height than in cynodont teeth and lacks the constriction at the level of the CEJ giving it a rectangular shape.
+### End"
+484,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Koeppe nodules are present on –, with the following options: A: Cornea, B: Conjunctiva, C: Iris, D: Retina
+
+### Response:
+","Iris nodules
+
+There are many types of nodules that develop on iris in granulomatous uveitis:-
+
+
+Koeppe nodule: - Seen at pupillary margin.
+Busacca's nodule: - Seen on the peripheral part of the anterior surface of iris.
+Tubercular nodules: - Scattered throughout the iris and ciliary body, mostly in the stroma. They are more common at pupillary margin.
+Syphilitic nodules:-At pupillary margin.
+Sarcoid nodules:-At pupillary margin or in the stroma of the iris.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Koeppe nodules are present on –, with the following options: A: Cornea, B: Conjunctiva, C: Iris, D: Retina
+
+### Response:
+Iris nodules
+
+There are many types of nodules that develop on iris in granulomatous uveitis:-
+
+
+Koeppe nodule: - Seen at pupillary margin.
+Busacca's nodule: - Seen on the peripheral part of the anterior surface of iris.
+Tubercular nodules: - Scattered throughout the iris and ciliary body, mostly in the stroma. They are more common at pupillary margin.
+Syphilitic nodules:-At pupillary margin.
+Sarcoid nodules:-At pupillary margin or in the stroma of the iris.
+### End"
+485,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Lower border of pharynx is the level of:, with the following options: A: C2, B: C3, C: C4, D: C6
+
+### Response:
+","Pharynx, the upper portion of gut tube, is funnel-shaped fibromuscular tube that extends from the base of the skull to the inferior border of the cricoid cartilage at the level of C6 vertebra.
+It continues inferiorly as the esophagus.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Lower border of pharynx is the level of:, with the following options: A: C2, B: C3, C: C4, D: C6
+
+### Response:
+Pharynx, the upper portion of gut tube, is funnel-shaped fibromuscular tube that extends from the base of the skull to the inferior border of the cricoid cartilage at the level of C6 vertebra.
+It continues inferiorly as the esophagus.
+### End"
+486,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Functions of female health worker includes-, with the following options: A: Visit 4 subcentres\/month Health assistment, B: Enlist dais of the sub-centre, C: Conduct 50% delivery, D: Chlorination of water Health woh male
+
+### Response:
+",One of the functions of health worker female is maternal and child health.Functions include Registered and provide care to pregnant women Ensure that every pregnant women makes atleast 3 visits for antenatal checkups Conduct deliveries in her area when called for . Supervise deliveries conducted by Dias and assist them when ever called in (refer pgno:909 park 23rd edition),"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Functions of female health worker includes-, with the following options: A: Visit 4 subcentres\/month Health assistment, B: Enlist dais of the sub-centre, C: Conduct 50% delivery, D: Chlorination of water Health woh male
+
+### Response:
+One of the functions of health worker female is maternal and child health.Functions include Registered and provide care to pregnant women Ensure that every pregnant women makes atleast 3 visits for antenatal checkups Conduct deliveries in her area when called for . Supervise deliveries conducted by Dias and assist them when ever called in (refer pgno:909 park 23rd edition)
+### End"
+487,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Red cells are caught as innocent bystanders in the reaction between drug and antibodies against that drug, and develops hemolysis. Which drug is responsible for such a reaction?, with the following options: A: Penicillin, B: Sulfonamide, C: Naphthalene, D: Primaquine
+
+### Response:
+","After exposure red cells can be caught as innocent bystanders during the reaction between penicillin and antipenicillin antibodies. Ref: Harrison's principles of internal medicine, 18th edition, Page 881.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Red cells are caught as innocent bystanders in the reaction between drug and antibodies against that drug, and develops hemolysis. Which drug is responsible for such a reaction?, with the following options: A: Penicillin, B: Sulfonamide, C: Naphthalene, D: Primaquine
+
+### Response:
+After exposure red cells can be caught as innocent bystanders during the reaction between penicillin and antipenicillin antibodies. Ref: Harrison's principles of internal medicine, 18th edition, Page 881.
+### End"
+488,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Fixation reflex of eyes develop at, with the following options: A: 2 - 4 months, B: 4 - 5 months, C: 9 months, D: 6 - 8 months
+
+### Response:
+",Fixation reflex of eyes develop at 2 - 4 months.,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Fixation reflex of eyes develop at, with the following options: A: 2 - 4 months, B: 4 - 5 months, C: 9 months, D: 6 - 8 months
+
+### Response:
+Fixation reflex of eyes develop at 2 - 4 months.
+### End"
+489,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Most impoant predictor of coronary aery disease is:, with the following options: A: VLDL, B: LDL, C: Chylomicron, D: LDL/HDL
+
+### Response:
+","Answer is D (LDL/HDL) `The ratio of either LDL cholesterol to HDL cholesterol (LDH / HDL ratio) or Total cholesterol to HDL cholesterol (TC /HDL ratio) is highly predictive of coronary hea disease' - Essential cardiology 2""d/6","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Most impoant predictor of coronary aery disease is:, with the following options: A: VLDL, B: LDL, C: Chylomicron, D: LDL/HDL
+
+### Response:
+Answer is D (LDL/HDL) `The ratio of either LDL cholesterol to HDL cholesterol (LDH / HDL ratio) or Total cholesterol to HDL cholesterol (TC /HDL ratio) is highly predictive of coronary hea disease' - Essential cardiology 2""d/6
+### End"
+490,"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 stages of demographic cycle in order:\r\nI. High stationary \r\nII. Late expanding\r\nIII. Low stationary\r\nIV. Early expanding, with the following options: A: I, II, III & IV, B: I,III, IV & II, C: I, IV, III & II, D: I, IV, II & III
+
+### Response:
+","First stage (High stationary): This stage is characterised by high bih and death rate which cancel out each other and the population remains stationary. Second stage (Early expanding): The death rate begins to decline, while the bih rate tends to fall. Many countries in South Asia and Africa are in this phase. Third stage (late expanding): The death rate of the population is on declining trend. The bih rates are also falling. The population continues to grow as bih rate exceeds deaths. India is currently in this phase. Fouh stage (Low stationary): This stage is characterised by low bih and death rate with a result that the population becomes stationary as in Austria in 1980 to 1985. Fifth stage (declining): Population begins to decline because th bih rate is lower than the death rate. Ref: Park, 22nd edition pg: 441","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 stages of demographic cycle in order:\r\nI. High stationary \r\nII. Late expanding\r\nIII. Low stationary\r\nIV. Early expanding, with the following options: A: I, II, III & IV, B: I,III, IV & II, C: I, IV, III & II, D: I, IV, II & III
+
+### Response:
+First stage (High stationary): This stage is characterised by high bih and death rate which cancel out each other and the population remains stationary. Second stage (Early expanding): The death rate begins to decline, while the bih rate tends to fall. Many countries in South Asia and Africa are in this phase. Third stage (late expanding): The death rate of the population is on declining trend. The bih rates are also falling. The population continues to grow as bih rate exceeds deaths. India is currently in this phase. Fouh stage (Low stationary): This stage is characterised by low bih and death rate with a result that the population becomes stationary as in Austria in 1980 to 1985. Fifth stage (declining): Population begins to decline because th bih rate is lower than the death rate. Ref: Park, 22nd edition pg: 441
+### End"
+491,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Obturator nerve enters thigh at, with the following options: A: Adductor canal, B: Obturator canal, C: Superficial inguinal ring, D: Femoral canal
+
+### Response:
+","It descends through the fibers of the psoas major, and emerges from its medial border near the brim of pelvis; it then passes behind the common illaic aery and on the lateral side of the internal illiac aery and ureter, and runs along the lateral wall of the lesser pelvis, above and in front of the obturator vessel, to the upper pa of the obturator foramen. Here it enters the thigh, through the obturator canal, and divides into an anterior and a posterior branch, which are separated at first by some of the fibers of the obturator externus, and lower down by the adductor brevis. ref -sciencedirect.com","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Obturator nerve enters thigh at, with the following options: A: Adductor canal, B: Obturator canal, C: Superficial inguinal ring, D: Femoral canal
+
+### Response:
+It descends through the fibers of the psoas major, and emerges from its medial border near the brim of pelvis; it then passes behind the common illaic aery and on the lateral side of the internal illiac aery and ureter, and runs along the lateral wall of the lesser pelvis, above and in front of the obturator vessel, to the upper pa of the obturator foramen. Here it enters the thigh, through the obturator canal, and divides into an anterior and a posterior branch, which are separated at first by some of the fibers of the obturator externus, and lower down by the adductor brevis. ref -sciencedirect.com
+### End"
+492,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Gonioscope is used for visualization of, with the following options: A: Anteior chamber angle, B: Posterior chamber angle, C: Anterior surface of lens, D: Posterior chamber
+
+### Response:
+","Gonioscopy: Owing to lack of transparency of corneoscleral junction and total internal reflection of light (emitted from angle structures) at the anterior surface of cornea it is not possible to visualize the angle of anterior chamber directly. Therefore, a device (goniolens) is used to dive the beam of light and this technique of biomicroscopic examination of the angle of the anterior chamber is called gonioscopy. Types of goniolens: (i) Indirect goniolens provides a mirror image of the opposite angle, e.g., Goldmann and the Zeiss goniolens (ii) Direct goniolens provides a direct view of the angle. Koeppe goniolens is the most popular type. The angle structures seen from behind forwards are: 1. The root of the iris 2. The anteromedial surface of the ciliary body (ciliary band), 3. Scleral spur 4. Trabecular meshwork and Schlemm's canal and 5. Schwalbe's line Applications of gonioscopy: 1. Classification of glaucoma into open angle and closed angle based on the configuration of the angle. 2. Localization of foreign bodies, abnormal blood vessels or tumors in the angle. 3. Demonstration of the extent of peripheral anterior synechiae and hence planning of glaucoma surgery. Ref: Khurana comprehensive ophthalmology; 4th edition Pg: 546","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Gonioscope is used for visualization of, with the following options: A: Anteior chamber angle, B: Posterior chamber angle, C: Anterior surface of lens, D: Posterior chamber
+
+### Response:
+Gonioscopy: Owing to lack of transparency of corneoscleral junction and total internal reflection of light (emitted from angle structures) at the anterior surface of cornea it is not possible to visualize the angle of anterior chamber directly. Therefore, a device (goniolens) is used to dive the beam of light and this technique of biomicroscopic examination of the angle of the anterior chamber is called gonioscopy. Types of goniolens: (i) Indirect goniolens provides a mirror image of the opposite angle, e.g., Goldmann and the Zeiss goniolens (ii) Direct goniolens provides a direct view of the angle. Koeppe goniolens is the most popular type. The angle structures seen from behind forwards are: 1. The root of the iris 2. The anteromedial surface of the ciliary body (ciliary band), 3. Scleral spur 4. Trabecular meshwork and Schlemm's canal and 5. Schwalbe's line Applications of gonioscopy: 1. Classification of glaucoma into open angle and closed angle based on the configuration of the angle. 2. Localization of foreign bodies, abnormal blood vessels or tumors in the angle. 3. Demonstration of the extent of peripheral anterior synechiae and hence planning of glaucoma surgery. Ref: Khurana comprehensive ophthalmology; 4th edition Pg: 546
+### End"
+493,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Onychomycosis is most commonly caused by -, with the following options: A: Trichophyton rubrum, B: Trichophyton mentagrophytes, C: Epidermatophyton floccosum, D: Candida
+
+### Response:
+","Ans. is 'a' i.e., Trichophyton rubrum Tinea Unguium (Onychomycosis)o Tinea unguium is dermatophvtic infection of fingers and toe nails. Most common causative species is T-rubrum. Toe nails are more commonly involved. T. Unguium may be of two types : -Distal subungal onychomycosis : - This is most common type offungal infection of nail (90%). It starts at the distal edge of the nail plate and slowly growrs inwards to involve entire nail plate.Proximal Subungal onychomycosis : - Starts at the base of nail and slowly involves the entire nail plate.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: Onychomycosis is most commonly caused by -, with the following options: A: Trichophyton rubrum, B: Trichophyton mentagrophytes, C: Epidermatophyton floccosum, D: Candida
+
+### Response:
+Ans. is 'a' i.e., Trichophyton rubrum Tinea Unguium (Onychomycosis)o Tinea unguium is dermatophvtic infection of fingers and toe nails. Most common causative species is T-rubrum. Toe nails are more commonly involved. T. Unguium may be of two types : -Distal subungal onychomycosis : - This is most common type offungal infection of nail (90%). It starts at the distal edge of the nail plate and slowly growrs inwards to involve entire nail plate.Proximal Subungal onychomycosis : - Starts at the base of nail and slowly involves the entire nail plate.
+### End"
+494,"Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: HSV 2 causes:, with the following options: A: Genital herpes, B: Genital warts, C: Herpes zoster, D: Genital ulcer
+
+### Response:
+","Ans: a (Genital herpes) Ref: Shaw, 13th ed, p. 113Heipes genitalis is caused by HSV type 2. It is the most common DNA viral infection encountered in vulval disease.Symptoms: Tingling, itching, paraesthesia - vesicles - painful ulcers.Treatment: AcyclovirNote:Genital warts (condyloma accuminata) caused by HPV 6,11.Heipes zoster is caused by varicella virus.","Below is an instruction that describes a task. Write a response that appropriately completes the request.
+
+### Instruction:
+
+Answer the following medical question: HSV 2 causes:, with the following options: A: Genital herpes, B: Genital warts, C: Herpes zoster, D: Genital ulcer
+
+### Response:
+Ans: a (Genital herpes) Ref: Shaw, 13th ed, p. 113Heipes genitalis is caused by HSV type 2. It is the most common DNA viral infection encountered in vulval disease.Symptoms: Tingling, itching, paraesthesia - vesicles - painful ulcers.Treatment: AcyclovirNote:Genital warts (condyloma accuminata) caused by HPV 6,11.Heipes zoster is caused by varicella virus.
+### End"
+495,"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 drugs are commercially marketed as racemic mixture except-, with the following options: A: Bupivacaine, B: Thiopentone, C: Ropivacaine, D: Thiamylal
+
+### Response:
+","Ropivacaine is pure s-isomer of bupivacaine. Enantiomers exist in two different spatial configurations, like right- and left-handed gloves, and are present in equal amounts in a racemic solution. They are optically active and can be differentiated by their effects on the rotation of the plane of a polarised light into dextrorotatory or levorotatory stereoisomers. The physicochemical propeies of the two enantiomeric molecules are identical, but the two enantiomers can have substantially different behaviours in their affinity for either the site of action or the sites involved in the generation of side effects. R(+) and S(-) enantiomers of local anaesthetics have been demonstrated to have different affinity for different ion channels of sodium, potassium, and calcium; this results in a significant reduction in central nervous system (CNS) and cardiac toxicity (cardiotoxicity) of the S(-)enantiomer as compared with the R(+)enantiomer. The technological advancements have made it possible to develop Ropivacaine as an optically pure S(-) enantiomeric from the parent chiral molecule propivacaine. It belongs to the group of local anaesthetics, the pipecoloxylidides and has a propyl group on the piperidine nitrogen atom compared to bupivacaine, which has a butyl group.","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 drugs are commercially marketed as racemic mixture except-, with the following options: A: Bupivacaine, B: Thiopentone, C: Ropivacaine, D: Thiamylal
+
+### Response:
+Ropivacaine is pure s-isomer of bupivacaine. Enantiomers exist in two different spatial configurations, like right- and left-handed gloves, and are present in equal amounts in a racemic solution. They are optically active and can be differentiated by their effects on the rotation of the plane of a polarised light into dextrorotatory or levorotatory stereoisomers. The physicochemical propeies of the two enantiomeric molecules are identical, but the two enantiomers can have substantially different behaviours in their affinity for either the site of action or the sites involved in the generation of side effects. R(+) and S(-) enantiomers of local anaesthetics have been demonstrated to have different affinity for different ion channels of sodium, potassium, and calcium; this results in a significant reduction in central nervous system (CNS) and cardiac toxicity (cardiotoxicity) of the S(-)enantiomer as compared with the R(+)enantiomer. The technological advancements have made it possible to develop Ropivacaine as an optically pure S(-) enantiomeric from the parent chiral molecule propivacaine. It belongs to the group of local anaesthetics, the pipecoloxylidides and has a propyl group on the piperidine nitrogen atom compared to bupivacaine, which has a butyl group.
+### End"
+496,"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 about RSBY (Rashtriya Swasthya Bima Yojana)?, with the following options: A: Applies to BPL families only, B: Rupees 30,000 per family member, C: Both inpatient and outpatient charges includedi, D: Patients pays first then it is reimbursed by government
+
+### Response:
+","
Applies to BPL families only. Reference:RSBY Documents, Government of India. <\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 is true about RSBY (Rashtriya Swasthya Bima Yojana)?, with the following options: A: Applies to BPL families only, B: Rupees 30,000 per family member, C: Both inpatient and outpatient charges includedi, D: Patients pays first then it is reimbursed by government + +### Response: +
Applies to BPL families only. Reference:RSBY Documents, Government of India. <\p> +### End" +497,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A transection made at the lower end of medulla through the pyramids would cause all/except:, with the following options: A: In coordination, B: Involuntary movements, C: Spasticity, D: Increased tendon reflexes + +### Response: +","B. i.e. Involuantry movements LMN involves anterior horn cells, anterior spinal nerve root and peripheral nerve.- Involuantry movements & tremors are characteristic features of extrapyramidal disorder- Inocordination (ataxia) is mostly seen in cerebellar lesions but UMN lesions may also present with incordination due to spasticity & weakness.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A transection made at the lower end of medulla through the pyramids would cause all/except:, with the following options: A: In coordination, B: Involuntary movements, C: Spasticity, D: Increased tendon reflexes + +### Response: +B. i.e. Involuantry movements LMN involves anterior horn cells, anterior spinal nerve root and peripheral nerve.- Involuantry movements & tremors are characteristic features of extrapyramidal disorder- Inocordination (ataxia) is mostly seen in cerebellar lesions but UMN lesions may also present with incordination due to spasticity & weakness. +### End" +498,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What will happen to DNA if salt is added to it?, with the following options: A: Increase melting point (Tm), B: Decrease Tm, C: Not affect Tm, D: Melting lead to denaturation of DNA + +### Response: +",This makes the DNA less hydrophilic (less soluble in water). Ethanol has a lower dielectric constant than water so it&;s used to promote ionic bonds between the Na+ (from the salt) and the PO3- (from the DNA backbone) causing the DNA to precipitate.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What will happen to DNA if salt is added to it?, with the following options: A: Increase melting point (Tm), B: Decrease Tm, C: Not affect Tm, D: Melting lead to denaturation of DNA + +### Response: +This makes the DNA less hydrophilic (less soluble in water). Ethanol has a lower dielectric constant than water so it&;s used to promote ionic bonds between the Na+ (from the salt) and the PO3- (from the DNA backbone) causing the DNA to precipitate. +### End" +499,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Reis-Buckler dystrophy affects which layer of cornea, with the following options: A: Epithelium, B: Stroma, C: Bowman's membrane, D: Endothelium + +### Response: +","Ans. is 'c' i.e., Bowman's membrane","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Reis-Buckler dystrophy affects which layer of cornea, with the following options: A: Epithelium, B: Stroma, C: Bowman's membrane, D: Endothelium + +### Response: +Ans. is 'c' i.e., Bowman's membrane +### End" +500,"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 small-vessel vasculitis?, with the following options: A: Takayasu arteritis, B: Microscopicpolyangitis, C: Giant cellarteritis, D: Polyarteritis nodosa + +### Response: +","Ans. is 'b' i.e., Microscopic polyangitis o Vasculitis refers to inflammation of the wall of blood vessels.o Because the cause of most forms of vasculitis are not known the vasculitides are classified according to their clinicopathological features:o Vasculitis can be separated by the size of vessels involved.o Based on whether the process is primary i.e. of the unknown cause or secondary to some other conditionClassification of vasculitis on the size of vesselLarge vessel vasculitis (aorta and its largest branches to extremities and head and neck)o Giant cell arteritiso Takayasu arteritiso Cogan syndromeMedium vessel vasculitis (main visceral arteries and their branches)o Polyarteritis nodosao Kawasaki diseaseo Buerger s diseaseSmall vessel vasculitis (arterioles, venules, capillaries, occasionally small arteries)ANCA associated small vessel vasculitiso Wegener s granulomatosiso Microscopic polyangiitiso Churg strauss syndromeo Drug induced ANCA associated vasculitisANCA negative small vessel vasculitiso Behcet s diseaseo Hypersensitivity vasculitiso Urticarial vasculitis","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 small-vessel vasculitis?, with the following options: A: Takayasu arteritis, B: Microscopicpolyangitis, C: Giant cellarteritis, D: Polyarteritis nodosa + +### Response: +Ans. is 'b' i.e., Microscopic polyangitis o Vasculitis refers to inflammation of the wall of blood vessels.o Because the cause of most forms of vasculitis are not known the vasculitides are classified according to their clinicopathological features:o Vasculitis can be separated by the size of vessels involved.o Based on whether the process is primary i.e. of the unknown cause or secondary to some other conditionClassification of vasculitis on the size of vesselLarge vessel vasculitis (aorta and its largest branches to extremities and head and neck)o Giant cell arteritiso Takayasu arteritiso Cogan syndromeMedium vessel vasculitis (main visceral arteries and their branches)o Polyarteritis nodosao Kawasaki diseaseo Buerger s diseaseSmall vessel vasculitis (arterioles, venules, capillaries, occasionally small arteries)ANCA associated small vessel vasculitiso Wegener s granulomatosiso Microscopic polyangiitiso Churg strauss syndromeo Drug induced ANCA associated vasculitisANCA negative small vessel vasculitiso Behcet s diseaseo Hypersensitivity vasculitiso Urticarial vasculitis +### End" +501,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Sacrotuberous and sacrospinous ligaments attach sacrum to, with the following options: A: Ilium, B: Ischium, C: Pubis, D: Lumbar veebrae + +### Response: +","The sacrotuberous ligament is a strong broad band of fibrous tissue. It has broad upper end and narrow lower lateral end.Upper end is attached from above downward to posterior superior iliac spine, posterior inferior iliac spine, lower pa of posterior surface and lateral border of sacrum and adjoining pa of coccyx. The lower end is attached to medial margin of ischial tuberosity. Some of the fibres from lower end continue on to the ramus of ischium as the falciform process.The sacrospinous ligament is a triangular sheet of fibrous tissue with its apex attached laterally to the ischial spine and base medially to the side of sacrum and coccyx.The sacrospinous and sacrotuberous ligaments conve the greater and lesser sciatic notches of the hip bone into greater and lesser sciatic foramina-the two impoant exits from the pelvis.Reference: Textbook of anatomy, Abdomen and Lower limb, Vishram Singh, 2nd edition, page no.204","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Sacrotuberous and sacrospinous ligaments attach sacrum to, with the following options: A: Ilium, B: Ischium, C: Pubis, D: Lumbar veebrae + +### Response: +The sacrotuberous ligament is a strong broad band of fibrous tissue. It has broad upper end and narrow lower lateral end.Upper end is attached from above downward to posterior superior iliac spine, posterior inferior iliac spine, lower pa of posterior surface and lateral border of sacrum and adjoining pa of coccyx. The lower end is attached to medial margin of ischial tuberosity. Some of the fibres from lower end continue on to the ramus of ischium as the falciform process.The sacrospinous ligament is a triangular sheet of fibrous tissue with its apex attached laterally to the ischial spine and base medially to the side of sacrum and coccyx.The sacrospinous and sacrotuberous ligaments conve the greater and lesser sciatic notches of the hip bone into greater and lesser sciatic foramina-the two impoant exits from the pelvis.Reference: Textbook of anatomy, Abdomen and Lower limb, Vishram Singh, 2nd edition, page no.204 +### End" +502,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Bernad-Soulier Syndrome is characterised by which of the following, with the following options: A: Defect in GPIb -IX, B: Defect in GPIIb - III a, C: Deficiency of dence granules, D: Deficiency of VWF + +### Response: +","Bernad-Soulier Syndrome + +Inherited defect in Glycoprotein = GPIb - IX +Functional platelet defect. +Defective adhesion of platelets.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Bernad-Soulier Syndrome is characterised by which of the following, with the following options: A: Defect in GPIb -IX, B: Defect in GPIIb - III a, C: Deficiency of dence granules, D: Deficiency of VWF + +### Response: +Bernad-Soulier Syndrome + +Inherited defect in Glycoprotein = GPIb - IX +Functional platelet defect. +Defective adhesion of platelets. +### End" +503,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The medium that is most ideal for antibiotic sensitivity testing of bacterial isolates is, with the following options: A: Blood agar, B: Chocolate agar, C: Nutrient agar, D: MacConkey agar + +### Response: +",Nutrient agar is good for antibiotic sensitivity testing Muller Hinton medium for testing aerobes and facultative anaerobes Ref: Textbook of Microbiology Baveja 4th ed Pg 628,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The medium that is most ideal for antibiotic sensitivity testing of bacterial isolates is, with the following options: A: Blood agar, B: Chocolate agar, C: Nutrient agar, D: MacConkey agar + +### Response: +Nutrient agar is good for antibiotic sensitivity testing Muller Hinton medium for testing aerobes and facultative anaerobes Ref: Textbook of Microbiology Baveja 4th ed Pg 628 +### End" +504,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: To assess which of the following, Look Listen Feel technique is used?, with the following options: A: Airway, B: Breathing, C: Circulation, D: Definitive therapy + +### Response: +","Adequate breathing ensures that sufficiently oxygenated blood is in circulation. Breathing is assessed by the Look-Listen feel technique. The clinician observes the rise and fall of the chest and at the same time feels and listens to the breath sounds. +If the child is breathing adequately, then maintain the head tilt chin-lift and monitor the child. Alternatively, the child can be turned to a lateral position. +If the child does not show any signs of breathing, then oxygen has to be administered to the child under positive pressure using an Ambu bag. Care should be taken to see that the airway is held open using the head tilt chin lift during the process. The mouth to mouth or the mouth to nose techniques are not described here, because it is prudent that every dental setup be equipped with the indispensable and inexpensive Ambu bag. +In addition to being more hygienic, the Ambu bag also delivers 21% oxygen as compared to 18% using the mouth to mouth technique. It can also be attached to an oxygen cylinder to deliver 100% oxygen. Give two full puffs before proceeding to assess circulation.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: To assess which of the following, Look Listen Feel technique is used?, with the following options: A: Airway, B: Breathing, C: Circulation, D: Definitive therapy + +### Response: +Adequate breathing ensures that sufficiently oxygenated blood is in circulation. Breathing is assessed by the Look-Listen feel technique. The clinician observes the rise and fall of the chest and at the same time feels and listens to the breath sounds. +If the child is breathing adequately, then maintain the head tilt chin-lift and monitor the child. Alternatively, the child can be turned to a lateral position. +If the child does not show any signs of breathing, then oxygen has to be administered to the child under positive pressure using an Ambu bag. Care should be taken to see that the airway is held open using the head tilt chin lift during the process. The mouth to mouth or the mouth to nose techniques are not described here, because it is prudent that every dental setup be equipped with the indispensable and inexpensive Ambu bag. +In addition to being more hygienic, the Ambu bag also delivers 21% oxygen as compared to 18% using the mouth to mouth technique. It can also be attached to an oxygen cylinder to deliver 100% oxygen. Give two full puffs before proceeding to assess circulation. +### End" +505,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True statement (s) about posterior urethral valves in neonate, with the following options: A: Bilateral hydronephrosis may be present, B: Creatinine & urea levels remain normal, C: Enlarge & widen prostatic urethra, D: More common in Girls + +### Response: +","A posterior urethral valve (PUV) is a membranous fold within the lumen of the posterior urethra that causes functional obstruction of the urine outflow. It is a common cause of obstructive uropathy in boys during the neonatal period. Pathophysiology | Bladder pressure | Wall hyperophy + Collagen deposition | | Compliance Small amounts of urine may cause large increase in bladder pressure | Bilateral Hydronephrosis 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: True statement (s) about posterior urethral valves in neonate, with the following options: A: Bilateral hydronephrosis may be present, B: Creatinine & urea levels remain normal, C: Enlarge & widen prostatic urethra, D: More common in Girls + +### Response: +A posterior urethral valve (PUV) is a membranous fold within the lumen of the posterior urethra that causes functional obstruction of the urine outflow. It is a common cause of obstructive uropathy in boys during the neonatal period. Pathophysiology | Bladder pressure | Wall hyperophy + Collagen deposition | | Compliance Small amounts of urine may cause large increase in bladder pressure | Bilateral Hydronephrosis Reference: GHAI Essential pediatrics, 8th edition +### End" +506,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A radiographic study of inhalational lung diseases is conducted. One pattern of involvement is seen in persons whose total lung capacity, diffusing capacity, and compliance is decreased. This pattern consists of numerous bilateral nodular opacifications on chest radiographs. Polarizable needlelike crystals are seen on microscopic examination of these nodules. What inhaled substance is most likely to produce these findings?, with the following options: A: Cigarette smoke, B: Mold spores, C: Silica dust, D: Sulfur dioxide + +### Response: +","Silicotic nodules form when the silica crystals ingested by macrophages elicit a fibrogenic response as cytokines, such as tumor necrosis factor, are released. The nodules may become confluent with progressive massive fibrosis. Pneumoconioses such as silicosis lead to restrictive lung disease. Cigarette smoke contributes to loss of lung parenchyma with emphysema. Mold spores tend to elicit a hypersensitivity pneumonitis that rarely goes on to extensive restrictive lung disease. Sulfur dioxide in polluted air tends to drive chronic obstructive lung disease. Wood dust tends to elicit an asthmatic response.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A radiographic study of inhalational lung diseases is conducted. One pattern of involvement is seen in persons whose total lung capacity, diffusing capacity, and compliance is decreased. This pattern consists of numerous bilateral nodular opacifications on chest radiographs. Polarizable needlelike crystals are seen on microscopic examination of these nodules. What inhaled substance is most likely to produce these findings?, with the following options: A: Cigarette smoke, B: Mold spores, C: Silica dust, D: Sulfur dioxide + +### Response: +Silicotic nodules form when the silica crystals ingested by macrophages elicit a fibrogenic response as cytokines, such as tumor necrosis factor, are released. The nodules may become confluent with progressive massive fibrosis. Pneumoconioses such as silicosis lead to restrictive lung disease. Cigarette smoke contributes to loss of lung parenchyma with emphysema. Mold spores tend to elicit a hypersensitivity pneumonitis that rarely goes on to extensive restrictive lung disease. Sulfur dioxide in polluted air tends to drive chronic obstructive lung disease. Wood dust tends to elicit an asthmatic response. +### End" +507,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What can be the non-respiratory functions of lungs:, with the following options: A: Sodium balance., B: Fibrinolytic function., C: Secretion of heparin., D: All of the above. + +### Response: +","NON respiratory function of lung: + +ACE synthesized by lung – Na balance. +Fibrinolytic function – Pulmonary Endothelium is rich in PLASMIN activator. +Heparin – Lung is rich in mast cells which secrete heparin. +SURFACTANT – Synthesized by type 2 alveolar epithelial cells.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What can be the non-respiratory functions of lungs:, with the following options: A: Sodium balance., B: Fibrinolytic function., C: Secretion of heparin., D: All of the above. + +### Response: +NON respiratory function of lung: + +ACE synthesized by lung – Na balance. +Fibrinolytic function – Pulmonary Endothelium is rich in PLASMIN activator. +Heparin – Lung is rich in mast cells which secrete heparin. +SURFACTANT – Synthesized by type 2 alveolar epithelial cells. +### End" +508,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In brain death which of the organs cannot be transplanted: UPSC 14, with the following options: A: Brain, B: Hea, C: Liver, D: Kidney + +### Response: +",Ans. Brain,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In brain death which of the organs cannot be transplanted: UPSC 14, with the following options: A: Brain, B: Hea, C: Liver, D: Kidney + +### Response: +Ans. Brain +### End" +509,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True regarding the use of bromocriptine for suppression of lactation include:, with the following options: A: It can cause deep vein thrombosis, B: It can cause hypotension, C: Metoclopramide potentiates the action of Bromocriptine, D: It is given for 1 week only + +### Response: +","For suppression of lactation, D2 agonists like bromocriptine can be used. In hyperprolactinemia, these are given for long periods. +Metoclopramide being a D2 antagonist will stop the action of bromocriptine. +Adverse effects of bromocriptine include nausea, vomiting, postural hypotension, digital vasospasm and CNS effects like hallucinations, psychosis etc.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True regarding the use of bromocriptine for suppression of lactation include:, with the following options: A: It can cause deep vein thrombosis, B: It can cause hypotension, C: Metoclopramide potentiates the action of Bromocriptine, D: It is given for 1 week only + +### Response: +For suppression of lactation, D2 agonists like bromocriptine can be used. In hyperprolactinemia, these are given for long periods. +Metoclopramide being a D2 antagonist will stop the action of bromocriptine. +Adverse effects of bromocriptine include nausea, vomiting, postural hypotension, digital vasospasm and CNS effects like hallucinations, psychosis etc. +### End" +510,"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 the Right Coronary Aery (RCA) except___, with the following options: A: RCA diameter is less than left coronary aery, B: RCA arises from the anterior aoic sinus, C: RCA gives rise to circumflex coronary branch, D: Right Coronary aery is the first branch of RCA + +### Response: +","The right coronary aery arises from the anterior aoic sinus (Right coronary sinus) of the ascending aoa. (Option B) It passes anteriorly and descends veically in the coronary sulcus between the right atrium and the right ventricle. On reaching the inferior margin, it turns posteriorly and continues in the sulcus on to the diaphragmatic surface and the base of the hea. The diameter of the right coronary aery is less than that of the left coronary aery (option A) The right coronal aery is, usually the first branch of the coronary aery. (Option D) The circumflex coronary aery is a branch of the left coronary aery and is the exclusive supplier to the right bundle branch. Ref: Gray's Anatomy 41st edition Pgno: 1016","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 the Right Coronary Aery (RCA) except___, with the following options: A: RCA diameter is less than left coronary aery, B: RCA arises from the anterior aoic sinus, C: RCA gives rise to circumflex coronary branch, D: Right Coronary aery is the first branch of RCA + +### Response: +The right coronary aery arises from the anterior aoic sinus (Right coronary sinus) of the ascending aoa. (Option B) It passes anteriorly and descends veically in the coronary sulcus between the right atrium and the right ventricle. On reaching the inferior margin, it turns posteriorly and continues in the sulcus on to the diaphragmatic surface and the base of the hea. The diameter of the right coronary aery is less than that of the left coronary aery (option A) The right coronal aery is, usually the first branch of the coronary aery. (Option D) The circumflex coronary aery is a branch of the left coronary aery and is the exclusive supplier to the right bundle branch. Ref: Gray's Anatomy 41st edition Pgno: 1016 +### End" +511,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Local anaesthetic with prolonged action ?, with the following options: A: Procaine, B: Cocaine, C: Lidocaine, D: Dibucaine + +### Response: +","Ans. is 'd' i.e., Dibuca Dibucaine is the longest acting local anaesthetic Chlorprocaine is the shoest acting local anaesthetic Decreasing order of duration : - Dibucaine > Bupivacine = Tetracaine = Ropivacaine = Etidocaine > Prilocaine = Lignocaine = Mepivacaine = Cocaine > Procaine > Chlorprocaine .","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Local anaesthetic with prolonged action ?, with the following options: A: Procaine, B: Cocaine, C: Lidocaine, D: Dibucaine + +### Response: +Ans. is 'd' i.e., Dibuca Dibucaine is the longest acting local anaesthetic Chlorprocaine is the shoest acting local anaesthetic Decreasing order of duration : - Dibucaine > Bupivacine = Tetracaine = Ropivacaine = Etidocaine > Prilocaine = Lignocaine = Mepivacaine = Cocaine > Procaine > Chlorprocaine . +### End" +512,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Bruton’s agammaglobulinemia is due to?, with the following options: A: B-cell defect, B: IgA deficiency, C: Ig M deficiency, D: Ig G deficiency + +### Response: +","X-Linked agammaglobulinemia of bruton There is defective humoral immunity with normal cell-mediated immunity. It is characterized by the failure of B cell precursors (Pro-B cells and pre B cells) to mature into B cells. There is a mutation in cytoplasmic tyrosine kinase called B - cell tyrosine kinase (BtK). +The disease usually does not become apparent until about age 6 months, when maternal immunoglobulins are depleted. +B cells are absent or markedly decreased in the circulation and the serum levels of all classes of immunoglobulin. There are depletions of B cell area of lymph node (Cortical follicles and medullary cord) and spleen (perifollicular region, germinal centre and mantle layer). Tonsil and adenoids are atrophic +T-cell collection areas are normal i.e. +(i) Paracortical area in lymph nodes, and +(ii) Periarterial lymphoid region & malpighian corpuscle in white pulp of the spleen. +The disease is seen almost entirely in males. There are recurrent bacterial infections of the respiratory tract by H. influenzae, str. pneumonia or staph aureus. There is increased susceptibility to infection with enterovirus (echo, coxsackievirus, poliovirus), Giardia lamblia, and arthritis by mycoplasma +As there is agammaglobulinemia, Opsonization is defective (Immunoglobulins are the major opsonins in the body).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Bruton’s agammaglobulinemia is due to?, with the following options: A: B-cell defect, B: IgA deficiency, C: Ig M deficiency, D: Ig G deficiency + +### Response: +X-Linked agammaglobulinemia of bruton There is defective humoral immunity with normal cell-mediated immunity. It is characterized by the failure of B cell precursors (Pro-B cells and pre B cells) to mature into B cells. There is a mutation in cytoplasmic tyrosine kinase called B - cell tyrosine kinase (BtK). +The disease usually does not become apparent until about age 6 months, when maternal immunoglobulins are depleted. +B cells are absent or markedly decreased in the circulation and the serum levels of all classes of immunoglobulin. There are depletions of B cell area of lymph node (Cortical follicles and medullary cord) and spleen (perifollicular region, germinal centre and mantle layer). Tonsil and adenoids are atrophic +T-cell collection areas are normal i.e. +(i) Paracortical area in lymph nodes, and +(ii) Periarterial lymphoid region & malpighian corpuscle in white pulp of the spleen. +The disease is seen almost entirely in males. There are recurrent bacterial infections of the respiratory tract by H. influenzae, str. pneumonia or staph aureus. There is increased susceptibility to infection with enterovirus (echo, coxsackievirus, poliovirus), Giardia lamblia, and arthritis by mycoplasma +As there is agammaglobulinemia, Opsonization is defective (Immunoglobulins are the major opsonins in the body). +### End" +513,"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 increases the prevalence ofthe diseaseaEUR', with the following options: A: Immigration of healthy people, B: Increase in cure rates, C: Decrease in the number of new cases, D: Increase in duration of disease + +### Response: +","Increase in duration of disease [Ref: Park 20/e, p 58 (19/e, p 56, 57)J Prevalence refers ""to all current cases (old + new) existing at a given point in time (point prevalence) or over a period of time (period prevalence) in a given population"" It thus includes all the new cases, as well as those old persisting cases. It depends on 2 factors i. incidence of disease (I) ii.duration of disease (D) Thus, the longer the duration of disease, the greater its prevalence.","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 increases the prevalence ofthe diseaseaEUR', with the following options: A: Immigration of healthy people, B: Increase in cure rates, C: Decrease in the number of new cases, D: Increase in duration of disease + +### Response: +Increase in duration of disease [Ref: Park 20/e, p 58 (19/e, p 56, 57)J Prevalence refers ""to all current cases (old + new) existing at a given point in time (point prevalence) or over a period of time (period prevalence) in a given population"" It thus includes all the new cases, as well as those old persisting cases. It depends on 2 factors i. incidence of disease (I) ii.duration of disease (D) Thus, the longer the duration of disease, the greater its prevalence. +### End" +514,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Multiple pulp stones are seen in, with the following options: A: Down's syndrome, B: Elites Danlos syndrome, C: Marfan Syndrome, D: Apert's syndrome + +### Response: +","Ehler Danlos syndromes: +Includes more than 10 different disorders involving a genetic defect in collagen and connective tissue synthesis.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Multiple pulp stones are seen in, with the following options: A: Down's syndrome, B: Elites Danlos syndrome, C: Marfan Syndrome, D: Apert's syndrome + +### Response: +Ehler Danlos syndromes: +Includes more than 10 different disorders involving a genetic defect in collagen and connective tissue synthesis. +### End" +515,"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 rubella cataract:, with the following options: A: Pearly white cataract, B: May harbor virus inside the lens, C: Can be associated with cardiovascular anomalies, D: Reversible + +### Response: +",Rubella cataract is not reversible. Rubella Cataract Nuclear cataract which finally leads to total opacity. A/w maternal infection contracted in 1st trimester. Virus can be cultured from lens. Ocular Complications. Nuclear cataract (pearly white). Microphthalmos. Salt and pepper retinopathy. Glaucoma. Most common ocular complication is Cataract in India and retinopathy in the world. A/w CVS & Ear defects also.,"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 rubella cataract:, with the following options: A: Pearly white cataract, B: May harbor virus inside the lens, C: Can be associated with cardiovascular anomalies, D: Reversible + +### Response: +Rubella cataract is not reversible. Rubella Cataract Nuclear cataract which finally leads to total opacity. A/w maternal infection contracted in 1st trimester. Virus can be cultured from lens. Ocular Complications. Nuclear cataract (pearly white). Microphthalmos. Salt and pepper retinopathy. Glaucoma. Most common ocular complication is Cataract in India and retinopathy in the world. A/w CVS & Ear defects also. +### End" +516,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pharyngocutaneous fistula is seen in all expect ?, with the following options: A: Chemotherapy, B: Surgery, C: No wound care, D: Radiotherapy + +### Response: +",Ans is 'a' ie. Chemotherapy,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pharyngocutaneous fistula is seen in all expect ?, with the following options: A: Chemotherapy, B: Surgery, C: No wound care, D: Radiotherapy + +### Response: +Ans is 'a' ie. Chemotherapy +### End" +517,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The various habits of the lips can be divided into following, except:, with the following options: A: Lip sucking, B: Lip thrust, C: Lip insufficiency, D: None of the above + +### Response: +","The various habits of the lips can be divided into following: + +Lip sucking +Lip thrust +Lip insufficiency","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The various habits of the lips can be divided into following, except:, with the following options: A: Lip sucking, B: Lip thrust, C: Lip insufficiency, D: None of the above + +### Response: +The various habits of the lips can be divided into following: + +Lip sucking +Lip thrust +Lip insufficiency +### End" +518,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Stephen fowler surgery is done for, with the following options: A: Undescended testis, B: Ectopic testis, C: Retractile testis, D: Testicular torsion + +### Response: +",Stephen fowler surgery is two stage surgery for undescended testis.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Stephen fowler surgery is done for, with the following options: A: Undescended testis, B: Ectopic testis, C: Retractile testis, D: Testicular torsion + +### Response: +Stephen fowler surgery is two stage surgery for undescended testis. +### End" +519,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Wrist drop is due to injury to which nerve:, with the following options: A: Median, B: Ulnar, C: Axillary, D: Radial + +### Response: +","Ans. D. RadialWrist drop, is a medical condition in which the wrist and the fingers cannot extend at the metacarpophalangeal joints & wrist joint. The wrist remains partially flexed due to an opposing action of flexor muscles of the forearm. It is due to injury to radial nerve.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Wrist drop is due to injury to which nerve:, with the following options: A: Median, B: Ulnar, C: Axillary, D: Radial + +### Response: +Ans. D. RadialWrist drop, is a medical condition in which the wrist and the fingers cannot extend at the metacarpophalangeal joints & wrist joint. The wrist remains partially flexed due to an opposing action of flexor muscles of the forearm. It is due to injury to radial nerve. +### End" +520,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Marcus Gunn pupil is a feature of:, with the following options: A: Optic neuritis, B: Papilledema, C: Ciliary ganglion lesions, D: Lesion of Edinger-Westphal nucleus + +### Response: +",Ans. Optic neuritis,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Marcus Gunn pupil is a feature of:, with the following options: A: Optic neuritis, B: Papilledema, C: Ciliary ganglion lesions, D: Lesion of Edinger-Westphal nucleus + +### Response: +Ans. Optic neuritis +### End" +521,"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 anti psychotics is found to be restless, irresistible urge to move, can't sit or stand in one position. Diagnosis:, with the following options: A: Acute dystonia, B: Akathisia, C: Tardive dystinesia, D: Rabbit syndrome + +### Response: +","Akathisia is the most common side effect seen after administration of Anti psychotics, treated by B.blockers.","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 anti psychotics is found to be restless, irresistible urge to move, can't sit or stand in one position. Diagnosis:, with the following options: A: Acute dystonia, B: Akathisia, C: Tardive dystinesia, D: Rabbit syndrome + +### Response: +Akathisia is the most common side effect seen after administration of Anti psychotics, treated by B.blockers. +### End" +522,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: False about Rhinosporidiosis is, with the following options: A: Common is kerala & orissa, B: Histopathology reveals spherules, C: Dapsone has found to be effective, D: R. Seeberi is cultured on SDA + +### Response: +",R. seeberi is non-cultivable fungi.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: False about Rhinosporidiosis is, with the following options: A: Common is kerala & orissa, B: Histopathology reveals spherules, C: Dapsone has found to be effective, D: R. Seeberi is cultured on SDA + +### Response: +R. seeberi is non-cultivable fungi. +### End" +523,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The inflicted weapon should be, with the following options: A: Screw driver, B: Single edged knife, C: Double edged knife, D: Ice pick + +### Response: +","- The stab injury shows acute angles at both ends, which are suggestive of double edged weapon. If a double edged weapon is used, the wound will be elliptical or slit-like and both angles will besharp or pointed. If the knife penetrates to full length up to the guard, one or both edges maybe blunt. - In case of single edged knife wound is wedge shaped sometimes blunt edge of knife can harm the skin giving it a tail like appearance which is known as FISH TAIL. -In case of screwdriver the wound is slit-like with squared ends and abraded margins. - In case of ice pick the wound is circular in shape","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The inflicted weapon should be, with the following options: A: Screw driver, B: Single edged knife, C: Double edged knife, D: Ice pick + +### Response: +- The stab injury shows acute angles at both ends, which are suggestive of double edged weapon. If a double edged weapon is used, the wound will be elliptical or slit-like and both angles will besharp or pointed. If the knife penetrates to full length up to the guard, one or both edges maybe blunt. - In case of single edged knife wound is wedge shaped sometimes blunt edge of knife can harm the skin giving it a tail like appearance which is known as FISH TAIL. -In case of screwdriver the wound is slit-like with squared ends and abraded margins. - In case of ice pick the wound is circular in shape +### End" +524,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mirizzi's Syndrome is, with the following options: A: GB stone compressing common hepatic duct, B: GB carcinoma invading IVC., C: GB stone causing cholecystitis, D: Pancreatic carcinoma + +### Response: +",Mirriz's syndrome(Functional hepatic syndrome) It is defined as obstruction of the common hepatic duct or CBD by external compression or by erosion of stone in the Hamann pouch or cystic duct. External compression has been classified as type I where as erosion as type II Mirriz's syndrome by McSherry Ref: Sabiston 20th edition Pgno :1510,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mirizzi's Syndrome is, with the following options: A: GB stone compressing common hepatic duct, B: GB carcinoma invading IVC., C: GB stone causing cholecystitis, D: Pancreatic carcinoma + +### Response: +Mirriz's syndrome(Functional hepatic syndrome) It is defined as obstruction of the common hepatic duct or CBD by external compression or by erosion of stone in the Hamann pouch or cystic duct. External compression has been classified as type I where as erosion as type II Mirriz's syndrome by McSherry Ref: Sabiston 20th edition Pgno :1510 +### End" +525,"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 feature of polycystic disease of kidneys except:-, with the following options: A: Hematuria, B: Hypeension, C: Renal failure, D: Erythrocytosis + +### Response: +",PKD is autosomal dominant; 2 chromosomes involved - 16 & 4; abnormal protein involved is Polycystin. Bilateral kidneys are replaced with multiple cyst.,"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 feature of polycystic disease of kidneys except:-, with the following options: A: Hematuria, B: Hypeension, C: Renal failure, D: Erythrocytosis + +### Response: +PKD is autosomal dominant; 2 chromosomes involved - 16 & 4; abnormal protein involved is Polycystin. Bilateral kidneys are replaced with multiple cyst. +### End" +526,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: John Snow's discovery of cholera is an example of-, with the following options: A: Natural experiments, B: Spot map study, C: Randomized trial, D: Sho study + +### Response: +","Ans. is 'b' i.e., Spot map study","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: John Snow's discovery of cholera is an example of-, with the following options: A: Natural experiments, B: Spot map study, C: Randomized trial, D: Sho study + +### Response: +Ans. is 'b' i.e., Spot map study +### End" +527,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In cytochrome P450, P stands for, with the following options: A: Structural proteins, B: Substrate protein, C: Pigment, D: Polymer + +### Response: +","Molecular oxygen is incorporated into a variety of substrates by enzymes designated as oxygenases; many drugs, pollutants, and chemical carcinogens (xenobiotics) are metabolized by enzymes of this class, known as the cytochrome P450 systemCytochromes P450 Are Monooxygenases Impoant in Steroid Metabolism & for the Detoxification of Many DrugsReaction and also works together with cytochromes P450 in drug detoxificationRef: Harper&;s biochemistry text, 30th edition, biological oxidation","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In cytochrome P450, P stands for, with the following options: A: Structural proteins, B: Substrate protein, C: Pigment, D: Polymer + +### Response: +Molecular oxygen is incorporated into a variety of substrates by enzymes designated as oxygenases; many drugs, pollutants, and chemical carcinogens (xenobiotics) are metabolized by enzymes of this class, known as the cytochrome P450 systemCytochromes P450 Are Monooxygenases Impoant in Steroid Metabolism & for the Detoxification of Many DrugsReaction and also works together with cytochromes P450 in drug detoxificationRef: Harper&;s biochemistry text, 30th edition, biological oxidation +### End" +528,"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 feature of cerebral malaria?, with the following options: A: Bloody CSF, B: Retinal haemorrohages, C: Extensor plantar reflex, D: Absent abdominal reflex + +### Response: +","Bloody CSF is seen in SAH and herpes encephalitis pt's. Cerebral malaria manifests as diffuse symmetric encephalopathy; focal neurological signs are unusual. Convulsions, usually generalized and often repeated On Routine Fundoscopy:- Discrete spots of retinal opacification (30-60%) Retinal hemorrhage Papilledema","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 feature of cerebral malaria?, with the following options: A: Bloody CSF, B: Retinal haemorrohages, C: Extensor plantar reflex, D: Absent abdominal reflex + +### Response: +Bloody CSF is seen in SAH and herpes encephalitis pt's. Cerebral malaria manifests as diffuse symmetric encephalopathy; focal neurological signs are unusual. Convulsions, usually generalized and often repeated On Routine Fundoscopy:- Discrete spots of retinal opacification (30-60%) Retinal hemorrhage Papilledema +### End" +529,"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 drains into coronary sinus, EXCEPT:, with the following options: A: Great cardiac vein, B: Anterior cardiac vein, C: Middle cardiac vein, D: Left posterior ventricular vein + +### Response: +","The coronary sinus receives blood mainly from the small, middle, great and oblique cardiac veins. It also receives blood from the left marginal vein and the left posterior ventricular vein. It drains into the right atrium. The anterior cardiac veins do not drain into the coronary sinus but drain directly into the right atrium. Some small veins known as smallest cardiac veins drain directly into any of the four chambers 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: All of the following drains into coronary sinus, EXCEPT:, with the following options: A: Great cardiac vein, B: Anterior cardiac vein, C: Middle cardiac vein, D: Left posterior ventricular vein + +### Response: +The coronary sinus receives blood mainly from the small, middle, great and oblique cardiac veins. It also receives blood from the left marginal vein and the left posterior ventricular vein. It drains into the right atrium. The anterior cardiac veins do not drain into the coronary sinus but drain directly into the right atrium. Some small veins known as smallest cardiac veins drain directly into any of the four chambers of the hea. +### End" +530,"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 eye. Colonies of isolated organisms are black with microscopic feature of non-septate hyphae and obtuse branching. Diagnosis is ?, with the following options: A: Aspergillosis, B: Candidiasis, C: Mucormycosis, D: Histoplasmosis + +### Response: +","Ans. is 'c' i.e., Mucormycosis Information in this question are : i) Patient is diabetic ii) Orbital mycosis iii) Non-septate hyphae with obtuse branching (seen in rhizopus and mucor). All these suggest the diagnosis of mucormycosis, most common organism being rhizopus.","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 eye. Colonies of isolated organisms are black with microscopic feature of non-septate hyphae and obtuse branching. Diagnosis is ?, with the following options: A: Aspergillosis, B: Candidiasis, C: Mucormycosis, D: Histoplasmosis + +### Response: +Ans. is 'c' i.e., Mucormycosis Information in this question are : i) Patient is diabetic ii) Orbital mycosis iii) Non-septate hyphae with obtuse branching (seen in rhizopus and mucor). All these suggest the diagnosis of mucormycosis, most common organism being rhizopus. +### End" +531,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: pH of the whole blood is estimated in, with the following options: A: Plasma, B: Serum, C: RBC, D: Whole blood + +### Response: +",Ans: a (Plasma) Ref: Vasudevan 4th ed/p. 346.The pH of plasma is 7.4. The pH of plasma is maintained within a narrow range of 7.38 to 7.42,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: pH of the whole blood is estimated in, with the following options: A: Plasma, B: Serum, C: RBC, D: Whole blood + +### Response: +Ans: a (Plasma) Ref: Vasudevan 4th ed/p. 346.The pH of plasma is 7.4. The pH of plasma is maintained within a narrow range of 7.38 to 7.42 +### End" +532,"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 an infection of methicillin-resistant Staphylococcus aureus. Which of the following drug cannot be used to treat the infection:, with the following options: A: Vancomycin., B: Cotrimoxazole., C: Cefaclor., D: Ciprofloxacin. + +### Response: +",Cefaclor is a second generation cephalosporin and is not active against MRSA.,"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 an infection of methicillin-resistant Staphylococcus aureus. Which of the following drug cannot be used to treat the infection:, with the following options: A: Vancomycin., B: Cotrimoxazole., C: Cefaclor., D: Ciprofloxacin. + +### Response: +Cefaclor is a second generation cephalosporin and is not active against MRSA. +### End" +533,"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 man presents with cellulitis two days after he is bitten by his cat. What is the most likely dominant organism involved in the infection?, with the following options: A: Baonella henselae, B: Calymmatobacterium granulomatis, C: Pasteurella multocida, D: Toxoplasma gondii + +### Response: +","Pasteurella multocida is a dominant organism in the cat's mouth. Choice A, Baonella, is the causative agent of cat scratch fever and is less common in bites. Choice B, Calymmatobacterium, causes a sexually transmitted infection, and Toxoplasma (choice D) is associated with cats but transmitted by their faeces, not bites.","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 man presents with cellulitis two days after he is bitten by his cat. What is the most likely dominant organism involved in the infection?, with the following options: A: Baonella henselae, B: Calymmatobacterium granulomatis, C: Pasteurella multocida, D: Toxoplasma gondii + +### Response: +Pasteurella multocida is a dominant organism in the cat's mouth. Choice A, Baonella, is the causative agent of cat scratch fever and is less common in bites. Choice B, Calymmatobacterium, causes a sexually transmitted infection, and Toxoplasma (choice D) is associated with cats but transmitted by their faeces, not bites. +### End" +534,"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 Diabetes mellitus?, with the following options: A: Cushing's syndrome, B: Acromegaly, C: Hypothyroidism, D: Pheochromocytoma + +### Response: +",ANSWER: (C) HypothyroidismREF: Harrison's 18th ed ch: 344Endocrinopathies associated with Diabetes are:AcromegalyCushings syndromeGlucagonomaPheochromocytomaHyperthyroidismSomatostatinomaAldosteronoma,"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 Diabetes mellitus?, with the following options: A: Cushing's syndrome, B: Acromegaly, C: Hypothyroidism, D: Pheochromocytoma + +### Response: +ANSWER: (C) HypothyroidismREF: Harrison's 18th ed ch: 344Endocrinopathies associated with Diabetes are:AcromegalyCushings syndromeGlucagonomaPheochromocytomaHyperthyroidismSomatostatinomaAldosteronoma +### End" +535,"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 significance of increased nuchal translucency at 14 weeks of gestation?, with the following options: A: Oesophageal atresia, B: Foregut duplication cyst, C: Downs syndrome (Trisomy 21), D: Edwards syndrome (Trisomy 18) + +### Response: +","Nuchal translucency(NT) is a term used to describe a sonolucent area in the nuchal region (back of the neck) of the fetus and is typically observed in the first trimester (10-14weeks). Increased NT refers to NT measurement of greater than 2.5mm. One third of fetus with increased nuchal translucency will have a chromosome abnormality, and 1/2 of these are Down syndrome. Ref: Williams Obstetrics 23rd Edition Chapter 13; Obstetrics, Gynecology & Infeility By R Rajan Page 225-6; Textbook of Obstetrics By D. C Dutta, 6th Edition, Page 107.","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 significance of increased nuchal translucency at 14 weeks of gestation?, with the following options: A: Oesophageal atresia, B: Foregut duplication cyst, C: Downs syndrome (Trisomy 21), D: Edwards syndrome (Trisomy 18) + +### Response: +Nuchal translucency(NT) is a term used to describe a sonolucent area in the nuchal region (back of the neck) of the fetus and is typically observed in the first trimester (10-14weeks). Increased NT refers to NT measurement of greater than 2.5mm. One third of fetus with increased nuchal translucency will have a chromosome abnormality, and 1/2 of these are Down syndrome. Ref: Williams Obstetrics 23rd Edition Chapter 13; Obstetrics, Gynecology & Infeility By R Rajan Page 225-6; Textbook of Obstetrics By D. C Dutta, 6th Edition, Page 107. +### End" +536,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Trauma to breast causes which type of necrosis -, with the following options: A: Coagualtive necrosis, B: Liquefactive necrosis, C: Caseous necrosis, D: Fat necrosis + +### Response: +","Ans. is 'd' i.e., Fat necrosis Fat necrosisFat necrosis may be of two types : -Enzymatic fat necrosiso This is due to the action of lipase on adipose tissue,o It occurs most frequently in acute pancreatitis due to leakage of lipase,o Depending on the severity of acute pancreatitis, fat necrosis may occur in : -Adipose tissue contiguous to patter ease, i. e., retroperitoneal fat.Adipose tissue in the anterior mediastinum.Bone marrowOmental and abdominal fatNonenzymatic or Traumatic fat necrosiso Occurs due to traumao Is seen in the subcutaneous tissue of breast, thigh, and abdomen.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Trauma to breast causes which type of necrosis -, with the following options: A: Coagualtive necrosis, B: Liquefactive necrosis, C: Caseous necrosis, D: Fat necrosis + +### Response: +Ans. is 'd' i.e., Fat necrosis Fat necrosisFat necrosis may be of two types : -Enzymatic fat necrosiso This is due to the action of lipase on adipose tissue,o It occurs most frequently in acute pancreatitis due to leakage of lipase,o Depending on the severity of acute pancreatitis, fat necrosis may occur in : -Adipose tissue contiguous to patter ease, i. e., retroperitoneal fat.Adipose tissue in the anterior mediastinum.Bone marrowOmental and abdominal fatNonenzymatic or Traumatic fat necrosiso Occurs due to traumao Is seen in the subcutaneous tissue of breast, thigh, and abdomen. +### End" +537,"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 infectious disease is treated using multidrug therapy?, with the following options: A: Syphilis, B: Leprosy, C: Typhoid, D: None of the above + +### Response: +","Among the options given in the question, multidrug therapy is indicated in the treatment of leprosy. Rifampicin, Dapsone and Clofazimine are drugs used in its treatment. Reference: Essentials of Medical Pharmacology by K D Tripathi, 5e page 713.","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 infectious disease is treated using multidrug therapy?, with the following options: A: Syphilis, B: Leprosy, C: Typhoid, D: None of the above + +### Response: +Among the options given in the question, multidrug therapy is indicated in the treatment of leprosy. Rifampicin, Dapsone and Clofazimine are drugs used in its treatment. Reference: Essentials of Medical Pharmacology by K D Tripathi, 5e page 713. +### End" +538,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Parenteral agent used in diabetes, with the following options: A: Rosiglitazone, B: Exenatide, C: Repaglinide, D: Canagliflozin + +### Response: +","Agents Used for Treatment of Type 1 or Type 2 Diabetes Parenteral Amylin agonists Slow gastric emptying, glucagon Pramlintide 0.25-0.5 Reduce postprandial glycemia, weight loss Injection, nausea, risk of hypoglycemia with insulin Agents that also slow GI motility GLP-1 receptor agonists Insulin, glucagon, slow gastric emptying, satiety Exenatide, liraglutide, dulaglutide 0.5-1.0 Weigh loss, do not cause hypoglycemia Injection, nausea, risk of hypoglycemia with insulin secretagogues Renal disease, agents that also slow Gi motility; medullary carcinoma of thyroid Insulin Glucose utilization, hepatic glucose production and other anabolic actions See text and Table 418-4 Not limited Known safety profile Injection, weight gain , hypoglycemia Ref: Harrison 19e pg: 2414","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Parenteral agent used in diabetes, with the following options: A: Rosiglitazone, B: Exenatide, C: Repaglinide, D: Canagliflozin + +### Response: +Agents Used for Treatment of Type 1 or Type 2 Diabetes Parenteral Amylin agonists Slow gastric emptying, glucagon Pramlintide 0.25-0.5 Reduce postprandial glycemia, weight loss Injection, nausea, risk of hypoglycemia with insulin Agents that also slow GI motility GLP-1 receptor agonists Insulin, glucagon, slow gastric emptying, satiety Exenatide, liraglutide, dulaglutide 0.5-1.0 Weigh loss, do not cause hypoglycemia Injection, nausea, risk of hypoglycemia with insulin secretagogues Renal disease, agents that also slow Gi motility; medullary carcinoma of thyroid Insulin Glucose utilization, hepatic glucose production and other anabolic actions See text and Table 418-4 Not limited Known safety profile Injection, weight gain , hypoglycemia Ref: Harrison 19e pg: 2414 +### End" +539,"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 for management of Enuresis has least chances of relapse?, with the following options: A: Oxybutynin, B: Desmopressin, C: Bed Alarm, D: Imipramine + +### Response: +",.,"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 for management of Enuresis has least chances of relapse?, with the following options: A: Oxybutynin, B: Desmopressin, C: Bed Alarm, D: Imipramine + +### Response: +. +### End" +540,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: This appearance in a 60-year-old man is suggestive of:, with the following options: A: Eosinophilic granuloma, B: Multiple myeloma, C: Hyperparathyroidism, D: Acromegaly + +### Response: +",Ans. B Multiple myelomaRadiograph of skull shows multiple punched out uniform lytic lesions - peculiar of Multiple myeloma - described as Rain drop skullQ. Other imaging signs include Salt pepper appearance of vertebraQ on MRI/Vertebra planaQ/Wrinkled vertebraQ. Lesions show cold spots on 99m - Tc - MDP bone scanQ.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: This appearance in a 60-year-old man is suggestive of:, with the following options: A: Eosinophilic granuloma, B: Multiple myeloma, C: Hyperparathyroidism, D: Acromegaly + +### Response: +Ans. B Multiple myelomaRadiograph of skull shows multiple punched out uniform lytic lesions - peculiar of Multiple myeloma - described as Rain drop skullQ. Other imaging signs include Salt pepper appearance of vertebraQ on MRI/Vertebra planaQ/Wrinkled vertebraQ. Lesions show cold spots on 99m - Tc - MDP bone scanQ. +### End" +541,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Annexin V is a marker of -, with the following options: A: Apoptosis, B: Necrosis, C: Aherosclerosis, D: Inflammation + +### Response: +","Ans. is 'a' i.e., Apoptosis","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Annexin V is a marker of -, with the following options: A: Apoptosis, B: Necrosis, C: Aherosclerosis, D: Inflammation + +### Response: +Ans. is 'a' i.e., Apoptosis +### End" +542,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The following are related to fetal souffle except., with the following options: A: It is soft blowing murmur synchronous with the fetal heart sounds, B: It is due to rush of blood through the compressed umbilical arteries, C: It is heard in about 15% cases, D: When present is diagnostic of pregnancy + +### Response: +","Ans. is b, i.e. It is due to rush of blood through the compressed umbilical arteriesRef. Dutta 9/e, p 64Funic or fetal souffle is due to rush of blood through the umbilical arteries. It is a soft, blowing murmur synchronous with the fetal heart sounds.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The following are related to fetal souffle except., with the following options: A: It is soft blowing murmur synchronous with the fetal heart sounds, B: It is due to rush of blood through the compressed umbilical arteries, C: It is heard in about 15% cases, D: When present is diagnostic of pregnancy + +### Response: +Ans. is b, i.e. It is due to rush of blood through the compressed umbilical arteriesRef. Dutta 9/e, p 64Funic or fetal souffle is due to rush of blood through the umbilical arteries. It is a soft, blowing murmur synchronous with the fetal heart sounds. +### End" +543,"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 type of Type A disorder, with the following options: A: acheivement oriented, B: magical thinking, C: odd and excentric, D: pessimistic + +### Response: +","there are two types of personality disorders TYPE A PERONALITY PEOPLE are called' BORN WARRIORS' who are workaholics end up having hea disease TYPE D PERSONALITY PEOPLE are called 'BORN WORRIERS' who ruminate and have high risk of hea disease Ref. kaplon and Sadock synopsis of psychiatry, 11 th edition, pg no.746","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 type of Type A disorder, with the following options: A: acheivement oriented, B: magical thinking, C: odd and excentric, D: pessimistic + +### Response: +there are two types of personality disorders TYPE A PERONALITY PEOPLE are called' BORN WARRIORS' who are workaholics end up having hea disease TYPE D PERSONALITY PEOPLE are called 'BORN WORRIERS' who ruminate and have high risk of hea disease Ref. kaplon and Sadock synopsis of psychiatry, 11 th edition, pg no.746 +### End" +544,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Milroy's disease is, with the following options: A: Edema due to filariasis, B: Congenital lymphedema, C: Lymphedema following surgery, D: Post cellulitic lymphedema + +### Response: +","Congenital lymphedema or Milroy disease (10%), that is present at bih and associated with an autosomal dominant familial history","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Milroy's disease is, with the following options: A: Edema due to filariasis, B: Congenital lymphedema, C: Lymphedema following surgery, D: Post cellulitic lymphedema + +### Response: +Congenital lymphedema or Milroy disease (10%), that is present at bih and associated with an autosomal dominant familial history +### End" +545,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The loading dose of Aminophylline is, with the following options: A: 50-75mg/kg, B: O. 5-1mg/kg, C: 2-3.5mg /kg, D: 5-6mg/kg + +### Response: +","Refer KDT 6/e p 221 Aminophylline IA admistered I'm a dose of 5-7mg/kg slow intravenous infusion. In children, dose required is 7.5mg/kg","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The loading dose of Aminophylline is, with the following options: A: 50-75mg/kg, B: O. 5-1mg/kg, C: 2-3.5mg /kg, D: 5-6mg/kg + +### Response: +Refer KDT 6/e p 221 Aminophylline IA admistered I'm a dose of 5-7mg/kg slow intravenous infusion. In children, dose required is 7.5mg/kg +### End" +546,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Fetal nuchal skin thickness is useful in detecting: March 2012, with the following options: A: Fetal infection, B: Down syndrome, C: Anencephaly, D: Hydrops fetalis + +### Response: +","Ans: B i.e. Down syndrome Increased fetal nuchal skin thickness (in first trimester) of more than 3 mm by TVS is a strong marker for chromosomal anomalies (trisomy 21, 18, 13, triploidy and Turner's syndrome).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Fetal nuchal skin thickness is useful in detecting: March 2012, with the following options: A: Fetal infection, B: Down syndrome, C: Anencephaly, D: Hydrops fetalis + +### Response: +Ans: B i.e. Down syndrome Increased fetal nuchal skin thickness (in first trimester) of more than 3 mm by TVS is a strong marker for chromosomal anomalies (trisomy 21, 18, 13, triploidy and Turner's syndrome). +### End" +547,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Characteristic imaging findings in Alzheimer's disease?, with the following options: A: Temporal lobe and parietal lobe atrophy, B: Temporal and occipital lobe atrophy, C: Frontal and parietal lobe atrophy, D: Parietal and occipital lobe atrophy + +### Response: +",Ans AThe 2 most specific findings of Alzeimer's disease on neuroimaging are mesial temporal lobe atrophy (especially hippocampus and Enterohinal cortex) and temporoparietal cortical atrophy.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Characteristic imaging findings in Alzheimer's disease?, with the following options: A: Temporal lobe and parietal lobe atrophy, B: Temporal and occipital lobe atrophy, C: Frontal and parietal lobe atrophy, D: Parietal and occipital lobe atrophy + +### Response: +Ans AThe 2 most specific findings of Alzeimer's disease on neuroimaging are mesial temporal lobe atrophy (especially hippocampus and Enterohinal cortex) and temporoparietal cortical atrophy. +### End" +548,"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 familial hypercholesterolemia ?, with the following options: A: Gemfibrogil, B: Nicotinic acid, C: Lovastatin, D: Ceholestgramin + +### Response: +","Ans. is 'c' i.e., Lovastatin","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 familial hypercholesterolemia ?, with the following options: A: Gemfibrogil, B: Nicotinic acid, C: Lovastatin, D: Ceholestgramin + +### Response: +Ans. is 'c' i.e., Lovastatin +### End" +549,"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 provides the efferent impulses necessary for the esophageal actions that occur during swallowing?, with the following options: A: Glossopharyngeal, B: Hypoglossal, C: Spinal accessory, D: Vagus + +### Response: +","The vagus nerve supplies the efferent input into the esophagus that is necessary for swallowing.The glossopharyngeal nerve provides taste and sensation on the palate, but the only muscle it supplies is the stylopharyngeus.The hypoglossal nerve moves the tongue during the initiation of swallowing, but does not innervate the esophagus.The spinal accessory nerve plays no role in swallowing. This nerve mediates head and shoulder movement and innervates laryngeal muscles.Also Know:Injury to CN X:It may result in hoarseness (due to paralysis of the intrinsic laryngeal muscles) and difficulty swallowing (due to paralysis of pharyngeal muscles). On examination, the soft palate droops on the affected side, and the uvula detes opposite the affected side as a result of the unopposed action of the intact levator veli palatini muscle. There also may be loss of the gag reflex, where CN IX provides the sensory limb and CN XI provides the motor limb through innervation of the pharyngeal muscles.","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 provides the efferent impulses necessary for the esophageal actions that occur during swallowing?, with the following options: A: Glossopharyngeal, B: Hypoglossal, C: Spinal accessory, D: Vagus + +### Response: +The vagus nerve supplies the efferent input into the esophagus that is necessary for swallowing.The glossopharyngeal nerve provides taste and sensation on the palate, but the only muscle it supplies is the stylopharyngeus.The hypoglossal nerve moves the tongue during the initiation of swallowing, but does not innervate the esophagus.The spinal accessory nerve plays no role in swallowing. This nerve mediates head and shoulder movement and innervates laryngeal muscles.Also Know:Injury to CN X:It may result in hoarseness (due to paralysis of the intrinsic laryngeal muscles) and difficulty swallowing (due to paralysis of pharyngeal muscles). On examination, the soft palate droops on the affected side, and the uvula detes opposite the affected side as a result of the unopposed action of the intact levator veli palatini muscle. There also may be loss of the gag reflex, where CN IX provides the sensory limb and CN XI provides the motor limb through innervation of the pharyngeal muscles. +### End" +550,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The size of ovum is :, with the following options: A: 0.133 mm, B: 0.144 mm, C: 0.2 mm, D: None of the above + +### Response: +",0.133 mm,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The size of ovum is :, with the following options: A: 0.133 mm, B: 0.144 mm, C: 0.2 mm, D: None of the above + +### Response: +0.133 mm +### End" +551,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Quarter staggered arrangement is seen in:, with the following options: A: Immunoglobulin, B: Hemoglobin, C: Collagen, D: Keratin + +### Response: +",Ans. C. CollagenTriple Helix in CollagenQuarter Staggered arrangement in CollagenCovalent cross links in collagenDesmosine cross links in elastin,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Quarter staggered arrangement is seen in:, with the following options: A: Immunoglobulin, B: Hemoglobin, C: Collagen, D: Keratin + +### Response: +Ans. C. CollagenTriple Helix in CollagenQuarter Staggered arrangement in CollagenCovalent cross links in collagenDesmosine cross links in elastin +### End" +552,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Initial treatment of tumor lysis syndrome is -, with the following options: A: Rasburicase + Hydration + K binder + Urinary alkalization, B: Allopurinol + Hydration + K binder + alkalization, C: Both rasburicase + Allopurinol + Hydration and K binder, D: Hydration alone is sufficient + +### Response: +","Answer- A. Rasburicase + Hydration + K binder + Urinary alkalizationAllopurinol is used in prophylaxis in low and intermediate risk. Examinar is asking about treatment, in which rasburicase is used.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Initial treatment of tumor lysis syndrome is -, with the following options: A: Rasburicase + Hydration + K binder + Urinary alkalization, B: Allopurinol + Hydration + K binder + alkalization, C: Both rasburicase + Allopurinol + Hydration and K binder, D: Hydration alone is sufficient + +### Response: +Answer- A. Rasburicase + Hydration + K binder + Urinary alkalizationAllopurinol is used in prophylaxis in low and intermediate risk. Examinar is asking about treatment, in which rasburicase is used. +### End" +553,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: NSAIDS cause gastric ulcer because ?, with the following options: A: They inhibit COX - 2 enzyme, B: They inhibit mucus production, C: They increase HCI production, D: They delay gastric emptying + +### Response: +","Ans. is 'b' i.e., They inhibit mucus production Prostaglandins function as natural ulcer protectives by enhancing gastric mucus and HCO3- production, as well as by improving mucosal circulation and health. The ulcerogenic action of NSAIDs may be due to loss of this protective influence. PGE analogues are cytoprotective at low doses and inhibit gastric acid secretion at higher doses. NSAIDs inhibit prostaglandin secretion and thus antagonizes its cytoprotective effect. Misoprostol is used in NSAIDs induced ulcers.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: NSAIDS cause gastric ulcer because ?, with the following options: A: They inhibit COX - 2 enzyme, B: They inhibit mucus production, C: They increase HCI production, D: They delay gastric emptying + +### Response: +Ans. is 'b' i.e., They inhibit mucus production Prostaglandins function as natural ulcer protectives by enhancing gastric mucus and HCO3- production, as well as by improving mucosal circulation and health. The ulcerogenic action of NSAIDs may be due to loss of this protective influence. PGE analogues are cytoprotective at low doses and inhibit gastric acid secretion at higher doses. NSAIDs inhibit prostaglandin secretion and thus antagonizes its cytoprotective effect. Misoprostol is used in NSAIDs induced ulcers. +### End" +554,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Complications of Colle's fracture include the following except:, with the following options: A: Rupture of Extensor Pollicis Brevis tendon, B: Rupture of Extensor Pollicis Longus Tendon, C: Malunion, D: Sudek's osteodystrophy + +### Response: +","Ans. A. Rupture of Extensor Pollicis Brevis tendon. (Ref. Practical Orthopedics by Ebnezar/pg.141)Colies' FractureA Codes' fracture refers to an extra-articular, transverse fracture of the distal radial shaft. It most commonly occurs near the articular surface, causing dorsal angulation of the distal fragment in the metaphyseal area, giving the appearance of an upside-down dinner fork, radial deviation of hand, and swelling.Complications of Colie's fracture# Healing with some residual malalignment resulting in shortened radius or a distal radial displacement.# Triangular fibrocartilage complex (TFCC) tear# Distal radioulnar joint (DRUJ)subluxation or dislocation# Late complications include:- extensor policus longus (EPL) rupture,- reflex sympathetic dystrophy (Sudek's dystrophy),- median nerve compression/carpal tunnelsyndrome,- Malunion.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Complications of Colle's fracture include the following except:, with the following options: A: Rupture of Extensor Pollicis Brevis tendon, B: Rupture of Extensor Pollicis Longus Tendon, C: Malunion, D: Sudek's osteodystrophy + +### Response: +Ans. A. Rupture of Extensor Pollicis Brevis tendon. (Ref. Practical Orthopedics by Ebnezar/pg.141)Colies' FractureA Codes' fracture refers to an extra-articular, transverse fracture of the distal radial shaft. It most commonly occurs near the articular surface, causing dorsal angulation of the distal fragment in the metaphyseal area, giving the appearance of an upside-down dinner fork, radial deviation of hand, and swelling.Complications of Colie's fracture# Healing with some residual malalignment resulting in shortened radius or a distal radial displacement.# Triangular fibrocartilage complex (TFCC) tear# Distal radioulnar joint (DRUJ)subluxation or dislocation# Late complications include:- extensor policus longus (EPL) rupture,- reflex sympathetic dystrophy (Sudek's dystrophy),- median nerve compression/carpal tunnelsyndrome,- Malunion. +### End" +555,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 41 year old woman presented with a history of aches and pains all over the body and generalized weakness for four years. She cannot sleep because of the illness and has lost her appetite as well. She has lack of interest in work and doesn't like to meet friends and relatives. She denies feelings of sadness. Her most likely diagnosis is:, with the following options: A: Somatoform pain disorder, B: Major depression, C: Somatization disorder, D: Dissociative + +### Response: +","B i.e. Major depression For ruling outFor diagnosing Major depression* Somatization disorder, look for 4 pain, 2 gastrointestinal, 2A. essential criteriasexual & 1 pseudoneurological symptomsQ1. Depressed/Low mood* Dissociative disorder, look for2. Loss of interest or pleasureQ- Dissociative amnesia for stressful events of life (M.C.)B of the following for same 2 weeks- Wandering away from home with assumption of purposeful new identity1.,/t appetite or weightQ& complete amnesia for earlier life with absence of awareness of2. 411' sleepQamnesia (Fugue)3. 1/1.' psychomotor activityQ (not meeting- Multiple personality disorderfriends)- Trans/Possession disorder (control of person by spirit/bhoot)4. Concentration- Vorheirden or approximate answers (Ganser syndromeQ)5. Energy (Feeling of fatigue, weakness)Q* Somatoform Pain disorder, look for pain in one or more sites6. Feeling of wohlessness or guilt<2(more definite pain ex headache, pelvic pain)Q is predominantsymptom which is not intentionally produced and has strongassociation with psychological factors in onset, severity,exacerbation, or maintenance of painQ7. Suicidal thoughts","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 41 year old woman presented with a history of aches and pains all over the body and generalized weakness for four years. She cannot sleep because of the illness and has lost her appetite as well. She has lack of interest in work and doesn't like to meet friends and relatives. She denies feelings of sadness. Her most likely diagnosis is:, with the following options: A: Somatoform pain disorder, B: Major depression, C: Somatization disorder, D: Dissociative + +### Response: +B i.e. Major depression For ruling outFor diagnosing Major depression* Somatization disorder, look for 4 pain, 2 gastrointestinal, 2A. essential criteriasexual & 1 pseudoneurological symptomsQ1. Depressed/Low mood* Dissociative disorder, look for2. Loss of interest or pleasureQ- Dissociative amnesia for stressful events of life (M.C.)B of the following for same 2 weeks- Wandering away from home with assumption of purposeful new identity1.,/t appetite or weightQ& complete amnesia for earlier life with absence of awareness of2. 411' sleepQamnesia (Fugue)3. 1/1.' psychomotor activityQ (not meeting- Multiple personality disorderfriends)- Trans/Possession disorder (control of person by spirit/bhoot)4. Concentration- Vorheirden or approximate answers (Ganser syndromeQ)5. Energy (Feeling of fatigue, weakness)Q* Somatoform Pain disorder, look for pain in one or more sites6. Feeling of wohlessness or guilt<2(more definite pain ex headache, pelvic pain)Q is predominantsymptom which is not intentionally produced and has strongassociation with psychological factors in onset, severity,exacerbation, or maintenance of painQ7. Suicidal thoughts +### End" +556,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Investigation of choice to detect Hydatiform mole is:, with the following options: A: X-ray abdomen, B: USG, C: Serum HCG level, D: Gravindex + +### Response: +",USG,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Investigation of choice to detect Hydatiform mole is:, with the following options: A: X-ray abdomen, B: USG, C: Serum HCG level, D: Gravindex + +### Response: +USG +### End" +557,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 23-year-old man of nohern European lineage presents with anemia. His father and paternal aunt had a similar illness that was treated successfully by splenectomy. His peripheral blood smear is similar to that shown in the illustration. Which of the following additional abnormalities is expected?, with the following options: A: Bilirubinuria, B: high mean corpuscular volume, C: Increased direct (conjugated) serum bilirubin, D: Polychromatophilic erythrocytes on peripheral blood smear + +### Response: +","- Spherocytes are present in given peripheral smear; along with the history, strongly suggests diagnosis of hereditary spherocytosis. - Similar cells are also observed in warm antibody autoimmune hemolytic anemia. - These two conditions can be distinguished by direct Coombs test, which is negative in hereditary spherocytosis & positive in warm antibody autoimmune hemolytic anemia. - An expected finding in HS is increase in indirect (unconjugated) serum bilirubin, not direct (conjugated). - Polychromatophilic erythrocytes are an expected finding, as in any hemolytic anemia.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 23-year-old man of nohern European lineage presents with anemia. His father and paternal aunt had a similar illness that was treated successfully by splenectomy. His peripheral blood smear is similar to that shown in the illustration. Which of the following additional abnormalities is expected?, with the following options: A: Bilirubinuria, B: high mean corpuscular volume, C: Increased direct (conjugated) serum bilirubin, D: Polychromatophilic erythrocytes on peripheral blood smear + +### Response: +- Spherocytes are present in given peripheral smear; along with the history, strongly suggests diagnosis of hereditary spherocytosis. - Similar cells are also observed in warm antibody autoimmune hemolytic anemia. - These two conditions can be distinguished by direct Coombs test, which is negative in hereditary spherocytosis & positive in warm antibody autoimmune hemolytic anemia. - An expected finding in HS is increase in indirect (unconjugated) serum bilirubin, not direct (conjugated). - Polychromatophilic erythrocytes are an expected finding, as in any hemolytic anemia. +### End" +558,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ocular bobbing-, with the following options: A: Midbrain, B: Pons, C: Medulla, D: Coex + +### Response: +","Ocular bobbing centre is pons. Characterised by conjugate eye movements, beginning with a fast downward movement followed by slow drift back to midline. Causes: comatose patient with massive pontine lesion Metabolic encephalopathy.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ocular bobbing-, with the following options: A: Midbrain, B: Pons, C: Medulla, D: Coex + +### Response: +Ocular bobbing centre is pons. Characterised by conjugate eye movements, beginning with a fast downward movement followed by slow drift back to midline. Causes: comatose patient with massive pontine lesion Metabolic encephalopathy. +### End" +559,"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 boy with congenital hearing loss approached an ENT surgeon for cochlear implantation. TRUE regarding cochlear implants is:, with the following options: A: Contraindicated in children less than 5 years of age, B: Implanted in mild-to-moderate deafness, C: Malformed cochlea is not a contraindication, D: Inseed through oval window + +### Response: +",Congenital malformations of the cochlea are not contraindications to cochlear implantation. Contraindications for Cochlear Implants: 1. Deafness caused by lesions of the acoustic nerve or the central auditory pathway 2. Active middle ear infections 3. Cochlear ossification that prevents electrode inseion 4. Tympanic membrane perforation Appropriate age for cochlear implantation is between 2-17 years. Bilateral severe-to-profound sensorineural hearing loss is the main criteria for implantation. The electrode is inseed through the round window into the scala tympani of the cochlea.,"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 boy with congenital hearing loss approached an ENT surgeon for cochlear implantation. TRUE regarding cochlear implants is:, with the following options: A: Contraindicated in children less than 5 years of age, B: Implanted in mild-to-moderate deafness, C: Malformed cochlea is not a contraindication, D: Inseed through oval window + +### Response: +Congenital malformations of the cochlea are not contraindications to cochlear implantation. Contraindications for Cochlear Implants: 1. Deafness caused by lesions of the acoustic nerve or the central auditory pathway 2. Active middle ear infections 3. Cochlear ossification that prevents electrode inseion 4. Tympanic membrane perforation Appropriate age for cochlear implantation is between 2-17 years. Bilateral severe-to-profound sensorineural hearing loss is the main criteria for implantation. The electrode is inseed through the round window into the scala tympani of the cochlea. +### End" +560,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 45 year old female is having bilateral ovarian mass, ascites and omental caking on CT scan. There is high possibility that patient is having:, with the following options: A: Benign ovarian tumor, B: Malignant epithelial ovarian tumor, C: Dysgerminoma of ovary, D: Lymphoma of ovary + +### Response: +","Advanced epithelial ovarian cancer often completely replaces the omentum, forming an ""omental cake."" This disease may be adherent to the parietal peritoneum of the anterior abdominal wall, making entry into the abdominal cavity difficult. Omental caking is a term used to describe an abnormally thickened appearance of the omentum. This is due to infiltration of metastatic tumors arising from the ovary but may be from Ca stomach and TB peritonitis also.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 45 year old female is having bilateral ovarian mass, ascites and omental caking on CT scan. There is high possibility that patient is having:, with the following options: A: Benign ovarian tumor, B: Malignant epithelial ovarian tumor, C: Dysgerminoma of ovary, D: Lymphoma of ovary + +### Response: +Advanced epithelial ovarian cancer often completely replaces the omentum, forming an ""omental cake."" This disease may be adherent to the parietal peritoneum of the anterior abdominal wall, making entry into the abdominal cavity difficult. Omental caking is a term used to describe an abnormally thickened appearance of the omentum. This is due to infiltration of metastatic tumors arising from the ovary but may be from Ca stomach and TB peritonitis also. +### End" +561,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Regarding Kawasaki disease all are true EXCEPT, with the following options: A: Cervical lymph node enlargement is the least common among diagnostic criteria, B: Conjunctival ingestion is last to disappear among the diagnostic criteria, C: Coronary artery involvement is less common in infants, D: Atypical Kawasaki is more prone for cardiac involvement + +### Response: +","(C) Coronary artery involvement is less common in infants # KAWASAKI DISEASE: Keratic precipitates (detectable by a slit lamp but usually too small to be seen by the unaided eye), and swollen lymph nodes may also be present and can be the first manifestation of the disease. Bilateral, non-exudative conjunctivitis with perilimbal sparing - ""conjunctival injection. The cardiac complications are the most important aspect of the disease. Kawasaki disease can cause vasculitic changes (inflammation of blood vessels) in the coronary arteries and subsequent coronary artery aneurysms. These aneurysms can lead to myocardial infarction (heart attack) even in young children. Overall, about 10-18% of children with Kawasaki disease develop coronary artery aneurysms with much higher prevalence among patients who are not treated early in the course of illness. Kawasaki disease and rheumatic fever are the most common causes of acquired heart disease among children in the United States. Babies less than six months old are most at risk of developing AKD, along with potentially life-threatening damaged coronary arteries. Therefore, treatment is essential when prolonged fever accompanies even just one symptom of Kawasaki disease. Atypical Kawasaki disease (AKD) occurs when a child demonstrates fewer than four of the five diagnostic signs of classic Kawasaki disease (CKD). The subtype is also called incomplete Kawasaki disease.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Regarding Kawasaki disease all are true EXCEPT, with the following options: A: Cervical lymph node enlargement is the least common among diagnostic criteria, B: Conjunctival ingestion is last to disappear among the diagnostic criteria, C: Coronary artery involvement is less common in infants, D: Atypical Kawasaki is more prone for cardiac involvement + +### Response: +(C) Coronary artery involvement is less common in infants # KAWASAKI DISEASE: Keratic precipitates (detectable by a slit lamp but usually too small to be seen by the unaided eye), and swollen lymph nodes may also be present and can be the first manifestation of the disease. Bilateral, non-exudative conjunctivitis with perilimbal sparing - ""conjunctival injection. The cardiac complications are the most important aspect of the disease. Kawasaki disease can cause vasculitic changes (inflammation of blood vessels) in the coronary arteries and subsequent coronary artery aneurysms. These aneurysms can lead to myocardial infarction (heart attack) even in young children. Overall, about 10-18% of children with Kawasaki disease develop coronary artery aneurysms with much higher prevalence among patients who are not treated early in the course of illness. Kawasaki disease and rheumatic fever are the most common causes of acquired heart disease among children in the United States. Babies less than six months old are most at risk of developing AKD, along with potentially life-threatening damaged coronary arteries. Therefore, treatment is essential when prolonged fever accompanies even just one symptom of Kawasaki disease. Atypical Kawasaki disease (AKD) occurs when a child demonstrates fewer than four of the five diagnostic signs of classic Kawasaki disease (CKD). The subtype is also called incomplete Kawasaki disease. +### End" +562,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cytochrome oxidase contains-, with the following options: A: Copper, B: Iodine, C: Magnanes, D: Molybdenum + +### Response: +","Ans. is 'a' i.e., Copper o All cytochromes are haem protein, i.e. they contain iron.o Cytochrome oxidase (cytochrome C oxidase or cytochrome aa3) also contain coppor, beside haem iron.o Vitamin B12. is a corrinoid, i.e. cobalt-containing compound possesing the corrin ring.Microminerals or trace elementsChromiumPotentiate the effect of insulinQImpaired glucose metabolismCobaltConstituent of vitamin B12QMacrocytic anemiaCopperConstituent of oxidase enzymes, e.g., tyrosinase, lysyl oxidaseQ, superoxide dismutase, cytochrome oxidase, ferroxidse and ceruloplasmin, involved in iron absorption and mobilization'Microcytic hvporchromic anemia, depigmentation of skin, hair. Excessive deposition in liver in Wilson's diseaseQ, Menkes disease (''Kinky"" or ""steely"" hair disease) due to copper- binding P-type ATPase gene mutationQFluorideConstituent of bone and teeth, strengthens bone and teethDental cariesIodineConstituent of thyroid hormones (T3 and T4)Cretinism in children and goiter in adultsIronConstituent of heme and non-heme compounds and transport, storage of 02, cytochrome oxidase, xanthine oxidase, catalase, peroxidaseMicrocytic anemiaManganeseCofactor for number of enzymes, e.g., arginase, carboxylase, kinase, enolase, glucosyl transferase, phosphoglucomutaseNot well definedMolybdenumConstituent of xanthine oxidase, sulfite oxidase and aldehyde oxidaseXanthinuriaSeleniumAntioxidant, cofactor for glutathione peroxidase, protects cell against membrane lipid peroxidationCardiomyopathyZincCofactor for enzymes in DNA, RNA and protein synthesis, constituent of insulinQ, carbonic anhydraseQ. carboxvpeptidaseQ, LDHQ alcohol dehydrogenaseQ, alkaline phosphataseQ, glutamate dehydrogenase. Porphobilinogen synthase, superoxide dismutaseQ.Growth failure, impaired wound healing, defects in taste and smell, loss of apetite","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cytochrome oxidase contains-, with the following options: A: Copper, B: Iodine, C: Magnanes, D: Molybdenum + +### Response: +Ans. is 'a' i.e., Copper o All cytochromes are haem protein, i.e. they contain iron.o Cytochrome oxidase (cytochrome C oxidase or cytochrome aa3) also contain coppor, beside haem iron.o Vitamin B12. is a corrinoid, i.e. cobalt-containing compound possesing the corrin ring.Microminerals or trace elementsChromiumPotentiate the effect of insulinQImpaired glucose metabolismCobaltConstituent of vitamin B12QMacrocytic anemiaCopperConstituent of oxidase enzymes, e.g., tyrosinase, lysyl oxidaseQ, superoxide dismutase, cytochrome oxidase, ferroxidse and ceruloplasmin, involved in iron absorption and mobilization'Microcytic hvporchromic anemia, depigmentation of skin, hair. Excessive deposition in liver in Wilson's diseaseQ, Menkes disease (''Kinky"" or ""steely"" hair disease) due to copper- binding P-type ATPase gene mutationQFluorideConstituent of bone and teeth, strengthens bone and teethDental cariesIodineConstituent of thyroid hormones (T3 and T4)Cretinism in children and goiter in adultsIronConstituent of heme and non-heme compounds and transport, storage of 02, cytochrome oxidase, xanthine oxidase, catalase, peroxidaseMicrocytic anemiaManganeseCofactor for number of enzymes, e.g., arginase, carboxylase, kinase, enolase, glucosyl transferase, phosphoglucomutaseNot well definedMolybdenumConstituent of xanthine oxidase, sulfite oxidase and aldehyde oxidaseXanthinuriaSeleniumAntioxidant, cofactor for glutathione peroxidase, protects cell against membrane lipid peroxidationCardiomyopathyZincCofactor for enzymes in DNA, RNA and protein synthesis, constituent of insulinQ, carbonic anhydraseQ. carboxvpeptidaseQ, LDHQ alcohol dehydrogenaseQ, alkaline phosphataseQ, glutamate dehydrogenase. Porphobilinogen synthase, superoxide dismutaseQ.Growth failure, impaired wound healing, defects in taste and smell, loss of apetite +### End" +563,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: For the first 6 h following surgical repair of a leaking abdominal aortic aneurysm in a 70-year-old man, oliguria (total urinary output of 25 mL since the operation) has become a concern. Of most diagnostic help would be, with the following options: A: Renal scan, B: Aortogram, C: Left heart preload pressures, D: Urinary sodium concentration + +### Response: +","By far the most likely cause of the oliguria observed in this patient is hypovolemia. Volume status would be best assessed by floating a Swan-Ganz catheter to measure the preload pressures in the left atrium (by inference from the pulmonary capillary wedge pressures). Patients who have had a leaking aneurysm and then a long, usually difficult operation with large surgical fields that collect ""third-space"" fluids may be intravascularly depleted despite large volumes of intravenous fluid and blood replacement. The proper management usually involves titrating the cardiac output by providing as much fluid as necessary to keep the wedge pressures near 15 mm Hg. The other studies listed might become useful if urinary flow remains depressed after optimal cardiac output has been achieved, but in view of the probability of hypovolemia, they are not indicated as a first diagnostic study.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: For the first 6 h following surgical repair of a leaking abdominal aortic aneurysm in a 70-year-old man, oliguria (total urinary output of 25 mL since the operation) has become a concern. Of most diagnostic help would be, with the following options: A: Renal scan, B: Aortogram, C: Left heart preload pressures, D: Urinary sodium concentration + +### Response: +By far the most likely cause of the oliguria observed in this patient is hypovolemia. Volume status would be best assessed by floating a Swan-Ganz catheter to measure the preload pressures in the left atrium (by inference from the pulmonary capillary wedge pressures). Patients who have had a leaking aneurysm and then a long, usually difficult operation with large surgical fields that collect ""third-space"" fluids may be intravascularly depleted despite large volumes of intravenous fluid and blood replacement. The proper management usually involves titrating the cardiac output by providing as much fluid as necessary to keep the wedge pressures near 15 mm Hg. The other studies listed might become useful if urinary flow remains depressed after optimal cardiac output has been achieved, but in view of the probability of hypovolemia, they are not indicated as a first diagnostic study. +### End" +564,"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 diagnostic of the 'Rim sign' in a nephrogram?, with the following options: A: Pyelonephritis, B: Hyper nephroma, C: Polycystic kidney, D: Polycystic kidney + +### Response: +",Ans. Polycystic kidney,"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 diagnostic of the 'Rim sign' in a nephrogram?, with the following options: A: Pyelonephritis, B: Hyper nephroma, C: Polycystic kidney, D: Polycystic kidney + +### Response: +Ans. Polycystic kidney +### End" +565,"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 Hepatitis 'C' is true -, with the following options: A: DNA virus, B: Most common indication for liver transplant, C: Does not cause liver cancer, D: cause coinfection with hepatitis B + +### Response: +","HCV is TNA virus. doesnot cause coinfection with HBV.it is transmitted mainly by blood transfusion, transplant recipients REF:MICROBIOLOGY ANANTHA NARAYANAN NINTH EDITION PAGE.548","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 Hepatitis 'C' is true -, with the following options: A: DNA virus, B: Most common indication for liver transplant, C: Does not cause liver cancer, D: cause coinfection with hepatitis B + +### Response: +HCV is TNA virus. doesnot cause coinfection with HBV.it is transmitted mainly by blood transfusion, transplant recipients REF:MICROBIOLOGY ANANTHA NARAYANAN NINTH EDITION PAGE.548 +### End" +566,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Tense and painful thyroiditis is, with the following options: A: Dequern's thyroiditis, B: Riedel thyroiditis, C: Hashimoto thyroiditis, D: Subacute lymphocytic thyroiditis + +### Response: +",Answer- A. Dequern's thyroiditisDequervain thyroidits (granulomatous thyoiditis) - Most common cause of thyroid pain.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Tense and painful thyroiditis is, with the following options: A: Dequern's thyroiditis, B: Riedel thyroiditis, C: Hashimoto thyroiditis, D: Subacute lymphocytic thyroiditis + +### Response: +Answer- A. Dequern's thyroiditisDequervain thyroidits (granulomatous thyoiditis) - Most common cause of thyroid pain. +### End" +567,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hair on end appearance is most common is, with the following options: A: Sickle cell disease, B: Hereditary spherocytosis, C: G6PD deficiency, D: Cyanotic heart disease + +### Response: +","All of the above causes Hair on end appearance. +Thalassemia major > Sickle cell disease. +No Thalassemia major in Options.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hair on end appearance is most common is, with the following options: A: Sickle cell disease, B: Hereditary spherocytosis, C: G6PD deficiency, D: Cyanotic heart disease + +### Response: +All of the above causes Hair on end appearance. +Thalassemia major > Sickle cell disease. +No Thalassemia major in Options. +### End" +568,"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 anesthetic agents does not trigger malignant hypehermia, with the following options: A: Halothane, B: Isoflurane, C: Suxamethonium, D: Thiopentone + +### Response: +","Malignant hypehermia (MH) is a rare (1:15,000 in pediatric patients and 1:40,000 in adult patients) genetic hypermetabolic muscle disease, the characteristic phenotypical signs and symptoms of which most commonly appear with exposure to inhaled general anesthetics or succinylcholine (triggering agents). MH may occasionally present more than an hour after emergence from an anesthetic, and rarely may occur without exposure to known triggering agents. Most cases have been repoed in young males; almost none have been repoed in infants, and few have been repoed in the elderly. Neveheless, all ages and both sexes may be affected. The incidence of MH varies significantly from country to country and even among different geographic localities within the same country, reflecting varying gene pools. The upper Midwest appears to have the greatest incidence of MH in the United States. Anesthetic drugs that trigger MH include ether, halothane, enflurane, isoflurane, desflurane, sevoflurane, and depolarizing muscle relaxants, succinylcholine being the only anesthetic drug currently used. Desflurane and sevoflurane appear to be less potent triggers than halothane and produce a more gradual onset of MH. The onset may be explosive if succinylcholine is used. 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: Which of the following anesthetic agents does not trigger malignant hypehermia, with the following options: A: Halothane, B: Isoflurane, C: Suxamethonium, D: Thiopentone + +### Response: +Malignant hypehermia (MH) is a rare (1:15,000 in pediatric patients and 1:40,000 in adult patients) genetic hypermetabolic muscle disease, the characteristic phenotypical signs and symptoms of which most commonly appear with exposure to inhaled general anesthetics or succinylcholine (triggering agents). MH may occasionally present more than an hour after emergence from an anesthetic, and rarely may occur without exposure to known triggering agents. Most cases have been repoed in young males; almost none have been repoed in infants, and few have been repoed in the elderly. Neveheless, all ages and both sexes may be affected. The incidence of MH varies significantly from country to country and even among different geographic localities within the same country, reflecting varying gene pools. The upper Midwest appears to have the greatest incidence of MH in the United States. Anesthetic drugs that trigger MH include ether, halothane, enflurane, isoflurane, desflurane, sevoflurane, and depolarizing muscle relaxants, succinylcholine being the only anesthetic drug currently used. Desflurane and sevoflurane appear to be less potent triggers than halothane and produce a more gradual onset of MH. The onset may be explosive if succinylcholine is used. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e +### End" +569,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Zidovudine causes:, with the following options: A: Neurotoxicity, B: Nephrotoxicity, C: Neutropenia, D: Ototoxicity + +### Response: +","Nucleoside reverse transcriptase inhibitors (Nis) Zidovudine :It is a thymidine analogue (azidothymidine, AZT), the prototype NI. Adverse effects Toxicity is mainly due to paial inhibition of cellular DNA polymerase. Anaemia and neutropenia are the most impoant and dose-related adverse effects. Nausea, anorexia, abdominal pain, headache, insomnia and myalgia are common at the sta of therapy but diminish later. Myopathy, lactic acidosis, hepatomegaly, convulsions and encephalopathy are infrequent. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:770,771","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Zidovudine causes:, with the following options: A: Neurotoxicity, B: Nephrotoxicity, C: Neutropenia, D: Ototoxicity + +### Response: +Nucleoside reverse transcriptase inhibitors (Nis) Zidovudine :It is a thymidine analogue (azidothymidine, AZT), the prototype NI. Adverse effects Toxicity is mainly due to paial inhibition of cellular DNA polymerase. Anaemia and neutropenia are the most impoant and dose-related adverse effects. Nausea, anorexia, abdominal pain, headache, insomnia and myalgia are common at the sta of therapy but diminish later. Myopathy, lactic acidosis, hepatomegaly, convulsions and encephalopathy are infrequent. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:770,771 +### End" +570,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Alma Ata conference was held in, with the following options: A: 1978, B: 1977, C: 1956, D: 1948 + +### Response: +","The Declaration of Alma Act, 1978 stated that primary health care includes at leastEducation about health problems and methods of preventing and controlling themPromotion of food supply and nutritionAdequate supply of safe water and sanitationImmunizationPrevention and control of endemic diseasesAppropriate treatment of common diseases and injuriesProvision of essential drugs(Refer: K. Park's Textbook of Preventive and Social Medicine, 24th edition, pg no:928)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Alma Ata conference was held in, with the following options: A: 1978, B: 1977, C: 1956, D: 1948 + +### Response: +The Declaration of Alma Act, 1978 stated that primary health care includes at leastEducation about health problems and methods of preventing and controlling themPromotion of food supply and nutritionAdequate supply of safe water and sanitationImmunizationPrevention and control of endemic diseasesAppropriate treatment of common diseases and injuriesProvision of essential drugs(Refer: K. Park's Textbook of Preventive and Social Medicine, 24th edition, pg no:928) +### End" +571,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The commonest type of seizure in a newborn is, with the following options: A: Clonic, B: Tonic, C: Febrile, D: Myoclonic + +### Response: +","The most common seizures in late infancy and early childhood are febrile seizures.The overall prevalence is 3-5% and Patients often have a family history of febrile seizures or epilepsy.Febrile seizures usually occur between 3 months and 5 years of age and have a peak incidence between 18 and 24 months.The typical scenario is a child who has a generalized, tonic-clonic seizure during a febrile illness during the rising phase of the temperature curve (i.e., during the first day).A simple febrile seizure is a single, isolated event, brief, and symmetric in appearance.Complex febrile seizures are characterized by repeated seizure activity, duration >15 minutes, or by focal features.Complex febrile seizures have a risk of 2-5% of recurrence.Ref: Harrison; 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 commonest type of seizure in a newborn is, with the following options: A: Clonic, B: Tonic, C: Febrile, D: Myoclonic + +### Response: +The most common seizures in late infancy and early childhood are febrile seizures.The overall prevalence is 3-5% and Patients often have a family history of febrile seizures or epilepsy.Febrile seizures usually occur between 3 months and 5 years of age and have a peak incidence between 18 and 24 months.The typical scenario is a child who has a generalized, tonic-clonic seizure during a febrile illness during the rising phase of the temperature curve (i.e., during the first day).A simple febrile seizure is a single, isolated event, brief, and symmetric in appearance.Complex febrile seizures are characterized by repeated seizure activity, duration >15 minutes, or by focal features.Complex febrile seizures have a risk of 2-5% of recurrence.Ref: Harrison; 19th edition +### End" +572,"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 Zollinger-Ellison syndrome except:, with the following options: A: Recurrent ulceration after acid reducing surgery, B: Raised gastrin levels in all cases, C: Decreased BAO/MAO, D: Diarrhea + +### Response: +","Ans. (c) Decreased BAO/MAOBlood levels of ZES:* 100% all patients will have Se. gastrin >100pg/ml* BAO >15meq/hr in most patients* BAO will be 60% of MAO (BAO - Basal Acid output, MAO - Maximal Acid Output)* Levels of Se. Gastrin >1000pg/ml is diagnostic* If there is only borderline elevation provocative tests with secretin, Calcium etc are done* With Secretin stimulation gastrin increases >200pg/ml in 15 minutes is diagnostic","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 Zollinger-Ellison syndrome except:, with the following options: A: Recurrent ulceration after acid reducing surgery, B: Raised gastrin levels in all cases, C: Decreased BAO/MAO, D: Diarrhea + +### Response: +Ans. (c) Decreased BAO/MAOBlood levels of ZES:* 100% all patients will have Se. gastrin >100pg/ml* BAO >15meq/hr in most patients* BAO will be 60% of MAO (BAO - Basal Acid output, MAO - Maximal Acid Output)* Levels of Se. Gastrin >1000pg/ml is diagnostic* If there is only borderline elevation provocative tests with secretin, Calcium etc are done* With Secretin stimulation gastrin increases >200pg/ml in 15 minutes is diagnostic +### End" +573,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Megaloblastic anemia may be caused by all of the following except, with the following options: A: Dilantin toxicity, B: Vitamin B12 deficiency, C: Folic acid deficiency, D: Long term aspirin intake + +### Response: +",Dilantin is phneytion. It reults in folic acid deficiency that can result in Megaloblastic anemia,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Megaloblastic anemia may be caused by all of the following except, with the following options: A: Dilantin toxicity, B: Vitamin B12 deficiency, C: Folic acid deficiency, D: Long term aspirin intake + +### Response: +Dilantin is phneytion. It reults in folic acid deficiency that can result in Megaloblastic anemia +### End" +574,"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 an inflammatory mediator?, with the following options: A: Tumor necrosis factor, B: Integrin, C: Interleukin, D: Interferons + +### Response: +",Mediators Histamine Serotonin 1deg& 2deg Lysosomal granules Nitric Oxide (NO) Arachidonic Acid metabolites Cytokines & Interleukins Platelet Activation factors TNF,"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 an inflammatory mediator?, with the following options: A: Tumor necrosis factor, B: Integrin, C: Interleukin, D: Interferons + +### Response: +Mediators Histamine Serotonin 1deg& 2deg Lysosomal granules Nitric Oxide (NO) Arachidonic Acid metabolites Cytokines & Interleukins Platelet Activation factors TNF +### End" +575,"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 boy presents to the pediatric emergency unit with seizures. Blood pressure in the upper extremity measured as 200/140 mm Hg. Femoral pulses were not palpable. The most likely diagnosis amongst the following is:, with the following options: A: Takayasu's aooaeritis, B: Renal parenchymal disease, C: Grand mal seizures, D: Coarctation of aoa + +### Response: +","Isolated upper extremity hypeension (200/140 mm Hg), with absent/diminished femoral pulses, is characteristic of coarctation of the aoaSeizures may be due to severe hypeension or due to intracranial haemorrhage(from berry aneurysms which are more common in patients with coarctation)The classic sign of coarctation of the aoa is a disparity in pulsations and blood pressures in arms and legsThe femoral, popliteal, posterior tibial and dorsalis pedis pulses are weak (or absent in about 40% of patients) in contrast to bounding pulses in the arms and carotid vesselsBP in the legs is lower than in the arms and 90% of patients have hypeension in upper extremity greater than the 95th percentile for ageAge (yrs)95th percentile (mm Hg)>1 110/601-5115/756-10125/8511-18140/90Takayasu aooaeritis may also present with severe hypeension and absent femoral pulses due to acquired mid-aoic coarctation (but this is an uncommon presentation)Most commonly affects subclan aery and more commonly presents with claudicationCoarctation TakayasuMore commonMore common in boysUpper extremity hypeensionBounding pulses in arms and diminished or absent pulses in lower limbsHypeension is frequentLess commonMore common in girls (8:1 = f:m)Absent or decreased upper limb pulses and blood pressure difference between left and right arms are characteristicHypeension is frequentSystemic symptoms are more common(ref: Harrison's 18/e p1925)","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 boy presents to the pediatric emergency unit with seizures. Blood pressure in the upper extremity measured as 200/140 mm Hg. Femoral pulses were not palpable. The most likely diagnosis amongst the following is:, with the following options: A: Takayasu's aooaeritis, B: Renal parenchymal disease, C: Grand mal seizures, D: Coarctation of aoa + +### Response: +Isolated upper extremity hypeension (200/140 mm Hg), with absent/diminished femoral pulses, is characteristic of coarctation of the aoaSeizures may be due to severe hypeension or due to intracranial haemorrhage(from berry aneurysms which are more common in patients with coarctation)The classic sign of coarctation of the aoa is a disparity in pulsations and blood pressures in arms and legsThe femoral, popliteal, posterior tibial and dorsalis pedis pulses are weak (or absent in about 40% of patients) in contrast to bounding pulses in the arms and carotid vesselsBP in the legs is lower than in the arms and 90% of patients have hypeension in upper extremity greater than the 95th percentile for ageAge (yrs)95th percentile (mm Hg)>1 110/601-5115/756-10125/8511-18140/90Takayasu aooaeritis may also present with severe hypeension and absent femoral pulses due to acquired mid-aoic coarctation (but this is an uncommon presentation)Most commonly affects subclan aery and more commonly presents with claudicationCoarctation TakayasuMore commonMore common in boysUpper extremity hypeensionBounding pulses in arms and diminished or absent pulses in lower limbsHypeension is frequentLess commonMore common in girls (8:1 = f:m)Absent or decreased upper limb pulses and blood pressure difference between left and right arms are characteristicHypeension is frequentSystemic symptoms are more common(ref: Harrison's 18/e p1925) +### End" +576,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Paraneoplastic symdrome is not associated with any kind of antibody mediated-, with the following options: A: Stiff Pearson syndrome, B: Necrotizing myelopathy, C: Limbic encephalopathy, D: Eaton Lambe syndrome + +### Response: +","Answer is option 2 In paraneoplastic syndrome, there is Myelopathy, occurring as the main neurological syndrome, is less common. As with LE and BE, it may be pa of a more widespread encephalomyelitis. Rarely, it can progress with astonishing rapidity in the context of a necrotising myelopathy. Pathologically there is extensive necrosis of both white and grey matter, most notably in the thoracic segments.necrotising myelopathy. Myelopathy, occurring as the main neurological syndrome, is less common. As with LE and BE, it may be pa of a more widespread encephalomyelitis. Rarely, it can progress with astonishing rapidity in the context of a necrotising myelopathy. Pathologically there is extensive necrosis of both white and grey matter, most notably in the thoracic segments. jnnp. mnj. com>journals","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Paraneoplastic symdrome is not associated with any kind of antibody mediated-, with the following options: A: Stiff Pearson syndrome, B: Necrotizing myelopathy, C: Limbic encephalopathy, D: Eaton Lambe syndrome + +### Response: +Answer is option 2 In paraneoplastic syndrome, there is Myelopathy, occurring as the main neurological syndrome, is less common. As with LE and BE, it may be pa of a more widespread encephalomyelitis. Rarely, it can progress with astonishing rapidity in the context of a necrotising myelopathy. Pathologically there is extensive necrosis of both white and grey matter, most notably in the thoracic segments.necrotising myelopathy. Myelopathy, occurring as the main neurological syndrome, is less common. As with LE and BE, it may be pa of a more widespread encephalomyelitis. Rarely, it can progress with astonishing rapidity in the context of a necrotising myelopathy. Pathologically there is extensive necrosis of both white and grey matter, most notably in the thoracic segments. jnnp. mnj. com>journals +### End" +577,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Migrating motor complexes are due to which Gastrointestinal hormone?, with the following options: A: Gastrin, B: Motilin, C: CCK, D: VIP + +### Response: +","MMC is initiated by motilin, circulating levels of motilin increases at intervals of approximately 90-100 min in the interdigestive state Ref: Ganong 25th ed/page 497","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Migrating motor complexes are due to which Gastrointestinal hormone?, with the following options: A: Gastrin, B: Motilin, C: CCK, D: VIP + +### Response: +MMC is initiated by motilin, circulating levels of motilin increases at intervals of approximately 90-100 min in the interdigestive state Ref: Ganong 25th ed/page 497 +### End" +578,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Lochia is seen for :, with the following options: A: 1-4 days, B: 5-10 days, C: 10-14 days, D: 14-21 days + +### Response: +",14-21 days,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Lochia is seen for :, with the following options: A: 1-4 days, B: 5-10 days, C: 10-14 days, D: 14-21 days + +### Response: +14-21 days +### End" +579,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The HLA class-III region genes are impoant elements in, with the following options: A: Transplant rejection phenomenon, B: Complement system, C: Immune surveillance, D: Antigen presentation and elimination. + +### Response: +","HLA class III region contains genes that encode several components of the complement system (i.e. C2, C4a, C4b, Bf), they are responsible for the levels of components of the complement system. In addition to components of the complement system, MHC III genes code inflammatory cytokines, tumour necrosis factor a and 0 (TNF a and P), two heat shock proteins (HSP) Ref : Ananthanarayana textbook of Microbiology 9th edition Pgno : 140","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The HLA class-III region genes are impoant elements in, with the following options: A: Transplant rejection phenomenon, B: Complement system, C: Immune surveillance, D: Antigen presentation and elimination. + +### Response: +HLA class III region contains genes that encode several components of the complement system (i.e. C2, C4a, C4b, Bf), they are responsible for the levels of components of the complement system. In addition to components of the complement system, MHC III genes code inflammatory cytokines, tumour necrosis factor a and 0 (TNF a and P), two heat shock proteins (HSP) Ref : Ananthanarayana textbook of Microbiology 9th edition Pgno : 140 +### End" +580,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: 65 yr old man presented with hemoptysis and stage 3 clubbing. The probable diagnosis of the patient is?, with the following options: A: Non small cell lung Ca, B: Small cell cancer of lung, C: Tuberculosis, D: Sarcoidosis + +### Response: +",Ans. (a) Non small cell lung CaRef: Harrison 19th ed. / 510-511* Most common cause of hemoptysis is tuberculosis but at 65 years of age it is more likely a presentation of lung cancer.* Lung cancers can cause hemoptysis but clubbing is seen with non small cell cancer of the lung only. Remember that clubbing is absent in small cell cancer of the lung.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: 65 yr old man presented with hemoptysis and stage 3 clubbing. The probable diagnosis of the patient is?, with the following options: A: Non small cell lung Ca, B: Small cell cancer of lung, C: Tuberculosis, D: Sarcoidosis + +### Response: +Ans. (a) Non small cell lung CaRef: Harrison 19th ed. / 510-511* Most common cause of hemoptysis is tuberculosis but at 65 years of age it is more likely a presentation of lung cancer.* Lung cancers can cause hemoptysis but clubbing is seen with non small cell cancer of the lung only. Remember that clubbing is absent in small cell cancer of the lung. +### End" +581,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The efferent limb of the cremaster reflex is provided by, with the following options: A: Femoral branch of the genitofemoral, B: Genital branch of the genitofemoral nerve, C: Ilioinguinal nerve, D: Pudendal nerve + +### Response: +","- Cremastric reflex- + +Afferent- Femoral branch of genitofemoral nerve +Efferent- Genital branch of genitofemoral nerve","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The efferent limb of the cremaster reflex is provided by, with the following options: A: Femoral branch of the genitofemoral, B: Genital branch of the genitofemoral nerve, C: Ilioinguinal nerve, D: Pudendal nerve + +### Response: +- Cremastric reflex- + +Afferent- Femoral branch of genitofemoral nerve +Efferent- Genital branch of genitofemoral nerve +### End" +582,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Daily requirment of iron in pregnancy is -, with the following options: A: 1 mg, B: 2 mg, C: 3 mg, D: 3.5 mg + +### Response: +","Ans. is 'd' i.e., 3.5 mg","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Daily requirment of iron in pregnancy is -, with the following options: A: 1 mg, B: 2 mg, C: 3 mg, D: 3.5 mg + +### Response: +Ans. is 'd' i.e., 3.5 mg +### End" +583,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pancytopenia is most common after:, with the following options: A: Hepatitis, B: Infective carditis, C: Pyelonephritis, D: Meningitis + +### Response: +","Hepatitis is the most common preceding infection, and post hepatitis marrow failure accounts for about 5% of etiologies in most series. Patients are usually young men who have recovered from a bout of liver inflammation 1 to 2 months earlier; the subsequent pancytopenia is very severe. The hepatitis is seronegative (non-A, non-B, non-C, non-G) and possibly due to a novel, as yet undiscovered, virus. 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: Pancytopenia is most common after:, with the following options: A: Hepatitis, B: Infective carditis, C: Pyelonephritis, D: Meningitis + +### Response: +Hepatitis is the most common preceding infection, and post hepatitis marrow failure accounts for about 5% of etiologies in most series. Patients are usually young men who have recovered from a bout of liver inflammation 1 to 2 months earlier; the subsequent pancytopenia is very severe. The hepatitis is seronegative (non-A, non-B, non-C, non-G) and possibly due to a novel, as yet undiscovered, virus. Ref: Harrison's principle of internal medicine 17th edition, chapter 102. +### End" +584,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Severe Acute respiratory syndrome is caused by?, with the following options: A: H1N1, B: RSV, C: Parainfluenza virus, D: Corona virus type + +### Response: +","Ans. d. Corona virus typeCORONA VIRUSEnveloped, helicalPositive-sense ssRNAHemagglutinin molecules make up peplomers on virus surface, which give shape like sun with corona.Medical importance: ""Common cold,"" SARS, MERSSARS-COVReservoir: birds and small mammals (civet cats)Transmission: respiratory droplets; virus also found in urine, sweat, and feces; original case is thought to have jumped from animal to humanDisease:Severe acute respiratory syndrome (SARS)Atypical pneumoniaClinical case definition includes fever of >38.0C(100.4F), flu-like illness, dry cough, dyspnea, and progressive hypoxiaChest x-ray may show patchy distribution of focal interstitial infiltratesDiagnosisIncludes clinical presentation and prior history of travel to endemic area or an association with someone who recently traveled to endemic areaLab tests: detection of antibodies to SARS-CoV, RT-PCR, and isolation of the virus in cultureTreatment: supportive; ribavirin and interferon are promisingMERS-CoV (Middle Eastern Respiratory Syndrome)Reservoir: bats and camelsDisease and transmission: similar to SARS","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Severe Acute respiratory syndrome is caused by?, with the following options: A: H1N1, B: RSV, C: Parainfluenza virus, D: Corona virus type + +### Response: +Ans. d. Corona virus typeCORONA VIRUSEnveloped, helicalPositive-sense ssRNAHemagglutinin molecules make up peplomers on virus surface, which give shape like sun with corona.Medical importance: ""Common cold,"" SARS, MERSSARS-COVReservoir: birds and small mammals (civet cats)Transmission: respiratory droplets; virus also found in urine, sweat, and feces; original case is thought to have jumped from animal to humanDisease:Severe acute respiratory syndrome (SARS)Atypical pneumoniaClinical case definition includes fever of >38.0C(100.4F), flu-like illness, dry cough, dyspnea, and progressive hypoxiaChest x-ray may show patchy distribution of focal interstitial infiltratesDiagnosisIncludes clinical presentation and prior history of travel to endemic area or an association with someone who recently traveled to endemic areaLab tests: detection of antibodies to SARS-CoV, RT-PCR, and isolation of the virus in cultureTreatment: supportive; ribavirin and interferon are promisingMERS-CoV (Middle Eastern Respiratory Syndrome)Reservoir: bats and camelsDisease and transmission: similar to SARS +### End" +585,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In primary pulmonary hypeension, basic abnormality in gene lies in, with the following options: A: Bone morphogenic protein receptor II, B: Endothelin, C: Homebox gene, D: PAX - 11 + +### Response: +","Decreased expression of the voltage-regulated potassium channel, mutations in the bone morphogenetic protein-2 receptor, increased tissue factor expression, overactivation of the serotonin transpoer, transcription factor activation of hypoxia-inducible factor-1 alpha, and activation of nuclear factor of activated T cells. As a result, there appears to be a loss of apoptosis of the smooth muscle cells that allow their proliferation and the emergence of apoptosis-resistant endothelial cells that can obliterate the vascular lumen.Ref: Harrison's 18/e p2077","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In primary pulmonary hypeension, basic abnormality in gene lies in, with the following options: A: Bone morphogenic protein receptor II, B: Endothelin, C: Homebox gene, D: PAX - 11 + +### Response: +Decreased expression of the voltage-regulated potassium channel, mutations in the bone morphogenetic protein-2 receptor, increased tissue factor expression, overactivation of the serotonin transpoer, transcription factor activation of hypoxia-inducible factor-1 alpha, and activation of nuclear factor of activated T cells. As a result, there appears to be a loss of apoptosis of the smooth muscle cells that allow their proliferation and the emergence of apoptosis-resistant endothelial cells that can obliterate the vascular lumen.Ref: Harrison's 18/e p2077 +### End" +586,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Following are the contraindication for laparoscopic female sterilization, except-, with the following options: A: Hea disease, B: Obesity, C: Respiratory dysfunction, D: Hiatus hernia + +### Response: +","NOTE THAT THE QUESTION IS ASKING EXCEPT - Of the given options, the least worrisome condition for performing laparoscopic gynecological procedures is hiatal hernia. - Laparoscopy is not advisable for postpaum patients for 6 weeks following delivery. - However, it can be done as a concurrent procedure to MTP. - Haemoglobin percent should not be less than 8. - There should be no associated medical disorders such as hea disease, respiratory disease, diabetes and hypeension. - It is recommended that the patient be kept in hospital for a minimum of 48 hours after the operation.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Following are the contraindication for laparoscopic female sterilization, except-, with the following options: A: Hea disease, B: Obesity, C: Respiratory dysfunction, D: Hiatus hernia + +### Response: +NOTE THAT THE QUESTION IS ASKING EXCEPT - Of the given options, the least worrisome condition for performing laparoscopic gynecological procedures is hiatal hernia. - Laparoscopy is not advisable for postpaum patients for 6 weeks following delivery. - However, it can be done as a concurrent procedure to MTP. - Haemoglobin percent should not be less than 8. - There should be no associated medical disorders such as hea disease, respiratory disease, diabetes and hypeension. - It is recommended that the patient be kept in hospital for a minimum of 48 hours after the operation. +### End" +587,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: prophylaxis for Pneumocystis carinii is indicated in HIV positive patents When CD4 count is-, with the following options: A: <300 cells/mm3, B: < 200 cells / mm3, C: < 100 cells/mm3, D: < 50 cells / mm3 + +### Response: +","Low CD4 count correlated with risk of PCP (p < 0.0001); 79% had CD4 counts less than 100/microl and 95% had CD4 counts less than 200/microl. Bacterial pneumonia has been linked to several HIV-related factors, including CD4 counts, having an uncontrolled viral load, and not being on antiretroviral therapy. HIV-positive people with a weak immune system, paicularly a CD4 count below 200 cells/mm3, are at greatest risk. Ref Harrison20th edition pg 1107","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: prophylaxis for Pneumocystis carinii is indicated in HIV positive patents When CD4 count is-, with the following options: A: <300 cells/mm3, B: < 200 cells / mm3, C: < 100 cells/mm3, D: < 50 cells / mm3 + +### Response: +Low CD4 count correlated with risk of PCP (p < 0.0001); 79% had CD4 counts less than 100/microl and 95% had CD4 counts less than 200/microl. Bacterial pneumonia has been linked to several HIV-related factors, including CD4 counts, having an uncontrolled viral load, and not being on antiretroviral therapy. HIV-positive people with a weak immune system, paicularly a CD4 count below 200 cells/mm3, are at greatest risk. Ref Harrison20th edition pg 1107 +### End" +588,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Osteporosis may be seen in all except-, with the following options: A: Hyperparathyroidism, B: Hypoparathyroidism, C: Thyrotoxicosis, D: Heparin administration + +### Response: +","Hyperparathyroidism, Thyrotoxicosis and heparin administration can cause osteoporosis.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Osteporosis may be seen in all except-, with the following options: A: Hyperparathyroidism, B: Hypoparathyroidism, C: Thyrotoxicosis, D: Heparin administration + +### Response: +Hyperparathyroidism, Thyrotoxicosis and heparin administration can cause osteoporosis. +### End" +589,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hypomagnesemia is seen in all Except, with the following options: A: Gitelman syndrome, B: Hungry bone disease, C: Paget disease, D: Prolonged thiazide therapy + +### Response: +",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: Hypomagnesemia is seen in all Except, with the following options: A: Gitelman syndrome, B: Hungry bone disease, C: Paget disease, D: Prolonged thiazide therapy + +### Response: +Ref - researchgate.net +### End" +590,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hatter's shakes are seen in which poisoning, with the following options: A: Arsenic, B: Mercury, C: Copper, D: Lead + +### Response: +","Mercury Hatter's shakes are seen with chronic mercury poisoning Chronic mercury poisoning Also Ida hydrargyrism (Latin word for mercury is hydrargyrum, thus the symbol Hg ""hydr"" - meaning watery or runny & ""argyros"" - meaning silver i.e. liquid silver) Symptoms are salivation, metallic taste, inflammed gums, loosening of teeth & occasionally a blue-black line on the gums as with lead poisoning. Nephritis is a serious complication. Mercuria lentis - discolouration of the capsule of lens as observed through slit lamp is one of the early symptoms of chronic mercury poisoning. Tremors (sometimes called Danbury tremors) are moderately coarse & is interspersed by jerky movements. The advanced condition is k/a Hatter's or glass blower's shakes because they are common in persons working in gloss-blowing & hat industries. The most severe form is known as concussio mercurialis in which no activity is possible. Erethism is a peculiar disturbance of the personality characterised by shyness, irritability, tremors, loss of memory & insomnia. It is common in workers in mirror industry. Acrodynia or pink disease - characterised by generalised body rash, is an idiosyncratic hypersensitivity reaction paicularly seen in chldren. It is caused by chronic mercury exposure in any form usually in children. Minimata disease - A type of organic mercurial poisoning due to eating of fish poisoned by mercury. Treatment of chronic mercury poisoning - Removal of exposure - Demulcents (soothing agents) - Saline purgatives - Oral hygine - Chelation therapy (D-penicillamine, BAL, DMPS, DMSA)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hatter's shakes are seen in which poisoning, with the following options: A: Arsenic, B: Mercury, C: Copper, D: Lead + +### Response: +Mercury Hatter's shakes are seen with chronic mercury poisoning Chronic mercury poisoning Also Ida hydrargyrism (Latin word for mercury is hydrargyrum, thus the symbol Hg ""hydr"" - meaning watery or runny & ""argyros"" - meaning silver i.e. liquid silver) Symptoms are salivation, metallic taste, inflammed gums, loosening of teeth & occasionally a blue-black line on the gums as with lead poisoning. Nephritis is a serious complication. Mercuria lentis - discolouration of the capsule of lens as observed through slit lamp is one of the early symptoms of chronic mercury poisoning. Tremors (sometimes called Danbury tremors) are moderately coarse & is interspersed by jerky movements. The advanced condition is k/a Hatter's or glass blower's shakes because they are common in persons working in gloss-blowing & hat industries. The most severe form is known as concussio mercurialis in which no activity is possible. Erethism is a peculiar disturbance of the personality characterised by shyness, irritability, tremors, loss of memory & insomnia. It is common in workers in mirror industry. Acrodynia or pink disease - characterised by generalised body rash, is an idiosyncratic hypersensitivity reaction paicularly seen in chldren. It is caused by chronic mercury exposure in any form usually in children. Minimata disease - A type of organic mercurial poisoning due to eating of fish poisoned by mercury. Treatment of chronic mercury poisoning - Removal of exposure - Demulcents (soothing agents) - Saline purgatives - Oral hygine - Chelation therapy (D-penicillamine, BAL, DMPS, DMSA) +### End" +591,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Dryness of the mouth with facial nerve injury --- site of lesion at, with the following options: A: Chorda- tympani nerve, B: Cerebello- pontine angle, C: Geniculate ganglion, D: Concusion of Tympanic membrane + +### Response: +","(Chorda - tympani nerve) (97-Dhingra 4th)* Lesion in the cerebello pontine angle - is identified by the presence of vestibular and auditory defects and involvement of other cranial nerves such as Vth, IXth, Xth and Xlth* Lesion at the chorda typani nerve - presents with loss of taste from anterior two thirds of tongue* Decreased lacrimation indicates lesions proximal or at the geniculate ganglion; the secreto motor fibres leave the geniculate ganglion via greater superficial petrosal nerveChorda tympani arises from the facial nerve in the facial canal in the posterior wall of the middle ear, and leaves the middle ear through the petrotympanic fissureThe chorda tympani contains preganglionic parasympathetic secretomotor fibres to the submandibular and the sub lingual salivary gland, (Dryness of mouth)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Dryness of the mouth with facial nerve injury --- site of lesion at, with the following options: A: Chorda- tympani nerve, B: Cerebello- pontine angle, C: Geniculate ganglion, D: Concusion of Tympanic membrane + +### Response: +(Chorda - tympani nerve) (97-Dhingra 4th)* Lesion in the cerebello pontine angle - is identified by the presence of vestibular and auditory defects and involvement of other cranial nerves such as Vth, IXth, Xth and Xlth* Lesion at the chorda typani nerve - presents with loss of taste from anterior two thirds of tongue* Decreased lacrimation indicates lesions proximal or at the geniculate ganglion; the secreto motor fibres leave the geniculate ganglion via greater superficial petrosal nerveChorda tympani arises from the facial nerve in the facial canal in the posterior wall of the middle ear, and leaves the middle ear through the petrotympanic fissureThe chorda tympani contains preganglionic parasympathetic secretomotor fibres to the submandibular and the sub lingual salivary gland, (Dryness of mouth) +### End" +592,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Kaposi's sarcoma (KS) usually occurs when CD4+ lymphocyte counts are:, with the following options: A: Above 600, B: Between 1000-2000, C: Below 200, D: Above 2000 + +### Response: +","When CD4 count falls less than 200/L, the patient develops full-blown AIDS. This stage is characterized by the development of HIV wasting syndrome with weight loss and diarrhea for 1 month. +The patients with AIDS show a marked susceptibility to the development of malignancies. +Human herpes virus-8–associated Kaposi’s sarcoma is the most noted malignancy associated with AIDS. + +Parija SC. Textbook of Microbiology & Immunology. Elsevier Health Sciences; 2014. Page:571","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Kaposi's sarcoma (KS) usually occurs when CD4+ lymphocyte counts are:, with the following options: A: Above 600, B: Between 1000-2000, C: Below 200, D: Above 2000 + +### Response: +When CD4 count falls less than 200/L, the patient develops full-blown AIDS. This stage is characterized by the development of HIV wasting syndrome with weight loss and diarrhea for 1 month. +The patients with AIDS show a marked susceptibility to the development of malignancies. +Human herpes virus-8–associated Kaposi’s sarcoma is the most noted malignancy associated with AIDS. + +Parija SC. Textbook of Microbiology & Immunology. Elsevier Health Sciences; 2014. Page:571 +### End" +593,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: MCV (II) in infant of 1 month of age is -, with the following options: A: 76-80, B: 80-100, C: 90-100, D: 101-125 + +### Response: +","Ans. is 'b' i.e., 80-100 Mean MCV at the age of 1 months is 104 fL. Age Mean Hb g (g/dl) Mean PCV (%) Mean MCV (IL) TLC (109/L) Bih (cord blood) 16.5 51 108 18.1 1-3 days 18.5 56 108 18.9 7 days 17.5 54 107 12.2 14 days 16.5 51 105 11.4 1 month 14.0 43 104 10.8 2 months 11.5 35 96 10.8 6 months 11.5 35 91 11.9 1 year 12.0 36 78 11.4 2-6 years 12.5 37 81 9.1 6-12 years 13.5 40 86 8.4 12-18 years 14.0 42 90 8.1","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: MCV (II) in infant of 1 month of age is -, with the following options: A: 76-80, B: 80-100, C: 90-100, D: 101-125 + +### Response: +Ans. is 'b' i.e., 80-100 Mean MCV at the age of 1 months is 104 fL. Age Mean Hb g (g/dl) Mean PCV (%) Mean MCV (IL) TLC (109/L) Bih (cord blood) 16.5 51 108 18.1 1-3 days 18.5 56 108 18.9 7 days 17.5 54 107 12.2 14 days 16.5 51 105 11.4 1 month 14.0 43 104 10.8 2 months 11.5 35 96 10.8 6 months 11.5 35 91 11.9 1 year 12.0 36 78 11.4 2-6 years 12.5 37 81 9.1 6-12 years 13.5 40 86 8.4 12-18 years 14.0 42 90 8.1 +### End" +594,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cognitive model of depression is given by ?, with the following options: A: Ellis, B: Beck, C: Godfrey, D: Meicheinbanon + +### Response: +","Beck Cognitive therapy is a psychotherapy developed by American pyschiatrist Aaron T. Beck. Cognitive therapy is one of the therapeutic approaches within the larger group of cognitive behavioural therapies. Cognitive therapy seeks to help the client overcome difficulties by identifying and changing dysfunctional thinking, behaviour and emotional responses. This involves helping clients develop skills for modifying beliefs, identifying distoed thinkings, relative to others in different ways and changing behaviours. Treatment is based on collaboration between client and therapist and on testing beliefs. Therapy may consist of testing the assumptions which one makes and identifying how some of one's usually unquestioned thoughts are distoed, unrealistic and unhelpful. Once, those thoughts have been challenged, ones feelings about the subject matter of those thoughts are more easily subject to change. Beck initially focussed on depression and developed a list of errors in thought that he proposed could maintain depression, including arbitrary inference, selective abstraction, over generalization and magnification (of negatives) and minimization (of positives). According to Beck's theorey of the etiology of depression, depressed people acquire a negative view of the world in childhood and adolescence. Children and adolescent who suffer from depression acquire this negative view earlier. Depressed people acquire such view through a loss of a parent, rejection by peers, (criticism from teachers or parents, the depressive attitude and other negative events). When the person with such view encounters a situation that resembles the original conditions of the learned view in some way, even remotely, the negative views of the persons are activated. A simple example may illustrate the principle of how cognitive therapy works Having made a mistake at work, a person may believe ""I am useless and can't do anything right at work"". Strongly believing this then tends to worsen his mood. The problem may be worsened fuher if the individual reacts by avoiding activities and then behaviourally confirming the negative belief to himself. As a result, any adaptive response and fuher constructive consequences become unlikely, which reinforces the original belief of being useless. In therapy, the latter example could be identified as a self fulfilling prophecy or ""problem cycle"" and the effos of the therapist and client would be directed at working together to change it.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cognitive model of depression is given by ?, with the following options: A: Ellis, B: Beck, C: Godfrey, D: Meicheinbanon + +### Response: +Beck Cognitive therapy is a psychotherapy developed by American pyschiatrist Aaron T. Beck. Cognitive therapy is one of the therapeutic approaches within the larger group of cognitive behavioural therapies. Cognitive therapy seeks to help the client overcome difficulties by identifying and changing dysfunctional thinking, behaviour and emotional responses. This involves helping clients develop skills for modifying beliefs, identifying distoed thinkings, relative to others in different ways and changing behaviours. Treatment is based on collaboration between client and therapist and on testing beliefs. Therapy may consist of testing the assumptions which one makes and identifying how some of one's usually unquestioned thoughts are distoed, unrealistic and unhelpful. Once, those thoughts have been challenged, ones feelings about the subject matter of those thoughts are more easily subject to change. Beck initially focussed on depression and developed a list of errors in thought that he proposed could maintain depression, including arbitrary inference, selective abstraction, over generalization and magnification (of negatives) and minimization (of positives). According to Beck's theorey of the etiology of depression, depressed people acquire a negative view of the world in childhood and adolescence. Children and adolescent who suffer from depression acquire this negative view earlier. Depressed people acquire such view through a loss of a parent, rejection by peers, (criticism from teachers or parents, the depressive attitude and other negative events). When the person with such view encounters a situation that resembles the original conditions of the learned view in some way, even remotely, the negative views of the persons are activated. A simple example may illustrate the principle of how cognitive therapy works Having made a mistake at work, a person may believe ""I am useless and can't do anything right at work"". Strongly believing this then tends to worsen his mood. The problem may be worsened fuher if the individual reacts by avoiding activities and then behaviourally confirming the negative belief to himself. As a result, any adaptive response and fuher constructive consequences become unlikely, which reinforces the original belief of being useless. In therapy, the latter example could be identified as a self fulfilling prophecy or ""problem cycle"" and the effos of the therapist and client would be directed at working together to change it. +### End" +595,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Wave V in BERA corresponds to -, with the following options: A: Inferior colliculus, B: Lateral lemniscus, C: Cochlear nucleus, D: Eighth-nerve + +### Response: +",Ans- B Waves of BERA can be remembered by auditory pathway. WAVE 1-Distal part of 8th nerve WAVE 2-Proximal part of 8th nerve WAVE 3-Cochlear nucleus(lower pons) WAVE 4-Superior Olivary Nucleus WAVE 5-Lateral Lemniscus WAVE 6-Inferior colliculus WAVE 5 is most reliable most rhobust and reproducible and last wave to disappear i low intensity. Reember auditory pathway by SLIM Sup oli nucl-lateral LEMNISCUS-Inf Oli nucl-MEDIAL GENICULATE BODY. Mnemonic MGB-Music pathway LGB-Light pathway MGB-Music,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Wave V in BERA corresponds to -, with the following options: A: Inferior colliculus, B: Lateral lemniscus, C: Cochlear nucleus, D: Eighth-nerve + +### Response: +Ans- B Waves of BERA can be remembered by auditory pathway. WAVE 1-Distal part of 8th nerve WAVE 2-Proximal part of 8th nerve WAVE 3-Cochlear nucleus(lower pons) WAVE 4-Superior Olivary Nucleus WAVE 5-Lateral Lemniscus WAVE 6-Inferior colliculus WAVE 5 is most reliable most rhobust and reproducible and last wave to disappear i low intensity. Reember auditory pathway by SLIM Sup oli nucl-lateral LEMNISCUS-Inf Oli nucl-MEDIAL GENICULATE BODY. Mnemonic MGB-Music pathway LGB-Light pathway MGB-Music +### End" +596,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about following is?, with the following options: A: 115 degree C at for 20 min, B: 121-degree C at for 15 min, C: 118-degree C at for 15 min, D: 124-degree C at for 15 min + +### Response: +","Ans. B. 121-degree C at for 15 minHeat sterilization (Autoclave)-:a. A widely-used method for heat sterilization is the autoclave.b. Autoclaves commonly use steam heated to 121 degC or 134 degC.c. To achieve sterility, a holding time of at least 15 minutes at 121 degC or 3 minutes at 134 degC required.d. Additional sterilizing time is usually required for liquids and instruments packed in layers of cloth, as they may take longer to reach the required temperature.e. After sterilization, autoclaved liquids must be cooled slowly to avoid boiling over when the pressure is released.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about following is?, with the following options: A: 115 degree C at for 20 min, B: 121-degree C at for 15 min, C: 118-degree C at for 15 min, D: 124-degree C at for 15 min + +### Response: +Ans. B. 121-degree C at for 15 minHeat sterilization (Autoclave)-:a. A widely-used method for heat sterilization is the autoclave.b. Autoclaves commonly use steam heated to 121 degC or 134 degC.c. To achieve sterility, a holding time of at least 15 minutes at 121 degC or 3 minutes at 134 degC required.d. Additional sterilizing time is usually required for liquids and instruments packed in layers of cloth, as they may take longer to reach the required temperature.e. After sterilization, autoclaved liquids must be cooled slowly to avoid boiling over when the pressure is released. +### End" +597,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Classic triad of congenital rubella includes all except -, with the following options: A: Cataract, B: Deafness, C: Retinitis, D: CHD + +### Response: +","Cardiac defects, cataract, deafness constitute a classical triad REF:ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.555","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Classic triad of congenital rubella includes all except -, with the following options: A: Cataract, B: Deafness, C: Retinitis, D: CHD + +### Response: +Cardiac defects, cataract, deafness constitute a classical triad REF:ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.555 +### End" +598,"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 bowel obstruction is, with the following options: A: Malignancy, B: Vovulus, C: Peritoneal adhesions, D: External hernia + +### Response: +",".ADHESIONS AND BANDS - Adhesions and bands are the commonest causes of intestinal obstruction in Western countries. In India, hernia and then adhesions are the two common causes of intestinal obstruction. Causes- * Infection due to peritonitis, appendicitis, postlaparotomy, and other acute infective abdominal conditions. Type I--Fibrinous adhesions occur during 5-10th postsurgical period. It usually gets resolved completely. It is avascular and flimsy. Type II--Fibrous adhesions. Due to lack/poor blood supply, bowel gets attached to pa of peritoneum or omentum or other pas of the bowel with dense vascular adhesions to maintain blood supply. It will persist and precipitate intestinal obstruction, often-subacute and recurrent type. Adhesions due to tuberculosis are severe, dense and difficult to separate. ref:SRB&;s manual of surgery ,ed 3,pg no 870","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 bowel obstruction is, with the following options: A: Malignancy, B: Vovulus, C: Peritoneal adhesions, D: External hernia + +### Response: +.ADHESIONS AND BANDS - Adhesions and bands are the commonest causes of intestinal obstruction in Western countries. In India, hernia and then adhesions are the two common causes of intestinal obstruction. Causes- * Infection due to peritonitis, appendicitis, postlaparotomy, and other acute infective abdominal conditions. Type I--Fibrinous adhesions occur during 5-10th postsurgical period. It usually gets resolved completely. It is avascular and flimsy. Type II--Fibrous adhesions. Due to lack/poor blood supply, bowel gets attached to pa of peritoneum or omentum or other pas of the bowel with dense vascular adhesions to maintain blood supply. It will persist and precipitate intestinal obstruction, often-subacute and recurrent type. Adhesions due to tuberculosis are severe, dense and difficult to separate. ref:SRB&;s manual of surgery ,ed 3,pg no 870 +### End" +599,"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 breech presentation:, with the following options: A: Contrcted pelvis, B: Hydramnios, C: Prematurity, D: Oligohydramnios + +### Response: +",Prematurity,"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 breech presentation:, with the following options: A: Contrcted pelvis, B: Hydramnios, C: Prematurity, D: Oligohydramnios + +### Response: +Prematurity +### End" +600,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Increased gonadal production of estrogen is characteristic of, with the following options: A: Testicular feminization, B: Polycycstic ovarian disease, C: Congenital adrenal hyperplasia, D: Third trimester of pregnancy + +### Response: +","In persons with testicular feminization, estradiol secretion by the testes is markedly increased (but not to the level produced by normal ovaries); the mechanism is lack of suppression of LH by testosterone and consequently increased stimulation of gonadal testosterone and estradiol secretion. Ovaries containing follicle cysts may be a source of increased estrogen production, paicularly during the postmenopausal years, when gonadotropin levels are very high. The increase in estrogen production that is characteristic of PCOD is the consequence of the peripheral conversion of androstenedione to estrogen, not of direct gonadal production. During the third trimester of pregnancy estrogen production is increased because of the formation of estrogen by the placenta rather than by the ovary. Arrhenoblastoma is a virilizing ovarian tumor and does not secrete estrogen. Congenital adrenal hyperplasia causes virilization due to the increased adrenal output of androgens.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Increased gonadal production of estrogen is characteristic of, with the following options: A: Testicular feminization, B: Polycycstic ovarian disease, C: Congenital adrenal hyperplasia, D: Third trimester of pregnancy + +### Response: +In persons with testicular feminization, estradiol secretion by the testes is markedly increased (but not to the level produced by normal ovaries); the mechanism is lack of suppression of LH by testosterone and consequently increased stimulation of gonadal testosterone and estradiol secretion. Ovaries containing follicle cysts may be a source of increased estrogen production, paicularly during the postmenopausal years, when gonadotropin levels are very high. The increase in estrogen production that is characteristic of PCOD is the consequence of the peripheral conversion of androstenedione to estrogen, not of direct gonadal production. During the third trimester of pregnancy estrogen production is increased because of the formation of estrogen by the placenta rather than by the ovary. Arrhenoblastoma is a virilizing ovarian tumor and does not secrete estrogen. Congenital adrenal hyperplasia causes virilization due to the increased adrenal output of androgens. +### End" +601,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Splenic artery is a branch of:, with the following options: A: Abdominal aorta, B: Renal artery, C: Coeliac trunk, D: Left gastric artery + +### Response: +","Ans. is 'c' i.e. Coeliac trunk Blood supply and nerve supply Arterial supply to spleen is through splenic artery, largest branch of coeliac trunk. Venous drainage is through splenic vein which unites with superior mesenteric vein to form portal vein behind neck of pancreas. Nerve supply is through coeliac plexus, which is sympathetic supply of spleen.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Splenic artery is a branch of:, with the following options: A: Abdominal aorta, B: Renal artery, C: Coeliac trunk, D: Left gastric artery + +### Response: +Ans. is 'c' i.e. Coeliac trunk Blood supply and nerve supply Arterial supply to spleen is through splenic artery, largest branch of coeliac trunk. Venous drainage is through splenic vein which unites with superior mesenteric vein to form portal vein behind neck of pancreas. Nerve supply is through coeliac plexus, which is sympathetic supply of spleen. +### End" +602,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: DNA repair defect is associated, with the following options: A: Xeroderma pigmentosum, B: Icthyosis, C: Angelman syndrome, D: DiGeorge's syndrome + +### Response: +","Robbins basic pathology 9th edition page no 197, The basis of this disorder is DNA repair such dna damage is prevented by nucleotide excision repair system, and an inherited loss of any one of these can give rise to xeroderma pigmentosum","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: DNA repair defect is associated, with the following options: A: Xeroderma pigmentosum, B: Icthyosis, C: Angelman syndrome, D: DiGeorge's syndrome + +### Response: +Robbins basic pathology 9th edition page no 197, The basis of this disorder is DNA repair such dna damage is prevented by nucleotide excision repair system, and an inherited loss of any one of these can give rise to xeroderma pigmentosum +### End" +603,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Fracture mandible with edentulous jaw is best treated with -, with the following options: A: External fixator, B: Minerva-plaster, C: Interdental wiring, D: Intermaxillary elastic traction + +### Response: +","• Condylar neck is the weakest part of the mandible and MC site of fracture +• Mandible may fracture directly at the point of the blow +• Indirectly where the force from the blow is transmitted and the mandible fractures at a point of weakness distant from the original blow, known as ‘guardsman’ fracture. +• ‘Butterfly’ fracture of the mandible: A segment of mandible is detached from the rest of the mandible in the canine regions. +Diagnosis +• Recommended radiographic evaluation of a mandible fracture: Panoramic radiograph (Panorex) and Towne’s view x-ray. +Treatment +• As in midface fractures, restoration of dental occlusion forms the foundation for fracture management. +• Intermaxillary fixation before fracture exposure and plating is necessary. +• Condylar and subcondylar mandible fractures are most often treated by IMF alone. +• Medical management of mandibular fractures involves a purée-type diet, interdental fixation for several weeks, 1% chlorhexidine mouth rinses, and antibiotics.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Fracture mandible with edentulous jaw is best treated with -, with the following options: A: External fixator, B: Minerva-plaster, C: Interdental wiring, D: Intermaxillary elastic traction + +### Response: +• Condylar neck is the weakest part of the mandible and MC site of fracture +• Mandible may fracture directly at the point of the blow +• Indirectly where the force from the blow is transmitted and the mandible fractures at a point of weakness distant from the original blow, known as ‘guardsman’ fracture. +• ‘Butterfly’ fracture of the mandible: A segment of mandible is detached from the rest of the mandible in the canine regions. +Diagnosis +• Recommended radiographic evaluation of a mandible fracture: Panoramic radiograph (Panorex) and Towne’s view x-ray. +Treatment +• As in midface fractures, restoration of dental occlusion forms the foundation for fracture management. +• Intermaxillary fixation before fracture exposure and plating is necessary. +• Condylar and subcondylar mandible fractures are most often treated by IMF alone. +• Medical management of mandibular fractures involves a purée-type diet, interdental fixation for several weeks, 1% chlorhexidine mouth rinses, and antibiotics. +### End" +604,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Conventional contraceptives are, with the following options: A: IUCD, B: Coitus iterruptus, C: Condom, D: OCP + +### Response: +","Conventional contraceptives are those methods that require action at the time of sexual intercourse Examples are condom, spermicide etc. Reference : Park&;s textbook of preventive and social medicine, 23rd edition, Page no: 494","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Conventional contraceptives are, with the following options: A: IUCD, B: Coitus iterruptus, C: Condom, D: OCP + +### Response: +Conventional contraceptives are those methods that require action at the time of sexual intercourse Examples are condom, spermicide etc. Reference : Park&;s textbook of preventive and social medicine, 23rd edition, Page no: 494 +### End" +605,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Meckel's diveiculum is remnant of -, with the following options: A: Vitello intestinal duct, B: Urachus, C: Oganic diaphragm, D: None + +### Response: +","Ans. is 'a' i.e., Vitello intestinal duct","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Meckel's diveiculum is remnant of -, with the following options: A: Vitello intestinal duct, B: Urachus, C: Oganic diaphragm, D: None + +### Response: +Ans. is 'a' i.e., Vitello intestinal duct +### End" +606,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Meyer's-Kouwenaar syndrome is a synonym for, with the following options: A: Tropical pulmonary eosinophilia, B: Occult filariasis, C: Cutaneous larva migrans, D: Visceral larva migrans + +### Response: +","Occult filariasis (Meyers-Kouwenaar syndrome):*This is a condition in which there is massive eosinophilia (30-80%; absolute count >3000/ mm3), *generalised lymph node enlargement*hepatosplenomegaly*pulmonary symptoms absence of microfilaraemia(Ref: K.D Chatterjee 13th edition, p244)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Meyer's-Kouwenaar syndrome is a synonym for, with the following options: A: Tropical pulmonary eosinophilia, B: Occult filariasis, C: Cutaneous larva migrans, D: Visceral larva migrans + +### Response: +Occult filariasis (Meyers-Kouwenaar syndrome):*This is a condition in which there is massive eosinophilia (30-80%; absolute count >3000/ mm3), *generalised lymph node enlargement*hepatosplenomegaly*pulmonary symptoms absence of microfilaraemia(Ref: K.D Chatterjee 13th edition, p244) +### End" +607,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pyrexia due to wound infection commonly occursafter-, with the following options: A: Third post operation day, B: Fifth post operation day, C: Seventh post operation day, D: Second post operation day + +### Response: +","Ans. is 'b' i.e., Fifth post operation day ""Wound infections most commonly occur 5 to 6 days post operatively but may present sooner or later than that"" -Sabiston.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pyrexia due to wound infection commonly occursafter-, with the following options: A: Third post operation day, B: Fifth post operation day, C: Seventh post operation day, D: Second post operation day + +### Response: +Ans. is 'b' i.e., Fifth post operation day ""Wound infections most commonly occur 5 to 6 days post operatively but may present sooner or later than that"" -Sabiston. +### End" +608,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: An 8 days old child presents with yellow sclera, whitish stool and turmeric colour urine on the 3rd day of septicemia on broad-spectrum antibiotics, the likely diagnosis is –, with the following options: A: Galactosidase deficiency, B: Ammonia toxicity, C: Galactose 1–4 phosphatase uridyl transferase deficiency, D: Glucose 6 phosphatase deficiency + +### Response: +","A feature of conjugated bilirubinemia on the 3rd day accompanied by sepsis in a neonate suggests diagnosis of Galactosemia. +Due to the accumulation of galactitol; damage to nerve tissue and liver occurs which cause. + + +Hepatic parenchymal disease- jaundice, hepatomegaly and ascites +Mental retardation +Vitreous hemorrhage +Acidosis +Splenomegaly +Cataract +Seizures +Hypoglycemia + + +Fanconi syndrome → Aminoaciduria, proteinuria and phosphaturia. +The symptoms of the severe from of the disease are similar to the symptoms of the patient child in the Question -i Jaundice, hepatomegaly vomiting and septicemia (due to E. coli).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: An 8 days old child presents with yellow sclera, whitish stool and turmeric colour urine on the 3rd day of septicemia on broad-spectrum antibiotics, the likely diagnosis is –, with the following options: A: Galactosidase deficiency, B: Ammonia toxicity, C: Galactose 1–4 phosphatase uridyl transferase deficiency, D: Glucose 6 phosphatase deficiency + +### Response: +A feature of conjugated bilirubinemia on the 3rd day accompanied by sepsis in a neonate suggests diagnosis of Galactosemia. +Due to the accumulation of galactitol; damage to nerve tissue and liver occurs which cause. + + +Hepatic parenchymal disease- jaundice, hepatomegaly and ascites +Mental retardation +Vitreous hemorrhage +Acidosis +Splenomegaly +Cataract +Seizures +Hypoglycemia + + +Fanconi syndrome → Aminoaciduria, proteinuria and phosphaturia. +The symptoms of the severe from of the disease are similar to the symptoms of the patient child in the Question -i Jaundice, hepatomegaly vomiting and septicemia (due to E. coli). +### End" +609,"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 inhibits hea development?, with the following options: A: NKX2.5, B: WNT, C: BMP, D: None of the above + +### Response: +","Signals from anterior (cranial) endoderm induce a hea-forming region in overlying splanchnic mesoderm by inducing the transcription factor NKX2.5. The signals require secretion of BMPs 2 and 4 secreted by the endoderm and lateral plate mesoderm. Concomitantly, the activity of WNT proteins (3a and 8) secreted by the neural tube, must be blocked because they normally inhibit hea development. Inhibitors (crescent and cerberus) of the WNT proteins are produced by endoderm cells immediately adjacent to hea-forming mesoderm in the anterior half of the embryo. The combination of bone morphogenetic protein (BMP) activity and WNT inhibition by crescent and cerberus causes expression of NKX2.5, the master gene for hea development. BMP expression also up regulates expression of FGF8 that is impoant for the expression of cardiac-specific proteins. Ref: Langman's embryology 11th edition Chapter 12.","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 inhibits hea development?, with the following options: A: NKX2.5, B: WNT, C: BMP, D: None of the above + +### Response: +Signals from anterior (cranial) endoderm induce a hea-forming region in overlying splanchnic mesoderm by inducing the transcription factor NKX2.5. The signals require secretion of BMPs 2 and 4 secreted by the endoderm and lateral plate mesoderm. Concomitantly, the activity of WNT proteins (3a and 8) secreted by the neural tube, must be blocked because they normally inhibit hea development. Inhibitors (crescent and cerberus) of the WNT proteins are produced by endoderm cells immediately adjacent to hea-forming mesoderm in the anterior half of the embryo. The combination of bone morphogenetic protein (BMP) activity and WNT inhibition by crescent and cerberus causes expression of NKX2.5, the master gene for hea development. BMP expression also up regulates expression of FGF8 that is impoant for the expression of cardiac-specific proteins. Ref: Langman's embryology 11th edition Chapter 12. +### End" +610,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Peripheral aerial disease can be treated by all, EXCEPT:, with the following options: A: Pentoxifylline, B: Cilostazol, C: Sildenafil, D: Percutaneous angioplasty + +### Response: +","Pentoxifylline, a xanthine derivative, is thought to act by reducing the viscosity of blood, allowing it to flow more easily through paially obstructed areas. Cilostazol, a phosphodiesterase type 3 (PDE3) inhibitor, is poorly understood, but may have selective antiplatelet and vasodilating effects. Both drugs have been shown to increase exercise tolerance in patients with severe claudication. Percutaneous angioplasty with stenting is often effective in patients with medically intractable signs and symptoms of ischemia. Ref: Katzung, 11th edition, Chapter 12.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Peripheral aerial disease can be treated by all, EXCEPT:, with the following options: A: Pentoxifylline, B: Cilostazol, C: Sildenafil, D: Percutaneous angioplasty + +### Response: +Pentoxifylline, a xanthine derivative, is thought to act by reducing the viscosity of blood, allowing it to flow more easily through paially obstructed areas. Cilostazol, a phosphodiesterase type 3 (PDE3) inhibitor, is poorly understood, but may have selective antiplatelet and vasodilating effects. Both drugs have been shown to increase exercise tolerance in patients with severe claudication. Percutaneous angioplasty with stenting is often effective in patients with medically intractable signs and symptoms of ischemia. Ref: Katzung, 11th edition, Chapter 12. +### End" +611,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: 'Griesinger sign' is otalgia along with pain and edema over mastoid. It is typically seen in:, with the following options: A: Lateral sinus thrombosis, B: Acoustic neuroma, C: Otosclerosis, D: CSOM + +### Response: +","Lateral sinus thrombosis is a ominous complication of acute OM. It arises from extension of infection and inflammation in the mastoid, with eventual inflammation of the adjacent lateral or sigmoid sinus. Headache is the most common symptom, with papilledema, sixth-nerve palsy, and veigo being less frequently present. Occlusion of the lateral sinus produces pain over the ear and mastoid and may cause edema over the mastoid (Griesinger sign). Involvement of cranial nerves V and VI produces ipsilateral facial pain and lateral rectus weakness (Gradenigo syndrome).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: 'Griesinger sign' is otalgia along with pain and edema over mastoid. It is typically seen in:, with the following options: A: Lateral sinus thrombosis, B: Acoustic neuroma, C: Otosclerosis, D: CSOM + +### Response: +Lateral sinus thrombosis is a ominous complication of acute OM. It arises from extension of infection and inflammation in the mastoid, with eventual inflammation of the adjacent lateral or sigmoid sinus. Headache is the most common symptom, with papilledema, sixth-nerve palsy, and veigo being less frequently present. Occlusion of the lateral sinus produces pain over the ear and mastoid and may cause edema over the mastoid (Griesinger sign). Involvement of cranial nerves V and VI produces ipsilateral facial pain and lateral rectus weakness (Gradenigo syndrome). +### End" +612,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Asthenospermia means: September 2005, with the following options: A: Reduction in number of sperms, B: Reduction in motility of sperms, C: Absence of sperms, D: Absence of semen + +### Response: +","Ans. B: Reduction in motility of sperms Asthenozoospermia/""asthenospermia"" is the term for reduced sperm motility. It decreases the sperm quality and is therefore one of the major causes of infeility or reduced feility in men","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Asthenospermia means: September 2005, with the following options: A: Reduction in number of sperms, B: Reduction in motility of sperms, C: Absence of sperms, D: Absence of semen + +### Response: +Ans. B: Reduction in motility of sperms Asthenozoospermia/""asthenospermia"" is the term for reduced sperm motility. It decreases the sperm quality and is therefore one of the major causes of infeility or reduced feility in men +### End" +613,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Feature(s) of Alcohol withdrawl delirium is/are allexcept:, with the following options: A: Diarrhoea, B: Visual hallucination, C: Disorientation, D: All + +### Response: +",A i.e. Diarrhoea,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Feature(s) of Alcohol withdrawl delirium is/are allexcept:, with the following options: A: Diarrhoea, B: Visual hallucination, C: Disorientation, D: All + +### Response: +A i.e. Diarrhoea +### End" +614,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The treatment of traumatic rupture of tympanic membrane is-, with the following options: A: Aural packing, B: Chloromycetin ear dorps, C: Tympanoplasty, D: No active treatment + +### Response: +","Ans. is 'd' i.e., No active treatment T/T of traumatic rupture of tympanic membrane. Systemic antibiotics and topical optic medications are not required unless suppurative otorrhoea is present. Close follow up examination is necessary to ensure that Spontaneous healing occurs. If the tympanic membrane does not heal within several months, surgical graft repair should be considered.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The treatment of traumatic rupture of tympanic membrane is-, with the following options: A: Aural packing, B: Chloromycetin ear dorps, C: Tympanoplasty, D: No active treatment + +### Response: +Ans. is 'd' i.e., No active treatment T/T of traumatic rupture of tympanic membrane. Systemic antibiotics and topical optic medications are not required unless suppurative otorrhoea is present. Close follow up examination is necessary to ensure that Spontaneous healing occurs. If the tympanic membrane does not heal within several months, surgical graft repair should be considered. +### End" +615,"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 presents with a rash on the scalp, (extensor) elbows, knees and umbilicus. The rash is sharply demarcated erythematous plaques with silvery scale in those locations; there is no central clearing. The soles of the feet are normal. What is the most likely diagnosis?, with the following options: A: Allergic contact dermatitis, B: Atopic dermatitis, C: Psoriasis, D: Lichen planus + +### Response: +","Psoriasis is chronic, immune-mediated inflammatory condition. Activation of T cells of the adaptive immune system, Th1 and Th17 cells, activate keratinocytes to proliferate and produce multiple chemokines and antimicrobial peptides. Genetic predisposition is present in Type1 Plaque psoriasis and Guttate psoriasis with HLA-C Initial Lesions Location of initial Lesions Other Findings Diagnostic Aids Treatment Psoriasis Pink-red, silvery scale, sharply demarcated Elbows, knees, scalp, presacral area, intergluteal fold Nail dystrophy, ahritis, pustules; SAPHO syndrome, especially with palmoplantar pustulosis Skin biopsy Topical glucocoicoids, Vitamin D; UV-B (narrowband) > PUVA (psoralen with UVA) Oral retinoid; MTX, Cyclosporine, Anti-TNF agents, anti-IL-12/23 Ab","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 presents with a rash on the scalp, (extensor) elbows, knees and umbilicus. The rash is sharply demarcated erythematous plaques with silvery scale in those locations; there is no central clearing. The soles of the feet are normal. What is the most likely diagnosis?, with the following options: A: Allergic contact dermatitis, B: Atopic dermatitis, C: Psoriasis, D: Lichen planus + +### Response: +Psoriasis is chronic, immune-mediated inflammatory condition. Activation of T cells of the adaptive immune system, Th1 and Th17 cells, activate keratinocytes to proliferate and produce multiple chemokines and antimicrobial peptides. Genetic predisposition is present in Type1 Plaque psoriasis and Guttate psoriasis with HLA-C Initial Lesions Location of initial Lesions Other Findings Diagnostic Aids Treatment Psoriasis Pink-red, silvery scale, sharply demarcated Elbows, knees, scalp, presacral area, intergluteal fold Nail dystrophy, ahritis, pustules; SAPHO syndrome, especially with palmoplantar pustulosis Skin biopsy Topical glucocoicoids, Vitamin D; UV-B (narrowband) > PUVA (psoralen with UVA) Oral retinoid; MTX, Cyclosporine, Anti-TNF agents, anti-IL-12/23 Ab +### End" +616,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 42-year-old man who has been employed by a company for the past 2 years believes that,h is fellow employees have hatched a conspiracy to get him fired, he believes that they have tapped his phone and that they follow him home. He frequently checks his home for cameras as he believes that fellow employees are keeping an eye on him. He denies having auditory hallucinations and there are no other symptoms. Which of the following is the most appropriate diagnosis for this man?, with the following options: A: Paranoid schizophrenia, B: Catatonic schizophrenia, C: Delusional disorder (paranoid type), D: Paranoid personality disorder + +### Response: +","This 42-year-old man who believes that his fellow employees are conspiring to get him fired is most likely to have delusional disorder, paranoid type. This disorder is characterized by one chronic and fixed non-bizarre delusional system such as the patient's belief in a non-existent conspiracy. Hallucinations are usually absent in such patients","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 42-year-old man who has been employed by a company for the past 2 years believes that,h is fellow employees have hatched a conspiracy to get him fired, he believes that they have tapped his phone and that they follow him home. He frequently checks his home for cameras as he believes that fellow employees are keeping an eye on him. He denies having auditory hallucinations and there are no other symptoms. Which of the following is the most appropriate diagnosis for this man?, with the following options: A: Paranoid schizophrenia, B: Catatonic schizophrenia, C: Delusional disorder (paranoid type), D: Paranoid personality disorder + +### Response: +This 42-year-old man who believes that his fellow employees are conspiring to get him fired is most likely to have delusional disorder, paranoid type. This disorder is characterized by one chronic and fixed non-bizarre delusional system such as the patient's belief in a non-existent conspiracy. Hallucinations are usually absent in such patients +### End" +617,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Normal value of fetal scalp pH is?, with the following options: A: 6.9, B: 7, C: 7.1, D: 7.3 + +### Response: +","ANSWER: (D) 7.3REF: COGT 10th ed table 8-7AVERAGE ""NORMAL"" FETAL SCALP AND CORD ACID-BASE VALUES Before LaborSecond Stage of LaborScalp pH7.377.3CO2 pressure (mm Hg)3843Bicarbonate (mmol/L)2121Base excess (mmol/L)-3-5 Umbilical VeinUmbilical ArteryCord pH7.327.26PO238.917.7PCO237.140Base deficit6.86.7","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Normal value of fetal scalp pH is?, with the following options: A: 6.9, B: 7, C: 7.1, D: 7.3 + +### Response: +ANSWER: (D) 7.3REF: COGT 10th ed table 8-7AVERAGE ""NORMAL"" FETAL SCALP AND CORD ACID-BASE VALUES Before LaborSecond Stage of LaborScalp pH7.377.3CO2 pressure (mm Hg)3843Bicarbonate (mmol/L)2121Base excess (mmol/L)-3-5 Umbilical VeinUmbilical ArteryCord pH7.327.26PO238.917.7PCO237.140Base deficit6.86.7 +### End" +618,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Artemesinin is best used for, with the following options: A: Relapse of malaria, B: Chronic malaria, C: Cerebral malaria, D: Recrudescent malaria + +### Response: +","Treatment of cerebral malaria: + +IV Quinine: Needs continuous cardiac monitoring; can cause QTc prolongation, hypoglycemia +IV Artesunate has better efficacy and safer than quinine, 2.4 mg/kg IV BD. then OD +Exchange transfusion if parasite index is > 10% +Artemisinin (qinghaosu) acts rapidly against erythrocytic stages of malarial parasites. It is effective against complicated and multidrug resistant malaria. Due to their short half life, recrudescence is high if used alone, hence not useful for prophylaxis also. +Chloroquine sensitive falci and vivax: Chloroquine l g, 500mg at 6, 24,48 hrs, followed by Primaquine 15mg for 14 days +Chloroquine resistant, uncomplicated falciparum: Oral quinine. Mefloquine, Doxy, Clindamycin, Oral Artesunate","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Artemesinin is best used for, with the following options: A: Relapse of malaria, B: Chronic malaria, C: Cerebral malaria, D: Recrudescent malaria + +### Response: +Treatment of cerebral malaria: + +IV Quinine: Needs continuous cardiac monitoring; can cause QTc prolongation, hypoglycemia +IV Artesunate has better efficacy and safer than quinine, 2.4 mg/kg IV BD. then OD +Exchange transfusion if parasite index is > 10% +Artemisinin (qinghaosu) acts rapidly against erythrocytic stages of malarial parasites. It is effective against complicated and multidrug resistant malaria. Due to their short half life, recrudescence is high if used alone, hence not useful for prophylaxis also. +Chloroquine sensitive falci and vivax: Chloroquine l g, 500mg at 6, 24,48 hrs, followed by Primaquine 15mg for 14 days +Chloroquine resistant, uncomplicated falciparum: Oral quinine. Mefloquine, Doxy, Clindamycin, Oral Artesunate +### End" +619,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: 'Bird beak' appearance on barium swallow is feature of?, with the following options: A: Achalasia cardia, B: Diffuse esophageal spasm, C: Caustic stricture, D: Carcinoma of the esophagus + +### Response: +","Ans. A. Achalasia cardia. (Harrison's Medicine, 18th ch. 292; /Fig. 292-5).Achalasia cardia- Megaesophagus/sigmoid esophagus- ""Bird beak"" deformity- Absence of primary peristalsis below level of cricopharyngeus- Hurst phenomenon (temporary transit through cardia when hydrostatic pressure of barium column is above toxic LES pressure)- Vigorous achalasia (numerous tertiary contractions in non-dilated distal esophagus of early achalasia).Hiatus hernia- Epiphrenic bulge- >4 longitudinal coarse thick gastric folds above gastroesophageal junction or in the suprahiatal pouch- A Schatzki or B ring if present, is pathognomonic of a hiatal hernia because it marks the junction between squamous and columnar epithelium and represents the Z line.- Distance between B ring and hiatal margin > 2 cm- Peristalsis causes above hiatus.Schatzki ring (B ring/Lower esophageal mucosal ring, seen as a thin, web-like annular constriction at the esophagogastric junction is associated with a small hiatal hernia.Lye stricture(alkali/caustic strictures) - Long, tight and smooth stricturePeptic stricture- Short and tubular narrowing.Carcinoma oesophagus- Typical annular narrowing with overhang- ing margins and destruction of the mucosa.- 'Rat-tail' esophagus- Shouldering signLeomyoma/GIST- Smooth filling defect with right angles of origin from the esophageal wall (Submucosal smooth lesion)Cytomegalovirus esophagitis- iant ovoid flat ulcers (vasculitis of submucosal vessels)- Gastroesophageal junction with adjacent part of stomach is commonly affected.Herpes esophagitis- Discrete superficial punctate/linear serpentine/stellate/diamond shaped ulcers.Candidial esophagitis- Cobble stone mucosa- 'Shaggy' contour of the esophagus with small diffuse superficial ulcers- Irregular plaque-like filling defectsTertiary esophageal contractions (presbyesophagus, diffuse esophageal spasm, neuromuscular diseases)- ""Corkscrew"" appearance- ""Rosary-bead/Shish kebab"" configuration- ""Yo-Yo"" motion of bariumScleroderma- Esophageal shortening- Sliding hiatus hernia- Hidebound esophagus","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: 'Bird beak' appearance on barium swallow is feature of?, with the following options: A: Achalasia cardia, B: Diffuse esophageal spasm, C: Caustic stricture, D: Carcinoma of the esophagus + +### Response: +Ans. A. Achalasia cardia. (Harrison's Medicine, 18th ch. 292; /Fig. 292-5).Achalasia cardia- Megaesophagus/sigmoid esophagus- ""Bird beak"" deformity- Absence of primary peristalsis below level of cricopharyngeus- Hurst phenomenon (temporary transit through cardia when hydrostatic pressure of barium column is above toxic LES pressure)- Vigorous achalasia (numerous tertiary contractions in non-dilated distal esophagus of early achalasia).Hiatus hernia- Epiphrenic bulge- >4 longitudinal coarse thick gastric folds above gastroesophageal junction or in the suprahiatal pouch- A Schatzki or B ring if present, is pathognomonic of a hiatal hernia because it marks the junction between squamous and columnar epithelium and represents the Z line.- Distance between B ring and hiatal margin > 2 cm- Peristalsis causes above hiatus.Schatzki ring (B ring/Lower esophageal mucosal ring, seen as a thin, web-like annular constriction at the esophagogastric junction is associated with a small hiatal hernia.Lye stricture(alkali/caustic strictures) - Long, tight and smooth stricturePeptic stricture- Short and tubular narrowing.Carcinoma oesophagus- Typical annular narrowing with overhang- ing margins and destruction of the mucosa.- 'Rat-tail' esophagus- Shouldering signLeomyoma/GIST- Smooth filling defect with right angles of origin from the esophageal wall (Submucosal smooth lesion)Cytomegalovirus esophagitis- iant ovoid flat ulcers (vasculitis of submucosal vessels)- Gastroesophageal junction with adjacent part of stomach is commonly affected.Herpes esophagitis- Discrete superficial punctate/linear serpentine/stellate/diamond shaped ulcers.Candidial esophagitis- Cobble stone mucosa- 'Shaggy' contour of the esophagus with small diffuse superficial ulcers- Irregular plaque-like filling defectsTertiary esophageal contractions (presbyesophagus, diffuse esophageal spasm, neuromuscular diseases)- ""Corkscrew"" appearance- ""Rosary-bead/Shish kebab"" configuration- ""Yo-Yo"" motion of bariumScleroderma- Esophageal shortening- Sliding hiatus hernia- Hidebound esophagus +### End" +620,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Platelet are stored in -, with the following options: A: 22 +- 2degC, B: - 4degC, C: - 2degC, D: - 20degC + +### Response: +","Ans. is 'a' i.e., 22 +- 2degC Two methods of storage of platelats. 1. Liquid storage : Both whole blood derived and apheresis platelets concentrates may be storage for 5 days using following some principles. (a) Temperature must be 20_ 24degC. (b) Storage container must be constructed of a plastic material that allows adequate diffusion of 0; to meet cells metabolic needs. (c) Platelets concentrates must be agitated during storage. 2. Frozen Storage : The most widely used method for frozen storage employs controlled rate freezing (1degC/min); 5% DMSO as a cryoprotective agent.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Platelet are stored in -, with the following options: A: 22 +- 2degC, B: - 4degC, C: - 2degC, D: - 20degC + +### Response: +Ans. is 'a' i.e., 22 +- 2degC Two methods of storage of platelats. 1. Liquid storage : Both whole blood derived and apheresis platelets concentrates may be storage for 5 days using following some principles. (a) Temperature must be 20_ 24degC. (b) Storage container must be constructed of a plastic material that allows adequate diffusion of 0; to meet cells metabolic needs. (c) Platelets concentrates must be agitated during storage. 2. Frozen Storage : The most widely used method for frozen storage employs controlled rate freezing (1degC/min); 5% DMSO as a cryoprotective agent. +### End" +621,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 41 year old male presents with a weak flexor pollicis longus and flexor digitorum profundus of the index finger. The nerve inxolved could be -, with the following options: A: Ulnar nerve, B: Median nerve, C: Posterior interosseus nerve, D: Radial nerve + +### Response: +","Ans. is 'b' i.e., Median nerve * The various muscles supplied by median nerve are : -1) In the forearm# All the flexor muscles of the forearm, except the flexor carpi ulnaris and the medial half of flexor digitorum profundus to the ulnar two fingers.These muscles are: -i) Pronater teresiv) Flexor digitorum superficialvii) Pronator quadratusii) Flexor carpi radialisv) Flexor digitorum profundus (lateral half) iii) Palmaris longusvi) Flexor pollicis longus * Note: FDP (lateral half, pronator quadratus) and FPL are muscles of deep compartment of forearm, and are supplied by anterior interosseus branch of median nerve. Other muscles are supplied directly by median nerve.2) In hand# Median nerve supplies: -i) Thenar muscles (except adductor pollicis): - Flexor pollicis brevis, opponens pollicis and abductor pollicis brevis. Adductor pollicis is supplied by ulnar nerve.ii) First two lumbricals* Sensory supply by medial nerve is: -i). Lateral two thirds of palmii) Lateral three & half fingers on palmar side and distal phalanx of lateral three & half digits 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: A 41 year old male presents with a weak flexor pollicis longus and flexor digitorum profundus of the index finger. The nerve inxolved could be -, with the following options: A: Ulnar nerve, B: Median nerve, C: Posterior interosseus nerve, D: Radial nerve + +### Response: +Ans. is 'b' i.e., Median nerve * The various muscles supplied by median nerve are : -1) In the forearm# All the flexor muscles of the forearm, except the flexor carpi ulnaris and the medial half of flexor digitorum profundus to the ulnar two fingers.These muscles are: -i) Pronater teresiv) Flexor digitorum superficialvii) Pronator quadratusii) Flexor carpi radialisv) Flexor digitorum profundus (lateral half) iii) Palmaris longusvi) Flexor pollicis longus * Note: FDP (lateral half, pronator quadratus) and FPL are muscles of deep compartment of forearm, and are supplied by anterior interosseus branch of median nerve. Other muscles are supplied directly by median nerve.2) In hand# Median nerve supplies: -i) Thenar muscles (except adductor pollicis): - Flexor pollicis brevis, opponens pollicis and abductor pollicis brevis. Adductor pollicis is supplied by ulnar nerve.ii) First two lumbricals* Sensory supply by medial nerve is: -i). Lateral two thirds of palmii) Lateral three & half fingers on palmar side and distal phalanx of lateral three & half digits on dorsal side. +### End" +622,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Intravascular hemolysis is NOT associated with:, with the following options: A: Clostridium tetani, B: Baonella bacilliformis, C: Plasmodium falciparum, D: Babesia microti + +### Response: +","Baonella bacilliformis, Plasmodium falciparum and Babesia microti infects RBC s and produces intravascular hemolysis. Clostridium tetani produces exotoxins which is responsible for the clinical manifestations and is not associated with hemolysis. Ref: Harrisons principles of internal medicine, 18th edition, Page: 1099.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Intravascular hemolysis is NOT associated with:, with the following options: A: Clostridium tetani, B: Baonella bacilliformis, C: Plasmodium falciparum, D: Babesia microti + +### Response: +Baonella bacilliformis, Plasmodium falciparum and Babesia microti infects RBC s and produces intravascular hemolysis. Clostridium tetani produces exotoxins which is responsible for the clinical manifestations and is not associated with hemolysis. Ref: Harrisons principles of internal medicine, 18th edition, Page: 1099. +### End" +623,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Superior orbital fissure syndrome is frequently caused by:, with the following options: A: Carotid aneurysms, B: Meningioma, C: Arachnoiditis, D: All of the above + +### Response: +",Ans. 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: Superior orbital fissure syndrome is frequently caused by:, with the following options: A: Carotid aneurysms, B: Meningioma, C: Arachnoiditis, D: All of the above + +### Response: +Ans. All of the above +### End" +624,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 37-year-old primi Rh negative patient is very concerned above her pregnancy at this age. Her pregnancy is 16 weeks and she is HIV negative, hepatitis B surface Ag neg, Rubella nonimmune and has no complain.Her triple test repo is normal but still due to her age she insists on getting an amniocentesis done. Which of the following is the next best step in management:, with the following options: A: Advise against amniocentesis as it will increase the risk of isoimmunisation, B: Follow Rh titres carefully and give Anti D if evidence of isoimmunisation is present, C: Give Anti D at 28 weeks of pregnancy and after delivery if baby is Rh neg, D: Give Anti D prior to her amniocentesis + +### Response: +","Amniocentesis Precautions:prior sonographic localisation of placenta is desirable to preventbloody tap and fetomaternal bleeding.Prophylactic administration of 100mg of anti D immunoglobulin in Rh -ve nonimmunised mother.Hazards are reduced significantly when done under direct ultrasound control compared to blind procedure maternal complications: infection,hemorrhage,PROM,maternal isoimmunisation in Rh negative cases fetal complications: fetal loss,trauma.,oligohydramnios,fetal lung hypoplasia,respiratory distress D.C.DUTTA&;S TEXTBOOK OF OBSTETRICS,Pg no:648,7th edition","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 37-year-old primi Rh negative patient is very concerned above her pregnancy at this age. Her pregnancy is 16 weeks and she is HIV negative, hepatitis B surface Ag neg, Rubella nonimmune and has no complain.Her triple test repo is normal but still due to her age she insists on getting an amniocentesis done. Which of the following is the next best step in management:, with the following options: A: Advise against amniocentesis as it will increase the risk of isoimmunisation, B: Follow Rh titres carefully and give Anti D if evidence of isoimmunisation is present, C: Give Anti D at 28 weeks of pregnancy and after delivery if baby is Rh neg, D: Give Anti D prior to her amniocentesis + +### Response: +Amniocentesis Precautions:prior sonographic localisation of placenta is desirable to preventbloody tap and fetomaternal bleeding.Prophylactic administration of 100mg of anti D immunoglobulin in Rh -ve nonimmunised mother.Hazards are reduced significantly when done under direct ultrasound control compared to blind procedure maternal complications: infection,hemorrhage,PROM,maternal isoimmunisation in Rh negative cases fetal complications: fetal loss,trauma.,oligohydramnios,fetal lung hypoplasia,respiratory distress D.C.DUTTA&;S TEXTBOOK OF OBSTETRICS,Pg no:648,7th edition +### End" +625,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 32 year old male patient treated for high blood pressure with thiazides. Which of the following effect can happen in this patient?, with the following options: A: Hyperkalemic paralysis, B: Hypouricemia, C: Hypolipidemia, D: Impotence + +### Response: +","The incidence of erectile dysfunction is greater with thiazides than with several other antihypeensive agents (e.g., beta adrenergic receptor antagonists, Ca2+-channel blockers, or angiotensin conveing enzyme inhibitors). Other side effects include, CNS (e.g., veigo, headache, paresthesias, xanthopsia, and weakness) GI (e.g., anorexia, nausea, vomiting, cramping, diarrhea, constipation, cholecystitis, and pancreatitis) Hematological (e.g., blood dyscrasias) Dermatological (e.g., photosensitivity and skin rashes) Fluid and electrolyte imbalanceS (extracellular volume depletion, hypotension, hypokalemia, hyponatremia, hypochloremia, metabolic alkalosis, hypomagnesemia, hypercalcemia, and hyperuricemia) Increase in plasma levels of LDL cholesterol, total cholesterol, and total triglycerides Ref: Reilly R.F., Jackson E.K. (2011). Chapter 25. Regulation of Renal Function and Vascular Volume. 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 32 year old male patient treated for high blood pressure with thiazides. Which of the following effect can happen in this patient?, with the following options: A: Hyperkalemic paralysis, B: Hypouricemia, C: Hypolipidemia, D: Impotence + +### Response: +The incidence of erectile dysfunction is greater with thiazides than with several other antihypeensive agents (e.g., beta adrenergic receptor antagonists, Ca2+-channel blockers, or angiotensin conveing enzyme inhibitors). Other side effects include, CNS (e.g., veigo, headache, paresthesias, xanthopsia, and weakness) GI (e.g., anorexia, nausea, vomiting, cramping, diarrhea, constipation, cholecystitis, and pancreatitis) Hematological (e.g., blood dyscrasias) Dermatological (e.g., photosensitivity and skin rashes) Fluid and electrolyte imbalanceS (extracellular volume depletion, hypotension, hypokalemia, hyponatremia, hypochloremia, metabolic alkalosis, hypomagnesemia, hypercalcemia, and hyperuricemia) Increase in plasma levels of LDL cholesterol, total cholesterol, and total triglycerides Ref: Reilly R.F., Jackson E.K. (2011). Chapter 25. Regulation of Renal Function and Vascular Volume. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e. +### End" +626,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: SABE is most commonly due to:March 2013, with the following options: A: Staphylococcus aureus, B: Streptococcus pneumonia, C: Streptococcus viridans, D: HACEK group bacteria + +### Response: +","B i.e. Streptococcus viridansSubacute bacterial endocarditis/Endocarditis lentaIt can be considered a form of Type III hypersensitivity.It is usually caused by a form of streptococci viridians bacteria that normally live in the mouth and throat (Streptococcus mutans, mitis, sanguis or milleri).Osler's nodes can indicate this condition.Nail clubbing is also often seen in subacute endocarditis.In cases of subacute bacterial endocarditis, the causative organism (streptococcus viridans) needs a previous hea valve disease to colonize and cause such disease.On the other hand, in cases of acute bacterial endocarditis, the organism can colonize on the healthy hea valve, causing the disease.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: SABE is most commonly due to:March 2013, with the following options: A: Staphylococcus aureus, B: Streptococcus pneumonia, C: Streptococcus viridans, D: HACEK group bacteria + +### Response: +B i.e. Streptococcus viridansSubacute bacterial endocarditis/Endocarditis lentaIt can be considered a form of Type III hypersensitivity.It is usually caused by a form of streptococci viridians bacteria that normally live in the mouth and throat (Streptococcus mutans, mitis, sanguis or milleri).Osler's nodes can indicate this condition.Nail clubbing is also often seen in subacute endocarditis.In cases of subacute bacterial endocarditis, the causative organism (streptococcus viridans) needs a previous hea valve disease to colonize and cause such disease.On the other hand, in cases of acute bacterial endocarditis, the organism can colonize on the healthy hea valve, causing the disease. +### End" +627,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: You are administering anesthesia in a location that does not have an oxygen supply line. The E-cylinder that you are using reads 500 psig. Your oxygen flows are 10 L/min. Approximately how long does it take for your E-cylinder to empty, with the following options: A: 5 minutes, B: 15 minutes, C: 50 minutes, D: 100 minutes + +### Response: +","A full E-cylinder of oxygen contains 600 L of gas at a pressure of 2000 psig. Using Boyle law (P1 V1 = P2 V2 ) the volume of the paially depleted cylinder can be calculated, V2 = (P1 V1 )/P2 or V2 = (P1 /P2 ) x V1 . There is a quaer tank left, and therefore a quaer of 600 L, or 150 L. At 10 L/min, this volume of gas would last 15 minutes.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: You are administering anesthesia in a location that does not have an oxygen supply line. The E-cylinder that you are using reads 500 psig. Your oxygen flows are 10 L/min. Approximately how long does it take for your E-cylinder to empty, with the following options: A: 5 minutes, B: 15 minutes, C: 50 minutes, D: 100 minutes + +### Response: +A full E-cylinder of oxygen contains 600 L of gas at a pressure of 2000 psig. Using Boyle law (P1 V1 = P2 V2 ) the volume of the paially depleted cylinder can be calculated, V2 = (P1 V1 )/P2 or V2 = (P1 /P2 ) x V1 . There is a quaer tank left, and therefore a quaer of 600 L, or 150 L. At 10 L/min, this volume of gas would last 15 minutes. +### End" +628,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which among is not a primary skin lesion of:, with the following options: A: Plaque, B: Macule, C: Abscess, D: None + +### Response: +",C. i.e. Abscess,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which among is not a primary skin lesion of:, with the following options: A: Plaque, B: Macule, C: Abscess, D: None + +### Response: +C. i.e. Abscess +### End" +629,"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 ""lupus"" except, with the following options: A: Hydralazine, B: Clofibrate, C: Penicillamne, D: Chlorpromazine + +### Response: +",Drugs causing lupus sulfonamides hydralazine isoniazid procainamide anticonvulsants Lithium pencillamine diltiazem betablockers Sulfasalazine Interferon gamma TNF inhibitors iadvl textbook of dermatology page 1221,"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 ""lupus"" except, with the following options: A: Hydralazine, B: Clofibrate, C: Penicillamne, D: Chlorpromazine + +### Response: +Drugs causing lupus sulfonamides hydralazine isoniazid procainamide anticonvulsants Lithium pencillamine diltiazem betablockers Sulfasalazine Interferon gamma TNF inhibitors iadvl textbook of dermatology page 1221 +### End" +630,"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 poor prognostic factor in Acute Lymphoblastic Leukemia (ALL):, with the following options: A: Hyperdiploidy, B: t (9; 22); t (4; 11), C: 2-8 years of Age, D: WBC count < 50,000 + +### Response: +","Unourable cytogenetics in ALL are Philadelphia chromosomes t(9;22) & t(4;11) Ref: CMDT 2008 Edition, Page 447","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 poor prognostic factor in Acute Lymphoblastic Leukemia (ALL):, with the following options: A: Hyperdiploidy, B: t (9; 22); t (4; 11), C: 2-8 years of Age, D: WBC count < 50,000 + +### Response: +Unourable cytogenetics in ALL are Philadelphia chromosomes t(9;22) & t(4;11) Ref: CMDT 2008 Edition, Page 447 +### End" +631,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Dilator pupillae is supplied by, with the following options: A: postganglionic parasympathetic from Edingerwest phal nucleas, B: Postganglioninc sympathetic from cervical sympathetic chain, C: Third cranial nerve, D: Sympathatic fibres of fronto-orbital branch of trigeminal nerve + +### Response: +","ref : A K Khurana ophthalmology 6th edition (page no:7) Ganong 23/e p261,265 dilator pupillae muscle is supplied by the sympathetic fibers from the carotid plexus which enter the Gasserian ganglion of 5th cranial nerves. ultimately reach the muscle along with long ciliary branches of nasociliary nerves (ophthalmic division 5th CN)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Dilator pupillae is supplied by, with the following options: A: postganglionic parasympathetic from Edingerwest phal nucleas, B: Postganglioninc sympathetic from cervical sympathetic chain, C: Third cranial nerve, D: Sympathatic fibres of fronto-orbital branch of trigeminal nerve + +### Response: +ref : A K Khurana ophthalmology 6th edition (page no:7) Ganong 23/e p261,265 dilator pupillae muscle is supplied by the sympathetic fibers from the carotid plexus which enter the Gasserian ganglion of 5th cranial nerves. ultimately reach the muscle along with long ciliary branches of nasociliary nerves (ophthalmic division 5th CN) +### End" +632,"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 defensive virus -, with the following options: A: HAV, B: HBV, C: HCV, D: HDV + +### Response: +",Screening of blood donors for HBsAg automatically limit bloodborne HDV infection. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:550,"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 defensive virus -, with the following options: A: HAV, B: HBV, C: HCV, D: HDV + +### Response: +Screening of blood donors for HBsAg automatically limit bloodborne HDV infection. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:550 +### End" +633,"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 surgery for stress incontinence has highest success rate, with the following options: A: Bursch colposuspension, B: Pereyra sling, C: Kelly's stitch, D: Tension free vaginal tape (TVT) + +### Response: +","TENSION FREE VAGINAL TAPE TVT has been designed from non reactive synthetic material Procedure: After exposing the region of the bladder neck on vaginal dissection, the hammock of the tape is placed underneath it to provide suppo, at the mid urethral level, the lateral extensions are brought out paraurethrally on to the skin at the level of pubic symphisis and the vaginal incision is closed. After adjusting the proper elevation of the bladder neck region the extra length of the lateral arms of the tape is cut out. Success rate of 88-90% is claimed at the end of 3 years. Ref: SHAW&;S TEXTBOOK OF GYNAECOLOGY; 15th edition; Pg no: 194","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 surgery for stress incontinence has highest success rate, with the following options: A: Bursch colposuspension, B: Pereyra sling, C: Kelly's stitch, D: Tension free vaginal tape (TVT) + +### Response: +TENSION FREE VAGINAL TAPE TVT has been designed from non reactive synthetic material Procedure: After exposing the region of the bladder neck on vaginal dissection, the hammock of the tape is placed underneath it to provide suppo, at the mid urethral level, the lateral extensions are brought out paraurethrally on to the skin at the level of pubic symphisis and the vaginal incision is closed. After adjusting the proper elevation of the bladder neck region the extra length of the lateral arms of the tape is cut out. Success rate of 88-90% is claimed at the end of 3 years. Ref: SHAW&;S TEXTBOOK OF GYNAECOLOGY; 15th edition; Pg no: 194 +### End" +634,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pinta is caused by:, with the following options: A: Treponema peenue, B: Treponema carateum, C: Treponema pallidum, D: Treponema endemicum + +### Response: +","Pinta Non-sexually transmitted spircohetal infection caused by Treponema carateum. Three sub-species of T. pallidum are known: T. pallidum, which causes syphilis T. endemicum, which causes bejel or endemic syphilis T. peenue, which causes venereal syphilis or yaws","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pinta is caused by:, with the following options: A: Treponema peenue, B: Treponema carateum, C: Treponema pallidum, D: Treponema endemicum + +### Response: +Pinta Non-sexually transmitted spircohetal infection caused by Treponema carateum. Three sub-species of T. pallidum are known: T. pallidum, which causes syphilis T. endemicum, which causes bejel or endemic syphilis T. peenue, which causes venereal syphilis or yaws +### End" +635,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Aspirin in very low doses inhibits the formation of: September 2006, with the following options: A: Cyclooxygenase, B: Thromboxane A2, C: Prostaglandin 12, D: None of the above + +### Response: +",Ans. B: Thromboxane A2,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Aspirin in very low doses inhibits the formation of: September 2006, with the following options: A: Cyclooxygenase, B: Thromboxane A2, C: Prostaglandin 12, D: None of the above + +### Response: +Ans. B: Thromboxane A2 +### End" +636,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Scabies is caused by a small mite that burrows into the skin. The disease is best described by which one of the following statements?, with the following options: A: It is caused by a species of Sarcoptes, B: Secondary bacterial infection is rare, C: It is synonymous with Kawasaki's syndrome, D: It is best diagnosed by biopsy of the inflammatory region around the mite bite + +### Response: +","Sarcoptes scabiei is a small mite that burrows into human skin. Itching is significant, and a vesicular eruption, which often becomes secondarily infected with bacteria, develops. Diagnosis is made by microscopic detection of the mites. Gamma benzene hexachloride (Kwell), a topical insecticide, is an effective treatment for scabies. A number of etiologic agents have been proposed for Kawasaki's disease (KD), among them mites, but there is no evidence that mites either cause or are vectors of KD.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Scabies is caused by a small mite that burrows into the skin. The disease is best described by which one of the following statements?, with the following options: A: It is caused by a species of Sarcoptes, B: Secondary bacterial infection is rare, C: It is synonymous with Kawasaki's syndrome, D: It is best diagnosed by biopsy of the inflammatory region around the mite bite + +### Response: +Sarcoptes scabiei is a small mite that burrows into human skin. Itching is significant, and a vesicular eruption, which often becomes secondarily infected with bacteria, develops. Diagnosis is made by microscopic detection of the mites. Gamma benzene hexachloride (Kwell), a topical insecticide, is an effective treatment for scabies. A number of etiologic agents have been proposed for Kawasaki's disease (KD), among them mites, but there is no evidence that mites either cause or are vectors of KD. +### End" +637,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: To detect a 4 mm nodule in the pancreas, the investigation of your choice would be?, with the following options: A: PET scan, B: Endoscopic USG, C: CECT, D: MRI + +### Response: +","In detection and staging of small tumors EUS (Endoscopic ultrasound) is reliable. EUS is used in the detection of tumors smaller than 2 cm. EUS has a high sensitivity and specificity for pancreatic cancer, with an overall staging accuracy higher than 80%. The possibility of performing EUS-guided FNA significantly improves both diagnostic and staging capability of EUS Contrast enhanced CT is generally accepted as first line of investigation for suspected pancreatic cancer. MRI appears to be more valuable for staging the extent and spread of pancreatic carcinoma than for tumor detection of lesions smaller than 2 cm. PET scan is usually reserved, to confirm malignancy, to differentiate between carcinoma and a focal nodular pancreatitis and to recognize distant metastasis. In general, the sensitivity of PET is high in the detection of lesions more than a centimeter in diameter.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: To detect a 4 mm nodule in the pancreas, the investigation of your choice would be?, with the following options: A: PET scan, B: Endoscopic USG, C: CECT, D: MRI + +### Response: +In detection and staging of small tumors EUS (Endoscopic ultrasound) is reliable. EUS is used in the detection of tumors smaller than 2 cm. EUS has a high sensitivity and specificity for pancreatic cancer, with an overall staging accuracy higher than 80%. The possibility of performing EUS-guided FNA significantly improves both diagnostic and staging capability of EUS Contrast enhanced CT is generally accepted as first line of investigation for suspected pancreatic cancer. MRI appears to be more valuable for staging the extent and spread of pancreatic carcinoma than for tumor detection of lesions smaller than 2 cm. PET scan is usually reserved, to confirm malignancy, to differentiate between carcinoma and a focal nodular pancreatitis and to recognize distant metastasis. In general, the sensitivity of PET is high in the detection of lesions more than a centimeter in diameter. +### End" +638,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Myelin sheath in the central nervous system is formed by, with the following options: A: Schwann cell, B: Microglia, C: Oligodendrocytes, D: Protoplasmic astrocytes + +### Response: +","Oligodendrocytes are responsible for myelination in the CNS. In the PNS, Schwann cells form the myelin sheath. The process of myelination begins before bih and is not complete until a year or more after bih. (Ref: Vishram Singh textbook of neuroanatomy, second edition, pg- 19)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Myelin sheath in the central nervous system is formed by, with the following options: A: Schwann cell, B: Microglia, C: Oligodendrocytes, D: Protoplasmic astrocytes + +### Response: +Oligodendrocytes are responsible for myelination in the CNS. In the PNS, Schwann cells form the myelin sheath. The process of myelination begins before bih and is not complete until a year or more after bih. (Ref: Vishram Singh textbook of neuroanatomy, second edition, pg- 19) +### End" +639,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Alveolar hemorrhage is seen in all except-, with the following options: A: Idiopathic pulmonary fibrosis, B: Pulmonary cpillaritis, C: SLe, D: Microscopic polyantitis + +### Response: +","IDIOPATHIC PULMONARY FIBROSIS PATHOGENESIS. The pathogenesis of idiopathic pulmonary fibrosis is unknown and the condition is diagnosed by excluding all known causes of interstitial fibrosis. However, a few shreds of evidence point toward the immunologic mechanism: 1. High levels of autoantibodies such as rheumatoid factor and antinuclear antibodies. 2. Elevated titers of circulating immune complexes. 3. Immunofluorescent demonstration of the deposits of immunoglobulins and complement on the alveolar walls in biopsy specimens. CLINICAL FEATURES. Middle-aged males are affected more frequently. The usual features are of respiratory difficulty beginning with dry cough and slowly progressing dyspnoea. More advanced cases may develop clubbing of fingers and cor pulmonale. A rapidly progressive form of the idiopathic pulmonary fibrosis with death within 6 weeks to 6 months is termed Hamman-Rich syndrome. Ref: Harsh Mohan - Textbook of Pathology, 6th Edition.page no.496","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Alveolar hemorrhage is seen in all except-, with the following options: A: Idiopathic pulmonary fibrosis, B: Pulmonary cpillaritis, C: SLe, D: Microscopic polyantitis + +### Response: +IDIOPATHIC PULMONARY FIBROSIS PATHOGENESIS. The pathogenesis of idiopathic pulmonary fibrosis is unknown and the condition is diagnosed by excluding all known causes of interstitial fibrosis. However, a few shreds of evidence point toward the immunologic mechanism: 1. High levels of autoantibodies such as rheumatoid factor and antinuclear antibodies. 2. Elevated titers of circulating immune complexes. 3. Immunofluorescent demonstration of the deposits of immunoglobulins and complement on the alveolar walls in biopsy specimens. CLINICAL FEATURES. Middle-aged males are affected more frequently. The usual features are of respiratory difficulty beginning with dry cough and slowly progressing dyspnoea. More advanced cases may develop clubbing of fingers and cor pulmonale. A rapidly progressive form of the idiopathic pulmonary fibrosis with death within 6 weeks to 6 months is termed Hamman-Rich syndrome. Ref: Harsh Mohan - Textbook of Pathology, 6th Edition.page no.496 +### End" +640,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which vitamins are synthesised by intestinal bacteria ?a) Vit K and Db) Vit K and B12c) Vit K and H (biotin)d) Vit K and E, with the following options: A: ab, B: bc, C: abd, D: cd + +### Response: +","Vitamins formed by bacterial activity are vitamin K, vitamin B12, thiamine, riboflavin and biotin (vitamin H).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which vitamins are synthesised by intestinal bacteria ?a) Vit K and Db) Vit K and B12c) Vit K and H (biotin)d) Vit K and E, with the following options: A: ab, B: bc, C: abd, D: cd + +### Response: +Vitamins formed by bacterial activity are vitamin K, vitamin B12, thiamine, riboflavin and biotin (vitamin H). +### End" +641,"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 man admitted with a pathological fracture on examination he was found to be anemic, laboratory examination showed ESR: 100mm/hr, X-ray - multiple lytic lesions. Peripheral smear showed increased rouleaux formation of the red cells and thrombocytopenia. Bone marrow examination confirmed the diagnosis, with the following options: A: CML, B: Vitamin D deficiency, C: Multiple myeloma, D: Diffuse large B Cell Lymphoma + +### Response: +",Above clinical features are charateristic of multiple mycloma.,"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 man admitted with a pathological fracture on examination he was found to be anemic, laboratory examination showed ESR: 100mm/hr, X-ray - multiple lytic lesions. Peripheral smear showed increased rouleaux formation of the red cells and thrombocytopenia. Bone marrow examination confirmed the diagnosis, with the following options: A: CML, B: Vitamin D deficiency, C: Multiple myeloma, D: Diffuse large B Cell Lymphoma + +### Response: +Above clinical features are charateristic of multiple mycloma. +### End" +642,"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 contents of deep perineal pouch except, with the following options: A: Bulbourethral glands, B: Internal urethral sphincter, C: Dorsal nerve of penis, D: Bulb of penis + +### Response: +",The deep perineal pouch contains: Deep transverse perineal muscle External sphincter muscle of urethra External sphincter muscle of urethra (male) Compressor Urethrae Muscle (female) Urethrovaginal Sphincter (female) Membranous poion of the urethra (males) Bulbourethral gland (males) Vagina (females),"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 contents of deep perineal pouch except, with the following options: A: Bulbourethral glands, B: Internal urethral sphincter, C: Dorsal nerve of penis, D: Bulb of penis + +### Response: +The deep perineal pouch contains: Deep transverse perineal muscle External sphincter muscle of urethra External sphincter muscle of urethra (male) Compressor Urethrae Muscle (female) Urethrovaginal Sphincter (female) Membranous poion of the urethra (males) Bulbourethral gland (males) Vagina (females) +### End" +643,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Person preoccupied by worries about ill health is :, with the following options: A: Hypochondriac, B: Maniac, C: Depressed, D: Delirium + +### Response: +",A i.e. Hypochondriasis,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Person preoccupied by worries about ill health is :, with the following options: A: Hypochondriac, B: Maniac, C: Depressed, D: Delirium + +### Response: +A i.e. Hypochondriasis +### End" +644,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mallory-Weiss tear occurs at, with the following options: A: Gastro-oesophageal junction, B: Duodeno-jejunal flexure, C: Ileo-caecal junction, D: Colo-rectal junction + +### Response: +","MALLORY WEISS syndrome is seen in adults with severe prolonged vomiting, causing a longitudinal tear in the mucosa of the stomach at and just below the cardia leading to severe hematemesis.Violent vomiting may be due to a migraine or veigo or following a bout of alcohol.Common in 1 o' clock position.Investigations include Hb%, PCV.Treatment includes blood transfusion, IV fluids, sedation and hemostatic agents such as vasopressin. Ref: SRB&;s manual of surgery,5th ed, pg no 803","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mallory-Weiss tear occurs at, with the following options: A: Gastro-oesophageal junction, B: Duodeno-jejunal flexure, C: Ileo-caecal junction, D: Colo-rectal junction + +### Response: +MALLORY WEISS syndrome is seen in adults with severe prolonged vomiting, causing a longitudinal tear in the mucosa of the stomach at and just below the cardia leading to severe hematemesis.Violent vomiting may be due to a migraine or veigo or following a bout of alcohol.Common in 1 o' clock position.Investigations include Hb%, PCV.Treatment includes blood transfusion, IV fluids, sedation and hemostatic agents such as vasopressin. Ref: SRB&;s manual of surgery,5th ed, pg no 803 +### End" +645,"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 pouchitis except:, with the following options: A: Probiotics have shown promising response, B: Cause may be related to mucosal ischemia, C: Most commonly seen in ulcerative colitis surgeries, D: Episodes of pouchitis will not respond to antibiotics + +### Response: +",Ans. (d) Episodes of pouchitis will not respond to antibioticsTreatment protocol for pouchitis:* 1st line: Ciplox + Metronidazole* 2nd line: Probiotics added* 3rd line: Add ASA compounds* 4th line: Pouchectomy and permanent ileostomy,"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 pouchitis except:, with the following options: A: Probiotics have shown promising response, B: Cause may be related to mucosal ischemia, C: Most commonly seen in ulcerative colitis surgeries, D: Episodes of pouchitis will not respond to antibiotics + +### Response: +Ans. (d) Episodes of pouchitis will not respond to antibioticsTreatment protocol for pouchitis:* 1st line: Ciplox + Metronidazole* 2nd line: Probiotics added* 3rd line: Add ASA compounds* 4th line: Pouchectomy and permanent ileostomy +### End" +646,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: MDR TB must be treated for at least ?, with the following options: A: 12 months, B: 18 months, C: 20 months, D: 36 months + +### Response: +","Ans. is 'c' i.e., 20 months Resistance (or intolerance) to H Throughout (6) RZE Resistance (or intolerance) to R Throughout (12-18) HZEQ Resistance to H + R Throughout (at least 20 months) ZEQ + S (for another injectable agents) Resistance to all first-line drugs Throughout (at least 20 months 1 injectable agent + 3 of of these 4 ethionamide cycloserine, Q, PAS Intolerance to Z HRE","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: MDR TB must be treated for at least ?, with the following options: A: 12 months, B: 18 months, C: 20 months, D: 36 months + +### Response: +Ans. is 'c' i.e., 20 months Resistance (or intolerance) to H Throughout (6) RZE Resistance (or intolerance) to R Throughout (12-18) HZEQ Resistance to H + R Throughout (at least 20 months) ZEQ + S (for another injectable agents) Resistance to all first-line drugs Throughout (at least 20 months 1 injectable agent + 3 of of these 4 ethionamide cycloserine, Q, PAS Intolerance to Z HRE +### End" +647,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Who can be considerd as an expe witness :, with the following options: A: Medical men, B: Firearm expe, C: Chemical examiner, D: All + +### Response: +",D i.e. All,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Who can be considerd as an expe witness :, with the following options: A: Medical men, B: Firearm expe, C: Chemical examiner, D: All + +### Response: +D i.e. All +### End" +648,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Major aim of phase 1 clinical trials is to know the, with the following options: A: Safety, B: Efficacy, C: Maximum Tolerable Dose, D: Pharmacokinetics + +### Response: +","Phase I trial is designed as a dose-escalation study to determine the maximum tolerable dosage (MTD), that is, the maximum dose associated with an acceptable level of dose-limiting toxicity. Phase 1 Clinical Trials: The drug is tested in healthy human volunteers (extremes of ages ; elderly and children are excluded). As the drug is not tested in the patients, so we cannot determine efficacy in this phase. This is mainly for finding the maximum tolerable dose of the drug. This is first in human study. Because anti-cancer drugs can produce unacceptable toxicity and we cannot expose healthy humans to such a toxicity, the phase-1 trials for anticancer drugs are done in the patients","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Major aim of phase 1 clinical trials is to know the, with the following options: A: Safety, B: Efficacy, C: Maximum Tolerable Dose, D: Pharmacokinetics + +### Response: +Phase I trial is designed as a dose-escalation study to determine the maximum tolerable dosage (MTD), that is, the maximum dose associated with an acceptable level of dose-limiting toxicity. Phase 1 Clinical Trials: The drug is tested in healthy human volunteers (extremes of ages ; elderly and children are excluded). As the drug is not tested in the patients, so we cannot determine efficacy in this phase. This is mainly for finding the maximum tolerable dose of the drug. This is first in human study. Because anti-cancer drugs can produce unacceptable toxicity and we cannot expose healthy humans to such a toxicity, the phase-1 trials for anticancer drugs are done in the patients +### End" +649,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Decreased erythropoietin levels are seen in:, with the following options: A: End stage renal disease, B: Heart failure, C: Polycytic kidney disease, D: Advanced Liver failure + +### Response: +","Ans: A (End stage renal disease) Ref: Harrison's Principles of Internal Medicine, 18th ed.Explanation:End-stage renal disease is replaced by the term stage 5 CKD (Chronic kidney disease).""The primary cause in patients with CKD is insufficient production of erythropoietin (EPO) by the diseased kidneys "" Ref: Harrison.Causes of Anemia in CKDRelative deficiency of erythropoietinDiminished red blood cell survivalBleeding diathesisIron deficiencyHyperparathvroidism/bone marrow fibrosisChronic inflammationFolate or vitamin B12 deficiencyHemoglobinopathyComorbid disease","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Decreased erythropoietin levels are seen in:, with the following options: A: End stage renal disease, B: Heart failure, C: Polycytic kidney disease, D: Advanced Liver failure + +### Response: +Ans: A (End stage renal disease) Ref: Harrison's Principles of Internal Medicine, 18th ed.Explanation:End-stage renal disease is replaced by the term stage 5 CKD (Chronic kidney disease).""The primary cause in patients with CKD is insufficient production of erythropoietin (EPO) by the diseased kidneys "" Ref: Harrison.Causes of Anemia in CKDRelative deficiency of erythropoietinDiminished red blood cell survivalBleeding diathesisIron deficiencyHyperparathvroidism/bone marrow fibrosisChronic inflammationFolate or vitamin B12 deficiencyHemoglobinopathyComorbid disease +### End" +650,"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 are true regarding 'Bare lymphocyte syndrome', except:-, with the following options: A: Autosomal recessive inheritance, B: Defect in b2-Microglobulin, C: MHC overexpression, D: MHC non-expression + +### Response: +","BLS (Bare Lymphocyte Syndrome): Deficiencies in MHC class I or class II are called bare-lymphocyte syndrome, reflecting the absence of these proteins from cell surfaces. The impoant and ubiquitous role of MHC class I molecules is highlighted in patients with defective expression of all class I proteins. This rare immunodeficiency disorder can be caused by mutations in b2-microglobulin, a subunit of MHC class I proteins, or in the TAP proteins, which are vital to antigen presentation by MHC class I molecules. In early life, the TAP-deficient individual suffers frequent bacterial infections of the upper respiratory tract and in the second decade begins to experience chronic infection of the lungs. The most characteristic mark of the deficiency is the occurrence of necrotizing skin lesions on the extremities and the midface. These defects affecting MHC class I proteins result in impaired positive selection of CD8 T cells, depressed cell-mediated immunity, and heightened susceptibility to viral infection. Disorder Specific defect Impaired immune function Inheritance mode Bare-lymphocytesyndrome (BLS): MHCdeficiencies Class I: b2-Microglobulin, TAPpeptide transpoer, tapasin No/reduced MHC class I expression, reducing numberof CD8 T cells Autosomal Recessive (AR) Bare-lymphocytesyndrome (BLS): MHCdeficiencies Class II: Defect intranscription factorsactivating MHCII geneexpression No MHC class II molecules, reducing numbers of CD4T cells Autosomal Recessive (AR)","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 are true regarding 'Bare lymphocyte syndrome', except:-, with the following options: A: Autosomal recessive inheritance, B: Defect in b2-Microglobulin, C: MHC overexpression, D: MHC non-expression + +### Response: +BLS (Bare Lymphocyte Syndrome): Deficiencies in MHC class I or class II are called bare-lymphocyte syndrome, reflecting the absence of these proteins from cell surfaces. The impoant and ubiquitous role of MHC class I molecules is highlighted in patients with defective expression of all class I proteins. This rare immunodeficiency disorder can be caused by mutations in b2-microglobulin, a subunit of MHC class I proteins, or in the TAP proteins, which are vital to antigen presentation by MHC class I molecules. In early life, the TAP-deficient individual suffers frequent bacterial infections of the upper respiratory tract and in the second decade begins to experience chronic infection of the lungs. The most characteristic mark of the deficiency is the occurrence of necrotizing skin lesions on the extremities and the midface. These defects affecting MHC class I proteins result in impaired positive selection of CD8 T cells, depressed cell-mediated immunity, and heightened susceptibility to viral infection. Disorder Specific defect Impaired immune function Inheritance mode Bare-lymphocytesyndrome (BLS): MHCdeficiencies Class I: b2-Microglobulin, TAPpeptide transpoer, tapasin No/reduced MHC class I expression, reducing numberof CD8 T cells Autosomal Recessive (AR) Bare-lymphocytesyndrome (BLS): MHCdeficiencies Class II: Defect intranscription factorsactivating MHCII geneexpression No MHC class II molecules, reducing numbers of CD4T cells Autosomal Recessive (AR) +### End" +651,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: ""Osteosclerotic"" bone metastasis is found most commonly in which carcinoma:, with the following options: A: Kidney, B: Thyroid, C: Lung, D: Prostate + +### Response: +",Prostate,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: ""Osteosclerotic"" bone metastasis is found most commonly in which carcinoma:, with the following options: A: Kidney, B: Thyroid, C: Lung, D: Prostate + +### Response: +Prostate +### End" +652,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Equilibrium potential of Cl- ions ?, with the following options: A: + 60 mV, B: +90 mV, C: -90 mV, D: -70 mV + +### Response: +","Ans. is d i.e., -70 mV","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Equilibrium potential of Cl- ions ?, with the following options: A: + 60 mV, B: +90 mV, C: -90 mV, D: -70 mV + +### Response: +Ans. is d i.e., -70 mV +### End" +653,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Tissue biopsy for histopathological examination should be sent in: DNB 09, with the following options: A: Normal saline, B: Formalin, C: Rectified spirit, D: Saturated solution of saline + +### Response: +",Ans. Formalin,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Tissue biopsy for histopathological examination should be sent in: DNB 09, with the following options: A: Normal saline, B: Formalin, C: Rectified spirit, D: Saturated solution of saline + +### Response: +Ans. Formalin +### End" +654,"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 investigations is not required in Osteosarcoma?, with the following options: A: MRI, B: Bone marrow biopsy, C: CT chest, D: Bone scan + +### Response: +","A biopsy from the lesion is essential for grading of the tumour but a biopsy from bone marrow is not indicated. Bone scan, CT chest and MR1 femur are impoant staging investigations for osteosarcoma. Ref: Apley's system of ohopaedics and fractures 8th/185; Pediatric and Adolescent Osteosarcoma By Norman Jaffe, Oyvind S. Bruland, 2009, Page 209; Final FRCR 2B Long Cases: A Survival Guide By Jessie Aw, John Cuis, 2010, Page 165.","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 investigations is not required in Osteosarcoma?, with the following options: A: MRI, B: Bone marrow biopsy, C: CT chest, D: Bone scan + +### Response: +A biopsy from the lesion is essential for grading of the tumour but a biopsy from bone marrow is not indicated. Bone scan, CT chest and MR1 femur are impoant staging investigations for osteosarcoma. Ref: Apley's system of ohopaedics and fractures 8th/185; Pediatric and Adolescent Osteosarcoma By Norman Jaffe, Oyvind S. Bruland, 2009, Page 209; Final FRCR 2B Long Cases: A Survival Guide By Jessie Aw, John Cuis, 2010, Page 165. +### End" +655,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: USG is/are based on:, with the following options: A: Piezoelectric effect, B: Diamagnetic effect, C: Paramagnetic effect, D: Ferromagnetic effect + +### Response: +",Ans. A. Piezoelectric effectUltrasonography:Ultrasonic image(sonographic/echographic) is based on mechanical oscillations of the crystal excited by electrical pulses (Piezoelectric effect).,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: USG is/are based on:, with the following options: A: Piezoelectric effect, B: Diamagnetic effect, C: Paramagnetic effect, D: Ferromagnetic effect + +### Response: +Ans. A. Piezoelectric effectUltrasonography:Ultrasonic image(sonographic/echographic) is based on mechanical oscillations of the crystal excited by electrical pulses (Piezoelectric effect). +### End" +656,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Spleen develops from ?, with the following options: A: Ventral mesogastrium, B: Dorsal mesogastrium, C: Hindgut mesentery, D: Midgut mesentery + +### Response: +","Spleen develops in cephalic pa of dorsal mesogastrium from its left layer during 6th week of intrauterine life into a number of nodule which soon fuse to form a lobulated spleen.Notching of superior border is an evidence of its multiple origin.The nodules which fail to fuse form accessory/supernumerary -spleen or spleniculi.These may be found at :i) Hilum of spleen (most common site).ii) Tail of pancrease.iii) Derivatives ofdorsal mesogastrium :- Greater omentum, gastrophrenic ligament, gastrosplenic ligament, linorenal ligament.iv) Broad ligament of uterus (in males) and spermatic cord (in female); both left side.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Spleen develops from ?, with the following options: A: Ventral mesogastrium, B: Dorsal mesogastrium, C: Hindgut mesentery, D: Midgut mesentery + +### Response: +Spleen develops in cephalic pa of dorsal mesogastrium from its left layer during 6th week of intrauterine life into a number of nodule which soon fuse to form a lobulated spleen.Notching of superior border is an evidence of its multiple origin.The nodules which fail to fuse form accessory/supernumerary -spleen or spleniculi.These may be found at :i) Hilum of spleen (most common site).ii) Tail of pancrease.iii) Derivatives ofdorsal mesogastrium :- Greater omentum, gastrophrenic ligament, gastrosplenic ligament, linorenal ligament.iv) Broad ligament of uterus (in males) and spermatic cord (in female); both left side. +### End" +657,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cytokines are released by: September 2012, with the following options: A: Monocyte, B: Macrophage, C: T lymphocyte, D: B lymphocyte + +### Response: +","Ans. C i.e. T lymphocyte T helper cells (Th cells) They are a sub-group of lymphocytes that play an impoant role in the immune system, paicularly in the adaptive immune system. They help the activity of other immune cells by releasing T cell cytokines. They are essential in B cell antibody class switching, in the activation and growth of cytotoxic T cells, and in maximizing bactericidal activity of phagocytes such as macrophages.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cytokines are released by: September 2012, with the following options: A: Monocyte, B: Macrophage, C: T lymphocyte, D: B lymphocyte + +### Response: +Ans. C i.e. T lymphocyte T helper cells (Th cells) They are a sub-group of lymphocytes that play an impoant role in the immune system, paicularly in the adaptive immune system. They help the activity of other immune cells by releasing T cell cytokines. They are essential in B cell antibody class switching, in the activation and growth of cytotoxic T cells, and in maximizing bactericidal activity of phagocytes such as macrophages. +### End" +658,"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: +",Natural prostaglandin in body is PG E2 whereas Misoprostol and alprostadil are synthetic prostaglandins which are PG E1 analogues. Refer kDT 6/e p181,"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: +Natural prostaglandin in body is PG E2 whereas Misoprostol and alprostadil are synthetic prostaglandins which are PG E1 analogues. Refer kDT 6/e p181 +### End" +659,"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 absolute contraindication to liver transplantation?, with the following options: A: Age >70, B: Poal vein thrombosis, C: Severe obesity, D: AIDS + +### Response: +",Absolute contraindications Relative contraindications Uncontrolled hepatobiliary infection Age >70 Sepsis Poal vein thrombosis AIDS Severe obesity Cholangiocarcinoma HIV sero-positivity with low CD4 counts Metastasis to liver PAH Advanced cardiopulmonary disease Psychiatric disorders Active substance/ alcohol abuse Congenital anomaly (Uncorrectable),"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 absolute contraindication to liver transplantation?, with the following options: A: Age >70, B: Poal vein thrombosis, C: Severe obesity, D: AIDS + +### Response: +Absolute contraindications Relative contraindications Uncontrolled hepatobiliary infection Age >70 Sepsis Poal vein thrombosis AIDS Severe obesity Cholangiocarcinoma HIV sero-positivity with low CD4 counts Metastasis to liver PAH Advanced cardiopulmonary disease Psychiatric disorders Active substance/ alcohol abuse Congenital anomaly (Uncorrectable) +### End" +660,"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 chronic osteomyelitis, with the following options: A: Staphylococcus aureus, B: Streptococcus pyogenes, C: Mycobacterium tuberculosis, D: Staphylococcus epidermidis + +### Response: +","Chronic osteomyelitis is nearly always a sequel to acute osteomyelitisOccasionally infection is subacute or chronic from the beginningAs with acute osteomyelitis, the most common causative organism is staphylococcus areus(Refer: Mohindra's Fundamentals of Ohopedics, 2nd edition, pg no. 283, 284)","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 chronic osteomyelitis, with the following options: A: Staphylococcus aureus, B: Streptococcus pyogenes, C: Mycobacterium tuberculosis, D: Staphylococcus epidermidis + +### Response: +Chronic osteomyelitis is nearly always a sequel to acute osteomyelitisOccasionally infection is subacute or chronic from the beginningAs with acute osteomyelitis, the most common causative organism is staphylococcus areus(Refer: Mohindra's Fundamentals of Ohopedics, 2nd edition, pg no. 283, 284) +### End" +661,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ramsay Hunt syndrome is caused by infection of:, with the following options: A: Herpex simplex, B: Varicella zoster, C: Adenovirus, D: Picornavirus + +### Response: +","Varicella zoster virus may also cause facial nerve paralysis when the virus reactivates from dormancy in the nerve. This condition, known as Ramsay Hunt syndrome, is characterized by severe otalgia followed by the eruption of vesicles of the external ear. Treatment is similar to Bell's palsy, but full recovery is only seen in approximately two thirds of cases. Ref: Schwaz's principle of surgery 9th edition, chapter 18.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ramsay Hunt syndrome is caused by infection of:, with the following options: A: Herpex simplex, B: Varicella zoster, C: Adenovirus, D: Picornavirus + +### Response: +Varicella zoster virus may also cause facial nerve paralysis when the virus reactivates from dormancy in the nerve. This condition, known as Ramsay Hunt syndrome, is characterized by severe otalgia followed by the eruption of vesicles of the external ear. Treatment is similar to Bell's palsy, but full recovery is only seen in approximately two thirds of cases. Ref: Schwaz's principle of surgery 9th edition, chapter 18. +### End" +662,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All visual reflexes are developed by:, with the following options: A: 1 year, B: 2 year, C: 5 year, D: 10 year + +### Response: +",Ans. 1 year,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All visual reflexes are developed by:, with the following options: A: 1 year, B: 2 year, C: 5 year, D: 10 year + +### Response: +Ans. 1 year +### End" +663,"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 derivatives of the septum transversum except :, with the following options: A: Falciform ligament, B: Coronary ligament, C: Mesentery of the lesser sac, D: Ligamentum teres + +### Response: +","Ligamentum teres Ligamentum teres is the obliterated left umbilical vein.Septum transversum is a thick plate of mesodermal tissue that occupies the space between the thoracic cavity and yolk stalk.Ventral mesentery of stomach is derived from septum transversum.Ventral mesentery is divided into two pas by the growth of liver into it. The pa between stomach & liver becomes the lesser omentum while the pa b/w liver and the diaphragm (and the anterior abdominal wall) gives rise to the coronary & falciform, ligaments of the liverThe free margin of the falciform ligament contains the left umbilical vein which is obliterated after bih to form ligamentum teres or round ligament of the liver.Also knowCentral tendon of the diaphragm is also derived from septum transversum.Ligamentum teres is impoant in abdominal surgery as- It's division is the first step in the mobilization of liver.- It is a landmark and guide to the segment III hepatic duet used in hepaticojejunostomy formation.Ligament= venosum is obliterated venous connection that existed between the left poal vein and the left hepatic vein in fetal life","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 derivatives of the septum transversum except :, with the following options: A: Falciform ligament, B: Coronary ligament, C: Mesentery of the lesser sac, D: Ligamentum teres + +### Response: +Ligamentum teres Ligamentum teres is the obliterated left umbilical vein.Septum transversum is a thick plate of mesodermal tissue that occupies the space between the thoracic cavity and yolk stalk.Ventral mesentery of stomach is derived from septum transversum.Ventral mesentery is divided into two pas by the growth of liver into it. The pa between stomach & liver becomes the lesser omentum while the pa b/w liver and the diaphragm (and the anterior abdominal wall) gives rise to the coronary & falciform, ligaments of the liverThe free margin of the falciform ligament contains the left umbilical vein which is obliterated after bih to form ligamentum teres or round ligament of the liver.Also knowCentral tendon of the diaphragm is also derived from septum transversum.Ligamentum teres is impoant in abdominal surgery as- It's division is the first step in the mobilization of liver.- It is a landmark and guide to the segment III hepatic duet used in hepaticojejunostomy formation.Ligament= venosum is obliterated venous connection that existed between the left poal vein and the left hepatic vein in fetal life +### End" +664,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: With regard to ketamine, all of the following are true except –, with the following options: A: It is a direct myocardial depressant, B: Emergence phenomenon are more likely if anticholinergic premedication is used, C: It may induce cardiac dysarythmias in patients receiving tricyclic antidepressants, D: Has no effect on intracranial pressure + +### Response: +",Ketamine raises ICT.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: With regard to ketamine, all of the following are true except –, with the following options: A: It is a direct myocardial depressant, B: Emergence phenomenon are more likely if anticholinergic premedication is used, C: It may induce cardiac dysarythmias in patients receiving tricyclic antidepressants, D: Has no effect on intracranial pressure + +### Response: +Ketamine raises ICT. +### End" +665,"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 old male presents with a skin rash and epistaxis. He has had several, severe sinopulmonary infections. A careful history reveals that his maternal uncle died of bleeding complications following an emergency cholecystectomy. What additional findings are likely in this case?, with the following options: A: A CD4/CD8 ratio of < 1.5:1, B: Cerebellar ataxia, C: Elevated platelet count and high serum IgG, IgA, and IgE levels, D: Low platelet count and low serum IgM levels + +### Response: +","This clinical scenario is typical for Wiskott-Aldrich syndrome. This is a sex-linked recessive disorder presenting with the triad of thrombocytopenia, eczema, and recurrent sinopulmonary infections. Serum IgM levels are low but IgG, IgA, and IgE levels are increased. Patients have a defective response to polysaccharide antigens, which is due to a cytoskeletal defect in T cells that inhibits their binding to B cells. A CD4/CD8 ratio of < 1.5:1 is the pattern seen in AIDS due to selective tropism of the CD4+ T-helper cell population. Cerebellar ataxia is pa of the ataxia-telangiectasia syndrome. The ataxia develops between age 2 and 5. The defect is associated with a DNA repair enzyme deficiency. Elevated platelet count and increased serum levels of IgG, IgA, and IgE is not associated with a paicular syndrome. Polyclonal gammopathies result in an increase in immunoglobulin of more than one class. This benign alteration is frequently seen in viral or bacterial infections. Thrombocythemia may be associated with a myeloproliferative syndrome or with a secondary reactive process. Ref: Brooks G.F., Carroll K.C., Butel J.S., Morse S.A., Mietzner T.A. (2013). Chapter 8. Immunology. In G.F. Brooks, K.C. Carroll, J.S. Butel, S.A. Morse, T.A. Mietzner (Eds), Jawetz, Melnick, & Adelberg's Medical Microbiology, 26e.","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 old male presents with a skin rash and epistaxis. He has had several, severe sinopulmonary infections. A careful history reveals that his maternal uncle died of bleeding complications following an emergency cholecystectomy. What additional findings are likely in this case?, with the following options: A: A CD4/CD8 ratio of < 1.5:1, B: Cerebellar ataxia, C: Elevated platelet count and high serum IgG, IgA, and IgE levels, D: Low platelet count and low serum IgM levels + +### Response: +This clinical scenario is typical for Wiskott-Aldrich syndrome. This is a sex-linked recessive disorder presenting with the triad of thrombocytopenia, eczema, and recurrent sinopulmonary infections. Serum IgM levels are low but IgG, IgA, and IgE levels are increased. Patients have a defective response to polysaccharide antigens, which is due to a cytoskeletal defect in T cells that inhibits their binding to B cells. A CD4/CD8 ratio of < 1.5:1 is the pattern seen in AIDS due to selective tropism of the CD4+ T-helper cell population. Cerebellar ataxia is pa of the ataxia-telangiectasia syndrome. The ataxia develops between age 2 and 5. The defect is associated with a DNA repair enzyme deficiency. Elevated platelet count and increased serum levels of IgG, IgA, and IgE is not associated with a paicular syndrome. Polyclonal gammopathies result in an increase in immunoglobulin of more than one class. This benign alteration is frequently seen in viral or bacterial infections. Thrombocythemia may be associated with a myeloproliferative syndrome or with a secondary reactive process. Ref: Brooks G.F., Carroll K.C., Butel J.S., Morse S.A., Mietzner T.A. (2013). Chapter 8. Immunology. In G.F. Brooks, K.C. Carroll, J.S. Butel, S.A. Morse, T.A. Mietzner (Eds), Jawetz, Melnick, & Adelberg's Medical Microbiology, 26e. +### End" +666,"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 of propylthiouracil?, with the following options: A: It is used in the treatment of myxedema, B: It has a long half-life in the circulation, C: It increases proteolysis of thyroglobulin, D: It blocks thyroxine synthesis + +### Response: +","Ans. is 'd' i.e., It blocks thyroxine synthesis o Propylthiouracil blocks thyroxine synthesis by inhibiting thyroid peroxidase, and preventing oxidation of iodide/ iodotyrosyl residues, there by Inhibit iodination of tyrosine residue in thyroglobulin. Inhibit coupling of MIT and DIT to form T3 & T4. o Propylthiouracil also inhibit the peripheral conversion of T4 to T3. About other options o It is a hypothyroid drug, cannot be used in myxedema (hypothyroidism). It has a sho VA - 1-2 hours. It does not increase proteolysis of thyroxine.","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 of propylthiouracil?, with the following options: A: It is used in the treatment of myxedema, B: It has a long half-life in the circulation, C: It increases proteolysis of thyroglobulin, D: It blocks thyroxine synthesis + +### Response: +Ans. is 'd' i.e., It blocks thyroxine synthesis o Propylthiouracil blocks thyroxine synthesis by inhibiting thyroid peroxidase, and preventing oxidation of iodide/ iodotyrosyl residues, there by Inhibit iodination of tyrosine residue in thyroglobulin. Inhibit coupling of MIT and DIT to form T3 & T4. o Propylthiouracil also inhibit the peripheral conversion of T4 to T3. About other options o It is a hypothyroid drug, cannot be used in myxedema (hypothyroidism). It has a sho VA - 1-2 hours. It does not increase proteolysis of thyroxine. +### End" +667,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Normal intrapleural pressure is, with the following options: A: 1-2 mm Hg, B: 2-4 mm Hg, C: 9.5-10 mm Hg, D: -3 to -4 mm Hg + +### Response: +","The normal external pressure is equal to the normal intrapleural pressure (the pressure in the chest cavity), which is −4 mm Hg. Note in the figure that a rise in intrapleural pressure, to −2 mm Hg, shifts the entire cardiac output curve to the right by the same amount. This shift occurs because to fill the cardiac chambers with blood requires an extra 2 mm Hg right atrial pressure to overcome the increased pressure on the outside of the heart. Likewise, an increase in intrapleural pressure to +2 mm Hg requires a 6 mm Hg increase in right atrial pressure from the normal −4 mm Hg, which shifts the entire cardiac output curve 6 mm Hg to the right.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Normal intrapleural pressure is, with the following options: A: 1-2 mm Hg, B: 2-4 mm Hg, C: 9.5-10 mm Hg, D: -3 to -4 mm Hg + +### Response: +The normal external pressure is equal to the normal intrapleural pressure (the pressure in the chest cavity), which is −4 mm Hg. Note in the figure that a rise in intrapleural pressure, to −2 mm Hg, shifts the entire cardiac output curve to the right by the same amount. This shift occurs because to fill the cardiac chambers with blood requires an extra 2 mm Hg right atrial pressure to overcome the increased pressure on the outside of the heart. Likewise, an increase in intrapleural pressure to +2 mm Hg requires a 6 mm Hg increase in right atrial pressure from the normal −4 mm Hg, which shifts the entire cardiac output curve 6 mm Hg to the right. +### End" +668,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Diameter of odontoblastic tubules at the point of origin, at their pulpal end, with the following options: A: 3-4 micrometer, B: 1 micrometer, C: 2-3 micrometer, D: 6 micrometer + +### Response: +","Between the odontoblastic processes and the peritubular dentin is the periodontoblastic space which contains the dentinal fluid. The tubules are broader at their point of origin, i.e., at their pulpal end (3–4μm) and become gradually narrower at their point of termination (1μm), i.e., at dentinoenamel or cementoenamel junction. Also the tubules are closer together at the pulpal end (50–90,000 tubules/mm2) and further apart at their terminal end.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Diameter of odontoblastic tubules at the point of origin, at their pulpal end, with the following options: A: 3-4 micrometer, B: 1 micrometer, C: 2-3 micrometer, D: 6 micrometer + +### Response: +Between the odontoblastic processes and the peritubular dentin is the periodontoblastic space which contains the dentinal fluid. The tubules are broader at their point of origin, i.e., at their pulpal end (3–4μm) and become gradually narrower at their point of termination (1μm), i.e., at dentinoenamel or cementoenamel junction. Also the tubules are closer together at the pulpal end (50–90,000 tubules/mm2) and further apart at their terminal end. +### End" +669,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: 69XXY is a -, with the following options: A: complete mole, B: partial mole, C: Down syndrome, D: none of the above + +### Response: +","Ans. is 'b' i.e., Partial mole Important features of complete and partial molesFeaturesComplete molePartial moleo Embryo / fetuso Absento Presento Hydrophic degeneration of villio Prominent & diffuseo Variable and focalo Trophoblastic hyperplasiao Diffuseo Focalo Uterine sizeo More than date (30-60%)o Less than dateo Theca lutein cysto Common (25-50%)o Uncommono Karyotypeo 46 XX (85%), paternal in origino Triploidy (90%), diploid (10%)o Beta HCGo High (> 50,000)o Slight deviation (< 50,000)o Classic clinical symptomso Commono Rareo Risk of persistent GTDo 20%o < 5%","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: 69XXY is a -, with the following options: A: complete mole, B: partial mole, C: Down syndrome, D: none of the above + +### Response: +Ans. is 'b' i.e., Partial mole Important features of complete and partial molesFeaturesComplete molePartial moleo Embryo / fetuso Absento Presento Hydrophic degeneration of villio Prominent & diffuseo Variable and focalo Trophoblastic hyperplasiao Diffuseo Focalo Uterine sizeo More than date (30-60%)o Less than dateo Theca lutein cysto Common (25-50%)o Uncommono Karyotypeo 46 XX (85%), paternal in origino Triploidy (90%), diploid (10%)o Beta HCGo High (> 50,000)o Slight deviation (< 50,000)o Classic clinical symptomso Commono Rareo Risk of persistent GTDo 20%o < 5% +### End" +670,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Prostaglandins are used in all except ?, with the following options: A: Cervical ripening, B: PPH, C: Erectile dysfunction, D: Palliative treatment of PDA + +### Response: +","Ans. is 'd' i.e., Palliative treatment of PDA","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Prostaglandins are used in all except ?, with the following options: A: Cervical ripening, B: PPH, C: Erectile dysfunction, D: Palliative treatment of PDA + +### Response: +Ans. is 'd' i.e., Palliative treatment of PDA +### End" +671,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Anti RO antibodies are seen in -, with the following options: A: Subacute cutaneous lupus, B: Myasthenia gravis, C: Systemic sclerosis, D: Mixed connective tissue disorder + +### Response: +","Ans. is 'a' i.e., Subacute cutaneous lupus Anti-RNP SS-A (Ro), SS-B (La) are seen in neonatal lupus with congenital hea block and in subacute cutaneous lupus.These antibodies are associated with decreased risk of lupus nephritis.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Anti RO antibodies are seen in -, with the following options: A: Subacute cutaneous lupus, B: Myasthenia gravis, C: Systemic sclerosis, D: Mixed connective tissue disorder + +### Response: +Ans. is 'a' i.e., Subacute cutaneous lupus Anti-RNP SS-A (Ro), SS-B (La) are seen in neonatal lupus with congenital hea block and in subacute cutaneous lupus.These antibodies are associated with decreased risk of lupus nephritis. +### End" +672,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In a town with population of 100,000, the number of slides examined is 5000. Out of these, 100 slides were positive for malaria. The API is?, with the following options: A: 2, B: 5, C: 1, D: 0.5 + +### Response: +",ANSWER: (C) 1REF: Park 20th edition page 227API= (confirmed cases/population) x 1000: it is a measure of malaria incidence.= 100/100000 x 1000 = 1ABER= (slides examined/population) x 100: It is a measure of operational efficiency. ABER for this case=5,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In a town with population of 100,000, the number of slides examined is 5000. Out of these, 100 slides were positive for malaria. The API is?, with the following options: A: 2, B: 5, C: 1, D: 0.5 + +### Response: +ANSWER: (C) 1REF: Park 20th edition page 227API= (confirmed cases/population) x 1000: it is a measure of malaria incidence.= 100/100000 x 1000 = 1ABER= (slides examined/population) x 100: It is a measure of operational efficiency. ABER for this case=5 +### End" +673,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Coronary vasodilatation is caused by, with the following options: A: Adenosine, B: Bradykinin, C: Histamines, D: Ergotamine + +### Response: +","Refer kDT 7/e p536 It serves as a metabolic coupler between oxygen consumption andcoronary blood flow. ... Parasympathetic stimulation of the hea (i.e., vagal nerve activation) elicits modest coronary vasodilation(due to the direct effects of released acetylcholine on the coronaries). In some types of blood vessels, there is evidence that adenosine producesvasodilation through increases in cGMP, which leads to inhibition of calcium entry into the cells as well as opening of potassium channels. Incardiac tissue, adenosine binds to type 1 (A1) receptors, which are coupled to Gi-proteins.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Coronary vasodilatation is caused by, with the following options: A: Adenosine, B: Bradykinin, C: Histamines, D: Ergotamine + +### Response: +Refer kDT 7/e p536 It serves as a metabolic coupler between oxygen consumption andcoronary blood flow. ... Parasympathetic stimulation of the hea (i.e., vagal nerve activation) elicits modest coronary vasodilation(due to the direct effects of released acetylcholine on the coronaries). In some types of blood vessels, there is evidence that adenosine producesvasodilation through increases in cGMP, which leads to inhibition of calcium entry into the cells as well as opening of potassium channels. Incardiac tissue, adenosine binds to type 1 (A1) receptors, which are coupled to Gi-proteins. +### End" +674,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Effect of dopamine on renal vessels ?, with the following options: A: Vasodilatation, B: Vasoconstriction, C: Increased permeability, D: No effect + +### Response: +","Ans. is 'a' i.e., Vasodilatation. Injected dopamine produces renal vasodilation, probably by acting on a specific dopaminergic receptor. It also produces vasodilation in the mesentery. Elsewhere; it produces vasoconstriction, probably by releasing norepinephrine, and it has a positive inotropic effect on the hea by an aciton on fliadrenergic receptors. The net effect of moderate doses of dopamine is an increase in systolic pressure and no change in diastolic pressure. Because of these actions, dopamine is useful in the treatment of traumatic and cardiogenic shock.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Effect of dopamine on renal vessels ?, with the following options: A: Vasodilatation, B: Vasoconstriction, C: Increased permeability, D: No effect + +### Response: +Ans. is 'a' i.e., Vasodilatation. Injected dopamine produces renal vasodilation, probably by acting on a specific dopaminergic receptor. It also produces vasodilation in the mesentery. Elsewhere; it produces vasoconstriction, probably by releasing norepinephrine, and it has a positive inotropic effect on the hea by an aciton on fliadrenergic receptors. The net effect of moderate doses of dopamine is an increase in systolic pressure and no change in diastolic pressure. Because of these actions, dopamine is useful in the treatment of traumatic and cardiogenic shock. +### End" +675,"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 child presented with recurrent UI, mouth breathing and failure to grow. On examination he has high arched palate and impaired hearing. What is the management of choice in this child?, with the following options: A: Myringotomy, B: Myringotomy with grommet inseion, C: Adenoidectomy with grommet inseion, D: Tonsillectomy + +### Response: +","Child in the question is showing features of adenoid hyperplasia as indicated by mouth breathing, nasal obstruction and recurrent UI. He has impaired hearing as a result of serous otitis media which occur as a complication of adenoid hyperplasia. So the treatment of choice is adenoidectomy with grommet inseion which will take care of both the adenoid as well as serous 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 6 year old child presented with recurrent UI, mouth breathing and failure to grow. On examination he has high arched palate and impaired hearing. What is the management of choice in this child?, with the following options: A: Myringotomy, B: Myringotomy with grommet inseion, C: Adenoidectomy with grommet inseion, D: Tonsillectomy + +### Response: +Child in the question is showing features of adenoid hyperplasia as indicated by mouth breathing, nasal obstruction and recurrent UI. He has impaired hearing as a result of serous otitis media which occur as a complication of adenoid hyperplasia. So the treatment of choice is adenoidectomy with grommet inseion which will take care of both the adenoid as well as serous otitis media. +### End" +676,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Progressive secondary Amenorrhoea is associated with :, with the following options: A: Endometriosis, B: Pyschosomatic cause, C: Uterine anomaly, D: None + +### Response: +",Pyschosomatic cause,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Progressive secondary Amenorrhoea is associated with :, with the following options: A: Endometriosis, B: Pyschosomatic cause, C: Uterine anomaly, D: None + +### Response: +Pyschosomatic cause +### End" +677,"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 a glaucoma patient suffering from bronchial asthma:, with the following options: A: Timolol maleate, B: Latanoprost, C: Betaxolol, D: Brimonidine + +### Response: +","Ans. (a) Timolol maleateRef: A.K. Khurana 6th ed. 1236-37* Although timolol is considered as DOC for OAG in India, it is contraindicated in glaucoma patients suffering from bronchial asthma.* Timolol is a non selective Beta blocker which might aggravate the asthma of the patient.* For such patient Betaxolol is next best choice.","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 a glaucoma patient suffering from bronchial asthma:, with the following options: A: Timolol maleate, B: Latanoprost, C: Betaxolol, D: Brimonidine + +### Response: +Ans. (a) Timolol maleateRef: A.K. Khurana 6th ed. 1236-37* Although timolol is considered as DOC for OAG in India, it is contraindicated in glaucoma patients suffering from bronchial asthma.* Timolol is a non selective Beta blocker which might aggravate the asthma of the patient.* For such patient Betaxolol is next best choice. +### End" +678,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: CD 19 positive, CD22 positive, CD103 positive monoclonal B-cells with bright kappa positivity were found to comprise 60% of the peripheral blood lymphoid cells on flow cytometric analysis in a 55 year old man with massive splenomegaly and a total leucocyte count of 3.3 x 109/L. Which one of the following is the most likely diagnosis?, with the following options: A: Splenic lymphoma with villous lymphocytes, B: Mantle cell lymphoma, C: B-cell prolymphocytic leukemia, D: Hairy cell leukemia + +### Response: +","Answer is D (Hairy cell leukemia) Presence of massive splenomegaly, and granulocytopenia, alongwith characteristic immunophenotypic features (specially CD103) suggests the diagnosis of Hairy cell leukemia. CD103 is exclusively positive in Hairy cell leukemia and thus leaves no doubt as regards the correct diagnosis.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: CD 19 positive, CD22 positive, CD103 positive monoclonal B-cells with bright kappa positivity were found to comprise 60% of the peripheral blood lymphoid cells on flow cytometric analysis in a 55 year old man with massive splenomegaly and a total leucocyte count of 3.3 x 109/L. Which one of the following is the most likely diagnosis?, with the following options: A: Splenic lymphoma with villous lymphocytes, B: Mantle cell lymphoma, C: B-cell prolymphocytic leukemia, D: Hairy cell leukemia + +### Response: +Answer is D (Hairy cell leukemia) Presence of massive splenomegaly, and granulocytopenia, alongwith characteristic immunophenotypic features (specially CD103) suggests the diagnosis of Hairy cell leukemia. CD103 is exclusively positive in Hairy cell leukemia and thus leaves no doubt as regards the correct diagnosis. +### End" +679,"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 familial syndromes are associated with development of pheochromocytoma except:, with the following options: A: Sturge-Weber syndrome., B: Von Recklinghausen disease., C: MEN Type II., D: Prader-Willi syndrome. + +### Response: +",Ans. is 'd' i.e. Prader willi syndrome Pheochromocytoma is associated with the following familial syndromes.MEN syndrome * type II and * Type IIIVon Hippel Lindau syndromeVon RecklinghausenSturge weber Syndrome,"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 familial syndromes are associated with development of pheochromocytoma except:, with the following options: A: Sturge-Weber syndrome., B: Von Recklinghausen disease., C: MEN Type II., D: Prader-Willi syndrome. + +### Response: +Ans. is 'd' i.e. Prader willi syndrome Pheochromocytoma is associated with the following familial syndromes.MEN syndrome * type II and * Type IIIVon Hippel Lindau syndromeVon RecklinghausenSturge weber Syndrome +### End" +680,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Aboions in the second trimester is mostly due to:, with the following options: A: Incompetent cervix, B: Defective genes, C: Tuberculosis, D: Trauma + +### Response: +",Incompetent cervix,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Aboions in the second trimester is mostly due to:, with the following options: A: Incompetent cervix, B: Defective genes, C: Tuberculosis, D: Trauma + +### Response: +Incompetent cervix +### End" +681,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The Efferent fibers bundle of the substantia nigra transmits dopamine to one of the following areas, with the following options: A: Thalamus, B: Corpus striatum, C: Tegmentum of pons, D: Tectum of midbrain + +### Response: +","Ans. (b) Corpus striatum(Ref: Ganong, 25th ed/p.243)The Efferent fibers bundle of the substantia nigra transmits dopamine to corpus striatum","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The Efferent fibers bundle of the substantia nigra transmits dopamine to one of the following areas, with the following options: A: Thalamus, B: Corpus striatum, C: Tegmentum of pons, D: Tectum of midbrain + +### Response: +Ans. (b) Corpus striatum(Ref: Ganong, 25th ed/p.243)The Efferent fibers bundle of the substantia nigra transmits dopamine to corpus striatum +### End" +682,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Calcium channel blockers are used in all, except -, with the following options: A: Angina, B: Supraventricular tachycardia, C: Sick sinus syndrome, D: Hypeension + +### Response: +","Ans. is 'c' i.e., Sick sinus syndrome o Calcium channel blockers suppress SA node automaticity --> can cause cardiac arrest in sick sinus syndrome.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Calcium channel blockers are used in all, except -, with the following options: A: Angina, B: Supraventricular tachycardia, C: Sick sinus syndrome, D: Hypeension + +### Response: +Ans. is 'c' i.e., Sick sinus syndrome o Calcium channel blockers suppress SA node automaticity --> can cause cardiac arrest in sick sinus syndrome. +### End" +683,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about parotid tumor:a) Pleomorphic adenoma is the most common varietyb) Malignant disease is most common varietyc) Facial nerve involvement indicates malignancyd) Superficial paroditectomy is the t/t of choice, with the following options: A: abc, B: acd, C: bc, D: bde + +### Response: +","In parotid tumors, rapid growth, pain, paraesthesia, enlarged cervical LN and restriction of jaw movements, facial weakness or skin invasion and fixation of mastoid tip is suggestive of malignant transformation.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about parotid tumor:a) Pleomorphic adenoma is the most common varietyb) Malignant disease is most common varietyc) Facial nerve involvement indicates malignancyd) Superficial paroditectomy is the t/t of choice, with the following options: A: abc, B: acd, C: bc, D: bde + +### Response: +In parotid tumors, rapid growth, pain, paraesthesia, enlarged cervical LN and restriction of jaw movements, facial weakness or skin invasion and fixation of mastoid tip is suggestive of malignant transformation. +### End" +684,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A biopsy was performed for a patient with recurrent chalazion involving the upper lid. The most likely diagnosis on histopathology is:, with the following options: A: Sebaceous cell carcinoma, B: Basal cell carcinoma, C: Squamous cell carcinoma, D: Malignant Melanoma + +### Response: +","Ans. (a) Sebaceous cell carcinomaRef: Kanski 7/e, p. 21, 4Sebaceous Gland Carcinoma* Typically arises from meibomian glands or glands of ZeisQ* Most frequently arises from the upper eyelids[?] where meibomian gland are most frequent (in contrast to basal cell and squamous cell carcinoma)* Highly malignant with mortality of 5-10%* Elderly females are typically affected.* Nodular SGC masquerades a 'chalazion' and hence any patient with recurrent chalazion with an unusual consistency should undergo a full thickness resection and histological examination to exclude SGC.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A biopsy was performed for a patient with recurrent chalazion involving the upper lid. The most likely diagnosis on histopathology is:, with the following options: A: Sebaceous cell carcinoma, B: Basal cell carcinoma, C: Squamous cell carcinoma, D: Malignant Melanoma + +### Response: +Ans. (a) Sebaceous cell carcinomaRef: Kanski 7/e, p. 21, 4Sebaceous Gland Carcinoma* Typically arises from meibomian glands or glands of ZeisQ* Most frequently arises from the upper eyelids[?] where meibomian gland are most frequent (in contrast to basal cell and squamous cell carcinoma)* Highly malignant with mortality of 5-10%* Elderly females are typically affected.* Nodular SGC masquerades a 'chalazion' and hence any patient with recurrent chalazion with an unusual consistency should undergo a full thickness resection and histological examination to exclude SGC. +### End" +685,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In burns least useful is, with the following options: A: Normal saline, B: Blood, C: Dextran, D: Ringer lactate + +### Response: +","We know that Ringer's lactate is the preferred agent during initial 24 hrs. Nasogastric intubation is done to decrease the risk of emesis and possible aspiration (as parlytic ileus develops in a pt. with significant burn) Dextran is a colloid and can be used in 2nd 24 hrs., however albumin is the preferred and most widely used colloid. Blood has also role in burn patient. The need for Blood replacement is significant in extensive burns. Besides injury to red blood cells and their decreased half-life resulting in their early destruction, many patients may be anaemic. Hence, repeated and frequent transmission to maintain a hematocrit around 35% is necessary. Ref Bailey and love 27e p625 , Srb`s manual of surgery p133","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In burns least useful is, with the following options: A: Normal saline, B: Blood, C: Dextran, D: Ringer lactate + +### Response: +We know that Ringer's lactate is the preferred agent during initial 24 hrs. Nasogastric intubation is done to decrease the risk of emesis and possible aspiration (as parlytic ileus develops in a pt. with significant burn) Dextran is a colloid and can be used in 2nd 24 hrs., however albumin is the preferred and most widely used colloid. Blood has also role in burn patient. The need for Blood replacement is significant in extensive burns. Besides injury to red blood cells and their decreased half-life resulting in their early destruction, many patients may be anaemic. Hence, repeated and frequent transmission to maintain a hematocrit around 35% is necessary. Ref Bailey and love 27e p625 , Srb`s manual of surgery p133 +### End" +686,"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 pre-cancerous conditions of the lids except, with the following options: A: Solar keratosis, B: Naevus, C: Xeroderma pigmentosa, D: Carcinoma-in-situ + +### Response: +","TUMOURS OF THE LIDS Classification : 1. Benign tumours: These include; simple papilloma, naevus, angioma, haemangioma, neurofibroma and sebaceous adenoma. 2. Pre-cancerous conditions: These are solar keratosis, carcinoma-in-situ and xeroderma pigmentosa. 3. Malignant tumours: Commonly observed tumours include squamous cell carcinoma, basal cell carcinoma, malignant melanoma, and sebaceous gland adenocarcinoma. Ref:- A K KHURANA; pg num:-359","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 pre-cancerous conditions of the lids except, with the following options: A: Solar keratosis, B: Naevus, C: Xeroderma pigmentosa, D: Carcinoma-in-situ + +### Response: +TUMOURS OF THE LIDS Classification : 1. Benign tumours: These include; simple papilloma, naevus, angioma, haemangioma, neurofibroma and sebaceous adenoma. 2. Pre-cancerous conditions: These are solar keratosis, carcinoma-in-situ and xeroderma pigmentosa. 3. Malignant tumours: Commonly observed tumours include squamous cell carcinoma, basal cell carcinoma, malignant melanoma, and sebaceous gland adenocarcinoma. Ref:- A K KHURANA; pg num:-359 +### End" +687,"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 general anaesthetic can cause laryngospasm:, with the following options: A: Halothane, B: Nitrous oxide, C: Desflurane, D: Enflurane + +### Response: +","Desflurane is an irritant if used for induction can cause larygospasm. Desflurane is the most pungent of the volatile agents and may result in a cough, laryngospasm, and bronchospasm and so is not routinely used for induction in children.","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 general anaesthetic can cause laryngospasm:, with the following options: A: Halothane, B: Nitrous oxide, C: Desflurane, D: Enflurane + +### Response: +Desflurane is an irritant if used for induction can cause larygospasm. Desflurane is the most pungent of the volatile agents and may result in a cough, laryngospasm, and bronchospasm and so is not routinely used for induction in children. +### End" +688,"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 vitamins are antioxidants EXCEPT:, with the following options: A: Beta carotene, B: Vitamin B, C: Vitamin C, D: Vitamin E + +### Response: +","Ans. (b) Vitamin BRef: K. Park 23rded. 1626* Antioxidants are substances which are both nutrients and non-nutrients.* These anti-oxidants reduce the toxic effects of reactive oxygen species and nitrogen species which are generated during physiological or pathological conditions and result in oxidant damage* Vitamins which acts as antioxidants are remembered as ACE: vitamin A, C and E* Other vitamins which acts as anti-oxidants are: Selenium, Glutathione* Non-nutrient products that also act as anti-oxidants are: Plant phenols, Flavonoids, Coumarins, caffeic, benzyl isothiocyanates, gallic and ellagic acid.* Vitamin B is not an anti-oxidant.","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 vitamins are antioxidants EXCEPT:, with the following options: A: Beta carotene, B: Vitamin B, C: Vitamin C, D: Vitamin E + +### Response: +Ans. (b) Vitamin BRef: K. Park 23rded. 1626* Antioxidants are substances which are both nutrients and non-nutrients.* These anti-oxidants reduce the toxic effects of reactive oxygen species and nitrogen species which are generated during physiological or pathological conditions and result in oxidant damage* Vitamins which acts as antioxidants are remembered as ACE: vitamin A, C and E* Other vitamins which acts as anti-oxidants are: Selenium, Glutathione* Non-nutrient products that also act as anti-oxidants are: Plant phenols, Flavonoids, Coumarins, caffeic, benzyl isothiocyanates, gallic and ellagic acid.* Vitamin B is not an anti-oxidant. +### End" +689,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Central dot sign is seen in?, with the following options: A: Primary sclerosing cholangitis, B: Liver Hamaoma, C: Caroli's disease, D: Polycystic liver disease + +### Response: +",Ans is c i.e. Caroli's disease Caroli's disease is a rare congenital abnormality in which there is communicating cavernous ectasia of the intrahepatic biliary ducts. Caroli's disease is equivalent to type V choledochal cyst. It is commonly associated with congenital hepatic fibrosis and cystic lesions of the kidney.Patients present in late childhood or early adulthood with cholangitis. Ultrasound and CT shows cystic lesions within the liver. A central dot within the cystic lesions is specific for Caroli's disease. The central dot represents the poal vein surrounded by the dilated bile duct. Choledochal cyst A choledochal cyst is an isolated or combined congenital dilatation of the extrahepatic or intrahepatic biliary tree.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Central dot sign is seen in?, with the following options: A: Primary sclerosing cholangitis, B: Liver Hamaoma, C: Caroli's disease, D: Polycystic liver disease + +### Response: +Ans is c i.e. Caroli's disease Caroli's disease is a rare congenital abnormality in which there is communicating cavernous ectasia of the intrahepatic biliary ducts. Caroli's disease is equivalent to type V choledochal cyst. It is commonly associated with congenital hepatic fibrosis and cystic lesions of the kidney.Patients present in late childhood or early adulthood with cholangitis. Ultrasound and CT shows cystic lesions within the liver. A central dot within the cystic lesions is specific for Caroli's disease. The central dot represents the poal vein surrounded by the dilated bile duct. Choledochal cyst A choledochal cyst is an isolated or combined congenital dilatation of the extrahepatic or intrahepatic biliary tree. +### End" +690,"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 best to compare vital statistics of countries?, with the following options: A: Crude death and bih rates, B: Propoional moality rate, C: Age standardized death rate, D: Age specific death rate + +### Response: +","If we want to compare the death rates of two populations with different age-composition, the crude death rate is not the right yardstick This is because rates are only comparable if the populations upon which they are based ae comparable.It is cumbersome to use a series of age-specific death rates, hence &;age standardization&; is used to remove the confounding effect of different age groups.Park 23epg: 59","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 best to compare vital statistics of countries?, with the following options: A: Crude death and bih rates, B: Propoional moality rate, C: Age standardized death rate, D: Age specific death rate + +### Response: +If we want to compare the death rates of two populations with different age-composition, the crude death rate is not the right yardstick This is because rates are only comparable if the populations upon which they are based ae comparable.It is cumbersome to use a series of age-specific death rates, hence &;age standardization&; is used to remove the confounding effect of different age groups.Park 23epg: 59 +### End" +691,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: SLE mitral and tricuspid valve vegetations are?, with the following options: A: Salmon patch, B: Libmann sach's disease, C: Janeway lesions, D: Oslers nodes + +### Response: +","Ans. is 'b' i.e., Libmann sach's disease Endocarditis of Systemic Lupus Erythematosus (Libman-Sach's Disease)Mitral and tricuspid valvulitis with small, sterile vegetations, called Libman-Sach's endocarditis, is occasionally encountered in systemic lupus erythematosus.Due to the use of steriods, the incidence of this complication has been greatly reduced.The lesions are small (1 to 4 mm in diameter), single or multiple, sterile, pink vegetations with a way (verrucous) appearance located on the undersurfaces of the atrioventricular valves, on the valvuar endocardium, on the chords, or on the mural endocardium of atria or ventricles.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: SLE mitral and tricuspid valve vegetations are?, with the following options: A: Salmon patch, B: Libmann sach's disease, C: Janeway lesions, D: Oslers nodes + +### Response: +Ans. is 'b' i.e., Libmann sach's disease Endocarditis of Systemic Lupus Erythematosus (Libman-Sach's Disease)Mitral and tricuspid valvulitis with small, sterile vegetations, called Libman-Sach's endocarditis, is occasionally encountered in systemic lupus erythematosus.Due to the use of steriods, the incidence of this complication has been greatly reduced.The lesions are small (1 to 4 mm in diameter), single or multiple, sterile, pink vegetations with a way (verrucous) appearance located on the undersurfaces of the atrioventricular valves, on the valvuar endocardium, on the chords, or on the mural endocardium of atria or ventricles. +### End" +692,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Virulence of a biological agent is defind as -, with the following options: A: Ability of the agent to invade and multiply in host, B: Propoion of clinical cases resulting in severe clinical manifestation, C: Ability of the agent to induce a clinically apparent illness, D: Propoion of clinical cases in a virgin population + +### Response: +","For an infectious agent, infectivity refers to the propoion of exposed persons who become infected. Pathogenicity refers to the propoion of infected individuals who develop clinically apparent disease. Virulence refers to the propoion of clinically apparent cases that are severe or fatal. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 43","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Virulence of a biological agent is defind as -, with the following options: A: Ability of the agent to invade and multiply in host, B: Propoion of clinical cases resulting in severe clinical manifestation, C: Ability of the agent to induce a clinically apparent illness, D: Propoion of clinical cases in a virgin population + +### Response: +For an infectious agent, infectivity refers to the propoion of exposed persons who become infected. Pathogenicity refers to the propoion of infected individuals who develop clinically apparent disease. Virulence refers to the propoion of clinically apparent cases that are severe or fatal. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 43 +### End" +693,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Third generation oral contraceptive pills containing norgestrel and gestodene along with estrogens :, with the following options: A: Are more lipid friendly, B: Decreases the risk of venous thromboembolism, C: Increase the risk of breakthrough bleeding, D: Are not used for emergency contraception + +### Response: +","Ans. is a i.e. Are more lipid friendly 3rd generation Oral contraceptive pill contain 3rd generation progestins such as : Desogestrel Gestodene Norgestimate Advantages of 3rd generation progestins are : Diminished adverse effects on lipid metabolism. Reliable monthly blood pattern The 3rd generation pills appear to carry higher risk of venous thrombosis but have lower risk of aerial thrombosis. Use of third generation progestins increase the risk of venous thromboembolism according to Shaw 14/e, p 209 whereas they have no effect on rate of thrombolism according to Leon Speroff 7/e, p 890. ""Risks of aerial venous thrombosis are a consequence of the estrogen component of combination oral contraceptives."" ""There is no evidence that any oral contraceptive formulations that are approximately equivalent in estrogen and progesterin dosages are significantly different in the rate of breakthrough bleeding.""","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Third generation oral contraceptive pills containing norgestrel and gestodene along with estrogens :, with the following options: A: Are more lipid friendly, B: Decreases the risk of venous thromboembolism, C: Increase the risk of breakthrough bleeding, D: Are not used for emergency contraception + +### Response: +Ans. is a i.e. Are more lipid friendly 3rd generation Oral contraceptive pill contain 3rd generation progestins such as : Desogestrel Gestodene Norgestimate Advantages of 3rd generation progestins are : Diminished adverse effects on lipid metabolism. Reliable monthly blood pattern The 3rd generation pills appear to carry higher risk of venous thrombosis but have lower risk of aerial thrombosis. Use of third generation progestins increase the risk of venous thromboembolism according to Shaw 14/e, p 209 whereas they have no effect on rate of thrombolism according to Leon Speroff 7/e, p 890. ""Risks of aerial venous thrombosis are a consequence of the estrogen component of combination oral contraceptives."" ""There is no evidence that any oral contraceptive formulations that are approximately equivalent in estrogen and progesterin dosages are significantly different in the rate of breakthrough bleeding."" +### End" +694,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Kashima 's operation done for all conditions except:, with the following options: A: Vocal cord dysplasia, B: Ca larynx, C: Nasophargyneal Ca, D: Bilateral abductor palsy + +### Response: +",Kashima's operation: A transverse Endoscopic transverse chordectomy/ Posterior paial chordectomy using CO2 laser- performed for treating the respiratory difficulty caused as a result of bilateral abductor vocal fold paralysis. It is done in case of: - B/L Recurrent Laryngeal nerve palsy. - Dysplastic vocal folds - Malignancies (not a mainstay treatment for malignancies),"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Kashima 's operation done for all conditions except:, with the following options: A: Vocal cord dysplasia, B: Ca larynx, C: Nasophargyneal Ca, D: Bilateral abductor palsy + +### Response: +Kashima's operation: A transverse Endoscopic transverse chordectomy/ Posterior paial chordectomy using CO2 laser- performed for treating the respiratory difficulty caused as a result of bilateral abductor vocal fold paralysis. It is done in case of: - B/L Recurrent Laryngeal nerve palsy. - Dysplastic vocal folds - Malignancies (not a mainstay treatment for malignancies) +### End" +695,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The contraceptive method with a failure rate of <3 is :, with the following options: A: Copper-T, B: Vaginal sponge, C: Condom, D: Oral contraceptive pills + +### Response: +","The oral contraceptives are highly effective contraceptive methodThe failure rate is very low ( 0.3 c/o ), as ovulation is inhibitedRef: TEXTBOOK OF GYNAECOLOGY; Sheila Balakrishnan; SECOND EDITION; PAGE NO 366, 370","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The contraceptive method with a failure rate of <3 is :, with the following options: A: Copper-T, B: Vaginal sponge, C: Condom, D: Oral contraceptive pills + +### Response: +The oral contraceptives are highly effective contraceptive methodThe failure rate is very low ( 0.3 c/o ), as ovulation is inhibitedRef: TEXTBOOK OF GYNAECOLOGY; Sheila Balakrishnan; SECOND EDITION; PAGE NO 366, 370 +### End" +696,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Rigor mois not seen in: AIIMS 13, with the following options: A: Fetus < 7 months of age, B: Full term fetus, C: Elderly, D: Anemic person + +### Response: +",Ans. Fetus < 7 months of age,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Rigor mois not seen in: AIIMS 13, with the following options: A: Fetus < 7 months of age, B: Full term fetus, C: Elderly, D: Anemic person + +### Response: +Ans. Fetus < 7 months of age +### End" +697,"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 regarding tetracycline -, with the following options: A: It is not teratogenic, B: It can cause tooth discoloration, C: It can result in superinfection, D: It can lead to pseudomembranous colitis. + +### Response: +","Ans. is 'a' i.e., It is not teratogenic o Tetracycline is teratogenic - causes discoloration and defects of teeth and altered bone growth of the fetus. o Tetracycline can cause superinfection (including pseudomembranous colitis).","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 regarding tetracycline -, with the following options: A: It is not teratogenic, B: It can cause tooth discoloration, C: It can result in superinfection, D: It can lead to pseudomembranous colitis. + +### Response: +Ans. is 'a' i.e., It is not teratogenic o Tetracycline is teratogenic - causes discoloration and defects of teeth and altered bone growth of the fetus. o Tetracycline can cause superinfection (including pseudomembranous colitis). +### End" +698,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: antigen defect in Pemphigus Vulgaris -, with the following options: A: Desmoglein-1, B: Desmoglein-3, C: Desmocolin-3, D: Desmocollin-2 + +### Response: +","Antigen defect in Pemphigus Vulgaris is desmoglein 1 & 3. When adsorbed with extracellular domains of both Dsg3 and Dsg1, these sera no longer stained epidermis, demonstrating that most. if not all, of their cell surface reactivity can be attributed to antibodies against the extracellular domains of these desmogleins. Adsorption with only the Dsg1 extracellular domain left antibodies that stained only the basal and immediate suprabasal layers of the epidermis and immunoprecipitated only Dsg3, not Dsg1, from extracts of cultured cells synthesizing these molecules. In contrast, adsorption with only the Dsg3 extracellular domain Left antibodies that stained only the more superficial epidermis and immunoprecipitated only Dsg1. These data localize Dsg3 exactly to the area in the epidermis where Blisters occur in pemphigus vulgaris.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: antigen defect in Pemphigus Vulgaris -, with the following options: A: Desmoglein-1, B: Desmoglein-3, C: Desmocolin-3, D: Desmocollin-2 + +### Response: +Antigen defect in Pemphigus Vulgaris is desmoglein 1 & 3. When adsorbed with extracellular domains of both Dsg3 and Dsg1, these sera no longer stained epidermis, demonstrating that most. if not all, of their cell surface reactivity can be attributed to antibodies against the extracellular domains of these desmogleins. Adsorption with only the Dsg1 extracellular domain left antibodies that stained only the basal and immediate suprabasal layers of the epidermis and immunoprecipitated only Dsg3, not Dsg1, from extracts of cultured cells synthesizing these molecules. In contrast, adsorption with only the Dsg3 extracellular domain Left antibodies that stained only the more superficial epidermis and immunoprecipitated only Dsg1. These data localize Dsg3 exactly to the area in the epidermis where Blisters occur in pemphigus vulgaris. +### End" +699,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Maximum shortening of limbs occur in, with the following options: A: Trochantric femur, B: Post dislocation of hip, C: neck femur, D: Anterior dislocation of hip + +### Response: +","Ans. is 'b' i.e. posterior dislocation of hip Be sure of the answer, we have been taught this in the clinics.Shortening of the limb is seen in: (in decreasing order)Post dislocation of hip (maximum) shaft femur Intertrochanteric neck femur","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Maximum shortening of limbs occur in, with the following options: A: Trochantric femur, B: Post dislocation of hip, C: neck femur, D: Anterior dislocation of hip + +### Response: +Ans. is 'b' i.e. posterior dislocation of hip Be sure of the answer, we have been taught this in the clinics.Shortening of the limb is seen in: (in decreasing order)Post dislocation of hip (maximum) shaft femur Intertrochanteric neck femur +### End" +700,"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 sign of successful stellate ganglion block?, with the following options: A: Nasal stuffiness, B: Guttmansign, C: Horner's syndrome, D: Bradycardia + +### Response: +","Bradycardia is not an established sign of successful stellate ganglion block. Ref: Sho Textbook of Anesthesia By Ajay Yadav, 2nd Edition, Page 113; Image-Guided Intervention By Matthew A. Mauro, Kieran Murphy, Kenneth Thomson, Christoph L. Zollikofer, 2008, Page 1741; Atlas of Image-Guided Intervention in Regional Anesthesia and Pain Medicine By James P. Rathmell, 2005, Page 115","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 sign of successful stellate ganglion block?, with the following options: A: Nasal stuffiness, B: Guttmansign, C: Horner's syndrome, D: Bradycardia + +### Response: +Bradycardia is not an established sign of successful stellate ganglion block. Ref: Sho Textbook of Anesthesia By Ajay Yadav, 2nd Edition, Page 113; Image-Guided Intervention By Matthew A. Mauro, Kieran Murphy, Kenneth Thomson, Christoph L. Zollikofer, 2008, Page 1741; Atlas of Image-Guided Intervention in Regional Anesthesia and Pain Medicine By James P. Rathmell, 2005, Page 115 +### End" +701,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are alkylating agents, except, with the following options: A: 5-Fluorouracil, B: Melphalan, C: Cyclophosphamide, D: Chlorambucil + +### Response: +","Ans. (A) 5-Fluorouracil(Ref: Katzung 11th/e p945, KDT 8th/e p918-919)5-Fluorouracil is an antimetabolite whereas melphalan, cyclophosphamide and chlorambucil are alkylating agents.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are alkylating agents, except, with the following options: A: 5-Fluorouracil, B: Melphalan, C: Cyclophosphamide, D: Chlorambucil + +### Response: +Ans. (A) 5-Fluorouracil(Ref: Katzung 11th/e p945, KDT 8th/e p918-919)5-Fluorouracil is an antimetabolite whereas melphalan, cyclophosphamide and chlorambucil are alkylating agents. +### End" +702,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are oncogenic virus EXCEPT, with the following options: A: Human papilloma virus, B: Epstein-Barr virus, C: Hepatitis B virus, D: Herpes-simplex + +### Response: +","i.e. (Herpes - simplex): (563-65-Ananthanarayan 8th)Herpes simplex and cancer cervix - An association has been proposed between herpes simplex type 2 infection and cancer of the uterine cervix, though not proved.It has also been suggested that herpes simplex type I infection may be associated with cancer of the lip Herpes virus type 8 has been linked to Kaposi's sarcomaONCOGENIC VIRUSESRNA - Viruses Retroviruses1. Avian leukosis viruses2. Murine leukosis viruses3. Murine mammary tumour virus4. Leukosis - sarcoma virus of various animals5. Human T-cell leukemia virusesDNA - Viruses I. Papova viruses1. Papilloma viruses of human beings, rabbits and other animals2. Polyomavirus3. Simian vims 404. BK and JV virusesII. Poxvirus1.Molluscum contagiosum2. Yaba vims3. Shope fibromaIII. AdenovirusMany human and non human typesIV. Herpes virus1. Marek's disease vims2. Lucke's frog tumour vims3. Herpes vims pan, papio, ateles and saimiri4. Epstein - Barr vims5. Herpes simplex virus type I & II6. Cytomegalo vimsV. Hepatitis B and C viruses","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All are oncogenic virus EXCEPT, with the following options: A: Human papilloma virus, B: Epstein-Barr virus, C: Hepatitis B virus, D: Herpes-simplex + +### Response: +i.e. (Herpes - simplex): (563-65-Ananthanarayan 8th)Herpes simplex and cancer cervix - An association has been proposed between herpes simplex type 2 infection and cancer of the uterine cervix, though not proved.It has also been suggested that herpes simplex type I infection may be associated with cancer of the lip Herpes virus type 8 has been linked to Kaposi's sarcomaONCOGENIC VIRUSESRNA - Viruses Retroviruses1. Avian leukosis viruses2. Murine leukosis viruses3. Murine mammary tumour virus4. Leukosis - sarcoma virus of various animals5. Human T-cell leukemia virusesDNA - Viruses I. Papova viruses1. Papilloma viruses of human beings, rabbits and other animals2. Polyomavirus3. Simian vims 404. BK and JV virusesII. Poxvirus1.Molluscum contagiosum2. Yaba vims3. Shope fibromaIII. AdenovirusMany human and non human typesIV. Herpes virus1. Marek's disease vims2. Lucke's frog tumour vims3. Herpes vims pan, papio, ateles and saimiri4. Epstein - Barr vims5. Herpes simplex virus type I & II6. Cytomegalo vimsV. Hepatitis B and C viruses +### End" +703,"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 marker of seminoma?, with the following options: A: PLAP, B: Alpha fetoprotein, C: Beta HCG, D: LDH + +### Response: +",Alpha fetoprotein is not raised in seminoma and choriocarcinoma.,"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 marker of seminoma?, with the following options: A: PLAP, B: Alpha fetoprotein, C: Beta HCG, D: LDH + +### Response: +Alpha fetoprotein is not raised in seminoma and choriocarcinoma. +### End" +704,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Type of psoriasis is, with the following options: A: Plaque, B: Guttate, C: Pustular, D: Inverse + +### Response: +","Guttate(gutta- drop) psoriasis is an eruptive, inflammatory type with showers of small papules and plaques over the trunk and limbs, rarely face. Lesions typically occur as an abrupt eruption following upper respiratory infection, especially due to b-hemolytic streptococci. prognosis is good with spontaneou resolution. Guttate psoriasis (eruptive psoriasis) is most common in children and young adults. Ref: Harrison 19e pg: 347; Fitzpatrick dermatology","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Type of psoriasis is, with the following options: A: Plaque, B: Guttate, C: Pustular, D: Inverse + +### Response: +Guttate(gutta- drop) psoriasis is an eruptive, inflammatory type with showers of small papules and plaques over the trunk and limbs, rarely face. Lesions typically occur as an abrupt eruption following upper respiratory infection, especially due to b-hemolytic streptococci. prognosis is good with spontaneou resolution. Guttate psoriasis (eruptive psoriasis) is most common in children and young adults. Ref: Harrison 19e pg: 347; Fitzpatrick dermatology +### End" +705,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Dumping syndrome is due to:, with the following options: A: Diarrhoea, B: Presence of hypeonic content in small intestine, C: Vagotomy, D: Reduced gastric capacity + +### Response: +","Answer is B (Presence of Hypeonic Contents in small intestine) DUMPING SYNDROME refers to a syndrome of abdominal and vasomator symptoms which results from dumping of food stuffs with a high osmotic load, front the stomach, into the small bowel. Loss of storage capacity of stomach and ablation, by pass or destruction of pylorus, results in rapid emptying of hyperostnolar chyme into duodenummm and small intestine. Extracellular fluid then shifts into the intestinal lumen to restore isotonicity resulting in decreased intravascular volume, which gives rise to the vasomotor symptoms. Note that while reduced gastric capacity contributes, option (b) is a more accurate answer. Dumping Syndrome is actually of two types: Early dumping syndrome (as described above) Late dumping syndrome: This is Reactive hypoglvcemiae. The carbohydrate load in thesmall intestine later causes a rise in plasma glucose, which in turn causes insulin levels to rise causing a secondary hypoglycemia.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Dumping syndrome is due to:, with the following options: A: Diarrhoea, B: Presence of hypeonic content in small intestine, C: Vagotomy, D: Reduced gastric capacity + +### Response: +Answer is B (Presence of Hypeonic Contents in small intestine) DUMPING SYNDROME refers to a syndrome of abdominal and vasomator symptoms which results from dumping of food stuffs with a high osmotic load, front the stomach, into the small bowel. Loss of storage capacity of stomach and ablation, by pass or destruction of pylorus, results in rapid emptying of hyperostnolar chyme into duodenummm and small intestine. Extracellular fluid then shifts into the intestinal lumen to restore isotonicity resulting in decreased intravascular volume, which gives rise to the vasomotor symptoms. Note that while reduced gastric capacity contributes, option (b) is a more accurate answer. Dumping Syndrome is actually of two types: Early dumping syndrome (as described above) Late dumping syndrome: This is Reactive hypoglvcemiae. The carbohydrate load in thesmall intestine later causes a rise in plasma glucose, which in turn causes insulin levels to rise causing a secondary hypoglycemia. +### End" +706,"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 regarding Clostridium tetani is false, with the following options: A: Soil and intestine of human and animals are the reservoirs, B: Predominantly seen in dry and winter season, C: Transmission through contaminated wounds, D: No herd immunity or seen + +### Response: +","Ans. (b) Prodominantly seen in dry and winter season Epidemiology of Tetanus Natural habitat of Clostridium tetani is soil and dust. Bacilli can be found in intestine of herbivorous animals, e.g. cattle, horses. The spores can survive for years. Infection is acquired by contamination of wound with spores. Sequence of events are: introduction of spores; germination, elaboration of exotoxin and binding to the receptor. It is not transmitted from person to person.","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 regarding Clostridium tetani is false, with the following options: A: Soil and intestine of human and animals are the reservoirs, B: Predominantly seen in dry and winter season, C: Transmission through contaminated wounds, D: No herd immunity or seen + +### Response: +Ans. (b) Prodominantly seen in dry and winter season Epidemiology of Tetanus Natural habitat of Clostridium tetani is soil and dust. Bacilli can be found in intestine of herbivorous animals, e.g. cattle, horses. The spores can survive for years. Infection is acquired by contamination of wound with spores. Sequence of events are: introduction of spores; germination, elaboration of exotoxin and binding to the receptor. It is not transmitted from person to person. +### End" +707,"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 special stain used to diagnose fungal hyphae in tissues-, with the following options: A: Masson trichome, B: Silver methenamine, C: Congo Red, D: Alizarin Red + +### Response: +","Ans. is 'b' i.e., Silver methenamineo Gomori methamine silver stain (GMS) and periodic acid Schiff (PAS) are the two most common stains used to look for fungi in tissues and cytology specimens.","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 special stain used to diagnose fungal hyphae in tissues-, with the following options: A: Masson trichome, B: Silver methenamine, C: Congo Red, D: Alizarin Red + +### Response: +Ans. is 'b' i.e., Silver methenamineo Gomori methamine silver stain (GMS) and periodic acid Schiff (PAS) are the two most common stains used to look for fungi in tissues and cytology specimens. +### End" +708,"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 include the clinical features of Chronic Osteomyelitis?, with the following options: A: Excruciating pain and tenderness, B: Non healing bony and overlying soft tissue wounds with indurated soft tissue, C: Wooden character of bone, D: Draining sinuses + +### Response: +","→ Pain and tenderness : The pain is minimal. +→ Non-healing bony and overlying soft tissue wounds with induration of soft tissues. +→ Intraoral or extraoral draining sinuses. +→ Thickened or 'wooden' character of bone","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 include the clinical features of Chronic Osteomyelitis?, with the following options: A: Excruciating pain and tenderness, B: Non healing bony and overlying soft tissue wounds with indurated soft tissue, C: Wooden character of bone, D: Draining sinuses + +### Response: +→ Pain and tenderness : The pain is minimal. +→ Non-healing bony and overlying soft tissue wounds with induration of soft tissues. +→ Intraoral or extraoral draining sinuses. +→ Thickened or 'wooden' character of bone +### End" +709,"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 steroids is not used topically:, with the following options: A: Hydrocoisone, B: Fluticasone, C: Triamcinolone, D: Prednisonlone + +### Response: +",Prednisonlone,"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 steroids is not used topically:, with the following options: A: Hydrocoisone, B: Fluticasone, C: Triamcinolone, D: Prednisonlone + +### Response: +Prednisonlone +### End" +710,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Agoraphobia is a disorder characterized by all, except, with the following options: A: Visual hallucinations, B: Avoidance of situations in which it occurs, C: Presence of panic symptoms, D: Avoidance of being outside alone + +### Response: +",Visual hallucinations,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Agoraphobia is a disorder characterized by all, except, with the following options: A: Visual hallucinations, B: Avoidance of situations in which it occurs, C: Presence of panic symptoms, D: Avoidance of being outside alone + +### Response: +Visual hallucinations +### End" +711,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All or the following are true about excitation contraction coupling except:, with the following options: A: Acetylcholine is released at the nerve terminal, B: Calcium is pumped back into the sarcoplasmic reticulum during relaxation, C: Calcium is released from sarcoplasmic reticulum during contraction, D: Calcium binds to tropomyosin to initiate muscle contraction + +### Response: +","Ans. d. Calcium hinds to tropomyosin to initiate muscle contraction (Ref: Guyton 11/e p90)Calcium binds to Troponin C, not to the tropomyosin, to initiate muscle contraction.'The calcium released into the cytosol binds to Troponin C by the actin filaments, to allow cross-bridge cycling, producing force and, in some situations, motion.'Excitation-Contraction CouplingIn skeletal muscle, E-C coupling relies on a direct coupling between key proteins, the sarcoplasmic reticulum (SR) calcium release channel (identified as the ryanodine receptor, RyR) and voltage-gated L-type calcium channels (identified as dihydropyridine receptors, DHPRs).DHPRs are located on the sarcolemma (which includes the surface sarcolemma and the transverse tubules), while the RvRs reside across the SR membrane.The close apposition of a transverse tubule and two SR regions containing RyRs is described as a triad and is predominantly where E-C coupling takes place.E-C coupling proceeds as follows:The membrane potential of a skeletal muscle cell is depolarised by an action potential (e.g. from synaptic activation from an alpha motor neuron)This depolarisation activates voltage-gated DHPRsThis activates RyR type 1 via physical linkage (involving conformational changes that allosterically activates the RyRs)As the RyRs open, calcium is released from the SR into the local junctional space, which then diffuses into the bulk cytoplasm to cause a calcium transient. Note that the SR has a large calcium buffering capacity partially due to a calcium-binding protein called calsequestrin.The calcium released into the cytosol binds to Troponin C by the actin filaments, to allow cross-bridge cycling, producing force and, in some situations, motion.The sarco/endoplasmic reticulum calcium-ATPase (SERCA) actively pumps calcium back into the SR.As calcium declines back to resting levels, the force declines and relaxation occurs.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All or the following are true about excitation contraction coupling except:, with the following options: A: Acetylcholine is released at the nerve terminal, B: Calcium is pumped back into the sarcoplasmic reticulum during relaxation, C: Calcium is released from sarcoplasmic reticulum during contraction, D: Calcium binds to tropomyosin to initiate muscle contraction + +### Response: +Ans. d. Calcium hinds to tropomyosin to initiate muscle contraction (Ref: Guyton 11/e p90)Calcium binds to Troponin C, not to the tropomyosin, to initiate muscle contraction.'The calcium released into the cytosol binds to Troponin C by the actin filaments, to allow cross-bridge cycling, producing force and, in some situations, motion.'Excitation-Contraction CouplingIn skeletal muscle, E-C coupling relies on a direct coupling between key proteins, the sarcoplasmic reticulum (SR) calcium release channel (identified as the ryanodine receptor, RyR) and voltage-gated L-type calcium channels (identified as dihydropyridine receptors, DHPRs).DHPRs are located on the sarcolemma (which includes the surface sarcolemma and the transverse tubules), while the RvRs reside across the SR membrane.The close apposition of a transverse tubule and two SR regions containing RyRs is described as a triad and is predominantly where E-C coupling takes place.E-C coupling proceeds as follows:The membrane potential of a skeletal muscle cell is depolarised by an action potential (e.g. from synaptic activation from an alpha motor neuron)This depolarisation activates voltage-gated DHPRsThis activates RyR type 1 via physical linkage (involving conformational changes that allosterically activates the RyRs)As the RyRs open, calcium is released from the SR into the local junctional space, which then diffuses into the bulk cytoplasm to cause a calcium transient. Note that the SR has a large calcium buffering capacity partially due to a calcium-binding protein called calsequestrin.The calcium released into the cytosol binds to Troponin C by the actin filaments, to allow cross-bridge cycling, producing force and, in some situations, motion.The sarco/endoplasmic reticulum calcium-ATPase (SERCA) actively pumps calcium back into the SR.As calcium declines back to resting levels, the force declines and relaxation occurs. +### End" +712,"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 man came at the outpatient depament because he had suddenly developed double vision. On examination it was found that his right eye, when at rest was turned medially. The most likely anatomical structures involved are:, with the following options: A: Medial rectus and superior division of oculomotor nerve, B: Inferior oblique and inferior division of oculomotor nerve, C: Lateral rectus and abducent nerve, D: Superior rectus and trochlear nerve + +### Response: +",Ans. Lateral rectus and abducent nerve,"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 man came at the outpatient depament because he had suddenly developed double vision. On examination it was found that his right eye, when at rest was turned medially. The most likely anatomical structures involved are:, with the following options: A: Medial rectus and superior division of oculomotor nerve, B: Inferior oblique and inferior division of oculomotor nerve, C: Lateral rectus and abducent nerve, D: Superior rectus and trochlear nerve + +### Response: +Ans. Lateral rectus and abducent nerve +### End" +713,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mugging is:, with the following options: A: When the neck of the victim is held in the bend of the elbow., B: Compression of neck by human hands., C: When the neck is compressed by using 2 bamboo sticks., D: When the external respiratory orifice are closed by the hand or other means. + +### Response: +","Ans: a (When the neck......elbow) Ref: Reddy, 27th ed,p. 312Mugging is described as strangulation caused by holding the neck of the victim in the bend of the elbow.Throttling - Asphyxia produced by compression of the neck by human hands.Bansdola - One bamboo stick is placed across the back of the neck and another across the front. Both the ends are tied with a rope due to which the victim is squeezed to death.Garroting - The throat is grasped from behind or a ligature is thrown over the neck and quickly tightened by twisting it with a lever which results in sudden loss of consciousness and collapse.Smothering - Asphyxia is caused by closing the external respiratory orifices either by the hand or by other means.Gagging - This is a form of asphyxia which results from pushing a cloth or soft object into the mouth or the closure of mouth and nose by a cloth or similar material which is tied around the head.Burking - It is a method of homicidal smothering and traumatic asphyxia. In this the victim is thrown to the ground and a person sits on the chest and closes the nose and mouth with his hands and another person pulls the victim round the room by the feet.Lynching is a homicidal hanging of a suspect or accused by the mob.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mugging is:, with the following options: A: When the neck of the victim is held in the bend of the elbow., B: Compression of neck by human hands., C: When the neck is compressed by using 2 bamboo sticks., D: When the external respiratory orifice are closed by the hand or other means. + +### Response: +Ans: a (When the neck......elbow) Ref: Reddy, 27th ed,p. 312Mugging is described as strangulation caused by holding the neck of the victim in the bend of the elbow.Throttling - Asphyxia produced by compression of the neck by human hands.Bansdola - One bamboo stick is placed across the back of the neck and another across the front. Both the ends are tied with a rope due to which the victim is squeezed to death.Garroting - The throat is grasped from behind or a ligature is thrown over the neck and quickly tightened by twisting it with a lever which results in sudden loss of consciousness and collapse.Smothering - Asphyxia is caused by closing the external respiratory orifices either by the hand or by other means.Gagging - This is a form of asphyxia which results from pushing a cloth or soft object into the mouth or the closure of mouth and nose by a cloth or similar material which is tied around the head.Burking - It is a method of homicidal smothering and traumatic asphyxia. In this the victim is thrown to the ground and a person sits on the chest and closes the nose and mouth with his hands and another person pulls the victim round the room by the feet.Lynching is a homicidal hanging of a suspect or accused by the mob. +### End" +714,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 63-year-old bartender presents at his physician's office complaining of a painful sore on his tongue. On examination, it is found that he has an ulcerated lesion on his tongue and a mass in the submandibular gland triangle. What is the most likely diagnosis? SELECT ONE., with the following options: A: Lymphoma, B: Squamous cell carcinoma, C: Metastatic skin cancer, D: Benign mixed tumor + +### Response: +","The tip of the tongue drains into the submental lymph nodes, whereas, the side of the tongue drains into the submandibular lymph nodes.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 63-year-old bartender presents at his physician's office complaining of a painful sore on his tongue. On examination, it is found that he has an ulcerated lesion on his tongue and a mass in the submandibular gland triangle. What is the most likely diagnosis? SELECT ONE., with the following options: A: Lymphoma, B: Squamous cell carcinoma, C: Metastatic skin cancer, D: Benign mixed tumor + +### Response: +The tip of the tongue drains into the submental lymph nodes, whereas, the side of the tongue drains into the submandibular lymph nodes. +### End" +715,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: This patient presented with fatigue, fever, anorexia, and weight loss. What is the most likely diagnosis?, with the following options: A: Leukemia, B: Scurvy, C: Acquired immunodeficiency syndrome, D: Sarcoidosis + +### Response: +","Answer A. LeukemiaGingival infiltration in a patient with fever, fatigue, and weight loss is most suggestive of acute leukemia, especially monocytic variants of acute myelogenous leukemia. This patient's gingival infiltration resolved after treatment for acute myelomonocytic leukemia.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: This patient presented with fatigue, fever, anorexia, and weight loss. What is the most likely diagnosis?, with the following options: A: Leukemia, B: Scurvy, C: Acquired immunodeficiency syndrome, D: Sarcoidosis + +### Response: +Answer A. LeukemiaGingival infiltration in a patient with fever, fatigue, and weight loss is most suggestive of acute leukemia, especially monocytic variants of acute myelogenous leukemia. This patient's gingival infiltration resolved after treatment for acute myelomonocytic leukemia. +### End" +716,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 34-year-old man complains of hearing loss. He has had multiple bouts of ear infections over the last 20 years and was recently diagnosed with chronic suppurative otitis media. Which of the following is the most likely complication of this condition in this patient?, with the following options: A: Acoustic neuroma, B: Cholesteatoma, C: Chronic rhinitis, D: Chronic sinusitis + +### Response: +","Cholesteatoma is a complication of chronic suppurative otitis and a rupture of the eardrum. Cholesteatoma is a mass of accumulated keratin and squamous mucosa that results from the growth of squamous epithelium from the external ear canal through the perforated eardrum into the middle ear. Microscopically, cholesteatomas are identical to epidermal inclusion cysts and are surrounded by granulation tissue and fibrosis. The keratin mass frequently becomes infected and shields the bacteria from antibiotics. Squamous cell carcinoma (choice E) rarely occurs in the ear.Diagnosis: Cholesteatoma","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 34-year-old man complains of hearing loss. He has had multiple bouts of ear infections over the last 20 years and was recently diagnosed with chronic suppurative otitis media. Which of the following is the most likely complication of this condition in this patient?, with the following options: A: Acoustic neuroma, B: Cholesteatoma, C: Chronic rhinitis, D: Chronic sinusitis + +### Response: +Cholesteatoma is a complication of chronic suppurative otitis and a rupture of the eardrum. Cholesteatoma is a mass of accumulated keratin and squamous mucosa that results from the growth of squamous epithelium from the external ear canal through the perforated eardrum into the middle ear. Microscopically, cholesteatomas are identical to epidermal inclusion cysts and are surrounded by granulation tissue and fibrosis. The keratin mass frequently becomes infected and shields the bacteria from antibiotics. Squamous cell carcinoma (choice E) rarely occurs in the ear.Diagnosis: Cholesteatoma +### End" +717,"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 Oxybutynin?, with the following options: A: Cholinergic, B: Anticholinergic, C: Adrenergic, D: Selectively inhibits M2 receptor + +### Response: +","Ans. (b) AnticholinergicRef. KDT 6th ed. /107; Katzung Pharma 10th ed. Ch 8 MOA oxybutynin - cholinergic-muscarinic receptor antagonist* Oxybutynin is a selective M3 receptor blocker, used to relieve bladder spasm after urologic surgery, eg, prostatectomy. It is also used to relieve urinary and bladder difficulties, including frequent urination and inability to control urination, by decreasing muscle spasms of the bladder.* It competitively antagonizes the M3 subtypes of the muscarinic acetylcholine receptor.* M3 receptor blockers: (Mn: SOFT blaDar)# Solifenacin, Oxybutynin, Flavoxate, Tolterodine and Darifenacin","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 Oxybutynin?, with the following options: A: Cholinergic, B: Anticholinergic, C: Adrenergic, D: Selectively inhibits M2 receptor + +### Response: +Ans. (b) AnticholinergicRef. KDT 6th ed. /107; Katzung Pharma 10th ed. Ch 8 MOA oxybutynin - cholinergic-muscarinic receptor antagonist* Oxybutynin is a selective M3 receptor blocker, used to relieve bladder spasm after urologic surgery, eg, prostatectomy. It is also used to relieve urinary and bladder difficulties, including frequent urination and inability to control urination, by decreasing muscle spasms of the bladder.* It competitively antagonizes the M3 subtypes of the muscarinic acetylcholine receptor.* M3 receptor blockers: (Mn: SOFT blaDar)# Solifenacin, Oxybutynin, Flavoxate, Tolterodine and Darifenacin +### End" +718,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most retentive post among the following:, with the following options: A: Smooth tapered, B: Serrated tapered, C: Smooth parallel, D: Serrated parallel + +### Response: +","Parallel-sided posts may distribute stress more evenly than tapered posts, which may have a wedging effect. +Serrated are more retentive than smoother surface.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most retentive post among the following:, with the following options: A: Smooth tapered, B: Serrated tapered, C: Smooth parallel, D: Serrated parallel + +### Response: +Parallel-sided posts may distribute stress more evenly than tapered posts, which may have a wedging effect. +Serrated are more retentive than smoother surface. +### End" +719,"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 manifestation of hemophilla?, with the following options: A: Hemoptysis, B: Hemarthrosis, C: Hematemesis, D: Mucosal bleeding + +### Response: +",Ref. Robbins Pathology. 9th edition. Page. 665,"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 manifestation of hemophilla?, with the following options: A: Hemoptysis, B: Hemarthrosis, C: Hematemesis, D: Mucosal bleeding + +### Response: +Ref. Robbins Pathology. 9th edition. Page. 665 +### End" +720,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Calcitonin is produced by, with the following options: A: Thyroid, B: Pituitary, C: Pancreas, D: Hypothalamus + +### Response: +","Calcitonin (also known as thyrocalcitonin) is a 32-amino acid linear polypeptide hormone that is produced in humans primarily by the parafollicular cells (also known as C-cells) of the thyroid, and in many other animals in the ultimobranchial body. It acts to reduce blood calcium (Ca2+), opposing the effects of parathyroid hormone (PTH). Calcitonin has been found in fish, reptiles, birds, and mammals. Ref: Ganong&;s review of medical physiology; 24th edition; page no-377","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Calcitonin is produced by, with the following options: A: Thyroid, B: Pituitary, C: Pancreas, D: Hypothalamus + +### Response: +Calcitonin (also known as thyrocalcitonin) is a 32-amino acid linear polypeptide hormone that is produced in humans primarily by the parafollicular cells (also known as C-cells) of the thyroid, and in many other animals in the ultimobranchial body. It acts to reduce blood calcium (Ca2+), opposing the effects of parathyroid hormone (PTH). Calcitonin has been found in fish, reptiles, birds, and mammals. Ref: Ganong&;s review of medical physiology; 24th edition; page no-377 +### End" +721,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: BRCA 1 and 2 are located in which chromosome?, with the following options: A: 13 and 17, B: 17 and 13, C: 11 and 13, D: 13 and 11 + +### Response: +","Ans. is 'a' i.e., 13 and 17","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: BRCA 1 and 2 are located in which chromosome?, with the following options: A: 13 and 17, B: 17 and 13, C: 11 and 13, D: 13 and 11 + +### Response: +Ans. is 'a' i.e., 13 and 17 +### End" +722,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Diagnosis of tubercular pericarditis can be done by: September 2011, with the following options: A: Chest X-ray, B: USG, C: MRI, D: Aspiration and culture + +### Response: +",Ans. D: Aspiration and culture The diagnosis of tuberculous pericarditis may be confirmed by aspiration of the fluid and direct examination or culture for tubercle bacilli,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Diagnosis of tubercular pericarditis can be done by: September 2011, with the following options: A: Chest X-ray, B: USG, C: MRI, D: Aspiration and culture + +### Response: +Ans. D: Aspiration and culture The diagnosis of tuberculous pericarditis may be confirmed by aspiration of the fluid and direct examination or culture for tubercle bacilli +### End" +723,"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 risks of the endometrial biopsy that was performed on this patient is perforation of the uterus. The endometrial biopsy device is placed through the cervix and into the endometrial cavity. If complete perforation occurs, what is the sequence of layers that the biopsy device would penetrate prior to entering the peritoneal cavity?, with the following options: A: Endometrium, myometrium, serosa, B: Ovary, fallopian tube, broad ligament, C: Round ligament, cardinal ligament, uterosacral ligament, D: Serosa, myometrium, endometrium + +### Response: +","The uterus is a hollow, muscular organ that lies between the bladder and the rectum in the true pelvis. The uterus can be divided into three major segments: the uterine fundus, the uterine corpus (or body), and the cervix. The fallopian tubes enter the uterine fundus laterally in the region called the cornua. Moving from the inside (or hollow) poion of the uterus to the peritoneal cavity, the layers that would be penetrated are the endometrium, the myometrium, and the serosa. The endometrium is the poion of the uterus that proliferates during the menstrual cycle and sheds (the menses) if pregnancy does not occur, or suppos the pregnancy if conception and implantation take place. The myometrium is comprised of three layers: an inner layer of longitudinal smooth muscle, a middle layer of circular smooth muscle (the stratum vasculare), and an outer layer of longitudinal and circular smooth muscle (the stratum supervascularae). The final layer is the uterine serosa. The ovary, fallopian tube, and broad ligament are found posterolateral to the uterus. A biopsy device that perforated the uterus could also injure these structures, but the direct path of perforation is through the endometrium, myometrium, and serosa. Note: The round ligament, cardinal ligament, and uterosacral ligament are suppoing structures attached to the uterus. Again, while a perforating biopsy instrument could possibly involve these structures, this would not be the direct path of perforation. The serosa, myometrium, and endometrium are the correct structures that would be perforated, but they are in the wrong order. Staing within the uterus, the first layer is the endometrium, next is the myometrium and finally the serosa. Ref: Shaw's Textbook of Gynaecology, 13th Ed Page 7-10","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 risks of the endometrial biopsy that was performed on this patient is perforation of the uterus. The endometrial biopsy device is placed through the cervix and into the endometrial cavity. If complete perforation occurs, what is the sequence of layers that the biopsy device would penetrate prior to entering the peritoneal cavity?, with the following options: A: Endometrium, myometrium, serosa, B: Ovary, fallopian tube, broad ligament, C: Round ligament, cardinal ligament, uterosacral ligament, D: Serosa, myometrium, endometrium + +### Response: +The uterus is a hollow, muscular organ that lies between the bladder and the rectum in the true pelvis. The uterus can be divided into three major segments: the uterine fundus, the uterine corpus (or body), and the cervix. The fallopian tubes enter the uterine fundus laterally in the region called the cornua. Moving from the inside (or hollow) poion of the uterus to the peritoneal cavity, the layers that would be penetrated are the endometrium, the myometrium, and the serosa. The endometrium is the poion of the uterus that proliferates during the menstrual cycle and sheds (the menses) if pregnancy does not occur, or suppos the pregnancy if conception and implantation take place. The myometrium is comprised of three layers: an inner layer of longitudinal smooth muscle, a middle layer of circular smooth muscle (the stratum vasculare), and an outer layer of longitudinal and circular smooth muscle (the stratum supervascularae). The final layer is the uterine serosa. The ovary, fallopian tube, and broad ligament are found posterolateral to the uterus. A biopsy device that perforated the uterus could also injure these structures, but the direct path of perforation is through the endometrium, myometrium, and serosa. Note: The round ligament, cardinal ligament, and uterosacral ligament are suppoing structures attached to the uterus. Again, while a perforating biopsy instrument could possibly involve these structures, this would not be the direct path of perforation. The serosa, myometrium, and endometrium are the correct structures that would be perforated, but they are in the wrong order. Staing within the uterus, the first layer is the endometrium, next is the myometrium and finally the serosa. Ref: Shaw's Textbook of Gynaecology, 13th Ed Page 7-10 +### End" +724,"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 congestive heart failure was started on digoxin and diuretics. He later presents with bradycardia and GIT upset and visual disturbances. His K+ was found to be 2.5 The reason for these feature is, with the following options: A: Left ventricular aneurysm, B: Digoxin toxicity, C: Viral gastroenteritis, D: Hypokalemia + +### Response: +","(B) Digoxin toxicity > Digitalis is effective in patients with systolic HF complicated by atrial flutter and fibrillation and a rapid ventricular rate, who benefit both from slowing of the ventricular rate and from the positive inotropic effect.> Although digitalis does not improve survival in patients with systolic HF and sinus rhythm, it reduces symptoms of HF and the need for hospitalization.> Digitalis is of little or no value in patients with HF, sinus rhythm, and the following conditions: hypertrophic cardiomyopathy, myocarditis, mitral stenosis, chronic constrictive pericarditis, and any form of diastolic HF.> Digoxin, which has a half-life of 1.6 days, is filtered n the glomeruli and secreted by the renal tubules. Significant reductions of the glomerular filtration rate reduce the elimination of digoxin and, therefore, may prolong digoxin's effect, allowing it to accumulate to toxic levels, unless the dose is reduced.> DIGITALIS INTOXICATION: This is a serious and potentially fatal complication. Advanced age, hypokalemia, hypomagnesemia, hypoxemia, renal insufficiency, hypercalcemia, and acute myocardial infarction all may reduce tolerance to digitalis. Chronic digitalis intoxication may be insidious in onset and is characterized by anorexia, nausea, and vomiting, exacerbations of HF, weight loss, cachexia, neuralgias, gynecomastia, yellow vision, and delirium. The most frequent disturbances of cardiac rhythm are ventricular premature beats, bigeminy, ventricular tachycardia, and, rarely, ventricular fibrillation. Atrioventricular block and nonparoxysmal atrial tachycardia with variable atrioventricular block are characteristic of digitalis intoxication; withdrawal of the drug and treatment with li-adrenocepior blocker or lidocaine are indicated. If hypokalemia is present, potassium should be administered cautiously by the oral route. Fab fragments of purified, intact digitalis antibodies are a potentially lifesaving approach to the treatment of severe intoxication.> The administration of quinidine, verapamil, amiodarone, and propafenone to patients receiving digoxin raises the serum concentration of the latter, increasing the propensity to digitalis intoxication.> The dose of digitalis should be reduced by half in patients receiving these 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 with congestive heart failure was started on digoxin and diuretics. He later presents with bradycardia and GIT upset and visual disturbances. His K+ was found to be 2.5 The reason for these feature is, with the following options: A: Left ventricular aneurysm, B: Digoxin toxicity, C: Viral gastroenteritis, D: Hypokalemia + +### Response: +(B) Digoxin toxicity > Digitalis is effective in patients with systolic HF complicated by atrial flutter and fibrillation and a rapid ventricular rate, who benefit both from slowing of the ventricular rate and from the positive inotropic effect.> Although digitalis does not improve survival in patients with systolic HF and sinus rhythm, it reduces symptoms of HF and the need for hospitalization.> Digitalis is of little or no value in patients with HF, sinus rhythm, and the following conditions: hypertrophic cardiomyopathy, myocarditis, mitral stenosis, chronic constrictive pericarditis, and any form of diastolic HF.> Digoxin, which has a half-life of 1.6 days, is filtered n the glomeruli and secreted by the renal tubules. Significant reductions of the glomerular filtration rate reduce the elimination of digoxin and, therefore, may prolong digoxin's effect, allowing it to accumulate to toxic levels, unless the dose is reduced.> DIGITALIS INTOXICATION: This is a serious and potentially fatal complication. Advanced age, hypokalemia, hypomagnesemia, hypoxemia, renal insufficiency, hypercalcemia, and acute myocardial infarction all may reduce tolerance to digitalis. Chronic digitalis intoxication may be insidious in onset and is characterized by anorexia, nausea, and vomiting, exacerbations of HF, weight loss, cachexia, neuralgias, gynecomastia, yellow vision, and delirium. The most frequent disturbances of cardiac rhythm are ventricular premature beats, bigeminy, ventricular tachycardia, and, rarely, ventricular fibrillation. Atrioventricular block and nonparoxysmal atrial tachycardia with variable atrioventricular block are characteristic of digitalis intoxication; withdrawal of the drug and treatment with li-adrenocepior blocker or lidocaine are indicated. If hypokalemia is present, potassium should be administered cautiously by the oral route. Fab fragments of purified, intact digitalis antibodies are a potentially lifesaving approach to the treatment of severe intoxication.> The administration of quinidine, verapamil, amiodarone, and propafenone to patients receiving digoxin raises the serum concentration of the latter, increasing the propensity to digitalis intoxication.> The dose of digitalis should be reduced by half in patients receiving these drugs. +### End" +725,"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 thiazides is by -, with the following options: A: Inhibiting Na+/Cl- symporter in DCT, B: Inhibiting Na+/Cl- symporter in PCT, C: Inhibiting Na+K+2C1- in ascending limb of loop of henle, D: Inhibiting Na+K+2CI- in descending limb of loop of henle + +### Response: +","Ans. is ""a' i.e.. Inhibiting Na+/Cl- symporter in DCT o Thiazide diuretics act by inhibiting Na+/ Cl- reabsorption pump in the distal convoluted tubule, thereby increasing urinary excretion of Na+ and Cl-. This result in reduced ECF and plasma volume, which results in decreased CO.o Na+ absorption at different tubular sites.PT - 65-70%Asc. LH - 20-25%DT - 8-9%CD- 1-2%o Tubular absorption can be divided into four sites.Site I- Proximal tubuleo Four mechanisms of Na4 transport have been defined in this segment -1. Direct entry of Na4 along electrochemical gradient.2. Na+-K+ symport along with active reabsorption of glucose, aminoacids, organic anions and PO4 -33. Exchange with H+ by Na+ /H+ exchanger located in the luminal membrane of proximal tubule (PT) epithelial cells. The PT cells secrete H+ with the help of carbonic anhvdrase. H+ ion exchanges with Na+ present in tubular fluid through Na+-H+ exchanger (antiporter) and forms H2CO3 by combining with HCO3-. This H2CO3 is broken into H2O + CO2 by brush border carbonic anhydrase; both CO2 and H2O diffuse inside the cell and recombine to form H2CO3 with the help of intracellular carbonic anhydrase. This H2CO3 is the source of H+. The dissociated HCO3- in the cell is transported to cortical E.C.F. by basolateral membrane Na+-HCO3- symporter resulting in net reabsorption of NaHCO3.Carbonic anvdrase inhibitors (acetazoiamide) act predominantly in PCTand inhibit NaHCQ3 reabsorption.4. The disroportionately large HCO3-, acetate, PO4-3, passive driving forces for Cl- to diffuse through the paracellular pathway, particularly in the later PT. This takes Na+ and H2O along to maintain electrical neutrality and isotonicity; reabsorption in PT is isotonic.o Osmotic diuretics (mannitol) are solutes which are not absorbed in proximal tubule and therefore retain water:Site 11 Ascending limb of loop of Henleo The thick ascending limb can be distinguished into two distinct portion.1. Medullary portion lined by cuboidal cells.2. Cortical portion lined by flattened cells.o Both portions are relatively impermeable to water but absorb salt actively and thus dilute tubular fluid,o In the medullary portion a distinct luminal membrane carrier transports ions in ratio of Na+-K+-2Cl-. The sodium enters the cell is pumped to ECF by Na+ K+ ATPase at the basolateral membrane,o This Na+ -K+--2Cl= symport is inhibited by loop diuretics (eg-Furosemide)o In addition, a Na+-Cl- symporter moves Cl- down its electrochemical gradient into ECF and carries Na+ along.Site III - cortical diluting segment of loop of Henle and early DTo This segment is also impermeable to H2O and continues to absorb salt through Na+-Cl- symporter.o Thiazide diuretics act at this site.Site IV - late distal tubule and collecting ducto In late DT and CD, Na+ is actively reabsorbed; the cation-anion balance being maintained partly by passive Cl- diffusion and partly by secretion of K+ and H+.o Absorption of Na+ at this site occurs through a specific amiloride sensitive Na+ channel and is controlled to a large extent by aldosterone.o K+- sparing diuretics act at this site.o Collecting tubule is the most important site of K+ secretion by the kidney and the site at which virtually all diuretic induced changes in K+ balance occur - as K+ secretion occurs in exchange of Na+, higher the Na+ load in CD higher will be K+ excretion in urine - Diuretics which act on PCT (maximum absortion of Na+ occurs at PCT) like acetazolamide will cause maximum kaliuresis (K+ excretion in urine),o The principal cells are the major sites of Na+, K+, and water transport, and intercalated cells are the primary sites of H+ secretion.o The collecting tubule is also the site at which the final urine concentration is determined. ADH (vasopressin) controls the permeability of this segment to water by regulating the insertion of preformed wrater channels (aquaporin-2, AQP2) into the apical membrane via a G protein - coupled cAMP - mediated process.o ADH also stimulates the insertion of urea transporter UT1 molecules into the apical membranes of medullary collecting tubule cells. Urea concentration in the medulla plays an important role maintaining the high osmolarity of the medulla and in the concentration of urine.","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 thiazides is by -, with the following options: A: Inhibiting Na+/Cl- symporter in DCT, B: Inhibiting Na+/Cl- symporter in PCT, C: Inhibiting Na+K+2C1- in ascending limb of loop of henle, D: Inhibiting Na+K+2CI- in descending limb of loop of henle + +### Response: +Ans. is ""a' i.e.. Inhibiting Na+/Cl- symporter in DCT o Thiazide diuretics act by inhibiting Na+/ Cl- reabsorption pump in the distal convoluted tubule, thereby increasing urinary excretion of Na+ and Cl-. This result in reduced ECF and plasma volume, which results in decreased CO.o Na+ absorption at different tubular sites.PT - 65-70%Asc. LH - 20-25%DT - 8-9%CD- 1-2%o Tubular absorption can be divided into four sites.Site I- Proximal tubuleo Four mechanisms of Na4 transport have been defined in this segment -1. Direct entry of Na4 along electrochemical gradient.2. Na+-K+ symport along with active reabsorption of glucose, aminoacids, organic anions and PO4 -33. Exchange with H+ by Na+ /H+ exchanger located in the luminal membrane of proximal tubule (PT) epithelial cells. The PT cells secrete H+ with the help of carbonic anhvdrase. H+ ion exchanges with Na+ present in tubular fluid through Na+-H+ exchanger (antiporter) and forms H2CO3 by combining with HCO3-. This H2CO3 is broken into H2O + CO2 by brush border carbonic anhydrase; both CO2 and H2O diffuse inside the cell and recombine to form H2CO3 with the help of intracellular carbonic anhydrase. This H2CO3 is the source of H+. The dissociated HCO3- in the cell is transported to cortical E.C.F. by basolateral membrane Na+-HCO3- symporter resulting in net reabsorption of NaHCO3.Carbonic anvdrase inhibitors (acetazoiamide) act predominantly in PCTand inhibit NaHCQ3 reabsorption.4. The disroportionately large HCO3-, acetate, PO4-3, passive driving forces for Cl- to diffuse through the paracellular pathway, particularly in the later PT. This takes Na+ and H2O along to maintain electrical neutrality and isotonicity; reabsorption in PT is isotonic.o Osmotic diuretics (mannitol) are solutes which are not absorbed in proximal tubule and therefore retain water:Site 11 Ascending limb of loop of Henleo The thick ascending limb can be distinguished into two distinct portion.1. Medullary portion lined by cuboidal cells.2. Cortical portion lined by flattened cells.o Both portions are relatively impermeable to water but absorb salt actively and thus dilute tubular fluid,o In the medullary portion a distinct luminal membrane carrier transports ions in ratio of Na+-K+-2Cl-. The sodium enters the cell is pumped to ECF by Na+ K+ ATPase at the basolateral membrane,o This Na+ -K+--2Cl= symport is inhibited by loop diuretics (eg-Furosemide)o In addition, a Na+-Cl- symporter moves Cl- down its electrochemical gradient into ECF and carries Na+ along.Site III - cortical diluting segment of loop of Henle and early DTo This segment is also impermeable to H2O and continues to absorb salt through Na+-Cl- symporter.o Thiazide diuretics act at this site.Site IV - late distal tubule and collecting ducto In late DT and CD, Na+ is actively reabsorbed; the cation-anion balance being maintained partly by passive Cl- diffusion and partly by secretion of K+ and H+.o Absorption of Na+ at this site occurs through a specific amiloride sensitive Na+ channel and is controlled to a large extent by aldosterone.o K+- sparing diuretics act at this site.o Collecting tubule is the most important site of K+ secretion by the kidney and the site at which virtually all diuretic induced changes in K+ balance occur - as K+ secretion occurs in exchange of Na+, higher the Na+ load in CD higher will be K+ excretion in urine - Diuretics which act on PCT (maximum absortion of Na+ occurs at PCT) like acetazolamide will cause maximum kaliuresis (K+ excretion in urine),o The principal cells are the major sites of Na+, K+, and water transport, and intercalated cells are the primary sites of H+ secretion.o The collecting tubule is also the site at which the final urine concentration is determined. ADH (vasopressin) controls the permeability of this segment to water by regulating the insertion of preformed wrater channels (aquaporin-2, AQP2) into the apical membrane via a G protein - coupled cAMP - mediated process.o ADH also stimulates the insertion of urea transporter UT1 molecules into the apical membranes of medullary collecting tubule cells. Urea concentration in the medulla plays an important role maintaining the high osmolarity of the medulla and in the concentration of urine. +### End" +726,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 38-year-old woman visits her gynecologist for a routine Pap smear examination. During the collection of cells from her uterine cervix she feels a mild pain. Which of the following areas is most likely to experience ""referral of pain"" during this procedure?, with the following options: A: Perineum and lateral portion of the thigh, B: Suprapubic region, C: Umbilical region, D: Inguinal region + +### Response: +","Pain from this area is mediated via parasympathetic responses and would thus travel to the S2 to S4 levels through the pelvic splanchnic nerves. The S2, S3, and S4 spinal cord levels also provide sensory innervation of the perineum and posterior thigh. The suprapubic and inguinal regions are supplied by ilioinguinal and iliohypogastric nerves (L1). The umbilical region receives sensory innervation from the T10 level. In the epigastric region the sensory innervation is provided by T7 to T10.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 38-year-old woman visits her gynecologist for a routine Pap smear examination. During the collection of cells from her uterine cervix she feels a mild pain. Which of the following areas is most likely to experience ""referral of pain"" during this procedure?, with the following options: A: Perineum and lateral portion of the thigh, B: Suprapubic region, C: Umbilical region, D: Inguinal region + +### Response: +Pain from this area is mediated via parasympathetic responses and would thus travel to the S2 to S4 levels through the pelvic splanchnic nerves. The S2, S3, and S4 spinal cord levels also provide sensory innervation of the perineum and posterior thigh. The suprapubic and inguinal regions are supplied by ilioinguinal and iliohypogastric nerves (L1). The umbilical region receives sensory innervation from the T10 level. In the epigastric region the sensory innervation is provided by T7 to T10. +### End" +727,"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 japanese encephalitis is: March 2010, with the following options: A: It is caused by flavivirus, B: Transmitted by aedes mosquito, C: Not endemic in India, D: Man is dead-end host + +### Response: +","Ans. B: Transmitted by aedes mosquito The Japanese encephalitis virus is a virus from the family Flaviviridae. Domestic pigs and wild birds are reservoirs of the virus; transmission to humans may cause severe symptoms. Man is an incidental dead-end host. One of the most impoant vectors of this disease is the mosquito Culex tritaeniorhynchus. This disease is most prevalent in Southeast Asia, especially in Japan, china, and Korea. The causative agent Japanese encephalitis virus is an enveloped virus of the genus flavivirus; it is closely related to the West Nile virus and St. Louis encephalitis virus. Positive sense single stranded RNA genome is packaged in the capsid, formed by the capsid protein. It has been noted that the Japanese encephalitis virus (JEV) infects the lumen of the endoplasmic reticulum (ER) and rapidly accumulates substantial amounts of viral proteins for the JEV. Japanese Encephalitis is diagnosed by detection of antibodies in serum and CSF (cerebrospinal fluid) by IgM capture ELISA","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 japanese encephalitis is: March 2010, with the following options: A: It is caused by flavivirus, B: Transmitted by aedes mosquito, C: Not endemic in India, D: Man is dead-end host + +### Response: +Ans. B: Transmitted by aedes mosquito The Japanese encephalitis virus is a virus from the family Flaviviridae. Domestic pigs and wild birds are reservoirs of the virus; transmission to humans may cause severe symptoms. Man is an incidental dead-end host. One of the most impoant vectors of this disease is the mosquito Culex tritaeniorhynchus. This disease is most prevalent in Southeast Asia, especially in Japan, china, and Korea. The causative agent Japanese encephalitis virus is an enveloped virus of the genus flavivirus; it is closely related to the West Nile virus and St. Louis encephalitis virus. Positive sense single stranded RNA genome is packaged in the capsid, formed by the capsid protein. It has been noted that the Japanese encephalitis virus (JEV) infects the lumen of the endoplasmic reticulum (ER) and rapidly accumulates substantial amounts of viral proteins for the JEV. Japanese Encephalitis is diagnosed by detection of antibodies in serum and CSF (cerebrospinal fluid) by IgM capture ELISA +### End" +728,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Abductor of the larynx is:, with the following options: A: Crico-arytenoideus posterior, B: Crico-arytenoideus lateralis, C: Arytenoideus transversus, D: Vocalis muscle + +### Response: +","Abduction (opening) of the vocal folds: The posterior cricoarytenoid muscles pull the muscular processes posteriorly, rotating the vocal processes laterally and thus widening the rims glottides. Adduction (closing) of the vocal folds : The lateral cricoarytenoid muscles pull the muscular processes anteriorly, rotating the arytenoids so their vocal processes swing medially. When this action is combined with that of the transverse arytenoid muscles, which pull the arytenoid cailages together, the gap between the vocal folds is decreased. Air pushed through the rima glottidis causes vibration of the vocal ligaments.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Abductor of the larynx is:, with the following options: A: Crico-arytenoideus posterior, B: Crico-arytenoideus lateralis, C: Arytenoideus transversus, D: Vocalis muscle + +### Response: +Abduction (opening) of the vocal folds: The posterior cricoarytenoid muscles pull the muscular processes posteriorly, rotating the vocal processes laterally and thus widening the rims glottides. Adduction (closing) of the vocal folds : The lateral cricoarytenoid muscles pull the muscular processes anteriorly, rotating the arytenoids so their vocal processes swing medially. When this action is combined with that of the transverse arytenoid muscles, which pull the arytenoid cailages together, the gap between the vocal folds is decreased. Air pushed through the rima glottidis causes vibration of the vocal ligaments. +### End" +729,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Real-time PCR is used for:, with the following options: A: DNA detection only, B: RNA detection only, C: Protein detection only, D: For monitoring the amplification of target DNA + +### Response: +","Real-time PCR is used for monitoring the amplification of target DNA. In this PCR, we use SYBR-green dye, which has a propey of giving fluorescence when bound to dsDNA. When DNA synthesis is occurring then gradually ds DNA is increased in amount so fluorescence is also increased. This fluorescence can be measured and then amount of DNA can be calculated from that. Therefore it is known as Quantitative PCR (q PCR). Dyes used in qPCR: SYBR Based Detection: Uses SYBR Green dye (ds-DNA binding dye) - NOT sequence specific. TaqMan Based Detection: Uses a fluorogenic probe specific to target gene to detect target, as it accumulates during PCR.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Real-time PCR is used for:, with the following options: A: DNA detection only, B: RNA detection only, C: Protein detection only, D: For monitoring the amplification of target DNA + +### Response: +Real-time PCR is used for monitoring the amplification of target DNA. In this PCR, we use SYBR-green dye, which has a propey of giving fluorescence when bound to dsDNA. When DNA synthesis is occurring then gradually ds DNA is increased in amount so fluorescence is also increased. This fluorescence can be measured and then amount of DNA can be calculated from that. Therefore it is known as Quantitative PCR (q PCR). Dyes used in qPCR: SYBR Based Detection: Uses SYBR Green dye (ds-DNA binding dye) - NOT sequence specific. TaqMan Based Detection: Uses a fluorogenic probe specific to target gene to detect target, as it accumulates during PCR. +### End" +730,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Shortest diameter of pelvic outlet:, with the following options: A: Antero-posterior, B: Inter tuberous, C: Oblique, D: Inter-spinous + +### Response: +","Ans- B Inter tuberousRef.: D.C. Dutta 8th ed. / 94-97; William's 23rd ed. Chapter 2, Maternal Pelvic Anatomy* Most of the students answer interspinous for this question. Obviously interspinous is having the least diameter (10cm)y but it belongs to mid pelvis.* The question is asking about the shortest diameter of pelvic outlet, which is inter-tuberous (diameter between ischial tuberosity) diameter ~ 11cm.PLANES AND DIAMETERS OF THE PELVISThe pelvis is described as having four imaginary planes:* The plane of the pelvic inlet--the superior strait* The plane of the mid pelvis--the least pelvic dimensions* The plane of the pelvic outlet--the inferior strait* The plane of greatest pelvic dimension--of no obstetrical significance.Summarized data of maternal Pelvis planes and diameters (all the numerical data are derived from standard reference i.e. William's 23rd ed.)PlaneDiameterMeasured BetweenSizeTransverseGreatest distance between the linea terminalis on either side~ 13 cmA-P diameter aka true conjugateExtends from the uppermost margin of the symphysis pubis to the sacral promontory11cmOblique diameterExtends from one of the sacroiliac synchondroses to the iliopectineal eminence on the opposite side.12 cmInterspinous diameterBetween the ischial spines10cmAnteroposteriorAt the level of ischial spine11.5cmAntero-posteriorCoccyx to symphysis pubis11.5 cmTransverseBetween ischial tuberosities11 cmPosterior sagittalSacro-Coccygeal angle to the midline imaginary line at base11.5/2 cmObstetrical conjugateShortest distance between the sacral promontory and the symphysis pubis10 cm. the obstetrical conjugate is estimated indirectly by subtracting 1.5 to 2 cm from the diagonal conjugateDiagonal conjugatefrom the lower margin of the symphysis to the sacral promontory11.5-12 cm","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Shortest diameter of pelvic outlet:, with the following options: A: Antero-posterior, B: Inter tuberous, C: Oblique, D: Inter-spinous + +### Response: +Ans- B Inter tuberousRef.: D.C. Dutta 8th ed. / 94-97; William's 23rd ed. Chapter 2, Maternal Pelvic Anatomy* Most of the students answer interspinous for this question. Obviously interspinous is having the least diameter (10cm)y but it belongs to mid pelvis.* The question is asking about the shortest diameter of pelvic outlet, which is inter-tuberous (diameter between ischial tuberosity) diameter ~ 11cm.PLANES AND DIAMETERS OF THE PELVISThe pelvis is described as having four imaginary planes:* The plane of the pelvic inlet--the superior strait* The plane of the mid pelvis--the least pelvic dimensions* The plane of the pelvic outlet--the inferior strait* The plane of greatest pelvic dimension--of no obstetrical significance.Summarized data of maternal Pelvis planes and diameters (all the numerical data are derived from standard reference i.e. William's 23rd ed.)PlaneDiameterMeasured BetweenSizeTransverseGreatest distance between the linea terminalis on either side~ 13 cmA-P diameter aka true conjugateExtends from the uppermost margin of the symphysis pubis to the sacral promontory11cmOblique diameterExtends from one of the sacroiliac synchondroses to the iliopectineal eminence on the opposite side.12 cmInterspinous diameterBetween the ischial spines10cmAnteroposteriorAt the level of ischial spine11.5cmAntero-posteriorCoccyx to symphysis pubis11.5 cmTransverseBetween ischial tuberosities11 cmPosterior sagittalSacro-Coccygeal angle to the midline imaginary line at base11.5/2 cmObstetrical conjugateShortest distance between the sacral promontory and the symphysis pubis10 cm. the obstetrical conjugate is estimated indirectly by subtracting 1.5 to 2 cm from the diagonal conjugateDiagonal conjugatefrom the lower margin of the symphysis to the sacral promontory11.5-12 cm +### End" +731,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: An organism with sterols in their cell wall is, with the following options: A: Mycoplasma, B: Bacillus, C: Streptococcus, D: Spirillum + +### Response: +","“Mycoplasma lacks a rigid cell wall and they are bounded by a triple-layered unit membrane that contains sterols. +” Mycoplasma PPLO - by Nocard & Roux • Smallest free-living organism • Gram-negative.highly pleomorphic organism, +stained by Giemsa • Found in the form of elementary bodies & filaments of various size • Facultative anaerobe, require a source of cholesterol for growth +• Media = hayflick media, Eaton's media • Colonies = biphasic with a fried egg appearance • C/F: Primary atypical pneumonia. Bullous myringitis. +Otitis • Lab diagnosis: 1. Isolation of organism - from throat swab, respiratory secretion 2. serological diagnosis -1. +Specific - HI, IF. metabolic inhibition 2. Nonspecific- streptococcus MG 3. +Cold agglutination Treatment: DOC- Erythromycin (Presence of 70 S ribosome makes it susceptible to antibiotics that inhibit protein synthesis; +but due to the lack of cell wall they are resistant to penicillin) Remember +• Ureaplasma ureolyticum belongs to the family mycoplasmatacea; which can hydrolyse urea & is a cause for nongonococcal urethritis • +L forms of bacteria - are due to the loss of bacteria but they retain the biochemical & antigenic properties of present bacteria.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: An organism with sterols in their cell wall is, with the following options: A: Mycoplasma, B: Bacillus, C: Streptococcus, D: Spirillum + +### Response: +“Mycoplasma lacks a rigid cell wall and they are bounded by a triple-layered unit membrane that contains sterols. +” Mycoplasma PPLO - by Nocard & Roux • Smallest free-living organism • Gram-negative.highly pleomorphic organism, +stained by Giemsa • Found in the form of elementary bodies & filaments of various size • Facultative anaerobe, require a source of cholesterol for growth +• Media = hayflick media, Eaton's media • Colonies = biphasic with a fried egg appearance • C/F: Primary atypical pneumonia. Bullous myringitis. +Otitis • Lab diagnosis: 1. Isolation of organism - from throat swab, respiratory secretion 2. serological diagnosis -1. +Specific - HI, IF. metabolic inhibition 2. Nonspecific- streptococcus MG 3. +Cold agglutination Treatment: DOC- Erythromycin (Presence of 70 S ribosome makes it susceptible to antibiotics that inhibit protein synthesis; +but due to the lack of cell wall they are resistant to penicillin) Remember +• Ureaplasma ureolyticum belongs to the family mycoplasmatacea; which can hydrolyse urea & is a cause for nongonococcal urethritis • +L forms of bacteria - are due to the loss of bacteria but they retain the biochemical & antigenic properties of present bacteria. +### End" +732,"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 mainly found in?, with the following options: A: Brain stem, B: Cortical neurons, C: Hippocampus, D: Spinal cord + +### Response: +","Ans. (c) HippocampusRef: Harrison's 17th ed ch-188y Anantnarayan 7th ed p 539, Rabies: Scientific Basis of the Disease and Its Management by William H. Wanner, Alan C. Jackson p390.","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 mainly found in?, with the following options: A: Brain stem, B: Cortical neurons, C: Hippocampus, D: Spinal cord + +### Response: +Ans. (c) HippocampusRef: Harrison's 17th ed ch-188y Anantnarayan 7th ed p 539, Rabies: Scientific Basis of the Disease and Its Management by William H. Wanner, Alan C. Jackson p390. +### End" +733,"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 statements about influence of smoking on risk of coronary heart disease (CHD) is not true?, with the following options: A: Influence of smoking is independent of the risk factors for CHD, B: Influence of smoking is only additive to other factors for CHD, C: Influence of smoking is synergistic to other risk factors for CHD, D: Influence of smoking is directly related to number of cigarettes smoke per day + +### Response: +","park's textbook of preventive and social medicine 23rd edition . + +there is evidence that influence smoking not only independent of but also synergistic with other risk factors such as hypertension and elevated serum cholesterol.this means that the effect are more than additive.","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 statements about influence of smoking on risk of coronary heart disease (CHD) is not true?, with the following options: A: Influence of smoking is independent of the risk factors for CHD, B: Influence of smoking is only additive to other factors for CHD, C: Influence of smoking is synergistic to other risk factors for CHD, D: Influence of smoking is directly related to number of cigarettes smoke per day + +### Response: +park's textbook of preventive and social medicine 23rd edition . + +there is evidence that influence smoking not only independent of but also synergistic with other risk factors such as hypertension and elevated serum cholesterol.this means that the effect are more than additive. +### End" +734,"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 man who had been healthy all his life now has progressive, symmetric muscular weakness. A year ago, he noted weakness in the area of the head and neck, which caused difficulty with speech, eye movements, and swallowing. In the past year, the weakness in the upper and lower extremities has increased, and he can no longer stand, walk, or feed himself. His mental function remains intact. Which of the following cells is most likely being destroyed in this man?, with the following options: A: Ependymal cell, B: Lower motor neuron, C: Microglial cell, D: Oligodendrocyte + +### Response: +","The progressive and symmetric nature of this patient's disease is a classic feature of amyotrophic lateral sclerosis (ALS). The muscles show a denervation type of grouped atrophy from the loss of lower motor neurons in anterior horns of the spinal cord. The ""bulbar"" form of ALS affects mainly cranial nerve nuclei and has a more aggressive course. Cortical upper motor neurons may also be lost, but the mental function is preserved in ALS. Ependymal cells line ventricles, which are normal in ALS. Microglial cells have a macrophage-like function and may be involved in demyelinating plaques of multiple sclerosis that can produce various motor signs and symptoms over time, but symmetry is not a feature of this disease. Oligodendrocytes provide myelin to axons in the CNS. Parkinson's disease with loss of substantia nigra pigmented neurons is characterized by rigidity and involuntary movements, not by muscular weakness. Huntington disease with loss of spiny neurons in the caudate nucleus causes abnormal movements, not weakness, and there can be associated dementia over time.","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 man who had been healthy all his life now has progressive, symmetric muscular weakness. A year ago, he noted weakness in the area of the head and neck, which caused difficulty with speech, eye movements, and swallowing. In the past year, the weakness in the upper and lower extremities has increased, and he can no longer stand, walk, or feed himself. His mental function remains intact. Which of the following cells is most likely being destroyed in this man?, with the following options: A: Ependymal cell, B: Lower motor neuron, C: Microglial cell, D: Oligodendrocyte + +### Response: +The progressive and symmetric nature of this patient's disease is a classic feature of amyotrophic lateral sclerosis (ALS). The muscles show a denervation type of grouped atrophy from the loss of lower motor neurons in anterior horns of the spinal cord. The ""bulbar"" form of ALS affects mainly cranial nerve nuclei and has a more aggressive course. Cortical upper motor neurons may also be lost, but the mental function is preserved in ALS. Ependymal cells line ventricles, which are normal in ALS. Microglial cells have a macrophage-like function and may be involved in demyelinating plaques of multiple sclerosis that can produce various motor signs and symptoms over time, but symmetry is not a feature of this disease. Oligodendrocytes provide myelin to axons in the CNS. Parkinson's disease with loss of substantia nigra pigmented neurons is characterized by rigidity and involuntary movements, not by muscular weakness. Huntington disease with loss of spiny neurons in the caudate nucleus causes abnormal movements, not weakness, and there can be associated dementia over time. +### End" +735,"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 stridor after birth:, with the following options: A: Laryngeal papilloma, B: Laryngeal web, C: Laryngomalacia, D: Vocal cord palsy + +### Response: +","(c) Laryngomalacia(Ref. Current Diagnosis & Treatment Otolaryngology, Lalwani, 3rd ed., 481; Scott Brown, 8th ed., Vol 2; 333)Laryngomalacia, which is the most common congenital anomaly of the larynx, is the most common cause of congenital laryngeal stridor.Vocal cord palsy is the 2nd most common cause of congenital stridor. Laryngeal web, a rare malformation can also lead to stridor.Laryngeal papilloma is the most common benign tumour of the larynx in children. Here also the child presents with stridor. In laryngeal papilloma there is additionally hoarseness of voice as it involves the vocal cord, whereas in laryngomalacia which is supraglottic the cry of the child is normal. Also laryngeal papilloma is seen in children from 2 to 5 years whereas laryngomalacia disappears by 2 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: Most common cause of stridor after birth:, with the following options: A: Laryngeal papilloma, B: Laryngeal web, C: Laryngomalacia, D: Vocal cord palsy + +### Response: +(c) Laryngomalacia(Ref. Current Diagnosis & Treatment Otolaryngology, Lalwani, 3rd ed., 481; Scott Brown, 8th ed., Vol 2; 333)Laryngomalacia, which is the most common congenital anomaly of the larynx, is the most common cause of congenital laryngeal stridor.Vocal cord palsy is the 2nd most common cause of congenital stridor. Laryngeal web, a rare malformation can also lead to stridor.Laryngeal papilloma is the most common benign tumour of the larynx in children. Here also the child presents with stridor. In laryngeal papilloma there is additionally hoarseness of voice as it involves the vocal cord, whereas in laryngomalacia which is supraglottic the cry of the child is normal. Also laryngeal papilloma is seen in children from 2 to 5 years whereas laryngomalacia disappears by 2 years of age. +### End" +736,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Trypsin cleaves which amino acid?, with the following options: A: Glycine, B: Glutamate, C: Arginine, D: Aspartate + +### Response: +","Trypsin cleaves carboxy terminal of basic amino acids. Eg: Arginine, Lysine","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Trypsin cleaves which amino acid?, with the following options: A: Glycine, B: Glutamate, C: Arginine, D: Aspartate + +### Response: +Trypsin cleaves carboxy terminal of basic amino acids. Eg: Arginine, Lysine +### End" +737,"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 regardingGamma-Release-Assays for diagnosis of Tuberculosis is true -, with the following options: A: First Generation Quanti FERON-TB assay used ESAT-6, B: Second Generation Quanti FERON-TB (Gold) assay used ESAT-6 and CPF-10, C: These tests can distinguish between M. tuberculosis and M. bovis, D: None of the non-tuberculosis mycobacteria give a positive reaction with the test + +### Response: +","Ans. is 'b' i.e., Second Generation Quantiferon-TB (Gold) assay used ESAT-6 and CPF-10 These are also called Interferon-Gamma release assays because these detect release of IFN-y from persons who have been exposed to Mycobacterium-tuberculosis complex. It is an ELISA based test. Blood of the patient is exposed with a specific M. tuberculosis antigen and the production of IFN-y is measured by ELISA. Based on antigen used, these assays are divided into three types :- i) First generation or QuantiFERON TB (QFT) :- It responds to 1 tubercular protein, PPD (purified protein derivative). ii) Second generation or QuantiFERON TB Gold (QFT-G) :- This responds to 2 tubercular proteins : (1) ESAT-6 (earyl secretory antigen target-6), and (2) CFP-10 (culture filtrate protein-10). ESAT-6 and CFP-10 are secreted by all M. tuberculosis and pathogenic M. bovis strains. Therefore, test cannot distinguish between M. tuberculosis and M. bovis strains. Most non-tubercular mycobacteria do not secrete ESAT-6 and CFP-10. However, some nontubercular mycobacteria such as M. Kansasii, M. szulgai and M. maximum may secrete ESAT-6 and CFP-10 and hence test positive. iii) Third generation or QuantiFERON TB Gold In-Tube (QFT-GIT) :- This responds to 3 tubercular proteins : (1) ESAT-6, (2) CFP-10, and (3) TB 7.7.","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 regardingGamma-Release-Assays for diagnosis of Tuberculosis is true -, with the following options: A: First Generation Quanti FERON-TB assay used ESAT-6, B: Second Generation Quanti FERON-TB (Gold) assay used ESAT-6 and CPF-10, C: These tests can distinguish between M. tuberculosis and M. bovis, D: None of the non-tuberculosis mycobacteria give a positive reaction with the test + +### Response: +Ans. is 'b' i.e., Second Generation Quantiferon-TB (Gold) assay used ESAT-6 and CPF-10 These are also called Interferon-Gamma release assays because these detect release of IFN-y from persons who have been exposed to Mycobacterium-tuberculosis complex. It is an ELISA based test. Blood of the patient is exposed with a specific M. tuberculosis antigen and the production of IFN-y is measured by ELISA. Based on antigen used, these assays are divided into three types :- i) First generation or QuantiFERON TB (QFT) :- It responds to 1 tubercular protein, PPD (purified protein derivative). ii) Second generation or QuantiFERON TB Gold (QFT-G) :- This responds to 2 tubercular proteins : (1) ESAT-6 (earyl secretory antigen target-6), and (2) CFP-10 (culture filtrate protein-10). ESAT-6 and CFP-10 are secreted by all M. tuberculosis and pathogenic M. bovis strains. Therefore, test cannot distinguish between M. tuberculosis and M. bovis strains. Most non-tubercular mycobacteria do not secrete ESAT-6 and CFP-10. However, some nontubercular mycobacteria such as M. Kansasii, M. szulgai and M. maximum may secrete ESAT-6 and CFP-10 and hence test positive. iii) Third generation or QuantiFERON TB Gold In-Tube (QFT-GIT) :- This responds to 3 tubercular proteins : (1) ESAT-6, (2) CFP-10, and (3) TB 7.7. +### End" +738,"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 are true regarding Colostrum or breast milk except, with the following options: A: Vitamin D is most abundant vitamin in breast milk, B: Taurine amino acid is present which is required for brain development, C: In comparison to cow's milk, human has higher lactose, iron and calcium - phosphate ratio, D: IgA is in high quantity + +### Response: +","Constituent Breast milk grammes per liter Cow milk grammers per lliter Proteins: 11 33 Casein 4 28 Soluble proteins 7 5 Lactalbumin 3.5 1.5 to 1.8 Beta-Lactaglobulin 0 3.7 Lactotransferrin 1 to 2 0.2 to 0.5 Immunoglobulin 1 to 2 0.5 Lysozyme 0.5 Traces Non Protein: Nitrogenous Substances 0.32 0.32 Lipids: 35 35 Linoleic acid 3.5 1 Carbohydrates 70 50 Lactose 62 50 Nitrogenous oligosaccharides 8 0 Minerals 2 8 Ca (Calcium) 0.33 1 P (Phosphorous) 0.15 1 Fe (Iron) 0.4 to 1.5 mg 0.3 to 0.5 mg Vitamins: 2 8 Ca (calcium ) 0.33 1 P (Phosphorous) 0.15 1 Fe (Iron) 0.4 to 1.5 ,g 0.3 to 0.5 mg Vitamins C 60 mg 20 mg D 50 IU 25 IU Energy: 640-720 Kcal 2670-3000 KJ 650 Kcal 2717 KJ EFA exclusively present is DHA required for brain development and myelination. Amino acid present for brain development is Taurine Vitamin most deficient in breast milk is Vit - D","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 are true regarding Colostrum or breast milk except, with the following options: A: Vitamin D is most abundant vitamin in breast milk, B: Taurine amino acid is present which is required for brain development, C: In comparison to cow's milk, human has higher lactose, iron and calcium - phosphate ratio, D: IgA is in high quantity + +### Response: +Constituent Breast milk grammes per liter Cow milk grammers per lliter Proteins: 11 33 Casein 4 28 Soluble proteins 7 5 Lactalbumin 3.5 1.5 to 1.8 Beta-Lactaglobulin 0 3.7 Lactotransferrin 1 to 2 0.2 to 0.5 Immunoglobulin 1 to 2 0.5 Lysozyme 0.5 Traces Non Protein: Nitrogenous Substances 0.32 0.32 Lipids: 35 35 Linoleic acid 3.5 1 Carbohydrates 70 50 Lactose 62 50 Nitrogenous oligosaccharides 8 0 Minerals 2 8 Ca (Calcium) 0.33 1 P (Phosphorous) 0.15 1 Fe (Iron) 0.4 to 1.5 mg 0.3 to 0.5 mg Vitamins: 2 8 Ca (calcium ) 0.33 1 P (Phosphorous) 0.15 1 Fe (Iron) 0.4 to 1.5 ,g 0.3 to 0.5 mg Vitamins C 60 mg 20 mg D 50 IU 25 IU Energy: 640-720 Kcal 2670-3000 KJ 650 Kcal 2717 KJ EFA exclusively present is DHA required for brain development and myelination. Amino acid present for brain development is Taurine Vitamin most deficient in breast milk is Vit - D +### End" +739,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Spontaneous bleeding occurs when platelet count falls below:, with the following options: A: 50,000/mL, B: 40,000/mL, C: 30,000/mL, D: 20,000/mL + +### Response: +","d. 20,000/mL(Ref: Wintrobes 13/689)In general, the risk of significant spontaneous hemorrhage increases gradually as the platelet count drops to <50 109/L and is high at counts <5 109/L. So among the options the best answer is 20,000/mL.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Spontaneous bleeding occurs when platelet count falls below:, with the following options: A: 50,000/mL, B: 40,000/mL, C: 30,000/mL, D: 20,000/mL + +### Response: +d. 20,000/mL(Ref: Wintrobes 13/689)In general, the risk of significant spontaneous hemorrhage increases gradually as the platelet count drops to <50 109/L and is high at counts <5 109/L. So among the options the best answer is 20,000/mL. +### End" +740,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hypophosphatemia is caused by-, with the following options: A: Primary hypothyroidism, B: Primary hyperparathyroidism, C: Primary hyperthyroidism, D: Hypoparathyroidism + +### Response: +","Ans. is 'b' i.e., Primary hyperparathyroidism Causes of hypophosphatemia Internal redistribution Decreased intestinal absorption Increased urinary excretion o Increased insulin secretion o Inadequate intake o Primary' and secondary particularly during feeding o Antacids containing hyperparathyroidism o Acute respiratory alkalosis aluminum or magnesium o Vitamin D deficiency or o Hungry' bone syndrome o Steatorrhoea or chronic diarrhea resistance o Catecholamines o Vitamin D deficiency or resistance a Hereditary hypophosphatemia o Recovery' from starvation rickets or acidosis o Oncogenic osteomalacia o Gram negative sepsis o Fanconi syndrome o Other acetazolamide o Bartter syndrome Clinical feature of intracellular phosphate depletion o Most of the syndrome of hypophosphatemia are due to two consequences of intracellular phosphate depletion which virtually affect all organ system. o Red cell 2, 3- DPG (diphosphoglycerate) level falls, Thereby increasing the affinity1 of hemoglobin for oxygen and reducing oxygen release at the tissue level o Intracellular A TP level falls With severe hypophosphatemia those cell function that depend upon the energy rich phosphate compounds begin to fail. Effect of hypophosphatemia on various organs","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hypophosphatemia is caused by-, with the following options: A: Primary hypothyroidism, B: Primary hyperparathyroidism, C: Primary hyperthyroidism, D: Hypoparathyroidism + +### Response: +Ans. is 'b' i.e., Primary hyperparathyroidism Causes of hypophosphatemia Internal redistribution Decreased intestinal absorption Increased urinary excretion o Increased insulin secretion o Inadequate intake o Primary' and secondary particularly during feeding o Antacids containing hyperparathyroidism o Acute respiratory alkalosis aluminum or magnesium o Vitamin D deficiency or o Hungry' bone syndrome o Steatorrhoea or chronic diarrhea resistance o Catecholamines o Vitamin D deficiency or resistance a Hereditary hypophosphatemia o Recovery' from starvation rickets or acidosis o Oncogenic osteomalacia o Gram negative sepsis o Fanconi syndrome o Other acetazolamide o Bartter syndrome Clinical feature of intracellular phosphate depletion o Most of the syndrome of hypophosphatemia are due to two consequences of intracellular phosphate depletion which virtually affect all organ system. o Red cell 2, 3- DPG (diphosphoglycerate) level falls, Thereby increasing the affinity1 of hemoglobin for oxygen and reducing oxygen release at the tissue level o Intracellular A TP level falls With severe hypophosphatemia those cell function that depend upon the energy rich phosphate compounds begin to fail. Effect of hypophosphatemia on various organs +### End" +741,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Malignant hyperthermia is a rare complication of the use of the following anaesthetic:, with the following options: A: Ketamine, B: Thiopentone sodium, C: Halothane, D: Ether + +### Response: +","Rarely, halothane can cause malignant hyperthermia, which is treated with dantrolene.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Malignant hyperthermia is a rare complication of the use of the following anaesthetic:, with the following options: A: Ketamine, B: Thiopentone sodium, C: Halothane, D: Ether + +### Response: +Rarely, halothane can cause malignant hyperthermia, which is treated with dantrolene. +### End" +742,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 34-year-old woman is admitted to the emergency department after a car crash. Radiographic studies show marked edema and hematoma of the arm, but there are no fractures. During physical examination the patient presents with inability to abduct her arm without first establishing lateral momentum of the limb, and inability to flex the elbow and shoulder. Which of the following portions of the brachial plexus is most likely injured?, with the following options: A: Superior trunk, B: Middle trunk, C: Inferior trunk, D: Lateral cord + +### Response: +","The superior trunk of the brachial plexus includes C5 and C6, which give rise to the suprascapular nerve, which innervates the supraspinatus muscle. The supraspinatus muscle is the primary muscle involved in abduction of the arm from 0deg to 15deg. The deltoid muscle supplied primarily by C5, abducts the arm from 15 degrees to 90 degrees. The middle trunk is just C7 and has nothing to do with the muscle involved in initial abduction of the arm. The inferior trunk is C8-T1 and does not supply the supraspinatus muscle; therefore, it is not the right answer. The cords are distal to the branching of the supraspinatus muscle; therefore, neither lateral cord nor medial cord is the correct answer.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 34-year-old woman is admitted to the emergency department after a car crash. Radiographic studies show marked edema and hematoma of the arm, but there are no fractures. During physical examination the patient presents with inability to abduct her arm without first establishing lateral momentum of the limb, and inability to flex the elbow and shoulder. Which of the following portions of the brachial plexus is most likely injured?, with the following options: A: Superior trunk, B: Middle trunk, C: Inferior trunk, D: Lateral cord + +### Response: +The superior trunk of the brachial plexus includes C5 and C6, which give rise to the suprascapular nerve, which innervates the supraspinatus muscle. The supraspinatus muscle is the primary muscle involved in abduction of the arm from 0deg to 15deg. The deltoid muscle supplied primarily by C5, abducts the arm from 15 degrees to 90 degrees. The middle trunk is just C7 and has nothing to do with the muscle involved in initial abduction of the arm. The inferior trunk is C8-T1 and does not supply the supraspinatus muscle; therefore, it is not the right answer. The cords are distal to the branching of the supraspinatus muscle; therefore, neither lateral cord nor medial cord is the correct answer. +### End" +743,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Contents of the suboccipital triangle are formed by all of the following structures, EXCEPT?, with the following options: A: Veebral aery, B: Suboccipital nerve, C: Greater occipital nerve, D: Lesser occipital nerve + +### Response: +","The contents of the suboccipital triangle are veebral aery, suboccipital nerve and greater occipital nerve.The suboccipital triangle is the area in the suboccipital region between the rectus capitis posterior major and the obliquus capitis superior and inferior muscles. It is covered by a layer of dense fibro-fatty tissue, deep to the semispinalis capitis muscle. Its floor is formed by the posterior occipitoatlantal membrane and the posterior arch of the C1 veebrae. The suboccipital muscles are:Obliquus capitis superior muscleObliquus capitis inferior muscleRectus capitis posterior major muscleRectus capitis posterior minor muscle","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Contents of the suboccipital triangle are formed by all of the following structures, EXCEPT?, with the following options: A: Veebral aery, B: Suboccipital nerve, C: Greater occipital nerve, D: Lesser occipital nerve + +### Response: +The contents of the suboccipital triangle are veebral aery, suboccipital nerve and greater occipital nerve.The suboccipital triangle is the area in the suboccipital region between the rectus capitis posterior major and the obliquus capitis superior and inferior muscles. It is covered by a layer of dense fibro-fatty tissue, deep to the semispinalis capitis muscle. Its floor is formed by the posterior occipitoatlantal membrane and the posterior arch of the C1 veebrae. The suboccipital muscles are:Obliquus capitis superior muscleObliquus capitis inferior muscleRectus capitis posterior major muscleRectus capitis posterior minor muscle +### End" +744,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: ‘Dipstick Test’ for rapid diagnosis of Plasmodium falciparum is based on, with the following options: A: Arginine-rich protein, B: Serine-rich protein, C: Tyrosine-rich protein, D: Histidine-rich protein + +### Response: +","‘Dipstick Test’ is used for the rapid diagnosis of Plasmodium falciparum (Pf) +– Is a ‘rapid whole blood immuno-chromatographic test’ +– Uses 2 antibodies specific for ‘Pf Histidine Rich Protein II Antigen’ +– Is a ‘antigen capture assay’ – Colloidal gold is used in the test card +– Gives results in 3 – 5 minutes +– Specificity and negative predictive value is 99% +– Not as effective when parasite levels < 100 parasites/ml of blood +• Rapid tests for diagnosis of Pf: +– Dipstick test (Pf Histidine rich protein II – HRP II) +– Leishman stain +– Field’s stain +– Acridine orange.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: ‘Dipstick Test’ for rapid diagnosis of Plasmodium falciparum is based on, with the following options: A: Arginine-rich protein, B: Serine-rich protein, C: Tyrosine-rich protein, D: Histidine-rich protein + +### Response: +‘Dipstick Test’ is used for the rapid diagnosis of Plasmodium falciparum (Pf) +– Is a ‘rapid whole blood immuno-chromatographic test’ +– Uses 2 antibodies specific for ‘Pf Histidine Rich Protein II Antigen’ +– Is a ‘antigen capture assay’ – Colloidal gold is used in the test card +– Gives results in 3 – 5 minutes +– Specificity and negative predictive value is 99% +– Not as effective when parasite levels < 100 parasites/ml of blood +• Rapid tests for diagnosis of Pf: +– Dipstick test (Pf Histidine rich protein II – HRP II) +– Leishman stain +– Field’s stain +– Acridine orange. +### End" +745,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Streptokinase was infused in a patient for the management of deep vein thrombosis, following which the patient developed hematemesis. Which of the given agents can be chosen to manage this episode of hematemesis?, with the following options: A: Vitamin K, B: Noradrenaline, C: Epsilon amino caproic acid, D: Rutin + +### Response: +",Tranexamic acid and EACA are antifibrinolytic drugs which are used as antidotes for the management of fibrinolytic drug poisoning.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Streptokinase was infused in a patient for the management of deep vein thrombosis, following which the patient developed hematemesis. Which of the given agents can be chosen to manage this episode of hematemesis?, with the following options: A: Vitamin K, B: Noradrenaline, C: Epsilon amino caproic acid, D: Rutin + +### Response: +Tranexamic acid and EACA are antifibrinolytic drugs which are used as antidotes for the management of fibrinolytic drug poisoning. +### End" +746,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hypothalamopituitary axis becomes active and functional at:, with the following options: A: 20th week of gestation, B: 5th year of life, C: 5th week of life, D: 5th month of life + +### Response: +","Ans. a (20th week of gestation). (Ref. Nelson's textbook of Paediatrics 17th ed. 1870)# Hypothalamic neurons synthesize TRH by 6-8 weeks (of gestation) and TSH secretion is evident by 12th week of gestation.# Maturation of HP-thyroid axis occurs by 2nd half of gestation.# Feedback relationships by 3 months postnatally.- Fetal thyroid bilobed shape is recognised by 7th week of gestation- Thyroid folicle cell and colloid formation seen by 10th week- Thyroglobulin synthesis occurs from 4th week- T4, T3 synthesis and secretion from 12th week of gestationThe CNS-hypothalamic-pituitary-gonadal-target organ axisOvarian hormones have direct and indirect effects on other tissues (e.g., bone, skin, muscle). FSH = follicle-stimulating hormone; GnRH = gonadotropin-releasing hormone; LH = luteinizing hormone.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hypothalamopituitary axis becomes active and functional at:, with the following options: A: 20th week of gestation, B: 5th year of life, C: 5th week of life, D: 5th month of life + +### Response: +Ans. a (20th week of gestation). (Ref. Nelson's textbook of Paediatrics 17th ed. 1870)# Hypothalamic neurons synthesize TRH by 6-8 weeks (of gestation) and TSH secretion is evident by 12th week of gestation.# Maturation of HP-thyroid axis occurs by 2nd half of gestation.# Feedback relationships by 3 months postnatally.- Fetal thyroid bilobed shape is recognised by 7th week of gestation- Thyroid folicle cell and colloid formation seen by 10th week- Thyroglobulin synthesis occurs from 4th week- T4, T3 synthesis and secretion from 12th week of gestationThe CNS-hypothalamic-pituitary-gonadal-target organ axisOvarian hormones have direct and indirect effects on other tissues (e.g., bone, skin, muscle). FSH = follicle-stimulating hormone; GnRH = gonadotropin-releasing hormone; LH = luteinizing hormone. +### End" +747,"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 congenital glaucoma with corneal ulcer –, with the following options: A: Trabeculotomy, B: Goniotomy, C: Miotics, D: Steroids + +### Response: +",Trabeculotomy is particularly useful when corneal clouding prevents visualization of the angle (as in this question due to present of corneal ulcer).,"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 congenital glaucoma with corneal ulcer –, with the following options: A: Trabeculotomy, B: Goniotomy, C: Miotics, D: Steroids + +### Response: +Trabeculotomy is particularly useful when corneal clouding prevents visualization of the angle (as in this question due to present of corneal ulcer). +### End" +748,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Frequency of Carhart's notch is -, with the following options: A: 1000 Hz, B: 2000 Hz, C: 3000 Hz, D: 4000 Hz + +### Response: +","Ans. is 'b' i.e., 2000 Hzo Dip in bone conduction in otosclerosis (Carhart's notch)- 2000 Hzo Dip in noise induced hearing loss (Acoustic dip)- 4000 Hzo In otosclerosis bone conduction is usually normal (as would be in cases of conductive hearing loss). However, some cases show a dip in bone conduction on audiogram which is maximum at 2000 Hz (Cahart's notch),o In NIHL both bone conduction and air conduction are defective (as would be in SNHL) and there is a typical notch (acoustic dip) at 4000 Hz, both for air and bone conduction,o So, Caharfs notch of otosclerosis is a dip for bone conduction, while acoustic dip of NIHL is for both air as well as bone conduction.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Frequency of Carhart's notch is -, with the following options: A: 1000 Hz, B: 2000 Hz, C: 3000 Hz, D: 4000 Hz + +### Response: +Ans. is 'b' i.e., 2000 Hzo Dip in bone conduction in otosclerosis (Carhart's notch)- 2000 Hzo Dip in noise induced hearing loss (Acoustic dip)- 4000 Hzo In otosclerosis bone conduction is usually normal (as would be in cases of conductive hearing loss). However, some cases show a dip in bone conduction on audiogram which is maximum at 2000 Hz (Cahart's notch),o In NIHL both bone conduction and air conduction are defective (as would be in SNHL) and there is a typical notch (acoustic dip) at 4000 Hz, both for air and bone conduction,o So, Caharfs notch of otosclerosis is a dip for bone conduction, while acoustic dip of NIHL is for both air as well as bone conduction. +### End" +749,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Lisfranc fracture dislocation involves, with the following options: A: Lunate, B: Scaphoid, C: Tarso-metatarsal, D: Capitate + +### Response: +",Lisfranc Fracture - Fracture dislocation of tarso- metatarsal area. Chopas fracture - fracture dislocation of intearsal area,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Lisfranc fracture dislocation involves, with the following options: A: Lunate, B: Scaphoid, C: Tarso-metatarsal, D: Capitate + +### Response: +Lisfranc Fracture - Fracture dislocation of tarso- metatarsal area. Chopas fracture - fracture dislocation of intearsal area +### End" +750,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mephenteramine can be used in hypovolemic shock, although intravenous fluid supplementation is primary treatment. It acts by, with the following options: A: Increasing cardiac output, B: Increasing systolic blood pressure, C: Increasing diastolic blood pressure, D: All of the above + +### Response: +","Ans. d (All of the above) (Ref. KDT 5th/pg. 114)SYMPATHOMIMETICSCatecholaminesNoncatecholaminesAdrenalineEphedrineNoradrenalinePhenylephrineIsoprenalineMetaraminolDopamineMethoxamineDobutamine Dopexamine Selective b2-receptor agonists (salbutamol, terbutaline, ritodrine, metaproterenol, fenoterol and orciprenaline)Other Sympathomimetic Amines (amphetamine, methamphetamine, mephentermine and some newer agents like Prenalterol,Pirbuterol, Xamaterol, fenoldopam, etc)PrenalterolIt is a relatively selective pi agonist that has been used in the management of CHF.It is also useful orally, with a bioavailability of about 33%.PirbuterolIt a b2 agonist which has been used both as a bronchodilator and as an inotrope.XamaterolIt is an orally active partial b1 agonist used for chronic CHFDopamine analogsAside from dopexamine other dopamine analogs have been used in Rx of CHF and HTN.MEPHENTERMINEMechanism of action# Indirectly stimulates beta adrenergic receptors and possibly to a lesser extent alpha adrenergic receptors.# The main effect of therapeutic doses of mephentermine is cardiac stimulation .# Force of contraction and CO are usually increased, accompanied by an increased stroke volume.# Mephentermine shortens atrioventricular (AV) conduction velocity and the refractory period of the AV node and increases ventricular conduction velocity.# Heart rate may be increased, decreased or unchanged.# Mephentermine increases the coronary blood flow, but the work of the heart and myocardial consumption are correspondingly increased.# Mephentermine directly dilates the arteries and arterioles in the skeletal and mesenteric vascular beds.# Venous return to the heart is increased in patients receiving mephentermine.# The drug usually increases systolic and diastolic blood pressure by increasing cardiac output; increases in cardiac output are greatest when initial cardiac output is low. When initial cardiac output is high, increased total peripheral resistance may be responsible for increase in blood pressure.# Mephentermine also dilates the coronary, cerebral, splanchnic and renal blood vessels.# It stimulates the central nervous system and may cause anxiety, seizures or tachycardia.Indications# Shock accompanying myocardial infarction. Injection mephentermine is favoured in combating hypotensive states in cardiogenic shock.# Hypotension occurring during surgical procedures or following spinal anesthesia.# Prevention of hypotension attendant to spinal anesthesia to surgical procedures or occurring in recovery.Contraindications# Injection mephentine is not advocated for the treatment of hypotension caused by phenothiazines.# When shock is primarily due to loss of blood or fluid the primary consideration in treatment should be the replacement of circulating blood volume. The use of mephentine alone is not advocated in such conditions.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mephenteramine can be used in hypovolemic shock, although intravenous fluid supplementation is primary treatment. It acts by, with the following options: A: Increasing cardiac output, B: Increasing systolic blood pressure, C: Increasing diastolic blood pressure, D: All of the above + +### Response: +Ans. d (All of the above) (Ref. KDT 5th/pg. 114)SYMPATHOMIMETICSCatecholaminesNoncatecholaminesAdrenalineEphedrineNoradrenalinePhenylephrineIsoprenalineMetaraminolDopamineMethoxamineDobutamine Dopexamine Selective b2-receptor agonists (salbutamol, terbutaline, ritodrine, metaproterenol, fenoterol and orciprenaline)Other Sympathomimetic Amines (amphetamine, methamphetamine, mephentermine and some newer agents like Prenalterol,Pirbuterol, Xamaterol, fenoldopam, etc)PrenalterolIt is a relatively selective pi agonist that has been used in the management of CHF.It is also useful orally, with a bioavailability of about 33%.PirbuterolIt a b2 agonist which has been used both as a bronchodilator and as an inotrope.XamaterolIt is an orally active partial b1 agonist used for chronic CHFDopamine analogsAside from dopexamine other dopamine analogs have been used in Rx of CHF and HTN.MEPHENTERMINEMechanism of action# Indirectly stimulates beta adrenergic receptors and possibly to a lesser extent alpha adrenergic receptors.# The main effect of therapeutic doses of mephentermine is cardiac stimulation .# Force of contraction and CO are usually increased, accompanied by an increased stroke volume.# Mephentermine shortens atrioventricular (AV) conduction velocity and the refractory period of the AV node and increases ventricular conduction velocity.# Heart rate may be increased, decreased or unchanged.# Mephentermine increases the coronary blood flow, but the work of the heart and myocardial consumption are correspondingly increased.# Mephentermine directly dilates the arteries and arterioles in the skeletal and mesenteric vascular beds.# Venous return to the heart is increased in patients receiving mephentermine.# The drug usually increases systolic and diastolic blood pressure by increasing cardiac output; increases in cardiac output are greatest when initial cardiac output is low. When initial cardiac output is high, increased total peripheral resistance may be responsible for increase in blood pressure.# Mephentermine also dilates the coronary, cerebral, splanchnic and renal blood vessels.# It stimulates the central nervous system and may cause anxiety, seizures or tachycardia.Indications# Shock accompanying myocardial infarction. Injection mephentermine is favoured in combating hypotensive states in cardiogenic shock.# Hypotension occurring during surgical procedures or following spinal anesthesia.# Prevention of hypotension attendant to spinal anesthesia to surgical procedures or occurring in recovery.Contraindications# Injection mephentine is not advocated for the treatment of hypotension caused by phenothiazines.# When shock is primarily due to loss of blood or fluid the primary consideration in treatment should be the replacement of circulating blood volume. The use of mephentine alone is not advocated in such conditions. +### End" +751,"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 Plummer vinson syndrome except -, with the following options: A: Dysphagia, B: Oesophageal web, C: Iron deficiency, D: Kidney disease + +### Response: +","Ans. is 'd' i.e., Kidney disease Plummer-Vinson syndrome* Plummer-Vinson syndrome, also known as Brown-Kelly-Paterson syndrome or sederopenic dysphagia, seen in middle aged edentulous women.* The plummer Vinsion Paterson Brown Kelly Syndrome is characterized by: -# Dysphagia# Chronic iron deficiency anemia# Atrophic oral mucosa and glossitis# Brittle, spoon-shaped fingernails (Koilonychia)* The cause of dysphagia is usually a cervical esophageal web, but abnormal pharyngeal and esophageal motility may play a role.* The syndrome characterstically occurs in middle aged edentulous (without teeth) women.* It is a premalignant lesion. Approximately 10% of patient develop squamous cell Ca of esophagus, oral cavity or the hypopharynx.* As iron-deficiency anemia is a common finding, it is also known as sideropenic dysphagia.* Carcinoma develops in post-cricoid region (not in lower third esophagus).","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 Plummer vinson syndrome except -, with the following options: A: Dysphagia, B: Oesophageal web, C: Iron deficiency, D: Kidney disease + +### Response: +Ans. is 'd' i.e., Kidney disease Plummer-Vinson syndrome* Plummer-Vinson syndrome, also known as Brown-Kelly-Paterson syndrome or sederopenic dysphagia, seen in middle aged edentulous women.* The plummer Vinsion Paterson Brown Kelly Syndrome is characterized by: -# Dysphagia# Chronic iron deficiency anemia# Atrophic oral mucosa and glossitis# Brittle, spoon-shaped fingernails (Koilonychia)* The cause of dysphagia is usually a cervical esophageal web, but abnormal pharyngeal and esophageal motility may play a role.* The syndrome characterstically occurs in middle aged edentulous (without teeth) women.* It is a premalignant lesion. Approximately 10% of patient develop squamous cell Ca of esophagus, oral cavity or the hypopharynx.* As iron-deficiency anemia is a common finding, it is also known as sideropenic dysphagia.* Carcinoma develops in post-cricoid region (not in lower third esophagus). +### End" +752,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: ln stable angina-, with the following options: A: CK-MB is elevated, B: Troponin I is elevated, C: Myoglobin is elevated, D: The levels of cardiac marker remainUNCHANGED + +### Response: +","Ref R Alagappan - Manual of Practical Medicine 4th Edition -page no 180 Unstable Angina It is due to dynamic obstruction of coronary aery - spasm and or rupture of plaque. It is defined as angina pectoris or equivalent ischaemic discomfo with either one feature. 1. It occurs at rest or with minimal exeion usually lasting > 10 minutes. 2. It is severe and of new onset within the prior 4-6 weeks. 3. It has a crescendo pattern of pain - distinctly severe, prolonged and more frequent than before. Unstable angina is distinguished from non-STelevation myocardial infarction by the absence of elevated serological markers of myocardial necrosis. It is also distinguished from ST-elevation MI by the absence of persistent ST segment elevation. Pathogenesis 1. Plaque rupture or erosion with superimposed nonocclusive thrombus (most common) 2. Progressive mechanical obstruction - either rapidly advancing coronary atherosclerosis or restenosis following percutaneous coronary intervention. 3. Increased discrepancy between myocardial oxygen demand and supply. Management Immediately assess the following: * Clinical evaluation - history and physical examination * 12 - lead ECG recording * Measurement of cardiac specific markers - troponin and CK-MB. All ACS patients should be placed on aspirin, b-blocker, nitrate and clopidogrel immediately. Low risk patients - On observation if the patient remains pain-free with normal ECG and normal levels of cardiac markers, submit them for stress ECG. If the stress test is negative, consider alternative diagnosis. If the stress test is positive, continue medication and invasive testing when required. Intermediate and high risk patients - Patient has to be admitted in the intensive care unit and to be managed with anti-ischaemia, antiplatelet and anticoagulant group of drugs. In the meantime coronary angiography is planned.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: ln stable angina-, with the following options: A: CK-MB is elevated, B: Troponin I is elevated, C: Myoglobin is elevated, D: The levels of cardiac marker remainUNCHANGED + +### Response: +Ref R Alagappan - Manual of Practical Medicine 4th Edition -page no 180 Unstable Angina It is due to dynamic obstruction of coronary aery - spasm and or rupture of plaque. It is defined as angina pectoris or equivalent ischaemic discomfo with either one feature. 1. It occurs at rest or with minimal exeion usually lasting > 10 minutes. 2. It is severe and of new onset within the prior 4-6 weeks. 3. It has a crescendo pattern of pain - distinctly severe, prolonged and more frequent than before. Unstable angina is distinguished from non-STelevation myocardial infarction by the absence of elevated serological markers of myocardial necrosis. It is also distinguished from ST-elevation MI by the absence of persistent ST segment elevation. Pathogenesis 1. Plaque rupture or erosion with superimposed nonocclusive thrombus (most common) 2. Progressive mechanical obstruction - either rapidly advancing coronary atherosclerosis or restenosis following percutaneous coronary intervention. 3. Increased discrepancy between myocardial oxygen demand and supply. Management Immediately assess the following: * Clinical evaluation - history and physical examination * 12 - lead ECG recording * Measurement of cardiac specific markers - troponin and CK-MB. All ACS patients should be placed on aspirin, b-blocker, nitrate and clopidogrel immediately. Low risk patients - On observation if the patient remains pain-free with normal ECG and normal levels of cardiac markers, submit them for stress ECG. If the stress test is negative, consider alternative diagnosis. If the stress test is positive, continue medication and invasive testing when required. Intermediate and high risk patients - Patient has to be admitted in the intensive care unit and to be managed with anti-ischaemia, antiplatelet and anticoagulant group of drugs. In the meantime coronary angiography is planned. +### End" +753,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cholinomimetics can be used for the treatment of following condition except, with the following options: A: Closed angle glaucoma, B: Bradycardia, C: Cobra bite, D: Myasthenia gravis + +### Response: +",Chlolinometic drug will cause bradycardia as an adverse effect and thus cannot be used for its treatment Ref-KDT 6/e p104,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cholinomimetics can be used for the treatment of following condition except, with the following options: A: Closed angle glaucoma, B: Bradycardia, C: Cobra bite, D: Myasthenia gravis + +### Response: +Chlolinometic drug will cause bradycardia as an adverse effect and thus cannot be used for its treatment Ref-KDT 6/e p104 +### End" +754,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The commonest cause of pathological fracture is generalized affection is:, with the following options: A: Carcinoma, B: Osteoporosis, C: Cyst, D: All of the above + +### Response: +",B i.e. Ostoporosis,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The commonest cause of pathological fracture is generalized affection is:, with the following options: A: Carcinoma, B: Osteoporosis, C: Cyst, D: All of the above + +### Response: +B i.e. Ostoporosis +### End" +755,"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 catheter materials is most suited for long term is used, with the following options: A: Latex, B: Silicone, C: Rubber, D: Pol yurathane + +### Response: +","Ans. is 'b' i.e., Silicone ""Catheters made of silicone are, in general better tolerated over the long-term than those made of materials like latex and polyurathane."" - Cambell, 8/e Also remember Catheter size is usually measured in French (fr) it refers to the outside circumference of the catheter, not the luminal diameter. (Thus a 20 fr catheter may have different luminal size for urinary drainage, depending on the type of material used for construction and the number of lumens within the catheter). 1 Fr = 0.33 nun in diameter thus 3 Fr = 1 mm in diameter (thus a 21 Fr catheter would be 7 mm in diameter)","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 catheter materials is most suited for long term is used, with the following options: A: Latex, B: Silicone, C: Rubber, D: Pol yurathane + +### Response: +Ans. is 'b' i.e., Silicone ""Catheters made of silicone are, in general better tolerated over the long-term than those made of materials like latex and polyurathane."" - Cambell, 8/e Also remember Catheter size is usually measured in French (fr) it refers to the outside circumference of the catheter, not the luminal diameter. (Thus a 20 fr catheter may have different luminal size for urinary drainage, depending on the type of material used for construction and the number of lumens within the catheter). 1 Fr = 0.33 nun in diameter thus 3 Fr = 1 mm in diameter (thus a 21 Fr catheter would be 7 mm in diameter) +### End" +756,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: ""Multibacillary"" is a spectrum of disease seen in -, with the following options: A: Leprosy, B: TB, C: Tetanus, D: Trachoma + +### Response: +",Operational classification of Leprosy (According to skin smear positivity) to serve as a basis for chemotherapy Paucibacillary Leprosy (PBL) Multibacillary Leprosy (MBL) BI <2 BI >= 2 Included types Indeterminate Polar tuberculoid (TT) Border Tuberculoid (BT) Polar lepromatous (LL) Borderline lepromatous (BL) Mid-borderline (BB) Multidrug therapy (MDT) in NLEP (Drugs) Rifampicin 600mg OAMS Dapsone 100mg daily Rifampicin 600mg OAMS Dapsone 100mg daily Clofazimine 300mg OAMS 5 mg daily Treatment duration 6 months 12 months Follow up (after treatment) Annually for 2 years Annually for 5 years BI: bacteriological index OAMS: Once a month supervised Ref: Park 25th edition Pgno : 332-347,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: ""Multibacillary"" is a spectrum of disease seen in -, with the following options: A: Leprosy, B: TB, C: Tetanus, D: Trachoma + +### Response: +Operational classification of Leprosy (According to skin smear positivity) to serve as a basis for chemotherapy Paucibacillary Leprosy (PBL) Multibacillary Leprosy (MBL) BI <2 BI >= 2 Included types Indeterminate Polar tuberculoid (TT) Border Tuberculoid (BT) Polar lepromatous (LL) Borderline lepromatous (BL) Mid-borderline (BB) Multidrug therapy (MDT) in NLEP (Drugs) Rifampicin 600mg OAMS Dapsone 100mg daily Rifampicin 600mg OAMS Dapsone 100mg daily Clofazimine 300mg OAMS 5 mg daily Treatment duration 6 months 12 months Follow up (after treatment) Annually for 2 years Annually for 5 years BI: bacteriological index OAMS: Once a month supervised Ref: Park 25th edition Pgno : 332-347 +### End" +757,"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 could be prescribed for a child who suffer from night terrors?, with the following options: A: Meprobamate, B: Clonazepam, C: Lithium, D: Amphetamine + +### Response: +","Clonazepam is a benzodiazepine. Besides being useful for seizure disorders, including petit mal, it is an antianxiety agent and helps to relieve night terrors. Meprobamate, one of the earliest antianxiety agents, has been largely replaced by the benzodiazepines. Lithium is used for the treatment of bipolar disease. Amphetamine can produce a calming effect with long-term therapy in hyperkinetic 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 drugs could be prescribed for a child who suffer from night terrors?, with the following options: A: Meprobamate, B: Clonazepam, C: Lithium, D: Amphetamine + +### Response: +Clonazepam is a benzodiazepine. Besides being useful for seizure disorders, including petit mal, it is an antianxiety agent and helps to relieve night terrors. Meprobamate, one of the earliest antianxiety agents, has been largely replaced by the benzodiazepines. Lithium is used for the treatment of bipolar disease. Amphetamine can produce a calming effect with long-term therapy in hyperkinetic syndrome. +### End" +758,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Thyroarytenoid muscle causes, with the following options: A: Adduction of vocal cord, B: Tenses vocal cord, C: Relaxes vocal cord, D: Closes inlet of larynx + +### Response: +","Thyroarytenoid muscle is relaxor of vocal cord. Vocalis muscle which is medial fibre of thyroarytenoid, causes tension in anterior ⅓ and relaxation in posterior ⅔ of vocal cord.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Thyroarytenoid muscle causes, with the following options: A: Adduction of vocal cord, B: Tenses vocal cord, C: Relaxes vocal cord, D: Closes inlet of larynx + +### Response: +Thyroarytenoid muscle is relaxor of vocal cord. Vocalis muscle which is medial fibre of thyroarytenoid, causes tension in anterior ⅓ and relaxation in posterior ⅔ of vocal cord. +### End" +759,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The following is true about bronchial carcinoids-, with the following options: A: Highly radiosensitive, B: Metastasis common, C: Carcinoid syndrome does not manifest, D: Commonly arise from terminal bronchioles + +### Response: +","Ref:Textbook of pathology (Harsh mohan) 6th edition,page no.503 BRONCHIAL CARCINOID AND OTHER NEUROENDOCRINE TUMOURS Neuroendocrine tumours of the lung represent a continuum spectrum of lung tumours with progressively increasing aggressiveness which include: typical carcinoid (least aggressive), atypical carcinoid, and large cell endocrine carcinoma, and also small cell carcinoma (most aggressive). All these tumours arise from neuroendocrine (Kulchitsky) cells of bronchial mucosa. Formerly, bronchial carcinoids used to be classified as 'bronchial adenomas' but now it is known that they are locally invasive and have the capacity to metastasise. Bronchial carcinoids tend to occur at a younger age than bronchogenic carcinoma, often appearing below the age of 40 years, and are not related to cigarette smoking. CLINICAL FEATURES. Bronchial carcinoids occur at a relatively early age and have equal sex incidence. Most of the symptoms in bronchial carcinoids occur as a result of bronchial obstruction such as cough, haemoptysis, atelectasis and secondary infection. About 5-10% of bronchial carcinoids metastasise to the liver and these cases are capable of producing carcinoid syndrome.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The following is true about bronchial carcinoids-, with the following options: A: Highly radiosensitive, B: Metastasis common, C: Carcinoid syndrome does not manifest, D: Commonly arise from terminal bronchioles + +### Response: +Ref:Textbook of pathology (Harsh mohan) 6th edition,page no.503 BRONCHIAL CARCINOID AND OTHER NEUROENDOCRINE TUMOURS Neuroendocrine tumours of the lung represent a continuum spectrum of lung tumours with progressively increasing aggressiveness which include: typical carcinoid (least aggressive), atypical carcinoid, and large cell endocrine carcinoma, and also small cell carcinoma (most aggressive). All these tumours arise from neuroendocrine (Kulchitsky) cells of bronchial mucosa. Formerly, bronchial carcinoids used to be classified as 'bronchial adenomas' but now it is known that they are locally invasive and have the capacity to metastasise. Bronchial carcinoids tend to occur at a younger age than bronchogenic carcinoma, often appearing below the age of 40 years, and are not related to cigarette smoking. CLINICAL FEATURES. Bronchial carcinoids occur at a relatively early age and have equal sex incidence. Most of the symptoms in bronchial carcinoids occur as a result of bronchial obstruction such as cough, haemoptysis, atelectasis and secondary infection. About 5-10% of bronchial carcinoids metastasise to the liver and these cases are capable of producing carcinoid syndrome. +### End" +760,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most peptide and protein hormones are synthesized as, with the following options: A: A secretagogue, B: A pleiotropic hormone, C: Proopiomelanocoin (POMC), D: A preprohormone + +### Response: +",Preprohormones are the gene products for most peptide and protein hormones. These are rapidly cleaved to form prohormones. POMC and propressophysin are two examples of specific prohormones.Ref: Guyton; 13th edition,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most peptide and protein hormones are synthesized as, with the following options: A: A secretagogue, B: A pleiotropic hormone, C: Proopiomelanocoin (POMC), D: A preprohormone + +### Response: +Preprohormones are the gene products for most peptide and protein hormones. These are rapidly cleaved to form prohormones. POMC and propressophysin are two examples of specific prohormones.Ref: Guyton; 13th edition +### End" +761,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Volume of ECF in body is, with the following options: A: 0.1 × body weight, B: 0.2 × body weight, C: 0.3 × body weight, D: 0.4 × body weight + +### Response: +","Total body weight = 0.6 × body weight +ICF = 0.4 × body weight +ECF = 0.2 × body weight +Plasma = 0.05 × body weight +Interstitial fluid = 0.15 × body weight","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Volume of ECF in body is, with the following options: A: 0.1 × body weight, B: 0.2 × body weight, C: 0.3 × body weight, D: 0.4 × body weight + +### Response: +Total body weight = 0.6 × body weight +ICF = 0.4 × body weight +ECF = 0.2 × body weight +Plasma = 0.05 × body weight +Interstitial fluid = 0.15 × body weight +### End" +762,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Brown colour of contusion is due to:, with the following options: A: Biliverdin, B: Reduced hemoglobin, C: Haemosiderin, D: Bilirubin + +### Response: +",Ans. (C). Haemosiderin(Ref: Review of Forensic Medicine & toxicology; Gautum Biswas; 2nd edition; Pg- 193)ColourPigmentTime DurationRedOxy haemoglobinFreshBlueQDeoxyhaemoglobinQFew hours - 3 daysBrownQHemosiderinQ4 -5 daysGreenBiliverdin/ hematoidin6 -7 daysYellowBilirubin7-14 days,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Brown colour of contusion is due to:, with the following options: A: Biliverdin, B: Reduced hemoglobin, C: Haemosiderin, D: Bilirubin + +### Response: +Ans. (C). Haemosiderin(Ref: Review of Forensic Medicine & toxicology; Gautum Biswas; 2nd edition; Pg- 193)ColourPigmentTime DurationRedOxy haemoglobinFreshBlueQDeoxyhaemoglobinQFew hours - 3 daysBrownQHemosiderinQ4 -5 daysGreenBiliverdin/ hematoidin6 -7 daysYellowBilirubin7-14 days +### End" +763,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which among the following is not included in the triad of necrotizing enterocolitis, with the following options: A: Thrombocytopenia, B: Metabolic acidosis, C: Hypokalemia, D: Hyponatremia + +### Response: +","Necrotising Enterocolitis:- * Most common life-threatening emergency of the gastrointestinal tract in the newborn period * The distal pa of the ileum and the proximal segment of colon are involved most frequently * The greatest risk factor for NEC is prematurity. NEC can occur secondary to bih asphyxia, Down syndrome, congenital hea disease, rotavirus infections, and Hirschsprung disease, red cells transfusion * Coagulation necrosis is the characteristic histologic finding in intestinal specimen. * Common pathogens causing NNEC include Escherichia coli, Klebsiella, Clostridium perfringens, Staphylococcus epidermidis, astrovirus, norovirus, and rotavirus. * Aggressive enteral feeding may predispose to the development of NEC * The onset of NEC is usually in the 2nd or 3rd wk of life but can be as late as 3 months in VLBW infants. * Pneumatosis intestinalis (air in the bowel wall) is diagnostic Triad of Necrotising Enterocolitis Includes: - * Thrombocytopenia * Metabolic Acidosis * Refractory Hyponatremia Ref:- Nelson 20th Edition; Pg num:- 870,871","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which among the following is not included in the triad of necrotizing enterocolitis, with the following options: A: Thrombocytopenia, B: Metabolic acidosis, C: Hypokalemia, D: Hyponatremia + +### Response: +Necrotising Enterocolitis:- * Most common life-threatening emergency of the gastrointestinal tract in the newborn period * The distal pa of the ileum and the proximal segment of colon are involved most frequently * The greatest risk factor for NEC is prematurity. NEC can occur secondary to bih asphyxia, Down syndrome, congenital hea disease, rotavirus infections, and Hirschsprung disease, red cells transfusion * Coagulation necrosis is the characteristic histologic finding in intestinal specimen. * Common pathogens causing NNEC include Escherichia coli, Klebsiella, Clostridium perfringens, Staphylococcus epidermidis, astrovirus, norovirus, and rotavirus. * Aggressive enteral feeding may predispose to the development of NEC * The onset of NEC is usually in the 2nd or 3rd wk of life but can be as late as 3 months in VLBW infants. * Pneumatosis intestinalis (air in the bowel wall) is diagnostic Triad of Necrotising Enterocolitis Includes: - * Thrombocytopenia * Metabolic Acidosis * Refractory Hyponatremia Ref:- Nelson 20th Edition; Pg num:- 870,871 +### End" +764,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Indications for hypotensive anaesthesia include, with the following options: A: Mastoid surgery, B: Spinal surgery, C: Arteriovenous malformations, D: All of the above + +### Response: +",(D) 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: Indications for hypotensive anaesthesia include, with the following options: A: Mastoid surgery, B: Spinal surgery, C: Arteriovenous malformations, D: All of the above + +### Response: +(D) All of the above +### End" +765,"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 old child presents with normal development milestones except delayed speech and poor concentration. He has difficulty in communication and relating to others and also difficulty in making friends but plays with himself. The likely diagnosis is:, with the following options: A: Autism, B: ADHD, C: Specific learning disability, D: Mental retardation + +### Response: +",A. i.e. Autism,"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 old child presents with normal development milestones except delayed speech and poor concentration. He has difficulty in communication and relating to others and also difficulty in making friends but plays with himself. The likely diagnosis is:, with the following options: A: Autism, B: ADHD, C: Specific learning disability, D: Mental retardation + +### Response: +A. i.e. Autism +### End" +766,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A sputum sample was brought to the laboratory for analysis. Gram stain revealed the following: rare epithelial cells, 8 to 10 polymorphonu-clear leukocytes per high-power field, and pleomorphic Gram-negative rods. As the laboratory consultant, which of the following interpretations should you make?, with the following options: A: The sputum specimen is too contaminated by saliva to be useful, B: The patient has pneumococcal pneumonia, C: The patient has Vincent's disease, D: The appearance of the sputum is suggestive of Haemophilus pneumonia + +### Response: +","Many sputum specimens are cultured unnecessarily. Sputum is often contaminated with saliva or is almost totally made up of saliva. These specimens rarely reveal the cause of the patient's respiratory problem and may provide laboratory information that is harmful. The sputum in question appears to be a good specimen. The pleomorphic Gram-negative rods are suggestive of Haemophilus, but culture of the secretions is necessary.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A sputum sample was brought to the laboratory for analysis. Gram stain revealed the following: rare epithelial cells, 8 to 10 polymorphonu-clear leukocytes per high-power field, and pleomorphic Gram-negative rods. As the laboratory consultant, which of the following interpretations should you make?, with the following options: A: The sputum specimen is too contaminated by saliva to be useful, B: The patient has pneumococcal pneumonia, C: The patient has Vincent's disease, D: The appearance of the sputum is suggestive of Haemophilus pneumonia + +### Response: +Many sputum specimens are cultured unnecessarily. Sputum is often contaminated with saliva or is almost totally made up of saliva. These specimens rarely reveal the cause of the patient's respiratory problem and may provide laboratory information that is harmful. The sputum in question appears to be a good specimen. The pleomorphic Gram-negative rods are suggestive of Haemophilus, but culture of the secretions is necessary. +### End" +767,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Child (girl) is suffering from varicella (fever rash). And child\'s aunt is pregnant. When is it earliest that the child can meet her aunt –, with the following options: A: When the lesions have crusted, B: Immediately, C: Anytime as the child is aunt's favourite, D: After the delivery of the baby + +### Response: +","Varicella Zoster (chicken pox) is a highly contagious disease, a centripetal, pleomorphic rash appearing on the first day of the illness and a relatively short course of illness. +The crusts from chicken pox lesions don’t contain viable virus and are therefore not infective. Period of infectivity range from a day prior to the illness and up to 5 days after the onset. Children with chickenpox are removed from school or daycare centres for 6 days after the appearance of the rash.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Child (girl) is suffering from varicella (fever rash). And child\'s aunt is pregnant. When is it earliest that the child can meet her aunt –, with the following options: A: When the lesions have crusted, B: Immediately, C: Anytime as the child is aunt's favourite, D: After the delivery of the baby + +### Response: +Varicella Zoster (chicken pox) is a highly contagious disease, a centripetal, pleomorphic rash appearing on the first day of the illness and a relatively short course of illness. +The crusts from chicken pox lesions don’t contain viable virus and are therefore not infective. Period of infectivity range from a day prior to the illness and up to 5 days after the onset. Children with chickenpox are removed from school or daycare centres for 6 days after the appearance of the rash. +### End" +768,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Traumatic glenohumeral instability on one direction with Bankas lesion are treated by, with the following options: A: Consv ervative methods, B: Surgery, C: Rehabilitation, D: Observation f/b inferior capsule shift + +### Response: +",B i.e. Surgery,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Traumatic glenohumeral instability on one direction with Bankas lesion are treated by, with the following options: A: Consv ervative methods, B: Surgery, C: Rehabilitation, D: Observation f/b inferior capsule shift + +### Response: +B i.e. Surgery +### End" +769,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Following an upper respiratory infection, a 7 year old child develops multiple petechial hemorrhages over her entire body. Her mother takes her to the physician, who does a complete blood count, revealing marked thrombocytopenia. Which of the following diagnoses is most appropriate for this individual?, with the following options: A: Bernard-Soulier syndrome, B: Idiopathic thrombocytopenic purpura, C: Thrombasthenia, D: Thrombotic thrombocytopenic purpura + +### Response: +","The process described is commonly called acute idiopathic thrombocytopenic purpura (ITP), even though the autoimmune basis has been clearly established (some authors use ""immune thrombocytopenic purpura,"" so that the initials still work). The thrombocytopenia in this disorder appears to be secondary to splenic destruction of opsonized platelets, and usually follows a viral upper respiratory tract infection or exanthem. The acute form of ITP is usually explosive, but self-limited; a chronic form in adults may respond to steroid therapy or splenectomy. In Bernard-Soulier syndrome, platelets are unable to adhere to collagen. Thrombasthenia is associated with a functional defect in platelets (they do not aggregate). In thrombotic thrombocytopenic purpura, platelets are consumed in intravascular platelet microthrombi. Ref: Alexandrescu D.T., Gallo R.L. (2010). Chapter 123. The Vascular Purpuras. 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: Following an upper respiratory infection, a 7 year old child develops multiple petechial hemorrhages over her entire body. Her mother takes her to the physician, who does a complete blood count, revealing marked thrombocytopenia. Which of the following diagnoses is most appropriate for this individual?, with the following options: A: Bernard-Soulier syndrome, B: Idiopathic thrombocytopenic purpura, C: Thrombasthenia, D: Thrombotic thrombocytopenic purpura + +### Response: +The process described is commonly called acute idiopathic thrombocytopenic purpura (ITP), even though the autoimmune basis has been clearly established (some authors use ""immune thrombocytopenic purpura,"" so that the initials still work). The thrombocytopenia in this disorder appears to be secondary to splenic destruction of opsonized platelets, and usually follows a viral upper respiratory tract infection or exanthem. The acute form of ITP is usually explosive, but self-limited; a chronic form in adults may respond to steroid therapy or splenectomy. In Bernard-Soulier syndrome, platelets are unable to adhere to collagen. Thrombasthenia is associated with a functional defect in platelets (they do not aggregate). In thrombotic thrombocytopenic purpura, platelets are consumed in intravascular platelet microthrombi. Ref: Alexandrescu D.T., Gallo R.L. (2010). Chapter 123. The Vascular Purpuras. In J.T. Prchal, K. Kaushansky, M.A. Lichtman, T.J. Kipps, U. Seligsohn (Eds),Williams Hematology, 8e. +### End" +770,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Non-union is common in fracture of, with the following options: A: Scapula, B: Talus, C: Neck of femur, D: Tibial fracture + +### Response: +",The following are some of the clinical findings which suggest delayed union and non union : Persistent pain Pain on stressing the fracture Mobility (in non-union) Increasing deformity at the fracture site (in non-union). Ref essential ohopaedic maheshwari and mhaskar 9TH ED p 48,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Non-union is common in fracture of, with the following options: A: Scapula, B: Talus, C: Neck of femur, D: Tibial fracture + +### Response: +The following are some of the clinical findings which suggest delayed union and non union : Persistent pain Pain on stressing the fracture Mobility (in non-union) Increasing deformity at the fracture site (in non-union). Ref essential ohopaedic maheshwari and mhaskar 9TH ED p 48 +### End" +771,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In Scaphoid fracture, impoant views are all except:, with the following options: A: AP, B: Lateral, C: Oblique, D: Cone + +### Response: +",D i.e. Cone,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In Scaphoid fracture, impoant views are all except:, with the following options: A: AP, B: Lateral, C: Oblique, D: Cone + +### Response: +D i.e. Cone +### End" +772,"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 dementia: March 2011, with the following options: A: Forgetfulness, B: Alteration of consciousness, C: Reduced personal care, D: Loss of neurons in brain + +### Response: +","Ans. B: Alteration of consciousnessThere is impairment of judgement and impulse control, and also impairment of abstract thinking There is however usually no impairment of consciousness in dementia (unlike in delirium) Dementia:Chronic onsetNo disturbance of consciousnessCognitive impairmentPersonality alterationImpaired memoryImpaired judgmentAbsent diurnal variation","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 dementia: March 2011, with the following options: A: Forgetfulness, B: Alteration of consciousness, C: Reduced personal care, D: Loss of neurons in brain + +### Response: +Ans. B: Alteration of consciousnessThere is impairment of judgement and impulse control, and also impairment of abstract thinking There is however usually no impairment of consciousness in dementia (unlike in delirium) Dementia:Chronic onsetNo disturbance of consciousnessCognitive impairmentPersonality alterationImpaired memoryImpaired judgmentAbsent diurnal variation +### End" +773,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The best parameter for assessment of chronic malnutrition is -, with the following options: A: Weight of age, B: Weight for height, C: Height for age, D: Any of the above + +### Response: +","parks textbook of preventive and social medicine 23rd edition * height is a stable measurement of growth as opposed to body weight .whereas the weight reflects only the present health status of the child,height indicate the events in the past also. *low height for age also knownn as nutritional stunting or drawfting.it reflects past or chronic mal nutrition.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The best parameter for assessment of chronic malnutrition is -, with the following options: A: Weight of age, B: Weight for height, C: Height for age, D: Any of the above + +### Response: +parks textbook of preventive and social medicine 23rd edition * height is a stable measurement of growth as opposed to body weight .whereas the weight reflects only the present health status of the child,height indicate the events in the past also. *low height for age also knownn as nutritional stunting or drawfting.it reflects past or chronic mal nutrition. +### End" +774,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Sever&;s disease involves which of the following bone ?, with the following options: A: lunate, B: Tibial tubercle, C: calcaneum, D: Navicular + +### Response: +",type of osteochondritis bone affected Kienbock Lunate osgood shalter tibial tuberosity Sever&;s Calcaneum Kohler Navicular 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: Sever&;s disease involves which of the following bone ?, with the following options: A: lunate, B: Tibial tubercle, C: calcaneum, D: Navicular + +### Response: +type of osteochondritis bone affected Kienbock Lunate osgood shalter tibial tuberosity Sever&;s Calcaneum Kohler Navicular ref : maheswari 9th ed +### End" +775,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Healthy carriers are found in all EXCEPT, with the following options: A: Poliomyelitis, B: Measles, C: Diphtheria, D: Salmonellosis + +### Response: +","B. i.e. (Measles) (90 - Park 19th) (91 - Park 20th)Carriers-classifications Incubatory carriers - Measles, mumps, polio, pertussis, influenza, diphtheria and Hepatitis - B Convalescent carriers - Typhoidfever, dysentery, cholera, diphtheria, and whooping cough Healthy carriers - Poliomyelitis*, Cholera, meningococcal meningitis, salmonellosis and diphtheria* Chronic carrier - Typhoidfever, hepatitisB, dysentery, cerebro- spinal meningitis, malaria, gonorrhoea","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Healthy carriers are found in all EXCEPT, with the following options: A: Poliomyelitis, B: Measles, C: Diphtheria, D: Salmonellosis + +### Response: +B. i.e. (Measles) (90 - Park 19th) (91 - Park 20th)Carriers-classifications Incubatory carriers - Measles, mumps, polio, pertussis, influenza, diphtheria and Hepatitis - B Convalescent carriers - Typhoidfever, dysentery, cholera, diphtheria, and whooping cough Healthy carriers - Poliomyelitis*, Cholera, meningococcal meningitis, salmonellosis and diphtheria* Chronic carrier - Typhoidfever, hepatitisB, dysentery, cerebro- spinal meningitis, malaria, gonorrhoea +### End" +776,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ehrlich phenomenon seen in:, with the following options: A: Proteus, B: Mycobacterium TB, C: Corynebacterium, D: Staphylococcus + +### Response: +","Ans. is 'c' i.e., Corynebacterium(It is due to presence in toxin preparation of varying amounts of toxoid and antitoxin to combine in varying proportions and is called Ehrlich phenomenon).Ehrlich defined the minimum lethal dose (MLD) of the diphtheria toxin as the least amount of toxin required to kill a guinea pig weighing 250g within 96 hours after subcutaneous inoculation.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ehrlich phenomenon seen in:, with the following options: A: Proteus, B: Mycobacterium TB, C: Corynebacterium, D: Staphylococcus + +### Response: +Ans. is 'c' i.e., Corynebacterium(It is due to presence in toxin preparation of varying amounts of toxoid and antitoxin to combine in varying proportions and is called Ehrlich phenomenon).Ehrlich defined the minimum lethal dose (MLD) of the diphtheria toxin as the least amount of toxin required to kill a guinea pig weighing 250g within 96 hours after subcutaneous inoculation. +### End" +777,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: If constitutive sequence of 4 nucleotide codes for 1 amino acid, how many amino acids can be theoretically formed?, with the following options: A: 4, B: 64, C: 16, D: 256 + +### Response: +","Codon -The triplet nucleotide sequence present in the mRNA representing specific amino acid: + +If 1 base represent 1 amino acid, only 4 amino acid. +If 2 base represent 1 amino acid, 42 amino acids, i.e. 16 amino acids. +If 3 base represent one amino acid, 43 i.e. 64 amino acids. +If 4 bases represent 1 amino acid, 44 i.e. 256 amino acids. + +Reference- Harper 30th edition Pg- 415","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: If constitutive sequence of 4 nucleotide codes for 1 amino acid, how many amino acids can be theoretically formed?, with the following options: A: 4, B: 64, C: 16, D: 256 + +### Response: +Codon -The triplet nucleotide sequence present in the mRNA representing specific amino acid: + +If 1 base represent 1 amino acid, only 4 amino acid. +If 2 base represent 1 amino acid, 42 amino acids, i.e. 16 amino acids. +If 3 base represent one amino acid, 43 i.e. 64 amino acids. +If 4 bases represent 1 amino acid, 44 i.e. 256 amino acids. + +Reference- Harper 30th edition Pg- 415 +### End" +778,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which among the following is considered as a hallmark of the fibrogenic repair:, with the following options: A: Granulation tissue, B: Neovascularization, C: Neutrophilic infiltration, D: All of the above + +### Response: +",Granulation tissue is the hallmark of the fibrogenic repair.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which among the following is considered as a hallmark of the fibrogenic repair:, with the following options: A: Granulation tissue, B: Neovascularization, C: Neutrophilic infiltration, D: All of the above + +### Response: +Granulation tissue is the hallmark of the fibrogenic repair. +### End" +779,"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 hemorrhagic stroke ?, with the following options: A: Phenylpropanolamine, B: Terfenadine, C: Quinidine, D: Fenfluramine + +### Response: +","Ans. is 'a' i.e., Phenylpropanolamine Many repos associating phenylpropanolamine use for weight loss with haemorrhagic stroke among women, appeared in U.S.A.","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 hemorrhagic stroke ?, with the following options: A: Phenylpropanolamine, B: Terfenadine, C: Quinidine, D: Fenfluramine + +### Response: +Ans. is 'a' i.e., Phenylpropanolamine Many repos associating phenylpropanolamine use for weight loss with haemorrhagic stroke among women, appeared in U.S.A. +### End" +780,"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 pigment is only produced by Psedomonas aeruginosa?, with the following options: A: Pyoverdin, B: Pyorubin, C: Pyocyanin, D: Pyomelanin + +### Response: +","Pseudomonas produces a number of pigments which diffuse freely into surrounding, inhibit other bacteria and mediate tissue injury. Pyocyanin is a blue green pigment produced only by P. aeruginosa","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 pigment is only produced by Psedomonas aeruginosa?, with the following options: A: Pyoverdin, B: Pyorubin, C: Pyocyanin, D: Pyomelanin + +### Response: +Pseudomonas produces a number of pigments which diffuse freely into surrounding, inhibit other bacteria and mediate tissue injury. Pyocyanin is a blue green pigment produced only by P. aeruginosa +### End" +781,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Metabolic acidosisis caused by which of the following?, with the following options: A: Hypovolemia, B: Hypokalemia, C: Hypocalcemia, D: Hypoaldosteronism + +### Response: +","The principal function of aldosterone is to increase sodium reabsorption in the distal tubule and collecting ducts, which causes secretion of potassium and hydrogen ions. +Hypoaldosteronism (e.g., in Addison’s disease)therefore results in a decrease in H+ secretion, which leads to the production of metabolic acidosis (and hyperkalemia and hyponatremia). +Hypoventilationproduces respiratory acidosis. +Hypokalemiacauses an increase in K+ reabsorption and an increase in H+ secretion, resulting in a metabolic alkalosis. +Hypovolemiaresults in an increase in aldosterone secretion, which can lead to an increase in H+ secretion and a metabolic alkalosis. +Hypocalcemia does not directly affect acid-base balance.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Metabolic acidosisis caused by which of the following?, with the following options: A: Hypovolemia, B: Hypokalemia, C: Hypocalcemia, D: Hypoaldosteronism + +### Response: +The principal function of aldosterone is to increase sodium reabsorption in the distal tubule and collecting ducts, which causes secretion of potassium and hydrogen ions. +Hypoaldosteronism (e.g., in Addison’s disease)therefore results in a decrease in H+ secretion, which leads to the production of metabolic acidosis (and hyperkalemia and hyponatremia). +Hypoventilationproduces respiratory acidosis. +Hypokalemiacauses an increase in K+ reabsorption and an increase in H+ secretion, resulting in a metabolic alkalosis. +Hypovolemiaresults in an increase in aldosterone secretion, which can lead to an increase in H+ secretion and a metabolic alkalosis. +Hypocalcemia does not directly affect acid-base balance. +### End" +782,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Soil may acts as reservoir for all except -, with the following options: A: Brucellosis, B: Anthrax, C: Tetanus, D: Coccidiomycosis + +### Response: +","Ans. is 'a' i.e., Brucellosis Reservoir in non-living things o Soil and inaminate matter can also act as reservoirs of infection. o For example, soil may harbour agents that cause tetanus, anthrax, Coccidiomycosis, mycetoma.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Soil may acts as reservoir for all except -, with the following options: A: Brucellosis, B: Anthrax, C: Tetanus, D: Coccidiomycosis + +### Response: +Ans. is 'a' i.e., Brucellosis Reservoir in non-living things o Soil and inaminate matter can also act as reservoirs of infection. o For example, soil may harbour agents that cause tetanus, anthrax, Coccidiomycosis, mycetoma. +### End" +783,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Streptococcal Toxic shock syndrome is due to the following virulence factor :, with the following options: A: M protein, B: Pyrogenic exotoxin, C: Streptolysin O., D: Carbohydrate cell wall. + +### Response: +",Ans. is 'b' i.e. Pyrogenic exotoxin Streptococcal toxic shock syndrome is caused due to the release of pyrogenic exotoxins or erythrogenic exotoxins. * These exotoxins are produced only by few strains of beta hemolytic group A streptococci. *Usually these toxins cause scarlet fever but sometimes these strains produce exotoxins that are superantigens.These superantigens (exotoxins) directly super stimulate T cells to pour out inflammatory cytokines. This causes streptococcal toxic shock syndromeMore questions on erythrogenic or pyrogenic exotoxinsDick testIt is a test used to identify children susceptible to scarlet fever.Intradermal injection of erythrogenic toxin into susceptible individual produces an erythematous reaction.Schultz Charlton reactionIt is a diagnostic test for scarlet fever.Blanching of the rash produced during scarlet fever on local injection of convalescent serum is called Schultz Charlton reaction.Also know:,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Streptococcal Toxic shock syndrome is due to the following virulence factor :, with the following options: A: M protein, B: Pyrogenic exotoxin, C: Streptolysin O., D: Carbohydrate cell wall. + +### Response: +Ans. is 'b' i.e. Pyrogenic exotoxin Streptococcal toxic shock syndrome is caused due to the release of pyrogenic exotoxins or erythrogenic exotoxins. * These exotoxins are produced only by few strains of beta hemolytic group A streptococci. *Usually these toxins cause scarlet fever but sometimes these strains produce exotoxins that are superantigens.These superantigens (exotoxins) directly super stimulate T cells to pour out inflammatory cytokines. This causes streptococcal toxic shock syndromeMore questions on erythrogenic or pyrogenic exotoxinsDick testIt is a test used to identify children susceptible to scarlet fever.Intradermal injection of erythrogenic toxin into susceptible individual produces an erythematous reaction.Schultz Charlton reactionIt is a diagnostic test for scarlet fever.Blanching of the rash produced during scarlet fever on local injection of convalescent serum is called Schultz Charlton reaction.Also know: +### End" +784,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Kinky hair disease is a disorder where an affected child has peculiar white stubby hair, does not grow, brain degenration is seen and dies by age of two years. Mrs A is hesitant about having children because her two sisters had sons who had died from kinky hair disease. Her mother's brother also died of the same condition. Which of the following is the possible mode of inheritance in her family?, with the following options: A: X-linked recessive, B: X-linked dominant, C: Autosomal recessive, D: Autosomal dominant + +### Response: +","Answer is A (X-linked Recessive) : The transmission of disease follows on X-Linked recessive pattern The pedigree analysis reveals the following -Males only are affected by disease - Females are acting as carriers (sister 1 & sister 2) The disease is thus likely to be transmitted through the 'X' chromosome in the mother It is a recessive condition and the mother is a carrier, because if it were a dominant condition, the mother would also manifest the disease. So would sister 1 and sister 2 who carry the affection at least on a single X chromosome as is evident by the affection of male children of both sisters. Males having a single X chromosome (XY) manifest a recessive condition as a disease Also note: females with only one chromosome eg Turner's syndrome can manifest X-linked recessive disorders in the same way as males do.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Kinky hair disease is a disorder where an affected child has peculiar white stubby hair, does not grow, brain degenration is seen and dies by age of two years. Mrs A is hesitant about having children because her two sisters had sons who had died from kinky hair disease. Her mother's brother also died of the same condition. Which of the following is the possible mode of inheritance in her family?, with the following options: A: X-linked recessive, B: X-linked dominant, C: Autosomal recessive, D: Autosomal dominant + +### Response: +Answer is A (X-linked Recessive) : The transmission of disease follows on X-Linked recessive pattern The pedigree analysis reveals the following -Males only are affected by disease - Females are acting as carriers (sister 1 & sister 2) The disease is thus likely to be transmitted through the 'X' chromosome in the mother It is a recessive condition and the mother is a carrier, because if it were a dominant condition, the mother would also manifest the disease. So would sister 1 and sister 2 who carry the affection at least on a single X chromosome as is evident by the affection of male children of both sisters. Males having a single X chromosome (XY) manifest a recessive condition as a disease Also note: females with only one chromosome eg Turner's syndrome can manifest X-linked recessive disorders in the same way as males do. +### End" +785,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Regarding Shick's test which of the following is false?, with the following options: A: Erythematous reaction in both arm indicates hypersensitivity, B: Positive test means that person is immune to Diphtheria, C: Diphtheria antitoxin is given intradermally, D: Test done to find out immune status against diphtheria + +### Response: +","Ans. is 'b' i.e., Positive test means that person is immune to DiphtheriaSchick TestType - Neutralization test (Toxin - antitoxin).Use - It is used for susceptibility for diphtheria, Intradermal test readings are at 1-2 days and 5-7 days but not in use because safer toxoid preparations are available.Interpretation of the test Reaction in control arm indicates hypersensitivity (erythema and induration).Schick Test Positive means that person is susceptible to Diphtheria so vaccine was administered.Schick Test Negative means that person is immune to Diphtheria.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Regarding Shick's test which of the following is false?, with the following options: A: Erythematous reaction in both arm indicates hypersensitivity, B: Positive test means that person is immune to Diphtheria, C: Diphtheria antitoxin is given intradermally, D: Test done to find out immune status against diphtheria + +### Response: +Ans. is 'b' i.e., Positive test means that person is immune to DiphtheriaSchick TestType - Neutralization test (Toxin - antitoxin).Use - It is used for susceptibility for diphtheria, Intradermal test readings are at 1-2 days and 5-7 days but not in use because safer toxoid preparations are available.Interpretation of the test Reaction in control arm indicates hypersensitivity (erythema and induration).Schick Test Positive means that person is susceptible to Diphtheria so vaccine was administered.Schick Test Negative means that person is immune to Diphtheria. +### End" +786,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Drug used for HER-2/neu positive breast cancer, with the following options: A: Imitanib, B: Trastuzumab, C: Erlotinib, D: Cetuximab + +### Response: +",Answer- B. TrastuzumabHerceptin (Trastuzumab)Herceptin is a humanized antibody and is used in breast cancers which are HER2 positive.HER2 stands for - human epidermal growth factor receptor.HER2 gene produces HER2 protein also called HER2 receptor.In HER2 (+ve) breast cancer the cancer cell have abnormally high number of HER2 genes per cell when this happens too much HER2 protein appears on the surface of these cancer cells.Currently transtuzumab is approved for HER2/neu overexpressing metastatic breast cancer in combination with paclitaxel as initial treatment or as monotherapy following chemotherapy.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Drug used for HER-2/neu positive breast cancer, with the following options: A: Imitanib, B: Trastuzumab, C: Erlotinib, D: Cetuximab + +### Response: +Answer- B. TrastuzumabHerceptin (Trastuzumab)Herceptin is a humanized antibody and is used in breast cancers which are HER2 positive.HER2 stands for - human epidermal growth factor receptor.HER2 gene produces HER2 protein also called HER2 receptor.In HER2 (+ve) breast cancer the cancer cell have abnormally high number of HER2 genes per cell when this happens too much HER2 protein appears on the surface of these cancer cells.Currently transtuzumab is approved for HER2/neu overexpressing metastatic breast cancer in combination with paclitaxel as initial treatment or as monotherapy following chemotherapy. +### End" +787,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ketamine should be avoided in:, with the following options: A: The presence of increased aerial pressure, B: Pregnancy, C: Hypovolemic shock, D: Asthmatic + +### Response: +","Ketamine should be avoided in hypeension,CCF, cerebral hemorrhage,increased intra cranial tension, psychiatric disorders and pregnancy before term. Ketamine causes increase in HR,CO and BP. From padmaja 4th edition Page no 196","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ketamine should be avoided in:, with the following options: A: The presence of increased aerial pressure, B: Pregnancy, C: Hypovolemic shock, D: Asthmatic + +### Response: +Ketamine should be avoided in hypeension,CCF, cerebral hemorrhage,increased intra cranial tension, psychiatric disorders and pregnancy before term. Ketamine causes increase in HR,CO and BP. From padmaja 4th edition Page no 196 +### End" +788,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cholangiocarcinoma -, with the following options: A: Obesity, B: Opistorchissinensis infection, C: Salmonella carrier state, D: HBV infection + +### Response: +","Ans. is 'b' i.e., Opistorchissinensis infection Cholangiocarcinomao Cholangiocarcinoma is malignancy of the biliary tree, arising from bile ducts within or outside the liver,o Risk factors : -# Primary' sclerosing cholangitisCongenital fibropolycystic disease of the biliary system (caroli disease, choledochal cyst).Exposure to thorotrast.Opisthorchis sinensis infection.Pathologyo Cholangiocarcinoma are adenocarcinoma arising from bile ducts epithelium,o Most are well to moderately differentiated.o Markdfy desmoplastic, with dens collegenous stroma separating the glandular elements.o Cells are not bile stained, because bile is synthesized by hepatocytes and not by bile duct epithelium.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cholangiocarcinoma -, with the following options: A: Obesity, B: Opistorchissinensis infection, C: Salmonella carrier state, D: HBV infection + +### Response: +Ans. is 'b' i.e., Opistorchissinensis infection Cholangiocarcinomao Cholangiocarcinoma is malignancy of the biliary tree, arising from bile ducts within or outside the liver,o Risk factors : -# Primary' sclerosing cholangitisCongenital fibropolycystic disease of the biliary system (caroli disease, choledochal cyst).Exposure to thorotrast.Opisthorchis sinensis infection.Pathologyo Cholangiocarcinoma are adenocarcinoma arising from bile ducts epithelium,o Most are well to moderately differentiated.o Markdfy desmoplastic, with dens collegenous stroma separating the glandular elements.o Cells are not bile stained, because bile is synthesized by hepatocytes and not by bile duct epithelium. +### End" +789,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pyruvate is converted to which substance to start gluconeogenesis?, with the following options: A: Oxaloacetate, B: Phosphenol pyruvate, C: Cis-aconitate, D: Succinate + +### Response: +","Ans. (a) OxaloacetateRef Harper's Biochemistry 28/e, chapter 20","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pyruvate is converted to which substance to start gluconeogenesis?, with the following options: A: Oxaloacetate, B: Phosphenol pyruvate, C: Cis-aconitate, D: Succinate + +### Response: +Ans. (a) OxaloacetateRef Harper's Biochemistry 28/e, chapter 20 +### End" +790,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 28 yrs old lady, is suspected to have polycystic ovarian disease. Sample for testing LH and FSH are best taken on the following days of menstrual cycle:, with the following options: A: 4-Jan, B: 10-Aug, C: 13-15, D: 24-26 + +### Response: +","LH and FSH are maximum during pre ovulatory period. So the best option provided here is 8-10 days. Ref: Shaw's Textbook of Gynaecology, 12th Edition, Page 77 ; The Menstrual Cycle: Physiology, Reproductive Disorders and Infeility By Michel Ferin, Raphael Jewelewicz, Michelle P. Warren, 1993, Page 5 ; Reproductive Endocrinology and Infeility: Integrating Modern Clinical and Laboratory Practice By Douglas T. Carrell, 2010, Page 147","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 28 yrs old lady, is suspected to have polycystic ovarian disease. Sample for testing LH and FSH are best taken on the following days of menstrual cycle:, with the following options: A: 4-Jan, B: 10-Aug, C: 13-15, D: 24-26 + +### Response: +LH and FSH are maximum during pre ovulatory period. So the best option provided here is 8-10 days. Ref: Shaw's Textbook of Gynaecology, 12th Edition, Page 77 ; The Menstrual Cycle: Physiology, Reproductive Disorders and Infeility By Michel Ferin, Raphael Jewelewicz, Michelle P. Warren, 1993, Page 5 ; Reproductive Endocrinology and Infeility: Integrating Modern Clinical and Laboratory Practice By Douglas T. Carrell, 2010, Page 147 +### End" +791,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Vagabond's disease is also known as, with the following options: A: Pediculosis pubis, B: Peduculosis capitis, C: Peduculosis corporis, D: Tinea capitis + +### Response: +","Pediculosis corporis is a cutaneous condition caused by body lice (specifically Pediculus corporis) that lay their eggs in the seams of clothing. Body louse infestation is also known as vagabond disease, and individuals who have an infestation for many years can develop a condition termed vagabond skin. It is also impoant to examine for systemic illness that may be related to one of the vector-borne diseases associated with P corporis (see Complications). Ref Harrison20th edition pg 1221","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Vagabond's disease is also known as, with the following options: A: Pediculosis pubis, B: Peduculosis capitis, C: Peduculosis corporis, D: Tinea capitis + +### Response: +Pediculosis corporis is a cutaneous condition caused by body lice (specifically Pediculus corporis) that lay their eggs in the seams of clothing. Body louse infestation is also known as vagabond disease, and individuals who have an infestation for many years can develop a condition termed vagabond skin. It is also impoant to examine for systemic illness that may be related to one of the vector-borne diseases associated with P corporis (see Complications). Ref Harrison20th edition pg 1221 +### End" +792,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In a freak hunting accident, a 17-year-old boy was shot with an arrow that penetrated into his Suboccipital Triangle, injuring the Suboccipital Nerve between the Veebral Aery and the Posterior Arch of the Atlas. Which of the following muscles would be unaffected by such a Lesion?, with the following options: A: Rectus Capitis Posterior Major, B: Semispinalis Capitis, C: Splenius Capitis, D: Obliquus Capitis Superior + +### Response: +","The splenius capitis is innervated by dorsal primary rami of the middle and lower cervical nerves. The suboccipital nerve (dorsal primary ramus of C1) supplies the muscles of the suboccipital area, including the rectus capitis posterior major, obliquus capitis superior and inferior, and the semispinalis capitis. Note Rectus capitis posterior minor remains intact because it is not associated with C2 veebrae fracture","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In a freak hunting accident, a 17-year-old boy was shot with an arrow that penetrated into his Suboccipital Triangle, injuring the Suboccipital Nerve between the Veebral Aery and the Posterior Arch of the Atlas. Which of the following muscles would be unaffected by such a Lesion?, with the following options: A: Rectus Capitis Posterior Major, B: Semispinalis Capitis, C: Splenius Capitis, D: Obliquus Capitis Superior + +### Response: +The splenius capitis is innervated by dorsal primary rami of the middle and lower cervical nerves. The suboccipital nerve (dorsal primary ramus of C1) supplies the muscles of the suboccipital area, including the rectus capitis posterior major, obliquus capitis superior and inferior, and the semispinalis capitis. Note Rectus capitis posterior minor remains intact because it is not associated with C2 veebrae fracture +### End" +793,"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 derived from 1st pharyngeal pouch?, with the following options: A: Middle ear, B: Eustachean tube, C: Tympanic membrane, D: Palatine tonsils + +### Response: +","Ans. D Palatine tonsilsRef: I.B. Singh, 9th ed. pg. 1118; Fundamental Anatomy By Walter Carl Hartwig, pg. 185* First pharyngeal pouch is located between 1st and 2nd pharyngeal arch* Palatine tonsil is a derivative of 2nd pharyngeal pouch* Eustachean tube, Middle ear, mastoid antrum and tympanic membrane is derived from 1st pharyngeal pouch.","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 derived from 1st pharyngeal pouch?, with the following options: A: Middle ear, B: Eustachean tube, C: Tympanic membrane, D: Palatine tonsils + +### Response: +Ans. D Palatine tonsilsRef: I.B. Singh, 9th ed. pg. 1118; Fundamental Anatomy By Walter Carl Hartwig, pg. 185* First pharyngeal pouch is located between 1st and 2nd pharyngeal arch* Palatine tonsil is a derivative of 2nd pharyngeal pouch* Eustachean tube, Middle ear, mastoid antrum and tympanic membrane is derived from 1st pharyngeal pouch. +### End" +794,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Gonorrhea is assumed to be caused by gonococcus. Gonococcus can be identified by being:, with the following options: A: By the growth on McConkey medium, B: By the fermentation of maltose, C: By the fermentation of glucose, D: Gram positive + +### Response: +",By the fermentation of glucose,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Gonorrhea is assumed to be caused by gonococcus. Gonococcus can be identified by being:, with the following options: A: By the growth on McConkey medium, B: By the fermentation of maltose, C: By the fermentation of glucose, D: Gram positive + +### Response: +By the fermentation of glucose +### End" +795,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Floaters can be seen in following except, with the following options: A: Vitreous haemorrhage, B: Retinal detachment, C: Uveitis, D: Acute congestive Glaucoma + +### Response: +","Black spots or floaters in front of the eyes may appear singly or in clusters. They move with the movement of the eyes and become more apparent when viewed against a clear surface e.g., the sky. Common causes of black floaters are: Vitreous hemorrhage Vitreous degeneration e.g., - senile vitreous degeneration, vitreous degeneration in pathological myopia Exudates in vitreous Lenticular opacity Reference : AK KHURANA COMPREHENSIVE OPHTHALMOLOGY, E4, Page-463","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Floaters can be seen in following except, with the following options: A: Vitreous haemorrhage, B: Retinal detachment, C: Uveitis, D: Acute congestive Glaucoma + +### Response: +Black spots or floaters in front of the eyes may appear singly or in clusters. They move with the movement of the eyes and become more apparent when viewed against a clear surface e.g., the sky. Common causes of black floaters are: Vitreous hemorrhage Vitreous degeneration e.g., - senile vitreous degeneration, vitreous degeneration in pathological myopia Exudates in vitreous Lenticular opacity Reference : AK KHURANA COMPREHENSIVE OPHTHALMOLOGY, E4, Page-463 +### End" +796,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Leaf like helminths are also called:, with the following options: A: Flukes, B: Roundworms, C: Tapeworms, D: Cestodes + +### Response: +","Ans. is 'a' i.e., Flat leaf like worms* Cylindrical helminthes - Nematodes (roundworms)* Flat, segmented helminthes - Cestodes (tapeworms)* Flat, leaf like helminthes - Trematodes (flukes)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Leaf like helminths are also called:, with the following options: A: Flukes, B: Roundworms, C: Tapeworms, D: Cestodes + +### Response: +Ans. is 'a' i.e., Flat leaf like worms* Cylindrical helminthes - Nematodes (roundworms)* Flat, segmented helminthes - Cestodes (tapeworms)* Flat, leaf like helminthes - Trematodes (flukes) +### End" +797,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Absorption of vitamin A can be enhanced by giving the child a diet rich in -, with the following options: A: Fat, B: Protein, C: Minerals, D: Carbohydrates + +### Response: +","Vitamin A is fat soluble. Hence fat diet helps in enhanced absorption. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 568,569","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Absorption of vitamin A can be enhanced by giving the child a diet rich in -, with the following options: A: Fat, B: Protein, C: Minerals, D: Carbohydrates + +### Response: +Vitamin A is fat soluble. Hence fat diet helps in enhanced absorption. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 568,569 +### End" +798,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ergot alkaloids are used in all except -, with the following options: A: Migraine, B: Acromegaly, C: Hypertension, D: Parkinsonism + +### Response: +","Ans. is 'c' i.e., Hypertension Uses of ergot alkaloids1. Migraineo In migraine, throbbing headache is due to dilatation of pain sensitive arteries outside the brain, i.e. extracerebral vessels.o Ergot alkaloids are vasoconstrictor (due to a agonistic action) and oppose these effects,o Ergot alkaloids used in migraine -Prophylaxis-MethysergideAcute attack-Ergotamine & dihydroergotamine2. Parkinsonismo In parkinsonism, there is degeneration of dopaminergic neurons.o Bromocriptine; an ergot alkaloid, is dopamine agonist at D2 receptor - can be used in parkinsonism.3. Hyperprolactinemiao Prolactin is under predominant inhibitory control of hypothalamus through dopamine that act on receptor of pituitary lactotroph.o Bromocriptine by D2 agonistic activity, decreases prolactin secretion.4. Acromegalyo Dopamine increases GH release in normal subjects but decreases it in acromegalics,o Bromocriptine also acts in same way due to its dopamine agonistic action.5. Dementiao Dihydroergotoxin increases cerebral blood flow and act by protecting altered brain metabolism.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ergot alkaloids are used in all except -, with the following options: A: Migraine, B: Acromegaly, C: Hypertension, D: Parkinsonism + +### Response: +Ans. is 'c' i.e., Hypertension Uses of ergot alkaloids1. Migraineo In migraine, throbbing headache is due to dilatation of pain sensitive arteries outside the brain, i.e. extracerebral vessels.o Ergot alkaloids are vasoconstrictor (due to a agonistic action) and oppose these effects,o Ergot alkaloids used in migraine -Prophylaxis-MethysergideAcute attack-Ergotamine & dihydroergotamine2. Parkinsonismo In parkinsonism, there is degeneration of dopaminergic neurons.o Bromocriptine; an ergot alkaloid, is dopamine agonist at D2 receptor - can be used in parkinsonism.3. Hyperprolactinemiao Prolactin is under predominant inhibitory control of hypothalamus through dopamine that act on receptor of pituitary lactotroph.o Bromocriptine by D2 agonistic activity, decreases prolactin secretion.4. Acromegalyo Dopamine increases GH release in normal subjects but decreases it in acromegalics,o Bromocriptine also acts in same way due to its dopamine agonistic action.5. Dementiao Dihydroergotoxin increases cerebral blood flow and act by protecting altered brain metabolism. +### End" +799,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: On chest radiology, ""egg-shell calcification"" is seen in:, with the following options: A: Asbestosis, B: Silicosis, C: Coal-worker pneumoconiosis, D: Berylliosis + +### Response: +",Silicosis/Grinder's disease/Sand blasting disease : Most common pneumoconiosis Due to inhalation of quaz crystals (SiO2) Nodules seen in hilar lympho nodes and upper lobes of lung Increased risk of TB / malignancy CXR - Egg shell calcification (calcification on hilar LN) Histologic examination reveals the hallmark lesion characterized by a central area of whorled collagen fibers with a more peripheral zone of dust-laden macrophages.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: On chest radiology, ""egg-shell calcification"" is seen in:, with the following options: A: Asbestosis, B: Silicosis, C: Coal-worker pneumoconiosis, D: Berylliosis + +### Response: +Silicosis/Grinder's disease/Sand blasting disease : Most common pneumoconiosis Due to inhalation of quaz crystals (SiO2) Nodules seen in hilar lympho nodes and upper lobes of lung Increased risk of TB / malignancy CXR - Egg shell calcification (calcification on hilar LN) Histologic examination reveals the hallmark lesion characterized by a central area of whorled collagen fibers with a more peripheral zone of dust-laden macrophages. +### End" +800,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What passes through diaphragm at T12 level ?, with the following options: A: Esophagus, B: IVC, C: Thoracic duct, D: Phrenic nerve + +### Response: +","Ans. is 'c' i.e., Thoracic duct","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What passes through diaphragm at T12 level ?, with the following options: A: Esophagus, B: IVC, C: Thoracic duct, D: Phrenic nerve + +### Response: +Ans. is 'c' i.e., Thoracic duct +### End" +801,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 15 day old baby presented to the emergency depament with history of seizures. Blood tests revealed serum calcium of 5mg/dl, serum phosphate of 9 mg/dl and an intact PTH of 30 pg/ml (Normal Intact PTH = 10-60 pg/ml). Which of the following is the most likely diagnosis?, with the following options: A: Pseudohypoparathyroidism, B: Hypoparathyroidism, C: Vitamin D Deficiency, D: Hypoxic Ischaemic Encephalopathy + +### Response: +","Baby is showing features of relative hypoparathyroidism. In hypoparathyroidism serum calcium level is decreased, Phosphate level is increased and PTH levels is inappropriately normal, low or undetectable. Ref: Endocrinology and Metabolism By Pauline M. Camacho page77; The Cambridge encyclopedia of human paleopathology By Ahur C. Aufderheide, Conrado Rodriguez-Main, Odin Langsjoen page 333.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 15 day old baby presented to the emergency depament with history of seizures. Blood tests revealed serum calcium of 5mg/dl, serum phosphate of 9 mg/dl and an intact PTH of 30 pg/ml (Normal Intact PTH = 10-60 pg/ml). Which of the following is the most likely diagnosis?, with the following options: A: Pseudohypoparathyroidism, B: Hypoparathyroidism, C: Vitamin D Deficiency, D: Hypoxic Ischaemic Encephalopathy + +### Response: +Baby is showing features of relative hypoparathyroidism. In hypoparathyroidism serum calcium level is decreased, Phosphate level is increased and PTH levels is inappropriately normal, low or undetectable. Ref: Endocrinology and Metabolism By Pauline M. Camacho page77; The Cambridge encyclopedia of human paleopathology By Ahur C. Aufderheide, Conrado Rodriguez-Main, Odin Langsjoen page 333. +### End" +802,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which portion of antibody binds to antigen -, with the following options: A: Hinge region, B: Constant region, C: Variable region, D: Hypervariable region + +### Response: +","Ans. is 'd' i.e., Hypervariable region o The aminoacid sequences of the variable regions are not uniformly variable along their length, but consist of relatively invariable and some highly variable zones. The highly variable zones are involved with the formation of antigen binding sites. The sites on the hyervariable regions that make actual contact with the epitopes are called ""complementarity determining regions (CDRs)"".""The idiotype is defined as the specific region of the fab portion of the Ig molecule to which antigen binds - Harrison 16th/e 1922o The infinite range of the antibody specificity of immunoglobulin depends on the variability of the aminoacid sequences at the variable regions of the H and L chains which form the antigen combining sites.o Antigen binding region on antibody - Hypervariable region, idiotype region, paratopeo Antibody binding region on antigen - Epitope","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which portion of antibody binds to antigen -, with the following options: A: Hinge region, B: Constant region, C: Variable region, D: Hypervariable region + +### Response: +Ans. is 'd' i.e., Hypervariable region o The aminoacid sequences of the variable regions are not uniformly variable along their length, but consist of relatively invariable and some highly variable zones. The highly variable zones are involved with the formation of antigen binding sites. The sites on the hyervariable regions that make actual contact with the epitopes are called ""complementarity determining regions (CDRs)"".""The idiotype is defined as the specific region of the fab portion of the Ig molecule to which antigen binds - Harrison 16th/e 1922o The infinite range of the antibody specificity of immunoglobulin depends on the variability of the aminoacid sequences at the variable regions of the H and L chains which form the antigen combining sites.o Antigen binding region on antibody - Hypervariable region, idiotype region, paratopeo Antibody binding region on antigen - Epitope +### End" +803,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Falciparum ligament contains?, with the following options: A: Ligamentum venosus, B: Ligamentum teres, C: Linorenal ligament, D: None of the above + +### Response: +","Peritoneal ligamentsGastrosplenic ligament :- It extends from hilum of spleen to greater curvature of stomach. It contains sho gastric and left gastroepiploic vessels.Linorenal ligament :- It extends from hilum of spleen to anterior surface of left kidney. It contains splenic vessels and tail of pancreas. It develops from dorsal mesogastrium.Gastrophrenic ligament :- It connects the greater curvature of stomach to diaphragm. It develops from dorsal mesogastrium.Phrenicocolic ligament :- It connects left colic (splenic) flexure to diaphragm. It suppos the anterior border of spleen.Falciform ligament :- It demarcates the right and left lobes of liver. It contains ligamentum teres (remnant of left umblical vein) and paraumblical vein. It develops of ventral mesogastrium (ventral pa).Coronary ligaments :- It contains superior and inferior layers which connect liver to diaphragm, and encloses the triangular 'bare area of liver'.Triangular ligaments (a right and a left) :- These connect right and left lobes of liver to diaphragm. It develops from ventral mesogastrium.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Falciparum ligament contains?, with the following options: A: Ligamentum venosus, B: Ligamentum teres, C: Linorenal ligament, D: None of the above + +### Response: +Peritoneal ligamentsGastrosplenic ligament :- It extends from hilum of spleen to greater curvature of stomach. It contains sho gastric and left gastroepiploic vessels.Linorenal ligament :- It extends from hilum of spleen to anterior surface of left kidney. It contains splenic vessels and tail of pancreas. It develops from dorsal mesogastrium.Gastrophrenic ligament :- It connects the greater curvature of stomach to diaphragm. It develops from dorsal mesogastrium.Phrenicocolic ligament :- It connects left colic (splenic) flexure to diaphragm. It suppos the anterior border of spleen.Falciform ligament :- It demarcates the right and left lobes of liver. It contains ligamentum teres (remnant of left umblical vein) and paraumblical vein. It develops of ventral mesogastrium (ventral pa).Coronary ligaments :- It contains superior and inferior layers which connect liver to diaphragm, and encloses the triangular 'bare area of liver'.Triangular ligaments (a right and a left) :- These connect right and left lobes of liver to diaphragm. It develops from ventral mesogastrium. +### End" +804,"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 suffers massive trauma in a motorcycle accident. A CT scan shows multiple intracerebral hemorrhages. The patient expires after 6 months in a coma. At autopsy, there are cystic cavities within the frontal and temporal lobes, corresponding to the areas of prior hemorrhage. These cavities were formed in large measure due to the phagocytic activity of which of the following cell types?, with the following options: A: Astrocytes, B: Endothelial cells, C: Microglial cells, D: Neutrophils + +### Response: +","Microglia are phagocytic macrophage-derived cells of the CNS, accounting for 5% of all glial cells. In response to necrosis, macroglia become phagocytic, accumulate lipids and other cellular debris, and are designated gitter cells. Some reactive microglia exhibit a prominent elongated nucleus, in which case they are referred to as rod cells. After microglial phagocytosis, astrocytosis (choice A) then leads to local scar formation, which persists as telltale evidence of a prior injury.Diagnosis: Cerebral contusion","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 suffers massive trauma in a motorcycle accident. A CT scan shows multiple intracerebral hemorrhages. The patient expires after 6 months in a coma. At autopsy, there are cystic cavities within the frontal and temporal lobes, corresponding to the areas of prior hemorrhage. These cavities were formed in large measure due to the phagocytic activity of which of the following cell types?, with the following options: A: Astrocytes, B: Endothelial cells, C: Microglial cells, D: Neutrophils + +### Response: +Microglia are phagocytic macrophage-derived cells of the CNS, accounting for 5% of all glial cells. In response to necrosis, macroglia become phagocytic, accumulate lipids and other cellular debris, and are designated gitter cells. Some reactive microglia exhibit a prominent elongated nucleus, in which case they are referred to as rod cells. After microglial phagocytosis, astrocytosis (choice A) then leads to local scar formation, which persists as telltale evidence of a prior injury.Diagnosis: Cerebral contusion +### End" +805,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In the case of CNS relapse in AML, chemotherapy would consist of intrathecal -, with the following options: A: Methotrexate, B: Methotrexate + cytosine arabinoside, C: Prednisolone, D: None + +### Response: +","Ans. is 'None' Treatment of AML o The most commonly used chemotherapy regimen is combination of cytarabine (cytosine arabinoside) and anthrocycline (Doxorubian or daunorubicin). 3-4 cycles are given. o Patients who fails to attain complete remission after two induction courses, Should immediately proceed to an allogenic stem cell transplant (SCT).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In the case of CNS relapse in AML, chemotherapy would consist of intrathecal -, with the following options: A: Methotrexate, B: Methotrexate + cytosine arabinoside, C: Prednisolone, D: None + +### Response: +Ans. is 'None' Treatment of AML o The most commonly used chemotherapy regimen is combination of cytarabine (cytosine arabinoside) and anthrocycline (Doxorubian or daunorubicin). 3-4 cycles are given. o Patients who fails to attain complete remission after two induction courses, Should immediately proceed to an allogenic stem cell transplant (SCT). +### End" +806,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Best position for intubating on adult patient when using macintosh laryngoscope-, with the following options: A: Shoulder elevated, B: Flexion of the lower cervical spine and extension of head, C: Flat on the bed, D: Hyperextension of neck + +### Response: +",This is called morning sniffing position. There is movement on two joints atlantoccipital jt and neck joint . Atlantoccipital joint is extended. Neck joint is flexed.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Best position for intubating on adult patient when using macintosh laryngoscope-, with the following options: A: Shoulder elevated, B: Flexion of the lower cervical spine and extension of head, C: Flat on the bed, D: Hyperextension of neck + +### Response: +This is called morning sniffing position. There is movement on two joints atlantoccipital jt and neck joint . Atlantoccipital joint is extended. Neck joint is flexed. +### End" +807,"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 man is transpoed to the emergency depament with severe pain of his right hip and thigh. A radiographic examination reveals avascular necrosis of the femoral head. Which of the following conditions most likely occurred to produce avascular necrosis in this patient?,, with the following options: A: Thrombosis of the obturator aery, B: Interochanteric fracture of the femur, C: Intracapsular femoral neck fracture, D: Comminuted fracture of the extracapsular femoral neck + +### Response: +",An Intracapsular femoral neck fracture causes Avascular Necrosis of the Femoral Head because the fracture damages the radicular branches of the Medial and Lateral Circumflex Aeries that pass beneath the Ischiofemoral ligament and pierce the femoral neck. Comminuted fracture of the Extracapsular Femoral Neck would not ordinarily imperil the vascular supply.,"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 man is transpoed to the emergency depament with severe pain of his right hip and thigh. A radiographic examination reveals avascular necrosis of the femoral head. Which of the following conditions most likely occurred to produce avascular necrosis in this patient?,, with the following options: A: Thrombosis of the obturator aery, B: Interochanteric fracture of the femur, C: Intracapsular femoral neck fracture, D: Comminuted fracture of the extracapsular femoral neck + +### Response: +An Intracapsular femoral neck fracture causes Avascular Necrosis of the Femoral Head because the fracture damages the radicular branches of the Medial and Lateral Circumflex Aeries that pass beneath the Ischiofemoral ligament and pierce the femoral neck. Comminuted fracture of the Extracapsular Femoral Neck would not ordinarily imperil the vascular supply. +### End" +808,"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 complication of surgery for thoracic outlet syndrome., with the following options: A: Pneumothorax, B: Brachial plexus injury, C: Lymphocutaneous fistula, D: Long thoracic nerve injury + +### Response: +","Surgical treatment in thoracic outlet syndrome has been known to have devastating complications, especially brachial plexopathy (eg, injury to the long thoracic nerve with scapular winging). Conservative treatment appears to be the most universally accepted approach, with even surgeons recommending a prolonged trial before any operative procedure +Complications of surgical tit of thoracic outlet syndrome + +Brachial plexus injury +Injury to long thoracic nerve leading to winging of the scapula +Homer's syndrome +Vascular injuries — subclavian artery , subclavian vein +Air embolus as a result of subclavian vein injury +Pneumothorax + +Thoracic Outlet Syndrome + +Thoracic outlet syndrome ( TOS ) refers to compression of the subclavian vessels and nerves of the brachial plexus in the region of the thoracic inlet. ( note that even though the actual site of pathology is the thoracic inlet the condition is called thoracic outlet syndrome ) +These neurovascular structures of the upper extremity may be compressed by a variety of structures, such as +Bone- cervical rib, abnormal first rib, long transverse process of C7, osteoarthritis +Muscles- scalenus +Trauma- neck hematoma, bone dislocation, clavicular fracture +Fibrous bands- congenital or acquired +Neoplasms- Pancoast's tumor emedicine.com writes + + +The primary cause is believed to be mechanical or postural. Stress, depression, overuse, and habit all can lead to the forward head, droopy shoulder, and collapsed chest posture that allows the thoracic outlet to narrow and compress the neurovascular structures. Accessory ribs or fibrous bands when present, predispose the site to narrow and compression. + +Management + +Initial method of management is nonsurgical. + +Physical and occupational therapy: + +improvements in a postural sitting, standing, and sleeping positions are recommended, along with behavior modification at work. +muscle strengthening and stretching exercises +superficial or deep heat therapy +50 to 90% of patients can be treated with these nonsurgical measures. + + +Surgery + +resection of the first rib, accessory rib or fibrous band, scalenectomy","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 complication of surgery for thoracic outlet syndrome., with the following options: A: Pneumothorax, B: Brachial plexus injury, C: Lymphocutaneous fistula, D: Long thoracic nerve injury + +### Response: +Surgical treatment in thoracic outlet syndrome has been known to have devastating complications, especially brachial plexopathy (eg, injury to the long thoracic nerve with scapular winging). Conservative treatment appears to be the most universally accepted approach, with even surgeons recommending a prolonged trial before any operative procedure +Complications of surgical tit of thoracic outlet syndrome + +Brachial plexus injury +Injury to long thoracic nerve leading to winging of the scapula +Homer's syndrome +Vascular injuries — subclavian artery , subclavian vein +Air embolus as a result of subclavian vein injury +Pneumothorax + +Thoracic Outlet Syndrome + +Thoracic outlet syndrome ( TOS ) refers to compression of the subclavian vessels and nerves of the brachial plexus in the region of the thoracic inlet. ( note that even though the actual site of pathology is the thoracic inlet the condition is called thoracic outlet syndrome ) +These neurovascular structures of the upper extremity may be compressed by a variety of structures, such as +Bone- cervical rib, abnormal first rib, long transverse process of C7, osteoarthritis +Muscles- scalenus +Trauma- neck hematoma, bone dislocation, clavicular fracture +Fibrous bands- congenital or acquired +Neoplasms- Pancoast's tumor emedicine.com writes + + +The primary cause is believed to be mechanical or postural. Stress, depression, overuse, and habit all can lead to the forward head, droopy shoulder, and collapsed chest posture that allows the thoracic outlet to narrow and compress the neurovascular structures. Accessory ribs or fibrous bands when present, predispose the site to narrow and compression. + +Management + +Initial method of management is nonsurgical. + +Physical and occupational therapy: + +improvements in a postural sitting, standing, and sleeping positions are recommended, along with behavior modification at work. +muscle strengthening and stretching exercises +superficial or deep heat therapy +50 to 90% of patients can be treated with these nonsurgical measures. + + +Surgery + +resection of the first rib, accessory rib or fibrous band, scalenectomy +### End" +809,"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 uses of enzyme-linked immunosorbent assay detection except, with the following options: A: Hepatitis B markers, B: Rotavirus, C: Enterotoxin of E coli, D: Hepatitis A virus + +### Response: +","ELISA is used for the detection of HIV, Hep B, rotavirus, E coli, TB Hepatitis A is detected by immune electron microscopic test Ref: Textbook of Microbiology Baveja 5th ed Pg 118","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 uses of enzyme-linked immunosorbent assay detection except, with the following options: A: Hepatitis B markers, B: Rotavirus, C: Enterotoxin of E coli, D: Hepatitis A virus + +### Response: +ELISA is used for the detection of HIV, Hep B, rotavirus, E coli, TB Hepatitis A is detected by immune electron microscopic test Ref: Textbook of Microbiology Baveja 5th ed Pg 118 +### End" +810,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Radium emits which of the following radiations: September 2007, 2010, with the following options: A: Gamma rays, B: Alpha rays, C: Beta rays, D: All of the above + +### Response: +","Ans. D All of the above Radium was discovered in 1898 by French physicist and Nobel laureate Marie Curie in pitchblende (a uranium andradiumbearing mineral). There is about 1 gram of radium in 7 tons of pitchblende.Elemental radium was isolated by Madam Merry Curie in 1911 Radium is a naturally radioactive, silvery-white metal when freshly cut. It blackens on exposure to air. Purified radium and some radium compounds glow in the dark (luminesce). The radiation emitted by radium can also cause ceain materials, called ""phosphors"" to emit light. Mixtures of radium salts and appropriate phosphors were widely used for clock dials and gauges before the risks of radium exposure were understood. Metallic radium is highly chemically reactive. It forms compounds that are very similar to barium compounds, making separation of the two elements difficult. The various isotopes of radium originate from the radioactive decay of uranium or thorium. Radium-226, the most common isotope, is an alpha emitter, with accompanying gamma radiation, and has a half-life of about 1600 years. Radium-228, is principally a beta emitter and has a half-life of 5.76 years. Radium-224, an alpha emitter, has a half life of 3.66 days. Radium decays to form isotopes of the radioactive gas radon, which is not chemically reactive. Stable lead is the finalproduct of this lengthy radioactive decay series.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Radium emits which of the following radiations: September 2007, 2010, with the following options: A: Gamma rays, B: Alpha rays, C: Beta rays, D: All of the above + +### Response: +Ans. D All of the above Radium was discovered in 1898 by French physicist and Nobel laureate Marie Curie in pitchblende (a uranium andradiumbearing mineral). There is about 1 gram of radium in 7 tons of pitchblende.Elemental radium was isolated by Madam Merry Curie in 1911 Radium is a naturally radioactive, silvery-white metal when freshly cut. It blackens on exposure to air. Purified radium and some radium compounds glow in the dark (luminesce). The radiation emitted by radium can also cause ceain materials, called ""phosphors"" to emit light. Mixtures of radium salts and appropriate phosphors were widely used for clock dials and gauges before the risks of radium exposure were understood. Metallic radium is highly chemically reactive. It forms compounds that are very similar to barium compounds, making separation of the two elements difficult. The various isotopes of radium originate from the radioactive decay of uranium or thorium. Radium-226, the most common isotope, is an alpha emitter, with accompanying gamma radiation, and has a half-life of about 1600 years. Radium-228, is principally a beta emitter and has a half-life of 5.76 years. Radium-224, an alpha emitter, has a half life of 3.66 days. Radium decays to form isotopes of the radioactive gas radon, which is not chemically reactive. Stable lead is the finalproduct of this lengthy radioactive decay series. +### End" +811,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mouse nibbled appearance of vocal cords is seen in:, with the following options: A: Tb larynx, B: Syphilis, C: Achalasia Cardia, D: Lupus + +### Response: +","Ref: Diseases of the Ear Nose and Throat by PL Dhingra .5th edn .2010 page. 312Explanation:TB LarynxTb larynx is almost secondary to pulmonary lbSeen mostly in middle aged malesBacilli reach the larynx by bronchogenic (via sputum) and hematogenous routeMost commonly posterior part of the larynx is affected i.e. arytenoids, inter arytenoids areaClinical FeaturesWeakness of voice (earliest symptom)Pain radiating to ear due to ulcerationOdynophagiaExamination FindingsMonocorditis - hyperemia of the vocal cord with impairment of adduction (earliest sign)Swelling in the inter arytenoids area giving it a niamiJated appearanceUlceration of the vocal cord - mouse nibbled appearanceUlceration and granulation over the arytenoids and inter arytenoid areaPsuedoedema of the epiglottis - Turban epiglottisPale mucosaSwelling of the false cord and aryepiglotticDiagnosis is by chest x-ray and sputum AFB examinationShould take a biopsy to rule out malignancy in suspected casesTreatment is with ATTLupusAffects the anterior part of larynxFirst epiglottis is affectedPainless and mostly asymptomaticGood prognosisTreatment is with ATTSyphilisCan affect any part any part of larynxLarynx generally affected in the tertiary stageDiagnosed with biopsy and serologyComplication - laryngeal stenosis","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mouse nibbled appearance of vocal cords is seen in:, with the following options: A: Tb larynx, B: Syphilis, C: Achalasia Cardia, D: Lupus + +### Response: +Ref: Diseases of the Ear Nose and Throat by PL Dhingra .5th edn .2010 page. 312Explanation:TB LarynxTb larynx is almost secondary to pulmonary lbSeen mostly in middle aged malesBacilli reach the larynx by bronchogenic (via sputum) and hematogenous routeMost commonly posterior part of the larynx is affected i.e. arytenoids, inter arytenoids areaClinical FeaturesWeakness of voice (earliest symptom)Pain radiating to ear due to ulcerationOdynophagiaExamination FindingsMonocorditis - hyperemia of the vocal cord with impairment of adduction (earliest sign)Swelling in the inter arytenoids area giving it a niamiJated appearanceUlceration of the vocal cord - mouse nibbled appearanceUlceration and granulation over the arytenoids and inter arytenoid areaPsuedoedema of the epiglottis - Turban epiglottisPale mucosaSwelling of the false cord and aryepiglotticDiagnosis is by chest x-ray and sputum AFB examinationShould take a biopsy to rule out malignancy in suspected casesTreatment is with ATTLupusAffects the anterior part of larynxFirst epiglottis is affectedPainless and mostly asymptomaticGood prognosisTreatment is with ATTSyphilisCan affect any part any part of larynxLarynx generally affected in the tertiary stageDiagnosed with biopsy and serologyComplication - laryngeal stenosis +### End" +812,"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 a patient with this migratory, pruritic skin eruption?, with the following options: A: Cutaneous larva migrans, B: Contact dermatitis, C: Paragonimiasis, D: Myiasis + +### Response: +",Answer A. Cutaneous larva migransCutaneous larva migrans is the correct answer. It is most commonly caused by cat or dog hookworm larvae. The parasite is typically confined to the epidermis as it lacks the collagenase necessary to break through the basement membrane. Most infections are localized in the lower extremity as it is a common site of larval penetration. The eruption appears to migrate as the larvae move up to a few centimeters daily.,"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 a patient with this migratory, pruritic skin eruption?, with the following options: A: Cutaneous larva migrans, B: Contact dermatitis, C: Paragonimiasis, D: Myiasis + +### Response: +Answer A. Cutaneous larva migransCutaneous larva migrans is the correct answer. It is most commonly caused by cat or dog hookworm larvae. The parasite is typically confined to the epidermis as it lacks the collagenase necessary to break through the basement membrane. Most infections are localized in the lower extremity as it is a common site of larval penetration. The eruption appears to migrate as the larvae move up to a few centimeters daily. +### End" +813,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: An infant presents with mild anemia, jaundice, and splenomegaly. A complete blood count with differential reveals spherocytosis; the reticulocyte count is elevated. The parents state that several relatives have also suffered from a similar illness.The infant's condition is most likely caused by defective?, with the following options: A: Clathrin, B: Connexon, C: Dynein, D: Spectrin + +### Response: +","The infant is suffering from hereditary spherocytosis, a disease that can result from defective erythrocyte cytoskeletal proteins such as spectrin or ankyrin. Spectrin is a cytoskeletal protein in the erythrocyte that binds to the ankyrin/band 3 protein complex. It also binds to a protein 4.1/actin complex to form a stable suppoing cytoskeletal network just below the plasma membrane. This helps to maintain the biconcave shape of the cell. Defective spectrin can lead to a destabilization of this network and a tendency of the affected cells to assume a spherical shape and become osmotically fragile. Such cells often become trapped in the splenic cords, and are subsequently destroyed by phagocytes. This can lead to hemolytic anemia, jaundice and splenomegaly. Clathrin is a protein found on the cytoplasmic side of the plasma membrane. It is located within the coating of the so-called coated pits seen in electron micrographs of cells engaged in receptor-mediated endocytosis. Connexon is a protein found in gap junctions, usually aggregated around the aqueous pores within the junctional area. Dynein is an ATPase protein responsible for the interaction and sliding of microtubule doublets, resulting in the bending of cilia and flagella. Ref: Murray R.K. (2011). Chapter 52. Red & White Blood Cells. 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: An infant presents with mild anemia, jaundice, and splenomegaly. A complete blood count with differential reveals spherocytosis; the reticulocyte count is elevated. The parents state that several relatives have also suffered from a similar illness.The infant's condition is most likely caused by defective?, with the following options: A: Clathrin, B: Connexon, C: Dynein, D: Spectrin + +### Response: +The infant is suffering from hereditary spherocytosis, a disease that can result from defective erythrocyte cytoskeletal proteins such as spectrin or ankyrin. Spectrin is a cytoskeletal protein in the erythrocyte that binds to the ankyrin/band 3 protein complex. It also binds to a protein 4.1/actin complex to form a stable suppoing cytoskeletal network just below the plasma membrane. This helps to maintain the biconcave shape of the cell. Defective spectrin can lead to a destabilization of this network and a tendency of the affected cells to assume a spherical shape and become osmotically fragile. Such cells often become trapped in the splenic cords, and are subsequently destroyed by phagocytes. This can lead to hemolytic anemia, jaundice and splenomegaly. Clathrin is a protein found on the cytoplasmic side of the plasma membrane. It is located within the coating of the so-called coated pits seen in electron micrographs of cells engaged in receptor-mediated endocytosis. Connexon is a protein found in gap junctions, usually aggregated around the aqueous pores within the junctional area. Dynein is an ATPase protein responsible for the interaction and sliding of microtubule doublets, resulting in the bending of cilia and flagella. Ref: Murray R.K. (2011). Chapter 52. Red & White Blood Cells. 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" +814,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In an adult man weighing 70 Kgs, the Total body water volume will be about -, with the following options: A: 42L, B: 25L, C: 15L, D: 12L + +### Response: +","Ans. A. 42L60% of body weight is composed of water. Therefore, total body water in a 70 Kg man would be 60% of 70 Kg, ie, 42 Kg, which is equivalent to 42 L.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In an adult man weighing 70 Kgs, the Total body water volume will be about -, with the following options: A: 42L, B: 25L, C: 15L, D: 12L + +### Response: +Ans. A. 42L60% of body weight is composed of water. Therefore, total body water in a 70 Kg man would be 60% of 70 Kg, ie, 42 Kg, which is equivalent to 42 L. +### End" +815,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about Sarcoidosis is?, with the following options: A: Skin is the most common organ involved, B: Premalignant condition, C: Non-caseating granuloma, D: May be associated with hypocalcaemia + +### Response: +","Ans. is 'c' i.e., Non caseating granulomas Sarcoidosis* Sarcoidosis is an immune system disorder characterized by the presence of non-caseating granulomas (aggregate of tightly clustered epitheloid cells, often with langhans or forein body type giant cells. Central necrosis is unusual)* Granulomas most often appear in the lung or the lymph nodes --> Bilateral hilar lymphadenopathy or lung involvement is visible on chest radiograph in 90% of cases.* Granulomas also contain:-A. Schaumann bodies - Laminated concretions composed of calcium and proteins.B. Asteroid bodies - Stellate inclusions within giant cells.Clinical features1. Lung and lymph nodes (95%)* Respiratory complaints including cough and dysnea are the most common presenting symptoms. Usually the infiltrate in sarcoidosis are predominantly an upper lobe process. There is bilateral hilar lymphadenopathy.* 'Potato nodes' are seen in sarcoidosis.2. Skin (24%-43%)* Skin lesions include erythma nodosum, maculopapular lesion, subcutaneous nodules, hypo or hyperpigmentation, keloid formation and lupus pernio.* Lupus pernio is involvement of bridge of nose, area beneath the eyes and cheek. It is diagnostic for a chronic form of sarcoidosis.3. Eye (12-29%)* Eye lesions include uveitis, retinitis, pars planitis and dry eye due to lacrimal gland involvement.* Uveoparotid fever (Heerfordt-Waldenstrome syndrome) include classical triad of Uveitis, parotitisand 7th nerve palsy.4. Other organs involved* These are salivary glands particulary parotid (causing dry mouth), spleen (splenomegaly), liver, heart and brain (neurosarcoidosis). Granuloma in sarcoidosis can secrete 1-25 (OH)2 vitamin-D which causes hypercalcemia.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about Sarcoidosis is?, with the following options: A: Skin is the most common organ involved, B: Premalignant condition, C: Non-caseating granuloma, D: May be associated with hypocalcaemia + +### Response: +Ans. is 'c' i.e., Non caseating granulomas Sarcoidosis* Sarcoidosis is an immune system disorder characterized by the presence of non-caseating granulomas (aggregate of tightly clustered epitheloid cells, often with langhans or forein body type giant cells. Central necrosis is unusual)* Granulomas most often appear in the lung or the lymph nodes --> Bilateral hilar lymphadenopathy or lung involvement is visible on chest radiograph in 90% of cases.* Granulomas also contain:-A. Schaumann bodies - Laminated concretions composed of calcium and proteins.B. Asteroid bodies - Stellate inclusions within giant cells.Clinical features1. Lung and lymph nodes (95%)* Respiratory complaints including cough and dysnea are the most common presenting symptoms. Usually the infiltrate in sarcoidosis are predominantly an upper lobe process. There is bilateral hilar lymphadenopathy.* 'Potato nodes' are seen in sarcoidosis.2. Skin (24%-43%)* Skin lesions include erythma nodosum, maculopapular lesion, subcutaneous nodules, hypo or hyperpigmentation, keloid formation and lupus pernio.* Lupus pernio is involvement of bridge of nose, area beneath the eyes and cheek. It is diagnostic for a chronic form of sarcoidosis.3. Eye (12-29%)* Eye lesions include uveitis, retinitis, pars planitis and dry eye due to lacrimal gland involvement.* Uveoparotid fever (Heerfordt-Waldenstrome syndrome) include classical triad of Uveitis, parotitisand 7th nerve palsy.4. Other organs involved* These are salivary glands particulary parotid (causing dry mouth), spleen (splenomegaly), liver, heart and brain (neurosarcoidosis). Granuloma in sarcoidosis can secrete 1-25 (OH)2 vitamin-D which causes hypercalcemia. +### End" +816,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Haloperidol induced extarpyramidal side effects are treated by -, with the following options: A: Benzodiazepines, B: Barbiturates, C: Anticholinergic drugs, D: SSRIs + +### Response: +","Ans is 'c' i.e. Anticholinergic drugs o Extrapyramidal symptoms (EPS), also known as extrapyramidal side effects (EPSE), are drug-induced movement disorders that include acute and tardive symptoms. These symptoms include dystonia (continuous spasms and muscle contractions), akathisia (motor restlessness), parkinsonism (characteristic symptoms such as rigidity), bradvkinesia (slowness of movement), and tremor, and tardive dyskinesia (irregular, jerky movements)o Anticholinergic drugs are used to control neuroleptic-induced EPS, although akathisia may require beta blockers or even benzodiazepines.o Commonly used medications for EPS are anticholinergic agents such as Benztropine, Diphenhydramine and trihexyphenidyl . Another common course of treatment includes dopamine agonist agents such as pramipexole.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Haloperidol induced extarpyramidal side effects are treated by -, with the following options: A: Benzodiazepines, B: Barbiturates, C: Anticholinergic drugs, D: SSRIs + +### Response: +Ans is 'c' i.e. Anticholinergic drugs o Extrapyramidal symptoms (EPS), also known as extrapyramidal side effects (EPSE), are drug-induced movement disorders that include acute and tardive symptoms. These symptoms include dystonia (continuous spasms and muscle contractions), akathisia (motor restlessness), parkinsonism (characteristic symptoms such as rigidity), bradvkinesia (slowness of movement), and tremor, and tardive dyskinesia (irregular, jerky movements)o Anticholinergic drugs are used to control neuroleptic-induced EPS, although akathisia may require beta blockers or even benzodiazepines.o Commonly used medications for EPS are anticholinergic agents such as Benztropine, Diphenhydramine and trihexyphenidyl . Another common course of treatment includes dopamine agonist agents such as pramipexole. +### End" +817,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Green colored urine is seen after ingestion of: (Repeat), with the following options: A: Copper sulphate, B: Phenol, C: Organophosphorus, D: Cyanide + +### Response: +",Ans: B (Phenol) Ref: The Essentials of Forensic Medicine and Toxicology by KS Narayan Reddy. 29th edition. 2010. Pg: 478Explanation:Refer 2011 forensic medicine question explanation,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Green colored urine is seen after ingestion of: (Repeat), with the following options: A: Copper sulphate, B: Phenol, C: Organophosphorus, D: Cyanide + +### Response: +Ans: B (Phenol) Ref: The Essentials of Forensic Medicine and Toxicology by KS Narayan Reddy. 29th edition. 2010. Pg: 478Explanation:Refer 2011 forensic medicine question explanation +### End" +818,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hardness of drinking water should be:, with the following options: A: Less than 1, B: 3-Jan, C: More than 3, D: More than 6 + +### Response: +",3-Jan,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hardness of drinking water should be:, with the following options: A: Less than 1, B: 3-Jan, C: More than 3, D: More than 6 + +### Response: +3-Jan +### End" +819,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Bleuler's symptoms for schizophrenia are all except, with the following options: A: Loosening of association, B: Affect disturbances, C: Autism, D: Hallucinations + +### Response: +","Eugen Bleuler's Fundamental Symptoms of Schizophrenia (Also called as 4 A's of Bleuler) 1. Ambivalence: Marked inability to decide for or against 2. Autism: Withdrawal into self 3. Affect disturbances: Disturbances of affect such as inappropriate affect 4. Association disturbances: Loosening of associations; thought disorder Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 55","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Bleuler's symptoms for schizophrenia are all except, with the following options: A: Loosening of association, B: Affect disturbances, C: Autism, D: Hallucinations + +### Response: +Eugen Bleuler's Fundamental Symptoms of Schizophrenia (Also called as 4 A's of Bleuler) 1. Ambivalence: Marked inability to decide for or against 2. Autism: Withdrawal into self 3. Affect disturbances: Disturbances of affect such as inappropriate affect 4. Association disturbances: Loosening of associations; thought disorder Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 55 +### End" +820,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The structure which passes superficial to the flexor retinaculum, with the following options: A: Median nerve, B: Flexor digitorum superficialis, C: Ulnar nerve, D: Flexor digitorum profundus + +### Response: +","Structures passing over the flexor retinaculum: + +Ulnar nerve and vessels through the Guyon's canal (volar carpal ligament). +Palmar cutaneous branch of ulnar nerve (supply skin over hypothenar muscles). +Palmaris Longus. +Palmar cutaneous branch of median nerve (supply skin over the thenar muscles). +Superficial palmar branch of the radial artery.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The structure which passes superficial to the flexor retinaculum, with the following options: A: Median nerve, B: Flexor digitorum superficialis, C: Ulnar nerve, D: Flexor digitorum profundus + +### Response: +Structures passing over the flexor retinaculum: + +Ulnar nerve and vessels through the Guyon's canal (volar carpal ligament). +Palmar cutaneous branch of ulnar nerve (supply skin over hypothenar muscles). +Palmaris Longus. +Palmar cutaneous branch of median nerve (supply skin over the thenar muscles). +Superficial palmar branch of the radial artery. +### End" +821,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Rabies free country is -, with the following options: A: USA, B: Russia, C: Australia, D: France + +### Response: +","
Rabies free zone ""Rabies free area"" is defined as the one in which no case of indigenously acquired rabies has occurred in man or any animal species for 2 years. In India, Union territory of lakshadweep and Andaman and Nicobar islands are free of disease. Australia,china,cyprus, iceland, Ireland, Japan , Malta,New Zealand, the UK and the islands of western pacific are free of the disease. The Liberian peninsula,and Finland, Norway and Sweden are all free from rabies. {Reference: park&;s textbook of preventive and social medicine, 23rd edition, pg no.277}
","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Rabies free country is -, with the following options: A: USA, B: Russia, C: Australia, D: France + +### Response: +Rabies free zone ""Rabies free area"" is defined as the one in which no case of indigenously acquired rabies has occurred in man or any animal species for 2 years. In India, Union territory of lakshadweep and Andaman and Nicobar islands are free of disease. Australia,china,cyprus, iceland, Ireland, Japan , Malta,New Zealand, the UK and the islands of western pacific are free of the disease. The Liberian peninsula,and Finland, Norway and Sweden are all free from rabies. {Reference: park&;s textbook of preventive and social medicine, 23rd edition, pg no.277}
+### End" +822,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Swarm of bees appearance seen in?, with the following options: A: Androgenetic alopecia, B: Anagen effluvium, C: Alopecia aerata, D: Telogen effluvium + +### Response: +","Alopecia aerata - Histopathology - Swarm of bees appearance , the lymphocytes surrounding the hair follicles same as peribulbar/perfollicular infilteration of lymphocytes","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Swarm of bees appearance seen in?, with the following options: A: Androgenetic alopecia, B: Anagen effluvium, C: Alopecia aerata, D: Telogen effluvium + +### Response: +Alopecia aerata - Histopathology - Swarm of bees appearance , the lymphocytes surrounding the hair follicles same as peribulbar/perfollicular infilteration of lymphocytes +### End" +823,"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 stem cell of the bone marrow, with the following options: A: Lymphoblast, B: Myeloblast, C: Myoblast, D: Normoblast + +### Response: +","Ref Robbins 9/e p580;8/e p85 Bone marrow cells include: hematopoietic stem cells include lymphoblast ,myeloblast and normoblast Marrow stromal cell / multipotent stem cells(MSC) Including myoblast , osteoblast ,chondrocytes, adipocytes and endithelial cell precursor.Myoblast is an example of MSC giving rise to muscle cells or myocytes","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 stem cell of the bone marrow, with the following options: A: Lymphoblast, B: Myeloblast, C: Myoblast, D: Normoblast + +### Response: +Ref Robbins 9/e p580;8/e p85 Bone marrow cells include: hematopoietic stem cells include lymphoblast ,myeloblast and normoblast Marrow stromal cell / multipotent stem cells(MSC) Including myoblast , osteoblast ,chondrocytes, adipocytes and endithelial cell precursor.Myoblast is an example of MSC giving rise to muscle cells or myocytes +### End" +824,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Caudal regression syndrome is specifically seen in babies of mother having, with the following options: A: Diabetes, B: PIH, C: Cardiac disease, D: Anaemia + +### Response: +",Congenital malformations in diabetes Cardiac defects are most common (transposition of great vessels and VSD) Neural tube defects like anencephaly and spina bifida Caudal regression syndrome or sacral agenesis is the congenital defect which is specific to diabetes Reference: Textbook of Obstetrics; Sheila Balakrishnan; 2nd edition; Page no:243,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Caudal regression syndrome is specifically seen in babies of mother having, with the following options: A: Diabetes, B: PIH, C: Cardiac disease, D: Anaemia + +### Response: +Congenital malformations in diabetes Cardiac defects are most common (transposition of great vessels and VSD) Neural tube defects like anencephaly and spina bifida Caudal regression syndrome or sacral agenesis is the congenital defect which is specific to diabetes Reference: Textbook of Obstetrics; Sheila Balakrishnan; 2nd edition; Page no:243 +### End" +825,"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 features our pancreatic adenocarcinoma over non-functioning PET (NF PET) in differentiating both the tumours, with the following options: A: <5cm, B: Calcifications, C: Negative chromogranin A, D: Negative Somatostatin receptor scintigraphy + +### Response: +",Differentiation from the more aggressive pancreatic adenocarcinoma is extremely impoant. Recognition of NF-PETs is imperative because of their respectability and excellent long-term survival compared with their exocrine counterpas.Pancreatic cancerNF-PETsTumour size<5cm>5cmCT scanHypodensityHyperdensityNo calcificationsCalcifications possibleChromogranin ANegativePositiveSomatostatin receptorscintigraphyNegativePositiveRef: Bailey and Love 27e pg: 852,"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 features our pancreatic adenocarcinoma over non-functioning PET (NF PET) in differentiating both the tumours, with the following options: A: <5cm, B: Calcifications, C: Negative chromogranin A, D: Negative Somatostatin receptor scintigraphy + +### Response: +Differentiation from the more aggressive pancreatic adenocarcinoma is extremely impoant. Recognition of NF-PETs is imperative because of their respectability and excellent long-term survival compared with their exocrine counterpas.Pancreatic cancerNF-PETsTumour size<5cm>5cmCT scanHypodensityHyperdensityNo calcificationsCalcifications possibleChromogranin ANegativePositiveSomatostatin receptorscintigraphyNegativePositiveRef: Bailey and Love 27e pg: 852 +### End" +826,"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 impaction of gell stones in gall stone lieus is :, with the following options: A: Ist pa of duodenum, B: IInd pa of duodenum, C: Terminal ileum, D: Colon + +### Response: +","Answer is C (Terminal ileum):'Classically there is obstruction / impaction about 60 cm proximal to ileocaecal valve'- Bailey'The site of obstruction by the impacted gall stone is usually at the ileocaecal valve"" provided that the more proximal S.I. is of normal calibre. - HarrisonsIf both choices come simultaneously in a question go for 60 cm proximal to ileacoecal valve, as, it has been defined as the narrowest pa of small intestine.","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 impaction of gell stones in gall stone lieus is :, with the following options: A: Ist pa of duodenum, B: IInd pa of duodenum, C: Terminal ileum, D: Colon + +### Response: +Answer is C (Terminal ileum):'Classically there is obstruction / impaction about 60 cm proximal to ileocaecal valve'- Bailey'The site of obstruction by the impacted gall stone is usually at the ileocaecal valve"" provided that the more proximal S.I. is of normal calibre. - HarrisonsIf both choices come simultaneously in a question go for 60 cm proximal to ileacoecal valve, as, it has been defined as the narrowest pa of small intestine. +### End" +827,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common manifestation of rheumatic fever –, with the following options: A: Arthritis, B: Carditis, C: Chorea, D: Nodules + +### Response: +","Arthritis in RF + +It is the most frequent major manifestation (75% of cases). +It is migratory polyarthritis, i.e., several joints are involved in quick succession and each for a brief period of time. +Any joint may be affected but involvement of large joints such as knee, anlde, elbow, and wrist is common. +Small joints of hands and feet are not involved. +Inflammation of any one joint subside spontaneously within a week and the entire bout of polyarthritis rarely last more than 4 weeks. +Resolution is complete with no residual joint damage. +A striking feature is dramatic response to salicylates.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Most common manifestation of rheumatic fever –, with the following options: A: Arthritis, B: Carditis, C: Chorea, D: Nodules + +### Response: +Arthritis in RF + +It is the most frequent major manifestation (75% of cases). +It is migratory polyarthritis, i.e., several joints are involved in quick succession and each for a brief period of time. +Any joint may be affected but involvement of large joints such as knee, anlde, elbow, and wrist is common. +Small joints of hands and feet are not involved. +Inflammation of any one joint subside spontaneously within a week and the entire bout of polyarthritis rarely last more than 4 weeks. +Resolution is complete with no residual joint damage. +A striking feature is dramatic response to salicylates. +### End" +828,"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 first line drug for follicle induction in infeility in PCOS, with the following options: A: Clomiphene citrate, B: GnRH agonist, C: Combined oral Pills, D: Letrozole + +### Response: +",Letrozole is the Drug of choice- Induction of ovulation in a case of PCOS; Mode of action- Aromatase Inhibitor Decrease Estrogen production-->Inhibit Negative feedback on FSH --> increases FSH --> increase stimulation of follicles Letrozole preferred over Clomiphene citrate because decreases chances of multifetal pregnancy increased live bih rate OHSS : Rare with it Given for 5 days (D5-D9) Sta with 2.5mg Max dose 7.5mg,"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 first line drug for follicle induction in infeility in PCOS, with the following options: A: Clomiphene citrate, B: GnRH agonist, C: Combined oral Pills, D: Letrozole + +### Response: +Letrozole is the Drug of choice- Induction of ovulation in a case of PCOS; Mode of action- Aromatase Inhibitor Decrease Estrogen production-->Inhibit Negative feedback on FSH --> increases FSH --> increase stimulation of follicles Letrozole preferred over Clomiphene citrate because decreases chances of multifetal pregnancy increased live bih rate OHSS : Rare with it Given for 5 days (D5-D9) Sta with 2.5mg Max dose 7.5mg +### End" +829,"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 may be the effect of positive 'g' acceleratory force on the body of ator:September 2011, with the following options: A: Increased cardiac output, B: Initial rise and then fall of blood pressure, C: Thrombocytopenia, D: Pooling of blood in lower body + +### Response: +","As. D: Pooling of blood in lower bodyDuring exposure to positive 'g' for the first few seconds, blood is thrown into the lower pas of the body, therefore, venous return to hea decreases resulting in fall in cardiac output and systolic BPAngular acceleration or centrifugal force.If a fighter pilot is diving at the rate of 450 miles an hour and pulls out of this dive on the arc of a circle having a radius of about one-half mile, centrifugal force will press his body down onto the seat of the plane with a force which will be slightly more than five times the force of gravity.Thus if the flyer's weight is 180 lbs., the force of his body against the seat of the plane would equal more than 900 lbs.His arms would be so heavy that he would be unable to lift them.The blood would have a weight five times its normal value.This would make it difficult for the Hea to pump an adequate amount of blood to the brain.Blood would, therefore, tend to drain out of, the upper pa of the body and become pooled in the abdomen and the legs, and the ator would suffer from cerebral ischemia.The first effect of this ischemia would be a blurring and graying of the vision as though a semi-transparent cuain were lowered before the eyes.This would be accompanied by a narrowing of the visual field.If the centrifugal force on the body is continued or increased, the ator will ""black out,"" that is, he will suffer a complete loss of vision and finally will lose consciousness.The extent of the physiological changes produced depends upon both the magnitude and duration of the centrifugal force applied to the body.","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 may be the effect of positive 'g' acceleratory force on the body of ator:September 2011, with the following options: A: Increased cardiac output, B: Initial rise and then fall of blood pressure, C: Thrombocytopenia, D: Pooling of blood in lower body + +### Response: +As. D: Pooling of blood in lower bodyDuring exposure to positive 'g' for the first few seconds, blood is thrown into the lower pas of the body, therefore, venous return to hea decreases resulting in fall in cardiac output and systolic BPAngular acceleration or centrifugal force.If a fighter pilot is diving at the rate of 450 miles an hour and pulls out of this dive on the arc of a circle having a radius of about one-half mile, centrifugal force will press his body down onto the seat of the plane with a force which will be slightly more than five times the force of gravity.Thus if the flyer's weight is 180 lbs., the force of his body against the seat of the plane would equal more than 900 lbs.His arms would be so heavy that he would be unable to lift them.The blood would have a weight five times its normal value.This would make it difficult for the Hea to pump an adequate amount of blood to the brain.Blood would, therefore, tend to drain out of, the upper pa of the body and become pooled in the abdomen and the legs, and the ator would suffer from cerebral ischemia.The first effect of this ischemia would be a blurring and graying of the vision as though a semi-transparent cuain were lowered before the eyes.This would be accompanied by a narrowing of the visual field.If the centrifugal force on the body is continued or increased, the ator will ""black out,"" that is, he will suffer a complete loss of vision and finally will lose consciousness.The extent of the physiological changes produced depends upon both the magnitude and duration of the centrifugal force applied to the body. +### End" +830,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The clinical sign of hyaline membrane disease generally first appears -, with the following options: A: In the first 6 hours of life, B: Between 12 and 24 hours of life, C: Between 36 and 48 hours of life, D: After 48 hours of lilfe + +### Response: +","Ans. is 'a' i.e., In the first 6 hours of life","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The clinical sign of hyaline membrane disease generally first appears -, with the following options: A: In the first 6 hours of life, B: Between 12 and 24 hours of life, C: Between 36 and 48 hours of life, D: After 48 hours of lilfe + +### Response: +Ans. is 'a' i.e., In the first 6 hours of life +### End" +831,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Myasthenia gravis is associated with -, with the following options: A: Thymoma, B: Thymic carcinoma, C: Thymic hyperplasia, D: Lymphoma + +### Response: +","Myasthenia gravis + +It is a muscle disease caused by immune-mediated loss of acetylcholine receptors. +When arising before age 40 years, it is most commonly seen in women, but there is equal occurrence between the sexes in older patients. +Thymic hyperplasia is found in 65% and thymoma in 15% of patients. +Analysis of neuromuscular transmission in myasthenia gravis shows a decrease in the number of muscle acetylcholine receptors (AChRs), and circulating antibodies to the AChR are present in nearly all patients with myasthenia gravis, +Patients show improvement in strength in response to administration of anticholinesterase agents. This remains a most useful test on clinical examination. +Respiratory compromise was a major cause of mortality in the past","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Myasthenia gravis is associated with -, with the following options: A: Thymoma, B: Thymic carcinoma, C: Thymic hyperplasia, D: Lymphoma + +### Response: +Myasthenia gravis + +It is a muscle disease caused by immune-mediated loss of acetylcholine receptors. +When arising before age 40 years, it is most commonly seen in women, but there is equal occurrence between the sexes in older patients. +Thymic hyperplasia is found in 65% and thymoma in 15% of patients. +Analysis of neuromuscular transmission in myasthenia gravis shows a decrease in the number of muscle acetylcholine receptors (AChRs), and circulating antibodies to the AChR are present in nearly all patients with myasthenia gravis, +Patients show improvement in strength in response to administration of anticholinesterase agents. This remains a most useful test on clinical examination. +Respiratory compromise was a major cause of mortality in the past +### End" +832,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Thiamine deficiency is seen in all except ?, with the following options: A: Chronic diarrhoea, B: Chronic alcoholism, C: Homocystinemia, D: Food faddist + +### Response: +","Ans. is 'c' i.e., Homocystienentia Causes of Thiamine deficiency o Persons may become deficient in thiamine either by not ingesting enough vitamin B-1 through the diet or by excess use, which may occur in hypehyroidism, pregnancy, lactation, or fever (sates of high energy consumption, such as hypehyroidism, pregnancy, or severe illness, require more thiamine and other nutrients.) o Prolonged diarrhea may impair the body's ability to absorb vitamin B-1, and severe liver disease impairs its use. D Decreased absorption is seen in Diarrhea Chronic intestinal disease Alcoholism Malnutrition Gastric bypass surgery Malabsorption syndrome Celiac and tropical sprue 1-Iyperemesis gravidarum Long term starvation Fad diets( Fad diets often do not contain necessary amounts of thiamine) Increased depletion is seen in Diuretic therapies Peritoneal dialysis Hemodialysis (Dialysis robs thiamine from the circulation) o Alcohol is known to interfere directly with the absorption of thiamine and with the synthesis of thiamine pyrophosphate.( thiamine should always be replenished when refeeding a patient with alcoholism, as carbohydrate repletion without adequate thiamine can precipitate acute thiamine deficiency.) o Beriberi has been repoed among refugees who are relying on emergency food aids. This is due to the lack of available micronutrition supplementation Food faddism and fad diet are terms which refer to the tendency for idiosyncratic diets and eating patterns. A fad diet is supposed and promoted to improve health but may do nothing at all, or even have the opposite results if it is nutritionally unbalanced and unconfirmed by scientific studies o Developing countries are known to have more vitamin deficiency problems in general.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Thiamine deficiency is seen in all except ?, with the following options: A: Chronic diarrhoea, B: Chronic alcoholism, C: Homocystinemia, D: Food faddist + +### Response: +Ans. is 'c' i.e., Homocystienentia Causes of Thiamine deficiency o Persons may become deficient in thiamine either by not ingesting enough vitamin B-1 through the diet or by excess use, which may occur in hypehyroidism, pregnancy, lactation, or fever (sates of high energy consumption, such as hypehyroidism, pregnancy, or severe illness, require more thiamine and other nutrients.) o Prolonged diarrhea may impair the body's ability to absorb vitamin B-1, and severe liver disease impairs its use. D Decreased absorption is seen in Diarrhea Chronic intestinal disease Alcoholism Malnutrition Gastric bypass surgery Malabsorption syndrome Celiac and tropical sprue 1-Iyperemesis gravidarum Long term starvation Fad diets( Fad diets often do not contain necessary amounts of thiamine) Increased depletion is seen in Diuretic therapies Peritoneal dialysis Hemodialysis (Dialysis robs thiamine from the circulation) o Alcohol is known to interfere directly with the absorption of thiamine and with the synthesis of thiamine pyrophosphate.( thiamine should always be replenished when refeeding a patient with alcoholism, as carbohydrate repletion without adequate thiamine can precipitate acute thiamine deficiency.) o Beriberi has been repoed among refugees who are relying on emergency food aids. This is due to the lack of available micronutrition supplementation Food faddism and fad diet are terms which refer to the tendency for idiosyncratic diets and eating patterns. A fad diet is supposed and promoted to improve health but may do nothing at all, or even have the opposite results if it is nutritionally unbalanced and unconfirmed by scientific studies o Developing countries are known to have more vitamin deficiency problems in general. +### End" +833,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: MCV (II) in infant of 1 month of age is:, with the following options: A: 76-80, B: 80-100, C: 90-110, D: 101-125 + +### Response: +","Ans: C (90-110) - Singie best answer!: Mean MCV at 1 month of age is 104 fl(-2SD: 85) ,so range will be 85-104 - O.P. Ghai 7th/298MCV of cord blood is 110 & during 6month- 6 year 70-74 fl Nelson 18th/2003AgeMean Hb (g/dl)Mean PCV (%}Mean MCV (fL)TLC (109/L)Birth (cord blood)16.55110818.11-3 days18.55610818.97 days17.55410712.214 days16.55110511.41 month14.043104108.2 months11.5359610.86 months11.5359111.91 year12.0367811.42-6 years12.537819.16-12 years13.540868.412-18 years14.042908.1","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: MCV (II) in infant of 1 month of age is:, with the following options: A: 76-80, B: 80-100, C: 90-110, D: 101-125 + +### Response: +Ans: C (90-110) - Singie best answer!: Mean MCV at 1 month of age is 104 fl(-2SD: 85) ,so range will be 85-104 - O.P. Ghai 7th/298MCV of cord blood is 110 & during 6month- 6 year 70-74 fl Nelson 18th/2003AgeMean Hb (g/dl)Mean PCV (%}Mean MCV (fL)TLC (109/L)Birth (cord blood)16.55110818.11-3 days18.55610818.97 days17.55410712.214 days16.55110511.41 month14.043104108.2 months11.5359610.86 months11.5359111.91 year12.0367811.42-6 years12.537819.16-12 years13.540868.412-18 years14.042908.1 +### End" +834,"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 man presents with progressive atrophy and weakness of hands & forearms. On examination he is found to have slight spasticity of the legs, generalized hyper-reflexia and increased signal in the coico-spinal tracts on T2 weighted MR1. The most likely diagnosis is :, with the following options: A: Multiple sclerosis, B: Amyotrophic lateral sclerosis, C: Subacute combined degeneration, D: Progressive spinal muscular atrophy + +### Response: +","Answer is B (Amyotrophic lateral sclerosis) : The presence of both lower motor neuron features (progressive atrophy and weakness of hands and firearms) and upper motor neuron features (spasticity and hyper reliever, in the patient leads us to the diagnosis of .-bnyotrophic lateral sclerosis. Increased signal in the coicospinal tracts on T2 weighted MRI is characteristic MR/ finding.","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 man presents with progressive atrophy and weakness of hands & forearms. On examination he is found to have slight spasticity of the legs, generalized hyper-reflexia and increased signal in the coico-spinal tracts on T2 weighted MR1. The most likely diagnosis is :, with the following options: A: Multiple sclerosis, B: Amyotrophic lateral sclerosis, C: Subacute combined degeneration, D: Progressive spinal muscular atrophy + +### Response: +Answer is B (Amyotrophic lateral sclerosis) : The presence of both lower motor neuron features (progressive atrophy and weakness of hands and firearms) and upper motor neuron features (spasticity and hyper reliever, in the patient leads us to the diagnosis of .-bnyotrophic lateral sclerosis. Increased signal in the coicospinal tracts on T2 weighted MRI is characteristic MR/ finding. +### End" +835,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All satements are true about papilloedema except-, with the following options: A: Collection of extra - cellular fluid, B: Disruption of neurofilament, C: Stasis of axoplasmic transpo, D: Swelling of the axon + +### Response: +","Though, papilloedema is a neurological emergency, it is not associated with disruption of neurofilament Where as, all the other features are present Collection of extracellular fluid Stasis of axoplasmic transpo Swelling of axon Ref AK khurana 6/e p 324","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All satements are true about papilloedema except-, with the following options: A: Collection of extra - cellular fluid, B: Disruption of neurofilament, C: Stasis of axoplasmic transpo, D: Swelling of the axon + +### Response: +Though, papilloedema is a neurological emergency, it is not associated with disruption of neurofilament Where as, all the other features are present Collection of extracellular fluid Stasis of axoplasmic transpo Swelling of axon Ref AK khurana 6/e p 324 +### End" +836,"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 the characteristic feature of kwashiorkor ?, with the following options: A: Hair and skin changes, B: Muscle wasting, C: Growth retardation, D: Psychomotor changes + +### Response: +","Early signs of kwashiorkor present as general symptoms of malnutrition and include fatigue, irritability and lethargy. As protein deprivation continues the following abnormalities become apparent. Failure to thrive (failure to put on height and weight) Loss of muscle mass Generalised swelling (oedema) Large protuberant belly (pot belly) Fatty liver Failing immune system so prone to infections and increased severity of normally mild infections Skin and hair changes Cutaneous features of kwashiorkor Characteristic skin and hair changes occur in kwashiorkor and develop over a few days. Skin lesions are at first erythematousbefore turning purple and reddish-brown in colour with marked exfoliation (skin peeling and sloughing) Where the skin becomes dark and dry, it splits open when stretched to reveal pale areas between the cracks (""lacquered flaky paint"", ""crazy pavement dermatosis"") Irregular or patchy discolouration of the skin caused by pigmentary changes Hair becomes dry and lustreless and may turn reddish yellow to white in colour. It becomes sparse and brittle and can be pulled out easily. Nail plates are thin and soft and may be fissured or ridged.","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 the characteristic feature of kwashiorkor ?, with the following options: A: Hair and skin changes, B: Muscle wasting, C: Growth retardation, D: Psychomotor changes + +### Response: +Early signs of kwashiorkor present as general symptoms of malnutrition and include fatigue, irritability and lethargy. As protein deprivation continues the following abnormalities become apparent. Failure to thrive (failure to put on height and weight) Loss of muscle mass Generalised swelling (oedema) Large protuberant belly (pot belly) Fatty liver Failing immune system so prone to infections and increased severity of normally mild infections Skin and hair changes Cutaneous features of kwashiorkor Characteristic skin and hair changes occur in kwashiorkor and develop over a few days. Skin lesions are at first erythematousbefore turning purple and reddish-brown in colour with marked exfoliation (skin peeling and sloughing) Where the skin becomes dark and dry, it splits open when stretched to reveal pale areas between the cracks (""lacquered flaky paint"", ""crazy pavement dermatosis"") Irregular or patchy discolouration of the skin caused by pigmentary changes Hair becomes dry and lustreless and may turn reddish yellow to white in colour. It becomes sparse and brittle and can be pulled out easily. Nail plates are thin and soft and may be fissured or ridged. +### End" +837,"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 Mollaret meningitis is true?, with the following options: A: Caused by Herpes simplex 2 in most of the cases., B: Is a recurrent, benign septic meningitis, C: Is also referred to as ""Benign Recurrent Neutrophilic Meningitis"", D: Does not resolve without treatment + +### Response: +",Answer is A (Caused by Herpes simplex 2 in most of the cases): Mollaret's Meningitis is a form of Self-limiting Benign Recurrent Aseptic Lymphocvtic Meningitis that is most commonly caused by HSV-2 infection of the CNS. Several etiologies have been proposed for Mollaret's Meningitis however recent studies suggest that most cases of Mollaret's Meningitis result from Herpes Simplex Virus -2 (HSV-2) infection Mollaret's Meningitis It is the name given to a Self-Limited Recurrent form of Aseptic Meningitis It is also referred to as Benign Recurrent Lymphocytic Meningitis Recurrent episodes (typically> 3 episodes) of meningismus and fever lasting for 2-5 days with spontaneous resolution is highly suggestive of a diagnosis of Mollaret's Meningitis CSF Examination is characterized by a cloudy spinal fluid with lymphocytic pleocytosis and normal glucose and protein. Presence of large granular cells on Papanicolaou's stain of the CSF called `Mollaret's Cells' is considered pathognomonic (Mollaret's cells were once thought to be endothelial cells but are now believed to be from the monocyte/ macrophage family) Several etiologies. have been proposed for Mollaret's Meningitis however recent studies suggest that most cases of Mollaret Meningitis result from Herpes Simplex Virus -2 (HSV-2) infection Presence of HSV DNA on PCR is highly suggestive of Mollaret's Meningitis (In most cases HSV-2 DNA is detected It is not associated with genital herpetic lesions,"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 Mollaret meningitis is true?, with the following options: A: Caused by Herpes simplex 2 in most of the cases., B: Is a recurrent, benign septic meningitis, C: Is also referred to as ""Benign Recurrent Neutrophilic Meningitis"", D: Does not resolve without treatment + +### Response: +Answer is A (Caused by Herpes simplex 2 in most of the cases): Mollaret's Meningitis is a form of Self-limiting Benign Recurrent Aseptic Lymphocvtic Meningitis that is most commonly caused by HSV-2 infection of the CNS. Several etiologies have been proposed for Mollaret's Meningitis however recent studies suggest that most cases of Mollaret's Meningitis result from Herpes Simplex Virus -2 (HSV-2) infection Mollaret's Meningitis It is the name given to a Self-Limited Recurrent form of Aseptic Meningitis It is also referred to as Benign Recurrent Lymphocytic Meningitis Recurrent episodes (typically> 3 episodes) of meningismus and fever lasting for 2-5 days with spontaneous resolution is highly suggestive of a diagnosis of Mollaret's Meningitis CSF Examination is characterized by a cloudy spinal fluid with lymphocytic pleocytosis and normal glucose and protein. Presence of large granular cells on Papanicolaou's stain of the CSF called `Mollaret's Cells' is considered pathognomonic (Mollaret's cells were once thought to be endothelial cells but are now believed to be from the monocyte/ macrophage family) Several etiologies. have been proposed for Mollaret's Meningitis however recent studies suggest that most cases of Mollaret Meningitis result from Herpes Simplex Virus -2 (HSV-2) infection Presence of HSV DNA on PCR is highly suggestive of Mollaret's Meningitis (In most cases HSV-2 DNA is detected It is not associated with genital herpetic lesions +### End" +838,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Typical silvery scales of psoriasis are absent in -, with the following options: A: Scalp, B: Knee, C: Groin, D: Elbow + +### Response: +","PSORIASIS:-Inflammatory skin disease.Genetic predisposition. Psoriasis susceptibility 1 (PSORS1) is the most impoant susceptibility locus. Clinical features:-1. Classic lesion-Well defined erythematous plaque with a silvery white scales.2. Size varies from pin point papules to plaques. Types:-1. Chronic plaque psoriasis/psoriasis vulgaris:- Most common type Erythematous scaly plaques with silvery white scales of various sizes distributed symmetrically on the extensor aspect of extremities 2. Eruptive psoriasis:- More commonly seen in children and young adults with a shower of small papules and plaques all over the trunk and limbs. lesions are of size 1-2 cm, associated with streptococcal infection 3. Flexural psoriasis:-Involvement of flexural areas-axillae,perineum ,groin and inflammatory folds. Scaling minimal or absent. 4. Sebo - psoriasis : Occurs in sebum rich areas.Predominantly on scalp,face,inframammary region, retroauricular regions Moist erythematous lesions with yellow greasy scales. {Reference: IADVL textbook of dermatology page 1032","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Typical silvery scales of psoriasis are absent in -, with the following options: A: Scalp, B: Knee, C: Groin, D: Elbow + +### Response: +
PSORIASIS:-Inflammatory skin disease.Genetic predisposition. Psoriasis susceptibility 1 (PSORS1) is the most impoant susceptibility locus. Clinical features:-1. Classic lesion-Well defined erythematous plaque with a silvery white scales.2. Size varies from pin point papules to plaques. Types:-1. Chronic plaque psoriasis/psoriasis vulgaris:- Most common type Erythematous scaly plaques with silvery white scales of various sizes distributed symmetrically on the extensor aspect of extremities 2. Eruptive psoriasis:- More commonly seen in children and young adults with a shower of small papules and plaques all over the trunk and limbs. lesions are of size 1-2 cm, associated with streptococcal infection 3. Flexural psoriasis:-Involvement of flexural areas-axillae,perineum ,groin and inflammatory folds. Scaling minimal or absent. 4. Sebo - psoriasis : Occurs in sebum rich areas.Predominantly on scalp,face,inframammary region, retroauricular regions Moist erythematous lesions with yellow greasy scales. {Reference: IADVL textbook of dermatology page 1032 +### End" +839,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A new bom of 3-4 days old passes greenish stools 8-10 times /day management is, with the following options: A: Give ORS, B: Give antibiotics, C: Reassure the mother that this is normal, D: Send stool for culture + +### Response: +","(C) (Reassure the mother that this is normal)What will my newborn's poos be like?For the first couple of days after the birth, baby will pass meconium. Meconium is greeny-black in colour, and has a sticky, tar-like texture. It is made up of mucus, amniotic fluid, and everything baby has ingested while she was in mothers womb (uterus). Meconium may be difficult to wipe off baby's tiny bottom, but its appearance is a good sign that her bowels are working normally. In the early weeks, baby may poo during or after every feed. On average, she will do four poos a day in the first week. This will slowly settle down and her bowels will work out their own routine. One then find that she poos at a similar time each day.A newborn can have as many as eight to ten bowel movements a day, but as long as she is having at least one, she's probably all right.One day without a bowel movement is usually no cause for concern. As long as baby is feeding well and wetting her diaper five or six times a day, then she's most likely getting enough to eat. If she starts to become uncomfortable or has a persistently swollen abdomen, then she may need some help with pooping, and one should speak to pediatrician about how to facilitate this.In the early days, a newborn's bowel movements are thick and dark green in color. This is due to a substance called meconium that has been building up in her intestines during pregnancy. As the baby starts to feed and have bowel movements, she will finish expelling the meconium and her stools will start to turn yellowish. It is not uncommon for an infant's bowel movements to vary in color from day to day. The color of the stools can depend on a variety of things, including what a breastfeeding mom is eating, how hydrated the baby is, and the type and frequency of formula the infant is being fed, if applicable* Most sensitive indicator of intravascular volume depletion in infants- Heart rate *** Probiotics have been shown to have beneficial effects in prevention of Necrotizing enterocolitis in preterm infants* Rota virus is the single most common cause (MCC) of diarrhea amonget children in both developed and developing world* Enterotoxigenic E.coli (ETEC) is the MCC of bacterial diarrhea amongs children in developing world* ETEC is the MC bacterial cause for Traveler's diarrhea **","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A new bom of 3-4 days old passes greenish stools 8-10 times /day management is, with the following options: A: Give ORS, B: Give antibiotics, C: Reassure the mother that this is normal, D: Send stool for culture + +### Response: +(C) (Reassure the mother that this is normal)What will my newborn's poos be like?For the first couple of days after the birth, baby will pass meconium. Meconium is greeny-black in colour, and has a sticky, tar-like texture. It is made up of mucus, amniotic fluid, and everything baby has ingested while she was in mothers womb (uterus). Meconium may be difficult to wipe off baby's tiny bottom, but its appearance is a good sign that her bowels are working normally. In the early weeks, baby may poo during or after every feed. On average, she will do four poos a day in the first week. This will slowly settle down and her bowels will work out their own routine. One then find that she poos at a similar time each day.A newborn can have as many as eight to ten bowel movements a day, but as long as she is having at least one, she's probably all right.One day without a bowel movement is usually no cause for concern. As long as baby is feeding well and wetting her diaper five or six times a day, then she's most likely getting enough to eat. If she starts to become uncomfortable or has a persistently swollen abdomen, then she may need some help with pooping, and one should speak to pediatrician about how to facilitate this.In the early days, a newborn's bowel movements are thick and dark green in color. This is due to a substance called meconium that has been building up in her intestines during pregnancy. As the baby starts to feed and have bowel movements, she will finish expelling the meconium and her stools will start to turn yellowish. It is not uncommon for an infant's bowel movements to vary in color from day to day. The color of the stools can depend on a variety of things, including what a breastfeeding mom is eating, how hydrated the baby is, and the type and frequency of formula the infant is being fed, if applicable* Most sensitive indicator of intravascular volume depletion in infants- Heart rate *** Probiotics have been shown to have beneficial effects in prevention of Necrotizing enterocolitis in preterm infants* Rota virus is the single most common cause (MCC) of diarrhea amonget children in both developed and developing world* Enterotoxigenic E.coli (ETEC) is the MCC of bacterial diarrhea amongs children in developing world* ETEC is the MC bacterial cause for Traveler's diarrhea ** +### End" +840,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Tetraethylammonium (TEA) is a blocker of the:, with the following options: A: Na+ channels, B: K+ channels, C: Chloride channels, D: Ca++ channels + +### Response: +","Tetraethylammonium (TEA) ion is known to block the K+ channels. It is used sometimes to stop the K+ currents, in order to study the other ionic currents and their effects on membrane potential. Tetrodotoxin (TTX) and saxitoxin (STX) are the blockers of Na+ channels. Niflumic acid is Cl- channel blocker used in scientific research studies.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Tetraethylammonium (TEA) is a blocker of the:, with the following options: A: Na+ channels, B: K+ channels, C: Chloride channels, D: Ca++ channels + +### Response: +Tetraethylammonium (TEA) ion is known to block the K+ channels. It is used sometimes to stop the K+ currents, in order to study the other ionic currents and their effects on membrane potential. Tetrodotoxin (TTX) and saxitoxin (STX) are the blockers of Na+ channels. Niflumic acid is Cl- channel blocker used in scientific research studies. +### End" +841,"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 for sarcoidosis except: September 2008, with the following options: A: Kveim test is the most specific test for sarcoidosis, B: Caseating epithelioid granulomas, C: Most commonly involves lungs, D: Unknown etiology + +### Response: +","Ans. B: Caseating epithelioid granulomas Although Jonathan Hutchinson described the first case in 1869, the etiology of the disease is still unknown. The disease most commonly involves granuloma formation in the lungs. Other commonly involved organ systems include the lymph nodes (especially the intrathoracic nodes); the skin; the eyes; the liver; the hea; and the nervous, musculoskeletal, renal, and endocrine systems. Sarcoidosis is characterized by noncaseating epithelioid granulomas that may affect any organ system. Kveim test is the most specific test for sarcoidosis. The Kveim test involves intradermal injection of tissue from the spleen or the lymph node of a patient with sarcoidosis. A biopsy sample is obtained from the area 4-6 weeks after injection, and it is histologically examined for noncaseating granuloma formation, which, if found, indicates a positive result.","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 for sarcoidosis except: September 2008, with the following options: A: Kveim test is the most specific test for sarcoidosis, B: Caseating epithelioid granulomas, C: Most commonly involves lungs, D: Unknown etiology + +### Response: +Ans. B: Caseating epithelioid granulomas Although Jonathan Hutchinson described the first case in 1869, the etiology of the disease is still unknown. The disease most commonly involves granuloma formation in the lungs. Other commonly involved organ systems include the lymph nodes (especially the intrathoracic nodes); the skin; the eyes; the liver; the hea; and the nervous, musculoskeletal, renal, and endocrine systems. Sarcoidosis is characterized by noncaseating epithelioid granulomas that may affect any organ system. Kveim test is the most specific test for sarcoidosis. The Kveim test involves intradermal injection of tissue from the spleen or the lymph node of a patient with sarcoidosis. A biopsy sample is obtained from the area 4-6 weeks after injection, and it is histologically examined for noncaseating granuloma formation, which, if found, indicates a positive result. +### End" +842,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 27-year-old woman in the third trimester of her third pregnancy discovers a lump in her left breast. On physical examination, a 2-cm, discrete, freely movable mass beneath the nipple is palpable. After the birth of a term infant, the mass appears to decrease in size. The infant is breastfed without difficulty. What is the most likely diagnosis?, with the following options: A: Fibroadenoma, B: Intraductal papilloma, C: Lobular carcinoma in situ, D: Medullary carcinoma + +### Response: +",Fibroadenomas are common and may enlarge during pregnancy or late in each menstrual cycle. Most intraductal papillomas are smaller than 1 cm and are not influenced by hormonal changes. Lobular carcinoma in situ is typically an ill-defined lesion without a mass effect. Medullary carcinomas tend to be large; they account for only about 1% of all breast carcinomas. Phyllodes tumors are uncommon and tend to be larger than 4 cm.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 27-year-old woman in the third trimester of her third pregnancy discovers a lump in her left breast. On physical examination, a 2-cm, discrete, freely movable mass beneath the nipple is palpable. After the birth of a term infant, the mass appears to decrease in size. The infant is breastfed without difficulty. What is the most likely diagnosis?, with the following options: A: Fibroadenoma, B: Intraductal papilloma, C: Lobular carcinoma in situ, D: Medullary carcinoma + +### Response: +Fibroadenomas are common and may enlarge during pregnancy or late in each menstrual cycle. Most intraductal papillomas are smaller than 1 cm and are not influenced by hormonal changes. Lobular carcinoma in situ is typically an ill-defined lesion without a mass effect. Medullary carcinomas tend to be large; they account for only about 1% of all breast carcinomas. Phyllodes tumors are uncommon and tend to be larger than 4 cm. +### End" +843,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Leflunomide used against Rheumatoid arthritis acts by inhibiting:, with the following options: A: Ionisne monophosphate dehydrogenase, B: Dihydroorotate dehydrogenase, C: Aldehyde dehydrogenase, D: TNF-α receptor + +### Response: +",Leflunomide inhibits Dihydroorotate Dehydrogenase and inhibits synthesis of pyrimidine and arrests growth of B-cells.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Leflunomide used against Rheumatoid arthritis acts by inhibiting:, with the following options: A: Ionisne monophosphate dehydrogenase, B: Dihydroorotate dehydrogenase, C: Aldehyde dehydrogenase, D: TNF-α receptor + +### Response: +Leflunomide inhibits Dihydroorotate Dehydrogenase and inhibits synthesis of pyrimidine and arrests growth of B-cells. +### End" +844,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: On a given day, a hospital had 50 admissions with about 20 girls and 30 boys, out of which 10 girls and 20 boys needed surgery. What is the possibility of picking up a person requiring surgery, with the following options: A: 2\/6, B: 3\/5, C: 1\/2, D: 6\/25 + +### Response: +","
2/6. Reference:Text of preventive and social medicine,K.Park,20th edition,page no:755. <\p>","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: On a given day, a hospital had 50 admissions with about 20 girls and 30 boys, out of which 10 girls and 20 boys needed surgery. What is the possibility of picking up a person requiring surgery, with the following options: A: 2\/6, B: 3\/5, C: 1\/2, D: 6\/25 + +### Response: +
2/6. Reference:Text of preventive and social medicine,K.Park,20th edition,page no:755. <\p> +### End" +845,"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 scoring system for the severity of wound infection?, with the following options: A: PRISMA guidelines, B: ASEPSIS score, C: Manchester scoring system, D: POSSUM score + +### Response: +","Southampton scoring systems and ASEPSIS systems are for the severity of wound infection, which are paicularly useful in surveillance and research. PRISMA guidelines are for the methods of systematic review and meta-analysis Manchester scoring system for severity of illnessPOSSUM score (Physiologic and Operative Severity Score for the enUmeration of Moality and Morbidity) are used to predict all-cause moality in postoperative critical care patientsRef: Bailey and Love 27e pg: 47","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 scoring system for the severity of wound infection?, with the following options: A: PRISMA guidelines, B: ASEPSIS score, C: Manchester scoring system, D: POSSUM score + +### Response: +Southampton scoring systems and ASEPSIS systems are for the severity of wound infection, which are paicularly useful in surveillance and research. PRISMA guidelines are for the methods of systematic review and meta-analysis Manchester scoring system for severity of illnessPOSSUM score (Physiologic and Operative Severity Score for the enUmeration of Moality and Morbidity) are used to predict all-cause moality in postoperative critical care patientsRef: Bailey and Love 27e pg: 47 +### End" +846,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Permanent kidney in humans arise from which of the following embryological structure?, with the following options: A: Pronephros, B: Mesonephros, C: Metanephros, D: All of the above + +### Response: +","In humans metanephros is responsible for the formation of the permanent kidney. The metanephros develop from two sources: ureteric bud from the mesonephric duct and the metanephrogenic cap from the intermediate cell mass of mesenchyme of the lower lumbar and sacral regions.The ureteric bud forms the ureter which dilates to form the pelvis of the ureter. The pelvis then branches to form the major calyces, minor calyces and collecting tubules.Metanephrogenic cap condenses around the ureter and forms the glomerular capsules, proximal and distal convoluted tubule and loop of Henle. Ref: Clinical Anatomy by Regions By Richard S. Snell page 267.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Permanent kidney in humans arise from which of the following embryological structure?, with the following options: A: Pronephros, B: Mesonephros, C: Metanephros, D: All of the above + +### Response: +In humans metanephros is responsible for the formation of the permanent kidney. The metanephros develop from two sources: ureteric bud from the mesonephric duct and the metanephrogenic cap from the intermediate cell mass of mesenchyme of the lower lumbar and sacral regions.The ureteric bud forms the ureter which dilates to form the pelvis of the ureter. The pelvis then branches to form the major calyces, minor calyces and collecting tubules.Metanephrogenic cap condenses around the ureter and forms the glomerular capsules, proximal and distal convoluted tubule and loop of Henle. Ref: Clinical Anatomy by Regions By Richard S. Snell page 267. +### End" +847,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Why oxygen transpo by haemoglobin is impaired by decreased glycolytic activity?, with the following options: A: Reduced synthesis of haemoglobin, B: Reduced energy production, C: Increased production of 2,3 bisphosphoglycerate, D: Decreased production of 2,3 bisphosphoglycerate + +### Response: +","2,3 bisphosphoglycerate is an impoant allosteric modifier of haemoglobin oxygen saturation and desaturation. During decreased glycolytic activity decreased production of 2,3 bisphosphoglycerate is responsible for increased oxygen affinity for Hb and decreased dissociation from it leading to impaired oxygen delivery to tissues.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Why oxygen transpo by haemoglobin is impaired by decreased glycolytic activity?, with the following options: A: Reduced synthesis of haemoglobin, B: Reduced energy production, C: Increased production of 2,3 bisphosphoglycerate, D: Decreased production of 2,3 bisphosphoglycerate + +### Response: +2,3 bisphosphoglycerate is an impoant allosteric modifier of haemoglobin oxygen saturation and desaturation. During decreased glycolytic activity decreased production of 2,3 bisphosphoglycerate is responsible for increased oxygen affinity for Hb and decreased dissociation from it leading to impaired oxygen delivery to tissues. +### End" +848,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: C1 esterase inhibitor deficiency causes -, with the following options: A: Neisseria infection, B: Hereditary angioneurotic edema, C: Hemolytic disease, D: Hemolytic uremic syndrome + +### Response: +","Ans. is 'b' i.e., Hereditary angioneurotic edema o Hereditary angioneurotic edema is due to Ci inhibitor (Cj esterase inhibitor) deficiency.Complement Deficiencies and Associated DiseasesComponentAssociated DiseasesCLASSIC PATHWAYClq,Clr,ClS,C4C2Cl inhibitorImmune-complex syndromes, ""pyogenic infections""Immune-complex syndromes, ""few with pyogenic infections""Rare immune-complex diseases, few with pyogenic infections,Hereditary angioneurotic edemaC3 AND ALTERNATIVE PATHWAYC3.C3DProperdinIHImmune-complex syndrome, ""pyogenic infections"", Neisseria infectionsPyogenic infections. Neisseria infectionsNeisseria infectionsPyogenic infectionsHemolytic uremic syndromeMEMBRANE ATTACK COMPLEXC5, C6, C7, C8C9Recurrent Neisseria infections, immune-complex diseaseRare Neisseria infections","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: C1 esterase inhibitor deficiency causes -, with the following options: A: Neisseria infection, B: Hereditary angioneurotic edema, C: Hemolytic disease, D: Hemolytic uremic syndrome + +### Response: +Ans. is 'b' i.e., Hereditary angioneurotic edema o Hereditary angioneurotic edema is due to Ci inhibitor (Cj esterase inhibitor) deficiency.Complement Deficiencies and Associated DiseasesComponentAssociated DiseasesCLASSIC PATHWAYClq,Clr,ClS,C4C2Cl inhibitorImmune-complex syndromes, ""pyogenic infections""Immune-complex syndromes, ""few with pyogenic infections""Rare immune-complex diseases, few with pyogenic infections,Hereditary angioneurotic edemaC3 AND ALTERNATIVE PATHWAYC3.C3DProperdinIHImmune-complex syndrome, ""pyogenic infections"", Neisseria infectionsPyogenic infections. Neisseria infectionsNeisseria infectionsPyogenic infectionsHemolytic uremic syndromeMEMBRANE ATTACK COMPLEXC5, C6, C7, C8C9Recurrent Neisseria infections, immune-complex diseaseRare Neisseria infections +### End" +849,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Parasites transmitted by ingestion are the following EXCEPT, with the following options: A: Trichuris trichura, B: Ankylostoma duodenale, C: Trichinella spiralis, D: Dracunculus medinensis + +### Response: +","Ans. b (Ankylostoma duodenale) (Ref. Parasitology by Chatteijee 12th ed., 164)HOOKWORM# Ankylostoma duodenale# Portal of entry is skin# Adult worm lives in small intestine of man (the only definitive host)# Eggs float in saturated solution of common salt# Habitual Blood sucker# It causes -- Bronchitis and bronchopneumonia,- Creeping eruptions (cutaneous larva migrans),# Ground itch (Ancylostome dermatitis),# Iron deficiency and diamorphic anemia.TransmissionParasite Feco-oral Transmission# Enterobius vermicularis (pin/thread worm)# Trichuris trichura (whip worm) # Ascaris lumbricoides (round worm)# Toxocara # Entamoeba# Giardia # Isospora# Cryptococosis # Cyclospora# Taenia # Guinea worm Soil-Skin Transmission# Ankylostoma duodenale (hookworm)# Necatar americanusTRICHINOSIS# Trichinosis develops after meat ingestion containing cysts of trichinella, causes severe enteritis, periorbital edema, myositis and infrequently death and symptoms arise from successive phases of parasitic enteric invasion, larval migration and muscle encystment.# Myocarditis can occur.# Although not a neuroparasite, rarely encephalitis can occur.TRICHURIASIS# Asymptomatic# Acute appendicitis# Abdominal pain, mucous diarrhea, and weight loss (in heavy infection)# Occasionally rectal prolapse in massive Trichuriasis.Trophozoites or cvstic forms mav be detected in stool in the following:1. Amoebiasis2. Balantidiasis3. GiardiasisEggs may be detected in stool in the following:# Ascariasis# Ankylostomiasis# Trichuriasis# Fasciolopsiasis# Int. Schistosomiasis# Taeniasis# Diphyllobothriasis# Hymenolepiasis# Dipylidiasis# Fascioliasis# Clonarchiasis# Enterobius (rarely)Larvae may be detected in stool in the following:# StrongyloidosisAdult worm mav be detected in stool in the following:# Ascariasis,# Hookworm infection (after verifuge),# EnterobiasisSegments of adult worm mav be detected in stool in the following:# Taeniasis,# Diphyllobothriasis,# And other intestinal tapeworm infectionsAlso rememberfeatureParasites whose larvae are found in muscles?# rarasites# Trichinella spiralis# Taenia solium# Echinococcus# Toxoplasma gondii# Schistosoma mansoni# Trypanosoma cruziParasites whose larvae are found in heart muscles?# Trichinella spiralis# Toxoplasma gondii# Trypanosoma cruziWorms found in duodenum?Worms found in small intestine?# Strongyloides stercoralis# Taenia# Ankylostoma# Ascaris lumbricoides# Necator amerianusWorms found in large bowel?# Trichuris trichuraNote:# Band/ Rectangular forms of trophozoites are common in P malariae.# Sabin-Feldman dye test is for trophozoites of Toxoplasma gondii.Educational Points:D/D of AUTOINFECTION:# T. solium} # Enetrobious vermicularis # Capillaria philippinensis(Mnemonic: She Tc)# Hymenolepis nana # Strongyloides","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Parasites transmitted by ingestion are the following EXCEPT, with the following options: A: Trichuris trichura, B: Ankylostoma duodenale, C: Trichinella spiralis, D: Dracunculus medinensis + +### Response: +Ans. b (Ankylostoma duodenale) (Ref. Parasitology by Chatteijee 12th ed., 164)HOOKWORM# Ankylostoma duodenale# Portal of entry is skin# Adult worm lives in small intestine of man (the only definitive host)# Eggs float in saturated solution of common salt# Habitual Blood sucker# It causes -- Bronchitis and bronchopneumonia,- Creeping eruptions (cutaneous larva migrans),# Ground itch (Ancylostome dermatitis),# Iron deficiency and diamorphic anemia.TransmissionParasite Feco-oral Transmission# Enterobius vermicularis (pin/thread worm)# Trichuris trichura (whip worm) # Ascaris lumbricoides (round worm)# Toxocara # Entamoeba# Giardia # Isospora# Cryptococosis # Cyclospora# Taenia # Guinea worm Soil-Skin Transmission# Ankylostoma duodenale (hookworm)# Necatar americanusTRICHINOSIS# Trichinosis develops after meat ingestion containing cysts of trichinella, causes severe enteritis, periorbital edema, myositis and infrequently death and symptoms arise from successive phases of parasitic enteric invasion, larval migration and muscle encystment.# Myocarditis can occur.# Although not a neuroparasite, rarely encephalitis can occur.TRICHURIASIS# Asymptomatic# Acute appendicitis# Abdominal pain, mucous diarrhea, and weight loss (in heavy infection)# Occasionally rectal prolapse in massive Trichuriasis.Trophozoites or cvstic forms mav be detected in stool in the following:1. Amoebiasis2. Balantidiasis3. GiardiasisEggs may be detected in stool in the following:# Ascariasis# Ankylostomiasis# Trichuriasis# Fasciolopsiasis# Int. Schistosomiasis# Taeniasis# Diphyllobothriasis# Hymenolepiasis# Dipylidiasis# Fascioliasis# Clonarchiasis# Enterobius (rarely)Larvae may be detected in stool in the following:# StrongyloidosisAdult worm mav be detected in stool in the following:# Ascariasis,# Hookworm infection (after verifuge),# EnterobiasisSegments of adult worm mav be detected in stool in the following:# Taeniasis,# Diphyllobothriasis,# And other intestinal tapeworm infectionsAlso rememberfeatureParasites whose larvae are found in muscles?# rarasites# Trichinella spiralis# Taenia solium# Echinococcus# Toxoplasma gondii# Schistosoma mansoni# Trypanosoma cruziParasites whose larvae are found in heart muscles?# Trichinella spiralis# Toxoplasma gondii# Trypanosoma cruziWorms found in duodenum?Worms found in small intestine?# Strongyloides stercoralis# Taenia# Ankylostoma# Ascaris lumbricoides# Necator amerianusWorms found in large bowel?# Trichuris trichuraNote:# Band/ Rectangular forms of trophozoites are common in P malariae.# Sabin-Feldman dye test is for trophozoites of Toxoplasma gondii.Educational Points:D/D of AUTOINFECTION:# T. solium} # Enetrobious vermicularis # Capillaria philippinensis(Mnemonic: She Tc)# Hymenolepis nana # Strongyloides +### End" +850,"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 Rheumatic fever in children –a) Polyarthritisb) Caused by c hemolytic streptococcic) Erythema marginatum is most common manifestationd) Most common valve involvement is Mitrale) Erythema marginatum is common in face, with the following options: A: b, B: c, C: ac, D: ad + +### Response: +","Most commonly involved valve in case of Rheumatic carditis is the mitral valve and the most common valvular deformity produced is mitral regurgitation. +In patient with Rheumatic heart disease the mitral valve alone is involved in 65% to 70% cases, followed by Aortic valve in 25% cases. +The valvular deformity becomes manifested when Rheumatic fever becomes chronic. +Chronic Rheumatic heart disese is characterized by organization of the acute inflammation and subsequent fibrosis. +In particular, the valvular leaflets becomes thickened and retracted causing permanent deformity. +The cardinal anatomical changes which are produced to chronicity are leaflet thickening. commissuralfizsion and shortening and thickening and fusion of the tendinous cords. +These abnormalities lead to the most serious complication of Rheumatic fever i.e., Valvular stenosis and /or regurgitation. +Most common manifestation of Rheumatic fever is arthritis. +Erythema marginatum spares the face.","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 Rheumatic fever in children –a) Polyarthritisb) Caused by c hemolytic streptococcic) Erythema marginatum is most common manifestationd) Most common valve involvement is Mitrale) Erythema marginatum is common in face, with the following options: A: b, B: c, C: ac, D: ad + +### Response: +Most commonly involved valve in case of Rheumatic carditis is the mitral valve and the most common valvular deformity produced is mitral regurgitation. +In patient with Rheumatic heart disease the mitral valve alone is involved in 65% to 70% cases, followed by Aortic valve in 25% cases. +The valvular deformity becomes manifested when Rheumatic fever becomes chronic. +Chronic Rheumatic heart disese is characterized by organization of the acute inflammation and subsequent fibrosis. +In particular, the valvular leaflets becomes thickened and retracted causing permanent deformity. +The cardinal anatomical changes which are produced to chronicity are leaflet thickening. commissuralfizsion and shortening and thickening and fusion of the tendinous cords. +These abnormalities lead to the most serious complication of Rheumatic fever i.e., Valvular stenosis and /or regurgitation. +Most common manifestation of Rheumatic fever is arthritis. +Erythema marginatum spares the face. +### End" +851,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: X-rays are produced when:, with the following options: A: Electron beam strike the nucleus of the atom, B: Electron beam strikes the anode, C: Electron beam reacts with the electromagnetic field., D: Electron beam strikes the cathode + +### Response: +",B i.e. Electron beam strikes the anode,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: X-rays are produced when:, with the following options: A: Electron beam strike the nucleus of the atom, B: Electron beam strikes the anode, C: Electron beam reacts with the electromagnetic field., D: Electron beam strikes the cathode + +### Response: +B i.e. Electron beam strikes the anode +### End" +852,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pure-tone audiometry of a 30 year old field worker shows Carha's notch. He has the following condition:, with the following options: A: Otospongiosis, B: CSOM, C: Meniere's disease, D: Acoustic neuroma + +### Response: +","The hallmark of bone conduction thresholds in otosclerosis/otospongiosis is the Carha notch. This is characterized by the elevation of bone conduction thresholds of approximately 5, 10, and 15 dB at 500, 1000, and 2000 Hz, respectively. The Carha notch is thought to result from the disruption of normal ossicular resonance, which is approximately 2000 Hz. It is therefore a mechanical phenomenon and not a true reflection of cochlear reserve since it reverses after successful surgery.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pure-tone audiometry of a 30 year old field worker shows Carha's notch. He has the following condition:, with the following options: A: Otospongiosis, B: CSOM, C: Meniere's disease, D: Acoustic neuroma + +### Response: +The hallmark of bone conduction thresholds in otosclerosis/otospongiosis is the Carha notch. This is characterized by the elevation of bone conduction thresholds of approximately 5, 10, and 15 dB at 500, 1000, and 2000 Hz, respectively. The Carha notch is thought to result from the disruption of normal ossicular resonance, which is approximately 2000 Hz. It is therefore a mechanical phenomenon and not a true reflection of cochlear reserve since it reverses after successful surgery. +### End" +853,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Band shaped keratopathy is formed due to deposition of:, with the following options: A: Calcium, B: Amyloid, C: Iron, D: Melanin + +### Response: +","Ans. a. Calcium (Ref: Parson's 20/e p202; Yanoff's 2/e p449; Kanski 6/e p304-305)Band shaped keratopathy is essentially a degenerative change associated with deposition of calcium salts in Bowman's membrane, most superficial part of stroma and in deeper layers of epithelium.Band Shaped Keratopathy/Calcific band KeratopathyBand shaped keratopathy is essentially a degenerative change associated with deposition of calcium saltsQ in Bowman's membrane, most superficial part of stroma and in deeper layers of epithelium.Causes of Band Shaped KeratopathyIdiopathicChronic Eye Disease (MC)Systemic Conditions associated with hypercalcemiaLocal corneal damage* Idiopathic and age related in otherwise healthy eyes* Chronic uveitis: JRA, Sarcoidosis* Chronic glaucoma* Chronic keratitis* Sarcoidosis* Hyper-parathyroidism* Vitamin D toxicity* Extensive metastatic neoplasm to bone* Chronic renal failure (secondary hyperparathyroidism)* Intraocular silicon oil* Phosphate forms of corticosteroids Comeal PigmentationConditionDeposited MaterialSite of DepositionArgyrosisSilver nitrate (AgNO3)Brown discoloration of Descemet's membraneChalcosis (Kayser Fleisher ring)Copper (Cu)Grayish-green or golden brown discoloration of stroma of peripheral corneaHudson-Stahli lineElderlyBrown horizontal line in inferior third of corneaKrukenberg's spindleMyopic menVertical spindle shaped brown uveal pigment depositionFleisher ringIron (Fe)Epithelial iron deposits at the base of KeratoconusSiderosisFe (hemosiderin)* Green or brown discoloration of deeper layers of cornea* Fleisher's ring representing deposition of hemosiderin is found in KeratoconusStocker's linePterygium Topical epinephrineUsed for glaucomaResult in black corneaWilson's disease (Kayser Fleisher ring)Copper (Cu)Greyish green or brown ring is seen just inside the limbus due to Cu deposition between Descemet's membrane and endothelium","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Band shaped keratopathy is formed due to deposition of:, with the following options: A: Calcium, B: Amyloid, C: Iron, D: Melanin + +### Response: +Ans. a. Calcium (Ref: Parson's 20/e p202; Yanoff's 2/e p449; Kanski 6/e p304-305)Band shaped keratopathy is essentially a degenerative change associated with deposition of calcium salts in Bowman's membrane, most superficial part of stroma and in deeper layers of epithelium.Band Shaped Keratopathy/Calcific band KeratopathyBand shaped keratopathy is essentially a degenerative change associated with deposition of calcium saltsQ in Bowman's membrane, most superficial part of stroma and in deeper layers of epithelium.Causes of Band Shaped KeratopathyIdiopathicChronic Eye Disease (MC)Systemic Conditions associated with hypercalcemiaLocal corneal damage* Idiopathic and age related in otherwise healthy eyes* Chronic uveitis: JRA, Sarcoidosis* Chronic glaucoma* Chronic keratitis* Sarcoidosis* Hyper-parathyroidism* Vitamin D toxicity* Extensive metastatic neoplasm to bone* Chronic renal failure (secondary hyperparathyroidism)* Intraocular silicon oil* Phosphate forms of corticosteroids Comeal PigmentationConditionDeposited MaterialSite of DepositionArgyrosisSilver nitrate (AgNO3)Brown discoloration of Descemet's membraneChalcosis (Kayser Fleisher ring)Copper (Cu)Grayish-green or golden brown discoloration of stroma of peripheral corneaHudson-Stahli lineElderlyBrown horizontal line in inferior third of corneaKrukenberg's spindleMyopic menVertical spindle shaped brown uveal pigment depositionFleisher ringIron (Fe)Epithelial iron deposits at the base of KeratoconusSiderosisFe (hemosiderin)* Green or brown discoloration of deeper layers of cornea* Fleisher's ring representing deposition of hemosiderin is found in KeratoconusStocker's linePterygium Topical epinephrineUsed for glaucomaResult in black corneaWilson's disease (Kayser Fleisher ring)Copper (Cu)Greyish green or brown ring is seen just inside the limbus due to Cu deposition between Descemet's membrane and endothelium +### End" +854,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A score of BIRADS- 0 on mammography indicates:, with the following options: A: Negative for cancer, B: Benign, C: Low suspicious of malignancy, D: Needs additional imaging of prior examination + +### Response: +",Final Assessment Categories Category Management Likelihood of cancer 0 Need additional imaging of prior examinations Recall for additional imaging and /or await prior examinations N/A 1 Negative Routine screening Essentially 0% 2 Benign Routine screening Essentially 0% 3 Probably Benign Sho interval-follow-up (6 month) or continued >0% but< 2 % 4 Suspicious Tissue diagnosis 4a. low suspicion for malignancy (>2% to <10%) 4b. moderate suspicion for malignancy (>10% to< 50%) 4c. high suspicion for malignancy (>50% to <95%) 5 Highly suggestive of malignancy Tissue diagnosis > 95% 6 Known biopsy proven Surgical excision when clinical appropriate N/A,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A score of BIRADS- 0 on mammography indicates:, with the following options: A: Negative for cancer, B: Benign, C: Low suspicious of malignancy, D: Needs additional imaging of prior examination + +### Response: +Final Assessment Categories Category Management Likelihood of cancer 0 Need additional imaging of prior examinations Recall for additional imaging and /or await prior examinations N/A 1 Negative Routine screening Essentially 0% 2 Benign Routine screening Essentially 0% 3 Probably Benign Sho interval-follow-up (6 month) or continued >0% but< 2 % 4 Suspicious Tissue diagnosis 4a. low suspicion for malignancy (>2% to <10%) 4b. moderate suspicion for malignancy (>10% to< 50%) 4c. high suspicion for malignancy (>50% to <95%) 5 Highly suggestive of malignancy Tissue diagnosis > 95% 6 Known biopsy proven Surgical excision when clinical appropriate N/A +### End" +855,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Child changes a rattle from one hand to another at the age of –, with the following options: A: 3 months, B: 6 months, C: 9 months, D: 1 year + +### Response: +",A child can transfer objects from one hand to the other by 5-7 months.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Child changes a rattle from one hand to another at the age of –, with the following options: A: 3 months, B: 6 months, C: 9 months, D: 1 year + +### Response: +A child can transfer objects from one hand to the other by 5-7 months. +### End" +856,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Thiazide causes, with the following options: A: Metabolic acidosis, B: Metabolic alkalosis, C: Respiratory alkalosis, D: Respiratory acidosis + +### Response: +",The increased hydrogen ion loss in the urine can lead to metabolic alkalosis in the plasma- seen with thiazides and loop diuretics metabolic acidosis is seen with potassium-sparing diuretics- (due to the increase in chloride content in the plasma)and with CA inhibitors 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: Thiazide causes, with the following options: A: Metabolic acidosis, B: Metabolic alkalosis, C: Respiratory alkalosis, D: Respiratory acidosis + +### Response: +The increased hydrogen ion loss in the urine can lead to metabolic alkalosis in the plasma- seen with thiazides and loop diuretics metabolic acidosis is seen with potassium-sparing diuretics- (due to the increase in chloride content in the plasma)and with CA inhibitors Ref KD Tripathi 8th ed +### End" +857,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Filamentary keratitis may occur:, with the following options: A: In trachoma, B: In kerato conjunctivitis sicca, C: Following cataract surgery, D: All of the above + +### Response: +",Ans. 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: Filamentary keratitis may occur:, with the following options: A: In trachoma, B: In kerato conjunctivitis sicca, C: Following cataract surgery, D: All of the above + +### Response: +Ans. All of the above +### End" +858,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Number of oocytes at bih ?, with the following options: A: 2 million, B: 6 million, C: 5 million, D: 10 million + +### Response: +","Ans. is 'a' i.e., 2 million In humans, no new ova are formed after bih. During fetal development, the ovaries contain over 7 million primordial follicles. However,-many undergo atresia (involution) before bih and others are lost after bih. At the time of bih, there are 2 million ova, but 50% of these are atretic. The million that are normal undergo the first pa of the first meiotic division at about this time and enter a stage of arrest in prophase in which those that survive persist until adulthood. Atresia continues during development, and the number of ova in both of the ovaries at the time of pubey is less than 300,000.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Number of oocytes at bih ?, with the following options: A: 2 million, B: 6 million, C: 5 million, D: 10 million + +### Response: +Ans. is 'a' i.e., 2 million In humans, no new ova are formed after bih. During fetal development, the ovaries contain over 7 million primordial follicles. However,-many undergo atresia (involution) before bih and others are lost after bih. At the time of bih, there are 2 million ova, but 50% of these are atretic. The million that are normal undergo the first pa of the first meiotic division at about this time and enter a stage of arrest in prophase in which those that survive persist until adulthood. Atresia continues during development, and the number of ova in both of the ovaries at the time of pubey is less than 300,000. +### End" +859,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Carbohydrate in ABO blood group antigens is ?, with the following options: A: Glucose, B: Frucose, C: Inulin, D: Maltose + +### Response: +","Ans. is 'b' i.e., FrucoseABO antigens are glycoproteins, i.e. saccharides (carbohydrates) linked with polypeptides.There are four main groups :i) Blood group A : Containing A antigenii) Blood group B : Containing B antigeniii) Blood group AB : Containing both 'A' and 'EV antigeniv) Blood group 0 : No ABO antigen'A' and 'EV antigens are derived from H-antigen. H-antigen is formed by adding fucose to terminal galactose of backbone strucuture. The addition of N-acetyl-D-galactosamine or D-galactose to the galactose residue of H-antigen confers 'A' or 'B' antigen, respectively.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Carbohydrate in ABO blood group antigens is ?, with the following options: A: Glucose, B: Frucose, C: Inulin, D: Maltose + +### Response: +Ans. is 'b' i.e., FrucoseABO antigens are glycoproteins, i.e. saccharides (carbohydrates) linked with polypeptides.There are four main groups :i) Blood group A : Containing A antigenii) Blood group B : Containing B antigeniii) Blood group AB : Containing both 'A' and 'EV antigeniv) Blood group 0 : No ABO antigen'A' and 'EV antigens are derived from H-antigen. H-antigen is formed by adding fucose to terminal galactose of backbone strucuture. The addition of N-acetyl-D-galactosamine or D-galactose to the galactose residue of H-antigen confers 'A' or 'B' antigen, respectively. +### End" +860,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: N.K. cell and cytotoxic cells are differentiated by ?, with the following options: A: Interferons reduce N.K. cell activity, B: Antibody specificity, C: Receptor for IgG, D: Presence in spleen + +### Response: +","Ans. is 'b' i.e., Antibody specificity . Cytotoxicity of NK cells is not antibody dependent or MHC restricted, while cytotoxic cells are capable of lysing or killing target cells sensitized with antibody.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: N.K. cell and cytotoxic cells are differentiated by ?, with the following options: A: Interferons reduce N.K. cell activity, B: Antibody specificity, C: Receptor for IgG, D: Presence in spleen + +### Response: +Ans. is 'b' i.e., Antibody specificity . Cytotoxicity of NK cells is not antibody dependent or MHC restricted, while cytotoxic cells are capable of lysing or killing target cells sensitized with antibody. +### End" +861,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Vitamin A prophylaxis is given to children every: September 2007, with the following options: A: 3 months, B: 6 months, C: 12 months, D: 18 months + +### Response: +","Ans. B: 6 months National programme for prevention of nutritional blindness focuses on Promoting consumption of vitamin A rich foods by pregnant and lactating women and by children under 5 years of age. Administration of massive doses of vitamin A up to 5 years. First dose of 100,000 IU with measles vaccination at 9 months and subsequent doses of 200,000 IU each, every 6 months up to the age of 5 years should be given.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Vitamin A prophylaxis is given to children every: September 2007, with the following options: A: 3 months, B: 6 months, C: 12 months, D: 18 months + +### Response: +Ans. B: 6 months National programme for prevention of nutritional blindness focuses on Promoting consumption of vitamin A rich foods by pregnant and lactating women and by children under 5 years of age. Administration of massive doses of vitamin A up to 5 years. First dose of 100,000 IU with measles vaccination at 9 months and subsequent doses of 200,000 IU each, every 6 months up to the age of 5 years should be given. +### End" +862,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Avoiding awareness of pain of reality by negative sensory data is seen in which of the following defense mechanisms?, with the following options: A: Distoion, B: Denial, C: Humor, D: Anticipation + +### Response: +","Denial is the defense mechanism which helps a person to avoid (or refuse to accept) the reality. Don't get confused by the phrase ""negative sensory data"".","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Avoiding awareness of pain of reality by negative sensory data is seen in which of the following defense mechanisms?, with the following options: A: Distoion, B: Denial, C: Humor, D: Anticipation + +### Response: +Denial is the defense mechanism which helps a person to avoid (or refuse to accept) the reality. Don't get confused by the phrase ""negative sensory data"". +### End" +863,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Branched chain ketoacid decarboxylation is defective in, with the following options: A: Maple Syrup urine disease, B: Hartnup disease, C: Alkaptonuria, D: GMI Gangliosidosis + +### Response: +",Maple syrup urine disease is due to deficiency of the enzyme branched chain α-keto dehydrogenase which catalyzes decarboxylation of branched - chain amino acid.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Branched chain ketoacid decarboxylation is defective in, with the following options: A: Maple Syrup urine disease, B: Hartnup disease, C: Alkaptonuria, D: GMI Gangliosidosis + +### Response: +Maple syrup urine disease is due to deficiency of the enzyme branched chain α-keto dehydrogenase which catalyzes decarboxylation of branched - chain amino acid. +### End" +864,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: You’re assessing the stoma of a patient with a healthy, well-healed colostomy. You expect the stoma to appear:, with the following options: A: Pale, pink and moist, B: Red and moist, C: Dark or purple colored, D: Dry and black + +### Response: +","Good circulation causes tissues to be moist and red, so a healthy, well-healed stoma appears red and moist","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: You’re assessing the stoma of a patient with a healthy, well-healed colostomy. You expect the stoma to appear:, with the following options: A: Pale, pink and moist, B: Red and moist, C: Dark or purple colored, D: Dry and black + +### Response: +Good circulation causes tissues to be moist and red, so a healthy, well-healed stoma appears red and moist +### End" +865,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Malrotation presents as -a) Mass abdomenb) Bleeding PRc) Billious vomitingd) Haematemesis, with the following options: A: a, B: bc, C: ac, D: b + +### Response: +","""Bilious vomiting is the first sign of volvulus, and all infants with bilious vomiting must be evaluated rapidly to ensure that they do not have intestinal malrotation with volvulus. If left untreated, vascular compromise of the midgut initially causes bloody stools, but eventually results in circulatory collapse."" - Schwartz","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Malrotation presents as -a) Mass abdomenb) Bleeding PRc) Billious vomitingd) Haematemesis, with the following options: A: a, B: bc, C: ac, D: b + +### Response: +""Bilious vomiting is the first sign of volvulus, and all infants with bilious vomiting must be evaluated rapidly to ensure that they do not have intestinal malrotation with volvulus. If left untreated, vascular compromise of the midgut initially causes bloody stools, but eventually results in circulatory collapse."" - Schwartz +### End" +866,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 4-day-old baby boy has not defecated since coming home from the hospital even though feeding has been normal without any excessive vomiting. Rectal examination reveals a normal anus, anal canal and rectum. However, a large fecal mass is found in the colon and a large release of flatus and feces followsthe rectal examination. Which of the following conditions would be suspected?, with the following options: A: Imperforate anus, B: Anal agenesis, C: Anorectal agenesis, D: Colonic aganglionosis + +### Response: +","This baby boy suffers from colonic aganglionosis, or Hirschsprung disease, which results in the retention of fecal material, causing the normal colon to enlarge. The retention of fecal material results from a lack of peristalsis in the narrow segment of colon distal to the enlarged colon. A biopsy of the narrow segment of colon would reveal the absence of parasympathetic ganglion cells in the myenteric plexus caused by failure of neural crest migration.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 4-day-old baby boy has not defecated since coming home from the hospital even though feeding has been normal without any excessive vomiting. Rectal examination reveals a normal anus, anal canal and rectum. However, a large fecal mass is found in the colon and a large release of flatus and feces followsthe rectal examination. Which of the following conditions would be suspected?, with the following options: A: Imperforate anus, B: Anal agenesis, C: Anorectal agenesis, D: Colonic aganglionosis + +### Response: +This baby boy suffers from colonic aganglionosis, or Hirschsprung disease, which results in the retention of fecal material, causing the normal colon to enlarge. The retention of fecal material results from a lack of peristalsis in the narrow segment of colon distal to the enlarged colon. A biopsy of the narrow segment of colon would reveal the absence of parasympathetic ganglion cells in the myenteric plexus caused by failure of neural crest migration. +### End" +867,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In the fed state, major fate of glucose-6-phosphate in tissues is:, with the following options: A: Storage as fructose, B: Storage as glyceraldehyde-3-phosphate, C: Enters HMP shunt via ribulose-5-phosphate, D: Storage as glycogen + +### Response: +","Ans. D. Stored as Glycogen(Ref: Harper 31/e page 136,137)The uptake of glucose into the liver GLUT 2 is independent of insulin.In the well fed state, the concentration of glucose entering the liver increases, so does the rate of synthesis of glucose-6-phosphateThis is in excess of the liver's requirement for energy-yielding metabolism. So it is used mainly for synthesis of glycogen.In both liver and skeletal muscle, insulin acts to stimulate glycogen synthetase and inhibit glycogen phosphorylase.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In the fed state, major fate of glucose-6-phosphate in tissues is:, with the following options: A: Storage as fructose, B: Storage as glyceraldehyde-3-phosphate, C: Enters HMP shunt via ribulose-5-phosphate, D: Storage as glycogen + +### Response: +Ans. D. Stored as Glycogen(Ref: Harper 31/e page 136,137)The uptake of glucose into the liver GLUT 2 is independent of insulin.In the well fed state, the concentration of glucose entering the liver increases, so does the rate of synthesis of glucose-6-phosphateThis is in excess of the liver's requirement for energy-yielding metabolism. So it is used mainly for synthesis of glycogen.In both liver and skeletal muscle, insulin acts to stimulate glycogen synthetase and inhibit glycogen phosphorylase. +### End" +868,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Stimulation of the nerves of the pelvic parasympathetic plexus results in, with the following options: A: Penile erection, B: Constriction of the internal urethral sphincter, C: Vasoconstriction, D: Contraction of the genital smooth muscle + +### Response: +","(A) Penile erection # PELVIC SPLANCHNIC NERVES or NERVI ERIGENTES are splanchnic nerves that arise from sacral spinal nerves S2, S3, S4 to provide parasympathetic innervation to the hindgut.> Structure: The pelvic splanchnic nerves arise from the ventral rami of the S2-S4 and enter the sacral plexus. They travel to their side's corresponding inferior hypogastric plexus, located bilaterally on the walls of the rectum. From there, they contribute to the innervation of the pelvic and genital organs. The nerves regulate the emptying of the urinary bladder and the rectum as well as sexual functions like erection. They contain both preganglionic parasympathetic fibers as well as visceral afferent fibers. The parasympathetic nervous system is referred to as the craniosacral outflow; the pelvic splanchnic nerves are the sacral component. They are in the same region as the sacral splanchnic nerves, which arise from the sympathetic trunk and provide sympathetic efferent fibers. The proximal 2/3 of the transverse colon, and the rest of the proximal gastrointestinal tract is supplied its parasympathetic fibers by the vagus nerve. In the distal 1/3 of the transverse colon, and through the sigmoid and rectum, the pelvic splanchnic nerves take over.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Stimulation of the nerves of the pelvic parasympathetic plexus results in, with the following options: A: Penile erection, B: Constriction of the internal urethral sphincter, C: Vasoconstriction, D: Contraction of the genital smooth muscle + +### Response: +(A) Penile erection # PELVIC SPLANCHNIC NERVES or NERVI ERIGENTES are splanchnic nerves that arise from sacral spinal nerves S2, S3, S4 to provide parasympathetic innervation to the hindgut.> Structure: The pelvic splanchnic nerves arise from the ventral rami of the S2-S4 and enter the sacral plexus. They travel to their side's corresponding inferior hypogastric plexus, located bilaterally on the walls of the rectum. From there, they contribute to the innervation of the pelvic and genital organs. The nerves regulate the emptying of the urinary bladder and the rectum as well as sexual functions like erection. They contain both preganglionic parasympathetic fibers as well as visceral afferent fibers. The parasympathetic nervous system is referred to as the craniosacral outflow; the pelvic splanchnic nerves are the sacral component. They are in the same region as the sacral splanchnic nerves, which arise from the sympathetic trunk and provide sympathetic efferent fibers. The proximal 2/3 of the transverse colon, and the rest of the proximal gastrointestinal tract is supplied its parasympathetic fibers by the vagus nerve. In the distal 1/3 of the transverse colon, and through the sigmoid and rectum, the pelvic splanchnic nerves take over. +### End" +869,"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 drugs can be used for the chronic oral treatment of arrhythmia except:, with the following options: A: Amiodarone, B: Esmolol, C: Quinidine, D: Verapamil + +### Response: +","Esmolol is an ultrasho acting b1 blocker devoid of paial agonistic or membrane stabilizing actions. It is inactivated by esterases in blood. Plasma t 1/2 is < 10 min Action disappears 15-20 min after terminating i.v infusion--degree of b blockade can be titrated by regulating the rate of infusion. It has been used to terminate supraventricular tachycardia, episodic atrial fibrillation or flutter, arrhythmia during anesthesia, to reduce HR and BP during and after cardiac surgery, and in early treatment of MI. Avoided in presence of systolic hea failure or asthma.","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 drugs can be used for the chronic oral treatment of arrhythmia except:, with the following options: A: Amiodarone, B: Esmolol, C: Quinidine, D: Verapamil + +### Response: +Esmolol is an ultrasho acting b1 blocker devoid of paial agonistic or membrane stabilizing actions. It is inactivated by esterases in blood. Plasma t 1/2 is < 10 min Action disappears 15-20 min after terminating i.v infusion--degree of b blockade can be titrated by regulating the rate of infusion. It has been used to terminate supraventricular tachycardia, episodic atrial fibrillation or flutter, arrhythmia during anesthesia, to reduce HR and BP during and after cardiac surgery, and in early treatment of MI. Avoided in presence of systolic hea failure or asthma. +### End" +870,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The zone of fibrinoid degeneration where the trophoblast and the decidua meet is known as:, with the following options: A: Folds of Hoboken, B: Nitabuch's layer, C: Parietal decidua, D: Chorion + +### Response: +","Ans. B. Nitabuch's layerThere is an area of fibroid degeneration, where trophoblast cells (covered with syncytium) meet the decidua. This zone is known as Nitabuch layer. This layer limits further invasion of the decidua by the trophoblast. The membrane is absent in placenta accreta.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The zone of fibrinoid degeneration where the trophoblast and the decidua meet is known as:, with the following options: A: Folds of Hoboken, B: Nitabuch's layer, C: Parietal decidua, D: Chorion + +### Response: +Ans. B. Nitabuch's layerThere is an area of fibroid degeneration, where trophoblast cells (covered with syncytium) meet the decidua. This zone is known as Nitabuch layer. This layer limits further invasion of the decidua by the trophoblast. The membrane is absent in placenta accreta. +### End" +871,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: An adult male presented 4 weeks after intercourse with fever, rubbery ulcer, inguinal lymphadenopathy. Causative organism:, with the following options: A: LGV, B: Syphillis, C: Chancroid, D: HIV + +### Response: +","Ans. (a) LGVRef: Neena Khanna Synopsis of Dermatology 4th ed./322*LGV is an STD, caused by chlamydia presents classically with painless lymphadenopathy.*Mnemonic to remember LGV:# ABCDEFG: Asymptomatic, Bubo, Chlamydia, Doxy, Esthiomine, Fries test, Groove signDiseaseUlcerLymph nodeSyphilisPainlessPainlessChancroidPainfulPainfulLGVPainlessPainful (Bubo)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: An adult male presented 4 weeks after intercourse with fever, rubbery ulcer, inguinal lymphadenopathy. Causative organism:, with the following options: A: LGV, B: Syphillis, C: Chancroid, D: HIV + +### Response: +Ans. (a) LGVRef: Neena Khanna Synopsis of Dermatology 4th ed./322*LGV is an STD, caused by chlamydia presents classically with painless lymphadenopathy.*Mnemonic to remember LGV:# ABCDEFG: Asymptomatic, Bubo, Chlamydia, Doxy, Esthiomine, Fries test, Groove signDiseaseUlcerLymph nodeSyphilisPainlessPainlessChancroidPainfulPainfulLGVPainlessPainful (Bubo) +### End" +872,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Salt and pepper fundus occurs in, with the following options: A: Toxoplasma, B: Toxocara, C: Rubella, D: Ehlers Danlos syndrome + +### Response: +",C i.e. Rubella Congenital syphilis show dusty discrete pigmentation of peripheral retinae where multitude of black & white spots appears ('pepper & salt fundus' Q) + anterior retinitis + interstitial keratitis,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Salt and pepper fundus occurs in, with the following options: A: Toxoplasma, B: Toxocara, C: Rubella, D: Ehlers Danlos syndrome + +### Response: +C i.e. Rubella Congenital syphilis show dusty discrete pigmentation of peripheral retinae where multitude of black & white spots appears ('pepper & salt fundus' Q) + anterior retinitis + interstitial keratitis +### End" +873,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Argus 2 implants have been experimentally tried in:, with the following options: A: Failed penetrating keratoplasty, B: Retinitis pigmentosa, C: Advanced Glaucoma, D: Optic atrophy + +### Response: +",Argus 2 retinal implants have been tried in Retinitis pigmentosa patients. Treatment modalities for Retinitis Pigmentosa Crisp Car technique Low vision aids Bionic eye Argus 2 retinal implant High dose vitamin A are the modalities tested,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Argus 2 implants have been experimentally tried in:, with the following options: A: Failed penetrating keratoplasty, B: Retinitis pigmentosa, C: Advanced Glaucoma, D: Optic atrophy + +### Response: +Argus 2 retinal implants have been tried in Retinitis pigmentosa patients. Treatment modalities for Retinitis Pigmentosa Crisp Car technique Low vision aids Bionic eye Argus 2 retinal implant High dose vitamin A are the modalities tested +### End" +874,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about protooncogene-, with the following options: A: Impoant for normal cell growth, B: Oncogenesis, C: C-myc overexpression causes lymphoma, D: Mutation causes Retinoblastoma + +### Response: +","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 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 protooncogene-, with the following options: A: Impoant for normal cell growth, B: Oncogenesis, C: C-myc overexpression causes lymphoma, D: Mutation causes Retinoblastoma + +### Response: +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 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" +875,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In Klippel-Feil syndrome, the patient has all of the following clinical features, EXCEPT:, with the following options: A: Low hair line, B: Bilateral Neck webbing, C: Bilateral shoness of sterno mastoid muscles, D: Gross limitations of neck movements + +### Response: +","Bilateral shoness of sternomastoid is not included in Klippel-Feil syndrome. Ref:Harrison's Principles of Internal Medicine, 14th Edition, Page 2120 and 15th Edition, Page 2174","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: In Klippel-Feil syndrome, the patient has all of the following clinical features, EXCEPT:, with the following options: A: Low hair line, B: Bilateral Neck webbing, C: Bilateral shoness of sterno mastoid muscles, D: Gross limitations of neck movements + +### Response: +Bilateral shoness of sternomastoid is not included in Klippel-Feil syndrome. Ref:Harrison's Principles of Internal Medicine, 14th Edition, Page 2120 and 15th Edition, Page 2174 +### End" +876,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Gluconeogenesis does not occur sighnificantly from...... in humans-, with the following options: A: Lactate, B: Fatty acids, C: Pyruvate, D: Amino acid + +### Response: +",B i.e. Fatty acid,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Gluconeogenesis does not occur sighnificantly from...... in humans-, with the following options: A: Lactate, B: Fatty acids, C: Pyruvate, D: Amino acid + +### Response: +B i.e. Fatty acid +### End" +877,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Froment's Sign is seen in:, with the following options: A: Ulnar nerve palsy, B: Median nerve palsy, C: Musculocutaneous nerve palsy, D: Posterior Interosseous nerve palsy + +### Response: +","Froment Sign: In case of ulnar nerve palsy adductor pollicis supplied by ulnar nerve is paralysed. S o, patient holds the book between thumb and palm by using flexor pollicis longus (supplied by AIN nerve) . This produces flexion at inter-phalangeal joint, while holding book.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Froment's Sign is seen in:, with the following options: A: Ulnar nerve palsy, B: Median nerve palsy, C: Musculocutaneous nerve palsy, D: Posterior Interosseous nerve palsy + +### Response: +Froment Sign: In case of ulnar nerve palsy adductor pollicis supplied by ulnar nerve is paralysed. S o, patient holds the book between thumb and palm by using flexor pollicis longus (supplied by AIN nerve) . This produces flexion at inter-phalangeal joint, while holding book. +### End" +878,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A lady has history of previous child birth with neural tube defect. What is the dose of folic acid to be given to prevent to neural tube defect in this child, with the following options: A: 4000 mcg in periconceptional period, B: 400 mg after confirmation of pregnancy, C: 400 mg in periconceptional period, D: 4000 mcg in 1st / 2nd trimester. + +### Response: +","Dose of folic acid for primary prevention is 400 mcg / day +Dose of folic acid for secondary prevention (prevoius child affected with neural tube defect) is 4000 mcg / day started in periconception period = 1 month before to 3 months after conception.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A lady has history of previous child birth with neural tube defect. What is the dose of folic acid to be given to prevent to neural tube defect in this child, with the following options: A: 4000 mcg in periconceptional period, B: 400 mg after confirmation of pregnancy, C: 400 mg in periconceptional period, D: 4000 mcg in 1st / 2nd trimester. + +### Response: +Dose of folic acid for primary prevention is 400 mcg / day +Dose of folic acid for secondary prevention (prevoius child affected with neural tube defect) is 4000 mcg / day started in periconception period = 1 month before to 3 months after conception. +### End" +879,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Painful ulcer on glans penis is seen in:, with the following options: A: Syphilis, B: Lymphogranuloma venerum, C: Chancroid, D: Chancre + +### Response: +","Ans: (c) ChancroidRef: Harrison 19th ed. / 881, 1134* Chancroid is a bacterial STD caused by H.Ducreyi. It is characterized by painful sores on the genitalia. Chancroid is known to spread from one individual to another solely throueh sexual contact.* A chancre on the other hand is a painless ulceration/ sore most commonly formed during the primary stage of syphilis.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Painful ulcer on glans penis is seen in:, with the following options: A: Syphilis, B: Lymphogranuloma venerum, C: Chancroid, D: Chancre + +### Response: +Ans: (c) ChancroidRef: Harrison 19th ed. / 881, 1134* Chancroid is a bacterial STD caused by H.Ducreyi. It is characterized by painful sores on the genitalia. Chancroid is known to spread from one individual to another solely throueh sexual contact.* A chancre on the other hand is a painless ulceration/ sore most commonly formed during the primary stage of syphilis. +### End" +880,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hellers operation is indicated for, with the following options: A: Achlasia, B: Gastric cancer, C: Esophageal cancer, D: Hiatus hernia + +### Response: +","Ans. is 'a' i.e., Achalasia * The most common surgical procedure for achalasia is laparoscopic Heller myotomy, usually performed in conjunction with an antireflux procedure (partial fundoplication); good to excellent results are reported in 62- 100% of cases.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Hellers operation is indicated for, with the following options: A: Achlasia, B: Gastric cancer, C: Esophageal cancer, D: Hiatus hernia + +### Response: +Ans. is 'a' i.e., Achalasia * The most common surgical procedure for achalasia is laparoscopic Heller myotomy, usually performed in conjunction with an antireflux procedure (partial fundoplication); good to excellent results are reported in 62- 100% of cases. +### End" +881,"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 Thymomas:, with the following options: A: Red cell aplasia, B: Myasthenia gravis, C: Hypergammaglobulinemia, D: Compression of the superior mediastinum + +### Response: +",Answer is C (Hypergammoglobulinemia): Thymoma is associated with Hypogammaglobulinemia and not with hypergammaglobulinemia.,"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 Thymomas:, with the following options: A: Red cell aplasia, B: Myasthenia gravis, C: Hypergammaglobulinemia, D: Compression of the superior mediastinum + +### Response: +Answer is C (Hypergammoglobulinemia): Thymoma is associated with Hypogammaglobulinemia and not with hypergammaglobulinemia. +### End" +882,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: T/t of choice for grade IV vesicoureteric reflux with recurrent UTI, with the following options: A: Cotrimox azole, B: Bilateral reimplantation of ureter, C: Injection of Collegen in the ureter, D: Endoscopic resection of ureter + +### Response: +","Ans. is 'a' ie. Cotrimoxazole (Ref. Nelson, 18/e p2233 (16/e, p 1628))Don't get misled by this statement given in O.P. Ghai - ""Operative correction of VUR is indicated inpts. with - persistent severe (grade IV or V) refluxThis statement does not mean that any pt. with grade IV & V reflux will be given surgical management and rest medical management. Treatment is not so clear-cut.The choice b/w medical or surgical modality is based on certain principles (go through the following text to understand it).The below given explanation is a bit lengthy. Bear with me for giving such a long text, as it is one of the most important but less read topic (UG books do not give sufficient information on its treatment).This explanation will help you to tackle any future question on t/t of VUR with different patient profile (as t/t changes with grades as well as age of the patient)Vesicoureteral reflux (VUR)is the retrograde flow of urine from the bladder to the ureter and the renal pelvisGrading of VUR : is based on the appearance of the urinary tract on Micturating Cystourethrogram (MCU).Grade 1reflux into a non-dilated ureterGrade IIreflux into the upper collecting system without dilatation.Grade IIIreflux into dilated ureter and /or blunting of calyceal fornicesGrade IVreflux into a grossly dilated ureterGrade VGross dilatation of the ureter, renal pelvis & calyces : calyces show loss of papillary impression. Complications of VURReflux predisposes to renal infection (pyelonephritis) by facilitating the transport of bacteria from the bladder to the upper urinary tract.The inflammatory reaction caused by a pyelonephritic infection may result in renal injury or scarring.Extensive renal scarring impair renal function and may result in renin mediated hypertension, reflux nephropathy, renal insufficiency, end stage renal disease, reduced somatic growth and morbidity during pregnancy.* TreatmentThe goals of t/t are to prevent pyelonephritis, renal injury, and other complication of reflux.Treatment modality is either medical or surgical.Medical therapyis based on the principle that reflux often resolves over time and the antibiotics maintain urine sterility and prevent infection and complication while awaiting spontaneous resolution.Surgical therapy :the basis for surgical therapy is that in selected children, ongoing reflux has caused or has significant potential for causing renal injury.The decision to do medical or surgical t/t is based on certain principles and parental, patient preferences.Below is given a chart listing the treatment recommendation for VUR.Before going through the chart lets see the basic principles on which this chart is based -With bladder growth and maturation, there is tendency for reflux to resolve or improve over time.Lower grades of reflux are much more likely to resolve than are higher grades.For grades I & II reflux, the likelihood of resolution is similar irrespective of age at diagnosis and whether if it unilateral or bilateral.For grade III & IV a younger age at diagnosis and unilateral reflux generally are associated with a higher rate of spontaneous resolution.Grade V reflux rarely resolves.The mean age for reflux resolution is 6 - 7 yrs.Reflux is unlikely to cause any renal injury in the absence of infection.Treatment Recommendation for VUR diagnosed following a UTI.GradeAge (yrs)ScarringInitial t/tFollow-upI-iiAny-Antibiotic prophylaxis-III - IV0-5-Antibiotic prophylaxisSurgeryIII - IV6- 10-U/L: Antibiotic prophylaxisSurgeryIII - IV6 - 10-B/L: Surgery V<1-Antibiotic prophylaxisSurgeryV1 - 5NoU/L: Antibiotic prophylaxisSurgeryV1 - 5NoB/L: Surgery V1 - 5YesSurgery V6- 10-Surgery * ThusMedical Management is the initial t/t in almost all children except for -Grade III & IV (Bilateral)Grade V (Mostly)Medical management (antibiotic prophylaxis) is continued till the reflux resolves.Pt. is shifted from medical to surgical management, in children withbreakthrough UTI (Recurrent UTI despite prophylaxis)Development of new renal scarsFailure of reflux to resolve.Thus in this question we will begin with medical management ie cotrimoxazole. This pt is having recurrent UTI. This will not alter our t/t. If the pt. had recurrent UTI despite prophylaxis, we would have done a surgical management.If you have a close look at the statement of O.P. Ghai, you will note that he is not stating that grades IV & V will be t/t surgically. It is persistent grades IV & V that are t/t surgically (persistent means VUR that are not resolving over time).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: T/t of choice for grade IV vesicoureteric reflux with recurrent UTI, with the following options: A: Cotrimox azole, B: Bilateral reimplantation of ureter, C: Injection of Collegen in the ureter, D: Endoscopic resection of ureter + +### Response: +Ans. is 'a' ie. Cotrimoxazole (Ref. Nelson, 18/e p2233 (16/e, p 1628))Don't get misled by this statement given in O.P. Ghai - ""Operative correction of VUR is indicated inpts. with - persistent severe (grade IV or V) refluxThis statement does not mean that any pt. with grade IV & V reflux will be given surgical management and rest medical management. Treatment is not so clear-cut.The choice b/w medical or surgical modality is based on certain principles (go through the following text to understand it).The below given explanation is a bit lengthy. Bear with me for giving such a long text, as it is one of the most important but less read topic (UG books do not give sufficient information on its treatment).This explanation will help you to tackle any future question on t/t of VUR with different patient profile (as t/t changes with grades as well as age of the patient)Vesicoureteral reflux (VUR)is the retrograde flow of urine from the bladder to the ureter and the renal pelvisGrading of VUR : is based on the appearance of the urinary tract on Micturating Cystourethrogram (MCU).Grade 1reflux into a non-dilated ureterGrade IIreflux into the upper collecting system without dilatation.Grade IIIreflux into dilated ureter and /or blunting of calyceal fornicesGrade IVreflux into a grossly dilated ureterGrade VGross dilatation of the ureter, renal pelvis & calyces : calyces show loss of papillary impression. Complications of VURReflux predisposes to renal infection (pyelonephritis) by facilitating the transport of bacteria from the bladder to the upper urinary tract.The inflammatory reaction caused by a pyelonephritic infection may result in renal injury or scarring.Extensive renal scarring impair renal function and may result in renin mediated hypertension, reflux nephropathy, renal insufficiency, end stage renal disease, reduced somatic growth and morbidity during pregnancy.* TreatmentThe goals of t/t are to prevent pyelonephritis, renal injury, and other complication of reflux.Treatment modality is either medical or surgical.Medical therapyis based on the principle that reflux often resolves over time and the antibiotics maintain urine sterility and prevent infection and complication while awaiting spontaneous resolution.Surgical therapy :the basis for surgical therapy is that in selected children, ongoing reflux has caused or has significant potential for causing renal injury.The decision to do medical or surgical t/t is based on certain principles and parental, patient preferences.Below is given a chart listing the treatment recommendation for VUR.Before going through the chart lets see the basic principles on which this chart is based -With bladder growth and maturation, there is tendency for reflux to resolve or improve over time.Lower grades of reflux are much more likely to resolve than are higher grades.For grades I & II reflux, the likelihood of resolution is similar irrespective of age at diagnosis and whether if it unilateral or bilateral.For grade III & IV a younger age at diagnosis and unilateral reflux generally are associated with a higher rate of spontaneous resolution.Grade V reflux rarely resolves.The mean age for reflux resolution is 6 - 7 yrs.Reflux is unlikely to cause any renal injury in the absence of infection.Treatment Recommendation for VUR diagnosed following a UTI.GradeAge (yrs)ScarringInitial t/tFollow-upI-iiAny-Antibiotic prophylaxis-III - IV0-5-Antibiotic prophylaxisSurgeryIII - IV6- 10-U/L: Antibiotic prophylaxisSurgeryIII - IV6 - 10-B/L: Surgery V<1-Antibiotic prophylaxisSurgeryV1 - 5NoU/L: Antibiotic prophylaxisSurgeryV1 - 5NoB/L: Surgery V1 - 5YesSurgery V6- 10-Surgery * ThusMedical Management is the initial t/t in almost all children except for -Grade III & IV (Bilateral)Grade V (Mostly)Medical management (antibiotic prophylaxis) is continued till the reflux resolves.Pt. is shifted from medical to surgical management, in children withbreakthrough UTI (Recurrent UTI despite prophylaxis)Development of new renal scarsFailure of reflux to resolve.Thus in this question we will begin with medical management ie cotrimoxazole. This pt is having recurrent UTI. This will not alter our t/t. If the pt. had recurrent UTI despite prophylaxis, we would have done a surgical management.If you have a close look at the statement of O.P. Ghai, you will note that he is not stating that grades IV & V will be t/t surgically. It is persistent grades IV & V that are t/t surgically (persistent means VUR that are not resolving over time). +### End" +883,"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 compressible swelling?, with the following options: A: Lipoma, B: Hernia, C: Hemangioma, D: Sebaceous cyst + +### Response: +","Hemangioma REF: Bedside Clinics in Surgery By M.L. Saha Page 314 ""In Hemangioma compressibility test is positive continued pressure and squeezing will drive the blood out of the lesion and the swelling crumbles. As soon as the pressure removed, the swelling reappears with refilling""","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 compressible swelling?, with the following options: A: Lipoma, B: Hernia, C: Hemangioma, D: Sebaceous cyst + +### Response: +Hemangioma REF: Bedside Clinics in Surgery By M.L. Saha Page 314 ""In Hemangioma compressibility test is positive continued pressure and squeezing will drive the blood out of the lesion and the swelling crumbles. As soon as the pressure removed, the swelling reappears with refilling"" +### End" +884,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A primigravida in first trimester was observed to be sputum positive for acid fast bacilli. She had no previous history of tuberculosis. Which of the following should be the treatment strategy?, with the following options: A: Category I DOTS, B: Category II DOTS, C: Category III DOTS, D: Defer treatment + +### Response: +","The patient in the clinical scenario is a sputum positive newly diagnosed case thus belongs to the category I. Patients in this category are given Rifampicin / Ethambutol / Isoniazid / Pyrazinamide for 2 months followed by Rifampicin/Isoniazid thrice weekly for 4 months. All the above mentioned drugs can be safely used in pregnancy. While streptomycin, ethionamide and fluroquinolones are teratogenic. Ref: Emerging Infections in Asia By Yichen Lu, Max Essex, Bryan Robes, Pages 217-219; Park textbook of preventive and social medicine 21st edition Page 173.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A primigravida in first trimester was observed to be sputum positive for acid fast bacilli. She had no previous history of tuberculosis. Which of the following should be the treatment strategy?, with the following options: A: Category I DOTS, B: Category II DOTS, C: Category III DOTS, D: Defer treatment + +### Response: +The patient in the clinical scenario is a sputum positive newly diagnosed case thus belongs to the category I. Patients in this category are given Rifampicin / Ethambutol / Isoniazid / Pyrazinamide for 2 months followed by Rifampicin/Isoniazid thrice weekly for 4 months. All the above mentioned drugs can be safely used in pregnancy. While streptomycin, ethionamide and fluroquinolones are teratogenic. Ref: Emerging Infections in Asia By Yichen Lu, Max Essex, Bryan Robes, Pages 217-219; Park textbook of preventive and social medicine 21st edition Page 173. +### End" +885,"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 right bronchus, with the following options: A: Shoer, B: Wider, C: More horizontal, D: In the line of trachea + +### Response: +","Ans. is 'c' i.e., More horizontal Trachea bifurcates at Carina (at lower border of T4 veebra at T4-T, disc space) into right and left principal (primary) bronchi.Right principal bronchus is wider, shoer (2.5 cm long), and more veical in the line of trachea (25deg with median plane.Therefore a foreign body is most likely to lodge in the right bronchus.Right bronchus divides into epiaerial and hypaerial bronchi, passing respectively above and below the pulmonary aery, before entering the hilum.Left principal bronchus is narrower, longer (5 cm long) and more horizontal (45deg with median plane). Left bronchus crosses in front of the esophagus producing a slight constriction.Inside the lung it divides into 2 lobar bronchi: upper and lower.","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 right bronchus, with the following options: A: Shoer, B: Wider, C: More horizontal, D: In the line of trachea + +### Response: +Ans. is 'c' i.e., More horizontal Trachea bifurcates at Carina (at lower border of T4 veebra at T4-T, disc space) into right and left principal (primary) bronchi.Right principal bronchus is wider, shoer (2.5 cm long), and more veical in the line of trachea (25deg with median plane.Therefore a foreign body is most likely to lodge in the right bronchus.Right bronchus divides into epiaerial and hypaerial bronchi, passing respectively above and below the pulmonary aery, before entering the hilum.Left principal bronchus is narrower, longer (5 cm long) and more horizontal (45deg with median plane). Left bronchus crosses in front of the esophagus producing a slight constriction.Inside the lung it divides into 2 lobar bronchi: upper and lower. +### End" +886,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Treatment of leukoplakia is, with the following options: A: Radiation, B: Excision and Cryotherapy, C: Topical chemotherapy, D: Repositioning of ill fitting dentures + +### Response: +","Management of Leukoplakia : (i) Many of the lesions will disappear spontaneously if the causative agent is removed.(ii) In lesions with higher potential for malignant change, a biopsy is taken to rule out malignancy.(iii) In suspicious small lesions, surgical excision or ablation with laser or cryotherapy can be done. (Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 253)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Treatment of leukoplakia is, with the following options: A: Radiation, B: Excision and Cryotherapy, C: Topical chemotherapy, D: Repositioning of ill fitting dentures + +### Response: +Management of Leukoplakia : (i) Many of the lesions will disappear spontaneously if the causative agent is removed.(ii) In lesions with higher potential for malignant change, a biopsy is taken to rule out malignancy.(iii) In suspicious small lesions, surgical excision or ablation with laser or cryotherapy can be done. (Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 253) +### End" +887,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: When activated by b-adrenergic receptors, the G protein:, with the following options: A: Activates phospholipase C, B: Activates adenylate cyclase, C: Activates protein kinase C, D: Conves guanosine diphosphate (GDP) to guanosine triphosphate (GTP) + +### Response: +","When norepinephrine binds to a beta-adrenergic receptor, it activates a G protein (i.e., a guanosine triphosphate (GTP) binding protein), which, in turn, activates adenylate cyclase. Adenylate cyclase catalyzes the formation of cyclic adenosine 3',5'-monophosphate (cAMP), which activates a variety of kinases. One of these kinases (protein kinase A) phosphorylates phospholamban, which reduces the inhibition of the sarcoplasmic reticular Ca2+ pump, increasing sequestration of Ca2+ from the cytoplasm. Ref: Biaggioni I., Robeson D. (2012). Chapter 9. Adrenoceptor Agonists & Sympathomimetic Drugs. 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: When activated by b-adrenergic receptors, the G protein:, with the following options: A: Activates phospholipase C, B: Activates adenylate cyclase, C: Activates protein kinase C, D: Conves guanosine diphosphate (GDP) to guanosine triphosphate (GTP) + +### Response: +When norepinephrine binds to a beta-adrenergic receptor, it activates a G protein (i.e., a guanosine triphosphate (GTP) binding protein), which, in turn, activates adenylate cyclase. Adenylate cyclase catalyzes the formation of cyclic adenosine 3',5'-monophosphate (cAMP), which activates a variety of kinases. One of these kinases (protein kinase A) phosphorylates phospholamban, which reduces the inhibition of the sarcoplasmic reticular Ca2+ pump, increasing sequestration of Ca2+ from the cytoplasm. Ref: Biaggioni I., Robeson D. (2012). Chapter 9. Adrenoceptor Agonists & Sympathomimetic Drugs. In B.G. Katzung, S.B. Masters, A.J. Trevor (Eds),Basic & Clinical Pharmacology, 12e. +### End" +888,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Regarding testicular torsion, which of the following is FALSE?, with the following options: A: Undescended testicle is a risk factor., B: Decreased blood flow relative to contralateral testicle demonstrable by ultrasound., C: Testicular salvage decreases to <5% if surgery is delayed >6 hours., D: Surgical exploration should include fixation of the contralateral testicle. + +### Response: +","Risk Factors for torsion include : undescended testis testicular tumour ""bell-clapper"" deformity--poor gubernacular fixation of the testicles to the scrotal wall. The diagnosis is made by clinical history and examination, but can be suppoed by a Doppler ultrasound, which typically shows decreased intra-testicular blood flow relative to the contralateral testis. Immediate surgical exploration can salvage an ischemic testis. More than 80% of testes can be salvaged if surgery is performed within 6 hours; this rate decreases to <20% as time lapses beyond 12 hours. At the time of surgery, the contralateral testes must also be explored and fixed to the daos fascia due to the possibility that the same anatomic defect allowing torsion exists on the contralateral side.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Regarding testicular torsion, which of the following is FALSE?, with the following options: A: Undescended testicle is a risk factor., B: Decreased blood flow relative to contralateral testicle demonstrable by ultrasound., C: Testicular salvage decreases to <5% if surgery is delayed >6 hours., D: Surgical exploration should include fixation of the contralateral testicle. + +### Response: +Risk Factors for torsion include : undescended testis testicular tumour ""bell-clapper"" deformity--poor gubernacular fixation of the testicles to the scrotal wall. The diagnosis is made by clinical history and examination, but can be suppoed by a Doppler ultrasound, which typically shows decreased intra-testicular blood flow relative to the contralateral testis. Immediate surgical exploration can salvage an ischemic testis. More than 80% of testes can be salvaged if surgery is performed within 6 hours; this rate decreases to <20% as time lapses beyond 12 hours. At the time of surgery, the contralateral testes must also be explored and fixed to the daos fascia due to the possibility that the same anatomic defect allowing torsion exists on the contralateral side. +### End" +889,"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 leukemia is associated with a convent girl appearance?, with the following options: A: Chronic myleogenous leukemia, B: Chronic lymphocytic leukemia, C: Hairy cell leukemia, D: Diffuse large B cell lymphoma + +### Response: +","In the neoplastic cells have similar appearance when seen in peripheral smear, k/a Convent girl appearance. CLL - ""Convent girl"". (Image below) Whereas , CML (image below) shows ""college girl"" or ""garden pay appearance"" Above image is of CML showing leukocytosis with the presence of precursor cells of the myeloid lineage described as garden pay appearance. In addition, basophilia, eosinophilia, and thrombocytosis can also be 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 leukemia is associated with a convent girl appearance?, with the following options: A: Chronic myleogenous leukemia, B: Chronic lymphocytic leukemia, C: Hairy cell leukemia, D: Diffuse large B cell lymphoma + +### Response: +In the neoplastic cells have similar appearance when seen in peripheral smear, k/a Convent girl appearance. CLL - ""Convent girl"". (Image below) Whereas , CML (image below) shows ""college girl"" or ""garden pay appearance"" Above image is of CML showing leukocytosis with the presence of precursor cells of the myeloid lineage described as garden pay appearance. In addition, basophilia, eosinophilia, and thrombocytosis can also be seen +### End" +890,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Richest source of vitamin C -, with the following options: A: Guava, B: Lime, C: Orange, D: Tomato + +### Response: +","Ans. is 'a' i.e., Guava o The richest source of vitamin C is Indian goosebery (Amla),o Important sources of vitamin C in decreasing order : -Amla > Guava > Cabbage > Amaranath > Lime > Cauliflower > Orange > Spinach > Tomato > Potato","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Richest source of vitamin C -, with the following options: A: Guava, B: Lime, C: Orange, D: Tomato + +### Response: +Ans. is 'a' i.e., Guava o The richest source of vitamin C is Indian goosebery (Amla),o Important sources of vitamin C in decreasing order : -Amla > Guava > Cabbage > Amaranath > Lime > Cauliflower > Orange > Spinach > Tomato > Potato +### End" +891,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Major apolipoprotein of chylomicrons ?, with the following options: A: B-100, B: D, C: B-48, D: None + +### Response: +","Ans. is 'c' i.e., B-48","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Major apolipoprotein of chylomicrons ?, with the following options: A: B-100, B: D, C: B-48, D: None + +### Response: +Ans. is 'c' i.e., B-48 +### End" +892,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Acute exacerbation of COPD is done by all except:, with the following options: A: Pneumococcus, B: Moraxella catarrhalis, C: H. influenza, D: Staph. aureus + +### Response: +","Bacterias like Pneumococcus , Moraxella catarrhalis are implicated in exacerbation of COPD.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Acute exacerbation of COPD is done by all except:, with the following options: A: Pneumococcus, B: Moraxella catarrhalis, C: H. influenza, D: Staph. aureus + +### Response: +Bacterias like Pneumococcus , Moraxella catarrhalis are implicated in exacerbation of COPD. +### End" +893,"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 Neurocysticercosis is:, with the following options: A: Usually presents with generalized seizures, B: Albendazole is more effective than praziquantel, C: Usually presents with 6th nerve palsy and hemiparesis, D: High does steroid are given for hydrocephalus + +### Response: +","Neurocysticercosis- Usually presents with focal seizures Standard therapy consists of Albendazole (10-15 mg/kg/d orally) or praziquantel (50 mg/kg/d orally). Albendazole is preferred, and coicosteroids appear to lower circulating praziquantel levels but increase albendazole levels. Coicosteroids are used for controlling seizures and some repos have shown exacerbation of disease after anti-helminthic therapy. Active lesions with a high likelihood of progression, such as intra-ventricular cysts, may benefit from therapy. Inactive calcified lesions probably do not benefit from therapy.","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 Neurocysticercosis is:, with the following options: A: Usually presents with generalized seizures, B: Albendazole is more effective than praziquantel, C: Usually presents with 6th nerve palsy and hemiparesis, D: High does steroid are given for hydrocephalus + +### Response: +Neurocysticercosis- Usually presents with focal seizures Standard therapy consists of Albendazole (10-15 mg/kg/d orally) or praziquantel (50 mg/kg/d orally). Albendazole is preferred, and coicosteroids appear to lower circulating praziquantel levels but increase albendazole levels. Coicosteroids are used for controlling seizures and some repos have shown exacerbation of disease after anti-helminthic therapy. Active lesions with a high likelihood of progression, such as intra-ventricular cysts, may benefit from therapy. Inactive calcified lesions probably do not benefit from therapy. +### End" +894,"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 the most common location of hypeensive intracranial hemorrhage occurring in the brain?, with the following options: A: Pons, B: Medulla oblongata, C: Putamen/external capsule, D: Cerebral coex + +### Response: +","Hypeensive intraparenchymal hemorrhage usually results from spontaneous rupture of a small penetrating aery deep in the brain. The most common sites are the basal ganglia (especially the putamen), thalamus, cerebellum, and pons. The two most common sites of hypeensive hemorrhage are the putamen and the thalamus, which are separated by the posterior limb of the internal capsule. Most hypeensive intraparenchymal hemorrhages develop over 30-90 minutes, whereas those associated with anticoagulant therapy evolve in 24-48 hours. Within 48 hours macrophages begins to phagocytize the hemorrhage and after 1-6 months, the hemorrhage resolves into a slit like orange cavity lined with glial scar and hemosiderin-laden macrophages. Ref: Harrison's Internal Medicine, 18th Edition, Chapter 370","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 the most common location of hypeensive intracranial hemorrhage occurring in the brain?, with the following options: A: Pons, B: Medulla oblongata, C: Putamen/external capsule, D: Cerebral coex + +### Response: +Hypeensive intraparenchymal hemorrhage usually results from spontaneous rupture of a small penetrating aery deep in the brain. The most common sites are the basal ganglia (especially the putamen), thalamus, cerebellum, and pons. The two most common sites of hypeensive hemorrhage are the putamen and the thalamus, which are separated by the posterior limb of the internal capsule. Most hypeensive intraparenchymal hemorrhages develop over 30-90 minutes, whereas those associated with anticoagulant therapy evolve in 24-48 hours. Within 48 hours macrophages begins to phagocytize the hemorrhage and after 1-6 months, the hemorrhage resolves into a slit like orange cavity lined with glial scar and hemosiderin-laden macrophages. Ref: Harrison's Internal Medicine, 18th Edition, Chapter 370 +### End" +895,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 65-year-old man who has a long history of hypeension presents to the emergency depament with tearing chest pain that radiates to the back. An electrocardiogram is normal, as are cardiac enzymes. A ""stat"" chest radiograph demonstrates widening of the mediastinum. Which of the following is the most likely?, with the following options: A: Aeriovenous fistula, B: Atherosclerotic aneurysm, C: Syphilitic aneurysm, D: Dissecting aneurysm + +### Response: +","The clinical presentation of a dissecting aoic aneurysm mimics that of a myocardial infarction; however, electrocardiographic changes and increased concentration of cardiac enzymes are notably absent. The mediastinum is often widened by radiographic examination. Although there is an association with hypeension and disorders of connective tissue (e.g., Marfan syndrome and Ehlers-Danlos syndrome), there is no association with atherosclerosis. The presentation exemplified by this scenario is a true surgical emergency!","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 65-year-old man who has a long history of hypeension presents to the emergency depament with tearing chest pain that radiates to the back. An electrocardiogram is normal, as are cardiac enzymes. A ""stat"" chest radiograph demonstrates widening of the mediastinum. Which of the following is the most likely?, with the following options: A: Aeriovenous fistula, B: Atherosclerotic aneurysm, C: Syphilitic aneurysm, D: Dissecting aneurysm + +### Response: +The clinical presentation of a dissecting aoic aneurysm mimics that of a myocardial infarction; however, electrocardiographic changes and increased concentration of cardiac enzymes are notably absent. The mediastinum is often widened by radiographic examination. Although there is an association with hypeension and disorders of connective tissue (e.g., Marfan syndrome and Ehlers-Danlos syndrome), there is no association with atherosclerosis. The presentation exemplified by this scenario is a true surgical emergency! +### End" +896,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A substance, when added to a culture causes inhibition of multiplication but on removal causes enhanced growth. This substance is called:, with the following options: A: Bacteriostatic, B: Bactericidal, C: Sterilization, D: Bacteriophage + +### Response: +","Ans. (a) Bacteriostatic Jinni naray,, , i) 28 Bacteriostatic - Chemical or substance inhibiting growth without killing. Bactericidal - Chemical or substance killing organism. Sterilization - The process by which aicle or medium is freed of all living microorganism either in the vegetative or spore state. Bacteriophage - Virus infecting bacteria.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A substance, when added to a culture causes inhibition of multiplication but on removal causes enhanced growth. This substance is called:, with the following options: A: Bacteriostatic, B: Bactericidal, C: Sterilization, D: Bacteriophage + +### Response: +Ans. (a) Bacteriostatic Jinni naray,, , i) 28 Bacteriostatic - Chemical or substance inhibiting growth without killing. Bactericidal - Chemical or substance killing organism. Sterilization - The process by which aicle or medium is freed of all living microorganism either in the vegetative or spore state. Bacteriophage - Virus infecting bacteria. +### End" +897,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pyridoxine should be given when treating with ?, with the following options: A: Isoniazid, B: Rifampicin, C: Pyrazinamide, D: Streptomycin + +### Response: +","Ans. is 'a' i.e., Isoniazid Peripheral neuritis associated with isoniaide probably relates to interference with pyridoxine (vitamin B6). Thus when treating a patient with isoniazid it is essential to supplement with pyridoxine to reduce chances of peripheral neuritis.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Pyridoxine should be given when treating with ?, with the following options: A: Isoniazid, B: Rifampicin, C: Pyrazinamide, D: Streptomycin + +### Response: +Ans. is 'a' i.e., Isoniazid Peripheral neuritis associated with isoniaide probably relates to interference with pyridoxine (vitamin B6). Thus when treating a patient with isoniazid it is essential to supplement with pyridoxine to reduce chances of peripheral neuritis. +### End" +898,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: High dose methotrexate is used for the treatment of(REPEAT), with the following options: A: Osteosarcoma, B: Rhabdomyosarcoma, C: Retinoblastoma, D: Ewing's sarcoma + +### Response: +",Ref: Harrison's 17th/612 Drugs used for osteosarcoma are: Doxorubicin Ifosfamide Cisplatin High dose methotrexate with leucovorin,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: High dose methotrexate is used for the treatment of(REPEAT), with the following options: A: Osteosarcoma, B: Rhabdomyosarcoma, C: Retinoblastoma, D: Ewing's sarcoma + +### Response: +Ref: Harrison's 17th/612 Drugs used for osteosarcoma are: Doxorubicin Ifosfamide Cisplatin High dose methotrexate with leucovorin +### End" +899,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Primary prevention is -, with the following options: A: Prevention of emergence of risk factors, B: Specific protection, C: Early diagnosis, D: Rehablitation + +### Response: +","Ans. is 'b' i.e., Specific protection","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Primary prevention is -, with the following options: A: Prevention of emergence of risk factors, B: Specific protection, C: Early diagnosis, D: Rehablitation + +### Response: +Ans. is 'b' i.e., Specific protection +### End" +900,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Antidote for organophosphorus poisoning is -, with the following options: A: PAM, B: Adrenaline, C: Anti-dopaminergics, D: Ephedrine + +### Response: +","Antidotes for OP compounds : (1) atropine (2) oximes (Pralidoxime : PAM, obidoxime and diacetylmonoxirne : DAM).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Antidote for organophosphorus poisoning is -, with the following options: A: PAM, B: Adrenaline, C: Anti-dopaminergics, D: Ephedrine + +### Response: +Antidotes for OP compounds : (1) atropine (2) oximes (Pralidoxime : PAM, obidoxime and diacetylmonoxirne : DAM). +### End" +901,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The hypothetical situation is-, with the following options: A: Police inquest, B: Magistrate inquest, C: Dying declaration, D: Dying deposition + +### Response: +","Dying deposition is the statement of a person on oath, recorded by a magistrate. + +In the presence of the accused or his lawyer. +The lawyer is allowed to cross-examine the witness. +This procedure is not followed in India. +Such a situation is so-called hypothetical as it is practically very difficult to achieve or virtually impossible.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The hypothetical situation is-, with the following options: A: Police inquest, B: Magistrate inquest, C: Dying declaration, D: Dying deposition + +### Response: +Dying deposition is the statement of a person on oath, recorded by a magistrate. + +In the presence of the accused or his lawyer. +The lawyer is allowed to cross-examine the witness. +This procedure is not followed in India. +Such a situation is so-called hypothetical as it is practically very difficult to achieve or virtually impossible. +### End" +902,"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 feature of battered baby syndrome, with the following options: A: Subdural haemorrhage occurs in 40 % of fatal cases, B: Nobbing fractures on the anterior angles of the ribs, C: Vitreous and subhyaloid hemorrhages in the eyes, D: Torn frenulum on the lower lip is a characteristic lesion + +### Response: +","Battered baby syndrome/ Caffeys syndrome/ non accidental injury of childhood: Nobbing fractures occur on the posterior angles of the ribs in the paraveebral gutter region Subdural haemorrhage occurs in 40 % of fatal cases In the eyes, retinal detachment, retinal hemorrhages, Vitreous and subhyaloid hemorrhages are seen Torn frenulum on the lower lip is a characteristic lesion","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 feature of battered baby syndrome, with the following options: A: Subdural haemorrhage occurs in 40 % of fatal cases, B: Nobbing fractures on the anterior angles of the ribs, C: Vitreous and subhyaloid hemorrhages in the eyes, D: Torn frenulum on the lower lip is a characteristic lesion + +### Response: +Battered baby syndrome/ Caffeys syndrome/ non accidental injury of childhood: Nobbing fractures occur on the posterior angles of the ribs in the paraveebral gutter region Subdural haemorrhage occurs in 40 % of fatal cases In the eyes, retinal detachment, retinal hemorrhages, Vitreous and subhyaloid hemorrhages are seen Torn frenulum on the lower lip is a characteristic lesion +### End" +903,"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 treatment of typical CLL are true, except :, with the following options: A: Treatment should be initiated as soon as diagnosis is established, B: Chlorambucil and Fludarabine are the most commonly used agents, C: Fludarabine is preferred in the young and Chlorambucil is preferred in the elderly, D: Young patients are candidates for Bone marrow transplantation + +### Response: +",Answer is A (Treatment should be initiated as soon as diagnosis is established) It is not essential to initiate treatment as soon as a diagnosis of CLL is established. 'An unusual feature of CLL compared to other leukemias is that making the diagnosis is not necessarily an indication to initiate treatment' - DeVita Treatment need not be initiated as soon as diagnosis of CLL is established Early stage asymptomatic disease requires no treatment. CLL may be diagnosed in an asymptomatic patient and have a prolonged course. Meta-analysis has shown no survival advantage of initiating treatment in early stage disease. Active monitoring should however be pursued and treatment initiated only if and when the patient meets established 'criteria for treatment'. Criteria for treatment Progressive marrow failure Massive(>10cm)/progressive lymphadenopathy Massive (>6cm)/progressive splenomegaly Progressive lymphocytosis (doubling time <6 months) Systemic symptoms; Weight loss >10%in 6 months fever>38deg C for >2 weeks extreme fatigue or night sweats Autoimmune cytopenias (this may only require treatment of the autoimmune component not necessarily the leukaemia) Chlorambucil and Fludarabine are the most commonly used agents. The most common treatment for CLL are Chlorambucil or Fludarabine alone or in combination. Chlorambucil Can be administered orally and has few side effects Less active than Fludarabine and usually unsuccessful in achieving remission Most common agent chosen for treatment of elderly patients requiring therapy. (Majority of elderly patients have significant comorbid conditions associated with aging and may have an indolent disease) Fludarabine Administered intravenously and has significant side effects (Significant immune suppression) More active agent and by far the only drug associatedwith a significant incidence of complete remission Preferred agent for treatment of young patientsrequiring therapy Fludarabine is often used incombination with Cyclophosphamide (FC).Following theresults of LRF CC4 Trial many now consider FC to be thegold standard first Line treatment of CLL in the young Young patients are candidates for Bone marrow transplanatation Bendamustine is an alkylating agent structurally related to nitrogen mustards that is highly effective and is vying with fludarabine as the primary treatment of choice. Rituximab (AntiCD20) and Alemtuzumab (anti CD52) may also be used. `Young patients with CLL can be candidates for Allogenic bone marrow transplantation. Allogenic bone marrow transplantation can be urative but is associated with a significant treatment related moality rate' - Harrison,"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 treatment of typical CLL are true, except :, with the following options: A: Treatment should be initiated as soon as diagnosis is established, B: Chlorambucil and Fludarabine are the most commonly used agents, C: Fludarabine is preferred in the young and Chlorambucil is preferred in the elderly, D: Young patients are candidates for Bone marrow transplantation + +### Response: +Answer is A (Treatment should be initiated as soon as diagnosis is established) It is not essential to initiate treatment as soon as a diagnosis of CLL is established. 'An unusual feature of CLL compared to other leukemias is that making the diagnosis is not necessarily an indication to initiate treatment' - DeVita Treatment need not be initiated as soon as diagnosis of CLL is established Early stage asymptomatic disease requires no treatment. CLL may be diagnosed in an asymptomatic patient and have a prolonged course. Meta-analysis has shown no survival advantage of initiating treatment in early stage disease. Active monitoring should however be pursued and treatment initiated only if and when the patient meets established 'criteria for treatment'. Criteria for treatment Progressive marrow failure Massive(>10cm)/progressive lymphadenopathy Massive (>6cm)/progressive splenomegaly Progressive lymphocytosis (doubling time <6 months) Systemic symptoms; Weight loss >10%in 6 months fever>38deg C for >2 weeks extreme fatigue or night sweats Autoimmune cytopenias (this may only require treatment of the autoimmune component not necessarily the leukaemia) Chlorambucil and Fludarabine are the most commonly used agents. The most common treatment for CLL are Chlorambucil or Fludarabine alone or in combination. Chlorambucil Can be administered orally and has few side effects Less active than Fludarabine and usually unsuccessful in achieving remission Most common agent chosen for treatment of elderly patients requiring therapy. (Majority of elderly patients have significant comorbid conditions associated with aging and may have an indolent disease) Fludarabine Administered intravenously and has significant side effects (Significant immune suppression) More active agent and by far the only drug associatedwith a significant incidence of complete remission Preferred agent for treatment of young patientsrequiring therapy Fludarabine is often used incombination with Cyclophosphamide (FC).Following theresults of LRF CC4 Trial many now consider FC to be thegold standard first Line treatment of CLL in the young Young patients are candidates for Bone marrow transplanatation Bendamustine is an alkylating agent structurally related to nitrogen mustards that is highly effective and is vying with fludarabine as the primary treatment of choice. Rituximab (AntiCD20) and Alemtuzumab (anti CD52) may also be used. `Young patients with CLL can be candidates for Allogenic bone marrow transplantation. Allogenic bone marrow transplantation can be urative but is associated with a significant treatment related moality rate' - Harrison +### End" +904,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Site of Topical block of sphenopalatine ganglion is?, with the following options: A: Above the superior turbinate, B: Posterior to Superior turbinate, C: Posterior to middle turbinate, D: Posterior to inferior turbinate + +### Response: +","ANSWER: (C) Posterior to middle turbinateREF: Morgan Anesthesiology 4th ed chapter 18, Lee's Synopsis of Anaesthesia 13th ed page 411, Dhingra 4th ed page 131Sphenopalatine ganglion block may be used in the treatment of acute migraine headache, acute cluster headache, and a variety of facial neuralgias including Sluder's, Vail's, and Gardner's syndromes.Most of the posterior two- thirds of nasal cavity (both septum and lateral wall) is supplied by branches of sphenopalatine ganglion which can be blocked by placing a pledget of cottonsoaked in anaesthetic solution near the sphenopalatine foramen situated at the posterior extremity of middle turbinate. Anterior ethmoidal nerve which supplies anterior and superior part of the nasal cavity (lateral wall and septum) can be blocked by placing the pledget high up on the inside of nasal bones where the nerve enters.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Site of Topical block of sphenopalatine ganglion is?, with the following options: A: Above the superior turbinate, B: Posterior to Superior turbinate, C: Posterior to middle turbinate, D: Posterior to inferior turbinate + +### Response: +ANSWER: (C) Posterior to middle turbinateREF: Morgan Anesthesiology 4th ed chapter 18, Lee's Synopsis of Anaesthesia 13th ed page 411, Dhingra 4th ed page 131Sphenopalatine ganglion block may be used in the treatment of acute migraine headache, acute cluster headache, and a variety of facial neuralgias including Sluder's, Vail's, and Gardner's syndromes.Most of the posterior two- thirds of nasal cavity (both septum and lateral wall) is supplied by branches of sphenopalatine ganglion which can be blocked by placing a pledget of cottonsoaked in anaesthetic solution near the sphenopalatine foramen situated at the posterior extremity of middle turbinate. Anterior ethmoidal nerve which supplies anterior and superior part of the nasal cavity (lateral wall and septum) can be blocked by placing the pledget high up on the inside of nasal bones where the nerve enters. +### End" +905,"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 arthritis erosions are not seen:, with the following options: A: Rheumatoid arthritis, B: Systemic lupus erthematosus (SLE), C: Psoriasis, D: Gout + +### Response: +","Ans. is b' i.e., Systemic lupus erythematosus (SLE) About Musculoskeletal manifestation in SLE patients, Harrison writes -""Poly arthralgias and polyarthritis eventually occur in 90% of SLE patients.The arthritis initially involve the small joints in hands, knees and wrists.Joint deformities develop in only 10%.Erosions on joint X-rays are rare, their presence suggest a non lupus inflammatory arthropathy such as rheumatoid arthritis.""Joint erosion are well known in all the other three options.","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 arthritis erosions are not seen:, with the following options: A: Rheumatoid arthritis, B: Systemic lupus erthematosus (SLE), C: Psoriasis, D: Gout + +### Response: +Ans. is b' i.e., Systemic lupus erythematosus (SLE) About Musculoskeletal manifestation in SLE patients, Harrison writes -""Poly arthralgias and polyarthritis eventually occur in 90% of SLE patients.The arthritis initially involve the small joints in hands, knees and wrists.Joint deformities develop in only 10%.Erosions on joint X-rays are rare, their presence suggest a non lupus inflammatory arthropathy such as rheumatoid arthritis.""Joint erosion are well known in all the other three options. +### End" +906,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 35 yr old lady with normal PT and increased aPTT. 2 year back, she was operated for cholecystectomy & did not have any bleeding episoe. What is next investigation for clinical diagnosis -, with the following options: A: Factor VIII assay, B: Anti viper venom assay, C: Platelet aggregation test, D: Ristocetin Cofactor assay + +### Response: +","Ans. is 'b' i.e., Anti viper venom assay The only clue given in the question is patient with prolonged APTT and no clinical bleeding.First we, look at the causes of isolated prolongation of APTT.Causes of isolated prolongation of PTHeparinLupus anticoagulantCoagulation factor deficiency (factor VIII, IX and XI, XII, prekallikrein, high molecular weight kininogen (HMWK)Specific coagulation factor inhibitors (antibodies against factor VIII or IX)Now we look for those causes of prolonged APTT which are not associated with bleedingNow we move on to the options and find out which among them will cause prolongation of PTT with no bleeding. Factor VIIIc assay:-Factor VIIIc or intrinsic factor VIII can be ruled out because its deficiency is associated with bleeding.Platelet a2sre2ation testsPlatelet aggregation test measures platelet functionAny defect in platelet function will cause clinical bleedingPlatelet function defect does not affect PTT (it affects bleeding time, BT)Ristocetin co-factor assayRistocetin co-factor assays are used to detect Von Willebrand's diseaseVon wile brands disease cause prolongation of PTT but it is also associated with clinical bleeding so it can be ruled out.Russel viper venom test (Dilute Russel viper venom test) (dRVVT)Dilute Russel viper venom test is one of the test to detect lupus anticoagulant.Lupus anticoagulant is associated with prolongation in PTT and thrombosis (no bleeding)Lupus anticoagulantLupus anticoagulants are acquired inhibitors directed against phospholipid binding proteins and are a common cause of APTT prolongationIn Vivo,Lupus anticoagulant do not interfere with coagulation factor complex formation on the platelet surface and are not usually associated with bleeding tendency, instead they are frequently associated with thrombosis.In Vitro,This prolongation results in paradoxical prolongation of phospholipid based clotting assays such as PTT, kaolin clotting time and Dilute Russel viper venom antibody (DRVVT testing).A panel of test is required to confirm the presence of lupus anticoagulantThese are:-PTTKaolin clotting timeDilute Russel viper Venom test (DRVT)These are phospholipid dependent testsWe have already discussed thatLupus anticoagulant act against phospholipids and in vitro this inhibition leads to prolongation of phospholipid dependent assays.Follow up testing is performed to confirm or exclude the presence of lupus anticoagulant:- These may include:-Mixing studyAn equal volume of patient plasma is mixed with normal pooled plasma and a PTT or DRVVT is performed on this mixture. The basic principle is that the normal plasma contributes a sufficient amount of clotting factor to correct for a factor deficiency.A mixing study that corrects the APTT is characteristic of a coagulation factor where as one that does not correct indicates a factor inhibitor.Correction neutralization (with phospholipids)An excess of phospholipid is added to the patient sample and APII, DRVVT is performed.The basic principle behind this is that lupus anticoagulant is directed against phospholipid. Hence phospholipid dependent assays are prolonged.When excess phospholipid is added it overcomes the LA inhibition and corrects the test","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 35 yr old lady with normal PT and increased aPTT. 2 year back, she was operated for cholecystectomy & did not have any bleeding episoe. What is next investigation for clinical diagnosis -, with the following options: A: Factor VIII assay, B: Anti viper venom assay, C: Platelet aggregation test, D: Ristocetin Cofactor assay + +### Response: +Ans. is 'b' i.e., Anti viper venom assay The only clue given in the question is patient with prolonged APTT and no clinical bleeding.First we, look at the causes of isolated prolongation of APTT.Causes of isolated prolongation of PTHeparinLupus anticoagulantCoagulation factor deficiency (factor VIII, IX and XI, XII, prekallikrein, high molecular weight kininogen (HMWK)Specific coagulation factor inhibitors (antibodies against factor VIII or IX)Now we look for those causes of prolonged APTT which are not associated with bleedingNow we move on to the options and find out which among them will cause prolongation of PTT with no bleeding. Factor VIIIc assay:-Factor VIIIc or intrinsic factor VIII can be ruled out because its deficiency is associated with bleeding.Platelet a2sre2ation testsPlatelet aggregation test measures platelet functionAny defect in platelet function will cause clinical bleedingPlatelet function defect does not affect PTT (it affects bleeding time, BT)Ristocetin co-factor assayRistocetin co-factor assays are used to detect Von Willebrand's diseaseVon wile brands disease cause prolongation of PTT but it is also associated with clinical bleeding so it can be ruled out.Russel viper venom test (Dilute Russel viper venom test) (dRVVT)Dilute Russel viper venom test is one of the test to detect lupus anticoagulant.Lupus anticoagulant is associated with prolongation in PTT and thrombosis (no bleeding)Lupus anticoagulantLupus anticoagulants are acquired inhibitors directed against phospholipid binding proteins and are a common cause of APTT prolongationIn Vivo,Lupus anticoagulant do not interfere with coagulation factor complex formation on the platelet surface and are not usually associated with bleeding tendency, instead they are frequently associated with thrombosis.In Vitro,This prolongation results in paradoxical prolongation of phospholipid based clotting assays such as PTT, kaolin clotting time and Dilute Russel viper venom antibody (DRVVT testing).A panel of test is required to confirm the presence of lupus anticoagulantThese are:-PTTKaolin clotting timeDilute Russel viper Venom test (DRVT)These are phospholipid dependent testsWe have already discussed thatLupus anticoagulant act against phospholipids and in vitro this inhibition leads to prolongation of phospholipid dependent assays.Follow up testing is performed to confirm or exclude the presence of lupus anticoagulant:- These may include:-Mixing studyAn equal volume of patient plasma is mixed with normal pooled plasma and a PTT or DRVVT is performed on this mixture. The basic principle is that the normal plasma contributes a sufficient amount of clotting factor to correct for a factor deficiency.A mixing study that corrects the APTT is characteristic of a coagulation factor where as one that does not correct indicates a factor inhibitor.Correction neutralization (with phospholipids)An excess of phospholipid is added to the patient sample and APII, DRVVT is performed.The basic principle behind this is that lupus anticoagulant is directed against phospholipid. Hence phospholipid dependent assays are prolonged.When excess phospholipid is added it overcomes the LA inhibition and corrects the test +### End" +907,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Danger area of neck is situated between, with the following options: A: Buccopharyngeal and preveebral fascia, B: Pharyngobasilar and preveebral fascia, C: Preveebral and alar fascia, D: Buccopharyngeal and alar fascia + +### Response: +",The space between Alar fascia & Preveebral fascia proper is called danger area as the infection or pus in this place can spread to posterior mediastinum.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Danger area of neck is situated between, with the following options: A: Buccopharyngeal and preveebral fascia, B: Pharyngobasilar and preveebral fascia, C: Preveebral and alar fascia, D: Buccopharyngeal and alar fascia + +### Response: +The space between Alar fascia & Preveebral fascia proper is called danger area as the infection or pus in this place can spread to posterior mediastinum. +### End" +908,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: An important clinical feature of a concussed tooth is:, with the following options: A: Tooth is markedly tender to percussion, B: Tooth is displaced from the socket, C: Evidence of haemorrhage at gingival margin, D: Clinically crown appears shorter + +### Response: +","Concussion + +Tooth is not displaced. +Mobility is not present. +Tooth is tender to percussion because of edema and hemorrhage in the periodontal ligament. +Pulp may respond normal to testing.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: An important clinical feature of a concussed tooth is:, with the following options: A: Tooth is markedly tender to percussion, B: Tooth is displaced from the socket, C: Evidence of haemorrhage at gingival margin, D: Clinically crown appears shorter + +### Response: +Concussion + +Tooth is not displaced. +Mobility is not present. +Tooth is tender to percussion because of edema and hemorrhage in the periodontal ligament. +Pulp may respond normal to testing. +### End" +909,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: When the confidence level of a test is increased which of the following will happen-, with the following options: A: No effect on significance, B: Previously insignificant value becomes significant, C: Previously significant value becomes significant, D: No change in hypothesis + +### Response: +",.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: When the confidence level of a test is increased which of the following will happen-, with the following options: A: No effect on significance, B: Previously insignificant value becomes significant, C: Previously significant value becomes significant, D: No change in hypothesis + +### Response: +. +### End" +910,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A young woman with six weeks amenorrhoea presents with mass abdomen. USG shows empty uterus. Diagnosis is:, with the following options: A: Ovarian cyst, B: Ectopic pregnancy, C: Complete abortion, D: None of the above + +### Response: +","Ans. is b, i.e. Ectopic pregnancyRef. Dutta Obs 7/e p 182, 183; Shaw 14/e, p 244, 245Well friends--a young woman presenting with 6 weeks of amenorrhea and USG showing empty uterus could either mean it is an ectopic pregnancy or abortion. In abortion - patient will give history of bleeding, pain but mass in abdomen does not favour it.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A young woman with six weeks amenorrhoea presents with mass abdomen. USG shows empty uterus. Diagnosis is:, with the following options: A: Ovarian cyst, B: Ectopic pregnancy, C: Complete abortion, D: None of the above + +### Response: +Ans. is b, i.e. Ectopic pregnancyRef. Dutta Obs 7/e p 182, 183; Shaw 14/e, p 244, 245Well friends--a young woman presenting with 6 weeks of amenorrhea and USG showing empty uterus could either mean it is an ectopic pregnancy or abortion. In abortion - patient will give history of bleeding, pain but mass in abdomen does not favour it. +### End" +911,"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 malignant hypehermia except:, with the following options: A: Bradycardia, B: Hyperkalemia, C: Metabolic acidosis, D: Hypeension + +### Response: +",A 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: All are seen in malignant hypehermia except:, with the following options: A: Bradycardia, B: Hyperkalemia, C: Metabolic acidosis, D: Hypeension + +### Response: +A i.e. Bradycardia +### End" +912,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A child climbs with alternate steps, builds a tower 8–9 cubes, tells 'I' but not his name and can not say his age and sex, the probable age is –, with the following options: A: 36 months, B: 24 months, C: 30 months, D: 48 months + +### Response: +","A child climbs stairs with alternating feet, refers to self as 'I' and builds a tower of 9 cubes by the age of 30 months. +A child knows his gender and age by 3 years.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A child climbs with alternate steps, builds a tower 8–9 cubes, tells 'I' but not his name and can not say his age and sex, the probable age is –, with the following options: A: 36 months, B: 24 months, C: 30 months, D: 48 months + +### Response: +A child climbs stairs with alternating feet, refers to self as 'I' and builds a tower of 9 cubes by the age of 30 months. +A child knows his gender and age by 3 years. +### End" +913,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cavitating pulmonary lesions can be seen in the following except, with the following options: A: Sarcoidoses, B: Tuberculosis, C: Carcinoma of lung, D: none + +### Response: +","Cavitory lung diseases infections pulmonary abscess septic emboli tuberculosis Non tubercular mycobacterium aspergillosis Systemic diseases like granulomatosis with poly angitis,rheumatic nodules,sarcoidosis,malignancies.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cavitating pulmonary lesions can be seen in the following except, with the following options: A: Sarcoidoses, B: Tuberculosis, C: Carcinoma of lung, D: none + +### Response: +Cavitory lung diseases infections pulmonary abscess septic emboli tuberculosis Non tubercular mycobacterium aspergillosis Systemic diseases like granulomatosis with poly angitis,rheumatic nodules,sarcoidosis,malignancies. +### End" +914,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Thermo philus sachari causes ?, with the following options: A: Bagassosis, B: Siderosis, C: Byssinosis, D: Anthracosis + +### Response: +","Ans. is 'a' i.e., Bagassosis Bagassosiso Bagassosis is the name given to an occupational disease of the lung caused by inhalation of bagasse or sugar- cane dust.o Bagassosis has been shown to be due to a termophilic actinomycete - Thermoactinomyces sacchari.Anthracosis-Coal dustSilicosis-SilicaSiderosis-ironByssinosis-Cotton dustFarmer's lung-Hay or grain dustSequousis-Moldy red wood saw dustSuberosis-Moldy cork dustDetergent worker's lung-Enzyme additivesBaggassosis-Sugarcane dust","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Thermo philus sachari causes ?, with the following options: A: Bagassosis, B: Siderosis, C: Byssinosis, D: Anthracosis + +### Response: +Ans. is 'a' i.e., Bagassosis Bagassosiso Bagassosis is the name given to an occupational disease of the lung caused by inhalation of bagasse or sugar- cane dust.o Bagassosis has been shown to be due to a termophilic actinomycete - Thermoactinomyces sacchari.Anthracosis-Coal dustSilicosis-SilicaSiderosis-ironByssinosis-Cotton dustFarmer's lung-Hay or grain dustSequousis-Moldy red wood saw dustSuberosis-Moldy cork dustDetergent worker's lung-Enzyme additivesBaggassosis-Sugarcane dust +### End" +915,"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 treatment of pneumocystis carinii except, with the following options: A: Pentamidine, B: Dapsone, C: Cotrimoxazole, D: Fluoroquinolones + +### Response: +","The treatment of choice for PCP is trimethoprim-sulfamethoxazole (TMP-SMX), given either IV or PO for 14-21 days. Sulfadiazine plus pyrimethamine, an oral regimen more often used for treatment of toxoplasmosis, also is highly effective. Dapsone plus pyrimethamine or dapsone plus trimethoprim also can be used. Intravenous pentamidine or the combination of clindamycin plus primaquine is an option for patients who cannot tolerate TMP-SMXand for patients in whose treatment TMP-SMX appears to be failing. Ref Harrison 19th edition pg 1017","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 treatment of pneumocystis carinii except, with the following options: A: Pentamidine, B: Dapsone, C: Cotrimoxazole, D: Fluoroquinolones + +### Response: +The treatment of choice for PCP is trimethoprim-sulfamethoxazole (TMP-SMX), given either IV or PO for 14-21 days. Sulfadiazine plus pyrimethamine, an oral regimen more often used for treatment of toxoplasmosis, also is highly effective. Dapsone plus pyrimethamine or dapsone plus trimethoprim also can be used. Intravenous pentamidine or the combination of clindamycin plus primaquine is an option for patients who cannot tolerate TMP-SMXand for patients in whose treatment TMP-SMX appears to be failing. Ref Harrison 19th edition pg 1017 +### End" +916,"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 cluster sampling except-, with the following options: A: Samples are similar to those in simple Random sampling, B: Is a Rapid and simple method, C: The sample size may very according to study design, D: It is a type of probability sample + +### Response: +",.,"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 cluster sampling except-, with the following options: A: Samples are similar to those in simple Random sampling, B: Is a Rapid and simple method, C: The sample size may very according to study design, D: It is a type of probability sample + +### Response: +. +### End" +917,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 70 year old man with a known history of Parkinson's disease is to receive prophylaxis against Influenza A virus. He is given a drug that is useful against Parkinson's disease as well for prophylaxis against influenza. The drug with which of the following mechanisms of action is most likely to have been given?, with the following options: A: It prevents entry and penetration of the virus, B: It prevents uncoating of the virus, C: It prevents replication of the virus, D: It prevents assembly of newly synthesized virus paicles + +### Response: +",The drug that is used for both Parkinson&;s and influenza is amantadine which is a dopamine facilitator or agonist. It acts by preventing the uncoating of viral paicles.Ref: HL Sharma 3rd ed Pg: 797,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 70 year old man with a known history of Parkinson's disease is to receive prophylaxis against Influenza A virus. He is given a drug that is useful against Parkinson's disease as well for prophylaxis against influenza. The drug with which of the following mechanisms of action is most likely to have been given?, with the following options: A: It prevents entry and penetration of the virus, B: It prevents uncoating of the virus, C: It prevents replication of the virus, D: It prevents assembly of newly synthesized virus paicles + +### Response: +The drug that is used for both Parkinson&;s and influenza is amantadine which is a dopamine facilitator or agonist. It acts by preventing the uncoating of viral paicles.Ref: HL Sharma 3rd ed Pg: 797 +### End" +918,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Burns involving the eyelid leads to formation of -, with the following options: A: Spastic ectropion, B: Mechanical ectropion, C: Cicatricialectropion, D: None of the above + +### Response: +","Ans. is 'c' i.e., Cicatricial ectropion ECTROPIONo Out rolling or outward turning of the lid margin is called ectropion.Typeso Senile ectropion. It is the commonest variety and involves only the lower lids. It occurs due to senile laxity of the tissues of the lids and loss of tone of the orbicularis muscle,o Cicatricial ectropion. It occurs due to scarring of the skin and can involve both the lids. Common causes of skin scarring are: thermal burns, chemical bums, lacerating injuries and skin ulcers,o Paralytic ectropion. It results due to paralysis of the seventh nerve. It mainly occurs in the lower lids. Common causes of facial nerve patsy are: Bell's palsy, head injury and infections of the middle ear.o Mechanical ectropion. It occurs in conditions where either the lower lid is pulled down (as in tumours) or pushed out and down (as in proptosis and marked chemosis of the conjunctiva),o Spastic ectropion. It is a rare entity, seen in children and young adults following spasm of the orbicularis, where lids are well supported by the globe.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Burns involving the eyelid leads to formation of -, with the following options: A: Spastic ectropion, B: Mechanical ectropion, C: Cicatricialectropion, D: None of the above + +### Response: +Ans. is 'c' i.e., Cicatricial ectropion ECTROPIONo Out rolling or outward turning of the lid margin is called ectropion.Typeso Senile ectropion. It is the commonest variety and involves only the lower lids. It occurs due to senile laxity of the tissues of the lids and loss of tone of the orbicularis muscle,o Cicatricial ectropion. It occurs due to scarring of the skin and can involve both the lids. Common causes of skin scarring are: thermal burns, chemical bums, lacerating injuries and skin ulcers,o Paralytic ectropion. It results due to paralysis of the seventh nerve. It mainly occurs in the lower lids. Common causes of facial nerve patsy are: Bell's palsy, head injury and infections of the middle ear.o Mechanical ectropion. It occurs in conditions where either the lower lid is pulled down (as in tumours) or pushed out and down (as in proptosis and marked chemosis of the conjunctiva),o Spastic ectropion. It is a rare entity, seen in children and young adults following spasm of the orbicularis, where lids are well supported by the globe. +### End" +919,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cutis marmorata occurs due to exposure to, with the following options: A: Cold temperature, B: Dust, C: Hot temperature, D: Humidity + +### Response: +","(A) Cold temperature[?]CUTIS MARMORATA:It is a transient cyanotic mottling of the skin which occurs as a physiological response to cold exposure and disappears with warming.It is usually encountered in healthy infants and resolves during the first year of life.Involvement of the trunk as well as the limbs is common.Physiological livedo reticularis rarely occurs in adults.Transient mottling when infant is exposed to decreased temperature.Acrocyanosis:Cyanosis of hands & feet.A common response to cold.An underlying cardiac defect should be suspected if acrocyanosis is persistent or more intense in the feet than hands.Benign cutaneous vascular phenomena seen in neonates as an accentuated physiologic vasomotor response to cold.Reticulate, bluish mottling of skin on trunk and extremities.Usually disappear as the infants is rewarmed.It's persistence is seen in Downs syndrome, trisomy-18, hypothyrioidism.Resolves quickly with warming.Onset during first 2 to 4 weeks of life.Due to immaturity of the autonomic nervous system of newborns.If persists after the infant is warmed implies an obstruction to blood flow such as hyperviscosity or vasculitis.Persistence beyond neonatal period is a possible marker for trisomy 18, Down syndrome, hypothyroidismDDX from sepsis and hypovolemia.Cutis marmorata telangiectatica congenita (CMTC):It is an uncommon, congenital, vascular malformation, first described by Van Lohuizen, comprising a fixed reticulate erythema which may resemble physiological cutis marmorata.Aetiology of CMTC is unknown.Histopathology of the vascular abnormality reveals dilated capillaries, venous & capillary lakes, and dilated veins in the dermis and subcutis.Clinical features:The vascular abnormality is a reticulate erythema producing the marbling that is akin to the physiological marbling seen in neonates.This is fixed and does not disappear after warming (unlike physiological cutis marmorata).Limbs are more commonly affected than other sites, & a sharp demarcation line is common.Associated atrophy (more common) or hypertrophy of the underlying subcutaneous tissue.Other congenital anomalies:Common: Aplasia cutis, developmental delay & cleft palate.Less common: Macrocephaly, glaucoma, hypothyroidism, scoliosis & anogenital abnormalities.Treatment: Rarely require treatment as many children improve in the first 2 years of life.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cutis marmorata occurs due to exposure to, with the following options: A: Cold temperature, B: Dust, C: Hot temperature, D: Humidity + +### Response: +(A) Cold temperature[?]CUTIS MARMORATA:It is a transient cyanotic mottling of the skin which occurs as a physiological response to cold exposure and disappears with warming.It is usually encountered in healthy infants and resolves during the first year of life.Involvement of the trunk as well as the limbs is common.Physiological livedo reticularis rarely occurs in adults.Transient mottling when infant is exposed to decreased temperature.Acrocyanosis:Cyanosis of hands & feet.A common response to cold.An underlying cardiac defect should be suspected if acrocyanosis is persistent or more intense in the feet than hands.Benign cutaneous vascular phenomena seen in neonates as an accentuated physiologic vasomotor response to cold.Reticulate, bluish mottling of skin on trunk and extremities.Usually disappear as the infants is rewarmed.It's persistence is seen in Downs syndrome, trisomy-18, hypothyrioidism.Resolves quickly with warming.Onset during first 2 to 4 weeks of life.Due to immaturity of the autonomic nervous system of newborns.If persists after the infant is warmed implies an obstruction to blood flow such as hyperviscosity or vasculitis.Persistence beyond neonatal period is a possible marker for trisomy 18, Down syndrome, hypothyroidismDDX from sepsis and hypovolemia.Cutis marmorata telangiectatica congenita (CMTC):It is an uncommon, congenital, vascular malformation, first described by Van Lohuizen, comprising a fixed reticulate erythema which may resemble physiological cutis marmorata.Aetiology of CMTC is unknown.Histopathology of the vascular abnormality reveals dilated capillaries, venous & capillary lakes, and dilated veins in the dermis and subcutis.Clinical features:The vascular abnormality is a reticulate erythema producing the marbling that is akin to the physiological marbling seen in neonates.This is fixed and does not disappear after warming (unlike physiological cutis marmorata).Limbs are more commonly affected than other sites, & a sharp demarcation line is common.Associated atrophy (more common) or hypertrophy of the underlying subcutaneous tissue.Other congenital anomalies:Common: Aplasia cutis, developmental delay & cleft palate.Less common: Macrocephaly, glaucoma, hypothyroidism, scoliosis & anogenital abnormalities.Treatment: Rarely require treatment as many children improve in the first 2 years of life. +### End" +920,"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 causing malabsorption has no effect on villus architecture and no inflammatory reaction?, with the following options: A: Giardiasis, B: Crohn's, C: Whipple's, D: Abetalipoprotienemia + +### Response: +","Answer is D (Abetalipoprotenemia) Abetalipoproteinemia is typically associated with normal villas architecture and no inflammatory reaction. Features of lipid accumulation within enterocytes (vacuolated epithelial cells) is diagnostic and specific. Crohn's Disease and Whipple's disease are typically associated with inflammation. Giardiasis also does not induce significant villous architectural change or an inflammatory response. Majority of patients with Giardiasis have none or relatively mild abnormalities of villous architecture and no or minimal inflammation. However the full spectrum of abnormalities ranging from normal to subtotal villous atrophy has been described in human giardiasis. Patients with symptomatic giardiasis may have normal villous architecture with no mucosal inflammation and if abetalipoproteinemia was not provided amongst the options, Giardiasis should have been the single best answer of choice. Patients with symptomatic giardiasis may have normal villous architecture with no mucosal inflammation and if abetalipoproteinemia was not provided amongst the options, Giardiasis should have been the single best 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: Which of the following condition causing malabsorption has no effect on villus architecture and no inflammatory reaction?, with the following options: A: Giardiasis, B: Crohn's, C: Whipple's, D: Abetalipoprotienemia + +### Response: +Answer is D (Abetalipoprotenemia) Abetalipoproteinemia is typically associated with normal villas architecture and no inflammatory reaction. Features of lipid accumulation within enterocytes (vacuolated epithelial cells) is diagnostic and specific. Crohn's Disease and Whipple's disease are typically associated with inflammation. Giardiasis also does not induce significant villous architectural change or an inflammatory response. Majority of patients with Giardiasis have none or relatively mild abnormalities of villous architecture and no or minimal inflammation. However the full spectrum of abnormalities ranging from normal to subtotal villous atrophy has been described in human giardiasis. Patients with symptomatic giardiasis may have normal villous architecture with no mucosal inflammation and if abetalipoproteinemia was not provided amongst the options, Giardiasis should have been the single best answer of choice. Patients with symptomatic giardiasis may have normal villous architecture with no mucosal inflammation and if abetalipoproteinemia was not provided amongst the options, Giardiasis should have been the single best answer of choice +### End" +921,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 60 yrs old pt presenting with dysphagia of 6 wks duration with solid foods. Now can swallow only liquids. Investigations done to diagnose here ?, with the following options: A: CxR, B: Ba Swallow, C: Endoscopy, D: All + +### Response: +","Ans is 'a' i.e. CXR; 'b' i.e. Ba- swallow; 'c' i.e. Endoscopy A progressive dysphagia first for solid only and later for liquids also, suggests mechanical obstruction such as carcinoma or peptic stricture. Patients with peptic stricture give h/o chronic reflux disease. So this is most probably a case of carcinoma. Investigations done in Ca esophagus Chest X-ray can show metastasis, plural effussion or complication of aspiration (pneumonia, lung abscess) Ba swallow this is the first investigation for any esophageal disease it can show - irregular filling defect with or without proximal dilatation. - annular lesion appear as constricting bands CT scan - are useful to diagnose liver metastasis, and lymph node involvement. Can also show the local spread of Ca. Esophageal endosonography - is quite accurate in determination of wall penetration and mediastinal invasion. Endoscopy & biopsy - this is the investigation of choice for esophageal Ca.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 60 yrs old pt presenting with dysphagia of 6 wks duration with solid foods. Now can swallow only liquids. Investigations done to diagnose here ?, with the following options: A: CxR, B: Ba Swallow, C: Endoscopy, D: All + +### Response: +Ans is 'a' i.e. CXR; 'b' i.e. Ba- swallow; 'c' i.e. Endoscopy A progressive dysphagia first for solid only and later for liquids also, suggests mechanical obstruction such as carcinoma or peptic stricture. Patients with peptic stricture give h/o chronic reflux disease. So this is most probably a case of carcinoma. Investigations done in Ca esophagus Chest X-ray can show metastasis, plural effussion or complication of aspiration (pneumonia, lung abscess) Ba swallow this is the first investigation for any esophageal disease it can show - irregular filling defect with or without proximal dilatation. - annular lesion appear as constricting bands CT scan - are useful to diagnose liver metastasis, and lymph node involvement. Can also show the local spread of Ca. Esophageal endosonography - is quite accurate in determination of wall penetration and mediastinal invasion. Endoscopy & biopsy - this is the investigation of choice for esophageal Ca. +### End" +922,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: B-cells are dispersed in which pa of spleen?, with the following options: A: White pulp, B: Red pulp, C: Capsule, D: None + +### Response: +","Ans. is 'a' i.e., White pulp","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: B-cells are dispersed in which pa of spleen?, with the following options: A: White pulp, B: Red pulp, C: Capsule, D: None + +### Response: +Ans. is 'a' i.e., White pulp +### End" +923,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All statements are true regarding skin except, with the following options: A: Skin is stratified squamous epithelium, B: Melanocyte & merkel cells are immigrant cells, C: Keratin filaments are a hall mark of epidermal cells, D: Keratinization process cause hydration of cells + +### Response: +",D i.e. Keratinization process cause hydration of cells,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: All statements are true regarding skin except, with the following options: A: Skin is stratified squamous epithelium, B: Melanocyte & merkel cells are immigrant cells, C: Keratin filaments are a hall mark of epidermal cells, D: Keratinization process cause hydration of cells + +### Response: +D i.e. Keratinization process cause hydration of cells +### End" +924,"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 characteristic finding in AGN?, with the following options: A: Red blood cell cast, B: Hematuria, C: Proteinuria, D: Epithelial Cells + +### Response: +",* RBC casts indicate glomerular bleeding and are seen with acute glomerulonephritis. * Hematuria can be seen with even kidney stones or bladder cancer and hence is not a characteristic finding of AGN.,"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 characteristic finding in AGN?, with the following options: A: Red blood cell cast, B: Hematuria, C: Proteinuria, D: Epithelial Cells + +### Response: +* RBC casts indicate glomerular bleeding and are seen with acute glomerulonephritis. * Hematuria can be seen with even kidney stones or bladder cancer and hence is not a characteristic finding of AGN. +### End" +925,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Dorsal column lesions are associated with loss of:, with the following options: A: Ankle jerk, B: Knee jerk, C: Proprioception, D: Superficial abdominal reflexes + +### Response: +","Ans: C (Proprioception) Ref: Harrison's Principles of Internal Medicine, 18th ed.Explanation:The posterior column (dorsal column)It refers to the area of white matter in the dorsomedial side of the spinal cord.It is made up of the fasciculus gracilis and fasciculus cuneatusIt is part of an ascending pathway that is important for well-localized fine touch and conscious proprioception called the posterior column-medial lemniscus pathway.Joint capsules, tactile and pressure receptors send a signal through the dorsal root ganglia up through the fasciculus gracilis for lower body sensory impulses and the fasciculus cuneatus for upper body impulses.Once the fasciculus gracilis reaches the nucleus gracilis and the fasciculus cuneatus reaches the nucleus cuneatus in the lower medulla, they begin to cross over the medulla as the internal arcuate fibers.When they reach the contralateral side, they become the medial lemniscus, which is the second part of the posterior column-medial lemniscus pathway.Lesions in this pathway can diminish oi completely abolish tactile sensations and movement or position sense below the lesionTests of sensationModalityPathwayLight touchLarge fast-conducting axonsProprioceptionDorsal columnsVibrationMedial lemniscusTwo-point discrimination Pinprick (superficial pain)Smaller slower-conducting axonsSpinothalamic tracts Deep painTemperature StereognosisParietal cortex (only valid if peripheral sensory function intact)GraphaesthesiaTwo-point discrimination","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Dorsal column lesions are associated with loss of:, with the following options: A: Ankle jerk, B: Knee jerk, C: Proprioception, D: Superficial abdominal reflexes + +### Response: +Ans: C (Proprioception) Ref: Harrison's Principles of Internal Medicine, 18th ed.Explanation:The posterior column (dorsal column)It refers to the area of white matter in the dorsomedial side of the spinal cord.It is made up of the fasciculus gracilis and fasciculus cuneatusIt is part of an ascending pathway that is important for well-localized fine touch and conscious proprioception called the posterior column-medial lemniscus pathway.Joint capsules, tactile and pressure receptors send a signal through the dorsal root ganglia up through the fasciculus gracilis for lower body sensory impulses and the fasciculus cuneatus for upper body impulses.Once the fasciculus gracilis reaches the nucleus gracilis and the fasciculus cuneatus reaches the nucleus cuneatus in the lower medulla, they begin to cross over the medulla as the internal arcuate fibers.When they reach the contralateral side, they become the medial lemniscus, which is the second part of the posterior column-medial lemniscus pathway.Lesions in this pathway can diminish oi completely abolish tactile sensations and movement or position sense below the lesionTests of sensationModalityPathwayLight touchLarge fast-conducting axonsProprioceptionDorsal columnsVibrationMedial lemniscusTwo-point discrimination Pinprick (superficial pain)Smaller slower-conducting axonsSpinothalamic tracts Deep painTemperature StereognosisParietal cortex (only valid if peripheral sensory function intact)GraphaesthesiaTwo-point discrimination +### End" +926,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Apoptosis is inhibited by, with the following options: A: p53, B: N-myC, C: RAS, D: BCl-2 + +### Response: +","The integrity of the mitochondrial outer membrane is regulated by pro-apoptotic and anti-apoptotic members of the BCL2 family of proteins. The pro-apoptotic proteins BAX and BAK are directly promoting mitochondrial permeabilization. Their action is inhibited by the anti-apoptotic proteins BCL2 and BCL-XL. The third set of proteins, the so-called BH3-only proteins, which include BAD, BID, and PUMA, regulate the balance between the pro- and anti-apoptotic members of the BCL2 family.( Robbins Basic Pathology, 9th edition, page 189 )","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Apoptosis is inhibited by, with the following options: A: p53, B: N-myC, C: RAS, D: BCl-2 + +### Response: +The integrity of the mitochondrial outer membrane is regulated by pro-apoptotic and anti-apoptotic members of the BCL2 family of proteins. The pro-apoptotic proteins BAX and BAK are directly promoting mitochondrial permeabilization. Their action is inhibited by the anti-apoptotic proteins BCL2 and BCL-XL. The third set of proteins, the so-called BH3-only proteins, which include BAD, BID, and PUMA, regulate the balance between the pro- and anti-apoptotic members of the BCL2 family.( Robbins Basic Pathology, 9th edition, page 189 ) +### End" +927,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Wernicke's heminopic pupillary reaction indicates lesions at the level of:, with the following options: A: Optic tract, B: Distal pa of optic nerve, C: Optic chiasma, D: Optic radiations + +### Response: +",Ans. Optic tract,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Wernicke's heminopic pupillary reaction indicates lesions at the level of:, with the following options: A: Optic tract, B: Distal pa of optic nerve, C: Optic chiasma, D: Optic radiations + +### Response: +Ans. Optic tract +### End" +928,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The assessment of Health Programme where the benefit is expressed in terms of results achieved is called –, with the following options: A: Cost benefit analysis, B: Cost effective analysis, C: Cost accounting, D: Cost containment + +### Response: +","Cost-benefit analysis + +The economic benefit of any programme are compared with the cost of that programme +The benefits are expressed in monetary terms. + +Cost - effective analysis + +It is similar to cost - benefit analysis except that benefit, instead of being expressed in monetary terms is expressed in terms of results achieved, e.g., number of live saved, the number of days free from disease. + +Cost-accounting + +Cost accounting establishes budget and actual cost of operations or processes and the analysis of variance, profitability or social use of funds.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The assessment of Health Programme where the benefit is expressed in terms of results achieved is called –, with the following options: A: Cost benefit analysis, B: Cost effective analysis, C: Cost accounting, D: Cost containment + +### Response: +Cost-benefit analysis + +The economic benefit of any programme are compared with the cost of that programme +The benefits are expressed in monetary terms. + +Cost - effective analysis + +It is similar to cost - benefit analysis except that benefit, instead of being expressed in monetary terms is expressed in terms of results achieved, e.g., number of live saved, the number of days free from disease. + +Cost-accounting + +Cost accounting establishes budget and actual cost of operations or processes and the analysis of variance, profitability or social use of funds. +### End" +929,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Viruses can be grown using all of the following except:, with the following options: A: Tissue culture, B: Embryonated eggs, C: Animals, D: Enriched media + +### Response: +","Ans. D. Enriched mediaViruses are strict/obligate cellular parasites, as they lack necessary enzymes for nucleic acid and protein synthesis. They are dependent on host cells for this, hence can't grow in cell free (artificial) culture medium.Methods for virus isolation/culturea. Animalb. Embryonated eggs (CAM, Amnion, Allantoic, Yolk sac)c. Tissue Culture","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Viruses can be grown using all of the following except:, with the following options: A: Tissue culture, B: Embryonated eggs, C: Animals, D: Enriched media + +### Response: +Ans. D. Enriched mediaViruses are strict/obligate cellular parasites, as they lack necessary enzymes for nucleic acid and protein synthesis. They are dependent on host cells for this, hence can't grow in cell free (artificial) culture medium.Methods for virus isolation/culturea. Animalb. Embryonated eggs (CAM, Amnion, Allantoic, Yolk sac)c. Tissue Culture +### End" +930,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about Carcinoma cervix :, with the following options: A: 90% associated with HPV, B: Nulliparity, C: androgens, D: Immunocompetent patients + +### Response: +","Cervical cancer is the most common genital tract malignancy in females in India.There are many clinical characteristics that predispose a woman to cervical cancer. These high-risk features are: Average age 35-45 years. Pre-cancerous lesions occur 10-15 years earlier. Coitus before the age of 18 years. Multiple sexual paners. Delivery of the first baby before the age of 20 years. Multiparity with poor bih spacing between pregnancies. Poor personal hygiene. Carcinoma of the cervix shares similar epidemiological features to those of sexually transmitted diseases and viral infections and these are strongly linked to cancer cervix as causative agents. Poor socioeconomic status. At one time, exposure to smegma from uncircumcised paners was considered an impoant factor, accounting for lower incidence of cancer of the cervix amongst Jews and Muslims. Now it is realized that the incidence of human papilloma virus (HPV) is low in circumcised men, and that is the reason for low incidence of cancer in their wives. Smoking and drug abuse, including alcohol, are immunosuppressive (13-fold). Women with STD, HIV infection, herpes simplex virus 2 infection, HPV infection (16, 18, 31, 33) and condylomata have a high predisposition to cancer. Of these, HPV is now considered the most impoant oncogenic cause. Most HPV infection 16, 18 are symptomless in young women and clear within 2 years. Persistent infection is the cause of cancer of the cervix in 70-90% cases.Before the age of 30 years, 90% women with intact immune system are able to get rid of HPV infections. 10% with persistent infection after the age of 30 years tend to progress to CIN or invasive cancer. Immunosuppressed individuals (following transplant surgery), viral infections and HIV. Women with pre-invasive lesions. Women who do not come for regular health check-up and Pap tests. COC and progestogens use over 8-year periods can cause adenocarcinoma of the endocervix (double the risk). Five per cent women exposed to diethylstilboestrol in utero developed carcinoma of vagina and cervix. With withdrawal of this hormone, its incidence has dropped. Reference : Shaw's Textbook of Gynaecology;16th edition; Pg no: 485","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about Carcinoma cervix :, with the following options: A: 90% associated with HPV, B: Nulliparity, C: androgens, D: Immunocompetent patients + +### Response: +Cervical cancer is the most common genital tract malignancy in females in India.There are many clinical characteristics that predispose a woman to cervical cancer. These high-risk features are: Average age 35-45 years. Pre-cancerous lesions occur 10-15 years earlier. Coitus before the age of 18 years. Multiple sexual paners. Delivery of the first baby before the age of 20 years. Multiparity with poor bih spacing between pregnancies. Poor personal hygiene. Carcinoma of the cervix shares similar epidemiological features to those of sexually transmitted diseases and viral infections and these are strongly linked to cancer cervix as causative agents. Poor socioeconomic status. At one time, exposure to smegma from uncircumcised paners was considered an impoant factor, accounting for lower incidence of cancer of the cervix amongst Jews and Muslims. Now it is realized that the incidence of human papilloma virus (HPV) is low in circumcised men, and that is the reason for low incidence of cancer in their wives. Smoking and drug abuse, including alcohol, are immunosuppressive (13-fold). Women with STD, HIV infection, herpes simplex virus 2 infection, HPV infection (16, 18, 31, 33) and condylomata have a high predisposition to cancer. Of these, HPV is now considered the most impoant oncogenic cause. Most HPV infection 16, 18 are symptomless in young women and clear within 2 years. Persistent infection is the cause of cancer of the cervix in 70-90% cases.Before the age of 30 years, 90% women with intact immune system are able to get rid of HPV infections. 10% with persistent infection after the age of 30 years tend to progress to CIN or invasive cancer. Immunosuppressed individuals (following transplant surgery), viral infections and HIV. Women with pre-invasive lesions. Women who do not come for regular health check-up and Pap tests. COC and progestogens use over 8-year periods can cause adenocarcinoma of the endocervix (double the risk). Five per cent women exposed to diethylstilboestrol in utero developed carcinoma of vagina and cervix. With withdrawal of this hormone, its incidence has dropped. Reference : Shaw's Textbook of Gynaecology;16th edition; Pg no: 485 +### End" +931,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Placenta previa true are:, with the following options: A: Incidence increases by two fold after LSCS, B: More common in primipara, C: Most common in developed countries, D: 1 per 1000 pregnancies + +### Response: +","Chances of placenta previa are increased in case of history of prior cesarean section— +“The probability of placenta previa is four times greater in patients with prior cesareans than in patients without uterine scars.” +Fernando Arias 3/e, p 333, 334 +Therefore, option a is correct (partly though) because the option says two-fold increase +As far as - other options are concerned: +Option ‘b’ i.e. it is more common in primipara is absolutely wrong as - placenta previa is more common in multipara. +Option ‘c’ It is more common in developed countries. +Now that is incorrect because - +“Increased family planning acceptance with limitation and spacing of birth, lowers the incidence of placenta previa.” +Dutta obs 6/e, p 243 +Which clearly means it is less common in developed countries than in developing countries. +Option ‘d’ - Incidence is 1 per 1000 pregnancies: +According to Dutta Obs 6/e, p 243 +“Incidence of placenta previa ranges from 0.5 to 1% among hospital deliveries.” +“According to 2003 birth certificate data in the US, placenta previa complicated almost 1 in 300 deliveries” +Williams Obs 23/e, p 770 +i.e. option ‘d’ is incorrect. +As far as option e is concerned placenta previa is a cause of APH and not PPH. So, amongst all options - option ‘a’ is partly correct, so it is the answer of choice here","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Placenta previa true are:, with the following options: A: Incidence increases by two fold after LSCS, B: More common in primipara, C: Most common in developed countries, D: 1 per 1000 pregnancies + +### Response: +Chances of placenta previa are increased in case of history of prior cesarean section— +“The probability of placenta previa is four times greater in patients with prior cesareans than in patients without uterine scars.” +Fernando Arias 3/e, p 333, 334 +Therefore, option a is correct (partly though) because the option says two-fold increase +As far as - other options are concerned: +Option ‘b’ i.e. it is more common in primipara is absolutely wrong as - placenta previa is more common in multipara. +Option ‘c’ It is more common in developed countries. +Now that is incorrect because - +“Increased family planning acceptance with limitation and spacing of birth, lowers the incidence of placenta previa.” +Dutta obs 6/e, p 243 +Which clearly means it is less common in developed countries than in developing countries. +Option ‘d’ - Incidence is 1 per 1000 pregnancies: +According to Dutta Obs 6/e, p 243 +“Incidence of placenta previa ranges from 0.5 to 1% among hospital deliveries.” +“According to 2003 birth certificate data in the US, placenta previa complicated almost 1 in 300 deliveries” +Williams Obs 23/e, p 770 +i.e. option ‘d’ is incorrect. +As far as option e is concerned placenta previa is a cause of APH and not PPH. So, amongst all options - option ‘a’ is partly correct, so it is the answer of choice here +### End" +932,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: pulmonary embolism is best diagnosed by ?, with the following options: A: ecg, B: perfusion scan, C: angiography, D: plain xray + +### Response: +","Angiography : Angiography is a diagnostic test used by ophthalmologists to photograph structures in the back of the eye and is especially useful in finding damage to the blood vessels, which nourish the retina. There are two types of angiography: fluorescein and indocyanine green (ICG). Fluorescein angiography is used primarily to study blood circulation in and just beneath the surface of the retina, while ICG angiography is better for photographing the deeper choroidal vessels 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: pulmonary embolism is best diagnosed by ?, with the following options: A: ecg, B: perfusion scan, C: angiography, D: plain xray + +### Response: +Angiography : Angiography is a diagnostic test used by ophthalmologists to photograph structures in the back of the eye and is especially useful in finding damage to the blood vessels, which nourish the retina. There are two types of angiography: fluorescein and indocyanine green (ICG). Fluorescein angiography is used primarily to study blood circulation in and just beneath the surface of the retina, while ICG angiography is better for photographing the deeper choroidal vessels ref : david sutton 9th ed +### End" +933,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Tract ABSENT in superior cerebellar peduncle, with the following options: A: Tecto-cerebellar, B: Dentato thalamic, C: Dorsal spinocerebellar, D: Ventral spinocerebellar + +### Response: +",* Dorsal spinocerebellar fibers pass through inferior (not superior) cerebellar peduncle. Peduncle Afferent Middle cerebellar peduncle Coico ponto cerebellar tract Inferior cerebellar peduncle Olivocerebellar tract Dorsal Spinocerebellar Superior cerebellar peduncle Ventral spinocerebellar Tectocerebellar * Efferent fiber of superior cerebellar peduncle : Dento Rubro thalamic tract,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Tract ABSENT in superior cerebellar peduncle, with the following options: A: Tecto-cerebellar, B: Dentato thalamic, C: Dorsal spinocerebellar, D: Ventral spinocerebellar + +### Response: +* Dorsal spinocerebellar fibers pass through inferior (not superior) cerebellar peduncle. Peduncle Afferent Middle cerebellar peduncle Coico ponto cerebellar tract Inferior cerebellar peduncle Olivocerebellar tract Dorsal Spinocerebellar Superior cerebellar peduncle Ventral spinocerebellar Tectocerebellar * Efferent fiber of superior cerebellar peduncle : Dento Rubro thalamic tract +### End" +934,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The following diseases have defect in DNA repair mechanism except for, with the following options: A: Xeroderma Pigmentosa, B: Fanconi syndrome, C: Huntington's disease, D: Hereditary non polyposis colon cancer + +### Response: +",Robbins basic pathology 9th edition page no 840 Huntington disease is an autosomal dominant movement disorder associated with degeneration of the striatum. All other disorders have defect in DNA,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The following diseases have defect in DNA repair mechanism except for, with the following options: A: Xeroderma Pigmentosa, B: Fanconi syndrome, C: Huntington's disease, D: Hereditary non polyposis colon cancer + +### Response: +Robbins basic pathology 9th edition page no 840 Huntington disease is an autosomal dominant movement disorder associated with degeneration of the striatum. All other disorders have defect in DNA +### End" +935,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mili is suspected to have an infection on her second pre-natal visit. Her pet cat could act as a reservoir for which of the following conditions?, with the following options: A: Toxoplasma gondii, B: Rabies, C: Streptocerca infection, D: Plague + +### Response: +","Toxoplasmosis is usually a self-limiting infection due to a parasite called Toxoplasma gondii. The toxoplasmosis parasitic disease is capable of infecting almost all species of warm-blooded animals, including humans, but the primary host is the various members of the cat family. They are the only hosts in which the oocyst-producing sexual stage of Toxoplasma can develop. A wide host range, comprising all the hot-blooded animals including birds and rodents, can serve as a reservoir of rabies. Monkeys are reservoirs for Streptocerca. Wild rodents such as field mice, gerbils, and skunks are the natural reservoir of plague. In India, Tatera indica (wild rat) is considered the main reservoir and not Ratus ratus (domestic rat).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mili is suspected to have an infection on her second pre-natal visit. Her pet cat could act as a reservoir for which of the following conditions?, with the following options: A: Toxoplasma gondii, B: Rabies, C: Streptocerca infection, D: Plague + +### Response: +Toxoplasmosis is usually a self-limiting infection due to a parasite called Toxoplasma gondii. The toxoplasmosis parasitic disease is capable of infecting almost all species of warm-blooded animals, including humans, but the primary host is the various members of the cat family. They are the only hosts in which the oocyst-producing sexual stage of Toxoplasma can develop. A wide host range, comprising all the hot-blooded animals including birds and rodents, can serve as a reservoir of rabies. Monkeys are reservoirs for Streptocerca. Wild rodents such as field mice, gerbils, and skunks are the natural reservoir of plague. In India, Tatera indica (wild rat) is considered the main reservoir and not Ratus ratus (domestic rat). +### End" +936,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: 75% contribution to parasympathetic system is by which cranial nerve -, with the following options: A: Oculomotor, B: Facial, C: Glossopharyngeal, D: Vagus + +### Response: +","Ans. is D i.e., Vagus ""Vagus nerve contains almost 75% of all parasympathetic nerve fibers"" - Clinical anatomy ""About 75% of all parasympathetic nerve fibers are in vagus nerve"" - Miller's Anesthesia","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: 75% contribution to parasympathetic system is by which cranial nerve -, with the following options: A: Oculomotor, B: Facial, C: Glossopharyngeal, D: Vagus + +### Response: +Ans. is D i.e., Vagus ""Vagus nerve contains almost 75% of all parasympathetic nerve fibers"" - Clinical anatomy ""About 75% of all parasympathetic nerve fibers are in vagus nerve"" - Miller's Anesthesia +### End" +937,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Regarding Vulval Carcinoma, false statement is :, with the following options: A: Squamous hyperplasia predisposes, B: Paget's disease of vulva predisposes, C: Lichen planus, D: Condylomata acuminata + +### Response: +","Predisposing diseases for vulval carcinoma are: Bowen's disease Paget'sdisease microinvasive melanoma insitu lichen sclerosis condyloma accuminata SHAW'S TEXTBOOK OF GYNECOLOGY.,Pg no:393,15th edition","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Regarding Vulval Carcinoma, false statement is :, with the following options: A: Squamous hyperplasia predisposes, B: Paget's disease of vulva predisposes, C: Lichen planus, D: Condylomata acuminata + +### Response: +Predisposing diseases for vulval carcinoma are: Bowen's disease Paget'sdisease microinvasive melanoma insitu lichen sclerosis condyloma accuminata SHAW'S TEXTBOOK OF GYNECOLOGY.,Pg no:393,15th edition +### End" +938,"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 combination shows antimicrobial synergism?, with the following options: A: Penicillin + Streptomycin in SABE, B: Ampicillin + Tetracycline in endocarditis, C: Sulfamethoxazole + Trimethoprim in UTI, D: Amphotericin B + Flucytosine in cryptococcal meningitis + +### Response: +","Every AMA has a specific effect on selected microorganisms. Depending on the drug pair as well as the organism involved, either synergism (supra-additive effect), additive action, indifference or antagonism may be observed when two AMAs belonging to different classes are used together Every combination is unique; the same drugs may be synergistic for one organism but antagonistic for another. However, general guidelines are: (a) Two bacteriostatic agents are often additive, rarely synergistic,i.e. combination of tetracyclines, chloramphenicol, erythromycin, etc. (b) Two bactericidal drugs are frequently additive and sometime synergistic if the organism is sensitive to both, e.g.: * Penicillin/ ampicillin + streptomycin/ gentamicin or vancomycin + gentamicin for enterococcal SABE. Penicillins by acting on the cell wall may enhance the penetration of the aminoglycoside into the bacterium (c) Combination of a bactericidal with a bacteriostatic drug may be synergistic or antagonistic depending on the organism ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:677","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 combination shows antimicrobial synergism?, with the following options: A: Penicillin + Streptomycin in SABE, B: Ampicillin + Tetracycline in endocarditis, C: Sulfamethoxazole + Trimethoprim in UTI, D: Amphotericin B + Flucytosine in cryptococcal meningitis + +### Response: +Every AMA has a specific effect on selected microorganisms. Depending on the drug pair as well as the organism involved, either synergism (supra-additive effect), additive action, indifference or antagonism may be observed when two AMAs belonging to different classes are used together Every combination is unique; the same drugs may be synergistic for one organism but antagonistic for another. However, general guidelines are: (a) Two bacteriostatic agents are often additive, rarely synergistic,i.e. combination of tetracyclines, chloramphenicol, erythromycin, etc. (b) Two bactericidal drugs are frequently additive and sometime synergistic if the organism is sensitive to both, e.g.: * Penicillin/ ampicillin + streptomycin/ gentamicin or vancomycin + gentamicin for enterococcal SABE. Penicillins by acting on the cell wall may enhance the penetration of the aminoglycoside into the bacterium (c) Combination of a bactericidal with a bacteriostatic drug may be synergistic or antagonistic depending on the organism ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:677 +### End" +939,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Lowest frequency of twin pregnancy is seen in:, with the following options: A: Nigeria, B: Philippines, C: India, D: Japan + +### Response: +","
Lowest frequency of twin pregnancy is seen in Japan(2/1000). Reference:Textbook of obstetrics,Sheila Balakrishnan,2nd edition,page no:178. <\p>","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Lowest frequency of twin pregnancy is seen in:, with the following options: A: Nigeria, B: Philippines, C: India, D: Japan + +### Response: +
Lowest frequency of twin pregnancy is seen in Japan(2/1000). Reference:Textbook of obstetrics,Sheila Balakrishnan,2nd edition,page no:178. <\p> +### End" +940,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mammography can be best used in?, with the following options: A: Early breast carcinoma, B: Mastitis, C: Fibroadenoma, D: Phylloides tumor + +### Response: +","Ans. a (Early breast carcinoma). (Grainger, Diagnostic Radiology, 4th/pg.2245)Indications for mammography# Screening asymptomatic women aged 50 years and over# Screening asymptomatic women aged 35 years and over who have a high risk of developing breast cancer:- women who have one or more first degree relatives who have been diagnosed with premenopausal breast cancer- women with histologic risk factors found at previous surgery, e.g. atypical ductal hyperplasia# Investigation of symptomatic women aged 35 years and over with a breast lump or other clinical evidence of breast cancer# Surveillance of the breast following local excision of breast carcinoma# Evaluation of a breast lump in women following augmentation mammoplasty# Investigation of a suspicious breast lump in a man.# Before breast surgery, as it may avert an unnecessary biopsy demonstrating that the palpable mass has a character istically benign appearance.# Follow up of breast cancer patients.# Work up a patient with metastases from an unknown primary.# Mammographic screening is best screening method for carcinoma breast.- MRI is emerging as perhaps the most promising imaging investigation for breast cancer detection to date.# Positron emission tomography (PET) may not yet be sensitive enough for small occult lesions mammographically detected by screening.Mammographic features of breast cancer: (AIIMS NOV 2003)# The most common mammographic appearance of invasive carcinoma is a ""spiculated"" mass.# ""Microcalcifications"" may be seen in 30% cases of invasive carcinoma & 95% of cases of DCIS (granular & casting).# Its ""sunburst"" appearance readily distinguishes it from benign breast masses.# Often the tumor mass itself may not be visible, so that the only evidence of carcinoma is the presence of abnormal trabecular markings i.e. ""distorted architecture"".# Individual straight dense spicules with central solid mass which has little change in different views known as ""white star"" stellate or speculated breast lesion favours malignancy.# On mammography, this typically appears as linear, fragmented, branching, irregular and 'casting type' calcifications.Mammographic features of benign breast lesion:# Well defined nodules < 1 cm are of low risk for cancer.# 'Halo' sign of apparent lucency due to optical illusion of mach effect + true radiolucent halo is almost always benign.# Fat containing lesions (e.g. galactocele, hamartoma, traumatic cyst) are never malignant.# Granular calcification (amorphous, dot like/elongated, fragmented grouped very closely to each other) & casting calcification (fragmented cast of calcification within ducts) favour malignancy.# Clinical examination, Mammography, biopsy/cytology = TRIPLE ASSESSMENT for carcinoma breast.# The mammographic appearance of the breast depends on the relative amounts of fat and glandular tissue which are present. The young womanys breast contains a large proportion of glandular tissue which appears as soft-tissue density on the mammogram; in older women, when involution of the glandular tissue has occurred, most of the breast tissue appears of fatty density.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mammography can be best used in?, with the following options: A: Early breast carcinoma, B: Mastitis, C: Fibroadenoma, D: Phylloides tumor + +### Response: +Ans. a (Early breast carcinoma). (Grainger, Diagnostic Radiology, 4th/pg.2245)Indications for mammography# Screening asymptomatic women aged 50 years and over# Screening asymptomatic women aged 35 years and over who have a high risk of developing breast cancer:- women who have one or more first degree relatives who have been diagnosed with premenopausal breast cancer- women with histologic risk factors found at previous surgery, e.g. atypical ductal hyperplasia# Investigation of symptomatic women aged 35 years and over with a breast lump or other clinical evidence of breast cancer# Surveillance of the breast following local excision of breast carcinoma# Evaluation of a breast lump in women following augmentation mammoplasty# Investigation of a suspicious breast lump in a man.# Before breast surgery, as it may avert an unnecessary biopsy demonstrating that the palpable mass has a character istically benign appearance.# Follow up of breast cancer patients.# Work up a patient with metastases from an unknown primary.# Mammographic screening is best screening method for carcinoma breast.- MRI is emerging as perhaps the most promising imaging investigation for breast cancer detection to date.# Positron emission tomography (PET) may not yet be sensitive enough for small occult lesions mammographically detected by screening.Mammographic features of breast cancer: (AIIMS NOV 2003)# The most common mammographic appearance of invasive carcinoma is a ""spiculated"" mass.# ""Microcalcifications"" may be seen in 30% cases of invasive carcinoma & 95% of cases of DCIS (granular & casting).# Its ""sunburst"" appearance readily distinguishes it from benign breast masses.# Often the tumor mass itself may not be visible, so that the only evidence of carcinoma is the presence of abnormal trabecular markings i.e. ""distorted architecture"".# Individual straight dense spicules with central solid mass which has little change in different views known as ""white star"" stellate or speculated breast lesion favours malignancy.# On mammography, this typically appears as linear, fragmented, branching, irregular and 'casting type' calcifications.Mammographic features of benign breast lesion:# Well defined nodules < 1 cm are of low risk for cancer.# 'Halo' sign of apparent lucency due to optical illusion of mach effect + true radiolucent halo is almost always benign.# Fat containing lesions (e.g. galactocele, hamartoma, traumatic cyst) are never malignant.# Granular calcification (amorphous, dot like/elongated, fragmented grouped very closely to each other) & casting calcification (fragmented cast of calcification within ducts) favour malignancy.# Clinical examination, Mammography, biopsy/cytology = TRIPLE ASSESSMENT for carcinoma breast.# The mammographic appearance of the breast depends on the relative amounts of fat and glandular tissue which are present. The young womanys breast contains a large proportion of glandular tissue which appears as soft-tissue density on the mammogram; in older women, when involution of the glandular tissue has occurred, most of the breast tissue appears of fatty density. +### End" +941,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Koplik's Spots are seen in -, with the following options: A: Rubeola, B: Rubella, C: Diphtheria, D: Polio + +### Response: +","Ans. is 'a' i.e., Rubeola Clinical features of measles (rubeola)o Clinical features are divided into following stages :-1) Prodromal stage# It begins 10 days after the infection and is characterized by fever, coryza with sneezing, lacrimation and photophobia. A day or two before eruptive phase (appearance of rash), Koplik spot (pathognomonic of measles) appears on buccal mucosa, opposite the 1st and 2nd lower molars.2) Eruptive phase# It begins 14 days after infection. A maculopapular rash begins behind the ears and spreads rapidly.3) Post measle stage# It is characterized by weight loss, growth retardation, diarrhea, cancrum oris, candidiasis, reactivation of TB and malnutrition particularly vitamin A deficiency (keratomalacia, xerophthalmia).","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Koplik's Spots are seen in -, with the following options: A: Rubeola, B: Rubella, C: Diphtheria, D: Polio + +### Response: +Ans. is 'a' i.e., Rubeola Clinical features of measles (rubeola)o Clinical features are divided into following stages :-1) Prodromal stage# It begins 10 days after the infection and is characterized by fever, coryza with sneezing, lacrimation and photophobia. A day or two before eruptive phase (appearance of rash), Koplik spot (pathognomonic of measles) appears on buccal mucosa, opposite the 1st and 2nd lower molars.2) Eruptive phase# It begins 14 days after infection. A maculopapular rash begins behind the ears and spreads rapidly.3) Post measle stage# It is characterized by weight loss, growth retardation, diarrhea, cancrum oris, candidiasis, reactivation of TB and malnutrition particularly vitamin A deficiency (keratomalacia, xerophthalmia). +### End" +942,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: After A a young male presented with non pulsatile retroperitoneal hematoma. On table IVU was done. Right kidney not visualized. Left kidney showed immediate excretion of dye. What is next step in management:, with the following options: A: Nephrectomy, B: Open Gerota's fascia and explore proximal renal vessels, C: Perform Retrograde pyelography, D: Perform on table angiography + +### Response: +","Ans is 'd' i.e. Perform on table angiography ""nonvisualization of the kidney requires immediate aeriography or CT scan to determine whether renal vascular injury exists.""- Smith's Urology ""Absence of kidney perfusion is an indication for renal aery angiography""- Sabiston The major causes of nonvisualization on an IVU are total pedicle avulsion, aerial thrombosis, severe contusion causing vascular spasm, and absence of the kidney. Aeriography would help identify major aerial and parenchymal injuries.Aerial thrombosis and avulsion of the renal pedicle are best diagnosed by aeriography. Also know: Best imaging study to detect and stage renal and retroperitoneal injuries is - computed tomography with contrast media. It can define the size and extent of the retroperitoneal hematoma, renal lacerations, urinary extravasation, and renal aerial and venous injuries; additionally, it can detect other intra-abdominal injuries. Management: Blunt injuries--Minor renal injuries from blunt trauma account for 85% of cases and do not usually require operation. Bleeding stops spontaneously with bed rest and hydration. Cases in which operation is indicated include those associated with persistent retroperitoneal bleeding, urinary extravasation, evidence of nonble renal parenchyma, and renal pedicle injuries (less than 5% of all renal injuries). Aggressive preoperative staging allows complete definition of injury before operation. Penetrating injuries--Penetrating injuries should be surgically explored. A rare exception to this rule is when staging has been complete and only minor parenchymal injury, with no urinary extravasation, is noted. In 80% of cases of penetrating injury, associated organ injury requires operation; thus, renal exploration is only an extension of this procedure. In the above question, the patient had non pulsatile hematoma. A pulsatile or expanding hematoma is an indication for surgical exploration.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: After A a young male presented with non pulsatile retroperitoneal hematoma. On table IVU was done. Right kidney not visualized. Left kidney showed immediate excretion of dye. What is next step in management:, with the following options: A: Nephrectomy, B: Open Gerota's fascia and explore proximal renal vessels, C: Perform Retrograde pyelography, D: Perform on table angiography + +### Response: +Ans is 'd' i.e. Perform on table angiography ""nonvisualization of the kidney requires immediate aeriography or CT scan to determine whether renal vascular injury exists.""- Smith's Urology ""Absence of kidney perfusion is an indication for renal aery angiography""- Sabiston The major causes of nonvisualization on an IVU are total pedicle avulsion, aerial thrombosis, severe contusion causing vascular spasm, and absence of the kidney. Aeriography would help identify major aerial and parenchymal injuries.Aerial thrombosis and avulsion of the renal pedicle are best diagnosed by aeriography. Also know: Best imaging study to detect and stage renal and retroperitoneal injuries is - computed tomography with contrast media. It can define the size and extent of the retroperitoneal hematoma, renal lacerations, urinary extravasation, and renal aerial and venous injuries; additionally, it can detect other intra-abdominal injuries. Management: Blunt injuries--Minor renal injuries from blunt trauma account for 85% of cases and do not usually require operation. Bleeding stops spontaneously with bed rest and hydration. Cases in which operation is indicated include those associated with persistent retroperitoneal bleeding, urinary extravasation, evidence of nonble renal parenchyma, and renal pedicle injuries (less than 5% of all renal injuries). Aggressive preoperative staging allows complete definition of injury before operation. Penetrating injuries--Penetrating injuries should be surgically explored. A rare exception to this rule is when staging has been complete and only minor parenchymal injury, with no urinary extravasation, is noted. In 80% of cases of penetrating injury, associated organ injury requires operation; thus, renal exploration is only an extension of this procedure. In the above question, the patient had non pulsatile hematoma. A pulsatile or expanding hematoma is an indication for surgical exploration. +### End" +943,"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 bilirubin value of 8 mg/dl and serum creatinine of 1.9 mg/dl is planned for surgery. What is the muscle relaxant of choice in this patient –, with the following options: A: Vecuronium, B: Pancuronium, C: Atracurium, D: Rocuronium + +### Response: +",Atracurium is the muscle relaxant of choice in patient with renal and hepatic dysfunction.,"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 bilirubin value of 8 mg/dl and serum creatinine of 1.9 mg/dl is planned for surgery. What is the muscle relaxant of choice in this patient –, with the following options: A: Vecuronium, B: Pancuronium, C: Atracurium, D: Rocuronium + +### Response: +Atracurium is the muscle relaxant of choice in patient with renal and hepatic dysfunction. +### End" +944,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about heterochromic uveitis-, with the following options: A: Involves posterior surface of iris, B: Involves anterior part of iris, C: Involves posterior chamber, D: Posterior synechiae + +### Response: +","Ans. is 'b' i.e., Involves anterior part of iris o In Fush's heterochromic iridocyclitis, anterior surface is involved more commonly.""Inflammatory membranes are common over the anterior surface of the iris and anterior face of the ciliary body "",.....YanoffFuch's heterochromic iridocyclitis (Fush's uveitis syndrome)o It is a form of anterior and intermediate uveitis.o The condition is usually unilateral and chronic in nature and is characterized by a chronic non-granulomatous uveitis and eventually results in iris heterochromia (a change in the colour of iris),o The disease has following characteristic features :Heterochromia of irisDiffuse stromal iris atrophyFine KPs at back of corneaFaint aqueous flareAbsence of posterior svnechiaeA fairly common rubeosis iridis, sometimes associated with neovascularisation of the angle of anterior chamber.Comparatively early development of complicated cataract and secondary glaucoma (usually open angle type). Glaucoma has been reported in 10-59% of cases.Treatmento Fuch's heterchromic uveitis responds variable to steroids and cycloplegics. The complications of long term use of these drugs may at times outweigh their potential benefits. Therefore, treatment with topical steroids is given to iritis which is sufficiently active to require the treatment, otherwise the patient is routinely followed without giving any treatment.o Cataract responds well to most forms of intraocular surgeries, including the standard IOL implantation.Hyphemia may occur because of rubeosis iridis (neovascularization of iris),o Glaucoma control may be somewhat more problematic, with surgical options indicated for later forms of disease.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about heterochromic uveitis-, with the following options: A: Involves posterior surface of iris, B: Involves anterior part of iris, C: Involves posterior chamber, D: Posterior synechiae + +### Response: +Ans. is 'b' i.e., Involves anterior part of iris o In Fush's heterochromic iridocyclitis, anterior surface is involved more commonly.""Inflammatory membranes are common over the anterior surface of the iris and anterior face of the ciliary body "",.....YanoffFuch's heterochromic iridocyclitis (Fush's uveitis syndrome)o It is a form of anterior and intermediate uveitis.o The condition is usually unilateral and chronic in nature and is characterized by a chronic non-granulomatous uveitis and eventually results in iris heterochromia (a change in the colour of iris),o The disease has following characteristic features :Heterochromia of irisDiffuse stromal iris atrophyFine KPs at back of corneaFaint aqueous flareAbsence of posterior svnechiaeA fairly common rubeosis iridis, sometimes associated with neovascularisation of the angle of anterior chamber.Comparatively early development of complicated cataract and secondary glaucoma (usually open angle type). Glaucoma has been reported in 10-59% of cases.Treatmento Fuch's heterchromic uveitis responds variable to steroids and cycloplegics. The complications of long term use of these drugs may at times outweigh their potential benefits. Therefore, treatment with topical steroids is given to iritis which is sufficiently active to require the treatment, otherwise the patient is routinely followed without giving any treatment.o Cataract responds well to most forms of intraocular surgeries, including the standard IOL implantation.Hyphemia may occur because of rubeosis iridis (neovascularization of iris),o Glaucoma control may be somewhat more problematic, with surgical options indicated for later forms of disease. +### End" +945,"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 absent in breast milk?, with the following options: A: Iron, B: Vitamin A, C: Vitamin D, D: None of the above + +### Response: +",The earlier teaching that human milk is deficient in vitamin D is no longer accepted. Vitamin D is present in human milk in water-soluble form. Human milk contains more vitamin A and vitamin C than cows milk.Recent work shows that iron contained in milk has a high level of bioavailability.Ref: Park; 23rd ed; Pg: 540,"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 absent in breast milk?, with the following options: A: Iron, B: Vitamin A, C: Vitamin D, D: None of the above + +### Response: +The earlier teaching that human milk is deficient in vitamin D is no longer accepted. Vitamin D is present in human milk in water-soluble form. Human milk contains more vitamin A and vitamin C than cows milk.Recent work shows that iron contained in milk has a high level of bioavailability.Ref: Park; 23rd ed; Pg: 540 +### End" +946,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mould therapy is used in the treatment of:, with the following options: A: Pelvic cancer, B: Lung cancer, C: Prostate cancer, D: Skin cancer + +### Response: +","Ans: d (Skin cancer)Mould therapy is actually used in the treatment of penile carcinomas. But in the choices there was no penile cancer.As penile carcinoma can be considered as penile skin cancer and is squamous cell carcinoma, it better to go for the option skin cancer","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Mould therapy is used in the treatment of:, with the following options: A: Pelvic cancer, B: Lung cancer, C: Prostate cancer, D: Skin cancer + +### Response: +Ans: d (Skin cancer)Mould therapy is actually used in the treatment of penile carcinomas. But in the choices there was no penile cancer.As penile carcinoma can be considered as penile skin cancer and is squamous cell carcinoma, it better to go for the option skin cancer +### End" +947,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Flea bitten appearance of the kidney is seen in -, with the following options: A: Malignant hypertension, B: Benign hypertension, C: Chronic pyelonephritis, D: Diabetes mellitus + +### Response: +","Ans. is 'a' i.e., Malignant hypertension Causes of flea - bitten kidney -o Malignant hypertensiono RPGNo TTPo Acute poststreptococcal GNo HUSo PANo Infective endocarditis/subacuteo Wegener's granulomatosisbacterial endocarditiso Henoch - scholoin purpuraCauses of Granular contracted kidney -o Chronic glomerulonephritis (symmetric)o Chronic pyelonephritis (asymmetric)o Benign Nephrosclerosis (Symmetric)Sometimes, Diabetes too can cause granular contracted kidney.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Flea bitten appearance of the kidney is seen in -, with the following options: A: Malignant hypertension, B: Benign hypertension, C: Chronic pyelonephritis, D: Diabetes mellitus + +### Response: +Ans. is 'a' i.e., Malignant hypertension Causes of flea - bitten kidney -o Malignant hypertensiono RPGNo TTPo Acute poststreptococcal GNo HUSo PANo Infective endocarditis/subacuteo Wegener's granulomatosisbacterial endocarditiso Henoch - scholoin purpuraCauses of Granular contracted kidney -o Chronic glomerulonephritis (symmetric)o Chronic pyelonephritis (asymmetric)o Benign Nephrosclerosis (Symmetric)Sometimes, Diabetes too can cause granular contracted kidney. +### End" +948,"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 impoant effector pathway for action of Nitric Oxide:, with the following options: A: Adenylate cyclase pathway, B: Phosphatidylinositol pathway, C: Guanylate cyclase pathway, D: MAP Kinase pathway + +### Response: +",The most impoant effector pathway for NO is activation of the soluble form of guanylyl cyclase. Soluble guanylate cyclase (sGC) catalyses the conversion of guanosine 5&;-triphosphate (GTP) to cyclic guanosine 3&;5&;-monophosphate (cGMP) Ref: Harper,"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 impoant effector pathway for action of Nitric Oxide:, with the following options: A: Adenylate cyclase pathway, B: Phosphatidylinositol pathway, C: Guanylate cyclase pathway, D: MAP Kinase pathway + +### Response: +The most impoant effector pathway for NO is activation of the soluble form of guanylyl cyclase. Soluble guanylate cyclase (sGC) catalyses the conversion of guanosine 5&;-triphosphate (GTP) to cyclic guanosine 3&;5&;-monophosphate (cGMP) Ref: Harper +### End" +949,"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 serous otitis media all are done except, with the following options: A: Inseion of grommet, B: Myringotomy, C: Adenoidectomy, D: Antibiotics are given + +### Response: +","Antibiotics are useful in cases of upper respiratory tract infections or unresolved acute suppurative otitis media. Myringotomy with grommet inseion is the treatment of choice for serious otitis media. Adenoid hyperplasia, being an impoant cause of serious otitis media, reasons out the need for adenoidectomy. Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 69","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 serous otitis media all are done except, with the following options: A: Inseion of grommet, B: Myringotomy, C: Adenoidectomy, D: Antibiotics are given + +### Response: +Antibiotics are useful in cases of upper respiratory tract infections or unresolved acute suppurative otitis media. Myringotomy with grommet inseion is the treatment of choice for serious otitis media. Adenoid hyperplasia, being an impoant cause of serious otitis media, reasons out the need for adenoidectomy. Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 69 +### End" +950,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: 4-day-old newborn baby having icterus involving sole, bilirubin level (mg/dl) -, with the following options: A: 12, B: 8, C: 6, D: 15 + +### Response: +","Dermal staining of bilirubin Described by Kramer +Jaundice progress in cephalocaudal direcon o Divided in 5 zone Zone Bilirubin + + +4-6 mg/dl - Face +6-8 mg/dl - Trun k & upper abdomen +8-12 mg/dl - Lower abdomen & thign +12-14 mg/dl - Arm & leg 5) > 15 mg/dl - Palm & sol","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: 4-day-old newborn baby having icterus involving sole, bilirubin level (mg/dl) -, with the following options: A: 12, B: 8, C: 6, D: 15 + +### Response: +Dermal staining of bilirubin Described by Kramer +Jaundice progress in cephalocaudal direcon o Divided in 5 zone Zone Bilirubin + + +4-6 mg/dl - Face +6-8 mg/dl - Trun k & upper abdomen +8-12 mg/dl - Lower abdomen & thign +12-14 mg/dl - Arm & leg 5) > 15 mg/dl - Palm & sol +### End" +951,"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 strong supports of uterus EXCEPT:, with the following options: A: Uterosacral ligament, B: Round ligament of uterus, C: Mackenrodt's ligament, D: Transcervical ligament + +### Response: +",Ans. B. Round ligament of uterusSUPPORTS OF UTERUS AND BLADDERThe supports of uterus and bladder are seen to be triradiate condensation of endopelvic fascia:a. The anterior spoke is the pubo-vesical cervical fascia which passes from anterolateral aspect of the cervix to be attached to back of pubic bone lateral to the symphysis. Some of its cervical attachments fans out laterally and imperceptibly into transverse cervical or Mackenrodt's ligament.b. Lateral spoke is Mackenrodt's ligamentc. Posterior spoke is utero- sacral ligament.,"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 strong supports of uterus EXCEPT:, with the following options: A: Uterosacral ligament, B: Round ligament of uterus, C: Mackenrodt's ligament, D: Transcervical ligament + +### Response: +Ans. B. Round ligament of uterusSUPPORTS OF UTERUS AND BLADDERThe supports of uterus and bladder are seen to be triradiate condensation of endopelvic fascia:a. The anterior spoke is the pubo-vesical cervical fascia which passes from anterolateral aspect of the cervix to be attached to back of pubic bone lateral to the symphysis. Some of its cervical attachments fans out laterally and imperceptibly into transverse cervical or Mackenrodt's ligament.b. Lateral spoke is Mackenrodt's ligamentc. Posterior spoke is utero- sacral ligament. +### End" +952,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The following are the complications of trichobezoars except, with the following options: A: Haematemesis, B: Perforation and peritonitis, C: Obstruction, D: Malignancy + +### Response: +","Rapunzel syndrome is the term for a trichobezoar (gastric 'hairball') which has a tail-like extension into the small bowel through the pylorus causing gastric outlet obstruction. Human hair (especially long hair) is resistant to digestion as well as peristalsis. So it tends to stay in the stomach and over a period of time may form a large 'hairball'. A trichobezoar may extend up to the pylorus, duodenum, or even jejunum. A pa may break off into small bowel and cause small bowel obstruction. For a discussion of other gastrointestinal foreign bodies, please see: bezoars Clinical presentation The patient usually is an adolescent girl. The patient may have a history of a psychiatric illness and occasionally a prior history of surgery may be present. The symptoms of Rapunzel syndrome is caused either by gastric outlet obstruction or its complications and includes: anorexia, bloating, early satiety weight loss vomiting immediately following meals acute epigastric pain patchy hair loss is seen in scalp hair Complications obstructive jaundice mechanical small bowel obstruction small bowel perforation peritonitis acute pancreatitis multiple complications of trichophagia included trichobezoars, malnutrition, intestinal obstruction, and ulceration with bleeding. One of the bouts of intestinal obstruction was associated with the superior mesenteric aery blocking the duodenum. Radiographic features Abdominal radiograph distended stomach shadow with an intragastric mottled gas pattern, outlined by fundal gas, which may resemble a food-led stomach free gas shadow under diaphragm may be seen on erect radiograph if bowel perforation is present Fluoroscopy: barium studies may show an intraluminal filling defect with mottled gas pattern without attachment to bowel wall over time the interstices of trichobezoar are filled with barium. This barium may remain for a considerable period of time and can be seen in delayed radiographs when the barium has exited the stomach and duodenum Ultrasound may be seen as an echogenic mass with intense acoustic shadow seen within stomach and pylorus region complex intraperitoneal free uid if complicated by bowel perforation CT CT is the best imaging modality for showing the size and configuration of the trichobezoar and most accurately identifying its location may show an intragastric well-circumscribed inhomogenous mass consisting of 'mottled gas pattern' or 'compressed concentric rings' pattern due to the presence of entrapped air and food debris body of the mass in stomach while tail may extend to the duodenum or jejunum normal stomach wall can be traced completely separate from the lesion no contrast enhancement mucosal edema and wall thickening may be seen in duodenum and jejunum Ref - Bailey and love 27e p1142","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The following are the complications of trichobezoars except, with the following options: A: Haematemesis, B: Perforation and peritonitis, C: Obstruction, D: Malignancy + +### Response: +Rapunzel syndrome is the term for a trichobezoar (gastric 'hairball') which has a tail-like extension into the small bowel through the pylorus causing gastric outlet obstruction. Human hair (especially long hair) is resistant to digestion as well as peristalsis. So it tends to stay in the stomach and over a period of time may form a large 'hairball'. A trichobezoar may extend up to the pylorus, duodenum, or even jejunum. A pa may break off into small bowel and cause small bowel obstruction. For a discussion of other gastrointestinal foreign bodies, please see: bezoars Clinical presentation The patient usually is an adolescent girl. The patient may have a history of a psychiatric illness and occasionally a prior history of surgery may be present. The symptoms of Rapunzel syndrome is caused either by gastric outlet obstruction or its complications and includes: anorexia, bloating, early satiety weight loss vomiting immediately following meals acute epigastric pain patchy hair loss is seen in scalp hair Complications obstructive jaundice mechanical small bowel obstruction small bowel perforation peritonitis acute pancreatitis multiple complications of trichophagia included trichobezoars, malnutrition, intestinal obstruction, and ulceration with bleeding. One of the bouts of intestinal obstruction was associated with the superior mesenteric aery blocking the duodenum. Radiographic features Abdominal radiograph distended stomach shadow with an intragastric mottled gas pattern, outlined by fundal gas, which may resemble a food-led stomach free gas shadow under diaphragm may be seen on erect radiograph if bowel perforation is present Fluoroscopy: barium studies may show an intraluminal filling defect with mottled gas pattern without attachment to bowel wall over time the interstices of trichobezoar are filled with barium. This barium may remain for a considerable period of time and can be seen in delayed radiographs when the barium has exited the stomach and duodenum Ultrasound may be seen as an echogenic mass with intense acoustic shadow seen within stomach and pylorus region complex intraperitoneal free uid if complicated by bowel perforation CT CT is the best imaging modality for showing the size and configuration of the trichobezoar and most accurately identifying its location may show an intragastric well-circumscribed inhomogenous mass consisting of 'mottled gas pattern' or 'compressed concentric rings' pattern due to the presence of entrapped air and food debris body of the mass in stomach while tail may extend to the duodenum or jejunum normal stomach wall can be traced completely separate from the lesion no contrast enhancement mucosal edema and wall thickening may be seen in duodenum and jejunum Ref - Bailey and love 27e p1142 +### End" +953,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about anaplastic thyroid carcinoma:a) Common in elderlyb) Well encapsulatedc) Will not invade surrounding structuresd) Distant metastasis commone) Some degree of differentiation to Papillary and Follicular types seen, with the following options: A: acd, B: bde, C: ade, D: ad + +### Response: +","About option 'e' Schwartz writes: +""On gross inspection, anaplastic tumors are firm and whitish in appearance. Microscopically, sheets of cells with marked heterogeneity are seen. Cells may be spindle-shaped, polygonal, or large, multinucleated cells. Foci of more differentiated thyroid tumors, either follicular or papillary, may be seen, suggesting that anaplastic tumors arise from more well-differentiated tumors.""","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: True about anaplastic thyroid carcinoma:a) Common in elderlyb) Well encapsulatedc) Will not invade surrounding structuresd) Distant metastasis commone) Some degree of differentiation to Papillary and Follicular types seen, with the following options: A: acd, B: bde, C: ade, D: ad + +### Response: +About option 'e' Schwartz writes: +""On gross inspection, anaplastic tumors are firm and whitish in appearance. Microscopically, sheets of cells with marked heterogeneity are seen. Cells may be spindle-shaped, polygonal, or large, multinucleated cells. Foci of more differentiated thyroid tumors, either follicular or papillary, may be seen, suggesting that anaplastic tumors arise from more well-differentiated tumors."" +### End" +954,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: For Carcinoma of the prostate the commonest site is ?, with the following options: A: Anterior zone, B: Peripheral zone, C: Central zone, D: Transitional zone + +### Response: +",Ans. is 'b' ie. Peripheral zone,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: For Carcinoma of the prostate the commonest site is ?, with the following options: A: Anterior zone, B: Peripheral zone, C: Central zone, D: Transitional zone + +### Response: +Ans. is 'b' ie. Peripheral zone +### End" +955,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The best graphic representation of frequency distribution of data gathered of a continuous variable is:, with the following options: A: Simple bar graph, B: Multiple bar, C: Line diagram, D: Histogram + +### Response: +","Histogram Statistical data are of two types: Qualitative Quantitative Qualitative data -is one in which the size or magnitude of the characteristic or attribute cannot be measured. - there is only one variable i.e. the number of persons and not the characteristic or attribute - persons with the same charactersitic are counted to form specific groups or classes. - eg: male/female, black/white, urban/suburban/rural, vaccinated/not vaccinated, treated/not treated. - as seen in the example the attribute or characteristic, vaccinated/not vaccinated cannot be measured. Only the frequency of persons vaccinated or not vaccinated varies. - Qualitative data are discrete in nature such as number of deaths in different years, population of different towns, persons with different blood groups in a population, and so on. Qualitative data are represented in Nominal or Ordinal scale. Quantitative data -is one in which the characteristic or attribute is variable. It has a magnitude that can be measured. - eg. : height, weight, temperature, blood pressure, pulse rate - here there are two variables, both the characteristic i.e. height or weight and frequency of persons. - The quantitative data obtained from characteristic variable are also called continuous data as each individual has one measurement from a continuous spectrum or range such as body temperature from 35 C to 42 C, height 140 cm to 190 cm, pulse rate from 70 bpm to 90 bpm. - quantitative data are represented on Interval or Ratio scales. The statistical details are presented, for easy viewing and understanding, in the form of tables, graphs and diagrams.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The best graphic representation of frequency distribution of data gathered of a continuous variable is:, with the following options: A: Simple bar graph, B: Multiple bar, C: Line diagram, D: Histogram + +### Response: +Histogram Statistical data are of two types: Qualitative Quantitative Qualitative data -is one in which the size or magnitude of the characteristic or attribute cannot be measured. - there is only one variable i.e. the number of persons and not the characteristic or attribute - persons with the same charactersitic are counted to form specific groups or classes. - eg: male/female, black/white, urban/suburban/rural, vaccinated/not vaccinated, treated/not treated. - as seen in the example the attribute or characteristic, vaccinated/not vaccinated cannot be measured. Only the frequency of persons vaccinated or not vaccinated varies. - Qualitative data are discrete in nature such as number of deaths in different years, population of different towns, persons with different blood groups in a population, and so on. Qualitative data are represented in Nominal or Ordinal scale. Quantitative data -is one in which the characteristic or attribute is variable. It has a magnitude that can be measured. - eg. : height, weight, temperature, blood pressure, pulse rate - here there are two variables, both the characteristic i.e. height or weight and frequency of persons. - The quantitative data obtained from characteristic variable are also called continuous data as each individual has one measurement from a continuous spectrum or range such as body temperature from 35 C to 42 C, height 140 cm to 190 cm, pulse rate from 70 bpm to 90 bpm. - quantitative data are represented on Interval or Ratio scales. The statistical details are presented, for easy viewing and understanding, in the form of tables, graphs and diagrams. +### End" +956,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What is seen in the X-ray of femur below, with the following options: A: Sunburst calcification, B: Onion peel effect, C: Codmann triangle, D: Bone marrow invasion + +### Response: +",.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: What is seen in the X-ray of femur below, with the following options: A: Sunburst calcification, B: Onion peel effect, C: Codmann triangle, D: Bone marrow invasion + +### Response: +. +### End" +957,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: ORS should be discarded after?, with the following options: A: 54 hours, B: 6 hours, C: 12 hours, D: 24 hours + +### Response: +","
ORS Aim of oral rehydration therapy is to prevent dehydration and reduce moality. Oral fluid therapy is based on the observation that glucose given orally enhances the intestinal absorption of salt and water and is capable of correcting electrolyte and water deficit. At first the composition of oral rehydration salt recommended by WHO was sodium bicarbonate based. Inclusion of trisodium citrate in place of sodium bicarbonate made the product more stable and it resulted in less stool output especially in high output diarrhoea, probably because of direct effect of trisodium citrate in increasing intestinal absorption of sodium and water. More recently an improved ORS formulation has been developed which is safe and effective as the original in preventing and treating diarrhoeal dehydration. It is focussed on reducing the osmolarity of ORS solution to avoid adverse effects of hypeonicity on net fluid absorption by reducing the concentration of glucose and sodium chloride in the solution. A freshly prepared ORS should be used before 24hrs. Decreasing the sodium concentration of ORS solution to 75 mOsm/l improved the efficacy of ORS regimen for children with acute non cholera diarrhoea. Reduced osmolarity ORS:-(g/L) Sodium chloride- 2.6 Glucose,anhydrous- 13.5 Potassium chloride- 1.5 Trisodium citrate,dihydrate-2.9 Total =20.5 g/L Reduced osmolarity ORS:-(mmol/L) Sodium-75 Chloride-65 Glucose,anhydrous-75 Potassium-20 Citrate-10 Total = 245 mmol/L {Reference: park&;s textbook of preventive and social medicine, 23rd edition, pg no.224}
","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: ORS should be discarded after?, with the following options: A: 54 hours, B: 6 hours, C: 12 hours, D: 24 hours + +### Response: +ORS Aim of oral rehydration therapy is to prevent dehydration and reduce moality. Oral fluid therapy is based on the observation that glucose given orally enhances the intestinal absorption of salt and water and is capable of correcting electrolyte and water deficit. At first the composition of oral rehydration salt recommended by WHO was sodium bicarbonate based. Inclusion of trisodium citrate in place of sodium bicarbonate made the product more stable and it resulted in less stool output especially in high output diarrhoea, probably because of direct effect of trisodium citrate in increasing intestinal absorption of sodium and water. More recently an improved ORS formulation has been developed which is safe and effective as the original in preventing and treating diarrhoeal dehydration. It is focussed on reducing the osmolarity of ORS solution to avoid adverse effects of hypeonicity on net fluid absorption by reducing the concentration of glucose and sodium chloride in the solution. A freshly prepared ORS should be used before 24hrs. Decreasing the sodium concentration of ORS solution to 75 mOsm/l improved the efficacy of ORS regimen for children with acute non cholera diarrhoea. Reduced osmolarity ORS:-(g/L) Sodium chloride- 2.6 Glucose,anhydrous- 13.5 Potassium chloride- 1.5 Trisodium citrate,dihydrate-2.9 Total =20.5 g/L Reduced osmolarity ORS:-(mmol/L) Sodium-75 Chloride-65 Glucose,anhydrous-75 Potassium-20 Citrate-10 Total = 245 mmol/L {Reference: park&;s textbook of preventive and social medicine, 23rd edition, pg no.224}
+### End" +958,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A neonate delivered at 38 weeks of gestation with a birth weight of 2.2 kg develops intolerance to feed/abdominal distension on the second day. Physical examination is unremarkable. Sepsis screen is negative. PCV is observed to be 72%. Which of the following represents the best management option –, with the following options: A: Hydration with IV Fluids, B: Partial Exchange Transfusion, C: Presumptive treatment for sepsis, D: Medical Management for intestinal obstruction + +### Response: +","PCV 72% in a neonate suggests the diagnosis of neonatal polycythemia. +Polycythemia is defined as central venous hematocrit level of greater than 65%. +The neonate in question is also having an intolerance to feed and abdominal distension. +So, this neonate is having symptomatic neonatal polycythemia. + +Treatment of neonatal polycythemia + +Therapy in newborns with polycythemia is based on both the measured central venous hematocrit level and the presence or absence of symptoms. + +(1) Symptomatic polycythemia + +Partial exchange transfusion is the treatment of choice. + +(2) Asymptomatic polycythemia + +In asymptomatic polycythemia, treatment depends upon hematocrit level (PCV). + +(i) PCV 65-75% + +Perform cardiorespiratory monitoring and monitoring of hematocrit and glucose levels every 6-12 hours and observe the patients for symptoms +If hematocrit (PCV) becomes more than 75%, consider partial exchange transfusion (PET). + +ii) PCV> 75% + +Partial exchange transfusion (PET) 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: A neonate delivered at 38 weeks of gestation with a birth weight of 2.2 kg develops intolerance to feed/abdominal distension on the second day. Physical examination is unremarkable. Sepsis screen is negative. PCV is observed to be 72%. Which of the following represents the best management option –, with the following options: A: Hydration with IV Fluids, B: Partial Exchange Transfusion, C: Presumptive treatment for sepsis, D: Medical Management for intestinal obstruction + +### Response: +PCV 72% in a neonate suggests the diagnosis of neonatal polycythemia. +Polycythemia is defined as central venous hematocrit level of greater than 65%. +The neonate in question is also having an intolerance to feed and abdominal distension. +So, this neonate is having symptomatic neonatal polycythemia. + +Treatment of neonatal polycythemia + +Therapy in newborns with polycythemia is based on both the measured central venous hematocrit level and the presence or absence of symptoms. + +(1) Symptomatic polycythemia + +Partial exchange transfusion is the treatment of choice. + +(2) Asymptomatic polycythemia + +In asymptomatic polycythemia, treatment depends upon hematocrit level (PCV). + +(i) PCV 65-75% + +Perform cardiorespiratory monitoring and monitoring of hematocrit and glucose levels every 6-12 hours and observe the patients for symptoms +If hematocrit (PCV) becomes more than 75%, consider partial exchange transfusion (PET). + +ii) PCV> 75% + +Partial exchange transfusion (PET) is the treatment of choice. +### End" +959,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Coupling agent between filler particle and resin is:, with the following options: A: Benzoyl peroxide, B: Vinyl silane, C: Benzoin ether, D: Hydroquinone + +### Response: +","Coupling agent : A bonding agent applied to the surfaces of reinforcing particles (filler) to ensure that they are chemically bonded to the resin matrix. Organo-silane compounds are the more common class of dental composite coupling agents. Although titanates and zirconates can be used as coupling agents, organosilanes—such as γ-methacryloxypropyl tri-methoxysilane are used most commonly. +Phillips 12 ed page no. 275,286","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Coupling agent between filler particle and resin is:, with the following options: A: Benzoyl peroxide, B: Vinyl silane, C: Benzoin ether, D: Hydroquinone + +### Response: +Coupling agent : A bonding agent applied to the surfaces of reinforcing particles (filler) to ensure that they are chemically bonded to the resin matrix. Organo-silane compounds are the more common class of dental composite coupling agents. Although titanates and zirconates can be used as coupling agents, organosilanes—such as γ-methacryloxypropyl tri-methoxysilane are used most commonly. +Phillips 12 ed page no. 275,286 +### End" +960,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A patient appeared in the emergency room with a submandibular mass. A smear was made of the drainage and a bewildering variety of bacteria were seen, including branched, Gram-positive rods. The most clinically appropriate action is, with the following options: A: Do no further clinical workup, B: Suggest to the laboratory that low colony counts may reflect infection, C: Determine if fluorescent microscopy is available for the diagnosis of actinomycosis, D: Consider vancomycin as an alternative drug + +### Response: +","The patient has actinomycosis. These laboratory data are not uncommon. There is no reason to work up all the contaminating bacteria. A fluorescent microscopy test for A. israelii is available. If positive, the FA provides a rapid diagnosis. In any event, it may be impossible to recover A. israelii from such a specimen. High-dose penicillin has been used to treat actinomycosis.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A patient appeared in the emergency room with a submandibular mass. A smear was made of the drainage and a bewildering variety of bacteria were seen, including branched, Gram-positive rods. The most clinically appropriate action is, with the following options: A: Do no further clinical workup, B: Suggest to the laboratory that low colony counts may reflect infection, C: Determine if fluorescent microscopy is available for the diagnosis of actinomycosis, D: Consider vancomycin as an alternative drug + +### Response: +The patient has actinomycosis. These laboratory data are not uncommon. There is no reason to work up all the contaminating bacteria. A fluorescent microscopy test for A. israelii is available. If positive, the FA provides a rapid diagnosis. In any event, it may be impossible to recover A. israelii from such a specimen. High-dose penicillin has been used to treat actinomycosis. +### End" +961,"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 girl presents with an annular plaque on the arm with peripheral scale. Topical nystatin ointment is prescribed and 2 weeks later the rash is unchanged. What is the next best step?, with the following options: A: Sta appropriate antifungal with efficacy against dermatophytes., B: Sta an oral antibiotic, C: Topical coicosteroid, D: Longer course of nystatin + +### Response: +","Characteristic lesions on arm with annular plaque and peripheral scaling is seen in dermatophyte infection Treatment involves the use of oral terbinafine, fluconazole, itraconazole, griseofulvin or one of several well-tried topical preparations.","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 girl presents with an annular plaque on the arm with peripheral scale. Topical nystatin ointment is prescribed and 2 weeks later the rash is unchanged. What is the next best step?, with the following options: A: Sta appropriate antifungal with efficacy against dermatophytes., B: Sta an oral antibiotic, C: Topical coicosteroid, D: Longer course of nystatin + +### Response: +Characteristic lesions on arm with annular plaque and peripheral scaling is seen in dermatophyte infection Treatment involves the use of oral terbinafine, fluconazole, itraconazole, griseofulvin or one of several well-tried topical preparations. +### End" +962,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Acoustic neuroma commonly arises from, with the following options: A: Superior division of vestibular nerve, B: Inferior division of vestibular nerve, C: Cochlear nerve, D: VIIth nerve + +### Response: +","Acoustic neuroma commonly arises from vestibular nerve and rarely from the cochlear division of the 8th nerve. Ref: Textbook of diseases of Ent, PL Dhingra, 7th edition, pg. 125","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Acoustic neuroma commonly arises from, with the following options: A: Superior division of vestibular nerve, B: Inferior division of vestibular nerve, C: Cochlear nerve, D: VIIth nerve + +### Response: +Acoustic neuroma commonly arises from vestibular nerve and rarely from the cochlear division of the 8th nerve. Ref: Textbook of diseases of Ent, PL Dhingra, 7th edition, pg. 125 +### End" +963,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Patients with both Graves' disease and Cushing syndrome are overproducing hormones that have which one of the following in common?, with the following options: A: Reacting with receptors in the cell membrane, B: Utilizing second messengers, C: Binding to intracellular receptors, D: Binding to RNA to produce physiologically active proteins + +### Response: +","Graves' disease is caused by the hypersecretion of thyroid hormone, whereas Cushing syndrome is an overproduction of cortisol. Steroid hormones and thyroid hormones cross the cell membrane and bind to intracellular receptors. The hormone-receptor complex binds to DNA, not RNA. Polypeptide hormones and epinephrine react with the receptors in the cell membrane, triggering second messengers to transmit the signal that the receptor is occupied. Ribosomal RNA (rRNA) does not ablate gene expression; the induction of miRNA has that ability.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Patients with both Graves' disease and Cushing syndrome are overproducing hormones that have which one of the following in common?, with the following options: A: Reacting with receptors in the cell membrane, B: Utilizing second messengers, C: Binding to intracellular receptors, D: Binding to RNA to produce physiologically active proteins + +### Response: +Graves' disease is caused by the hypersecretion of thyroid hormone, whereas Cushing syndrome is an overproduction of cortisol. Steroid hormones and thyroid hormones cross the cell membrane and bind to intracellular receptors. The hormone-receptor complex binds to DNA, not RNA. Polypeptide hormones and epinephrine react with the receptors in the cell membrane, triggering second messengers to transmit the signal that the receptor is occupied. Ribosomal RNA (rRNA) does not ablate gene expression; the induction of miRNA has that ability. +### End" +964,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Syndrome which is associated with increased risk of leukaemia:, with the following options: A: Plummer Vinson syndrome, B: Klienfelter syndrome, C: Sturge webber syndrome, D: Multiple Hamaoma + +### Response: +",Association of Klinefelter syndrome Breast cancer Extragonadal germ cell tumors Autoimmune diseases (SLE) Acute leukaemia.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Syndrome which is associated with increased risk of leukaemia:, with the following options: A: Plummer Vinson syndrome, B: Klienfelter syndrome, C: Sturge webber syndrome, D: Multiple Hamaoma + +### Response: +Association of Klinefelter syndrome Breast cancer Extragonadal germ cell tumors Autoimmune diseases (SLE) Acute leukaemia. +### End" +965,"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 fracture is known as, ""fracture-a la signature""?, with the following options: A: Gutter fracture, B: Depressed fracture, C: Ring fracture, D: Sutural fracture + +### Response: +","Depressed fractures are known as ""fractures a la signature"" (signature fractures), as their pattern often resembles the weapon or agent which caused it. These fractures are caused by local deformation of the skull. In this, fractured bone is driven inwards into the skull cavity. Gutter fractures are formed when pa of the thickness of the bone is removed so to form a gutter, e.g., in oblique bullet wounds. Ring or foramen fractures are fractures which encircle the skull in such a manner that the anterior third is separated at its junction with the middle and posterior third. Diastatic or sutural fractures in which separation of the sutures occur only in young persons, due to blow on head with blunt weapon. Ref: Textbook of Forensic Medicine and Toxicology by K S Narayan Reddy, 27th edition, Page 216-217.","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 fracture is known as, ""fracture-a la signature""?, with the following options: A: Gutter fracture, B: Depressed fracture, C: Ring fracture, D: Sutural fracture + +### Response: +Depressed fractures are known as ""fractures a la signature"" (signature fractures), as their pattern often resembles the weapon or agent which caused it. These fractures are caused by local deformation of the skull. In this, fractured bone is driven inwards into the skull cavity. Gutter fractures are formed when pa of the thickness of the bone is removed so to form a gutter, e.g., in oblique bullet wounds. Ring or foramen fractures are fractures which encircle the skull in such a manner that the anterior third is separated at its junction with the middle and posterior third. Diastatic or sutural fractures in which separation of the sutures occur only in young persons, due to blow on head with blunt weapon. Ref: Textbook of Forensic Medicine and Toxicology by K S Narayan Reddy, 27th edition, Page 216-217. +### End" +966,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cells in the aoa gonad mesonephros region is associated with:, with the following options: A: Hematopoeisis, B: Immunity, C: Neural tube formation, D: None of the above + +### Response: +","The definitive hematopoietic stem cells are derived from mesoderm surrounding the aoa in a site near the developing mesonephric kidney called the aoa-gonad-mesonephros region (AGM). These cells colonize the liver, which becomes the major hematopoietic organ of the embryo and fetus from approximately the second to seventh months of development. Stem cells from the liver colonize the bone marrow, the definitive blood-forming tissue, in the seventh month of gestation, and thereafter, the liver loses its blood-forming function. Ref: Langman's embryology 11th edition Chapter 7.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Cells in the aoa gonad mesonephros region is associated with:, with the following options: A: Hematopoeisis, B: Immunity, C: Neural tube formation, D: None of the above + +### Response: +The definitive hematopoietic stem cells are derived from mesoderm surrounding the aoa in a site near the developing mesonephric kidney called the aoa-gonad-mesonephros region (AGM). These cells colonize the liver, which becomes the major hematopoietic organ of the embryo and fetus from approximately the second to seventh months of development. Stem cells from the liver colonize the bone marrow, the definitive blood-forming tissue, in the seventh month of gestation, and thereafter, the liver loses its blood-forming function. Ref: Langman's embryology 11th edition Chapter 7. +### End" +967,"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 thalamic nuclei does NOT project to neocoex?, with the following options: A: Intralaminar nuclei, B: Reticular nuclei, C: Pulvinar nuclei, D: Anterior thalamicnuclei + +### Response: +","they have intra thalamic connections and do not project into cerebral coex, lie between external medullary lamina and the internal capsule Ref: Gray's 39e/p-227","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 thalamic nuclei does NOT project to neocoex?, with the following options: A: Intralaminar nuclei, B: Reticular nuclei, C: Pulvinar nuclei, D: Anterior thalamicnuclei + +### Response: +they have intra thalamic connections and do not project into cerebral coex, lie between external medullary lamina and the internal capsule Ref: Gray's 39e/p-227 +### End" +968,"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 berry's aneurysm is?, with the following options: A: Veebral aery, B: Basilar aery, C: Junction of anterior cerebral aery and anterior communicating aery, D: Posterior cerebral aery + +### Response: +","Ans. is 'c' i.e., Junction of anterior cerebral aery and anterior communicating aeryBerry aneurysm The fuher away the aneurysm from the anterior circulation or from the circle of willis , the less common will be its rate of occurance.Berry aneurysm or Saccualr aneurysm or Congenital aneurysm is the most frequent type of intracranial aneurysm. Most aneurysms occur in the anterior circulation and are found near the branchs points.Most common site is junction between anterior cerebral aery and anterior communication aery (40%). Next most common site is internal carotid aery and posterior communicating aery (20%)Less frequent sites include :?Top of basilar aeryJunction of basilar aery and the superior cerebllar aery or anterior inferior cerebellar aery. Junction of veebral aery and posterior inferior cerebellar aery.","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 berry's aneurysm is?, with the following options: A: Veebral aery, B: Basilar aery, C: Junction of anterior cerebral aery and anterior communicating aery, D: Posterior cerebral aery + +### Response: +Ans. is 'c' i.e., Junction of anterior cerebral aery and anterior communicating aeryBerry aneurysm The fuher away the aneurysm from the anterior circulation or from the circle of willis , the less common will be its rate of occurance.Berry aneurysm or Saccualr aneurysm or Congenital aneurysm is the most frequent type of intracranial aneurysm. Most aneurysms occur in the anterior circulation and are found near the branchs points.Most common site is junction between anterior cerebral aery and anterior communication aery (40%). Next most common site is internal carotid aery and posterior communicating aery (20%)Less frequent sites include :?Top of basilar aeryJunction of basilar aery and the superior cerebllar aery or anterior inferior cerebellar aery. Junction of veebral aery and posterior inferior cerebellar aery. +### End" +969,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Relaxation of mesangial cells of kidney is brought about by, with the following options: A: PGF2a, B: Vasopressin, C: cAMP, D: Endothelin + +### Response: +","Mesangial cells contractionMesangial cells relaxationEndothelinsAngiotensin IIVasopressinNor-epinephrinePlatelet -activation factorPlatelet-derived growth factorThromboxane A2PGF2LT-C4and D4HistamineANPDopaminePGE2cAMP(Refer: Ganong's Review of Medical Physiology 24thedition, pg no: 678-682)","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Relaxation of mesangial cells of kidney is brought about by, with the following options: A: PGF2a, B: Vasopressin, C: cAMP, D: Endothelin + +### Response: +Mesangial cells contractionMesangial cells relaxationEndothelinsAngiotensin IIVasopressinNor-epinephrinePlatelet -activation factorPlatelet-derived growth factorThromboxane A2PGF2LT-C4and D4HistamineANPDopaminePGE2cAMP(Refer: Ganong's Review of Medical Physiology 24thedition, pg no: 678-682) +### End" +970,"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 agent is not used in erectiledysfunction:, with the following options: A: Apomorphine, B: Vardenafil, C: Phenylephrine, D: Alprostadil + +### Response: +","Ref; KD Tripathi pharmacology 7th edition page no;303 Drugs used in erectile dysfunction is Androgens : PDE-5 inhibitors; sildenafil, tadalafil, vardenafil PGE1; Alprostadil P papaverine Phentolamine -alpha blocker apomorphine- dopamine agonist Phenylephrine is an adrenergic drug which is contraindicated in erectile dysfunction","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 agent is not used in erectiledysfunction:, with the following options: A: Apomorphine, B: Vardenafil, C: Phenylephrine, D: Alprostadil + +### Response: +Ref; KD Tripathi pharmacology 7th edition page no;303 Drugs used in erectile dysfunction is Androgens : PDE-5 inhibitors; sildenafil, tadalafil, vardenafil PGE1; Alprostadil P papaverine Phentolamine -alpha blocker apomorphine- dopamine agonist Phenylephrine is an adrenergic drug which is contraindicated in erectile dysfunction +### End" +971,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which inhibits adenyl cyclase enzyme?, with the following options: A: Somatostatin, B: Calcitonin, C: Epinephrine, D: Thyroxine + +### Response: +","Somatostatin acts directly on the acid-producing parietal cells a G-protein coupled receptor which inhibits adenylate cyclase, thus effectively antagonising the stimulatory effect of histamine to reduce acid secretion.Ref: DM Vasudevan, 7th edition","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Which inhibits adenyl cyclase enzyme?, with the following options: A: Somatostatin, B: Calcitonin, C: Epinephrine, D: Thyroxine + +### Response: +Somatostatin acts directly on the acid-producing parietal cells a G-protein coupled receptor which inhibits adenylate cyclase, thus effectively antagonising the stimulatory effect of histamine to reduce acid secretion.Ref: DM Vasudevan, 7th edition +### End" +972,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 9-month-old child presented to the ER with characteristic ""barking"" cough and hoarseness of voice. She had a history of rhinorrhoea, pharyngitis, mild cough, and low-grade fever for 1-3 days. Symptom worsened at night. O/E: - Normal to moderately inflamed pharynx Increased respiratory rate Nasal flaring Suprasternal, infrasternal, and intercostal retractions Continuous inspiratory stridor X-RAY NECK All of the following statements are true about the treatment of the above condition except: -, with the following options: A: Nebulized racemic epinephrine is an accepted treatment for moderate or severe croup., B: Patients can be safely discharged home after a 2-3 hr period of observation provided, they have no stridor at rest; have normal air entry, normal pulse oximetry, and normal level of consciousness; and have received steroids., C: Coicosteroids decrease the edema in the laryngeal mucosa through their anti-inflammatory action., D: Oral steroids are not beneficial in mild croup + +### Response: +","This is a case of acute laryngotracheobronchitis (croup). Acute infectious process M/C cause- parainfluenza viruses (types 1, 2, and 3) Presents with: - Bark-like / Brassy cough Hoarseness Inspiratory stridor Respiratory distress 4. Treatment Mainstay - airway management and treatment of hypoxia. Nebulized racemic epinephrine for moderate or severe croup. Oral steroids -beneficial even in mild croup","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 9-month-old child presented to the ER with characteristic ""barking"" cough and hoarseness of voice. She had a history of rhinorrhoea, pharyngitis, mild cough, and low-grade fever for 1-3 days. Symptom worsened at night. O/E: - Normal to moderately inflamed pharynx Increased respiratory rate Nasal flaring Suprasternal, infrasternal, and intercostal retractions Continuous inspiratory stridor X-RAY NECK All of the following statements are true about the treatment of the above condition except: -, with the following options: A: Nebulized racemic epinephrine is an accepted treatment for moderate or severe croup., B: Patients can be safely discharged home after a 2-3 hr period of observation provided, they have no stridor at rest; have normal air entry, normal pulse oximetry, and normal level of consciousness; and have received steroids., C: Coicosteroids decrease the edema in the laryngeal mucosa through their anti-inflammatory action., D: Oral steroids are not beneficial in mild croup + +### Response: +This is a case of acute laryngotracheobronchitis (croup). Acute infectious process M/C cause- parainfluenza viruses (types 1, 2, and 3) Presents with: - Bark-like / Brassy cough Hoarseness Inspiratory stridor Respiratory distress 4. Treatment Mainstay - airway management and treatment of hypoxia. Nebulized racemic epinephrine for moderate or severe croup. Oral steroids -beneficial even in mild croup +### End" +973,"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 Patent Ductus Aeriosus (PDA) are true, except:, with the following options: A: It is more common in males than females, B: It is a common hea lesion in rubella, C: Treatment is closure of defect by ligation and division of ductus, D: Hypoxia and immaturity are impoant in maintaining the patency + +### Response: +","Patent Ductus Aeriosus is more common in females than males. Ref: Harrison 17th Edition, Page 1461; O P Ghai 6th Edition, Page 406; Nelson 18th Edition, Page 1859, 1879, 1891","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 Patent Ductus Aeriosus (PDA) are true, except:, with the following options: A: It is more common in males than females, B: It is a common hea lesion in rubella, C: Treatment is closure of defect by ligation and division of ductus, D: Hypoxia and immaturity are impoant in maintaining the patency + +### Response: +Patent Ductus Aeriosus is more common in females than males. Ref: Harrison 17th Edition, Page 1461; O P Ghai 6th Edition, Page 406; Nelson 18th Edition, Page 1859, 1879, 1891 +### End" +974,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The most accurate imaging for the diagnosis of pulmonary embolism is -, with the following options: A: CT SCAN of chest, B: MRI of chest, C: X - ray chest, D: CT pulmonary angiography + +### Response: +","Ans. is 'd' i.e., CT pulmonary angiography o Invasive pulmonary angiography is the most accurate method for diagnosis of PE, it is an invasive procedure. # Investigation of choice for PE - Chest CT with contrast (especially MDCTA) # Investigation of 2nd choice - Lung scan (V/Q scan) # Best investigation for PE - Chest CT with contrast (MDCTA) # Most accurate investigation for PE - Invasive pulmonary angiography # Gold - standard test for PE - Invasive pulmonary angiography # Screening test for PE - D-dimer assay","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The most accurate imaging for the diagnosis of pulmonary embolism is -, with the following options: A: CT SCAN of chest, B: MRI of chest, C: X - ray chest, D: CT pulmonary angiography + +### Response: +Ans. is 'd' i.e., CT pulmonary angiography o Invasive pulmonary angiography is the most accurate method for diagnosis of PE, it is an invasive procedure. # Investigation of choice for PE - Chest CT with contrast (especially MDCTA) # Investigation of 2nd choice - Lung scan (V/Q scan) # Best investigation for PE - Chest CT with contrast (MDCTA) # Most accurate investigation for PE - Invasive pulmonary angiography # Gold - standard test for PE - Invasive pulmonary angiography # Screening test for PE - D-dimer assay +### End" +975,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: According to ICMR guidelines, what is the daily protein requirement of a girl age group 13-15 years of age, with the following options: A: 0.8 gms, B: 0.95 gms, C: 1.0 gms, D: 1.33 gms + +### Response: +",Ans. b. 0.95 gms,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: According to ICMR guidelines, what is the daily protein requirement of a girl age group 13-15 years of age, with the following options: A: 0.8 gms, B: 0.95 gms, C: 1.0 gms, D: 1.33 gms + +### Response: +Ans. b. 0.95 gms +### End" +976,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Death due to shock after burns occur within, with the following options: A: 2 hours, B: Within 24 hours, C: 24-48 hours, D: 5 days + +### Response: +","Fatal period Most of the death from burn injuries occur from shock within about 24-48 hours. Death due to toxemia occurs usually within 4-5 days. The first week happens to be the most critical period. In suppurative cases, death may ensue after a few weeks. Ref: TEXTBOOK OF FORENSIC MEDICINE AND TOXICOLOGY KRISHNAN VIJ FIFTH EDITION PAGE 163","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Death due to shock after burns occur within, with the following options: A: 2 hours, B: Within 24 hours, C: 24-48 hours, D: 5 days + +### Response: +Fatal period Most of the death from burn injuries occur from shock within about 24-48 hours. Death due to toxemia occurs usually within 4-5 days. The first week happens to be the most critical period. In suppurative cases, death may ensue after a few weeks. Ref: TEXTBOOK OF FORENSIC MEDICINE AND TOXICOLOGY KRISHNAN VIJ FIFTH EDITION PAGE 163 +### End" +977,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Knowing the capital of France is an example for, with the following options: A: Explicit memory, B: Declarative memory, C: Semantic memory, D: All of the above + +### Response: +","Explicit / Declarative memory +It involves concious recall of events + +Semantic memory : It is about facts +Episodic memory : It is about events of life","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Knowing the capital of France is an example for, with the following options: A: Explicit memory, B: Declarative memory, C: Semantic memory, D: All of the above + +### Response: +Explicit / Declarative memory +It involves concious recall of events + +Semantic memory : It is about facts +Episodic memory : It is about events of life +### End" +978,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Oochronosis is found in:, with the following options: A: Alkaptonuria, B: Tyrosinemia, C: Phenylketonuria, D: Homocystinuria + +### Response: +","a. Alkaptonuria(Ref: Nelson's 20/e p 636, Ghai 8/e p 652)Ochronosis (dark spot on sclera/ear cartilage) is seen in Alkaptonuria which is an autosomal recessive disorder due to deficiency of enzyme homogentisic acid oxidase.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Oochronosis is found in:, with the following options: A: Alkaptonuria, B: Tyrosinemia, C: Phenylketonuria, D: Homocystinuria + +### Response: +a. Alkaptonuria(Ref: Nelson's 20/e p 636, Ghai 8/e p 652)Ochronosis (dark spot on sclera/ear cartilage) is seen in Alkaptonuria which is an autosomal recessive disorder due to deficiency of enzyme homogentisic acid oxidase. +### End" +979,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 67-year-old man with lung cancer notices symptoms of weakness in his arms and legs. He describes difficulty in rising out of chair or going upstairs, but no pain or discomfort. On examination, proximal muscle strength is four out of five in the upper and lower limbs, but the reflexes, tone, and sensation are normal. He has a colored rash on his eyelids, and raised papules on his knuckles.For the above patient with muscle weakness, select the most likely anatomic site for the disorder, with the following options: A: anterior horn cell, B: peripheral nerve, C: neuromuscular junction, D: muscle + +### Response: +","Dermatomyositis is one of the inflammatory myopathies that has a characteristic rash on the eyelids (heliotrope) and knuckles (Gottron's papules). It is associated with certain cancers as a paraneoplastic syndrome. The muscle enzyme creatine kinase (CK) is elevated is most cases, but the condition is painless. Symptoms are those of proximal muscle weakness, with normal reflexes and tone on examination.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 67-year-old man with lung cancer notices symptoms of weakness in his arms and legs. He describes difficulty in rising out of chair or going upstairs, but no pain or discomfort. On examination, proximal muscle strength is four out of five in the upper and lower limbs, but the reflexes, tone, and sensation are normal. He has a colored rash on his eyelids, and raised papules on his knuckles.For the above patient with muscle weakness, select the most likely anatomic site for the disorder, with the following options: A: anterior horn cell, B: peripheral nerve, C: neuromuscular junction, D: muscle + +### Response: +Dermatomyositis is one of the inflammatory myopathies that has a characteristic rash on the eyelids (heliotrope) and knuckles (Gottron's papules). It is associated with certain cancers as a paraneoplastic syndrome. The muscle enzyme creatine kinase (CK) is elevated is most cases, but the condition is painless. Symptoms are those of proximal muscle weakness, with normal reflexes and tone on examination. +### End" +980,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Symptoms of thoracic outlet syndrome in cervical rib are produced due to compression of which nerve roots., with the following options: A: C5, C6, B: C6, C7, C: C7, C8, D: C8, T1 + +### Response: +","Cervical rib is usually represented by a fibrous band originating from the seventh cervical veebra and inseing onto the first thoracic rib. The lower trunk of the plexus (mainly T1) is compressed, leading to wasting of the interossei and altered sensation in the T1 distribution. Compression of the subclan aery may result in a post-stenotic dilatation with thrombus and embolus formation. Source : Bailet and Love 26th edition Pg : 872","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Symptoms of thoracic outlet syndrome in cervical rib are produced due to compression of which nerve roots., with the following options: A: C5, C6, B: C6, C7, C: C7, C8, D: C8, T1 + +### Response: +Cervical rib is usually represented by a fibrous band originating from the seventh cervical veebra and inseing onto the first thoracic rib. The lower trunk of the plexus (mainly T1) is compressed, leading to wasting of the interossei and altered sensation in the T1 distribution. Compression of the subclan aery may result in a post-stenotic dilatation with thrombus and embolus formation. Source : Bailet and Love 26th edition Pg : 872 +### End" +981,"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 congenital blockage in the nasolacrimal duct is:, with the following options: A: At the upper end, B: In the middle, C: At the lower end, D: Whole of the duct + +### Response: +",Ans. At the lower end,"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 congenital blockage in the nasolacrimal duct is:, with the following options: A: At the upper end, B: In the middle, C: At the lower end, D: Whole of the duct + +### Response: +Ans. At the lower end +### End" +982,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ulnar paradox is due to:, with the following options: A: FDP, B: FPL, C: ECRB, D: Radial nerve disease + +### Response: +","Ulnar paradox The higher the lesion of the median and ulnar nerve injury , the less prominent is the deformity and vice versa, because in higher lesions the long finger flexors are also paralysed (which were causing interphalangeal flexion/clawing). The loss of finger flexion makes the deformity look less obvious/ less clawing In low ulnar nerve palsy forearm muscles are spared but the clawing is more ( as compared to high ulnar nerve palsy) because in low ulnar nerve palsy finger flexors are spared which adds on to the deformity by flexing IP joints.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ulnar paradox is due to:, with the following options: A: FDP, B: FPL, C: ECRB, D: Radial nerve disease + +### Response: +Ulnar paradox The higher the lesion of the median and ulnar nerve injury , the less prominent is the deformity and vice versa, because in higher lesions the long finger flexors are also paralysed (which were causing interphalangeal flexion/clawing). The loss of finger flexion makes the deformity look less obvious/ less clawing In low ulnar nerve palsy forearm muscles are spared but the clawing is more ( as compared to high ulnar nerve palsy) because in low ulnar nerve palsy finger flexors are spared which adds on to the deformity by flexing IP joints. +### End" +983,"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 potent glucocoicoid: March 2010, with the following options: A: Hydrocoisone, B: Prednisolone, C: Betamethasone, D: Triamcinolone + +### Response: +","Ans. C: Betamethasone Betamethasone and dexamethasone are very potent and highly selective glucocoicoids. Long acting, causes marked pituitary-adrenal suppression, but fluid retention and hypeension is not a problem. Hence they are preferred in situations in which fluid retention must be avoided like cerebral edema.","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 potent glucocoicoid: March 2010, with the following options: A: Hydrocoisone, B: Prednisolone, C: Betamethasone, D: Triamcinolone + +### Response: +Ans. C: Betamethasone Betamethasone and dexamethasone are very potent and highly selective glucocoicoids. Long acting, causes marked pituitary-adrenal suppression, but fluid retention and hypeension is not a problem. Hence they are preferred in situations in which fluid retention must be avoided like cerebral edema. +### End" +984,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Kocher Langenbeck approach for emergency acetabular fixation is done in all Except -, with the following options: A: Open fracture, B: Progressive sciatic nerve injury, C: Recurrent dislocation inspite of closed reduction and traction, D: Morel - Lavallee lesion + +### Response: +","Morel - Lavalle lesion is a localized area of subcutaneous fat necrosis over the lateral aspect of hip caused by same trauma that causes the acetabular fracture. The operation through it has been a/w a higher (12%) rate of postoperative infection, wound dehiscence and healing by secondary intention. The presence of a significant Morel-Lavallee lesion can be suspected by hypermobility of the skin and subcutaneous tissue in the affected area from the shear-type separation of the subcutaneous tissue from the underlying fascia lata. Alternatively, some fractures can be treated through ilioinguinal approach, thus avoiding the affected area. +Therefore, In the presence of Morel-Lavalle lesion posterior kocher langenbeck approach is avoided.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Kocher Langenbeck approach for emergency acetabular fixation is done in all Except -, with the following options: A: Open fracture, B: Progressive sciatic nerve injury, C: Recurrent dislocation inspite of closed reduction and traction, D: Morel - Lavallee lesion + +### Response: +Morel - Lavalle lesion is a localized area of subcutaneous fat necrosis over the lateral aspect of hip caused by same trauma that causes the acetabular fracture. The operation through it has been a/w a higher (12%) rate of postoperative infection, wound dehiscence and healing by secondary intention. The presence of a significant Morel-Lavallee lesion can be suspected by hypermobility of the skin and subcutaneous tissue in the affected area from the shear-type separation of the subcutaneous tissue from the underlying fascia lata. Alternatively, some fractures can be treated through ilioinguinal approach, thus avoiding the affected area. +Therefore, In the presence of Morel-Lavalle lesion posterior kocher langenbeck approach is avoided. +### End" +985,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Failure of the administrators of the hospital to provide adequate facilities comes under, with the following options: A: Contributary negligence, B: Corporate negligence, C: Composite negligence, D: Therapeutic misadventure + +### Response: +","Corporate negligence It is the failure of the administrators of the hospital to provide the adequate facilities including doctors. The hospital administration should provide standard equipments and competent employees. If the damage has occured as a result of negligent action of hospital administration, then it is liable for the damages. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 382","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Failure of the administrators of the hospital to provide adequate facilities comes under, with the following options: A: Contributary negligence, B: Corporate negligence, C: Composite negligence, D: Therapeutic misadventure + +### Response: +Corporate negligence It is the failure of the administrators of the hospital to provide the adequate facilities including doctors. The hospital administration should provide standard equipments and competent employees. If the damage has occured as a result of negligent action of hospital administration, then it is liable for the damages. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 382 +### End" +986,"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 glycoprotein, produced by many mammalian cells, and used in the treatment of hepatitis, papillomaviruses, hairy-cell leukemia and AIDS-related Kaposi's sarcoma?, with the following options: A: Interferon, B: Idoxuridine, C: Zidovudine, D: Zalcitabine + +### Response: +","All the above agents are synthetic analogues, except Interferon which is a glycoprotein produced by many types of mammalian cells. It has been shown to be useful in treatment of hepatitis, papillomaviruses, hairy-cell leukemia and AIDS-related Kaposi's sarcoma. Idoxuridine, as its name implies, is a synthetic pyrimidine analog, which inhibits viral DNA polymerase. Zidovudine and zalcitabine are also synthetic pyrimidine analogs but they inhibit reverse transcriptase and act as chain terminators. Ref: Baden L.R., Dolin R. (2012). Chapter 178. Antiviral Chemotherapy, Excluding Antiretroviral Drugs. 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: Which is a glycoprotein, produced by many mammalian cells, and used in the treatment of hepatitis, papillomaviruses, hairy-cell leukemia and AIDS-related Kaposi's sarcoma?, with the following options: A: Interferon, B: Idoxuridine, C: Zidovudine, D: Zalcitabine + +### Response: +All the above agents are synthetic analogues, except Interferon which is a glycoprotein produced by many types of mammalian cells. It has been shown to be useful in treatment of hepatitis, papillomaviruses, hairy-cell leukemia and AIDS-related Kaposi's sarcoma. Idoxuridine, as its name implies, is a synthetic pyrimidine analog, which inhibits viral DNA polymerase. Zidovudine and zalcitabine are also synthetic pyrimidine analogs but they inhibit reverse transcriptase and act as chain terminators. Ref: Baden L.R., Dolin R. (2012). Chapter 178. Antiviral Chemotherapy, Excluding Antiretroviral Drugs. 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" +987,"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 involves, with the following options: A: Mammillary body, B: Thalamus, C: Frontal lobe, D: Arcuate fasciculus + +### Response: +","Wernicke's encephalopathy : The neuropathological lesions are symmetrical and paraventricular, involving the mammillary bodies, the thalamus, the hypothalamus, the midbrain, the pons, the medulla, the fornix, and the cerebellum. Ref: Synopsis of Psychiatry, 11th edition, page 632.","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 involves, with the following options: A: Mammillary body, B: Thalamus, C: Frontal lobe, D: Arcuate fasciculus + +### Response: +Wernicke's encephalopathy : The neuropathological lesions are symmetrical and paraventricular, involving the mammillary bodies, the thalamus, the hypothalamus, the midbrain, the pons, the medulla, the fornix, and the cerebellum. Ref: Synopsis of Psychiatry, 11th edition, page 632. +### End" +988,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: ACTH secretion is highest during -, with the following options: A: Noon, B: Evening, C: Morning, D: Night + +### Response: +","Ans. is 'c' i.e., Morning o Coisol levels in blood are normally elevated at 8.00 AM and decrease to less than 50% by midnight.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: ACTH secretion is highest during -, with the following options: A: Noon, B: Evening, C: Morning, D: Night + +### Response: +Ans. is 'c' i.e., Morning o Coisol levels in blood are normally elevated at 8.00 AM and decrease to less than 50% by midnight. +### End" +989,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Osgood Shattiler disease -, with the following options: A: Involve the knee joint, B: Pelvis, C: Wrist joint, D: Cervical spine + +### Response: +",Osgood-shaltter disease is osteochondritis of tibial tuberosity (just below the knee joint).,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Osgood Shattiler disease -, with the following options: A: Involve the knee joint, B: Pelvis, C: Wrist joint, D: Cervical spine + +### Response: +Osgood-shaltter disease is osteochondritis of tibial tuberosity (just below the knee joint). +### End" +990,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Rivastigmine and donepezil are drugs used predominantly in the management of:, with the following options: A: Depression, B: Dissociation, C: Delusion, D: Dementia + +### Response: +","Acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine) increase the concentration of and duration of action of acetylcholine in the central nervous system. There is evidence that in moderately severe Alzheimer's disease, these drugs improve cognitive function and behavior for up to a year.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Rivastigmine and donepezil are drugs used predominantly in the management of:, with the following options: A: Depression, B: Dissociation, C: Delusion, D: Dementia + +### Response: +Acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine) increase the concentration of and duration of action of acetylcholine in the central nervous system. There is evidence that in moderately severe Alzheimer's disease, these drugs improve cognitive function and behavior for up to a year. +### End" +991,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The bacteria frequently used as an immuno modulator is -, with the following options: A: Corynebacterium parvum, B: Mycobacterium marinum, C: Chromobacterium violasium, D: Flavobacterium meningosepticum + +### Response: +","Ans. is 'a' i.e., Corynebacterium parvum . Corynebacterium parum is frequently used as an immunomodulator. . It is a mixture of Propionibacterium species.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The bacteria frequently used as an immuno modulator is -, with the following options: A: Corynebacterium parvum, B: Mycobacterium marinum, C: Chromobacterium violasium, D: Flavobacterium meningosepticum + +### Response: +Ans. is 'a' i.e., Corynebacterium parvum . Corynebacterium parum is frequently used as an immunomodulator. . It is a mixture of Propionibacterium species. +### End" +992,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ist urge of micturition comes at, with the following options: A: 50ml, B: 150ml, C: 250ml, D: 350ml + +### Response: +","When 100-150 millilitres (3.5-5 ounces) of urine accumulate, the first sensations of a need to void are felt. The feeling increases in intensity as more urine accumulates, and it becomes uncomfoable at a bladder volume of 350-400 millilitres. Impulses from the pelvic nerves mediate the sensations of bladder filling, painful distension, and the conscious need to urinate. Ref: guyton and hall textbook of medical physiology 12 edition page number:519,520,521","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Ist urge of micturition comes at, with the following options: A: 50ml, B: 150ml, C: 250ml, D: 350ml + +### Response: +When 100-150 millilitres (3.5-5 ounces) of urine accumulate, the first sensations of a need to void are felt. The feeling increases in intensity as more urine accumulates, and it becomes uncomfoable at a bladder volume of 350-400 millilitres. Impulses from the pelvic nerves mediate the sensations of bladder filling, painful distension, and the conscious need to urinate. Ref: guyton and hall textbook of medical physiology 12 edition page number:519,520,521 +### End" +993,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Elsching pearls is seen in, with the following options: A: Wilsons disease, B: Secondary cataract, C: Complicated cataract, D: Congenital cataract + +### Response: +","After cataract is also known as 'secondary cataract' . Types of after cataract : Thickened posterior capsule opacification(PCO) Dense membranous after cataract Soemmering's ring which refers to a thick ring of after cataract formed behind the iris, enclosed between the two layers of capsule Elsching's pearls in which the vacuated subcapsular epithelial cells are clustered like soap bubbles along the poster capsule. Ref;A.K.Khurana; 6th edition; Page no:214 QUESTION REPEATED","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Elsching pearls is seen in, with the following options: A: Wilsons disease, B: Secondary cataract, C: Complicated cataract, D: Congenital cataract + +### Response: +After cataract is also known as 'secondary cataract' . Types of after cataract : Thickened posterior capsule opacification(PCO) Dense membranous after cataract Soemmering's ring which refers to a thick ring of after cataract formed behind the iris, enclosed between the two layers of capsule Elsching's pearls in which the vacuated subcapsular epithelial cells are clustered like soap bubbles along the poster capsule. Ref;A.K.Khurana; 6th edition; Page no:214 QUESTION REPEATED +### End" +994,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Factors that protect against endometrial cancer, with the following options: A: Obesity, B: Smoking, C: Nulliparity, D: Diabetes + +### Response: +","Factors that increase + endometrial cancer + risk +Factors that protect + against endometrial + cancer + + +Obesity +Hysterectomy + + +Diabetes +Combined oral contraceptive pill + + +Nulliparity +Progestin - based + Contraceptives, including injectables + + +Late menopause + > 52 years +Intrauterine device, including Cu-IUD and LNG-IUS + + +Unopposed oestrogen + therapy +Pregnancy + + +Tamoxifen therapy +Smoking + + + +Family history of + colorectal and + endometrial cancer","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Factors that protect against endometrial cancer, with the following options: A: Obesity, B: Smoking, C: Nulliparity, D: Diabetes + +### Response: +Factors that increase + endometrial cancer + risk +Factors that protect + against endometrial + cancer + + +Obesity +Hysterectomy + + +Diabetes +Combined oral contraceptive pill + + +Nulliparity +Progestin - based + Contraceptives, including injectables + + +Late menopause + > 52 years +Intrauterine device, including Cu-IUD and LNG-IUS + + +Unopposed oestrogen + therapy +Pregnancy + + +Tamoxifen therapy +Smoking + + + +Family history of + colorectal and + endometrial cancer +### End" +995,"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 nitric oxide except, with the following options: A: Acts through cAMP, B: Helps to regulate vascular tone, C: Impoant role in penile erection, D: Present in low concentration in cigarette smokers + +### Response: +","NO acts through guanylyl cyclase.Ref: Ganong&;sReview of medical physiology, 24th edition.Pg no. 151","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 nitric oxide except, with the following options: A: Acts through cAMP, B: Helps to regulate vascular tone, C: Impoant role in penile erection, D: Present in low concentration in cigarette smokers + +### Response: +NO acts through guanylyl cyclase.Ref: Ganong&;sReview of medical physiology, 24th edition.Pg no. 151 +### End" +996,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Rhabdomyolosis is seen in all except-, with the following options: A: Hyperphosphatemia, B: Prolonged seizure activity, C: Severe Hypothyroidism, D: Myopathy + +### Response: +",Causes of Rhabdomyolysis - Traumatic crush injury Coma or immobilisation Prolonged seizure activity Hypophosphatemia severe hypothyroidism Severe ischemia Myopathy Malignant hypehermia Heat stroke Infections Excessive exercise Ref:Harrison 20th edition pg no 2103,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Rhabdomyolosis is seen in all except-, with the following options: A: Hyperphosphatemia, B: Prolonged seizure activity, C: Severe Hypothyroidism, D: Myopathy + +### Response: +Causes of Rhabdomyolysis - Traumatic crush injury Coma or immobilisation Prolonged seizure activity Hypophosphatemia severe hypothyroidism Severe ischemia Myopathy Malignant hypehermia Heat stroke Infections Excessive exercise Ref:Harrison 20th edition pg no 2103 +### End" +997,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Disease not under integrated disease surveillance project is, with the following options: A: TB, B: Meningoencephalitis, C: Cholera, D: Herpes Zoster + +### Response: +","Herpes Zoster is not under integrated disease surveillance project. Disease under integrated disease surveillance includes, Malaria, Typhoid, JE, Dengue, Measles, TB, Polio, Cholera, Hepatitis, Leptospirosis, Yellow fever, Anthrax, Plague, Meningoencephalitis etc. Ref: PARK&;S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 23rd edition pg 475","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: Disease not under integrated disease surveillance project is, with the following options: A: TB, B: Meningoencephalitis, C: Cholera, D: Herpes Zoster + +### Response: +Herpes Zoster is not under integrated disease surveillance project. Disease under integrated disease surveillance includes, Malaria, Typhoid, JE, Dengue, Measles, TB, Polio, Cholera, Hepatitis, Leptospirosis, Yellow fever, Anthrax, Plague, Meningoencephalitis etc. Ref: PARK&;S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 23rd edition pg 475 +### End" +998,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 21-year-old woman went to her dentist because of facial asymmetry. This had occurred gradually over a period of 3 years. The patient had no symptoms. A diffusely opaque lesion was found in her right maxilla. All lab tests (CBC, alkaline phosphatase, calcium) were within normal limits. Biopsy was interpreted as a fibroosseous lesion. She most likely has _____., with the following options: A: Cementoblastoma, B: Fibrous dysplasia, C: Cherubism, D: Osteosarcoma + +### Response: +","Cherubism is a fibro-osseous lesion that occurs in teenagers. Characteristically, it presents with ill-defined margins and a “ground glass” appearance radiographically. The other features described also support this diagnosis.","Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: A 21-year-old woman went to her dentist because of facial asymmetry. This had occurred gradually over a period of 3 years. The patient had no symptoms. A diffusely opaque lesion was found in her right maxilla. All lab tests (CBC, alkaline phosphatase, calcium) were within normal limits. Biopsy was interpreted as a fibroosseous lesion. She most likely has _____., with the following options: A: Cementoblastoma, B: Fibrous dysplasia, C: Cherubism, D: Osteosarcoma + +### Response: +Cherubism is a fibro-osseous lesion that occurs in teenagers. Characteristically, it presents with ill-defined margins and a “ground glass” appearance radiographically. The other features described also support this diagnosis. +### End" +999,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The mother of this newborn had fever with rash at 18 weeks of gestation. What is this baby probably suffering from?, with the following options: A: Congenital Varicella, B: Congenital Rubella, C: Congenital CMV, D: Congenital Toxoplasmosis + +### Response: +",Cicatricial skin scarring in a zoster-like distribution & limb hypoplasia in this newborn points to a diagnosis of Congenital Varicella syndrome.,"Below is an instruction that describes a task. Write a response that appropriately completes the request. + +### Instruction: + +Answer the following medical question: The mother of this newborn had fever with rash at 18 weeks of gestation. What is this baby probably suffering from?, with the following options: A: Congenital Varicella, B: Congenital Rubella, C: Congenital CMV, D: Congenital Toxoplasmosis + +### Response: +Cicatricial skin scarring in a zoster-like distribution & limb hypoplasia in this newborn points to a diagnosis of Congenital Varicella syndrome. +### End"