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You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is 1st evidence of calcification of Mandibular canine is seen in and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Most common cause of HUS in children is - and explain in detail? | Ans. is 'a' i.e., E coli O157/H7 o The majority of HUS in children (90%) is related to prototypic diarrhea associated form, predominately in previously healthy children 6 months to 4 years of age with a peak between 1 and 2 years,o Shiga toxin producing E coli (STEC) is the major cause of diarrhea associated HUS.o Specifically, E coli with serotype Ol 57:H7 is the bacteria most commonly associated with HUS (90%) and is the most virulent.o Other common bacteria implicated in causation of HUS are :Shigella dysenteriaeSalmonella typhaeCamphylobacter jejuniYersinia speciesPseudomonas speciesClostridium difficle |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Extraction of mandibular first molar in an 8 year old child is known as: and explain in detail? | Wilkinson Extraction
Wilkinson advocated extraction of all the four first permanent molars between the age of 8 ½ & 9 years.
The basis of it is the fact that first molars are highly susceptible to caries.
The other benefits of extracting first molars at an early age are:
To avoid third molar impactions by providing additional space for their eruption.
To reduce crowding in the arch. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Postnatally when is the growth velocity maximum ? and explain in detail? | Growth follows a sigma shaped curve.
The fetus grows fast in the first half of gestation, thereafter the rate of growth is slowed down till the baby is born.
In the early postnatal period velocity of growth is high during the first few months.
A second phase of accelerated growth is during puberty. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Management of extradural hemorrhage is ? and explain in detail? | Ans. is 'b' i.e., Immediate evacuvation |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Drugs which increases nitric oxide are all except? and explain in detail? | Ans. is 'd' i.e., Fenoldopam o NO donors, which release NO are used to elicit smooth muscle relaxation. Drugs are - 1. Organic nitrates (nitroglycerine) 3. Sodium nitroprusside 5. Nebivolol 2. Organic nitrites (Isoamylnitrite) 4. Hydralazine |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Integrated management of childhood illness (IMCI) intiative was taken to prevent morbidity and moality from all of the following except - and explain in detail? | Ans. is `d' i.e., Neonatal tetanus Integrated management of childhood iliness.tIMCD The extent of childhood morbidity and moality caused by following diseases is substantial. i) Diarrhea iii) Malaria v) Malnutrition ii) ARI (pneumonia, otitis media) iv) Measles o Most sick children present with signs and symptoms of more than one of these conditions. o This overlap means that a signle diagnosis may not be possible or appropriate, and treatment may be complicated by the need to combine for several conditions. o Therefore, an integrated approach to menage Sick children is necessary. IMCI is a strategy for an integrated approach to the management of childhood illness as it is impoant for child health programmes to look beyond the treatment of a single disease. o This is cost effective and emphasizes prevention of disease and promotion of child health and development besides provision of standard case management of childhood illness. The target of IMCI --) Children < 5 years of age (0-2 months, 2 months - 5 years). o Health promotive and preventive components include:- I) Breast feeding: ii) Nutritional counseling; iii) Vitamin A & iron supplementation: iv) immunization; v) Treatment of helminthic infestation. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A young boy presented to OPD with multiple shiny pinhead size white papules over dorsum of hand, forearm and penis. What would be the diagnosis? and explain in detail? | lichen nitidus-monomorphic eruption of asymptomatic minute skin coloured shiny papules common sites- forearm, penis,buttocks, lower abdomen and chest age- common in children and young adults histopathology- claw clutching ball appearence rx- self limitingtopical steroids,PUVA,NBUVB,Systemic steroids. scabies - erythematous papules in web spaces, axilla, groins involving circle of hebra lichen planus- violaceous flat topped papules. molluscum contagiosum- pearly papules with central umbilication. IADVL textbook of dermatology page 1082. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Factors ouring fat embolism in a patient with major trauma : and explain in detail? | A i.e. Mobility of |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is AI toxicity -a) Dementiab) Bone diseasec) Cardiomyopathyd) Anemia and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Weakness of extensor Hallucis longus is due to which nerve root mainly? and explain in detail? | Ans. is 'a' i.e., L5 Important muscles and their chief myotomesMuscleMyotomeExtensor Hallucis LongusL5Tibialis anteriorL4Flexor Hallucis LongusS1GastrosoleusS1Gluteus Medius and MinimusL5Gluteus MaximusS1Quadriceps FemorisL3 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A 60-year-old man with small cell carcinoma of lung is rushed to emergency room in coma after suffering a clonic-tonic seizure. Patient's temperature is 37degC , blood pressure 100/50 mm Hg and pulse is 88 per minute. Laboratory studies show a serum sodium of 103 mmol/L, normal serum levels of BUN & creatinine and a dilute but otherwise normal urine. A CT scan of the head is normal. Which of the following is the most likely cause of seizures in this patient? and explain in detail? | - Given clinical features suggests the diagnosis of syndrome of inappropriate ADH (SIADH) secretion. SIADH - Associated with ADH excess, which causes resorption of excessive amount of free water, resulting in hyponatremia. - Causes of SIADH Secretion of ectopic ADH by malignant neoplasms (small-cell carcinomas of lung, intracranial neoplasms); Non-neoplastic diseases of lung Local injury to hypothalamus / neurohypophysis. - C/F- Hyponatremia, cerebral edema & neurologic dysfunction. - Cardinal features- Marked | in both serum sodium & osmolality | Urine osmolality. - Although total body water is increased, blood volume remains normal & peripheral edema does not develop. Diabetes mellitus may cause polyuria, glucosuria and does not cause severe hyponatremia. Diabetes insipidus - ADH deficiency causes diabetes insipidus, a condition characterized by excessive urination (polyuria) due to an inability of the kidney to resorb water properly from the urine, can occur in a variety of conditions, including head trauma, CNS tumors, inflammatory disorders of the hypothalamus and pituitary, and surgical complications. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A patient was advised Treadmill test, but he had lost both his limbs and then he was advised a stress test. The drug used for this test is: and explain in detail? | Uses of dobutamine Sho-term treatment of cardiac decompensation that may occur after cardiac surgery or in patients with congestive hea failure or acute myocardial infarction An infusion of dobutamine in combination with echocardiography is useful in noninvasive assessment of patients with coronary aery disease Stressing of the hea with dobutamine may reveal cardiac abnormalities in carefully selected patients. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Classical demonsable fibrinous inflammation is seen in which one of the following stages of lobar pneumonia - and explain in detail? | Ans. is 'c' i.e., Grey hepatization |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is All of the following enzymes are involved in oxidation-reduction, except: and explain in detail? | Enzymes involved in oxidation and reduction are called oxidoreductases and are classified into four groups: oxidases, dehydrogenases, hydroperoxidases, and oxygenases.
Reference- Haper 30th edition pg-120 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Ashley-Howe model analysis is used to predict: and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following diuretic should not be given along with aminoglycosides? and explain in detail? | Flurosemide is a loop diuretic which can lead to ototoxicity and hence contraindicated along with aminoglycosides. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following is an example of idiosyncratic reaction? and explain in detail? | Ans. is'd'i.e., Chloramphenicol - aPlastic anemia(Ref: KDT P/e p. 851) Idiosyncratic reactions e.g.:Barbiturates cause excitement and mental confusion in some individuals.Quinine/quinidine cause cramps, diarrhoea, purpura, asthma and vascular collapse in some patients.Chloramphenicol produces non dose-related serious aplastic anaemia in rare individuals. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is An increased incidence of pancreatitis is associated with all of the following except? and explain in detail? | Ans- (d) HypertensionRef: Robbings pathology 9th ed. /884-86* Acute pancreatitis is seen chiefly in males after age 40 and often associated with obesity and alcoholism.* In about 50 percent of the cases, gallstones are also present.* Pancreatitis occurs in about 10 percent of cases of hyperparathyroidism* Long term Thiazides can also contribute to development of pancreatitis* In some cases calculi resulting from the hypercalcemia of hyperparathyroidism develop in pancreatic ducts and lead to obstruction and inflammation. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Breast milk is rich in _____ when compared to cow's milk: and explain in detail? | Ref: Core of The Newborn by Meharban Singh 7th Edition, Page No. 163 Preventive and social medicine by A'.Park. 18th edition ,page no.398Explanation:Difference between human and cow's milk {composition per 100 ml)ConstituentBreast milkCow's milkPROTEIN1.1g3.3g-Casein0.4g2.8g-Soluble protein0.7g0.5gLIPID3.5g3.5gCARBOHYDRATES7.0g5-0g-Lactose6.5g4.5gCalcium34mg122mgPhosphorous15mg90mgIron0.29-0.45 mg0.01-0.38 mgFolic acid0.14-0.36pg0.01-0.06pgVitamin B120.0008-0.45pg0.07-1.15pgVitamin A0.5-10 lU70-220 IUVitaminC1.2-10 mg1.2-1.5 mgVitamin D0.5-10 IU0.5-4.5 IUVitamin K1.5mg6mgENERGY67 kcl65 kcal |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Irregular and infrequent menstruation is known as: and explain in detail? | Oligomenorrhoea - Infrequent and irregularly timed episodes of bleeding usually occuring at intervals of more than 35 days Polymenorrhoea - Frequent episodes of mentruation usually occurring at intervals of 21 days or less Menorrhagia - Increased menstrual flow/Increased duration at regular cycles Hypomenorrhoea - Scanty bleeding and shoer days of bleeding Metrorrhagia - Irregular bleeding in between the cycles Menometrorrhagia - Increased menstrual flow as well as irregular bleeding between the cycles |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Artery palpable at the anterior border of masseter
is _________ artery and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Acute GVHD is caused by? and explain in detail? | Ans. is 'b' i.e., T lymphocyteGraft versus host (gvh) diseasesGraft versus host disease occurs in any situation in which immunologically competent cells or their precursors are transplanted into immunologically crippled patients and the transferred cells recognize alloantigens in the host.Graft versus host disease occurs most commonly in the setting of allogenic bone marrow transplantation but may also follow transplantation of solid organs rich in lymphoid cells (e.g. the liver) or transfusion of unirradiated blood.Recipients of bone marrow transplants are immunodeficient because of either their primary disease or prior treatment of the disease with drugs or irradiation.When such recipients receive normal bone marrow cells from allogenic donors, the immunocompetent, T cells present in the donor marrow recognizes the recipient's HLA antigen as foreign antigen and react against them. Both CD4+ and CD8+T cells recognize and attack host tissues.In clinical practice GVH can be so severe that bone marrow transplants are done only between HLA matched donor and recipient. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following drugs cannot cross the blood placental barrier and explain in detail? | Refer kDT 7/e p116 Glycopyrrolate is a quaternary ammonium compound and is this water soluble and unable to penetrate blood brain barrier |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Study dealing with the effect of drugs on the body is known as: and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A 60 year old man has both HTN and DM for 10 years. There is reduced vision in one eye. On fundus examination there is a central bleed and the fellow eye is normal. The diagnosis is – and explain in detail? | Central bleed implies bleed in the macula and this is resulting in reduced vision in the involved eye.
Among the given options, macular bleed can be seen in diabetic retinopathy only. In diabetic retinopathy, neovascularization of macula may occur where there is growth of abnormal blood vessels under the retina which can cause leakage, bleeding and scarring resulting in reduced / loss of vision. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following is not true regarding cancrum oris and explain in detail? | Cancrum Oris Also known as Noma Disease or Gangrenous stomatitis) It is a gangrenous disease leading to tissue destruction of the face, especially the mouth and cheek Rapidly progressive, polymicrobial, oppounistic infection that occurs during periods of compromised immune function Main organisms implicated : Fusobacterium, prevotella and Borrelia vincentii Predisposing Factors Malnutrition or Dehydration Poor oral hygiene Poor sanitation Unsafe drinking water Recent illness Malignant Immunodeficiency disorder (AIDS) Clinical features Mainly affects children <12 years in the poorest countries of Africa Most children are between 2 and 6 years Mucous membranes of the mouth develop ulcers Rapid, painless tissue degeneration, can degrade tissues of the bones in the face Associated with high Morbidity and Moality Treatments Improvement in hygiene and nutrition Progression can be halted by antibiotics and improved nutrition Reconstructive plastic surgery to repair its permanent physical effects Ref: Sabiston 20th edition Pgno : 775 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is An 8 year old child presented with signs of increased intracranial tension. Imaging studies showed a growth in the brain. Which is the commonest tumor in a child in the posterior fossa of head? and explain in detail? | Medulloblastoma arises in the posterior pa of the cerebellar vermis and neuroepithelial roof of the fouh ventricle in children. It accounts for 20 percent of childhood brain tumors. Primitive neuroectodermal tumor is the most common type of medulloblastoma. Most occur in the first decade of life, but there is a second peak around age 30. Medulloblastoma is the most common malignant pediatric brain tumor. They are usually midline. Most occur in the cerebellum and present with symptoms of increased ICP. Ref: Ropper A.H., Samuels M.A. (2009). Chapter 31. Intracranial Neoplasms and Paraneoplastic Disorders. In A.H. Ropper, M.A. Samuels (Eds), Adams and Victor's Principles of Neurology, 9e. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A 8 years boy with headache, supracellar mass, with bilateral hemianopia, showing the following MRI scan of head. What is the diagnosis and explain in detail? | (A) Craniopharyngioma[?]Craniopharyngioma:Craniopharyngioma are pituitary gland tumor develop from the embryogenic remnants in pituitary gland.Present at any time during childhood, tumor is congenital &d arises from squamous epithelial cell rests of the embryonic Rathke's pouch.The neoplasm is usually cystic & benign.Clinical presentation:Headaches and raised ICPVisual symptoms: 20% of children & 80% adults.Hormonal imbalances:Short stature and delayed puberty in childrenDecreased libido; Amenorrhoea; Diabetes insipidusBehavioural change due to frontal or temporal extension.Growth failure; Signs of increased intracranial pressure; Endocrine abnormalities such as diabetes insipidus and delayed puberty (<10% of cases); Retarded Bone age.X-ray of skull may show calcificationMost preferred treatment is micro surgical excision & transcranial route through craniotomy.Tumor cyst can be aspirated or malignant craniopharyngiomas are treated with radiotherapy or implants.Types of Non Cancerous Brain Tumors seen in ChildrenChordomasMeningiomasCraniopharyngiomaPineocytomasGangliocytomasPituitary AdenomaGlomus JugulareSchwannomasOther Options[?]Pituitary apoplexy:Pituitary apoplexy or pituitary tumor apoplexy is bleeding into or impaired blood supply of the pituitary gland at the base of the brain. This usually occurs in the presence of a tumor of the pituitary, although in 80% of cases this has not been diagnosed previously.The most common initial symptom is a sudden headache, often associated with a rapidly worsening visual field defect or double vision caused by compression of nerves surrounding the gland.This is followed in many cases by acute symptoms caused by lack of secretion of essential hormones, predominantly adrenal insufficiency[?]Nasopharyngeal fibroma:Nasopharyngeal fibroma is a benign tumour but locally invasive and destroys the adjoining structures. It may extend into: Nasal cavity causing nasal obstruction, epistaxis and nasal discharge.Cranial cavity: Middle cranial fossa is the most common.There are two routes of entry:-By erosion of floor of middle cranial fossa, anterior to foramen lacerum. The tumour lies lateral to carotid artery & cavernous sinus.-Through sphenoid sinus, into the sella. Tumour lies medial to carotid artery.Surgical excision is now the treatment of choice. Radiotherapy has been used as a primary mode of treatment.Hormonal therapy as the primary or adjunctive treatment.Recurrent and residual lesions have been treated by chemotherapy.[?]Hypothalamic glioma:Rare tumors cause diencephalic syndrome in infants.Fail to thrive, loss of subcutaneous fat & suffer sleep & respiratory disturbances.Precocious puberty seen in older children.Associated histological types include glioma, pinealoma, teratomas & hamartomas. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A six-year-old boy presents to the emergency department with a painful limp. Clinical examination reveals tenderness in the femoral triangle and some limitation of hip movements. An X-ray was done which was normal. Which of the following should be the next course of action? and explain in detail? | Some of the guides have given option (MRI scan) as the answer by stating that this is a case of Perthe's disease. I do not agree with them.
Two most common causes of limp in a child between 4-10 years are :-
Transient synovitis of hip
Perthe's disease
The child in question has painful limp, tenderness in the femoral triangle and limitation of hip movement with normal X-ray. All of these can occur in both transient synovitis of hip and early stage of perthe's disease. However, the most favourable diagnosis here is transient synovitis because :-
Transient synovitis of hip is the most common cause of painful limp in a child between 4-10 years.
X-rays of transient synovitis are typically normal; however they may reveal subtle changes (widening of joint space). On the other hand x-rays are normal only in the initial stage of Perthe's; most of the time when patients present, the x-ray changes are there.
Child with perthe's disease may present with painful limp, but maximum patients present when pain has subsided and only limp is there, i.e. painless limp (in chronic stage).
Therefore, most probable diagnosis here is transient synovitis and management includes observation, bed rest and NSAIDs.
And this is the protocol, which is followed in most of the hospitals. In a suspected case of transient synovitis, we give conservative treatment, i.e. bed rest, NSAIDs and observation. If the child does not improve in 3-5 days, then we think of further investigation.
So, according to me option 'a' is the best answer here. You can choose your answer according to your thought process. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is All are complications of fibroid in pregnancy except: and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is An expectant mother feels quickening at: and explain in detail? | Ans. is b, i.e. 16-20 weeksRef. Dutta Obs 9/e, p 63: Reddy 27/e, p 434"Quickening (feeling of life) denotes the perception of active fetal movements by the women. It is usually felt about the 18th week Q, 2 weeks earlier in multiparae. Its appearance is a useful guide to calculate the expected date of delivery with reasonable accuracy" Ref. Dutta Obs, 9/e, p 63"Quickening is felt between 16th to 20th week Q" --Reddy 27/e, p 343PhenomenonTimePalpation of fetal part20 weeksActive fetal movement felt by placing a hand on abdomen20 weeksExternal ballottement20 weeksInternal ballottement16-28 weeksFHS audible by Stethoscope18-20 weeksFetal movement can be detected by Doppler10 weeksLightening38 weeks |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Housemaid's knee affects which of the following?(MH 2014) and explain in detail? | Ans. a (Prepatellar bursa). (Ref. Maheshwari, Orthopaedics, 2nd ed., 255)The 5 main bursae around the knee joint are - Prepatellar, Infrapatellar, Suprapatellar and Anserine bursa. Housemaid's knee is prepatellar bursitis (Irritation bursitis, or Infective bursitis). Named bursal diseaseMeans1Housemaid's kneePrepatellar superficial bursitis2Clergyman kneeInfrapatellar superficial bursitis3Student's elbowOlecranon bursitis4Weaver's bottomIschial bursitis5BunionBursitis at the first Metatarsophalangeal joint of foot causing swelling atmmedial aspect to the great toe base and lateral displacement of the toe.Bursae:# Sandwiched between tissues that slide past each other, bursae decrease the frictional forces present.# They are endothelialined cushions and normally contain little fluid.# If they are overloaded they can become inflamed, swollen and very painful.# Common sites for bursitis to develop are:- Olecranon;- Psoas tendon;- Greater trochanter; - Iliotibial band;- Prepatellar;- Infrapatellar;- Retro calcaneal.# Avoidance of the aggravating mechanical factors and a short course or anti-inflammatories is usually sufficient.# Intractable cases require aspiration and steroid injections and, more rarely, excision of the indurated bursal wall. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Microcherry appearance is a characteristic of and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Tubular maximum for kidney in practice is actually less than the calculated value because ? and explain in detail? | A i.e., Different nephrons have different transpo maximum |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is All of the following structures undergo mass contraction except and explain in detail? | Urine production by the kidneys is a continuous process. The contraction of the ureter is peristalic and not mass contraction. All other options are organs which show mass contraction. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Veronica’s parents were told that their daughter needs ribavirin (Virazole). This drug is used to treat which of the following? and explain in detail? | Option C: Ribavirin is an antiviral medication used for treating RSV infection and for children with RSV who are compromised (such as children with bronchopulmonary dysplasia or heart disease).
Options A, B, and D: The drug is not used to treat bronchiolitis, otitis media, or CF. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Die is and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following is true about Cones Fracture? and explain in detail? | Answer- D. It is associated with dorsal angulation |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Definition of hallucination - and explain in detail? | Ans. is 'a' i.e., Perception witout stimulus o Disorder of perception may be : -Altered perception : - There is alteration of preception of a real external stimulus. It may be : -Sensory distortion : - There is change in the intensity of a real external stimulus. For example micropsia (perceiving a real object smaller than its normal size) and hyperacusis (perceiving sounds as abnormally loud).Illusion : - There is misinterpretation of a real external stimulus. For example mistaking a stick for snake.False perception : - There is an internal perception without a real external stimulus, e.g., Hallucination and pseudo-hallucination |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Biological oxygen demand (BOD) measures the total organic content of water based on the consumption of oxygen in a sample at 20deg C Celsius over five days. A consumption of 10 to 20 mg of O2 per liter most likely represents a sample from and explain in detail? | Biological oxygen demand is a measure of organic content in water. The greater the demand, the greater the load of organic content that can be broken down, reflecting a high bac-terial load. Untreated freshwater has a BOD of 25 mg/l, treated sewage, 10-20, domestic sewage, 200-500, and industrial sewage, >2000. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Acute viral hepatitis — A is diagnosed by and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Loading dose depends on and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Delorme's operation is for and explain in detail? | Ans. B. Rectal prolapse. (Ref. LB 25th pg. 1225)RECTALPROPLASE# It may be mucosal or full thickness (whole wall included).# Commences as rectal intussusception.# In children, the prolapse is usually mucosal an should be Rxed conservatively.# In the adults, the prolapse is often full thickness and is frequently asociated with incontinence.# Surgery is necessary for full-thickness reactla prolpase.# The operation is performed either via perineum (Thiersch operation, Delorme's operation, &/or Altemeier operation) or via the abdomen (Well's operation, Ripstein's operation, or laparosocpic approach).Rx of RECTAL PROPLASE:# An abdominal rectopexy has a lower rate of recurrence but, when the patient is elderly and very frail, a perineal operation is indicated. As an abdominal procedure risks damage to the pelvic autonomic nerves, resulting in possible sexual dysfunction, a perineal approach is also usually preferred in young men.A. Perineal approach -These procedures have been used most commonly.# Thiersch operation- This procedure, which aimed to place a steel wire or, more commonly, a silastic or nylon suture around the anal canal, has become obsolete as the suture would often break or cause chronic perineal sepsis, or both, or the anal stenosis so created would produce severe functional problems. Delorme's operation is now the preferred perineal operation.# Delorme's operation- In this procedure, the rectal mucosa is removed circumferentially from the prolapsed rectum over its length. The underlying muscle is then plicated with a series of sutures, such that, when these are tied, the rectal muscle is concertinaed towards the anal canal. The anal canal mucosa is then sutured circumferentially to the rectal mucosa remaining at the tip of the prolapse. The prolapse is reduced, and a ring of muscle is created above the anal canal, which prevents recurrence.# Altemeier's procedure- This consists of excision of the prolapsed rectum and associated sigmoid colon from below, and construction of a coloanal anastomosis.B. Abdominal approach# The principle of all abdominal operations for rectal prolapse is to replace and hold the rectum in its proper position. They are recommended in patients with complete prolapse who are otherwise in good health.# Many variations have been described: in Wells' operation, the rectum is fixed firmly to the sacrum by inserting a sheet of polypropylene mesh between them; Ripstein's operation involves hitching up the rectosigmoid junction by a Teflon sling to the front of the sacrum; many surgeons simply suture the mobilised rectum to the sacrum using four to six interrupted non-absorbable sutures - so called sutured rectopexy. Recently, the technique has been performed laparoscopically. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Earliest sign of Pregnancy induced Hypertension is-(JIPMER 98) and explain in detail? | Source: style="font-family: Times New Roman, Times, serif"> What is pregnancy-induced hypertension (PIH)?Pregnancy-induced hypertension (PIH) is a form of high blood pressure in pregnancy. It occurs in about 7 to 10 percent of all pregnancies. Another type of high blood pressure is chronic hypertension - high blood pressure that is present before pregnancy begins.Pregnancy-induced hypertension is also called toxemia or preeclampsia. It occurs most often in young women with a first pregnancy. It is more common in twin pregnancies, and in women who had PIH in a previous pregnancy.Usually, there are three primary characteristics of this condition, including the following:high blood pressure (a blood pressure reading higher than 140/90 mm Hg or a significant increase in one or both pressures)protein in the urineedema (swelling)Eclampsia is a severe form of pregnancy-induced hypertension. Women with eclampsia have seizures resulting from the condition. Eclampsia occurs in about one in 1,600 pregnancies and develops near the end of pregnancy, in most cases.HELLP syndrome is a complication of severe preeclampsia or eclampsia. HELLP syndrome is a group of physical changes including the breakdown of red blood cells, changes in the liver, and low platelets (cells found in the blood that are needed to help the blood to clot in order to control bleeding).What causes pregnancy-induced hypertension (PIH)?The cause of PIH is unknown. Some conditions may increase the risk of developing PIH, including the following:pre-existing hypertension (high blood pressure)kidney diseasediabetesPIH with a previous pregnancymother's age younger than 20 or older than 40multiple fetuses (twins, triplets)Why is pregnancy-induced hypertension a concern?With high blood pressure, there is an increase in the resistance of blood vessels. This may hinder blood flow in many different organ systems in the expectant mother including the liver, kidneys, brain, uterus, and placenta.There are other problems that may develop as a result of PIH. Placental abruption (premature detachment of the placenta from the uterus) may occur in some pregnancies. PIH can also lead to fetal problems including intrauterine growth restriction (poor fetal growth) and stillbirth.If untreated, severe PIH may cause dangerous seizures and even death in the mother and fetus. Because of these risks, it may be necessary for the baby to be delivered early, before 37 weeks gestation.What are the symptoms of pregnancy-induced hypertension?The following are the most common symptoms of high blood pressure in pregnancy. However, each woman may experience symptoms differently. Symptoms may include:increased blood pressureprotein in the urineedema (swelling)sudden weight gainvisual changes such as blurred or double visionnausea, vomitingright-sided upper abdominal pain or pain around the stomachurinating small amountschanges in liver or kidney function testsHow is pregnancy-induced hypertension diagnosed?Diagnosis is often based on the increase in blood pressure levels, but other symptoms may help establish PIH as the diagnosis. Tests for pregnancy-induced hypertension may include the following:blood pressure measurementurine testingassessment of edemafrequent weight measurementseye examination to check for retinal changesliver and kidney function testsblood clotting testsTreatment for pregnancy-induced hypertension:Specific treatment for pregnancy-induced hypertension will be determined by your physician based on:your pregnancy, overall health and medical historyextent of the diseaseyour tolerance for specific medications, procedures, or therapiesexpectations for the course of the diseaseyour opinion or preferenceThe goal of treatment is to prevent the condition from becoming worse and to prevent it from causing other complications. Treatment for pregnancy-induced hypertension (PIH) may include:bedrest (either at home or in the hospital may be recommended).hospitalization (as specialized personnel and equipment may be necessary).magnesium sulfate (or other antihypertensive medications for PIH).fetal monitoring (to check the health of the fetus when the mother has PIH) may include:fetal movement counting - keeping track of fetal kicks and movements. A change in the number or frequency may mean the fetus is under stress.nonstress testing - a test that measures the fetal heart rate in response to the fetus' movements.biophysical profile - a test that combines nonstress test with ultrasound to observe the fetus.Doppler flow studies - type of ultrasound that uses sound waves to measure the flow of blood through a blood vessel.continued laboratory testing of urine and blood (for changes that may signal worsening of PIH).medications, called corticosteroids, that may help mature the lungs of the fetus (lung immaturity is a major problem of premature babies).delivery of the baby (if treatments do not control PIH or if the fetus or mother is in danger). Cesarean delivery may be recommended, in some cases.Prevention of pregnancy-induced hypertension:Early identification of women at risk for pregnancy-induced hypertension may help prevent some complications of the disease. Education about the warning symptoms is also important because early recognition may help women receive treatment and prevent worsening of the disease. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which is the most common primary malignant bone tumor? and explain in detail? | Secondaries are the most common malignant bone tumor. But the most common primary malignant bone tumor is Multiple myeloma.. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Structures passing through the aortic hiatus of diaphragm area) Aortab) Azygos veinc) Hemiazygos veind) Thoracic ducte) Sympathetic trunk and explain in detail? | Aortic opening
- Level- T12
- At osseoaponeurosis between right and left crus
- Structures transmitted
Aorta
Thoracic duct
Azygos vein |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Astasia-abasia is seen in patients with which of the following disorder? and explain in detail? | Astasia-abasia Seen in a Conversion disorder(FunctionalNeurological Symptom Disorder) Gait- Ataxic, staggering Movements - Gross, irregular, jerky truncal Waving and thrashing arm movements Fall is rarely seen |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is What medications are commonly used in the pharmacotherapy of status epilepticus, and what are the typical classes of drugs employed at different stages of treatment? and explain in detail? | Most patients with status epilepticus who are treated aggressively with a benzodiazepine, fosphenytoin, and/or phenobarbital experience complete cessation of their seizures. If status epilepticus does not stop, general anesthesia is indicated. Medications used in the treatment of status epilepticus include the following: 1. Benzodiazepines (eg, lorazepam, diazepam, midazolam): First-line agents 2. Anticonvulsant agents (eg, phenytoin, fosphenytoin) 3. Barbiturates (eg, phenobarbital, pentobarbital) 4. Anesthetics (eg, propofol) |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is All are true regarding Thrombotic Thrombocytopenia Purpurs (TTP), except- and explain in detail? | The signs and symptoms include: Purplish bruises on the skin or mucous membranes (such as in the mouth). ... Pinpoint-sized red or purple dots on the skin. ... Paleness or jaundice (a yellowish color of the skin or whites of the eyes). Fatigue (feeling very tired and weak). Fever. A fast hea rate or shoness of breath. Diagnosis. Laboratory studies for suspectedTTP include a CBC, platelet count, blood smears, coagulation studies, BUN creatinine, and serum bilirubin and lactate dehydrogenase. The exact etiology of TTP is unknown. ... Measuring ADAMTS13 activity level may aid in diagnosis. Ref Robbins 9/e pg 452 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is With regard to dantrolene sodium, false statement is and explain in detail? | Dantrolene inhibits release of calcium from sarcoplasmic reticulum. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is The national health policy is ba sed on - and explain in detail? | The ministry of Health and Family Welfare,Govt of India,evolved a National Health Policy in 1983 keeping in view the national commitment to attain the goal of Health for all by the year 2000.Since then there has been significant changes in the determinent factors relating to the health sector,necessitating revision of the policy and a new National Health Policy-2002 was evolved (refer pgno:873 park 23 rd edition) |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A boy alleging age 9 years is brought for medical examination. The total number of teeth at this age would be: and explain in detail? | Period of Mixed dentition- 6-11 years In this period, all the temporary teeth are replaced by permanent teeth and there is no addition. Calcification and eruption of permanent teeth Tooth Calcification begins Eruption Calcification complete First molar At bih 6 to 7 years 9 to 10 years Central incisor 3 to 4 months 6 to 8 years 10 years Lateral incisor 1 year 7 to 9 years 11 years First bicuspid 1 1/2 years 9 to 11 years 12 to 13 years Second bicuspid 2 years 10 to 12 years 12 to 14 years Canine 4 to 5 months 11 to 12 years 12 to 13 years Second molar 2 1/2 to 3 years 12 to 14 years 14 to 16 years Third molar 8 to 10 years 17 to 25 years 18 to 25 years |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is New RNTCP software online to monitor TB control programme is- and explain in detail? | To keep a track of the TB patients across the country, the Government of India has introduced a system called NIKSHAY. * The word is combination of two Hindi words NI and KSHAY meaning eradication of tuberculosis. * NIKSHAY (www.nikshay.gov.in) is a web enabled application, which facilitates monitoring of universal access to TB patients data by all concerned. * The system has been developed jointly by the Central TB Division of the Ministry of Health and Family Welfare and National Informatics Centre (NIC) and it was launched by the Government of India in June 2012 with issue of required administrative directions from Central TB Division for use of NIKSHAY . |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Prerenal and renal azotemia is differentiated on the basis of- and explain in detail? | the different types of azotemia, which may arise from or be a pa of renal failure, have different causes: when fluid flowing through the kidneys isn&;t enough to remove the nitrogen (prerenal azotemia) when the urinary tract is obstructed by something or by a rupture (postrenal azotemia) which may be differentiated by level of creatinine Prerenal azotemia refers to elevations in BUN and creatinine levels resulting from problems in the systemic circulation that decrease flow to the kidneys. In prerenal azotemia, decreased renal flow stimulates salt and water retention to restore volume and pressure Azotemia is an elevation of blood urea nitrogen (BUN) and serum creatinine levels. The reference range for BUN is 8-20 mg/dL, and the normal range for serum creatinine is 0.7-1.4 mg/dL. Each human kidney contains approximately 1 million functional units, nephrons, which are primarily involved in urine formation. Ref Harrison20th edition pg 278 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Kluver - Bucy Syndrome is associated with lesion in and explain in detail? | . *Effects of bilateral ablation of amygdala,when anterior pas of both temporal lobes are destroyed causes behavior changes. Kluver Bucy syndrome is a rare behavioral impairment characterized by inappropriate sexual behaviors and mouthing of objects. Other signs and symptoms, include a diminished ability to visually recognize objects, loss of normal fear and anger responses, memory loss, distractibility, seizures , and dementia Ref Harrison20th edition pg 1134 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Role of bile salts- and explain in detail? | Ans. is 'c' i.e., Emulsification of lipidso Emulsification is the process which breaks down ingested fats (mainly triglycerides) into smaller droplets so that they can be digested more efficiently. Thus, emulsification mainly helps in digestion of ingested fats.o Micelles formation is the process in which digested fats (FFAs and monoglycerides) are incorporated into much smaller droplets (micelles) so that they can be absorbed more efficiently. Thus, micelles formation helps in absorption of digested fats.o Detergent action of bile salts is necessary for both emulsification and micelles formation.Fat digestiono Ebner's glands on the dorsum of the tongue secrete lingual lipase and the stomach also secretes a lipase (gastric lipase),o However, they are of very little significance in fat digestionQo Fat digestion essentially begins in the duodenum with entry of pancreatic and biliary secretions,o Pancreatic juice contains lipase (pancreatic lipase), the most important enzyme for fat digestion,o The pancreatic lipase digests triglycerides (triacylglycerols) into free fatty acids and 2-monoglycerides (2-monocylglycerols). Pancreatic lipase hydrolyzes 1-and 3-bonds of trigiycerides relative sparing of 2-bonds, so the principal products of its action are free fatty acids and 2-monoglycerides,o Bile-salts help in digestion of fat by emulsification of fat in small intestine by detergent action of bile salts,o The detergent action of bile salts is due to their amphipathic property.o Emulsification increases the surface to volume ratio of the lipid droplets facilitating the action of lipases,o Bile salts also help in formation of micelles.o Micellar formation solubilizes the digested fats and provides a mechanism of their absorption into the enterocytes.o It is interesting to know that on one hand amphipathic property of bile salts helps in digestion and absorption of fats and micelles formation; on the other hand this property also creats a problem by inactivating lipase,o This inactivation of lipase by bile salts is prevented by colipase, a pancreatic enzy me,o Colipase is secreted by pancreas in precursor inactive (zymozen) form as procolipaseQ,o In the intestine, procolipase is converted into active colipase by try psinQ.o After fat digestion, fatty acids and monoglycerides are absorbed in small intestine especially in the jejunumQ and some amount also in ileum.o In side the enterocvte, fatty acids and monoglycerides again form triglycerides.o These triglycerides are incorporated into chylomicrons and transported to lymphatics and from there to blood vessels. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Morbid jealousy is diagnostic of : and explain in detail? | C i.e. Alcoholism |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Perforins are produced by: and explain in detail? | Perforins are hole forming proteins synthesized by cytotoxic T-cells. They can perforate the plasma membrane of the target cells that are under attack by CD8+ lymphocytes. Granzymes are delivered into the target cells through these holes formed by perforins. In addition, the perforin pores allow water to enter the cells, thus causing osmotic lysis. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Torticollis and explain in detail? | Torticollis, also known as wry neck, is a dystonic condition defined by an abnormal, asymmetrical head or neck position, which may be due to a variety of causes. The term torticollis is derived from the Latin words tortus for twisted and collum for neck.The most common case has no obvious cause, and the pain and difficulty with turning the head usually goes away after a few days, even without treatment in adults.
Signs and symptoms
Torticollis is a fixed or dynamic tilt, rotation, with flexion or extension of the head and/or neck.
The type of torticollis can be described depending on the positions of the head and neck.
laterocollis: the head is tipped toward the shoulder
rotational torticollis: the head rotates along the longitudinal axis
anterocollis: forward flexion of the head and neck
retrocollis: hyperextension of head and neck backwardA combination of these movements may often be observed. Torticollis can be a disorder in itself as well as a symptom in other conditions.
Other symptoms include:
Neck pain
Occasional formation of a mass
Thickened or tight sternocleidomastoid muscle
Tenderness on the cervical spine
Tremor in head
Unequal shoulder heights
Decreased neck movement
Causes
A multitude of conditions may lead to the development of torticollis including: muscular fibrosis, congenital spine abnormalities, or toxic or traumatic brain injury.
A rough categorization discerns between congenital torticollis and acquired torticollis.Other categories include:
Osseous
Traumatic
CNS/PNS
Ocular
Non-muscular soft tissue
Spasmodic
Drug induced
Oral ties (lip and tongue ties)
Congenital muscular torticollis
The congenital muscular torticollis is the most common torticollis which is present at birth. The cause of congenital muscular torticollis is unclear. Birth trauma or intrauterine malposition is considered to be the cause of damage to the sternocleidomastoid muscle in the neck. Other alterations to the muscle tissue arise from repetitive microtrauma within the womb or a sudden change in the calcium concentration in the body which causes a prolonged period of muscle contraction.Any of these mechanisms can result in a shortening or excessive contraction of the sternocleidomastoid muscle, which curtails its range of motion in both rotation and lateral bending. The head typically is tilted in lateral bending toward the affected muscle and rotated toward the opposite side. In other words, the head itself is tilted in the direction towards the shortened muscle with the chin tilted in the opposite direction.Congenital Torticollis is presented at 1–4 weeks of age, and a hard mass usually develops. It is normally diagnosed using ultrasonography and a colour histogram or clinically through evaluating the infants passive cervical range of motion.Congenital torticollis constitutes the majority of cases seen in clinical practice. The reported incidence of congenital torticollis is 0.3-2.0%. Sometimes a mass, such as a sternocleidomastoid tumor, is noted in the affected muscle. Torticollis does not resolve on its own and may result in plagiocephaly.
Acquired torticollis
Noncongenital muscular torticollis may result from scarring or disease of cervical vertebrae, adenitis, tonsillitis, rheumatism, enlarged cervical glands, retropharyngeal abscess, or cerebellar tumors. It may be spasmodic (clonic) or permanent (tonic). The latter type may be due to Potts Disease (tuberculosis of the spine).
A self-limiting spontaneously occurring form of torticollis with one or more painful neck muscles is by far the most common (stiff neck) and will pass spontaneously in 1–4 weeks. Usually the sternocleidomastoid muscle or the trapezius muscle is involved. Sometimes draughts, colds, or unusual postures are implicated; however, in many cases, no clear cause is found. These episodes are commonly seen by physicians.Most commonly this self-limiting form relates to an untreated dental occlusal dysfunction, which is brought on by clenching and grinding the teeth during sleep. Once the occlusion is treated it will completely resolve. Treatment is accomplished with an occlusal appliance, and equilibration of the dentition.
Tumors of the skull base (posterior fossa tumors) can compress the nerve supply to the neck and cause torticollis, and these problems must be treated surgically.
Infections in the posterior pharynx can irritate the nerves supplying the neck muscles and cause torticollis, and these infections may be treated with antibiotics if they are not too severe, but could require surgical debridement in intractable cases.
Ear infections and surgical removal of the adenoids can cause an entity known as Grisels syndrome, a subluxation of the upper cervical joints, mostly the atlantoaxial joint, due to inflammatory laxity of the ligaments caused by an infection.
The use of certain drugs, such as antipsychotics, can cause torticollis.
Antiemetics - Neuroleptic Class - Phenothiazines
There are many other rare causes of torticollis. A very rare cause of acquired torticollis is fibrodysplasia ossificans progressiva (FOP), the hallmark of which is malformed great toes.
Spasmodic torticollis
Torticollis with recurrent, but transient contraction of the muscles of the neck and especially of the sternocleidomastoid, is called spasmodic torticollis. Synonyms are "intermittent torticollis", "cervical dystonia" or "idiopathic cervical dystonia", depending on cause.
Trochlear torticollis
Torticollis may be unrelated to the sternocleidomastoid muscle, instead caused by damage to the trochlear nerve (fourth cranial nerve), which supplies the superior oblique muscle of the eye. The superior oblique muscle is involved in depression, abduction, and intorsion of the eye. When the trochlear nerve is damaged, the eye is extorted because the superior oblique is not functioning. The affected person will have vision problems unless they turn their head away from the side that is affected, causing intorsion of the eye and balancing out the extorsion of the eye. This can be diagnosed by the Bielschowsky test, also called the head-tilt test, where the head is turned to the affected side. A positive test occurs when the affected eye elevates, seeming to float up.
Anatomy
The underlying anatomical distortion causing torticollis is a shortened sternocleidomastoid muscle. This is the muscle of the neck that originates at the sternum and clavicle and inserts on the mastoid process of the temporal bone on the same side. There are two sternocleidomastoid muscles in the human body and when they both contract, the neck is flexed. The main blood supply for these muscles come from the occipital artery, superior thyroid artery, transverse scapular artery and transverse cervical artery. The main innervation to these muscles is from cranial nerve XI (the accessory nerve) but the second, third and fourth cervical nerves are also involved. Pathologies in these blood and nerve supplies can lead to torticollis.
Diagnosis
Evaluation of a child with torticollis begins with history taking to determine circumstances surrounding birth and any possibility of trauma or associated symptoms. Physical examination reveals decreased rotation and bending to the side opposite from the affected muscle. Some say that congenital cases more often involve the right side, but there is not complete agreement about this in published studies. Evaluation should include a thorough neurologic examination, and the possibility of associated conditions such as developmental dysplasia of the hip and clubfoot should be examined. Radiographs of the cervical spine should be obtained to rule out obvious bony abnormality, and MRI should be considered if there is concern about structural problems or other conditions.
Ultrasonography can be used to visualize muscle tissue, with a colour histogram generated to determine cross-sectional area and thickness of the muscle.Evaluation by an optometrist or an ophthalmologist should be considered in children to ensure that the torticollis is not caused by vision problems (IV cranial nerve palsy, nystagmus-associated "null position," etc.).
Differential diagnosis for torticollis includes
Cranial nerve IV palsy
Spasmus nutans
Sandifer syndrome
Myasthenia gravis
Cerebrospinal fluid leakCervical dystonia appearing in adulthood has been believed to be idiopathic in nature, as specific imaging techniques most often find no specific cause.
Treatment
Initially, the condition is treated with physical therapies, such as stretching to release tightness, strengthening exercises to improve muscular balance, and handling to stimulate symmetry. A TOT collar is sometimes applied. Early initiation of treatment is very important for full recovery and to decrease chance of relapse.
Physical therapy
Physical therapy is an option for treating torticollis in a non-invasive and cost-effective manner. In the children above 1 year of age, surgical release of the tight sternocleidomastoid muscle is indicated along with aggressive therapy and appropriate splinting. Occupational therapy rehabilitation in Congenital muscular torticollis concentrates on observation, orthosis, gentle stretching, myofascial release techniques, parents’ counseling-training, and home exercise program. While outpatient infant physiotherapy is effective, home therapy performed by a parent or guardian is just as effective in reversing the effects of congenital torticollis. It is important for physical therapists to educate parents on the importance of their role in the treatment and to create a home treatment plan together with them for the best results for their child. Five components have been recognized as the "first choice intervention" in PT for treatment of torticollis and include neck passive range of motion, neck and trunk active range of motion, development of symmetrical movement, environmental adaptations, and caregiver education. In therapy, parents or guardians should expect their child to be provided with these important components, explained in detail below. Lateral neck flexion and overall range of motion can be regained quicker in newborns when parents conduct physical therapy exercises several times a day.Physical therapists should teach parents and guardians to perform the following exercises:
Stretching the neck and trunk muscles actively. Parents can help promote this stretching at home with infant positioning. For example, prone positioning will encourage the child to lift their chin off the ground, thereby strengthening their bilateral neck and spine extensor muscles, and stretching their neck flexor muscles. Active rotation exercises in supine, sitting or prone position by using toys, lights and sounds to attract infants attention to turn neck and look toward the non-affected side.
Stretching the muscle in a prone position passively. Passive stretching is manual, and does not include infant involvement. Two people can be involved in these stretches, one person stabilizing the infant while the other holds the head and slowly brings it through the available range of motion. Passive stretching should not be painful to the child, and should be stopped if the child resists. Also, discontinue the stretch if changes in breathing or circulation are seen or felt.
Stretching the muscle in a lateral position supported by a pillow (have infant lie on the side with the neck supported by pillow). Affected side should be against the pillow to deviate the neck towards the non-affected side.
Environmental adaptations can control posture in strollers, car seats and swings (using U-shaped neck pillow or blankets to hold neck in neutral position)
Passive cervical rotation (much like stretching when being supported by a pillow, have affected side down)
Position infant in the crib with affected side by the wall so they must turn to the non-affected side to face outPhysical therapists often encourage parents and caregivers of children with torticollis to modify the environment to improve neck movements and position. Modifications may include:
Adding neck supports to the car seat to attain optimal neck alignment
Reducing time spent in a single position
Using toys to encourage the child to look in the direction of limited neck movement
Alternating sides when bottle or breastfeeding
Encouraging prone playtime (tummy time). Although the Back to Sleep campaign promotes infants sleeping on their backs to avoid sudden infant death syndrome during sleep, parents should still ensure that their infants spend some waking hours on their stomachs.
Microcurrent therapy
A Korean study has recently introduced an additional treatment called microcurrent therapy that may be effective in treating congenital torticollis. For this therapy to be effective the children should be under three months of age and have torticollis involving the entire sternocleidomastoid muscle with a palpable mass and a muscle thickness over 10 mm. Microcurrent therapy sends minute electrical signals into tissue to restore the normal frequencies in cells. Microcurrent therapy is completely painless and children can only feel the probe from the machine on their skin.Microcurrent therapy is thought to increase ATP and protein synthesis as well as enhance blood flow, reduce muscle spasms and decrease pain along with inflammation. It should be used in addition to regular stretching exercises and ultrasound diathermy. Ultrasound diathermy generates heat deep within body tissues to help with contractures, pain and muscle spasms as well as decrease inflammation. This combination of treatments shows remarkable outcomes in the duration of time children are kept in rehabilitation programs: Micocurrent therapy can cut the length of a rehabilitation program almost in half with a full recovery seen after 2.6 months.About 5–10% of cases fail to respond to stretching and require surgical release of the muscle.
Surgery
Surgical release involves the two heads of the sternocleidomastoid muscle being dissected free. This surgery can be minimally invasive and done laparoscopically. Usually surgery is performed on those who are over 12 months old. The surgery is for those who do not respond to physical therapy or botulinum toxin injection or have a very fibrotic sternocleidomastoid muscle. After surgery the child will be required to wear a soft neck collar (also called a Callots cast). There will be an intense physiotherapy program for 3–4 months as well as strengthening exercises for the neck muscles.Other treatments include:
Rest and analgesics for acute cases
Diazepam or other muscle relaxants
Botulinum toxin
Encouraging active movements for children 6–8 months of age
Ultrasound diathermy
Prognosis
Studies and evidence from clinical practice show that 85–90% of cases of congenital torticollis are resolved with conservative treatment such as physical therapy |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following anesthetic agent causes dissociative anesthesia:- and explain in detail? | Ketamine produces dose-dependent CNS depression leading to a so-called dissociative anesthetic state characterized by profound analgesia and amnesia, even though patient is conscious and maintains protective reflexes. Ketamine produces dissociative anesthesia through antagonistic actions at thephencyclidinesite of theNMDARmediated glutamatergic input to the GABA-ergic system. Dissociative anesthesia is a state where the patient appears conscious (eg, eye opening, swallowing, muscle contracture) but unable to process or respond to sensory input. Ketamine functionally "dissociates" thethalamus(which relays sensory impulses from the reticular activating system to the cerebral coex) from thelimbic coex(which is involved with the awareness of sensation). |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Visual axis is and explain in detail? | Axes of the eyes: 1. The optical axis is the line passing through the center of the cornea (P), the center of the lens (N) and meets the retina (R) on the nasal side of the fovea. 2. Visual axis is the line joining the fixation point (O), nodal point (N), and the fovea (F). 3. Fixation axis is the line joining the fixation point (O) and the center of rotation (C). simple definition of the visual axis is: " A straight line that passes through both the centre of the pupil and the centre of the fovea". There is also a stricter definition (in terms of nodal points) which is impoant for specialists in optics and related subjects Image : The Visual Axis of the eye Reference : Khurana comprehensive ophthalmology; 4th edition ; Page27 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Dysexecutive syndrome and explain in detail? | Dysexecutive syndrome (DES) consists of a group of symptoms, usually resulting from brain damage, that fall into cognitive, behavioural and emotional categories and tend to occur together. The term was introduced by Alan Baddeley to describe a common pattern of dysfunction in executive functions, such as planning, abstract thinking, flexibility and behavioural control. It is thought to be Baddeleys hypothesized working memory system and the central executive that are the hypothetical systems impaired in DES. The syndrome was once known as frontal lobe syndrome; however dysexecutive syndrome is preferred because it emphasizes the functional pattern of deficits (the symptoms) over the location of the syndrome in the frontal lobe, which is often not the only area affected.
Classification code in ICD-10 - F07
Symptoms and signs
Symptoms of DES fall into three broad categories: cognitive, emotional and behavioural. Many of the symptoms can be seen as a direct result of impairment to the central executive component of working memory, which is responsible for attentional control and inhibition. Although many of the symptoms regularly co-occur, it is common to encounter patients who have several, but not all symptoms. The accumulated effects of the symptoms have a large impact on daily life.
Cognitive symptoms
Cognitive symptoms refer to a persons ability to process thoughts. Cognition primarily refers to memory, the ability to learn new information, speech, and reading comprehension. Deficits within this area cause many problems with everyday life decisions.One of the main difficulties for an individual with DES is planning and reasoning. Impaired planning and reasoning affect the individuals ability to realistically assess and manage the problems of everyday living. New problems and situations may be especially poorly handled because of the inability to transfer previous knowledge to the new event. An individual that has DES may have a short attention span due to impairment in attentional control. This may alter the individuals ability to focus, and as such have difficulty with reading and following a storyline or conversation. For instance, they can easily lose track of conversations which can make it difficult to hold a meaningful conversation and may result in avoiding social interactions.Individuals with DES will have very poor working memory and short term memory due to executive dysfunction. The dysfunction can range from mild and subtle to severe and obvious. There is a tremendous variability in the manifestations of executive dysfunction with strong influences often apparent from the affected persons personality, life experiences and intellect. Individuals with DES may experience confabulation, which is the spontaneous reporting of events that never happened. This can affect their autobiographical memory. It is thought that patients may not be able to assess the accuracy of memory retrieval and therefore elaborate on implausible memories.Individuals with dementia, delirium or other severe psychiatric illnesses combined with DES often have disturbed sleep patterns. Some will not recognize that it is night-time and may become upset when someone tries to correct them.
Emotional symptoms
The emotional symptoms that individuals with DES experience may be quite extreme and can cause extensive problems. They may have difficulty inhibiting many types of emotions such as anger, excitement, sadness, or frustration. Due to multiple impairments of cognitive functioning, there can be much more frustration when expressing certain feelings and understanding how to interpret everyday situations. Individuals with DES may have higher levels of aggression or anger because they lack abilities that are related to behavioural control. They can also have difficulty understanding others points of view, which can lead to anger and frustration.
Behavioural symptoms
Behavioural symptoms are evident through an individuals actions. People with DES often lose their social skills because their judgments and insights into what others may be thinking are impaired. They may have trouble knowing how to behave in group situations and may not know how to follow social norms. The central executive helps control impulses; therefore when impaired, patients have poor impulse control. This can lead to higher levels of aggression and anger. DES can also cause patients to appear self-centered and stubbornUtilization behaviour is when a patient automatically uses an object in the appropriate manner, but at an inappropriate time. For example, if a pen and paper are placed in front of an individual with DES they will start to write or if there is a deck of cards they will deal them out. Patients showing this symptom will begin the behaviour in the middle of conversations or during auditory tests. Utilization behaviour is thought to occur because an action is initiated when an object is seen, but patients with DES lack the central executive control to inhibit acting it out at inappropriate times.Perseveration is also often seen in patients with DES. Perseveration is the repetition of thoughts, behaviours, or actions after they have already been completed. For instance, continually blowing out a match, after it is no longer lit is an example of perseveration behaviour. There are three types of perseveration: continuous perseveration, stuck-in-set perseveration, and recurrent perseveration. Stuck-in-set perseveration is most often seen in dysexecutive syndrome. This type of perseveration refers to when a patient cannot get out of a specific frame of mind, such as when asked to name animals they can only name one. If you ask them to then name colours, they may still give you animals. Perseveration may explain why some patients appear to have obsessive-compulsive disorder.
Comorbid disorders
DES often occurs with other disorders, which is known as comorbidity. Many studies have examined the presence of DES in patients with schizophrenia. Results of schizophrenic patients on the Behavioural Assessment of the Dysexecutive Syndrome (BADS) test (discussed below) are comparable to brain injured patients. Further, results of BADS have been shown to correlate with phases of schizophrenia. Patients in the chronic phase of the disorder have significantly lower scores than those who are acute. This is logical due to the similarities in executive disruptions that make everyday life difficult for those with schizophrenia and symptoms that form DES.
Patients with Alzheimers disease and other forms of dementia have been shown to exhibit impairment in executive functioning as well. The effects of DES symptoms on the executive functions and working memory, such as attentiveness, planning and remembering recently learned things, are some of the earliest indicators of Alzheimers disease and dementia with Lewy bodies.
Studies have also indicated that chronic alcoholism (see Korsakoffs syndrome) can lead to a mild form of DES according to results of BADS.
Causes
The most frequent cause of the syndrome is brain damage to the frontal lobe. Brain damage leading to the dysexecutive pattern of symptoms can result from physical trauma such as a blow to the head or a stroke or other internal trauma.
It is important to note that frontal lobe damage is not the only cause of the syndrome. It has been shown that damage, such as lesions, in other areas of the brain may indirectly affect executive functions and lead to similar symptoms (such as ventral tegmental area, basal ganglia and thalamus). There is not one specific pattern of damage that leads to DES, as multiple affected brain structures and locations have led to the symptoms. This is one reason why the term frontal lobe syndrome is not preferred.
Diagnosis
Assessment of patients with DES can be difficult because traditional tests generally focus on one specific problem for a short period of time. People with DES can do fairly well on these tests because their problems are related to integrating individual skills into everyday tasks. The lack of everyday application of traditional tests is known as low ecological validity.
Behavioural
The Behavioural Assessment of the Dysexecutive Syndrome (BADS) was designed to address the problems of traditional tests and evaluate the everyday problems arising from DES. BADS is designed around six subtests and ends with the Dysexecutive Questionnaire (DEX). These tests assess executive functioning in more complex, real-life situations, which improves their ability to predict day-to-day difficulties of DES.
The six tests are as follows:Rule Shift Cards - Assesses the subjects ability to ignore a prior rule after being given a new rule to follow.
Action Program - This test requires the use of problem solving to accomplish a new, practical task.
Key Search - This test reflects the real-life situation of needing to find something that has been lost. It assesses the patients ability to plan how to accomplish the task and monitor their own progress.
Temporal Judgment - Patients are asked to make estimated guesses to a series of questions such as, "how fast do racehorses gallop?". It tests the ability to make sensible guesses.
Zoo Map - Tests the ability to plan while following a set of rules.
Modified Six Elements - This test assesses the subjects ability to plan, organize and monitor behaviour.The Dysexecutive Questionnaire (DEX) is a 20-item questionnaire designed to sample emotional, motivational, behavioural and cognitive changes in a subject with DES. One version is designed for the subject to complete and another version is designed for someone who is close to the individual, such as a relative or caregiver. Instructions are given to the participant to read 20 statements describing common problems of everyday life and to rate them according to their personal experience. Each item is scored on a 5-point scale according to its frequency from never (0 point) to very often (4 points).
Treatment
There is no cure for individuals with DES, but there are therapies to help them cope with their symptoms. DES can affect a number of functions in the brain and vary from person to person. Because of this variance, it is suggested that the most successful therapy would include multiple methods. Researchers suggest that a number of factors in the executive functioning need to be improved, including self-awareness, goal setting, planning, self-initiation, self-monitoring, self-inhibition, flexibility, and strategic behaviour.
One method for individuals to improve in these areas is to help them plan and carry out actions and intentions through a series of goals and sub-goals. To accomplish this, therapists teach patients a three-step model called the General Planning Approach. The first step is Information and Awareness, in which the patients are taught about their own problems and shown how this affects their lives. The patients are then taught to monitor their executive functions and begin to evaluate them. The second stage, Goal Setting and Planning, consists of patients making specific goals, as well as devising a plan to accomplish them. For example, patients may decide they will have lunch with a friend (their goal). They are taught to write down which friend it may be, where they are going for lunch, what time they are going, how they will get there, etc. (sub-goals). They are also taught to make sure the steps go in the correct order. The final stage, named Initiation, Execution, and Regulation, requires patients to implement their goals in their everyday lives. Initiation can be taught through normal routines. The first step can cue the patient to go to the next step in their plan. Execution and regulation are put into action with reminders of how to proceed if something goes wrong in the behavioural script. This treatment method has resulted in improved daily executive functioning, however no improvements were seen on formal executive functioning tests.
Since planning is needed in many activities, different techniques have been used to improve this deficit in patients with DES. Autobiographical memories can be used to help direct future behaviour. You can draw on past experiences to know what to do in the future. For example, when you want to take a bus, you know from past experience that you have to walk to the bus stop, have the exact amount of change, put the change in the slot, and then you can go find a seat. Patients with DES seem to not be able to use this autobiographical memory as well as a normal person. Training for DES patients asks them to think of a specific time when they did an activity previously. They are then instructed to think about how they accomplished this activity. An example includes "how would you plan a holiday". Patients are taught to think of specific times they went on a holiday and then to think how they may have planned these holidays. By drawing on past experiences patients were better able to make good decisions and plans.
Cognitive Analytic Therapy (CAT) has also been used to help those with DES. Because individuals with this syndrome have trouble integrating information into their actions it is often suggested that they have programmed reminders delivered to a cell phone or pager. This helps them remember how they should behave and discontinue inappropriate actions. Another method of reminding is to have patients write a letter to themselves. They can then read the letter whenever they need to. To help patients remember how to behave, they may also create a diagram |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Halos due to conjunctiva can be eliminated by and explain in detail? | Irrigation of the cul de sac can reduce the halos in conjunctivitis Halos due to immature senile cataract are broken by slit (Fincham test) Halos due to corneal edema in glaucoma is reduced by decrease in IOP |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Father to son inheritance is never seen in case of: and explain in detail? | Ans. is 'c' i.e. X linked recessive inheritance X linked recessive inheritance is a sex linked disorders i.e. they are transmitted by sex chromosomes. Remember that all sex linked diseases are linked to X chromosome so it is quite obvious that none of the sex linked disease (whether X-linked recessive or X-linked dominant) will be transmitted from father to son, as father transmits only 'Y' chromosome to the son.Other characteristic of this disorder is that it is mostly seen in males. Where as the diseases transmitted through non sex. Chromosomes (autosomes) have equal male and female incidence.So it is clear from the figureAn affected male does not transmit the disorder to his sons, but all daughters are carriersSons of heterozygous woman have 50% choice of receiving the abnormal geneIt usually affects males because of the presence of Y chromosome which is not homologous to X chromosome and therefore the mutant genes on the X is not paired with alleles on the YIt is rare in females only possible when mother is carrier and father has overt disease.* Most of the X linked disorders or X linked recessive. There are only few X-linked dominant conditions. These arePseudonym aparathyroidism Hypophosphatemic rickets*.Example of X-linked recessive disordersDuchenne muscular dystrophy *Hemophilia A and B*Chronic granulomatous diseaseGlucose 6-PO4 dehydrogenase deficiency*AgammaglobulinemiaWiskott Aldrich syndrome*Diabetes insipidus*Fragile X syndrome*Lesch Nyhan syndrome |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Lung compliance is greatest at/during: and explain in detail? | Static compliance of the lung is 200 mL/cm H2O. However, the compliance goes on changing with stages of a respiratory cycle. This changing compliance is 'dynamic compliance' of the lung. At the sta of inspiration, with smaller diameter of the alveoli, the surfactant molecules are concentrated over a small surface area; it makes the surfactant more effective in reducing the surface tension. Lower the surface tension, less is the collapsibility and greater is the distensibility (i.e., compliance). By the end of inspiration (with enlarged alveoli), surfactant molecules spread, making the surfactant less efficient in reducing surface tension. Greater the surface tension, lower is the compliance. However, if inspiration and expiration are compared, compliance will be more during expiration. During expiration, alveoli are becoming small and concentrating the surfactant molecules. The surface tension will be low; compliance will be high during expiration. So the lung compliance is greatest at the end of expiration. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Chronic arsenic poisoning causes -a) Pure sensory neuropathyb) Pure motor neuropathyc) Mixed sensory and motor neuropathyd) Painful neuropathye) Hyperkeratosis of skin and explain in detail? | Arsenic causes mixed (sensory and motor) neuropathy and hyperkeratosis of palm and sole.
Neuropathy may cause painful paresthesia (i.e. painful neuropathy). |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Best solution for burns: and explain in detail? | Ans. (b) Ringer's lactateRef: Sabiston 19th ed. 529-30* IV fluid resuscitation is immediately required: In children with burn >10% TBS A and adult with burn >15% TBS A* Maximum fluid is given in first 8 hours (50%) rest of the fluid will be given in subsequent hours (25% + 25% in next 16 hours).* Most commonly used/preferred fluid:Ringer lactate (Crystalloids). Because it is a relatively isotonic crystalloid solution that is the key component of almost all resuscitative strategies, at least for the first 24-48 hours.* However, some centers use human albumin, FFP or hypertonic saline.* RL is preferable to isotonic sodium chloride solution (ie, normal saline ) for large-volume resuscitations because its lower sodium concentration (130 mEq/L vs 154 mEq/L) and higher pH concentration (6.5 vs 5.0) are closer to physiologic levels.* Hypotonic fluid is not given, as it can lead to hyponatremia and water intoxication.* Maintenance fluid in children: Dextrose -salineAlso Know* Hypertonic saline has been effective in treating burn shock as it produces hyperosmolarity and hypernatremia* This reduces the shift of intracellular water to the extracellular space |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Chlorphenamine and explain in detail? | Chlorphenamine (CP, CPM), also known as chlorpheniramine, is an antihistamine used to treat the symptoms of allergic conditions such as allergic rhinitis (hay fever). It is taken by mouth. The medication takes effect within two hours and lasts for about 4-6.Common side effects include sleepiness, restlessness, and weakness. Other side effects may include dry mouth and wheeziness. It is a first-generation antihistamine and works by blocking the H1 receptor.Chlorpheniramine was patented in 1948 and came into medical use in 1949. It is available as a generic medication and over the counter.
Medical uses
Combination products
Chlorphenamine is often combined with phenylpropanolamine to form an allergy medication with both antihistamine and decongestant properties, though phenylpropanolamine is no longer available in the US after studies showed it increased the risk of stroke in young women. Chlorphenamine remains available with no such risk.
Chlorphenamine may be combined with the opioid hydrocodone. Chlorphenamine/dihydrocodeine immediate-release syrups are also marketed. The antihistamine is helpful in cases where allergy or common cold is the reason for the cough; it is also a potentiator of opioids, allowing enhanced suppression of cough, analgesia, and other effects from a given quantity of the drug by itself. In various places in the world, cough and cold preparations containing codeine and chlorphenamine are available.In the drug Coricidin, chlorphenamine is combined with the cough suppressant dextromethorphan. In the drug Cêgripe, chlorphenamine is combined with the analgesic paracetamol.
Side effects
The adverse effects include drowsiness, dizziness, confusion, constipation, anxiety, nausea, blurred vision, restlessness, decreased coordination, dry mouth, shallow breathing, hallucinations, irritability, problems with memory or concentration, tinnitus and trouble urinating.
Chlorphenamine produces less sedation than other first-generation antihistamines.A large study on people 65 years old or older, linked the development of Alzheimers disease and other forms of dementia to the "higher cumulative" use of chlorphenamine and other first-generation antihistamines, due to their anticholinergic properties.
Pharmacology
Pharmacodynamics
Chlorphenamine acts primarily as a potent H1 antihistamine. It is specifically a potent inverse agonist of the histamine H1 receptor. The drug is also commonly described as possessing weak anticholinergic activity by acting as an antagonist of the muscarinic acetylcholine receptors. The dextrorotatory stereoisomer, dexchlorpheniramine, has been reported to possess Kd values of 15 nM for the H1 receptor and 1,300 nM for the muscarinic acetylcholine receptors in human brain tissue. The smaller the Kd value, the greater the binding affinity of the ligand for its target.
In addition to acting as an inverse agonist at the H1 receptor, chlorphenamine has been found to act as a serotonin reuptake inhibitor (Kd = 15.2 nM for the serotonin transporter) |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A 60 year old male patient complains of fever, pale skin, weakness and loss of appetite. Karyotyping findings reveal presence of Ph chromosome. This patient could suffer from any of the following except? and explain in detail? | The BCR-ABL fusion gene is present in granulocytic, erythroid, megakaryocytic, and B cell precursors, and in some cases T cell precursors as well, indicating that the tumor arises from a transformed hematopoietic stem cell. Although the Ph chromosome is highly characteristic of CML. It also is present in 25% of adult B cell–ALLs and a small subset of AMLs.
NOTE- Ph chromosome=Philadelphia chromosome.
Reference: Robbins Basic Pathology, Kumar, Abbas, Aster, Elsevier, 10th Edition, Page No: 482 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following condition is associated with increase in LDH levels? and explain in detail? | LDH is used in assessment of tissue breakdown in general or hemolysis. It is used to follow-up cancer (especially lymphoma) patients, as cancer cells have a high rate of turnover with destroyed cells leading to an elevated LDH activity. Here all given options are malignancies. But the term 'bulky disease' indicates increased disease burden than others. So that is the answer. LDH levels are raised in: Testicular carcinoma Hemolytic anemia Visceral infarction Lymphoma, Leukemia Pleural effusions and serositis Melanoma Interstitial lung diseases Myopathies Meningitis and encephalitis HIV Dysgerminoma Increased tissue turnover |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Munson's sign is seen in: and explain in detail? | Ans. Keratoconus |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Commonest stone in case of UTI - and explain in detail? | Ans is 'a' ie Phosphate Phosphate or struvite stones are infection stones associated with urea splitting organisms i.e. Proteus, Pseudomonas, Providincia, Klebsiella, Staphylococci and Mycoplasma. The high ammonium concentration desired from urea-splitting organisms results in an alkaline urinary pH, reauired for the precipitation of phosphate crystals. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is All of the following may be seen in ventricular premature beats, Except: and explain in detail? | Answer is B (Narrow QRS complex) Premature Ventricular beats are characterized by a wide QRS Complex and not a narrow QRS complex. AV dissociation, Fusion beats and capture beats may be observed when three or more than three PVC's occur in succession. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Most common screening test for acute pancreatitis - and explain in detail? | |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following is not a phagocytic cell - and explain in detail? | Ans. is 'c' i.e., NK cells* Micro-organisms entering the tissue fluid or blood stream are very rapidly engulfed by the cells called phagocytes.* Phagocytic cells are of two types:1) Mononuclear macrophages: Monocytes (blood), histiocytes (tissues), alveolar macrophages (lung), kupffer cells (liver), microglia (brain), osteoclasts (bone), and mesangial cells (kidney).2) Polymorphonuclear microphages: Neutrophils.* Basophils also belong to polymorphonuclear microphages but they are not phagocytes.* Eosinophils have only a limited degree of phagocytic activity. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Difference between total cations and anions is called- and explain in detail? | Ans. is 'b' i.e., Anion gap "The anion gap is calculated by substracting the serum concentration of anions (Chloride and bicarbonates) from the concentration of cations (Na+ & K+)"Anion gap* The plasma anion gap is the total concentration of anions, excluding HCO3 and Cl, that are present in the plasma. It therefore represents the total plasma concentration of anions like albumin, phosphates, sulfates, and other organic acids.* Since the molar concentration of plasma anions and cations must be equal, the plasma anion gap can be calculated by substracting concentration of HCO3 and Cl from the total concentration of cations.* Since Na+ is the predominant cation in plasma (concentration of K+, Ca+2 and Mg+2 being negligible in comparison), the formula for anion gap can be wirtten as: -Plasma anion gap = Plasma Na+ - (Plasma HCO3 + Plasma Cl)* The normal value of anion gap is 12 +- 2 mEq/L. Plasma albumin accounts for most of the anion gap.* The urine anion gap provides an indirect way of estimating the urinary NH4+. It is given by the formula.Urine anion gap = Urinary Na+ + Urinary K+ - Urinary Cl* It assumes that the major cations in urine are Na+, K+, and NH4 while the major anion is only Cl since urinary HCO3 is zero at pH more than 6.5. Normally, the urinary anion gap is negative and gives the urinary NH4+ concentration. It becomes zero if renal ammonium production is defective and becomes positive in bicarbonaturia. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Muttering delirium is seen with: NEET 13 and explain in detail? | Ans. Dhatura |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Increased LH : FSH ratio is found in : and explain in detail? | Polycystic ovary syndrome |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Young lady presents with acute abdominal pain and history of 11/2 months amenorrhoea, on USG examination there is collection of fluid in the pouch of douglas and empty gestational sac. Diagnosis is and explain in detail? | Ans. is a i.e. Ectopic pregnancy |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is The approximate no of genes contained in human genome and explain in detail? | Humans have a mere 30,000 genes rather than the 100000 predicted only recently . Recent ribbons mention the no of genes 20,000 to 25,000 Ribbons 7th/219 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Immersion syndrome is also called as ? and explain in detail? | Ans. is 'a' i.e., Hydrocution Immersion syndrome - is also called as hydrocution or submersion inhibition or vagal inhibition. Atypical drowning It refers to drowning in which even after submersion of body in water, little or no water anters respiratory passages and lungs. Hence typical findings of wet drowning in the form of froth and oedema aquosun: of lungs are not found. Atypical drowning may be : Dry drowning : On contact with water, especially cold water, there results intense laryngospasm, so that water does not enter the lungs. Death is due to asphyxia because of laryngospasm. Immersion syndrome (hydrocution/submersion inhibition/vagal inhibition) : Sudden death occurs due to vagal inhibition as a result of (a) sudden impact with cold water, (b) duck diving (falling in water with feet first), and (c) horizontal entry in water with impact on epigastrium. Submersion of unconscious : If person is unconscious since before submersion in water, little or no water enters respiratory passages. It may occur in MI, cerebrovascular accident, hypeension, epilepsy, cerebral aneurysm and in drunk state. Near drowning (secondary drowning syndrome/post immersion syndrome) : In this drowning is survived and death occurs at a later stage after removal from water. Either the person himself comes out of water or he is recovered alive, but due to complications of submersion, he dies at a later stage. It is due to hypoxic encephalopathy and fibrosing alveolitis. The death occurs due to combined effect of cerebral hypoxia, pulmonary edema, aspiration pneumonitis, electrolyte disturbances and metabolic acidosis. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following is a radioprotector? and explain in detail? | AMIFOSTINE: It is an organic thiophosphate which on activation by alkaline phosphatase acts as a cytoprotective against cancer chemotherapy and radiotherapy.It is paicularly used for prophylaxis of cisplatin induced neuro/nephrotoxicity and radiotherapy related xerostomia. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SEVENTH EDITION PAGE NO:876 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is In Teletherapy setup all are used except and explain in detail? | A i.e. Irridium 191 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is In a group of 100 people, the average GFR is 85 ml/ min with a standard detion of 25. What is the range for 90% confidence interval? and explain in detail? | Ans: A. 81-89(Ref: Park 24/e p888, 22/e p793; Essentials of Biostatistics 2/e pI70)Range for 90% confidence interval in the given question is 81-89.Confidence intervals:Lower limit & upper limit estimates for statistic given by:Lower Limit: statistic - C x SE (statistic)Upper Limit: statistic + C x SE.Confidence coefficient:C = Confidence coefficient = 1.65 for 90% confidence intervalC= 1.96 for 95% confidence intervalC= 2.58 for 99% confidence intervalC = 3.29 for 99.9% confidence intervalNow for 90% confidence interval:Upper limit = 85 + (1.65 x 2.5) = 85 + 4 = 89.Lower limit = 85 + (1.65 x 2.5) = 85 - 4 = 81.Hence, for 90% confidence interval will 81-89. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following does not cross the cell membrane : and explain in detail? | A i.e. Glucose-6-phosphate Glucose-6-phosphate cannot cross the cell membrane unless it in conveed into Glucose by the enzyme - Glucose-6-phosphatase.QVon Gerkes disease in deficiency of Glucose-6-phosphatase leads to accumulation of glucose-6-phosphate (and hence glycogen in the liver). In the absence of this enzyme, glucose-6-phosphate is not conveed into glucose and thus cannot enter the blood leading to hypoglycemia. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Vector for Yellow fever is: September 2011, March 2013 and explain in detail? | Ans. A: Aedes Aedes aegypti is the main vector for yellow fever across world Yellow fever/ "Yellow Jack" It is an acute viral hemorrhagic disease. The virus is a 40 to 50 nm enveloped RNA virus with positive sense of the Flaviviridae family. The yellow fever virus is transmitted by the bite of female mosquitoes (the yellow fever mosquito, Aedes aegypti, and other species) and is found in tropical and subtropical areas in South America and Africa, but not in Asia. The only known hosts of the virus are primates and several species of mosquito. In the 19th century, yellow fever was deemed one of the most dangerous infectious diseases. Yellow fever presents in most cases with fever, nausea, and pain and it generally subsides after several days. In some patients, a toxic phase follows, in which liver damage with jaundice (giving the name of the disease) can occur and lead to death. Because of the increased bleeding tendency (bleeding diathesis), yellow fever belongs to the group of hemorrhagic fevers. A safe and effective vaccine against yellow fever has existed since the middle of the 20th century and some countries require vaccinations for travelers. Since no therapy is known, vaccination programs are, along with measures to reduce the population of the transmitting mosquito, of great impoance in affected areas. Since the 1980s, the number of cases of yellow fever has been increasing, making it a reemerging disease Yellow fever is caused by the yellow fever virus, a 40 to 50 nm wide enveloped RNA virus belonging to the family Flaviviridae. The viruses infect amongst others monocytes, macrophages and dendritic cells. After entering the host cells, the viral genome is replicated in the rough endoplasmic reticulum (ER) and in the so-called vesicle packets. After transmission of the virus from a mosquito the viruses replicate in the lymph nodes and infect dendritic cells in paicular. From there they reach the liver and infect hepatocytes (probably indirectly Kupffer cells), which leads to eosinophilic degradation of these cells and to the release of cytokines. Necrotic masses (Councilman bodies) appear in the cytoplasm of hepatocytes. If yellow fever is suspected, the virus cannot be confirmed until six to ten days after the illness. A direct confirmation can be obtained by Reverse transcription polymerase chain reaction where the genome of the virus is amplified. Another direct approach is the isolation of the virus and its growth in cell culture using blood plasma; this can take one to four weeks. Serologically an enzyme linked immunosorbent assay during the acute phase of the disease using specific IgM against yellow fever or an increase in specific IgG-titer (compared to an earlier sample) can confirm yellow fever. Together with clinical symptoms, the detection of IgM or a fourfold increase in IgG-titer is considered sufficient indication for yellow fever. Since these tests can cross-react with other Flaviviruses, like Dengue virus, these indirect methods can never prove yellow fever infection. In a differential diagnosis, infections with yellow fever have to be distinguished from other feverish illnesses like malaria. Other viral hemorrhagic fever, such as Ebola virus, Lassa virus, Marburg virus or Junin virus have to be excluded as cause. For journeys into affected areas, vaccination is highly recommended since mostly non-native people are affected by severe cases of yellow fever. The protective effect is established 10 days after vaccination in 95% of the vaccinated people and lasts for at least 10 years (even 30 years later, 81% of patients retained the immunity). The attenuated live vaccine (stem 17D) was developed in 1937 by Max Theiler from a diseased patient in Ghana and is produced in chicken eggs. WHO recommends routine vaccinations for people living in endemic areas between the 9th and 12th month after bih. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is All are glycoprotein, except: and explain in detail? | GH |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A 75-year-old female with a long history of cigarette smoking is found to have a small tumor at the periphery of her right upper lobe. Initially, the tumor was believed to be a Stage I carcinoma (T1 NO MO), but after surgery it is found to be Stage II (T1 N1 MO). What is found at surgery that changed the staging? and explain in detail? | Although it is nearly impossible to memorize the staging rules for all the different kinds of tumors, there are several basic principles common to all. The TNM stage of a tumor is determined by the tumor size and extent (T for tumor), lymph node involvement (N for nodes), and metastasis (M for metastasis). N0 always means no lymph nodes are involved. An NI lesion has positive nodes, and only 2nd choice, positive bronchial lymph nodes, changes the patient's nodal status. Involvement of the chest wall is a feature of tumor size and extent-thus, it is a component of the T in TNM-staging. T2 lesions involve the chest wall. Histological features of the tumor, such as small cell morphology are not considered in tumor stage, but rather in tumor grade. Small cell tumors are considered high-grade carcinomas. Tumor extending to the carina reflects the tumor size and extent-thus, it is a component of the T in TNM-staging: T3 lesions involve the carina. Ref: Longo D.L. (2012). Chapter 81. Approach to the Patient with Cancer. 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. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Ranula and explain in detail? | A ranula is a mucus extravasation cyst involving a sublingual gland and is a type of mucocele found on the floor of the mouth. Ranulae present as a swelling of connective tissue consisting of collected mucin from a ruptured salivary gland caused by local trauma. If small and asymptomatic further treatment may not be needed, otherwise minor oral surgery may be indicated.
Signs and symptoms
A ranula usually presents as a translucent, blue, dome-shaped, fluctuant swelling in the tissues of the floor of the mouth. If the lesion is deeper, then there is a greater thickness of tissue separating from the oral cavity and the blue translucent appearance may not be a feature. A ranula can develop into a large lesion many centimeters in diameter, with resultant elevation of the tongue and possibly interfering with swallowing (dysphagia). The swelling is not fixed, may not show blanching, and is non-painful unless it becomes secondarily infected. The usual location is lateral to the midline, which may be used to help distinguish it from a midline dermoid cyst. A cervical ranula presents as a swelling in the neck, with or without a swelling in the mouth. In common with other mucoceles, ranulae may rupture and then cause recurrent swelling. Ranulae may be asymptomatic, although they can fluctuate rapidly in size, shrinking and swelling, making them difficult to detect.
Complications
Infection
Repeated trauma
Bursting and reformation
Dysphagia (in the case of a large ranula)
Causes
Minor trauma to the floor of the mouth is thought to damage the delicate ducts that drain saliva from the sublingual gland into the oral cavity. The lesion is a mucous extravasation cyst (mucocele) of the floor of mouth, although a ranula is often larger than other mucoceles (mainly because the overlying mucosa is thicker). They can grow so large that they fill the mouth. The most usual source of the mucin spillage is the sublingual salivary gland, but ranulae may also arise from the submandibular duct or the minor salivary glands in the floor of the mouth. A cervical ranula occurs when the spilled mucin dissects its way through the mylohyoid muscle, which separates the sublingual space from the submandibular space, and creates a swelling in the neck. It may occur following rupture of a simple ranula. Rarely, ranulae may extend backwards into the parapharyngeal space.
Mechanism
The fluid within a ranula has the viscous, jellylike consistency of egg white.
Diagnosis
The histologic appearance is similar to mucoceles from other locations. The spilled mucin causes a granulation tissue to form, which usually contains foamy histiocytes. Ultrasound and magnetic resonance imaging may be useful to image the lesion. A small squamous cell carcinoma obstructing the Wharton duct may require clinical examination to be distinguished from a ranula.
Criteria
Mostly seen in young children and adolescents, both sexes are equally affected. Swelling in floor of mouth, which may be painful. Mostly unilateral, on one side of frenulum.
Shape is spherical
Size varies from 1 – 5 cm in diameter
Color is pale blue with characteristics semi transparent appearance.
Surface is smooth and mucous membrane is mobile over the swelling.
Tenderness is absent
Fluctuation test is positive
Transillumination test is positive
Cervical lymph nodes are not enlarged.
May or may not have prolongation in the neck.
Classification
A ranula is a type of mucocele, and therefore could be classified as a disorder of the salivary glands |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is During radiotherapy the Buccal Mucosa exhibits radiation reaction before skin due to - and explain in detail? | Rapidly dividing cells are generally more radio sensitive then slowly dividing cells, reflecting radiation induced inhibition of D.N.A. synthesis. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Commonest endocrine tumor of pancreas and explain in detail? | Insulinomas- arising from B cells of pancreas- are the commonest endocrine pancreatic tumour(60%). Gastrinomas - arising from non-beta cells (G cells) of the pancreas- are the 2nd most common endocrine pancreatic tumour. Then comes Glucagonomas (arising from A cells) and VIPomas (arising from D2 cells of pancreas). Reference : page 709-10 SRB's manual of surgery 5th edition |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Common fungus causing corneal ulcer -a) Aspergillusb) Mucorc) Fusariumd) Sprothrix and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Paraneoplastic syndrome associated with RCC are all of the following, except: and explain in detail? | RCC is associated with wide range of paraneoplastic syndromes, ? Erythrocytosis (polycythemia ? Hypercalcemia ? Hypeension ? Non metastatic hepatic dysfunction Cushing syndrome is rarely seen in RCC. Ref: Emil A. Tanagho, Jack W. McAninch, (2004), Chapter 21, "Renal paranchymal neoplasm", In the book, "Smith's General Urology", LANGE SERIES, USA, Page 351; Harrison's Principles of Internal Medicine, 17th Edition, Page 592; Robbin's Basic Pathology , 7th Edition, Page 1018; Smith's Urology, 16th Edition, Page 351 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is In staphylococci, plasmids, encoding beta-lactamase are transmitted by: and explain in detail? | Transduction: It is the transfer of gene carrying resistance through the agency of a bacteriophage. The R foctor is taken up by the phage and delivered to another bacterium which it infects. Many Staph. aureus strains have acquired resistance by transduction. Ceain instances of :&;enicillin, erythromycin and chloramphenicol resistance have been found to be phage mediated Beta-lactamases are produced by staphylococci, Haemophilus, gonococci, etc. which inactivate penicillin G. The |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Premature adrenarche is growth of axillary and pubic hair prior to the age and explain in detail? | Premature adrenarche is defined as growth of axillary and pubic hair prior to age of 8 years. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Feature of Post mortem clots are and explain in detail? | Ans. is 'a' i.e., Can be washed away Antemortem vs postmortem woundFeatureAntemortal woundPost Mortem WoundHaemorrhage* Arterial* Blood clotted and the clot is# Laminated# Firmly adherent to the lining of endothelium# Firm, Rubbery and Variegated* Venous* Blood usually not clotted and if clot it is# Non laminated# Weakly adherent to the lining of endothelium# Soft friable chicken fat (yellow) or current jelly (red) appearance# Homogenous* Copious* Deep staining of edges which can't he washed away* Slight* Staining is superficial and can be washed awayWound edgesGapping, Everted, SwollenApposed, not swollenVital reactionSigns of inflammation, infectio (pus, slough) and healing (granulation tissue) presentNot presentEnzyme histo-chemistryNegative and positive vital reactionsVital reaction absentWound serotonin & histamine contentIncreasedNo increaseMicroscopy* Clot has Platelets* Leucocyte & RBC infiltration in between muscle fibres* Clot lacks platelets* No infiltration |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Salt losing nephritis is a feature of- and explain in detail? | Ans. is 'a' i.e., Interstitial nephritisCAUSES OF TUBULOINTERSTITIAL DISEASESInfectionso Acute bacterial pyelonephritiso Chronic pyelonephritis (including reflux nephropathy)o Other infections (e.g. viruses, parasites) Toxinso Drugso Acute hypersensitivity interstitial nephritis o Analgesic nephropathyo Heavy metalso Lead, cadmiumMetabolic diseaseso Urate nephropathyo Nephrocalcinosiso Hypokalemic nephropathyo Oxalate nephropathyPhysical factorsChronic urinary tract obstructionRadiation nephropathy NeoplasmsMultiple myelomaImmunological reactionsTransplant rejectionSjogren syndromeSarcoidosisVascular diseasesMiscellaneousBalkan nephropathyNephronopthsis - medullary cystic disease complexIdiopathic interstitial nephritisFollowing information have been added in 8th/e of Robbins Aristolochic nephropathyo A syndrome of tubulointerstitial nephritis caused by aristolochic acid, a supplement found in some herbal remedies, has been recognized recently.o The drug forms covalent adducts with DNA and causes a distinctive picture of renal failure and interstitial fibrosis associated with a relative paucity of infiltrating leukocytes.o There is an increased incidence of carcinoma in the kidney and urinary tract. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Wh,he follow morphogenic as well as mitogenic? and explain in detail? | Ans. c. Bone morphogenetic protein |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is 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: - and explain in detail? | 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 |