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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 Triple assessment includes all EXCEPT: and explain in detail? | ANSWER: (B) Bone scanREF: Bailey & Love 25th edition page 289, 290Triple assessment:In any patient who presents with a breast lump or other symptoms suspicious of carcinoma, the diagnosis should be made by a combination of clinical assessment, radiological imaging and a tissue sample taken for either cytological or histological analysis, the so called triple assessment. The positive predictive value (PPV) of this combination should exceed 99.9%. |
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 Delusions are not likely to be seen in: and explain in detail? | Delusion is a false, firm ,fixed and unshakable belief. It is not a feature of conversion disorder. It can be a feature of- schizophrenia depression with psychotic symptoms Dementia. |
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 Schizophrenia can be treated with all the following EXCEPT: and explain in detail? | Medications Antipsychotic Reduces or improves the symptoms of ceain psychiatric conditions. Anti-Tremor Helps control tremor, shaking and unsteadiness. Ref; KD Tripati 8th ed. |
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 female is suffereing from renal failure and is on hemodialysis since last 8 years. She developed carpal tunnel syndrome. Which of the following will be associated? - and explain in detail? | Reference :Robbins basic pathology 9th edition page no 158:Deposition of beta2 microglobulin amyloid in patients receivi g long term dialysis occurs most commonly in the carpal ligaments of the wrist resulting in compression of the median nerve leading to carpal tunnel 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 In cell membrane, following are true except: and explain in detail? | B i.e. Lipids are symmetricalPropeies of Cell MembraneMembranes are asymmetricalQ sheet like enclosed structure with distinct out and inner surfaces. This asymmetry is attributed to irregular distribution of protein with in the cell membranes external location of carbohydrate attached to membrane protein. (inside - outside asymmetry) specific enzymes are located exclusively on the outside or inside of membranes, (inside - outside asymmetry) gap junction synapses and tight junctions occupy only smaller regions of membrane and generate local (regional) asymmetry there is inside - outside (transverse) asymmetry of the phospholipidsThe choline- containing phospholipids (phosphotidylcholine or lecithin & sphingomyelin) are located mainly in the outer molecular layer; the aminophospholipids (phosphotidyl serine & phosphotidylethanolamine) are preferentially located in inner leaflet. There must be limited transverse mobility (flip- flop) of the membrane phospholipid to maintain this transverse asymmetry. Phospholipids exhibit an extraordinarily slow rate of flip flop. When ceain membrane proteins such as erythrocyte protein glycoplwrin are inseed aificially into synthetic bilayers, the frequency of phospholipid fillip -flop increases as much as 100 folds.Membranes are composed of - lipids, proteins and carbohydrates and membranes are dyanic structure- Major lipids in mammalian membranes are phospholipids (phosphoglycerides > sphingomyelin), glycolipids & cholesterol.Membrane lipids are amphipathetic i.e. contain both hydrophobic & hydrophilic regionsQ.- Membrane lipids are bilayer- Proteins are associated with lipid bilayer (+- covalent linkage) and may be integral or peripheral in location. Ion channels are transmembrane proteins that allow selective entry of various ions; ionophores are molecules that act as membrane shuttle for various ions and aquaporins are proteins that form water channels in ceain molecules.Oleic acid is most abundant unsaturated fatty acid in animal membrane lipids. Sphingolipids are found in membranes specifically in tissues of nervous system. Degree of unsaturation determines fluidity of membrane and cholesterol helps to regulate it. |
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 Thiamine deficiency causes and explain in detail? | Ans: a (Beri Beri)Ref: Park, 20th ed. Pg. 534, Davidson Principles and Practice of Medicine, 20th ed.Recommended name (alternative name)SourcesDeficiencyExcessInvestiga-tionsFAT-SOLUBLEVitamin ALiver, milk, butter, cheese, fish oilsXerophthalmia, almia, night blindness, keratomalacia, follicular hyperkeratosisLiver damage, bone damage, teratogenesisSerum retinolVitamin DMainly manufactured in skin under the influence of sunlightRickets, osteomalaciaHypercal- caemiaPlasma 25(OH)D or 1,25(OH) 2 DVitamin EVegetables, seed oilsHaemolytic anaemia, ataxia Plasma vitamin EVitamin KGreen vegetables, dairy productsCoagulation disorder Coagula-tion assay (e.g. proth-rombin time) +- plasma vitamin KWATERSOLUB LE Thiamine (Vitamin Bl)Cereals, grains, bean, porkBeri-beri, Wernicke- Korsakoff syndrome RBC trans-ketolase or whole blood vitamin B 1Riboflavin (Vitamin B 2)MilkGlossitis, stomatitis RBC glutat-hione reductase or whole blood vitamin B 2Niacin (Nicotinic acid, vitamin B 3) metabolitesMeat, cerealsPellagra Urinary nicotin- amide,Vitamin B 6 (Pyridoxine)Meat, fish, potatoes, bananasPolyneuropathyPolyneu-ropathyPlasma pyridoxal phosphate or eryth ro-cyte trans-aminase activation coefficient Biotin Dennatitis, alopecia, paraesthesiae Liver, egg yolk, cereals, yeastWhole blood or urine biotinFolateLiverAnaemiaRBC folateVitamin B 12 (Cobalamin)Animal productsAnaemia, neurological degenerationPlasma B 12Vitamin C (Ascorbic acid)Fresh fruit and vegetablesScurvyPlasma ascorbic acid (daily intake) Leucocyte ascorbic acid (tissue stores) |
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 Localised regional cerebral atrophy 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 Which of the following can deliver 90% oxygen? and explain in detail? | Non rebreathing masks: Can deliver upto 80% of oxygen. Rebreathing mask: When tightly fit, they can provide 100%oxygen.(Refer: Morgan's Clinical Anaesthesiology, 4th edition, pg no: 38-40) |
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 COMMONEST type of seizure in newborn? and explain in detail? | Essentials of Diagnosis & Typical Features of Neonatal seizures: Usual onset at 12-48 hours. Seizure types include subtle (characterized by variable findings), tonic, and multifocal clonic. Most common causes include hypoxic-ischemic encephalopathy, intracranial bleeds, and infection. Most common type of seizures is newborn are subtle seizures and they constitute 50% of all seizures. Subtle seizures are usually mild paroxysmal alterations in motor behaviour or autonomic function that are not clearly clonic, tonic or myoclonic. Newborns rarely have well-organized tonic-clonic seizures because of their incomplete coical organization and a preponderance of inhibitory synapses. The most common type of seizure is characterized by a constellation of findings, including horizontal detion of the eyes with or without jerking; eyelid blinking or fluttering; sucking, smacking, drooling, and other oral-buccal movements; swimming, rowing, or paddling movements; and apneic spells. Ref: Thilo E.H., Rosenberg A.A. (2012). Chapter 2. The Newborn Infant. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e. |
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 True about wilson's disease A/E - 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 Although 61 codons code for aminoacids, only 20 amino acids are naturally occurring. This feature of the genetic code is known as: and explain in detail? | THE GENETIC CODE IS DEGENERATE, UNAMBIGUOUS, NONOVERLAPPING, WITHOUT PUNCTUATION, & UNIVERSAL
Three of the 64 possible codons do not code for specific amino acids; these have been termed nonsense codons. These nonsense codons are utilized in the cell as termination signals. They specify where the polymerization of amino acids into a protein molecule is to stop. The remaining 61 codons code for the 20 naturally occurring amino acids.
Thus, there is “degeneracy” in the genetic code—that is, multiple codons decode the same amino acid.
Reference- Harper 30th edition Pg- 414 |
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 Transfer of the carbamoyl moiety of carbamoyl phosphate to ornithine is catalysed by a liver mitochondrial enzyme: and explain in detail? | The carbamoyl group is transferred to the NH2 group of ornithine by ornithine transcarbamoylase (OTC).
Reference: Vasudevan 7th ed, pg 204 |
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 Flare response in triple response occurs due to and explain in detail? | When the skin is stroked more firmly with a pointed instrument, instead of the white reaction there is reddening at the site that appears in about 10 s (red reaction). This is followed in a few minutes by local swelling and diffuse, mottled reddening around the injury. The initial redness is due to capillary dilation, a direct response of the capillaries to pressure. The swelling (wheal) is local edema due to increased permeability of the capillaries and postcapillary venules, with consequent extravasation of fluid. The redness spreading out from the injury (flare) is due to aeriolar dilation. This three-pa response--the red reaction, wheal, and flare--is called the triple response and is pa of the normal reaction to injury Ref: Ganong&;s Review of medical physiology 25th edition. Page: 613 |
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 Corpus leuteum stas regressing after how many days of ovulation ? and explain in detail? | Ans. is 'b' i.e., 10 daysIf ovum is not feilized, the corpus luteum stas degenerating around day 24 of cycle (about 10 days after ovulation) and is eventually is replaced by fibrous tissue, forming corpus albicans.Degeneration of corpus luteum is due to decline in level of LH (which is required for maintenance of corpus luteum) and increase in secretion of inhibin by luteal cell itself. |
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 Defect in the following is identified by nitroblue tetrazolium test? and explain in detail? | Deficiencies of oxidative metabolism (e.g., phagocytosis) are detected with either the nitroblue tetrazolium (NBT) dye test or the dihydrorhodamine (DHR) oxidation test. These tests are based on the ability of products of oxidative metabolism to alter the oxidation states of repoer molecules so that they can be detected microscopically (NBT) or by flow cytometry (DHR). Qualitative studies of superoxide and hydrogen peroxide production may fuher define neutrophil oxidative function. Ref: Gallin J.I. (2012). Chapter 60. Disorders of Granulocytes and Monocytes. 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 The magnitude of completed family size can be obtained from and explain in detail? | Total feility rate represents the average number of children a woman would have if she were to pass through her reproductive years bearing children at the same rate as the women now in each age group.This measure gives an approximate magnitude of &;completed family size&;(Ref:- Park. 23rd ed. Page no 489) |
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 associated with Non oliguric renal failure? and explain in detail? | Nonoliguric AKI (i.e. Without a significant reduction in urine volume) accompanies 10-30% of courses of aminoglycoside antibiotics, even when plasma levels are in the therapeutic range. Aminoglycosides are freely filtered across the glomerulus and then accumulate within the renal coex, where concentrations can greatly exceed those of the plasma. AKI typically manifests after 5-7 days of therapy and can present even after the drug has been discontinued. Hypomagnesemia is a common finding. Causes of Non Oliguric Renal failure: Tubulointerstitial disease, paial obstructive nephropathy, nephrotoxic and ischemic ATN radiocontrast-induced ARF, and rhabdomyolysis, aminoglycoside, streptomycin, polymyxin B. lithium, or cisplatin nephrotoxicity. |
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 Uronic acid pathway is impoant for the formation of? and explain in detail? | UDP-glucuronate (a product of uronic acid pathway) is a donar of glucuronate residue for various conjugation and synthetic processes. |
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 Stain which differentiates cryptococcus from other fungus ? and explain in detail? | Ans. is 'c' i.e., India ink Unstained wet preperations of CSF mixed with drop of India ink or nigrosine demonstrate the capsule as a clear halo. Methenamine silver or periodic acid-Schiff are used for staining a tissue sample. |
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 Post exposure prophylaxis of HIV is? and explain in detail? | Chance of person / Doctor getting HIV after prick from HIV positive is 0.3% Post Exposure Prophylaxis-Raltegravir + Emtricitabine + Tenofovir PEP not effective after 72 hours |
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 Myelination of optic nerve begins at what gestational age- and explain in detail? | Ans. is 'd' i.e., 7 months o Myelination of optic nerves starts between 6 and 8 months of gestational age.o Myelination of the optic nerves begins at the lateral geniculate nucleus, reaching the orbital part of the optic nerve at term, and continues over the following 2 years postnatally.o Myelination of geniculostriate pathway begins in the 10th fetal month and is fully mature about 4 months postnatally.o The rate of myelination appears to be hastened by light exposure. Thus, preterm infant, on reaching chronological term, has more advanced myelination than a full-term newborn. |
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 arachnoid villi responsible for cerebrospinal fluid absorption protrude mainly in the: and explain in detail? | A i.e. Superior saggital sinus |
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 testicular malignancy 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 A female neonate with DiGeorge syndrome develops severe muscle cramps and convulsions soon after birth. Which of the following is the cause of convulsions in this neonate? and explain in detail? | DiGeorge syndrome is caused by a failure in the development of the third and fourth branchial pouches, resulting in agenesis or hypoplasia of the thymus and parathyroid glands, congenital heart defects, dysmorphic facies, and a variety of other congenital anomalies. As a result of parathyroid agenesis, patients with DiGeorge syndrome exhibit hypocalcemia, which manifests as increased neuromuscular excitability. Symptoms range from mild tingling in the hands and feet to severe muscle cramps and convulsions. DiGeorge syndrome does not feature any of the other choices.Diagnosis: DiGeorge 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 Hyperventilation in high altitude is due to and explain in detail? | Hyperventilation in high altitude is due to respiratory alkalosis Ref: guyton and hall textbook of medical physiology 12 edition page number:375,376,377 |
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 Patient with a metallic foreign body in eye, which investigation is not done - and explain in detail? | Absolute contraindications to MRI : cardiac pacemakers metallic foreign bodies cerebral aneurysmal clips implanted electrodes |
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 polysaccharide used in assessing the glomerular filtration rate (GFR) is: and explain in detail? | Ans. C. InulinInulin is a fructosan, isolated from root tubers of Dahlia. It is used for assessing GFR. The test is known as Inulin Clearance test. |
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 statements about Rheumatoid Factor is true - and explain in detail? | Rheumatoid factor in Rheumatoid Arthritis is an IgM antibody directed against the Fc fragment of IgG
Anti CCP antibodies are most specific blood test for rheumatoid arthritis (specificity ∼ 95%).
Rheumatoid factor is positive in only 10% of patients with JRA. |
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 Marker for hairy cell leukaemia is? and explain in detail? | Hairy cell leukemia express CD 19 ,CD2O, CD22 antigen. In addition to Bcell markers they are also positive for CD11,CD25,CD103 Reference : Harsh Mohan textbook of pathology, 7th edition.Pg no.358 |
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 apoptosis permeabiiization of membrane occure in: and explain in detail? | Ans: D (Mitochondrial....) Outer mitochondrial membrane permeabilization during apoptosis toxsci.oxfordjournals.org/content/53/2/340-abstract"One critical step of apoptosis is the release of mitochondrial proteins through the outer mitochondrial membrane. Recent work shows that two pro-apoptotic Bcl-2 family proteins, Bax and Bid, as well as the mitochondrion-specific lipid cardiolipin may cooperate in chemically defined liposomes to generate a protein-permeable conduit, relaunching the debate on the identity of the pore responsible for mitochondrial membrane permeabilization during apoptosis"Outer mitochondrial membrane permeabilization during apoptosis triggers caspase-independent mitochondrial and caspase-dependent plasma membrane potential depolarization" jcs.biologists.org/cgi/content/ full/116 /3/525# Little is known about the temporal relationship between mitochondrial and plasma membrane potential changes and outer mitochondrial membrane permeabilization during apoptosis'. Of note, mitochondria did not completely depolarize but established a new steady-state level that could be further dissipated by treatment with the protonophore carbonyl cyanide p-trifluoromethoxy- phenylhydrazone. Treatment with the FOFl-ATP-synthase inhibitor oligomycin likewise induced a collapse of this steady-state level, suggesting that FOFl-ATP-synthase reversal maintained mitochondrial potential after outer mitochondrial membrane permeabilization.# Our results demonstrate that outer mitochondrial membrane permeabilization coordinates the depolarization of both membrane potentials during apoptosisMITOCHONDRIAL REGULATION en.wikipedia.org/wiki/ Apoptosis# Mitochondrial proteins known as SMACs (second mitochondria-derived activator of caspases) are released into the cytosol following an increase in permeability. SMAC binds to inhibitor of apoptosis proteins (IAPs) and deactivates them, preventing the lAPs from arresting the apoptotic process and therefore allowing apoptosis to proceed. IAP also normally suppresses the activity of a group of cysteine proteases called caspases, which carry out the degradation of the cell, therefore the actual degradation enzymes can be seen to be indirectly regulated by mitochondrial permeability.# MAC, also called "Mitochondrial Outer Membrane Permeabilization Pore" is regulated by various proteins, such as those encoded by the mammalian Bcl-2 family of anti-apoptopic genes, the homologs of the ced-9 gene found in C. elegans. |
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 Charcoat's joint includes all of the following EXCEPT: September 2012 and explain in detail? | Ans. D i.e. Ahrogryposis multiplex congenita Ahrogrypsosis multiplex congenita is a disorder of defective development of the muscles; the muscles are fibrotic and result in foot deformities, and deformities of other joints |
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 female patient with a mechanical heart valve who is taking warfarin informs you that she hopes to get pregnant in the near future. What advice do you give her regarding her antithrombotic medication during the anticipated pregnancy? and explain in detail? | Discontinuance of warfarin is appropriate during pregnancy because it is a known teratogen that causes bone dysmorphogenesis. The patient will need continued protection against thrombus formation, and heparin (or a related low molecular weight compound) is usually advised, despite the fact that the drug will require parenteral administration and can cause thrombocytopenia. |
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 40 year old female presented with dyspnoea on exertion grade and palpitations. ECG showed atrial fibrillation with fast ventricular rate. Echocardiography shows severe mitral stenosis with left atrial appendage clot. Which of the following is not advised? 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 pharyngeal pouch contributes to the thymus? and explain in detail? | The elongate ventral poions of the third pair of pharyngeal pouches migrate medially and fuse to form the primordium of the thymus gland. Development of the thymus is not complete at bih; it contains to grow and reaches its greatest size at pubey, after which it gradually shrinks and its functional tissue is replaced by a fatty tissue. Ref: Ochs H.D., Notarangelo L.D. (2010). Chapter 82. Immunodeficiency Diseases. In J.T. Prchal, K. Kaushansky, M.A. Lichtman, T.J. Kipps, U. Seligsohn (Eds),Williams Hematology, 8e. |
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 Fracture of clavicle is commonest at: and explain in detail? | B i.e. Junction of medial 2/3 & lateral 1/3rd |
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 Autoantibody specific for SLE - and explain in detail? | Ans. is 'a' i.e., ds DNA Antinuclear antibodies in SLEo Systemic lupus erythematosus is characterized by bewildering array of autoantibodies, particularly antinuclear antibodies.o The antibodies are directed against an array of nuclear and cytoplasmic components of the cell, in addition a third group of antibodies is directed against cell surface antigen of group cells,o The existence of seemingly limitless number of antibodies in patients against self-constituents indicate that the fundamental defect in SLE is a failure of the mechanism that maintain self-tolerance.o ANA is positive in virtually every patient of SLE, hence this test is sensitive but is not specific because patients with other autoimmune diseases are also positive.o Of the numerous antinuclear antibodies, antibodies to double stranded DNA and the antibodies, to (Smith) antigen are virtually diagnosis of SLEQ.o Presence of abtibodies to antismith and anti double stran ded DNA is virtually diagnostic of SLE.o The best serening test for SLE is demonstration of antinuclear antibodies.o Most sensitive antibody test for SLE - Antinuclear antibody test for SLE.o Afost specific antibody test for SLE - Anti ds DNA and Anti Sm antibodyo Antibody associated with drug induced SLE - Antihistone antibodyAutoantibodies in Systemic Lupus Ery thematosus (SLE! Prevalence Antibody%Antigen RecognizedClinical Utilityo Antinuclear antibodies98Multiple nuclearBest screening test; repeated negative tests make SLE unlikelyo Anti-ds DNA70DNA (double-stranded)High titers are SLE-specific and in some patients correlate with disease activity, nephritis, vasculitiso Anti-Sm25Protein complexed to 6 species of nuclear U1 RNASpecific for SLE; no definite clinical correlations; most patients also have anti-RNP; more common in blacks and Asians than whiteso Anti-RNP40Protein complexed to U1 RNAyNot specific for SLE; high titers associated with syndromes that have overlap features of several rheumatic syndromes including SLE; more common in blacks than whiteso Anti-Ro (SS-A)30Protein complexed to hY RNA, primarily 60 kDa and 52 kDaNot specific for SLE; associated with sicca syndrome, predisposes to subacute cutaneous lupus, and to neonatal lupus with congenital heart block; associated with decreased risk for nephritis -o Anti-La (S3-B)1047-kDa protein com- plexed to hY RNAUsually associated with anti-Ro; associated with decreased risk for nephritiso Antihistone70Histones associated with DNA (in nucleo-some, chromatin)More frequent in durg-induced lupus than in SLEo Antiphospholipid50Phospholipids, b2 glycoprotein 1 cofac- tor prothrombinThree tests available - ELISAs for cardiolipin and b2G1, sensitive prothrombin time (DRVVT); predisposes to clotting, fetal loss, thrombocytopeniao Antierythrocyte60Erythrocyte membraneMeasured as direct Coombs' test; a small proportion develops overt hemolysiso Antiplatelet30Surface and altered cytoplasmic antigens on plateletsAssociated with thrombocytopenia but sensitivity and specificity are not good; this is not a useful clinical testo Anti neuronal (includes anti-glutamate receptor!60Neuronal and IvmphoIn some series a positive test in CSF correlates with cyte surface antigens active CNS lupuso Antiribosomal P20Protein in ribosomesIn some series a positive test in serum correlates with depression or psychosis due to CNS lupus |
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 maternal moality - and explain in detail? | Post pattum hemorrhage is the main cause of maternal deaths. It account for about 25%.REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 516 |
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 Rhinoscleroma, true statement is: and explain in detail? | Rhinoscleroma is caused by the bacterium Klebsiella rhinoscleromatis. The infection is more frequent between 20 and 40 years. It is more common in rural areas where social and hygienic standards are low. The disease probably begins at the junction between the stratified squamous epithelium of the vestibule and the respiratory epithelium of the nose. The histopathological picture is pathognomonic. A dense infiltrate is observed consisting mainly of plasma cells and two types of highly characteristic cells. These cells are the Mikulicz cell and the Russell body. |
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 Bucket handle type of fractures are 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 'Dennie Morgan' folds are seen in? and explain in detail? | Ans. D. Atopic dermatitis (Ref. IADVL 2nd/433, 416-427; Rook's 7th/18.1 - 18.30)Dennie Morgan fold is a single or double fold in the lower eyelid, may be due to eyelid edema caused by eyelid dermatitis. It is seen as associated feature in atopic dermatitis.Atopic dermatitis# Is an eczema characterized by intense itching and relapsing course in infants and children with a personal or family h/o atopic disorders.# Coexists with asthma or rhinitis in 80% cases.# 70% of patients have family h/o atopy.# Genetically transmitted# Immunological dysfunction and 80% have raised total IgE.# Itching is the basic symptom.1Infantile phase# Upto 2 yrs.# Appears usually at or after 3 months of age.# Initial lesions are illdefined erythematous patches on the cheeks.# Later spread to scalp, upper trunk and extensor aspect of lower limbs.2Childhood phase# Flexural involvement is characteristic (antecubital and popliteal fossa)# Presence of extensor involvement denotes poor prognosis.3Adolescent phase# Lichenification is main feature# Involvement of face, neck, flexures and upper trunk is characteristic.# Excoriation due to scratching are important manifestation.Perioral pallor, pallor at nose and ears (Head light sign) and dermographism are characteristic of atopic dermatitis.Associated features:# Xerosis,# Ichthyosis# P.alba,# Dennie-Morgan fold0# Periorbital darkening# Cataract# Keratoconus# Lipstick cheilitis# Hand and foot eczema Management:1 First line therapy# Emollients# Topical steroids# Topical antiinfectives# Antihistaminics2 Second line therapy# Systemic steroids# Immunomodulators (azathioprine, cyclosporine, interferons, tacrolimus)# PhototherapyAdditional Educational points:Iris or target lesions= Erythema multiformieBulla spread sign and Nikolsky's sign= Pemphigus vulgaris.Auspitz sign= Plaque Psoriasis.Darrier's sign= Urticaria pigmentosa.White dermographism= Atopic dermatitis.Dimple sign= Dermatofibroma. |
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 Human skin color and explain in detail? | Human skin color ranges from the darkest brown to the lightest hues. Differences in skin color among individuals is caused by variation in pigmentation, which is the result of genetics (inherited from ones biological parents and or individual gene alleles), exposure to the sun, natural and sexual selection, or all of these. Differences across populations evolved through natural or sexual selection, because of social norms and differences in environment, as well as regulations of the biochemical effects of ultraviolet radiation penetrating the skin.The actual skin color of different humans is affected by many substances, although the single most important substance is the pigment melanin. Melanin is produced within the skin in cells called melanocytes and it is the main determinant of the skin color of darker-skin humans. The skin color of people with light skin is determined mainly by the bluish-white connective tissue under the dermis and by the hemoglobin circulating in the veins of the dermis. The red color underlying the skin becomes more visible, especially in the face, when, as consequence of physical exercise or sexual arousal, or the stimulation of the nervous system (anger, embarrassment), arterioles dilate. Color is not entirely uniform across an individuals skin; for example, the skin of the palm and the sole is lighter than most other skin, and this is especially noticeable in darker-skinned people.There is a direct correlation between the geographic distribution of ultraviolet radiation (UVR) and the distribution of indigenous skin pigmentation around the world. Areas that receive higher amounts of UVR, generally located closer to the equator, tend to have darker-skinned populations. Areas that are far from the tropics and closer to the poles have lower intensity of UVR, which is reflected in lighter-skinned populations. Some researchers suggest that human populations over the past 50,000 years have changed from dark-skinned to light-skinned and vice versa as they migrated to different UV zones, and that such major changes in pigmentation may have happened in as little as 100 generations (≈2,500 years) through selective sweeps. Natural skin color can also darken as a result of tanning due to exposure to sunlight. The leading theory is that skin color adapts to intense sunlight irradiation to provide partial protection against the ultraviolet fraction that produces damage and thus mutations in the DNA of the skin cells. In addition, it has been observed that females on average are significantly lighter in skin pigmentation than males. Females need more calcium during pregnancy and lactation. The body synthesizes vitamin D from sunlight, which helps it absorb calcium. Females evolved to have lighter skin so their bodies absorb more calcium.The social significance of differences in skin color has varied across cultures and over time, as demonstrated with regard to social status and discrimination.
Melanin and genes
Melanin is produced by cells called melanocytes in a process called melanogenesis. Melanin is made within small membrane–bound packages called melanosomes. As they become full of melanin, they move into the slender arms of melanocytes, from where they are transferred to the keratinocytes. Under normal conditions, melanosomes cover the upper part of the keratinocytes and protect them from genetic damage. One melanocyte supplies melanin to thirty-six keratinocytes according to signals from the keratinocytes. They also regulate melanin production and replication of melanocytes. People have different skin colors mainly because their melanocytes produce different amount and kinds of melanin.
The genetic mechanism behind human skin color is mainly regulated by the enzyme tyrosinase, which creates the color of the skin, eyes, and hair shades. Differences in skin color are also attributed to differences in size and distribution of melanosomes in the skin. Melanocytes produce two types of melanin. The most common form of biological melanin is eumelanin, a brown-black polymer of dihydroxyindole carboxylic acids, and their reduced forms. Most are derived from the amino acid tyrosine. Eumelanin is found in hair, areola, and skin, and the hair colors gray, black, blond, and brown. In humans, it is more abundant in people with dark skin. Pheomelanin, a pink to red hue is found in particularly large quantities in red hair, the lips, nipples, glans of the penis, and vagina.Both the amount and type of melanin produced is controlled by a number of genes that operate under incomplete dominance. One copy of each of the various genes is inherited from each parent. Each gene can come in several alleles, resulting in the great variety of human skin tones. Melanin controls the amount of ultraviolet (UV) radiation from the sun that penetrates the skin by absorption. While UV radiation can assist in the production of vitamin D, excessive exposure to UV can damage health.
Evolution of skin color
Loss of body hair in Hominini species is assumed to be related to the emergence of bipedalism some 5 to 7 million years ago. Bipedal hominin body hair may have disappeared gradually to allow better heat dissipation through sweating.
The emergence of skin pigmentation dates to about 1.2 million years ago, under conditions of a megadrought that drove early humans into arid, open landscapes. Such conditions likely caused excess UV-B radiation. This favored the emergence of skin pigmentation in order to protect from folate depletion due to the increased exposure to sunlight. A theory that the pigmentation helped counter xeric stress by increasing the epidermal permeability barrier has been disproved.With the evolution of hairless skin, abundant sweat glands, and skin rich in melanin, early humans could walk, run, and forage for food for long periods of time under the hot sun without brain damage due to overheating, giving them an evolutionary advantage over other species. By 1.2 million years ago, around the time of Homo ergaster, archaic humans (including the ancestors of Homo sapiens) had exactly the same receptor protein as modern sub-Saharan Africans.This was the genotype inherited by anatomically modern humans, but retained only by part of the extant populations, thus forming an aspect of human genetic variation. About 100,000–70,000 years ago, some anatomically modern humans (Homo sapiens) began to migrate away from the tropics to the north where they were exposed to less intense sunlight. This was possibly in part due to the need for greater use of clothing to protect against the colder climate. Under these conditions there was less photodestruction of folate and so the evolutionary pressure working against the survival of lighter-skinned gene variants was reduced. In addition, lighter skin is able to generate more vitamin D (cholecalciferol) than darker skin, so it would have represented a health benefit in reduced sunlight if there were limited sources of vitamin D. Hence the leading hypothesis for the evolution of human skin color proposes that:
From about 1.2 million years ago to less than 100,000 years ago, archaic humans, including archaic Homo sapiens, were dark-skinned.
As Homo sapiens populations began to migrate, the evolutionary constraint keeping skin dark decreased proportionally to the distance north a population migrated, resulting in a range of skin tones within northern populations.
At some point, some northern populations experienced positive selection for lighter skin due to the increased production of vitamin D from sunlight and the genes for darker skin disappeared from these populations.
Subsequent migrations into different UV environments and admixture between populations have resulted in the varied range of skin pigmentations we see today.The genetic mutations leading to light skin, though partially different among East Asians and Western Europeans, suggest the two groups experienced a similar selective pressure after settlement in northern latitudes.The theory is partially supported by a study into the SLC24A5 gene which found that the allele associated with light skin in Europe "determined […] that 18,000 years had passed since the light-skin allele was fixed in Europeans" but may have originated as recently as 12,000–6,000 years ago "given the imprecision of method" , which is in line with the earliest evidence of farming.Research by Nina Jablonski suggests that an estimated time of about 10,000 to 20,000 years is enough for human populations to achieve optimal skin pigmentation in a particular geographic area but that development of ideal skin coloration may happen faster if the evolutionary pressure is stronger, even in as little as 100 generations. The length of time is also affected by cultural practices such as food intake, clothing, body coverings, and shelter usage which can alter the ways in which the environment affects populations.One of the most recently proposed drivers of the evolution of skin pigmentation in humans is based on research that shows a superior barrier function in darkly pigmented skin. Most protective functions of the skin, including the permeability barrier and the antimicrobial barrier, reside in the stratum corneum (SC) and the researchers surmise that the SC has undergone the most genetic change since the loss of human body hair. Natural selection would have favored mutations that protect this essential barrier; one such protective adaptation is the pigmentation of interfollicular epidermis, because it improves barrier function as compared to non-pigmented skin. In lush rainforests, however, where UV-B radiation and xeric stress were not in excess, light pigmentation would not have been nearly as detrimental. This explains the side-by-side residence of lightly pigmented and darkly pigmented peoples.Population and admixture studies suggest a three-way model for the evolution of human skin color, with dark skin evolving in early hominids in Africa and light skin evolving partly separately at least two times after modern humans had expanded out of Africa.For the most part, the evolution of light skin has followed different genetic paths in Western and Eastern Eurasian populations. Two genes however, KITLG and ASIP, have mutations associated with lighter skin that have high frequencies in Eurasian populations and have estimated origin dates after humans spread out of Africa but before the divergence of the two lineages.
Genetics
The understanding of the genetic mechanisms underlying human skin color variation is still incomplete; however, genetic studies have discovered a number of genes that affect human skin color in specific populations, and have shown that this happens independently of other physical features such as eye and hair color. Different populations have different allele frequencies of these genes, and it is the combination of these allele variations that bring about the complex, continuous variation in skin coloration we can observe today in modern humans. Population and admixture studies suggest a 3-way model for the evolution of human skin color, with dark skin evolving in early hominids in sub-Saharan Africa and light skin evolving independently in Europe and East Asia after modern humans had expanded out of Africa.For skin color, the broad sense heritability (defined as the overall effect of genetic vs. nongenetic factors) is very high, provided one is able to control for the most important nongenetic factor, exposure to sunlight. Many aspects of the evolution of human skin and skin color can be reconstructed using comparative anatomy, physiology, and genomics. Enhancement of thermal sweating was a key innovation in human evolution that allowed maintenance of homeostasis (including constant brain temperature) during sustained physical activity in hot environments. Dark skin evolved pari passu with the loss of body hair and was the original state for the genus Homo. Melanin pigmentation is adaptive and has been maintained by natural selection. In recent prehistory, humans became adept at protecting themselves from the environment through clothing and shelter, thus reducing the scope for the action of natural selection on human skin. Credit for describing the relationship between latitude and skin color in modern humans is usually ascribed to an Italian geographer, Renato Basutti, whose widely reproduced "skin color maps" illustrate the correlation of darker skin with equatorial proximity. More recent studies by physical anthropologists have substantiated and extended these observations; a recent review and analysis of data from more than 100 populations (Relethford 1997) found that skin reflectance is lowest at the equator, then gradually increases, about 8% per 10° of latitude in the Northern Hemisphere and about 4% per 10° of latitude in the Southern Hemisphere. This pattern is inversely correlated with levels of UV irradiation, which are greater in the Southern than in the Northern Hemisphere. An important caveat is that we do not know how patterns of UV irradiation have changed over time; more importantly, we do not know when skin color is likely to have evolved, with multiple migrations out of Africa and extensive genetic interchange over the last 500,000 years (Templeton 2002).Regardless, most anthropologists accept the notion that differences in UV irradiation have driven selection for dark human skin at the equator and for light human skin at greater latitudes. What remains controversial are the exact mechanisms of selection. The most popular theory posits that protection offered by dark skin from UV irradiation becomes a liability in more polar latitudes due to vitamin D deficiency (Murray 1934). UVB (short-wavelength UV) converts 7-dehydrocholesterol into an essential precursor of cholecaliferol (vitamin D3); when not otherwise provided by dietary supplements, deficiency for vitamin D causes rickets, a characteristic pattern of growth abnormalities and bony deformities. An oft-cited anecdote in support of the vitamin D hypothesis is that Arctic populations whose skin is relatively dark given their latitude, such as the Inuit and the Lapp, have had a diet that is historically rich in vitamin D. Sensitivity of modern humans to vitamin D deficiency is evident from the widespread occurrence of rickets in 19th-century industrial Europe, but whether dark-skinned humans migrating to polar latitudes tens or hundreds of thousands of years ago experienced similar problems is open to question. In any case, a risk for vitamin D deficiency can only explain selection for light skin. Among several mechanisms suggested to provide a selective advantage for dark skin in conditions of high UV irradiation (Loomis 1967; Robins 1991; Jablonski and Chaplin 2000), the most tenable are protection from sunburn and skin cancer due to the physical barrier imposed by epidermal melanin.
Dark skin
All modern humans share a common ancestor who lived around 200,000 years ago in Africa. Comparisons between known skin pigmentation genes in chimpanzees and modern Africans show that dark skin evolved along with the loss of body hair about 1.2 million years ago and that this common ancestor had dark skin. Investigations into dark-skinned populations in South Asia and Melanesia indicate that skin pigmentation in these populations is due to the preservation of this ancestral state and not due to new variations on a previously lightened population.
MC1R
The melanocortin 1 receptor (MC1R) gene is primarily responsible for determining whether pheomelanin and eumelanin are produced in the human body. Research shows at least 10 differences in MC1R between African and chimpanzee samples and that the gene has probably undergone a strong positive selection (a selective sweep) in early Hominins around 1.2 million years ago. This is consistent with positive selection for the high-eumelanin phenotype seen in Africa and other environments with high UV exposure.
Light skin
For the most part, the evolution of light skin has followed different genetic paths in European and East Asian populations. Two genes, however, KITLG and ASIP, have mutations associated with lighter skin that have high frequencies in both European and East Asian populations. They are thought to have originated after humans spread out of Africa but before the divergence of the European and Asian lineages around 30,000 years ago. Two subsequent genome-wide association studies found no significant correlation between these genes and skin color, and suggest that the earlier findings may have been the result of incorrect correction methods and small panel sizes, or that the genes have an effect too small to be detected by the larger studies.
KITLG
The KIT ligand (KITLG) gene is involved in the permanent survival, proliferation and migration of melanocytes. A mutation in this gene, A326G (rs642742), has been positively associated with variations of skin color in African-Americans of mixed West African and European descent and is estimated to account for 15–20% of the melanin difference between African and European populations. This allele shows signs of strong positive selection outside Africa and occurs in over 80% of European and Asian samples, compared with less than 10% in African samples.
ASIP
Agouti signalling peptide (ASIP) acts as an inverse agonist, binding in place of alpha-MSH and thus inhibiting eumelanin production. Studies have found two alleles in the vicinity of ASIP are associated with skin color variation in humans. One, rs2424984, has been identified as an indicator of skin reflectance in a forensics analysis of human phenotypes across Caucasian, African-American, South Asian, East Asian, Hispanic and Native American populations and is about three times more common in non-African populations than in Africa. The other allele, 8188G (rs6058017) is significantly associated with skin color variation in African-Americans and the ancestral version occurs in only 12% of European and 28% of East Asian samples compared with 80% of West African samples.
Europe
A number of genes have been positively associated with the skin pigmentation difference between European and non-European populations. Mutations in SLC24A5 and SLC45A2 are believed to account for the bulk of this variation and show very strong signs of selection. A variation in TYR has also been identified as a contributor.
Research indicates the selection for the light-skin alleles of these genes in Europeans is comparatively recent, having occurred later than 20,000 years ago and perhaps as recently as 12,000 to 6,000 years ago. In the 1970s, Luca Cavalli-Sforza suggested that the selective sweep that rendered light skin ubiquitous in Europe might be correlated with the advent of farming and thus have taken place only around 6,000 years ago; This scenario found support in a 2014 analysis of mesolithic (7,000 years old) hunter-gatherer DNA from La Braña, Spain, which showed a version of these genes not corresponding with light skin color. In 2015 researchers analysed for light skin genes in the DNA of 94 ancient skeletons ranging from 8,000 to 3,000 years old from Europe and Russia. They found c. 8,000-year-old hunter-gatherers in Spain, Luxembourg, and Hungary were dark skinned while similarly aged hunter gatherers in Sweden were light skinned (having predominately derived alleles of SLC24A5, SLC45A2 and also HERC2/OCA2). Neolithic farmers entering Europe at around the same time were intermediate, being nearly fixed for the derived SLC24A5 variant but only having the derived SLC45A2 allele in low frequencies. The SLC24A5 variant spread very rapidly throughout central and southern Europe from about 8,000 years ago, whereas the light skin variant of SLC45A2 spread throughout Europe after 5,800 years ago.
SLC24A5
Solute carrier family 24 member 5 (SLC24A5) regulates calcium in melanocytes and is important in the process of melanogenesis. The SLC24A5 genes derived Ala111Thr allele (rs1426654) has been shown to be a major factor in light skin pigmentation and is common in Western Eurasia. Recent studies have found that the variant represents as much as 25–40% of the average skin tone difference between Europeans and West Africans. This derived allele is a reliable predictor of phenotype across a range of populations. It has been the subject of recent selection in Western Eurasia, and is fixed in European populations.
SLC45A2
Solute carrier family 45 member 2 (SLC45A2 or MATP) aids in the transport and processing of tyrosine, a precursor to melanin. It has also been shown to be one of the significant components of the skin color of modern Europeans through its Phe374Leu (rs16891982) allele that has been directly correlated with skin color variation across a range of populations. This variation is ubiquitous in European populations but extremely rare elsewhere and shows strong signs of selection.
TYR
The TYR gene encodes the enzyme tyrosinase, which is involved in the production of melanin from tyrosine. It has an allele, Ser192Tyr (rs1042602), found solely in 40–50% of Europeans and linked to light-colored skin in studies of South Asian and African-American populations.
East Asia
A number of genes known to affect skin color have alleles that show signs of positive selection in East Asian populations. Of these, only OCA2 has been directly related to skin color measurements, while DCT, MC1R and ATRN are marked as candidate genes for future study.
OCA2
Oculocutaneous albinism II (OCA2) assists in the regulation of pH in melanocytes. The OCA2 genes derived His615Arg (rs1800414) allele has been shown to account for about 8% of the skin tone difference between African and East Asian populations in studies of an East Asian population living in Toronto and a Chinese Han population. This variant is essentially restricted to East Asia, with highest frequencies in Eastern East Asia (49–63%), midrange frequencies in Southeast Asia, and the lowest frequencies in Western China and some Eastern European populations.
Candidate genes
A number of studies have found genes linked to human skin pigmentation that have alleles with statistically significant frequencies in Chinese and East Asian populations. While not linked to measurements of skin tone variation directly, dopachrome tautomerase (DCT or TYRP2 rs2031526), melanocortin 1 receptor (MC1R) Arg163Gln (rs885479) and attractin (ATRN) have been indicated as potential contributors to the evolution of light skin in East Asian populations.
Tanning response
Tanning response in humans is controlled by a variety of genes. MC1R variants Arg151Sys (rs1805007), Arg160Trp (rs1805008), Asp294Sys (rs1805009), Val60Leu (rs1805005) and Val92Met (rs2228479) have been associated with reduced tanning response in European and/or East Asian populations. These alleles show no signs of positive selection and only occur in relatively small numbers, reaching a peak in Europe with around 28% of the population having at least one allele of one of the variations. A study of self-reported tanning ability and skin type in American non-Hispanic Caucasians found that SLC24A5 Phe374Leu is significantly associated with reduced tanning ability and also associated TYR Arg402Gln (rs1126809), OCA2 Arg305Trp (rs1800401) and a 2-SNP haplotype in ASIP (rs4911414 and rs1015362) to skin type variation within a "fair/medium/olive" context.
Albinism
Oculocutaneous albinism (OCA) is a lack of pigment in the eyes, skin and sometimes hair that occurs in a very small fraction of the population. The four known types of OCA are caused by mutations in the TYR, OCA2, TYRP1, and SLC45A2 genes.
Age
In hominids, the parts of the body not covered with hair, like the face and the back of the hands, start out pale in infants and turn darker as the skin is exposed to more sun. All human babies are born pale, regardless of what their adult color will be. In humans, melanin production does not peak until after puberty.The skin of children becomes darker as they go through puberty and experience the effects of sex hormones. This darkening is especially noticeable in the skin of the nipples, the areola of the nipples, the labia majora in females, and the scrotum in males. In some people, the armpits become slightly darker during puberty. The interaction of genetic, hormonal, and environmental factors on skin coloration with age is still not adequately understood, but it is known that men are at their darkest baseline skin color around the age of 30, without considering the effects of tanning. Around the same age, women experience darkening of some areas of their skin.Human skin color fades with age. Humans over the age of thirty experience a decrease in melanin-producing cells by about 10% to 20% per decade as melanocyte stem cells gradually die. The skin of face and hands has about twice the amount of pigment cells as unexposed areas of the body, as chronic exposure to the sun continues to stimulate melanocytes. The blotchy appearance of skin color in the face and hands of older people is due to the uneven distribution of pigment cells and to changes in the interaction between melanocytes and keratinocytes.
Sexual dimorphism
It has been observed that females are found to have lighter skin pigmentation than males in some studied populations. This may be a form of sexual dimorphism due to the requirement in women for high amounts of calcium during pregnancy and lactation. Breastfeeding newborns, whose skeletons are growing, require high amounts of calcium intake from the mothers milk (about 4 times more than during prenatal development), part of which comes from reserves in the mothers skeleton. Adequate vitamin D resources are needed to absorb calcium from the diet, and it has been shown that deficiencies of vitamin D and calcium increase the likelihood of various birth defects such as spina bifida and rickets. Natural selection may have led to females with lighter skin than males in some indigenous populations because women must get enough vitamin D and calcium to support the development of fetus and nursing infants and to maintain their own health. However, in some populations such as in Italy, Poland, Ireland, Spain and Portugal men are found to have fairer complexions, and this has been ascribed as a cause to increased melanoma risk in men. Similarly, studies done in the late 19th Century/early 20th Century in Europe also conflicted with the notion at least in regards to Northern Europeans. The studies found that in England women tend to have darker hair, eyes, and skin complexation than men, and in particular women darken in relation to men during puberty. A study in Germany during this period showed that German men were more likely to have lighter skin, blond hair, and lighter eyes, while German women had darker hair, eyes and skin tone on average.The sexes also differ in how they change their skin color with age. Men and women are not born with different skin color, they begin to diverge during puberty with the influence of sex hormones. Women can also change pigmentation in certain parts of their body, such as the areola, during the menstrual cycle and pregnancy and between 50 and 70% of pregnant women will develop the "mask of pregnancy" (melasma or chloasma) in the cheeks, upper lips, forehead, and chin. This is caused by increases in the female hormones estrogen and progesterone and it can develop in women who take birth control pills or participate in hormone replacement therapy.
Disorders of pigmentation
Uneven pigmentation of some sort affects most people, regardless of bioethnic background or skin color. Skin may either appear lighter, or darker than normal, or lack pigmentation at all; there may be blotchy, uneven areas, patches of brown to gray discoloration or freckling. Apart from blood-related conditions such as jaundice, carotenosis, or argyria, skin pigmentation disorders generally occur because the body produces either too much or too little melanin.
Depigmentation
Albinism
Some types of albinism affect only the skin and hair, while other types affect the skin, hair and eyes, and in rare cases only the eyes. All of them are caused by different genetic mutations. Albinism is a recessively inherited trait in humans where both pigmented parents may be carriers of the gene and pass it down to their children. Each child has a 25% chance of being albino and a 75% chance of having normally pigmented skin. One common type of albinism is oculocutaneous albinism or OCA, which has many subtypes caused by different genetic mutations.
Albinism is a serious problem in areas of high sunlight intensity, leading to extreme sun sensitivity, skin cancer, and eye damage.Albinism is more common in some parts of the world than in others, but it is estimated that 1 in 70 humans carry the gene for OCA.
The most severe type of albinism is OCA1A, which is characterized by complete, lifelong loss of melanin production, other forms of OCA1B, OCA2, OCA3, OCA4, show some form of melanin accumulation and are less severe. The four known types of OCA are caused by mutations in the TYR, OCA2, TYRP1, and SLC45A2 genes.
Albinos often face social and cultural challenges (even threats), as the condition is often a source of ridicule, racism, fear, and violence. Many cultures around the world have developed beliefs regarding people with albinism. Albinos are persecuted in Tanzania by witchdoctors, who use the body parts of albinos as ingredients in rituals and potions, as they are thought to possess magical power.
Vitiligo
Vitiligo is a condition that causes depigmentation of sections of skin. It occurs when melanocytes die or are unable to function. The cause of vitiligo is unknown, but research suggests that it may arise from autoimmune, genetic, oxidative stress, neural, or viral causes. The incidence worldwide is less than 1%. Individuals affected by vitiligo sometimes suffer psychological discomfort because of their appearance.
Hyperpigmentation
Increased melanin production, also known as hyperpigmentation, can be a few different phenomena:
Melasma describes the darkening of the skin.
Chloasma describes skin discolorations caused by hormones. These hormonal changes are usually the result of pregnancy, birth control pills or estrogen replacement therapy.
Solar lentigo, also known as "liver spots" or "senile freckles", refers to darkened spots on the skin caused by aging and the sun. These spots are quite common in adults with a long history of unprotected sun exposure.Aside from sun exposure and hormones, hyperpigmentation can be caused by skin damage, such as remnants of blemishes, wounds or rashes. This is especially true for those with darker skin tones.
The most typical cause of darkened areas of skin, brown spots or areas of discoloration is unprotected sun exposure. Once incorrectly referred to as liver spots, these pigment problems are not connected with the liver.
On lighter to medium skin tones, solar lentigenes emerge as small- to medium-sized brown patches of freckling that can grow and accumulate over time on areas of the body that receive the most unprotected sun exposure, such as the back of the hands, forearms, chest, and face. For those with darker skin colors, these discolorations can appear as patches or areas of ashen-gray skin.
Exposure to the Sun
Melanin in the skin protects the body by absorbing solar radiation. In general, the more melanin there is in the skin the more solar radiation can be absorbed. Excessive solar radiation causes direct and indirect DNA damage to the skin and the body naturally combats and seeks to repair the damage and protect the skin by creating and releasing further melanin into the skins cells. With the production of the melanin, the skin color darkens, but can also cause sunburn. The tanning process can also be created by artificial UV radiation.
There are two different mechanisms involved. Firstly, the UVA-radiation creates oxidative stress, which in turn oxidizes existing melanin and leads to rapid darkening of the melanin, also known as IPD (immediate pigment darkening). Secondly, there is an increase in production of melanin known as melanogenesis. Melanogenesis leads to delayed tanning and first becomes visible about 72 hours after exposure. The tan that is created by an increased melanogenesis lasts much longer than the one that is caused by oxidation of existing melanin. Tanning involves not just the increased melanin production in response to UV radiation but the thickening of the top layer of the epidermis, the stratum corneum.A persons natural skin color affects their reaction to exposure to the sun. Generally, those who start out with darker skin color and more melanin have better abilities to tan. Individuals with very light skin and albinos have no ability to tan. The biggest differences resulting from sun exposure are visible in individuals who start out with moderately pigmented brown skin: the change is dramatically visible as tan lines, where parts of the skin which tanned are delineated from unexposed skin.Modern lifestyles and mobility have created mismatch between skin color and environment for many individuals. Vitamin D deficiencies and UVR overexposure are concerns for many. It is important for these people individually to adjust their diet and lifestyle according to their skin color, the environment they live in, and the time of year. For practical purposes, such as exposure time for sun tanning, six skin types are distinguished following Fitzpatrick (1975), listed in order of decreasing lightness:
Fitzpatrick scale
The following list shows the six categories of the Fitzpatrick scale in relation to the 36 categories of the older von Luschan scale:
Dark skin with large concentrations of melanin protects against ultraviolet light and skin cancers; light-skinned people have about a tenfold greater risk of dying from skin cancer, compared with dark-skinned persons, under equal sunlight exposure. Furthermore, UV-A rays from sunlight are believed to interact with folic acid in ways that may damage health. In a number of traditional societies the sun was avoided as much as possible, especially around noon when the ultraviolet radiation in sunlight is at its most intense. Midday was a time when people stayed in the shade and had the main meal followed by a nap, a practice similar to the modern siesta.
Geographic variation
Approximately 10% of the variance in skin color occurs within regions, and approximately 90% occurs between regions. Because skin color has been under strong selective pressure, similar skin colors can result from convergent adaptation rather than from genetic relatedness; populations with similar pigmentation may be genetically no more similar than other widely separated groups. Furthermore, in some parts of the world where people from different regions have mixed extensively, the connection between skin color and ancestry has substantially weakened. In Brazil, for example, skin color is not closely associated with the percentage of recent African ancestors a person has, as estimated from an analysis of genetic variants differing in frequency among continent groups.In general, people living close to the equator are highly darkly pigmented, and those living near the poles are generally very lightly pigmented. The rest of humanity shows a high degree of skin color variation between these two extremes, generally correlating with UV exposure. The main exception to this rule is in the New World, where people have only lived for about 10,000 to 15,000 years and show a less pronounced degree of skin pigmentation.In recent times, humans have become increasingly mobile as a consequence of improved technology, domestication, environmental change, strong curiosity, and risk-taking. Migrations over the last 4000 years, and especially the last 400 years, have been the fastest in human history and have led to many people settling in places far away from their ancestral homelands. This means that skin colors today are not as confined to geographical location as they were previously.
Social status, colorism and racism
According to classical scholar Frank Snowden, skin color did not determine social status in ancient Egypt, Greece or Rome. These ancient civilizations viewed relations between the major power and the subordinate state as more significant in a persons status than their skin colors.Nevertheless, some social groups favor specific skin coloring. The preferred skin tone varies by culture and has varied over time. A number of indigenous African groups, such as the Maasai, associated pale skin with being cursed or caused by evil spirits associated with witchcraft. They would abandon their children born with conditions such as albinism and showed a sexual preference for darker skin.Many cultures have historically favored lighter skin for women. Before the Industrial Revolution, inhabitants of the continent of Europe preferred pale skin, which they interpreted as a sign of high social status. The poorer classes worked outdoors and got darker skin from exposure to the sun, while the upper class stayed indoors and had light skin. Hence light skin became associated with wealth and high position. Women would put lead-based cosmetics on their skin to whiten their skin tone artificially. However, when not strictly monitored, these cosmetics caused lead poisoning. Other methods also aimed at achieving a light-skinned appearance, including the use of arsenic to whiten skin, and powders. Women would wear full-length clothes when outdoors, and would use gloves and parasols to provide shade from the sun.
Colonization and enslavement as carried out by European countries became involved with colorism and racism, associated with the belief that people with dark skin were uncivilized, inferior, and should be subordinate to lighter-skinned invaders. This belief exists to an extent in modern times as well. Institutionalized slavery in North America led people to perceive lighter-skinned African-Americans as more intelligent, cooperative, and beautiful. Such lighter-skinned individuals had a greater likelihood of working as house slaves and of receiving preferential treatment from plantation owners and from overseers. For example, they had a chance to get an education. The preference for fair skin remained prominent until the end of the Gilded Age, but racial stereotypes about worth and beauty persisted in the last half of the 20th century and continue in the present day. African-American journalist Jill Nelson wrote that, "To be both prettiest and black was impossible," and elaborated:
We learn as girls that in ways both subtle and obvious, personal and political, our value as females is largely determined by how we look. ... For black women, the domination of physical aspects of beauty in womens definition and value render us invisible, partially erased, or obsessed, sometimes for a lifetime, since most of us lack the major talismans of Western beauty. Black women find themselves involved in a lifelong effort to self-define in a culture that provides them no positive reflection.
A preference for fair or lighter skin continues in some countries, including Latin American countries where whites form a minority. In Brazil, a dark-skinned person is more likely to experience discrimination. Many actors and actresses in Latin America have European features—blond hair, blue eyes, and pale skin. A light-skinned person is more privileged and has a higher social status; a person with light skin is considered more beautiful and lighter skin suggests that the person has more wealth. Skin color is such an obsession in some countries that specific words describe distinct skin tones - from (for example) "jincha", Puerto Rican slang for "glass of milk" to "morena", literally "brown".In South Asia, society regards pale skin as more attractive and associates dark skin with lower class status; this results in a massive market for skin-whitening creams. Fairer skin-tones also correlate to higher caste-status in the Hindu social order—although the system is not based on skin tone. Actors and actresses in Indian cinema tend to have light skin tones, and Indian cinematographers have used graphics and intense lighting to achieve more "desirable" skin tones. Fair skin tones are advertised as an asset in Indian marketing.Skin-whitening products have remained popular over time, often due to historical beliefs and perceptions about fair skin. Sales of skin-whitening products across the world grew from $40 billion to $43 billion in 2008. In South and East Asian countries, people have traditionally seen light skin as more attractive, and a preference for lighter skin remains prevalent. In ancient China and Japan, for example, pale skin can be traced back to ancient drawings depicting women and goddesses with fair skin tones. In ancient China, Japan, and Southeast Asia, pale skin was seen as a sign of wealth. Thus skin-whitening cosmetic products are popular in East Asia. Four out of ten women surveyed in Hong Kong, Malaysia, the Philippines and South Korea used a skin-whitening cream, and more than 60 companies globally compete for Asias estimated $18 billion market. Changes in regulations in the cosmetic industry led to skin-care companies introducing harm-free skin lighteners |
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 chylomicrons, the Principle Apo-protein is: and explain in detail? | Apo B-48 |
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 sexual paraphilia? and explain in detail? | Sexual Paraphilia = A dent sexual preference for arousal Homosexuality = A normal sexual orientation towards the same gender Impoant Sexual Paraphilia Exhibitionism Exposure of one's genitalia Fetishism Use of non-living objects, E.g., undergarments, shoes, handkerchief, etc. Frotteurism Rubbing against or touching a non-consenting person to obtain sexual arousal Voyeurism Arousal through viewing another person's undressing, toileting, or sexual activity Transvestic fetishism The obligatory use of clothing of the opposite sex to achieve arousal Transvestism Crossdressing, not for sexual arousal Satyriasis Morbid, insatiable sexual need or desire in a man Sexual sadism Inflicting humiliation or suffering Sexual masochism Seeking humiliation or suffering Pedophilia Sexual fantasy pre-occupation or sexual activity with prepubescent individuals Nymphomania Abnormal, excessive, insatiable desire in woman for sexual intercourse |
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 10-year-old child presents with a preauricular sinus. There is no discharge or inflammation. Similar sinus was also observed in his mother who got treated at the age of 30 years. What will be your line of management? and explain in detail? | No treatment other than observation is advised. Further the patient should be educated that such sinus may get infected or form a cyst. Surgery is advised if sinus is symptomatic. |
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 types of collagen except one are present in cartilage 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 Blow back phenomenon seen in and explain in detail? | Blow back phenomenon in hard contact: This is most frequently seen in gunshot wounds on the head where the hot expanding gases forced back between the scalp and skull are released by creating tears in the scalp. The margins will be eveed due to gases coming out under pressure. Sometimes, due to negative pressure tissue fragments may be drawn into the barrel and outside called black spatter. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 148 |
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 most commonly used alloy in dentistry (Read the following table and answer the question) 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 Tamm Horsfall protein is produced by - and explain in detail? | Various components observed on microscopic examination of the urine in renal disease are red cells, pus cells, epithelial cells, crystals and urinary casts. The casts are moulded into cylindrical shapes by passage along tubules in which they are formed. They are the result of precipitation of proteins in the tubule that includes not only albumin but also the tubular secretion of the Tamm Horsfall protein. The latter is a high molecular weight urinary glycoprotein normally secreted by ascending loop of Henle and DCT and probably has body defence function normally. Its secretion is increased in glomerular and tubular diseases Ref: Textbook of pathology Harsh Mohan 6th edition page 652 |
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 First to be developed 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 the origin of the mitochondrial DNA of all human adult cells? and explain in detail? | The mitochondrial DNA of all human adult cells is of maternal origin only. In human feilization, the entire sperm enters the secondary oocyte cytoplasm. However, sperm mitochondria degenerate along with the sperm's tail. Therefore, only mitochondria present within the secondary oocyte (maternal) remain in the feilized zygote. |
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 Secondary hyperparathyroidism are seen in all except - and explain in detail? | Primary -Singleadenoma(90%) Multipleadenomas(4%) Nodularhyperplasia(5%) Carcinoma(1%) Secondary -Chronicrenalfailure ,Malabsorption,Osteomalacia'and rickets Teiary DAVIDSONS PRINCIPLES AND PRACTICE OF MEDICINE 22ND EDITION PAGE NO-769 |
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 child presents with a white patch over the tonsils; diagnosis is best made by culture in: and explain in detail? | In the child presenting with a white patch over the tonsil, we suspect a diagnosis of 'diphtheria'. Usual media used for cultivation of Diphtheria are Loeffler's serum slope & tellurite blood agar. Ref: Text Book of Microbilogy By Ananthanarayan, 6th Edition, Page 215 and 8th Edition, Page 233 |
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 Inversion of the foot is produced by: and explain in detail? | Ans. D. Tibialis anteriorInversion and eversion refer to movements that tilt the sole of the foot away from (eversion) or towards (inversion) the midline of the body. This movement occurs at subtalar joint. Eversion is the movement of the sole of the foot away from the median plane. Inversion is the movement of the sole towards the median plane.Inversion of the foot is produced by tibialis anterior & tibialis posterior. Eversion of the foot is produced by Peroneus longus & brevis. |
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 Ciliary staphyloma affects ciliary zone upto mm behind the limbus and explain in detail? | Answer- C. 8Staphyloma is an abnormal protrusion of uveal tissue through a weak and thin poion of cornea or sclera. So, a staphyloma is lined internally by weal tissue and ennally by weak cornea or sclera.Ciliary staphyloma : - This afects the ciliary zone that includes the region upto I mm behind the limbls. The ciliary body is incarcerated in the region of scleral ectasia. Causes are Developmental glaucoma, Primary or secondary glaucoma end stage, scleritis, trauma to ciliary region. |
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 5 year old female has a history of road traffic accident. On stroking the plantar surface of the foot from the heel to the toe, extension of great toe and fanning of remaining toes is seen. The clinical findings of this patient are indicative of : and explain in detail? | The Babinski sign, indicating an upper motor neuron lesion, is characterized by extension of the great toe and fanning of the remaining toes. Too vigorous stimulation may produce withdrawal, which may be misinterpreted as a Babinski sign. Plantar responses have limited diagnostic utility in neonates, because they are mediated by several competing reflexes and can be either flexor or extensor, depending on how the foot is positioned. Asymmetry of the reflexes or plantar response is a useful lateralizing sign in infants and children.
Note:
The Babinski sign can be elicited by stroking the sole of the foot with a firm stimulus. The normal adult response is plantar-flexion. The sign is positive when the application of the stimulus elicits extension of the large toe and fanning of the other toes. The Babinski sign is known to be a normal response in infants before full maturation of the corticospinal tract. However, in adults, a positive sign is indicative of underlying UMN damage. Other reflexes exist which represent lesions of the corticospinal tract. The Brissaud reflex is linked with the extensor response of the Babinski sign and is positive when stroking the sole of the foot elicits contraction of the tensor fascia latae of the ipsilateral leg. The Hoffman sign is an analog of the Babinski reflex for the upper limbs. The test is performed by loosely holding the patient’s middle finger and quickly flicking the fingernail downward. A positive sign is the flexion and adduction of the thumb.
Damage anywhere along the Corticospinal Tract can result in the presence of a Babinski sign. |
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 non-modifiable risk factor for hypeension is - and explain in detail? | Non modifiable risk factors for Hypeension- Age Sex Genetic factors Ethnicity Modifiable risk factors - Obesity Salt intake Saturated fat Environmental stress. Ref- Park&;s textbook of Preventive and Social Medicine 24th 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 Investigations in a clinically suspected case of tuberculosis and explain in detail? | The diagnostic procedures in a clinically suspected case of TB include AFB microscopy of sputum using Ziehl-Neelsen basic fuschsin stain;Mycobacterium culture using Lowenstein-Jensen or Middlebrook medium;nucleic acid amplifications using PCR,BACTEC;radiographic procedures like chest X ray with classic picture of upper-lobe disease with infiltrates & cavities,CT;Tuberculin skin testing with purified protein derivative which is a screening for latent M.tuberculosis infection Reference:Harrison's Medicine-18th edition,page no:1350,1351. |
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 folliculogenesis and ovulation except and explain in detail? | Ovulation The LH surge initiates the continuation of meiosis in the oocyte, luteinization of the granulosa, and synthesis of progesterone and prostaglandins within the follicle Progesterone enhances the activity of proteolytic enzymes responsible, together with prostaglandins, for digestion and rupture of the follicular wall The progesterone influenced midcycle rise in FSH serves to free the oocyte from follicular attachments, to conve plasminogen to the proteolytic enzyme, plasmin, and to ensure that sufficient LH receptors are present to allow an adequate normal luteal phase The onset of the LH surge appears to be the most reliable indicator of impending ovulation, occurring 34-36 hours prior to follicle rupture A reasonable and accurate estimate places ovulation approximately 10-12 hours after the LH peak and 24-36 hours after peak estradiol levels are attained Reference: Clinical Endocrinologic Gynecology and Infeility, Eighth edition; Chapter 6 |
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 Drug used for Urinary incontinence in Neurogenic Bladder acts on which cholinergic receptors: and explain in detail? | Ans: C. M3Cholinergic system stimulates detrusor and relaxes the trigone) - Increased micturation (M3 receptor).Selective M3 blockers:Oxybutynin, Darifenacin, Solifenacin, Tolterodine):Blocks M3 receptors in urinary bladder - Used in urinary incontinence. |
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 65 year old man complains of difficulty in reading newspaper with his left eye, three weeks after sustaining a gunshot injury to his Right eye. Diagnosis is and explain in detail? | It is a serious bilateral granulomatous panuveitis which follows a penetrating ocular trauma. |
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 genu valgum in children 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 IgA nephropathyis not associatedwith? 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 According to Body weight method what is the amount of IV fluid required in first 24 hours for a child weighing 14 kg? and explain in detail? | Ans. b (1200) (Ref. Nelson Textbook of Pediatrics, 17th ed. Table 46-1)BODY WEIGHT METHOD FOR CALCULATING MAINTENANCE FLUID VOLUMEBody WeightFluid per Day0-10 kg100 mL/kg11-20 kg1,000 mL + 50 mL/kg for each kg > 10 kg> 20 kg1,500 mL + 20 mL/kg for each kg > 10 kg** The maximum total fluid per day is normally 2,400 mL.Maintenance Water rate# 0-10 kg: 4 mL/kg/hr# 10-20 kg: 40 mL/hr + 2 mL/kg/hr x (wt-10 kg)# >20 kg: 60 mL/hr + 1 mL/kg/hr x (wt-20 kg)**The maximum fluid rate is normally 100 mL/hr.Maintenance Electrolytes# Sodium: 2-3 mEq/kg/24 hr# Potassium: 1-2 mEq/kg/24 hr |
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 Secondary (AA) amyloid is seen in all except - and explain in detail? | Robbins basic pathology 9th edition page no 155,Heading =Primary Amyloidosis Amyloidosis devolopes in only 6%to15%of patients with myeloma who have free light chains. Clearly, the presence of bence jones protiens although necessary is by itself not sufficient to produce amyloidosis. All other condition in the given questions can cause amyloidosis. |
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 Peptic ulceration occurs at all the following sites except - and explain in detail? | Peptic ulcer
Ulcers are defined histologically as a breach in the mucosa of the alimentary tract that extends through the muscular mucosa into the submucosa or deep.
Peptic ulcers are chronic, most often solitary lesions that occur in any portion of the gastrointestinal tract exposed to the aggressive action of acid/peptic juice.
Peptic ulcers located in the following sites, in order of decreasing frequency :
Duodenum, 1st portion
Stomach, usually antrum
At the gastro - esophageal junction in the setting of gastroesophageal reflux or Barrett's esophagus.
Within the margins of a gastrojejunostomy.
In the duodenum, stomach or jejunum of patients with Zollinger -Ellison Syndrome.
Within or adjacent to Meckel's diverticulum that contains ectopic gastric mucosa. |
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 specific for albinism except and explain in detail? | A common myth is that people with albinism have red eyes. Although lighting conditions can allow the blood vessels at the back of the eye to be seen, which can cause the eyes to look reddish or violet, most people with albinism have blue eyes, and some have hazel or brown eyes.Ocular albinism is a genetic condition that primarily affects the eyes. This condition reduces the coloring (pigmentation) of the iris, which is the colored pa of the eye, and the retina, which is the light-sensitive tissue at the back of the eye. Pigmentation in the eye is essential for normal vision. Ref khurana 6/e |
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 statements about Tigecycline is false: and explain in detail? | Tigecycline inhibit bacterial protein synthesis by binding to the 30S bacterial ribosome. Tigecycline is a broad-spectrum Glycylcycline antimicrobial (a novel drug of the tetracycline family), with potent activity against MRSA, MRSE and Enterococci including VRE (Vancomycin resistant Enterococci). Tigecycline is a bacteriostatic inhibitor of protein synthesis. It inhibits bacterial protein synthesis by binding to the 30S bacterial ribosome and preventing access of aminoacylt-RNA to the acceptor (A) site on the mRNA-ribosome complex. Tigecycline is available only for paterenteral administratio. It is eliminated mainly in the bile so dose adjustment is needed in hepatic disease not in renal insufficiency. The majority of antibiotics that block bacterial protein synthesis interfere with the processes at the 30S subunit or 50S subunit of the 70S bacterial ribosome. Antibiotics that inhibit Protein synthesis at the 30S ribosome subunit: Tetracycline Tigecycline (Glycylcycline) Aminoglycosides Antibiotics that inhibit protein synthesis at the 50S ribosome subunit: Macrolides- Erythromycin Lincosamide-Clindamycin Streptogramins (Quinupristin/dalfopristin) Oxazoladinone-Linezolid Chloramphenicol Ref: Goodman of Gilman 13th edition PGno: 1049 |
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 tonsillitis is caused by and explain in detail? | B. i.e. (Beta hemolytic streptococcus) (240 - Dhingra)ACUTE TONSILLITIS* Haemolytic streptococcus is the most commonly infecting organism others causes may be - staphylococcus pneumococci or H. influenzae* Penicillin is the drug of choice*** Complications include - chronic tonsillitis, peritonsillar abscess, Parapharyngeal abscess cervical abscess,Acute otitis media, Rheumatic fever, acute glomerulonephritis, SABE* Tonsil is supplied by1. Tonsillar branch offacial artery*2. Ascending pharyngeal artery*3. Ascending palatine*4. Dorsal lingual*5. Descending palatine*TREATMENTS* Bedrest, giving plenty of fluids, analgesics* Penicilline is the drug of choice *** Erythromycin and ampicilline may be needed for resistant cases |
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 child aged 24 months was brought to the Primary Health Centre with complaints of cough and fever for the past 2 days. On examination, the child weighed 11kg, respiratory rate was 38 per minute, chest indrawing was present. The most appropriate line of management for this patient is ? and explain in detail? | Ans. is `c' i.e., Classify as severe pneumonia, sta antibiotics and refer urgently |
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 line of conjunctival inflammation on lower eye lid margin is diagnostic of - and explain in detail? | Ans. is 'a' i.e., Measles It is called Steiner's line and is seen in measles |
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 Cyclothymia is classified under - and explain in detail? | Ans. is 'd' i.e., Persistent mood disorder Dysthymia is also know as Neurotic depressionMelancholic depression is also know as Endogenous depressionAdjustment disorder as reactive depression as it's in reaction to stress in lifeDouble depression is Dysthymia plus depressionPersistent depressive disorder is in DSM-5 any depression more the 2 years so both Dysthymia and Double Depression will fall under thisChronic depression any Depression more than 2 years this will also know fall under Persistent depressive disorderIn ICD-10 Cyclothymia and Dysthymia are classified as persistent depressive disorderDouble depression is a complication of a psychiatric illness called dysthymic disorder, or dysthymia. Dysthymia is a chronic, depressed mood accompanied by just one or two other symptoms of clinical depression (such as low energy or low self-esteem) that lasts at least two years in adults (or one year in kids). This low, dark mood -- sometimes described as a "veil of sadness" -- occurs nearly every day and can sometimes persist for many years. Some people may have this mood disorder for 10 to 20 years or even more before seeking treatment.Over time, more than half of people with dysthymia experience worsening symptoms that lead to the onset of a full syndrome of major depression superimposed on their dysthymic disorder. This is known as double depression. Persistent mood disorder o Mood disorders may run a chronic course over years with fluctuation of mood interposed with symptom free intervals. If symptoms persist for more than 2 years, they are referred to as persistent mood disorders. Two most important persistant mood disorders are Cyclothymia It is a subdued version of bipolar disorder, characterized by episodes of depression and hypomania that never have sufficient intensity to meet full diagnostic criteria for bipolar disorder. Dysthemia Long standing (persistent, i.e., 2 years) mild depression which is not severe enough to meet full diagnostic criteria for major depression. Symptoms are more prominent than signs (more subjective than objective depression). This means that disturbances in appetite and libido are uncharacteristic, and psychomotor agitation or retardation is not observed. Kaplan & Sadock's Synopsis Of Psychiatry -11E = In DSM-5, cyclothymic disorder is defined as a "chronic, fluctuating mood disturbance" with many periods of hypomania and of depression. The disorder is differentiated from bipolar II disorder, which is characterized by the presence of major (not minor) depressive and hypomanic episodes. As with dysthymia, the inclusion of cyclothymic disorder with the mood disorders implies a relation, probably biological, to bipolar I disorder. Some psychiatrists, however, consider cyclothymic disorder to have no biological component and to result from chaotic object relations early in life. |
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 Hormone Replacement therapy is not indicated in: and explain in detail? | H indicated in menopausal women to overcome the sho term and long term consequences of estrogen deficiency. Indications of hormone replacement therapy in a menopausal woman Relief of vasomotor symptoms: hot flushes Prevention and treatment of osteoporosis Urogenital atrophy Premature Menopause Hormone Replacement Therapy is NOT indicated for prevention or treatment of cardiovascular disease. Natural estrogens produced in the body till menopause are cardioprotective, however Hormone Replacement Therapy (containing exogenous estrogens and progesterones)is not cardioprotective, n fact it is detrimental to hea when used for long term. |
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 tissue macrophages are derived from the 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 Brain abscess and explain in detail? | Brain abscess (or cerebral abscess) is an abscess caused by inflammation and collection of infected material, coming from local (ear infection, dental abscess, infection of paranasal sinuses, infection of the mastoid air cells of the temporal bone, epidural abscess) or remote (lung, heart, kidney etc.) infectious sources, within the brain tissue. The infection may also be introduced through a skull fracture following a head trauma or surgical procedures. Brain abscess is usually associated with congenital heart disease in young children. It may occur at any age but is most frequent in the third decade of life.
Signs and symptoms
Fever, headache, and neurological problems, while classic, only occur in 20% of people with brain abscess.The famous triad of fever, headache and focal neurologic findings are highly suggestive of brain abscess. These symptoms are caused by a combination of increased intracranial pressure due to a space-occupying lesion (headache, vomiting, confusion, coma), infection (fever, fatigue etc.) and focal neurologic brain tissue damage (hemiparesis, aphasia etc.).The most frequent presenting symptoms are headache, drowsiness, confusion, seizures, hemiparesis or speech difficulties together with fever with a rapidly progressive course. Headache is characteristically worse at night and in the morning, as the intracranial pressure naturally increases when in the supine position. This elevation similarly stimulates the medullary vomiting center and area postrema, leading to morning vomiting.Other symptoms and findings depend largely on the specific location of the abscess in the brain. An abscess in the cerebellum, for instance, may cause additional complaints as a result of brain stem compression and hydrocephalus. Neurological examination may reveal a stiff neck in occasional cases (erroneously suggesting meningitis).
Pathophysiology
Bacterial
Anaerobic and microaerophilic cocci and gram-negative and gram-positive anaerobic bacilli are the predominant bacterial isolates. Many brain abscesses are polymicrobial. The predominant organisms include: Staphylococcus aureus, aerobic and anaerobic streptococci (especially Streptococcus intermedius), Bacteroides, Prevotella, and Fusobacterium species, Enterobacteriaceae, Pseudomonas species, and other anaerobes. Less common organisms include: Haemophillus influenzae, Streptococcus pneumoniae and Neisseria meningitidis.Bacterial abscesses rarely (if ever) arise de novo within the brain, although establishing a cause can be difficult in many cases. There is almost always a primary lesion elsewhere in the body that must be sought assiduously, because failure to treat the primary lesion will result in relapse. In cases of trauma, for example in compound skull fractures where fragments of bone are pushed into the substance of the brain, the cause of the abscess is obvious. Similarly, bullets and other foreign bodies may become sources of infection if left in place. The location of the primary lesion may be suggested by the location of the abscess: infections of the middle ear result in lesions in the middle and posterior cranial fossae; congenital heart disease with right-to-left shunts often result in abscesses in the distribution of the middle cerebral artery; and infection of the frontal and ethmoid sinuses usually results in collection in the subdural sinuses.
Other organisms
Fungi and parasites may also cause the disease. Fungi and parasites are especially associated with immunocompromised patients. Other causes include: Nocardia asteroides, Mycobacterium, Fungi (e.g. Aspergillus, Candida, Cryptococcus, Mucorales, Coccidioides, Histoplasma capsulatum, Blastomyces dermatitidis, Bipolaris, Exophiala dermatitidis, Curvularia pallescens, Ochroconis gallopava, Ramichloridium mackenziei, Pseudallescheria boydii), Protozoa (e.g. Toxoplasma gondii, Entamoeba histolytica, Trypanosoma cruzi, Schistosoma, Paragonimus), and Helminths (e.g. Taenia solium). Organisms that are most frequently associated with brain abscess in patients with AIDS are poliovirus, Toxoplasma gondii, and Cryptococcus neoformans, though in infection with the latter organism, symptoms of meningitis generally predominate.These organisms are associated with certain predisposing conditions:
Sinus and dental infections—Aerobic and anaerobic streptococci, anaerobic gram-negative bacilli (e.g. Prevotella, Porphyromonas, Bacteroides), Fusobacterium, S. aureus, and Enterobacteriaceae
Penetrating trauma—S. aureus, aerobic streptococci, Enterobacteriaceae, and Clostridium spp.
Pulmonary infections—Aerobic and anaerobic streptococci, anaerobic gram-negative bacilli (e.g. Prevotella, Porphyromonas, Bacteroides), Fusobacterium, Actinomyces, and Nocardia
Congenital heart disease—Aerobic and microaerophilic streptococci, and S. aureus
HIV infection—T. gondii, Mycobacterium, Nocardia, Cryptococcus, and Listeria monocytogenes
Transplantation—Aspergillus, Candida, Cryptococcus, Mucorales, Nocardia, and T. gondii
Neutropenia—Aerobic gram-negative bacilli, Aspergillus, Candida, and Mucorales
Diagnosis
The diagnosis is established by a computed tomography (CT) (with contrast) examination. At the initial phase of the inflammation (which is referred to as cerebritis), the immature lesion does not have a capsule and it may be difficult to distinguish it from other space-occupying lesions or infarcts of the brain. Within 4–5 days the inflammation and the concomitant dead brain tissue are surrounded with a capsule, which gives the lesion the famous ring-enhancing lesion appearance on CT examination with contrast (since intravenously applied contrast material can not pass through the capsule, it is collected around the lesion and looks as a ring surrounding the relatively dark lesion) |
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 Lymphatic of cervix drains into which nodes? 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 Citron bodies are formed by and explain in detail? | Clostridium septicum: form citron bodies, boat or leaf-shaped polymorphic bacilli. Motile by peritrichous flagella. Saccharolytic and produce abundant gas. Produce alpha, beta, delta and gamma toxin. Gas gangrene or malignant edema are characteristic Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 260 |
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 are unmyelinated nerve fibers? and explain in detail? | Ans. is 'c' i.e., Postganglionic sympathetic fibers[Ref Ganong 24h/e p. 92; Principles of medical physiology p. 5I2lType C fibers are unmyelinated fibers which include postganglionic autonomic fibers, |
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 Black gun pow der composition - and explain in detail? | Ans. is 'c' i.e., Charcoal 15% + Potassium nitrate 75% + sulphur 10% The classical gun powder is known as black powder, consists of charcol (15%), Sulphur (10%), and potassium nitrate (75%). Depending on fineness, the black gun powder is designated as FG, FFG, FFFG. etc. (F = fineness). Pyrodex is another gun powder with same components, but with different ratios.Black gun powder produces smoke, i.e. It is smoke producing pow der. Smokeless powder, in addition to black powder, has nitrocellulose (single base), or nitrocellulose plus nitroglycerine (double base), or nitrocellulose plus nitroglycerine plus nitroguanidine (triple base). Semi smokeless pow der has 80% black pow der and 20% smokeless powder (nitrocellulose). |
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 True about polio vaccination is all EXCEPT: and explain in detail? | Follow up of AFP every 30 days REF: Park 20thedition page 180-184 AFP surveillance is done every 60 days to check for residual paralysis Salk contains all three types of polio virus inactivated by formalin, contains 20,2 & 4D antigen of types 1,2 and 3 The doses of OPV given during pulse polio immunization are extra and supplemental, and do not replace the doses given during routine immunization. OPV induces both humoral and cell mediated immunity |
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 La bella indifference is seen in: and explain in detail? | D ref: Ahuja, 4th/e p. 95and 5th/e p. 105 |
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 Following surgical removal of a firm nodular swelling in the right breast and exploration of the right axilla, on examination the patient was found to have a winged right scapula. Most likely this could have occurred due to injury to the and explain in detail? | C. i.e. Long thoracic nerve |
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 25 year old executive presents with metamorphopsia in his right eye. On examination the fundus shows a shallow detachement at the macula. The fluorescein angiography shows a "smoke stack" sign. Which of the following management should be given ? and explain in detail? | Manifestation of metamorphosia, detachment of macula and "smoke stack" sign on fluorescein angiography in a 25 years old patient suggest the diagnosis of central serous retinopathy.
When left alone, central serous retinopathy heals spontaneously within 4-12 weeks, with full recovery of vision in 90% of patients. Therefore reassurence is the only treatment required in majority of the cases. |
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 following is the finding noted in a 12-month-old baby who is growing well and developing normally since bih. Which of the following is a true statement regarding this finding? and explain in detail? | The picture depicts a Simian crease-single transverse palmar crease. It is a normal finding in about 3% of population. And in child with Simian crease and normal growth and development, simple reassurance should be provided. Other options: A Simian crease is one of the findings of Down syndrome however presence of only this finding should not lead to a diagnosis of Down syndrome. Maternal history of Phenytoin intake during pregnancy doesnot lead to this finding. However,maternal alcohol intake can be associated with this condition. Chromosomal analysis in an otherwise well child is not indicated. Ref: Nelson textbook of pediatrics 21st edition Pgno: 995 |
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 Gold standard flap for breast reconstruction - and explain in detail? | Ans. is 'C' i.e., DIEP flap |
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 Type IV respiratory failure occurs due to 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 Cartilages and muscles of larynx and pharynx develop from? and explain in detail? | Ans. A. 4th and 6th branchial arch.Clefts = ectoderm Arches = mesoderm Pouches = endoderm. The 4th arch gives rise to: most pharyngeal constrictors; cricothyroid, levator veil palatini and 6th arch gives rise to ail intrinsic muscles of larynx except cricothyroid. Cartilages: thyroid, cricoid, arytenoids, corniculate, cuneiform also develop from 4th amd 5th arches.Branchial arch derivativesPharyngeal ArchArch ArteryCranial NerveSkeletal elementsMuscles1Terminal Branch of maxillary arteryMaxillary and mandibular division of trigeminal (V)Derived from arch cartilages (originating from neural crest):- From maxillary cartilages: Alispenoid, incus- From mandibular: Meckel's cartilage, malleusUpper portion of external ear (auricle) is derived from dorsal aspect of 1st pharyngeal arch.Derived by direct ossification from arch dermal mesenchyme-Maxilla, zygomatic, squamous portion of temporal bone, mandibleMuscles of mastication (temporalis, masseter, and pterygoids), mylohyoid, anterior belly of digastric, tensor tympani, tensor veli palatini (originate from cranial somitomere 4)2Stapedius artery (embryologic) & cortiotympanic artery (adult)Facial nerve (VII)Stapes, styloid process, stylohyoid ligament, lesser horns and upper rim of hyoid (derived from the second arch/ Ritcher's cartilage; originate from neural crest).Lower portion of external ear (auricle) is derived from 2nd pharyngeal arch.Muscles of facial expression (orbicularis oculi, orbicularis oris, auricularis, piatysma, fronto-ooccipitalis, buccinator), posterior belly of digastric, stylohyoid, stapedius (originate from cranial somitomere 6)3Common carotid artery, most of internal carotidGlossophary- ngeal (IX)Lower rim and greater horn of hyoid (derived from the third arch cartilage; originate from neural crest ceils)Sytlopharyngeus (originate from cranial somitomere 7)4Left: Arch of aorta; Right: Right subclavian artery; Original sprouts of pulmonary art.Superior laryngeal branch of vagus (X)Laryngeal cartilages (Derived from the 4th arch cartilage, originate from lateral plate mesoderm)Constrictors of pharynx cricothyroid, levator veli palatine (originate from occipital somites 2-4)5Ductus arteriosus; roots of definitive pulmonary arteriesRecurrent laryngeal branch of vagus (X)Laryngeal cartilages (derived from the Se- arch cartilage; originate from lateral plate mesoderm)Intrinsic muscles of larynx (originate from occipital somites 1 and 2) Derivates of pharyngeal pouches:First pouchAuditory tube, which comes in contact with epithelial line of first pharyngeal cleft, where future external acoustic meatus will form.Distal portion will form tympanic cavity (lining will become eardrum).Proximal portion will become auditory tube.Second pouchForms buds that penetrate surrounding mesenchyme, which together form the palatine tonsilsThird pouchForms thymus and inferior parathyroid glandsFourth pouchForms superior parathyroid glandsFifth pouchForms utlimobranchial body Derivatives of pharyngeal clefts/grooves:Initially, four clefts exist; however, only one gives rise to a definite structure in adults.1st pharyngeal cleftPenetrates underlying mesenchyme and forms EAM. The bottom of EAM forms lateral aspect of tympanic cavity.2nd pharyngeal cleftUndergoes active proliferation and overlaps remaining clefts. It merges with ectoderm of lower neck such that the remaining clefts lose contact with outside. Temporarily, the clefts form an ectodermally lined cavity, the cervical sinus, but this disappears during development |
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 Growth rate is calculated by ? and explain in detail? | park's textbook of preventive and social medicine 23rd edition. *when crude death rate is subtracted from crude bih rate the net residual is the current annual growth rate. |
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 Calcification of the aoic valve is seen in : and explain in detail? | Answer is A (Aoic Stenosis) Aoic calcification is most commonly associated with Aoic stenosis Aoic Calcification in Aoic stenosis is usually apparent on fluoroscopic examination with an image intensifier or by echocardiography. The absence of aoic calcification in an adult suggests that severe valvular Aoic stenosis is not present. |
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 appearance of markedly vacuolated, nucleated red cells in the marrow, anemia and reticulocytopenia are characteristic dose-dependent side effects 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 Sexual intercourse by a human being with an animal 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 The drug of choice for treating cholera in pregnant women 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 a absolute contra indication for ECT and explain in detail? | HISTORY * Medunna ====IM injection of camphor to induce seizures * Ugo cerletti and lucio bini==== ECT in a catatonic patient INDICATIONS * DEPRESSION SUICIDAL IDEAS-------------- first choice * CATATONIC SCHIZOPHRENIA * SCHIZOPHRENIA * MANIA * ELECTRODE PLACEMENT * Most commonly used=== bi fronto temporal * More cognitive side effects==bi fronto temporal * Less cognitive side effect======bi frontal * SIDE EFFECTS * RETROGRADE AMNESIA * BODY ACHE * MEDICATIONS USED IN THE PROCEDURE * ANAESTHETIC======Thiopentone / ethosuximide * MUSCLE RELAXANT====Succynyl choline CURARE IN PSEUDOCHOLINEESTERASE DEFICIENCY * ANTICHOLINERGIC=====Atropine CONTRA INDICATIONS * NO ABSOLUTE Contra indication * RELATIVE -----------------Brain tumour / arrythmia Ref. kaplon and saock, synopsis of psychiatry, 11 th edition, pg no. 1065 |
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 is not metabolized by acetylation ? 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 Cardiac manifestations can be seen in all of the following metabolic diseases EXCEPT? and explain in detail? | Cardiac manifestations can be seen in: Fatty acid oxidation defects Mitochondrial disorders Fabry disease Pompe disease (GSD type 2) Kearns Sayre syndrome Mucoplysaccharidoses Methylmalonic acidemia Familial hypercholesterolemia GM1 gangliosidosis. Cardiac manifestations are not seen in Galactosemia. |
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 4 years old child presents with rash on lower limbs, arthritis, and abdominal pain. Urine examination reveals microscopic hematuria. The most likely diagnosis is: and explain in detail? | Ans. (d) Henoch Schonlein purpura(Ref: R 9/909-912)The clinical history is suggestive of nephritic syndrome with arthritis and purpura which is a triad of Henoch Schonlein purpura |
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 which part of fallopian tube ectopic pregnancy will have longest survival: and explain in detail? | M.C site of ectopic pregnancy – Fallopian tubes.
In Fallopian Tubes – M/C sites in descending order are:
Ampulla > mus > infundibulum > interstitium
Rarest overall site of ectopic pregnancy is cervix or cesarean section scan
Average period of survival of ectopic pregnancy is 8 weeks.
Ectopic pregnancy survives for longest time in its annual 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 Untrue regarding ludwig's angina: 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 pt. of peptic ulcer disease. When investigated endoscopically showed chronic antral gastritis. Which of the following dye will be able to stain the specimen - and explain in detail? | Ans. is 'd' ie. Wahin starry stain Most cases of chronic gastritis are one of the two types - Type A - Autoimmune type associated with pernicious anemia, it primarily involves the body and fundus. Type B - associated with H. pylori infection, it primarily involves the antrum. Mnemonic Type A - Autoimmune Type B - Bacteria i.e. H. pylori In this pt. having chronic antral gastritis (type B) we will use a dye which will help stain H. pylori. Dye used for H. pylori is Wahin starry stain (or Giemsa or genta silver stain)* Some other imp stains Zeil Nelson* --> i i ()bacterium tuberculosis Albe stain* --> Corynebacterium diptheria Oil red 0 stain* -p Fats PAS* --> Glycogen Prussian blue* -> Iron Congo red * --> Amyloid Von Kossa* --> Calcium |
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 should not be used in setting of severe hypeension in elderly on empirical basis? and explain in detail? | Ans. is 'd' i.e., Prazosin o For initial treatment (emperical treatment) ACE inhibitors, ARBs, Diuretics or CCBs are used. Note - in most of the cases thiazide diuretic is the DOC for treatment initiation. |
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 enzyme does not catalyze the irreversible step in glycolysis - and explain in detail? | Ans- B Glycolysis (Embden Meyerh of Pathway) Definition: Glycolysis is a process by which glucose molecules are metabolized through a series of enzymatic reactions into 2 molecules of pyruvate. Site Of GlycolysisCytosol Purpose: Aerobic glycolysis produces 7 moles of ATP per mole of glucose and 2 moles of pyruvate (Ref: Harper 28th edition, pg 155) Anaerobic glycolysis produces 2 moles of ATP per mole of glucose and 2 moles of lactate. Tissues Dependent On Glycolysis: Erythrocytes, cornea, lens, kidney medulla. Irreversible Reactions Of Glycolysis are: Hexokinase and Glucokinase Have Different Properties Four different isoenzymes of hexokinase (I, II, III, and IV) are expressed in a tissue - specific manner in the body. The hexokinase isoenzymes found in most tissues (I, II, and III) have a low Km, for glucose (<0.1 mM) relative to its concentration in blood (~ 5 mM) and are strongly inhibited by the product glucose 6-phosphate (G6P). The latter is important as it prevents hexokinase from tying up all of the inorganic phosphate of a cell in the form of phosphorylated hexoses. Although the hexokinase reaction is not at equilibrium because of the inhibition imposed by G6P, the level at which hexokinase is expressed in cells can have a major impact on the rate of glycolysis in cells. Liver parenchymal cells and b cells of pancreas are unique in that they contain hexokinase isoenzyme IV, usually called glucokinase, which has strikingly different kinetic properties. Glucokinase catalyzes ATP-dependent phosphorylation of glucose like other hexokinase, but its S0.5 (Substrate concentration that gives enzyme activity of one half maximum velocity) for glucose is considerably higher than the Km for glucose of the other hexokinases. Furthermore, glucokinase is much less sensitive to product inhibition by G6P, and its glucose saturation curve is sigmoidal, which is indicative of cooperativity. Important Enzymes Of Glycolysis are: Difference between Hexokinase and Glucokinase: Hexokinase Glucokinase 1. Site 2. Substrate 3. Induction 4. Km for glucose 5. Inhibition by glucose-6-phosphate 6. Effect of feeding and insulin All tissues except liver Glucose, fructose or galactose. Non inducible Low Inhibited No change in activity Only in liver Only glucose Inducible High Not inhibited Increased rate. Hexokinase II And Cancer As a rule rapidly growing cancers metabolize glucose faster than normal cells, at least in part because overexpression of hexokinase II gives cancer cells greater enzymatic capacity for glucose phosphorylation. On top of this, tight binding of hexokinase II to the mitochondrial outer membrane provides the enzyme with first dibs for the ATP produced by oxidative phosphorylation. Phosphofructokinase: Major regulatory enzyme of glycolysis Activators of PFK: AMP; F6P; F2,6-BP; Inhibitors of PFK: ATP, citrate Enolase: Enzyme is inhibited by sodium fluoride Embden-Meyerhof pathway Fructose 2,6-Bisphosphate Plays a Unique Role in the Regulation of Glycolysis & Gluconeogenesis in Liver. Comment Energetics of Glycolysis During glycolysis 2 ATP are utilized and 4 ATP are produced at substrate level. 2 reducing equalents NADH+ are produced and reoxidized by electron transport chain, to generate 5 ATP molecules (2.5 ATP per NADH+ molecule). Thus total 9 ATP molecules are produced and 2 are utilized, i.e., There is net gain of 7 ATP molecules in aerobic glycolysis. In anaerobic conditions, the reoxidation of NADH by electron transport chain is prevented and NADH gets reoxidized by conversion of pyruvate to lactate by lactate dehydrogenase. Thus, in anaerobic glycolysis only 4 ATP are produced at substrate level. Therefore, there is net gain of 2 ATP molecules in anaerobic glycolysis. Note: - Previous calculations were made assuming that NADH produces 3 ATPs and FADH2 generates 2 ATPs. This will amount to a net generation of 8ATPs per glucose molecule during glycolysis. Recent experiments show that these old values are overestimates and NADH produces 2.5 ATPs and FADH2 produces 1.5 ATPs. Thus, net generation is only 7 ATPs during glycolysis. Reaction Enzyme No of ATPs gained (new calculation) No of ATPs gained (old calculations) Glucose - Glucose-6-phosphate Hexokinase, glucokinase - 1 - 1 Fructose-6-p -Fructose -1,6-bisphosphate Hexokinase, glucokinase - 1 - 1 Glyceraldehyde-3-P - 1,3 bisphosphoglycerate Glyceraldehyde-3-P, dehydrogenase + 5 (2.5 X 2 NADH) +6 (3.0 X 2 NADH) 1,3 bisphosphoglycerate - 3-phosphoglycerate Phosphoenol pyruvate - Pyruvate Phosphoglycerate mutase +2 +2 +2 +2 o Net generation in aerobic glycolysis Pyruvate kinase 9 - 2 = 7 10 - 2 = 8 Comment Important Points The most potent positive allosteric activator of phosphofructokinase-1 and inhibitor of fructose 1,6-bisphosphatase in liver is fructose 2,6-bisphosphate. It relieves inhibition of phosphofructokinase-1 by ATP and increases the affinity for fructose 6-phosphate. It inhibits fructose 1,6-bisphosphatase by increasing the Km for fructose 1,6-bisphosphate. Its concentration is under both substrate (allosteric) and hormonal control (covalent modification) Fructose 2,6-bisphosphate is formed by phosphorylation of fructose 6-phosphate by phosphofructokinase-2. The same enzyme protein is also responsible for its breakdown, since it has fructose 2,6-bisphosphatase activity. This bifunctional enzyme is under the allosteric control of fructose 6-phosphate, which stimulates the kinase and inhibits the phosphatase. When there is an abundant supply of glucose, the concentration of fructose 2,6-bisphosphate increases, stimulating glycolysis by activating phosphofructokinase-1 and inhibiting fructose 1,6-bisphosphatase. In the fasting state, glucagon stimulates the production of cAMP, activating cAMP-dependent protein kinase, which in turn inactivates phosphofructokinase-2 and activates fructose 2,6-bisphosphatase by phosphorylation. Hence, gluconeogenesis is stimulated by a decrease in the concentration of fructose 2,6-bisphosphate, which inactivates phosphofructokinase-1 and relieves the inhibition of fructose 1,6-bisphosphatase. |