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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 True about tropomysin is? and explain in detail? | ANSWER: (B) Lies on top of actinREF: Guyton 12th ed page 72-76SLIDING FILAMENT THEORY OF MUSCLE CONTRACTION:In resting muscle, the ends of the actin filaments extending from two successive Z discs barely begin to overlap one another. Troponin I is tightly bound to actin and tropomyosin covers the sites where myosin heads bind to actin i.e the tropomyosin molecules lie on top of the active sites of the actin strands, Thus, the troponin-tropomyosin complex constitutes a "relaxing protein" that inhibits the interaction between actin and myosin filaments to cause contractionIn contracted state, these actin filaments have been pulled inward among the myosin filaments, so their ends overlap one another to their maximum extent. Also, the Z discs have been pulled by the actin filaments up to the ends of the myosin filaments. Thus, muscle contraction occurs by a sliding filament mechanism.Actin filaments slide inward among the myosin filaments by forces generated by interaction of the cross-bridges from the myosin filaments with the actin filaments. Under resting conditions, these forces are inactive. But when an action potential travels along the muscle fiber, this causes the sarcoplasmic reticulum to release large quantities of calcium ions that rapidly surround the myofibrils. When the Ca2+ released by the action potential binds to troponin C, the binding of troponin I to actin is presumably weakened, and this permits the tropomyosin to move laterally. This movement uncovers binding sites for the myosin heads. ATP is then split and contraction occurs. Seven myosin-binding sites are uncovered for each molecule of troponin that binds a calcium ion. But energy is needed for the contractile process to proceed. This energy comes from high-energy bonds in the ATP molecule, which is degraded to adenosine diphosphate (ADP) to liberate the energy.Molecular Basis of ContractionThe process by which the shortening of the contractile elements in muscle is brought about is a sliding of the thin filaments over the thick filaments. The width of the A bands is constant, whereas the Z lines move closer together when the muscle contracts and farther apart when it is stretched. The sliding during muscle contraction occurs when the myosin heads bind firmly to actin, bend at the junction of the head with the neck, and then detach. This "power stroke" depends on the simultaneous hydrolysis of ATP. Myosin-II molecules are dimers that have two heads, but only one attaches to actin at a time. The process by which depolarization of the muscle fiber initiates contraction is called excitation-contraction coupling.Steps in contractionDischarge of motor neuron.Release of transmitter (acetylcholine) at motor end-plate.Binding of acetylcholine to nicotinic acetylcholine receptors.Increased Na+ and K+ conductance in end-plate membrane.Generation of end-plate potential.Generation of action potential in muscle fibers.Inward spread of depolarization along T tubules.Release of Ca2+ from terminal cisterns of sarcoplasmic reticulum and diffusion to thick and thin filaments.Binding of Ca2+ to troponin C, uncovering myosin-binding sites on actin.Formation of cross-linkages between actin and myosin and sliding of thin on thick filaments, producing movementSteps in relaxationCa2+ pumped back into sarcoplasmic reticulum.Release of Ca2+ from troponin.Cessation of interaction between actin and myosin. |
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 55-year-old man suffers from an acute myocardial infarction after occlusion of the left anterior descending coronary artery. The patient undergoes coronary bypass surgery 3 days later. Which of the following is the most frequent cause of saphenous vein graft failure several years following coronary bypass surgery? and explain in detail? | Saphenous veins are used as autografts in coronary artery bypass surgery. These grafts usually undergo a series of adaptive and reparative changes. Venous grafts in place for 5 to 10 years typically show atherosclerotic plaques that are indistinguishable from those found in native coronary arteries, a process referred to as atherosclerotic "restenosis."Diagnosis: Atherosclerosis |
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 One of your patient who was diagnosed to have hypogonadism was found to have normal FSH and oestradiol levels. This patient belongs to which type as per the WHO classification of disorders of ovulation? and explain in detail? | WHO classification of disorder of ovulation is given below Type I - Hypogonadotropic hypogonadism, low FSH and LH, low oestradiol Type II - Normogonadotropic hypogonadism, normal FSH, normal oestradiol Type III - Hypergonadotropic hypogonadism, high FSH and LH, low oestradiol Ref: Essentials of Gynaecology by Lakshmi Seshadri, Edition 1, page - 274. |
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 Rash is absent in ? and explain in detail? | Ans. is 'c' i.e., Q. fever |
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 Fastest acting proton pump inhibitor is and explain in detail? | Rabeprazole is the fastest acting proton pump inhibitor. |
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 Hyperlysinemia may be associated with: and explain in detail? | Ans. All of the above |
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 Knudson two hit hypothesis is seen with and explain in detail? | Ref Robbins 9/e p290 The Knudson hypothesis, also known as the two-hit hypothesis is the hypothesis that most genes require two mutations to cause a phenotypic change. It was first formulated by Alfred G. Knudson retinoblastoma, a tumor of the retina that occurs both as an inherited disease and sporadically. He noted that inherited retinoblastoma occurs at a younger age than the sporadic disease. In addition, the children with inherited retinoblastoma often developed the tumor in both eyes, suggesting an underlying predisposition. Knudson suggested that two "hits" to DNA were necessary to cause the cancer. In the children with inherited retinoblastoma, the first mutation in what later came to be identified as the RB1 gene, was inherited, the second one acquired. In non-inherited retinoblastoma, instead two mutations, or "hits", had to take place before a tumor could develop, explaining the later onset. |
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 Afterimage and explain in detail? | An afterimage is an image that continues to appear in the eyes after a period of exposure to the original image. An afterimage may be a normal phenomenon (physiological afterimage) or may be pathological (palinopsia). Illusory palinopsia may be a pathological exaggeration of physiological afterimages. Afterimages occur because photochemical activity in the retina continues even when the eyes are no longer experiencing the original stimulus.The remainder of this article refers to physiological afterimages. A common physiological afterimage is the dim area that seems to float before ones eyes after briefly looking into a light source, such as a camera flash. Palinopsia is a common symptom of visual snow.
Negative afterimages
Negative afterimages are caused when the eyes photoreceptors, primarily known as rods and cones, adapt to overstimulation and lose sensitivity. Newer evidence suggests there is cortical contribution as well. Normally, the overstimulating image is moved to a fresh area of the retina with small eye movements known as microsaccades. However, if the image is large or the eye remains too steady, these small movements are not enough to keep the image constantly moving to fresh parts of the retina. The photoreceptors that are constantly exposed to the same stimulus will eventually exhaust their supply of photopigment, resulting in a decrease in signal to the brain. This phenomenon can be seen when moving from a bright environment to a dim one, like walking indoors on a bright snowy day. These effects are accompanied by neural adaptations in the occipital lobe of the brain that function similar to color balance adjustments in photography. These adaptations attempt to keep vision consistent in dynamic lighting. Viewing a uniform background while these adaptations are still occurring will allow an individual to see the afterimage because localized areas of vision are still being processed by the brain using adaptations that are no longer needed.
The Young-Helmholtz trichromatic theory of color vision postulated that there were three types of photoreceptors in the eye, each sensitive to a particular range of visible light: short-wavelength cones, medium-wavelength cones, and long-wavelength cones. Trichromatic theory, however, can not explain all afterimage phenomena. Specifically, afterimages are the complementary hue of the adapting stimulus, and trichromatic theory fails to account for this fact.The failure of trichromatic theory to account for afterimages indicates the need for an opponent-process theory such as that articulated by Ewald Hering (1878) and further developed by Hurvich and Jameson (1957). The opponent process theory states that the human visual system interprets color information by processing signals from cones and rods in an antagonistic manner. The opponent color theory suggests that there are three opponent channels: red versus green, blue versus yellow, and black versus white. Responses to one color of an opponent channel are antagonistic to those of the other color. Therefore, a green image will produce a magenta afterimage. The green color fatigues the green photoreceptors, so they produce a weaker signal. Anything resulting in less green, is interpreted as its paired primary color, which is magenta, i.e. an equal mixture of red and blue.Example video which produces a distorted illusion after one watches it and looks away. See motion aftereffect.
Positive afterimages
Positive afterimages, by contrast, appear the same color as the original image. They are often very brief, lasting less than half a second. The cause of positive afterimages is not well known, but possibly reflects persisting activity in the brain when the retinal photoreceptor cells continue to send neural impulses to the occipital lobe.A stimulus which elicits a positive image will usually trigger a negative afterimage quickly via the adaptation process. To experience this phenomenon, one can look at a bright source of light and then look away to a dark area, such as by closing the eyes. At first one should see a fading positive afterimage, likely followed by a negative afterimage that may last for much longer |
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 Magnesium and explain in detail? | It is uncommon and always due to excessive intake either orally (antacids), rectally (enema) or parenterally. Causes of hypermagnesemia are listed in Box 35.19. Magnesium intoxication causes depression of neuromuscular system, causing lethargy, hypotension, respiratory depression, brady- cardia and weak tendon reflexes. In severe conditions, acute rhabdomyolysis results. Hypermagnesemia induces decrease in serum calcium by inhibiting PTH secretion, which in turn will have deleterious effects.Ref: DM Vasudevan, page no: 412 |
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 Bicornuate uterus belongs to which class according to WHO classification of Mullerian duct anomalies and explain in detail? | WHO classification of Mullerian duct anomalies
Class I - Mullerian agenesis
Class II - Unicornuate uterus
Class III - Uterus Didelphys
Class IV - Bicornuate uterus
Class V - Septate uterus
Class VI - Arcuate uterus
Class VII - DES related anomalies. |
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 26-year-old man has had myalgias and a fever for the past week. On physical examination, his temperature is 38.6deg C. He has diffuse muscle tenderness, but no rashes or joint pain on movement. Laboratory studies show elevated serum creatine kinase and peripheral blood eosinophilia. Larvae of Trichinella spiralis are present within the skeletal muscle fibers of a gastrocnemius biopsy specimen. Two years later, a chest radiograph shows only a few small calcifications in the diaphragm. Which of the following immunologic mechanisms most likely contributed to the destruction of the larvae? and explain in detail? | When antibody is directed at a parasitic infection, there is Fc receptor-mediated inflammation and phagocytosis, characteristic for ADCC. IgG and IgE antibodies bearing Fc receptors coat the parasite. Macrophages, natural killer cells, and neutrophils can then recognize the Fc receptor and destroy the antibody-coated target cells. Acute inflammatory reactions with abscess formation have little effect against tissue parasites. Complement-mediated lysis is most typical of immune destruction of RBCs with hemolysis. Langhans giant cells are seen in granulomatous inflammation, a form of type IV hypersensitivity. Leukotriene C4 is a potent agent that promotes vascular permeability and bronchial smooth muscle contraction in type I hypersensitivity reactions. |
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 Trisomy 21 is - and explain in detail? | Ans. is 'a' i.e., Dow n's syndrome Trisomy 21 is synonymous with down's syndrome and is the most common of the chromosomal disorders o Down's syndrome - Trisomy 21 o Edwards syndrome - Trisomy 18 o Patau syndrome - Trisomy 13 o Kleinfelter syndrome - 47XXY o Turner syndrome - 45 XO |
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 Intermediate host for hydatid disease aEUR' and explain in detail? | Man Hydatid disease of the liver is caused by Echinococcus granulosus: Ecchinococcus granulosus:- Also known as dog tapeworm, hydatid worm Habitat Small intestine of dog and other canine animals Definitive host --> Dog, wolf, fox, jackal (canine animals) Intermediate host Sheep, pig, cattle, horse, goat, man (dead end) Infective form .- Egg Mode of infection Ingestion of eggs Also know Man is the definitive host in most of the parasitic infection except the following parasites where it is an intermediate host. Echinococcus granulosus (Hydatid worm) Plasmodium (Malaria) Taenia solium (Man is both definitive an intermediate host) Toxoplasma gondii Sarocysts lindemanii |
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 Holdswoh classification of thoracolumbar spine fracture is based on how many columns of spine? and explain in detail? | Answer- A. TwoHoldswoh,s proposed two column concept of thoracolumbar spine fractureAntetior column : Consists veebral body, annulus fibrous, Anterior and posterior longitudinal ligamentsposterior column: Consists of veebral arch (pedicle, facets, laminae) and posterior ligaments (ligamentum flavum,interspinous and supraspinus ligament) |
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 most sensitive for diagnosis of HIV? and explain in detail? | Ans. a. PCR |
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 Substance responsible for erection of penis - and explain in detail? | Ans. is 'b' i.e., Papaverine Papaverineo It is a nonspecific phosphodiesterase inhibitor.o Injection of papaverine with or without phentolamine into corpus cavemosum produces penile tumiscence to permit intercourse.o Repeated injection can cause penile fibrosis. |
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 Mother to hid transmission of HIV - 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 How much is the risk of ovarian cancer increased above normal in a woman with non autosomal dominant genotype with one first degree relative with ovarian cancer : and explain in detail? | 2 - 3 times |
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 Nerve fibres carrying fast pain is and explain in detail? | Fast pain is carried by Aδ fibres
Slow pain is carried by C fibres |
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 the principle fibre group of the periodontal ligament 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 pathway produces the least number of ATPs? and explain in detail? | Pathway ATP produced Anaerobic Glycolysis 2 Glycogenolysis followed by anaerobic glycolysis 3 TCA cycle 10 Palmitate oxidation 106 Steric acid oxidation 120 HMP shunt & Uronic acid pathway 0 |
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 Eagle effect is seen in and explain in detail? | Some microbes demonstrate a curious response to b-lactam antibiotics known as Eagle-effect. Eagle-effect positive enterococci exhibit their greatest bactericidal response to penicillins at a concentration just above the MIC of the antibiotic, as concentration of P is increased above this value,bactericidal effect against enterococci is decreased. It is their unusual resistance to antibiotics - single outstanding characteristics. |
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 Deoxycholic acid and explain in detail? | Deoxycholic acid is a bile acid. Deoxycholic acid is one of the secondary bile acids, which are metabolic byproducts of intestinal bacteria. The two primary bile acids secreted by the liver are cholic acid and chenodeoxycholic acid. Bacteria metabolize chenodeoxycholic acid into the secondary bile acid lithocholic acid, and they metabolize cholic acid into deoxycholic acid. There are additional secondary bile acids, such as ursodeoxycholic acid. Deoxycholic acid is soluble in alcohol and acetic acid. When pure, it comes in a white to off-white crystalline powder form.
Deoxycholic acid is available as a generic medication in the United States as of April 2021, sold under the brand name Kybella among others.
Applications
Deoxycholic acid has been used since its discovery in various fields of human medicine. In the human body deoxycholic acid is used in the emulsification of fats for absorption in the intestine. It has, in some countries (including Switzerland) been licensed as an emulsifier in food industry, but it is no longer common. Outside the body it is used in experimental basis of cholagogues and is also in use to prevent and dissolve gallstones.In research deoxycholic acid is used as a mild detergent for the isolation of membrane associated proteins. The critical micelle concentration for deoxycholic acid is approximately 2.4–4 mM.Sodium deoxycholate, the sodium salt of deoxycholic acid, is often used as a biological detergent to lyse cells and solubilise cellular and membrane components. Sodium deoxycholate mixed with phosphatidylcholine, is used in mesotherapy injections to produce lipolysis, and has been used as an alternative to surgical excision in the treatment of lipomas.Deoxycholates and bile acid derivatives in general are actively being studied as structures for incorporation in nanotechnology. They also have found application in microlithography as photoresistant components.In the United States, deoxycholic acid, under the brand name Kybella, is approved by the Food and Drug Administration for reducing moderate-to-severe fat below the chin. When injected into submental fat, deoxycholic acid helps destroy fat cells. Kybella is produced by Kythera Biopharmaceuticals.
Research in immunology
Its function as a detergent and isolating agent for membrane proteins also suits it for production of outer membrane protein (OMP) vaccines such as MenB, a Norwegian vaccine developed in the early 1990s. The MeNZB vaccine was produced using the same method.Deoxycholic acid binds and activates the membrane enzyme NAPE-PLD, which catalyzes the release of the endogenous cannabinoid anandamide and other N-acylethanolamines. These bioactive signaling molecules play important roles in several physiological pathways including stress and pain response, appetite, and lifespan.Some publications point towards the effect of deoxycholic acid as an immunostimulant of the innate immune system, activating its main actors, the macrophages. According to these publications, a sufficient amount of deoxycholic acid in the human body would correspond with a good immune reaction of the non-specific immune system. Clinical studies conducted in the 1970s and 1980s confirm the expectation that deoxycholic acid is involved in the natural healing processes of local inflammations, different types of herpes, and possibly cancer.
Research in cancer
Deoxycholate and other secondary bile acids cause DNA damage. Secondary bile acids increase intracellular production of reactive oxygen and reactive nitrogen species resulting in increased oxidative stress and DNA damage. As shown in the figure below, deoxycholate added to the diet of mice increased the level of 8-oxo-dG, an oxidative DNA damage, in the colonic epithelium of mice. When the level of deoxycholate-induced DNA damage is high, DNA repair enzymes that ordinarily reverse DNA damage may not be able to keep up.DNA damage has frequently been proposed as a major cause of cancer. DNA damage can give rise to cancer by causing mutations.When deoxycholate was added to the food of mice so that their feces contained deoxycholate at about the same level present in feces of human on a high fat diet, 45% to 56% of the mice developed colon cancer over the next 10 months, while none of the mice on a diet without deoxycholate developed cancer. Thus, exposure of the colon to deoxycholate may cause cancer in mice. However, this same study reported that, when chlorogenic acid was added to the diet alongside deoxycholate, only 18% of the mice developed colon cancer. Chlorogenic acid is a component of common foods and beverages; coffee contains an average of 53.8 mg chlorogenic acid per 100 ml. Therefore, to consume the level of chlorogenic acid used in the study, a human on a "standard" 2000-calorie daily diet (416 g/d; 250g carbs, 100g protein, 66g fat) would need to consume roughly 55 mL of coffee each day, or just under 2 fluid ounces.
In humans, higher levels of colonic deoxycholate are associated with higher frequencies of colon cancer. As an example, the fecal deoxycholate concentrations in African Americans (who eat a relatively high fat diet) is more than five times higher than fecal deoxycholate of Native Africans in South Africa (who eat a low fat diet). Male African Americans have a high incidence of colon cancer of 72 per 100,000, while Native Africans in South Africa have a low incidence rate of colon cancer of less than 1 per 100,000, a more than 72-fold difference in rates of colon cancer.
A prospective human study investigating the relationship between microbial metabolites and cancer found a strong correlation between circulating deoxycholic acid and colorectal cancer risk in women.
Factors affecting deoxycholate levels
A number of factors, including diet, obesity, and exercise, affect the level of deoxycholate in the human colon. When humans were switched from their usual diet to a meat, egg and cheese based diet for five days, deoxycholate in their feces increased by factors of 2 to 10 fold. Rats fed diets with 30% beef tallow (high fat) had almost 2-fold more deoxycholate in their feces than rats fed 5% beef tallow (low fat). In the same study, adding the further dietary elements of curcumin or caffeic acid to the rats high fat (30% beef tallow) diet reduced the deoxycholate in their feces to levels comparable to levels seen in the rats on a low fat diet. Curcumin is a component of the spice turmeric, and caffeic acid is a component high in some fruits and spices |
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 50 year old male chronic smoker complains of hoarseness for the past 4 months. Microlaryngoscopic biopsy shows it to be keratosis of the larynx. All are suggested treatment modalities for this condition, except - and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Ascaris lumbricoides causes deficiency of? and explain in detail? | ANSWER: (D) Vitamin AREF: With text"Ascaris infestation may lead to malnutrition. Apart from anorexia leading to poor intake, studies have shown that lactose indigestion and intolerance also occur, and the absorption of vitamin A is impaired. All these leads to PEM, Iron deficiency anemia and vitamin A deficiency" (REF: Surgical Diseases in Tropical Countries by Suneet Sood Page 70)Diarrhea may be associated with Giardia and Ascaris, both of which reduce vitamin A absorption, in some instances by as much as 70% (REF: Vitamin A deficiency: health, survival, and vision - Alfred Sommer, Keith P. West Page 197)"Kwashiorkor has long been associated with Ascaris infection and it is known that ascariasis also contributes to vitamin A and possibly vitamin C deficiency" (REF: Imaging of tropical diseases: with epidemiological, pathological and clinical correlation: Volume 2 -Philip E. S. Palmer, Maurice Merrick Reeder Page 20) |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A 60 year old male comes to casuality with acute retention of urine since 12 hours. On examination there was distended bladder. His son gives a history of taking some drug by the pateint. Since 2 days as he is suffering from depression. The most likely drug is and explain in detail? | B i.e. Amitryptiline |
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 Van Nuys grading system is used for? and explain in detail? | Answer- B. DCISVan Nuys prognostic index is widely used to classify ductal carcinoma in situ (DCIS) into dissimilar risk categories that may be treated accordingly. |
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 18 years old male developed meningitis 5 days after taking a bath in pond. The likely causative organism - and explain in detail? | Ans. is 'c' i.e., Naegleria fowleri * Primary amebic meningoencephalitis (PAM) is an acute, fulminant, and rapidly fatal infection involving the central nervous system. It is caused by the parasite Naegleria fowleri, a free- living ameboflagellate found in soil and fresh or brackish water (lakes rivers, ponds). |
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 Chances of an offspring being affected when one parent is autosomal dominant heterozygote - 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 Engaging diameter in brow presentation is and explain in detail? | Brow presentation : Engaging diameter of head is Mentoveical which is 14 cm The position is commonly unstable and conves to either veex or face presentation Position can be confirmed by Palpating supraorbital ridges and anterior fontanel. Ref: Dutta Obs 9e pg 367. |
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 of the following transmissions meiosis occurs? and explain in detail? | Ans A. primary to secondary spermatocyte |
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 moem staining gets fixed after : and explain in detail? | D i.e. 7-8 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 C.E.A. (Carcinoma embryonic antigen) is elevated in all except - and explain in detail? | Ans. is 'd' i.e., Emphysema |
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 spinal cord: and explain in detail? | A, B, C i.e. In adults spinal cord ends at lower border of Li veebra, In newborn may extend up to L3, Cauda equine extends from lumbar veebra to coccyx |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A patient complains of persistent numbness of the chain, lower lip, and lower teeth. She fuher indicates that she difficulty chewing. Radiographic studies of the head demonstrated a small discrete mass in the infratemporal fossa. which nerve has been compromised by the mass and explain in detail? | While running in the mandibular canal the inferior alveolar nerve gives branches that supply the lower teeth and gums. The mental nerve emerges at the mental foramen and supplies the skin of the chin, and the skin and mucous membrane of the lower lip. Its incisive branch supplies the labial aspect of gums of canine and incisor teeth. Any damage to inferior alveolar nerve may cause neuralgic pain, which may be referred to the areas of distribution of the buccal and auriculotemporal nerves. If the nerve is paralyzed, the area supplied by the mental nerve becomes insensitive. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th 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 Granulomatous inflammation reaction is caused by all except and explain in detail? | ref Robbins 8/e p802 ,9/e p97 Granulomatous inflammation is a histologic pattern of tissue reaction which appears following cell injury.Granulomatous inflammation is caused by a variety of conditions including infection, autoimmune, toxic, allergic, drug, and neoplastic conditions. Although many infections are associated with granuloma formation, relatively few microorganisms cause the majority of cases. Mycobacteria and fungi are commonly associated with granulomatousinfection, and in paicular,tuberculosis is the most common cause of granulomasworldwide. |
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 or none law refers to: and explain in detail? | Action potential |
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 Garden -I fractures are also known as - and explain in detail? | Stage 1 : The fracture is incomplete, with head tilted in postero-lateral direction, i.e. into valgus, therefore is known as valgus (abduction) impacted fracture.
Stage 2 : Complete fracture but undisplaced.
Stage 3 : Complete fracture with partial displacement.
Stage 4 : Complete fracture with total displacement. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is What is DOC of Severe Complicated Falciparum Malaria is ? and explain in detail? | AEMESININS : Aemisinin and its three major semisynthetic derivatives in clinical use Dihydroaemisinin, Aemether and Aesunate are potent and Fast-acting Antimalarials. They are optimized for the treatment of Severe P. falciparum malaria and are also effective against the asexual erythrocytic stages of P.vivax. AESUNATE - All patients with Severe Falciparum Malaria should be treated with I/V or I/M Aesunate (atleast 24 hours). The semisynthetic aemisinins have been formulated for Oral (Dihydroaemisinin, Aesunate, and Aemether); Intramuscular (Aesunate and Aemether); Intravenous (Aesunate); and Rectal (Aesunate) routes. AEMETHER - is used only if Parenteral Aesunate is not available PROPEIES : Fastest acting Antimalarial drug Effective against MDR parasites Sho acting C/I in 1st Trimester |
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 investigative method of choice for confirmation of H.pylori eradication is and explain in detail? | In summary, it is not necessary to perform endoscopy to diagnose H. pylori. Serology is the test of choice for initial diagnosis when endoscopy is not required. If, however, endoscopy is to be performed, the rapid urease assay and histology are both excellent options, but the cost advantage lies with the rapid urease assay. After treatment, the urea breath test is the method of choice but again should not be performed until 4 weeks after therapy ends. If the breath test is unavailable, endoscopy may be performed in selected patients such as those with bleeding ulcers or other complications of their PUD. |
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 Chediak higashi syndrome, true is - and explain in detail? | Chediak-Higashi syndrome is autosomal recessive disorder. Polymorphonuclear leucocytes here possess larger lysosomes. These abnormal lysosomes do not fuse with phagosome. - this leucocytes posses diminished phagocytic activity. Reference : Baveja text book of microbiology, 4th edition, pg no:153 <\p> |
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 one of the following branches of sociology studies the relationship between organism and environment and explain in detail? | Ecology is defined as the science of mutual relationship between living organisms and their environments. Ergonomics is the study of people&;s efficiency in their working environment Ref : Park&;s Textbook of Preventive and Social Medicine; 23rd edition - Pgno 21 |
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 36 years male presented with complain of productive cough and fever for last 2 months. He has undergone kidney transplantation 2 years back. His sputum examination revealed a gram positive filamentous bacteria that showed acid fastness with modified Ziehl-Neelsen staining (1% H2SO4). The most likely etiological agent is ? and explain in detail? | Ans. is 'b' i.e., Nocardia asteroides |
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 the length tension relationship of skeletal muscle, the length at which active tension is maximum is: and explain in detail? | Ans. (d) E(Ref: Guyton and Hall Physiology Review, 3rd ed/p.14)Active tension produced in the muscle is at point E.In the graph, A is the active tension curve.C is the passive tension curve. |
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 Heme is which porphyrin? and explain in detail? | The protoporphyrinogen-III is oxidized by the enzyme protoporphyrinogen oxidase to protoporphyrin-III in the mitochondria. The xidation requires oxygen.The methylene bridges (-CH2) are oxidized to methenyl bridges ( -CH=) and colored porphyrins are formed.Protoporphyrins -9 is thus formed. The last step in the formation of heme is the attachment of ferrous iron to the protoporphyrin. The enzyme is heme synthase or ferrochelatase, which is also located in the mitochondria. REFERENCE : DM VASUDEVAN TEXTBOOK SEVENTH EDITION ; PAGE NO : 273. |
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 Stereotactic radiosurgery is done for and explain in detail? | Stereotactic Radiosurgery SRS is a non-surgical radiation therapy used to treat functional abnormalities & small tumors of brain Deliver precisely - targeted concentrated dose of radiation in fewer high-dose treatments to a defined volume in the brain When SRS is used to treat body tumors, its called stereotactic body radiotherapy (SRBT) Primary risks of stereotactic radiosurgery are radiation necrosis & radiation injury to surrounding structures Common uses of Stereotactic Radiosurgery (SRS) Brain tumor (Benign, malignant, primary & metastatic Tumors, single & multiple) Beingn lesions of the cranial nerves Aeriovenous malformation Trigeminal neuralgia SRBT is currently used and /or being investigated for use in treating malignant or benign small-to-medium size tumors of lung, liver, abdomen, spine, prostate, head and neck Ref: Sabiston 20th edition Pgno : 1923 |
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 Ramu, a 3 year 8 month old child is living in an area where fluoride water supply consists of 0.4 ppm. Fluoride supplement needed is and explain in detail? | Dietary Fluoride Supplementation Schedule |
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 As absolute contraindication of MRI is: and explain in detail? | Pacemaker |
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 70-year-old woman, previously in good health, is found to have an asymptomatic monoclonal immunoglobulin peak on serum electrophoresis. Her physical examination is normal, as is her CBC, electrolytes, renal function and calcium level. A skeletal survey does not reveal any osteolytic lesions and a bone-marrow aspirate reveals 5% plasma cells. Which of the following is the most likely diagnosis? and explain in detail? | MGUS is vastly more common than multiple myeloma, occurring in 1% of the population over age 50. Patients with MGUS have smaller M components (usually < 30 g/L); no urinary Bence Jones protein; < 10% bone marrow clonal plasma cells, and no anemia, renal failure, lytic bone lesions, or hypercalcemia. About 25% of patients with MGUS will go on to develop multiple myeloma. This patient's normal investigations and percentage of marrow plasma cells makes the diagnosis MGUS rather than myeloma. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Weakness of extraocular muscle may be seen in all of the following conditions except : and explain in detail? | A i.e. Polymyositis Ocular muscles are spared even in advanced, untreated cases of inflammatory myopathies (polymyositis, dermatomyositis & inclusion body myositis) Q. If these muscles are affected, the diagnosis of inflammatory myopathy should be questioned. (H-2540) Inflammatory Myopathies Characteristic Dermatomyositis Polymyositis Inclusion body myositis Age Adulthood and childhood > 18 years > 50 years Male: Female = 3:1 Sex Female > Male Familial association Absent Absent Present in some cases Associated conditions Drugs - D-penicillamine - D-penicillamine Absent - Contaminated tryptophan - Zidovudine Connective tissue disease Present e.g. scleroderma & mixed connective tissue disease (overlap Present e.g. SLE, RA, sjogren, systemic sclerosis & mixed Present e.g. SLE, RA, sjogren, systemic sclerosis syndrome) connective tissue disease & mixed connective tissue disease Systemic autoimmune disease Infrequent Frequent e.g. chron's ds, vasculitis, sarcoidosis, 10 biliary cirrhosis etc. Infrequent Malignancy Present, in upto 15% cases Absent Absent Viruses Unproven Present e.g. HIV & HTLV-1 Present e.g.HIV & HTLV-1 Parasites & bacteria Absent Present Absent Clinical features * Rash - Accompany or more often precede muscle weaknessQ - Consists of a blue purple discolouration on the upper eyelids with edema (heliotrope rash) Q, a flat red rash on the face & upper trunk, & erythema of knuckles with raised violaceous scaly eruption (Gottron rashQ). The erythematous rash on neck & anterior chest (V sign) or back & shoulder (Shawl sign) can also occur. * It is a diagnosis of exclusion. It is subacute myopathy affecting adults & rarely children who do not have - rash Q, involvement of extraocular & facial muscles Q, family h/o neuromuscular disease, h/o exposure to myotoxic drugs or toxins, endocrinopathy, neurogenic disease, muscular dystrophy, biochemical muscle disorder (deficiency of enzyme) or IBM as excluded by muscle biopsy analysis. - May worsen after sun exposure & may be pruritic * The cuticles may be irregular thickened & distoed and the fingers (lateral & palmar areas) may become rough & cracked with irregular diy horizontal lines, resembling mechanic's hands. Muscle weakness - Progressive & often - Progressive & often - Progress very slowly over symmetrical muscle weakness, which progress subacutely, over a period of weeks or month symmetrical muscle weakness, which progress sub acutely, over a period of weeks or years simulating a late life muscular dystrophy or - Increasing difficulty with month slowly progressive motor everyday tasks requiring the - Increasing difficulty with neuron disease use of proximal muscles Q such everyday tasks requiring the - Fine motor movements as getting up from a chair, climbing steps or combing hair etc. use of proximal muscles Q such as getting up from a chair, climbing steps or combing hair (distal muscles) are involved early _ Mild fascial weakness is - Fine motor movements that depend on the strength of distal etc. - Fine motor movements that common muscles, such as buttoning a depend on the strength of - Falling is common shi, sewing, knitting or distal muscles, such as because of early writing are affected only late in course buttoning a shi, sewing, knitting or writing are affected involvement of quadriceps muscle with buckling of - Fascial muscle are unaffected only late in course knees. - Myalagia & muscle tenderness may occur in some patients of - Fascial muscle are unaffected DM with connective tissue disease |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is All are true statement about digitalis action EXCEPT: and explain in detail? | Ans. (b) Pumps sodium out of cell* Digitalis is one of the cardiac glycosides which increases myocardial contractility and output in a hypodynamic heart without a proportionate increase in oxygen consumption.* Compounds in cardiac glycosides group include: digoxin, digitoxin, strophanthin, ouabain etc.* MOA of Digitalis: binds to Na+K+ATPase of myocardial fibres and inhibits this enzyme. This leads to progressive accumulation of Na+ intracellularly which indirectly results in intracellular Calcium accumulation.* ACTION:# Digitalis increases the force of contraction and decreases the heart rate# It also decreases the AV conduction, hence contraindication in WPW syndrome.# Causes diuresis in CHF patients# Causes decrease in peripheral resistance in CHF patients (because of withdrawal of reflex sympathetic overactivity) |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Best way to prevent caries 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 First antibody to appear in plasma/blood in acute hepatitis B is? and explain in detail? | Ig M Anti HBc REF: Harrison's 17ed chapter 298, markers See APPENDIX-28 for "MARKERS OF HEPATITIS-B" |
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 Oxygen content of the arterial blood is reduced in all except- a) Methemoglobinemia b) Fallot's tetralogy c) Carbon monoxide poisoning d) Fibrosing alveolitis 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 Collagen biosynthesis occurs inside 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 Which of the following is not compatible with a diagnosis of chronic myelomonocytic leukemia ? and explain in detail? | Ans. is 'b' i.e., More than 20% of blasts in blood or bone marrowChronic myelomonocytic leukemia (CMML) o The term myelomonocytic leukemia indicates that all cells of the myeloid lineage are involved (myelo-), but emphasizes the prominence of monocytoid features ("-mono-").o The hallmarks of CMML are -(i) Peripheral monocytosis > 1000 / 1 (>1 x 109 / L)(ii) < 20% of bone marrow blasts(iii) Peripheral (blood) blasts < 5%(iv) Presence of bone marrow dysplasiao CMML is also known as philadelphia chromosome negative leukemia.o CMML shares clinical and biological features with both myelodysplastic syndrome (MDS) and chronic myeloproliferative disorders (CMPDs), and may take on predominantly myelodysplastic (MD - CMML) or myeloproliferative (MP - CMML) characteristics.WHO diagnostic criteria for CMMLMajor criteria1. Persistent peripheral blood monocytosis > 100 / 12. Absence of philadelphia chromosome or BCR / Abl fusion gene.3. < 20% myeloblasts + tnonoblasts + promonocytes in peripheral blood or bone marrow4. Dysplastic changes in one or more myeloid lineages.Minor criteria1. Acquired clonal cytogenetic abnormality in bone marrow cells.2. Persistent monocytosis > 3 months, after exclusion of all other causes of monocytosis.o For the diagnosis of CMML all 4 major criteria must be present. In the absence of myelodysplasia, or when only minimal myelodysplasia is present, the diagnosis of CMML can be made when the first 3 criteria and at least one of the minor criteria are fulfilled.o CMML has been split into:- (i) CMML -1 < 10% bone marrow blastsCMML - 2 11-20% bone marrow blastsWHO criteria for the classification of CMMLCMML -1Bone marrow blasts < 10%Peripheral blood blasts < 5%CMML-2Bone marrow blasts 10-19%Peripheral blood blasts 5-19%OR : Presence of Auer rods when blasts in peripheral blood and bone marrow < 20%CMML -1 or CMML -2 with eosinophiliaAbove criteria for CMML - 1 or CMML - 2 ANDPeripheral blood absolute eosinophil count >1500 / 1 |
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 of choice in PSVT is- and explain in detail? | adenosine is the drug of choice in PSVT .verapamil is the next drug of choice Adenosine blocks AV node there by blocking reentry pathway Ref Harrison 20th edition pg 1445 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following is an absorbable suture 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 The parvocellular pathway from lateral geniculate nucleus to visual coex is most sensi ve for the stimulus of and explain in detail? | Color contrast Parvocellular pathway - Color vision, texture, shape, fine detail Magnocellular pathway - Detection of movement, depth, flickers |
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 common salivary gland malignant neoplasm in
bones 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 Blood group antigens chemically are and explain in detail? | Ans is 'b' i.e.,Glycoprotein The ABO antigens are determined to be glycoproteins and glycolipids. |
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 output return to normal how many days after delivery: and explain in detail? | Ans. D. 4 weeks* The cardiac output (CO) starts to increase from 5th week of pregnancy, reaches its peak 40-50% at about 30-40 weeks.* CO is lowest in the sitting or supine position and highest in the right or left lateral or knee chest position.* It increases further during labor (+50%) and immediately following delivery (+70%) over the pre-labor values.* Within 1-2 hours following birth, the cardiac output is estimated to be about 500ml/min and Hr 120-140/min* CO returns to pre labor values one hour after delivery.* It returns to the pre-pregnancy level in 4 weeks' time. |
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 Combination chemotherapy is used in tuberculosis in order to reduce:? and explain in detail? | Combination therapy:
Like in the case of TB, leprosy, HIV and malaria, combination therapy with 2 effective drugs has several advantages in the treatment of VL. These are:
Limiting risk of development of drug resistance, thereby prolonging the effective life-time of available medicines.
Attaining higher efficacy and cure rate.
Shortening of duration of therapeutic regimen; better compliance and convenience.
Reduction of overall dose; lower toxicity and cost.
Reference: Essentials of Medical Pharmacology Seventh Edition KD TRIPATHI page no 847 |
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 If the two buds of the pancreas do not fuse, the anomaly is- and explain in detail? | Ans. is 'b' i.e., Pancreatic divisum Ref - Pancreas divisum represents a variation in pancreatic ductal anatomy that can be associated with abdominal pain and idiopathic pancreatitis. It is characterised, in the majority of cases, by the dorsal pancreatic duct (main pancreatic and Santorini ducts) directly entering the minor papilla with no communication with the ventral duct (Wirsung), and thus, the major papilla. Epidemiology It is the most common variation of pancreatic duct formation and may be present in ~4-10 % of the general population 3-4,6. Its MRCP prevalence is at around 9% with autopsy prevalence going up to 14% 7. Clinical presentation Most people with a pancreas divisum are asymptomatic, but this is more frequently found in patients with chronic abdominal pain and idiopathic pancreatitis than in the general population 4. Pathology It results from failure of fusion of dorsal and ventral pancreatic anlages. As a result, the dorsal pancreatic duct drains most of the pancreatic glandular parenchyma via the minor papilla. Although controversial, this variant is considered as a cause of pancreatitis. Pancreatic divisum can result in a santorinicoele, which is a cystic dilatation of the distal dorsal duct (Santorini duct), immediately proximal to the minor papilla. Three subtypes are known: type 1 (classic): no connection at all; occurs in the majority of cases: 70% type 2 (absent ventral duct): minor papilla drains all of pancreas while major papilla drains bile duct; 20-25% type 3 (functional): filamentous or inadequate connection between dorsal and ventral ducts: 5-6% Radiographic features Fluoroscopy: ERCP This was the traditional method of diagnosis where a pancreas divisum was suspected when there was no contrast extending towards the pancreatic tail upon administration at the ampulla of Vater. MRCP/MRI pancreas It is the current gold standard method of evaluation. The key imaging features: the dorsal pancreatic duct being in direct continuity with the duct of Santorini, which drains into the minor ampulla ventral duct (Wirsung duct), which does not communicate with the dorsal duct but joins with the distal bile duct to enter the major ampulla Some authors suggest increased sensitivity of secretin MRCP (S-MRCP) in detection sensitivity of pancreas divisum 2. Treatment and prognosis A diagnosis of pancreas divisum does not routinely warrant treatment, especially when incidental and asymptomatic. In symptomatic patients (e.g. recurrent pancreatitis), management options may include 6: non-operative treatment +/- pancreatic enzyme supplements minor papillectomy minor papilla stenting balloon dilatation of any associated stricture |
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 methods are used for the diagnosis of HIV infection in a 2 month old child, except - and explain in detail? | diagnosis of HIV in 2 month old child is by p24 Sg asday ,PCR&viral culture.ELISA id not used REF:<\p> MICROBIOLOGY ANANTHA NARAYANAN NINTH EDITION PAGE.575 |
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 a penetrated injury in the submandibular triangle, the tongue of 45 year old patient detes to the left on protrusion. Which of the following nerves is injured? and explain in detail? | A lesion of the hypoglossal nerve causes detion of the tongue toward the injured side on protrusion. The lingual and glossopharyngeal nerves do not supply the tongue muscles. Hence option 4 i.e. left hypoglossal nerve (same as the side of detion) is correct. |
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 Bilateral spider leg sign on IVP is suggestive of: and explain in detail? | Ans. Polycystic kidney |
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 Viruses can be cultured in all except: and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Mechanism of analgesia is by and explain in detail? | The degree to which a person reacts to pain varies tremendously. This variation results paly from a capability of the brain itself to suppress input of pain signals to thenervous system by activating a pain control system called an analgesia system. The analgesia system consists of three major components: (1) The periaqueductal gray and periventricular areas of the mesencephalon and upper pons surround the aqueduct of Sylvius and poions of the third and fouh ventricles. Neurons from these areas send signals to (2) the raphe magnus nucleus, a thin midline nucleus located in the lower pons and upper medulla, and the nucleus reticularis paragigantocellularis, located laterally in the medulla. From these nuclei, second-order signals are transmitted down the dorsolateral columns in the spinal cord to (3) a pain inhibitory complex located in the dorsal horns of the spinal cord. At this point, the analgesia signals can block the pain before it is relayed to the brain. Ref: guyton and hall textbook of medical physiology 12 edition page number:698,699,700 |
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 Punishment for dowry death is imprisonment for and explain in detail? | Whoever commits dowry death shall be punished with imprisonment for a term that shall not be less than 7 years but that may extend to imprisonment for life Ref: TEXTBOOK OF FORENSIC MEDICINE AND TOXICOLOGY KRISHNAN VIJ FIFTH EDITION PAGE 169 |
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 Hemoglobin in normal adult is: March 2005 and explain in detail? | Ans. A: HbA In the embryo-Gower 1 (C2 r2) Gower 2 (a2E2) In the fetus: hemoglobin F (a2y2) In the adults: Hemoglobin A (GA) - The most common with a normal amount over 95% Hemoglobin A 2 (a26,) - Chain synthesis begins late in the third trimester and in adults, it has a normal range of 1.5-3.5% Hemoglobin A1c is increased in the patients with poorly controlled diabetes mellitus |
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 Acntholysis is characteristic of- and explain in detail? | HP of pemphigus vulgaris shows a suprabasal cleft with bulla formation just above the basal layer with a tomb stone appearance and with blister cavity containing acantholytic cells and inflammatory cells.Page no 282. Reference IADVL's concise textbook of dermatology |
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 statements about spasmodic dysphonia are true, except and explain in detail? | Like adductor spasm dysphonia, the cause of abductor spasmodic dysphonia is not known. It is a dystonia of Laryngeal Muscles. Treatment is an injection of botulinum toxin in posterior cricoarytenoid muscles. It can be done by percutaneous or endoscopic route. Speech therapy should be combined with injection treatment as speech therapy alone may not be effective. Patient with abductor dysphonia gets a breathy voice or breathy breaks in voice. Ref: PL Dhingra; Textbook of EAR, NOSE and THROAT; edition 7; Page - 356 |
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 Consequences of obstructive sleep apnea are all except and explain in detail? | Obstructive sleep apnea sympathetic hyper stimulation. |
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 T.T.K.G >8 is seen in all except: and explain in detail? | Transtubular potassium gradient > 8 is associated with hyperkalemia. Choices 1, 2, 3 lead to hyperkalemia. Choices 1 and 2 lead to kidney damage. Choice 3 due to aldosterone deficiency leads to potassium excess due to inability to loose potassium the collecting duct. Cushing syndrome has excess of coisol, which stimulates the mineralocoicoid receptors to cause hypokalemic metabolic alkalosis. |
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 Drospirenone/estetrol 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 In myocardial infarction the first enzyme to rise: 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 Emtricitabine is a/an ? 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 Adjuvant chemotherapy is of definite value in and explain in detail? | Ans. is 'a' i.e. CA colon Harrison writes - "Chemotherapy can be administered as an adjuvant, i.e., in addition to surgery or radiation, after all clinically apparent disease has been removed. This use of chemotherapy may have curative potential in breast and colorectal neoplasms, as it attempts to eliminate clinically unapparent tumor that may have already disseminated." Devita' Oncology writes-" Several well-conducted randomized phase 3 clinical studies have documented efficacy of adjuvant chemotherapy in prolonging disease freeand overall survival in patients with breast cancer, colon cancer, gastric cancer, non small-cell lung cancer, ovarian cancer, head and neck cancer, and cervical cancer, Wilms' tumor, and osteogenic sarcoma. There is also evidence to suppo the use of adjuvant chemotherapy in patients with Anaplastic astrocytomas. Patients with primary malignant melanoma at high risk of metastases derive benefit in terms of improved disease-free survival and overall survival from adjuvant treatment with the biologic agent interferon-I+- although this treatment must be given for 1 year for optimal clinical efficacy. Finally, the antiestrogens tamoxifen and anastrozole are effective adjuvant agents in postmenopausal women whose breast tumors express the estrogen receptor." Adjuvant Chemotherapy: Indicated for (Ref- Devita's Oncology) Anaplastic astrocytoma Osteogenic sarcoma Breast cancer Pancreatic cancer Colorectal cancer Ovarian cancer Gastric cancer Head and neck cancer Melanoma Cervical cancer Non small cell lung cancer Wilm's tumor (Note that Harrison 17/e table 81.1 lists only 4 cancers for adjuvant therapy i.e. --Breast, colon, osteogenic sarcoma and soft tissue sarcoma) Also know: Primary induction chemotherapy refers to drug therapy administered as the first treatment for patients who present with advanced cancer for which no alternative treatment exists. This approach applies for patients with advanced, metastatic disease. Cancer chemotherapy can be curative in a small but significant subset of patients who present with advanced disease. In adults, these curable cancers include- Hodgkin's and non-Hodgkin's lymphoma, acute lymphoblastic and myelogenous leukemia, germ cell cancer, ovarian and localized small-cell lung cancers, and choriocarcinoma. In pediatric patients. the major curable cancers include - acute leukemias, Burkitt's lymphoma, Wilms' tumor, and embryonal rhabdomyosarcoma. |
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 Infant has fever, one episode of febrile convulsions admitted for observation, fever than subsided and followed by rash on abdomen & chest, maculopapular erythematous-what is the cause? and explain in detail? | Ans. is 'a' i.e., Chickenpox In this question, infant had develop rash on first day offever & distribution of rash is in our of chickenpox, or varicella. Mnemonic for Day of appearance of rash in a febrile patient is Very Sick Person Must Take Double Tablets Very - Varicella (day 1) Sick - Scarlet fever (day 2) Person - Pox-small pox (day 3) Must - Measles (day 4) Take - Typhus (day 5) Double - Dengue (day 6) Tablets - Typhoid (day 7) Chicken pox (Varicella ): Caused by virus Child develop fever with rash Rash are macular, maculo-papular, vesicular (pleomorphic) Distribution is usually centripetal Complication include - more seen in immunocompromised child. Mild thrombocytopenia Hematurea GI Bledding Encephalitis Pneumonia |
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 pathognomic for motor neuron disease - 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 point in the below natural history of disease marks the onset of symptoms? and explain in detail? | (c) C* Point A marks the entry of infectious agent into the host* Point B marks the subclinical phase where symptoms and signs are not visible, but the disease agent induces tissue and physiological changes* Point C marks the Clinical horizon when symptoms and signs appear* Point D is present inside the Clinical phase after the Clinical horizon.ALSO REMEMBERNATURAL HISTORY OF DISEASE* Prepathogenesis phase* Pathogenesis phase:Begins with the entry of disease agent into the hostFinal outcome of the disease may be Recovery, Disability or DeathPathological changes are essentially below the level of Clinical horizonClinical stage begins when signs and symptoms appear |
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 Among the choices mentioned below is a member of family Herpesviridae. It is an enveloped virus with an icosahedral nucleocapsid that contains a double-stranded linear DNA genome. and explain in detail? | CMV |
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 mother presents to the neonatology OPD with her baby because of yellow extremities. On examination, there is petechial rash over the body, hepatosplenomagaly, microcephaly. What is the causative organism? and explain in detail? | Features of congenital CMV infection are: petechial rash, jaundice, hepatosplenomegaly, microcephaly, periventricular calcification, deafness, chorioretinitis,IUGR. congenital rubella syndrome: triad of cardiac defects, cataract and conductive hearing loss neonatal herpes presents as skin lesions with eye involvement, encephalitis, disseminated disease. fetal varicella syndrome: cicatrizing/ scarring skin lesions, chorioretenitis, hypoplastic limbs, LBW, CNS defects- due to cerebral atrophy. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A patient is referred to the neurologist because of ataxia. Neurological examination reveals a loss of proprioception and a wide-based, slapping gate. Magnetic resonance imaging reveals degeneration of the dorsal columns and dorsal roots of the spinal cord. Which of the following organisms is most likely to have caused this pattern of damage? and explain in detail? | The findings described are those of tabes dorsalis, a form of teiary syphilis caused by Treponema pallidum. Tabes dorsalis, and other forms of teiary syphilis, are now uncommon in this country, possibly because the common use of antibiotics may "treat" many unsuspected cases of syphilis. Haemophilus influenzae and Neisseria meningitidis can cause meningitis. Neisseria gonorrhoeae causes gonorrhea, which usually does not involve the CNS. Herpes simplex I can cause an encephalitis that typically involves the frontal and temporal lobes. |
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 regarding cervical cancer vaccine is/are -a) Bivalent and quadrivalent b) Given to married women in 20-45 years age groupc) MC subtypes 16, 18d) Two doses givene) Gives 100% protection 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 3-year-old Rajan is having sensorineural deafness, not benefited by hearing aids. Next best management is: and explain in detail? | (a) Cochlear implant(Ref. Cummings, 6th ed., 2434)Stapedectomy is done for otosclerosis.Fenestration operation used to be done previously for otosclerosis, though stapedotomy is done these days.Stapes fixation is no surgery |
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 Blister and explain in detail? | A blister is a small pocket of body fluid (lymph, serum, plasma, blood, or pus) within the upper layers of the skin, usually caused by forceful rubbing (friction), burning, freezing, chemical exposure or infection. Most blisters are filled with a clear fluid, either serum or plasma. However, blisters can be filled with blood (known as "blood blisters") or with pus (for instance, if they become infected).
The word "blister" entered English in the 14th century. It came from the Middle Dutch bluyster and was a modification of the Old French blostre, which meant a leprous nodule—a rise in the skin due to leprosy. In dermatology today, the words vesicle and bulla refer to blisters of smaller or greater size, respectively.
To heal properly, a blister should not be popped unless medically necessary. If popped, the excess skin should not be removed because the skin underneath needs the top layer to heal properly.
Causes
A blister may form when the skin has been damaged by friction or rubbing, heat, cold or chemical exposure. Fluid collects between the upper layers of skin (the epidermis) and the layers below (the dermis). This fluid cushions the tissue underneath, protecting it from further damage and allowing it to heal.
Friction
Intense rubbing can cause a blister, as can any friction on the skin if continued long enough. This kind of blister is most common after walking long distances or by wearing old or poorly fitting shoes. Blisters are most common on the hands and feet, as these extremities are susceptible while walking, running, or performing repetitive motions, such as joystick manipulation whilst playing certain video games, certain sports (e.g., baseball pitching), digging with a shovel, playing guitar or bass, etc. Blisters form more easily on damp skin than on dry or soaked skin, and are more common in warm conditions. Less-aggressive rubbing over long periods of time may cause calluses to form rather than a blister. Both blisters and calluses can lead to more serious complications, such as foot ulceration and infection, particularly when sensation or circulation is impaired, as in the case of diabetes, neuropathy or peripheral artery disease (PAD).
Burning
This type of blistering is one of the tools used to determine the degree of burns sustained. First and second degree burns may result in blistered skin; however, it is characteristic of second degree burns to blister immediately, whereas first degree burns can have blisters after a couple of days. Sunburn can also result in blisters.
Blisters can also form on the hands and feet as a result of tissue damage incurred by frostbite.
Chemical exposure
Sometimes, the skin will blister when it comes into contact with a cosmetic, detergent, solvent, or other chemical such as nickel sulfate, Balsam of Peru, or urushiol (poison ivy, poison oak, poison sumac). This is known as contact dermatitis. Blisters can also develop as a result of an allergic reaction to an insect bite or sting. Some chemical warfare agents, known as blister agents or vesicants, cause large, painful blisters wherever they contact skin; an example is mustard gas.
Blood blister
A blood blister usually forms when a minute blood vessel close to
the surface of the skin ruptures (breaks), and blood leaks into a tear between the layers of skin. This can happen if the skin is crushed, pinched or aggressively squeezed.
Medical conditions
There are also a number of medical conditions that cause blisters. The most common are chickenpox, herpes, impetigo, and a form of eczema called dyshidrosis. Other, much rarer conditions that cause blisters include:
Bullous pemphigoid: a skin disease that causes large, tightly filled blisters to develop, usually affecting people over the age of 60.
Pemphigus: a serious skin disease in which blisters develop if pressure is applied to the skin; the blisters burst easily, leaving raw areas that can become infected.
Dermatitis herpetiformis: a skin disease that causes intensely itchy blisters, usually on the elbows, knees, back and buttocks. The blisters usually develop in patches of the same shape and size on both sides of the body.
Chronic bullous dermatosis: a disease that causes clusters of blisters on the face, mouth or genitals.
Cutaneous radiation syndrome
Epidermolysis bullosa
Pathophysiology
Friction blisters
Friction blisters are caused by excess shear stress between the bottom and surface of the skin and the body. The strata of skin around the stratum spinosum are most susceptible to shear. As the stratum spinosum tears away from the connecting tissues below, plasma from the cells diffuses out. This plasma solution helps new cells divide and grow into new connective tissues and epidermal layers.
The clear fluid will be reabsorbed as new cells develop and the swollen appearance will subside. Painful blisters located on hands (palmar surface) and feet (plantar surface) are due to tissue shearing deeper in the epidermis, near nerve endings. Lower tissues are more susceptible to infection.
Prevention
Friction blisters
Friction blisters, caused by rubbing against the skin, can be prevented by reducing the friction to a level where blisters will not form. This can be accomplished in a variety of ways.
Blisters on the feet can be prevented by wearing comfortable, well-fitting shoes and clean socks. Inherently ill-fitting or stiffer shoes, such as high heels and dress shoes, present a larger risk of blistering. Blisters are more likely to develop on skin that is moist, so socks that manage moisture or frequent sock changes will aid those with particularly sweaty feet. While exercising or playing sports, special sports socks can help keep feet drier and reduce the chance of blisters. Before going for a long walk, it is also important to ensure that shoes or hiking boots have been properly broken in.
Even before a "hot" or irritated area on the foot is felt, taping a protective layer of padding or a friction-reducing interface between the affected area and the footwear can prevent the formation of a blister. Bandages, moleskin and tapes generally must be applied to the foot daily, and most have a very high coefficient of friction (COF), but a friction-management patch applied to the shoe will remain in place much longer, throughout many changes of socks and insoles. This type of intervention may be used with footwear that is worn daily, with specialty shoes and boots like hockey skates, ice skates, inline skates, ski boots and cleats, or even with orthotic braces and splints |
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 While charting the dentition of a child, the pedodontist finds that the following teeth are present in all the four quadrants; permanent central incisor, permanent lateral incisor, deciduous cuspid, deciduous first molar, deciduous 2nd molar and permanent 1st molar. The eruptive pattern may be considered most nearly normal for a child aged: 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 markedly decreased in restrictive lung disease and explain in detail? | In restrictive lung diseases,lung volumes are markedly reduced,like TLC,FRC,RV,as well as FVC.FEV1 is also reduced compared with normal values,but is relatively a greater value compared with lung volumes.As a result,FEV1/FVC ratio will be normal or increased in restrictive lung diseases. Reference :Harrison's medicine-18th edition,page no:2093. |
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 are true about neuroblastoma except - and explain in detail? | Ans. is 'c' i.e., Cafe au lait spots Neuroblastoma* Neuroblastoma is a malignant neuroendocrine tumor arising from any neural crest element of sympathetic autonomic nervous system.* It is the most common malignancy of infancy, the most common abdominal cancer in children and most common extracranial solid tumor of childhood.* Sites of involvement are adrenal medulla (most common), pelvis, cervical area (neck), posterior mediastinum, and paravertebral retroperitoneum.Clinical features* Clinical features arei) Due to mass: Abdominal (flank) mass (most common presentation), often crosses midline and displaces the kidney downwords without compressing collecting system; cervical tumor may cause Horner syndrome.ii) Due to metastasis: Orbital proptosis, Raccoan eyes (unilateral or bilateral periorbital or eyelid ecchymosis), fever, bone pain, lytic lesions in skull with sutural diastasis, spinal cord compression.iii) Due to catecholamine secretion by tumor: Tachycardia, headache, sweating, episodic diarrhea, flushing.iv) Uncommon features: Opsoclonus /opsomyoclonus, myastenia gravis.* Metastasis is present in 60-70% at the time of diagnosis. Commonest site of metastasis is skeletal system and neuroblastoma is the most common childhood malignancy metastasizes to bone. Other sites of involvement are liver, lymph nodes and skin. Lung metastasis is uncommon. Encasement of abdominal aorta and IVC may occur. |
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 22 year old athlete had twisting injury to his right ankle. A lot of swelling around the medial malleolus was observed . An X-ray which did not show any fracture. Most probable structur to be injured is : and explain in detail? | The structure injured here is Deltoid Ligament. Mechanism of Injury : Forced eversion combined with external rotation. Deltoid ligament Forms medial pa of the ankle joint. It attaches the medial malleolus to multiple tarsal bones. |
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 diuretic acts without requiring access to renal tubular lumen and explain in detail? | Mechanism of action of diuretics: Aldosterone antagonists: Aldosterone acts by combining with an intracellular mineralocoicoid receptor It induces the formation of aldosterone-induced proteins (AIP) . These AIPs promote Na+ reabsorption and K+ secretion Spironolactone is an aldosterone antagonist It acts from the interstitial side of the tubular cell It combines with Mineralocoicoid Receptor and inhibits the formation of AIPs |
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 component of carotid sheath and explain in detail? | It is a condensation of the fibroareolar tissue around the main vessels of the neck. There are the common and internal carotid arteries and internal jugular vein and the vagus 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 In Autoregulation of hormone? and explain in detail? | Ans. is 'b' i.e., A hormone inhibits its own secretion by inhibiting regulatory hormone.Feedback control (Autoregulation):The process of inhibiting or stimulating the first step by the final step product in a hormonal reaction pathway, is called feedback regulation. |
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 Obligatory intracellular organism is ? and explain in detail? | Ans. is 'b' i.e., Chlamydia |
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 Regarding efficacy and potency of a drug, all are true EXCEPT: and explain in detail? | Ans. C. ED50 of the drug corresponds to the efficacyED5 corresponds to the potency of the drugED50 is the dose required to produce desired effect in 50% of individuals. Dose is related to potency not efficacyLD50 is the dose required to produce death in 50% of individualsTherapeutic index (TI): =ED50 LD50 It is a measure of safety of a drug. |
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 Not a feature of Wernicke's Korsakoff Syndrome and explain in detail? | C i.e. Normal pupillary response |
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 cataract in a newborn is – and explain in detail? | A most common type of congenital cataract → punctate (blue dot) cataract.
A most common type of cataract which is clinically (visually) significant → zonular or lamellar cataract. |
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 human being, the least useful physiological response to low environmental temperature is: and explain in detail? | D i.e. Piloerection |