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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 Indications for artificial insemination with husband's semen are all except and explain in detail? | Ans-C (Azoospermia)INDICATIONS FOR ARTIFICIAL INSEMINATION WITH HUSBAND'S SEMEN# Oligospermia after sperm washout# Impotency# Premature/retrograde ejaculation# Unexplained infertility# Hypospadias# Donor semen# Antispiral abs in cervical mucus# X-Y fractionation of sperm for sex selection, in genetic and chromosomal abnormalitiesIndications for artificial insemination with donor's semen# Azoospermia# Genetic disease in a husband# Immunological factors not correctable |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Anterior fontanelle closes at ? and explain in detail? | Ans. is `d' i.e., 18-24 months |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 is a coho study and explain in detail? | A coho study is a paicular form of a longitudinal study that samples a coho (a group of people who share a defining characteristic, typically those who experienced a common event in a selected period, such as bih or graduation), performing a cross-section at intervals through time. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 83 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Presence of spiral grooves in the barrel of weapon is referred to as: and explain in detail? | Ans. (A). RiflingShotgunRifled gunCHOKING:* The terminal few cms (7-10) is constricted in shot guns.* Reduces the pelletsdispersionQ* Increases the explosive forces of the pellets.* Increases the velocity of the pellets.RIFLING:* Interior of bore has spiral grooves which run parallel to each other, but twisted spirally from breech to muzzle end.* These grooves are called 'rifling'* Imparts Spinning motion to the bulletQ* Greater power of penetration.* Straight trajectory* Increases accuracy & rangeFully choked shotgun - Least dispersion of pelletsUnchoked shotgun - Maximum dispersionQ of pellets. Paradox gun: A smooth bore gun with small terminal part rifled.Bullets that impart great tissue destruction:Soft nosed bullet that flatten on impactDum Dum bulletBullets that fragment (frangible bullet)Bullets that mushroom on impact |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is EB virus causes all the following except: and explain in detail? | §Kaposi’s sarcomais associated with HIV.
It is best known as the cause of infectious mononucleosis(glandular fever). It is also associated with particular forms of cancer, such as Hodgkin's lymphoma, Burkitt's lymphoma, nasopharyngeal carcinoma, and conditions associated with human immunodeficiency virus(HIV), such as hairy leukoplakiaand central nervous systemlymphomas.
There is evidence that infection with the virus is associated with a higher risk of certain autoimmune diseases,especially dermatomyositis, systemic lupus erythematosus, rheumatoid arthritis, Sjögren's syndrome, and multiple sclerosis |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Semen examination of a man showed counts of 25 million/cu.mm, volume - 1.5 ml; motility - 15%; Morphology - 15%. What is the diagnosis? and explain in detail? | World Health Organization reference values: Semen volume: 1.5 ml or more pH: 7.2-7.8 Sperm concentration: 15 million spermatozoa per ml or more Total sperm number: 39 million spermatozoa per ejaculate or more ( Range 36-42 million /ml) Total motility : 40% or more motile or 32% or more with progressive motility Round cells: <1 million /mL Vitality: 58% or more live spermatozoa Sperm morphology (Strict criteria): 4% or more of normal forms * Asthenospermia : Reduced sperm motility. * Azoospermia : Semen with no sperm. * Oligospermia: low concentration of sperm * Teratospermia :Sperm with abnormal morphology. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 6 year old child with acute onset of fever of 104° F developed febrile seizures and was treated. To avoid future recurrence of seizure attacks what should be given – 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 Infective diarrhoea is caused by-a) Rotavirusb) Calcivirusc) Flavivirusd) Enterovirus 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 Roopmati A56 year old female with lymph node positive breast with cancer was stated with systemic chemotherapy. 4 weeks letter should develop frequent urination suprapubic pain dysuria and hematuria.which of the following could have prevented this patients condition and explain in detail? | Ref-Katzung 11/r p941 The patient described in the question has hemorrhagic cystitis caused oyl drugs like cclophosphamide and itostamide. Hemorrhagic cystitis during therapy with cvclophosphamide or iostamide is caused by the urinary excretion of the toxic metabolite acrolein. This can be prevented byby aggressi hvdration, bladder irrigation, and administration of mesna, a sulfhydryl compound that binds acrolein in the urine. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is DOC in adrenal insufficiency - and explain in detail? | Ans. is 'c' i.e., Dexamethasone Treatment of acute adrenal insufficiency (adrenal crisis) in adultsEmergency measuresEstablish intravenous access with a large-gauge needle.Draw blood for immediate serum electrolytes and glucose and routine measurement ofplasma cortisol and A CTH. Do not wait for lab results.Infuse 2 to 3 liters of isotonic saline or 5 precent dextrose in isotonic saline as quickly as possible. Frequent hemodynamic monitoring and measurement of serum electrolytes should be performed to avoid iatrogenic fluid overload.Give 4 mg dexamethasone as intravenous bolus over one to five minutes and every 12 hours thereafter Dexamethasone is the drug of choice because it does not interfere with the measurement ofplasma cortisol. If dexamethasone is unavailable, intravenous hydrocortisone, 100 mg immediately and every six hours thereafter, may be used.Use supportive measures as needed.Subacute measures after stabilization of the patientContinue intravenous isotonic saline at a slower rate for next 24 to 48 hours.Search for and treat possible in fections precipitating causes of the adrenal crisis.Perform short ACTH stimulation test to confirm the diagnosis of adrenal insufficiency, ifpatient does not have know adrenal insufficiency. Determine the type of adrenal insu fficiency and its cause if not already known.Taper parenteral glucocorticoid over one to three days, if precipitating or complicating illness permits, to oral glucocorticoid maintenance dose.Begin meneralocorticoid replacement with fludrocortisone, 0.1 mg by mouth daily, when saline infusion is stopped. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 type of joint between the sacrum and the coccyx is a and explain in detail? | The sacrococcygeal symphysis is an amphiahrodial (slightly mobile) joint, formed between the oval surface at the apex of the sacrum, and the base of the coccyx.The movements which take place between the sacrum and coccyx, and between the different pieces of the latter bone, are forward and backward; they are very limited. Their extent increases during pregnancy.A zygapophyseal joint (or facet joint) is a veebral joint between the superior aicular process of one veebra and the inferior aicular process of the one adjacent. It is of plane synol variety. In fact, all the joints of veebra are plane synol Except the median one- which is a symphysis (as expected *).*All midline joints tend to be symphysis, only very few Exceptions are there. E.g., spheno-occipital joint, which is a synchondrosisInterveebral discs (or interveebral fibrocailage) lie between adjacent veebrae in the spine. Each disc forms a secondary cailaginous (symphysis) joint to allow slight movement of the veebrae, and acts as a ligament to hold the veebrae together.Discs consist of an outer annulus fibrosus, which surrounds the inner nucleus pulposus. The annulus fibrosus consists of several layers of fibrocailage. The strong annular fibers contain the nucleus pulposus and distribute pressure evenly across the disc. The nucleus pulposus contains loose fibers suspended in a mucoprotein gel the consistency of jelly. The nucleus of the disc acts as a shock absorber, absorbing the impact of the body&;s daily activities and keeping the two veebrae separated.The disc can be likened to a doughnut: whereby the annulus fibrosis is similar to the dough and the nucleus pulposis is the jelly. If one presses down on the front of the doughnut the jelly moves posteriorly or to the back. When one develops a prolapsed disc the jelly/ nucleus pulposis is forced out of the doughnut/ disc and may put pressure on the nerve located near the disc. This will give one the symptoms of sciatica if the disc herniation is at lumbosacral region.There is one disc between each pair of veebrae, Except for the first cervical segment, the atlas. There are a total of twenty-three discs in the spine.When the annulus fibrosus tears due to an injury or the aging process, the nucleus pulposus can begin to extrude through the tear, most commonly postero-lateral. This is called disc herniation. Near the posterior side of each disc, all along the spine, major spinal nerves extend out to different organs, tissues, extremities etc. It is very common for the herniated disc to press against these nerves (pinched nerve) causing radiating pain, numbness, tingling, and diminished strength and/or range of motion. In addition, the contact of the inner nuclear gel, which contains inflammatory proteins, with a nerve can also cause significant pain and muscle spasm. Nerve-related pain is called radicular pain. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Diagnosis of TB ace to DOTS ? and explain in detail? | Ans. is 'a' i.e., 1 out of 2 samples positive o Two sputum smear samples are examined. o If any of the two samples or both the samples are positive, the diagnosis of smear-positive TB is confirmed. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Ethinylestradiol/norethisterone acetate 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 Dose of Reteplase for management of acute MI is and explain in detail? | Ref Harrison 19 th ed pg 758 The recommended dose for Reteplase in acute MI is 10 UNIT bolis given over 2 minutes . It is recommended to repeat the second 10 unit dose after 30 minutes . Two bolus doses given 30 minutes apa are recommended. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 used in the management of haemophillic patient? and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Most common site of colon malignancy is and explain in detail? | A. i.e. (Sigmoid colon) (1179-B& L 25th) (696 - CSDT 12th) (1060- S. Das 5th)Sigmoid colon is the most common site*** Distribution of colorectal cancerRectum (38%) > Sigmoid colon (21%) > caecum (12%) Transverse colon (5.5%) > Ascending colon (5%)> Descending colon (4%) > Hepatic flexure (2%) and anus (2%) > Appendix (0.5%)* Sigmoid colon segment of colon undergoes maximum postprandial contraction**Right colonLeft colonRectum**Unexplained weakness or Iron deficiency anemia (Most common)* Occult blood in feces* Dyspeptic symptoms* Persistent right abdominal discomfort* Change in bowel habits* Gross blood in stool* Obstructive symptom* Tenesmus* Characteristic x-ray finding* Rectal bleeding alternation in bowel habits* Sensation of incomplete evacuation* Intrarectal palpable tumor* Sigmoidoscopic finding* Metastatic disease - Jaundice, ascitis, hepatomegaly* Carcinoma of the colon - particularly the right colon is more common in women*** Carcinoma of the rectum is more common in men*** Regional lymph node involvement is the most common form of metastasis in colo rectal carcinoma**.* Marker for Gastro intestinal stromal tumour (GIST) is CD-I 17*** High fibre diet is most protective against development of colorectal cancer**Risk factor for Development of colorectal cancer (574 - H17th)* Diet - Animal fat* Streptocccus bovies bacteremia* Hereditary syndrome (AD- Inheritance)* Ureterosigmoidostomy* Polyposis coli* Tobacco-use* Nonpolyposis syndrome (Lynch syndrome) * Inflammatory bowel syndrome |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which one of the following is a pan T lymphocyte marker - and explain in detail? | The most clearcut differentiation between T and B cells is by their surface markers, for example, by demonstration of CD3 on T cells and Ig on B cells. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Anal cancer is associated with and explain in detail? | Ans. (a) Human papilloma virusRef: Bailey & Love 26th ed. /1266* The development of anal cancer is associated with infection by human papilloma virus.* The infection may lead to:# Anal warts (condyloma acuminata)# Anal intraepithelial neoplasia# Squamous cell carcinoma.* The risk for anal cancer is increased among homosexual males.* Anal cancer risk is increased in both men and women with AIDS, because of their immunosuppressed state |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A 40 year old lady takes warfarin for DVT prophylaxis. She was given ceftriaxone for dental infection after which she experienced per vaginal bleed and dark coloured urine. This is due to? and explain in detail? | |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A 6 year old boy taken for ophthalmic examination under anaesthesia. His father told that he has lowerlimb weakness & his elder brother died at 14 years of age. Which anaethetic drug has to be avoided- and explain in detail? | Ans. is 'a' i.e., Succinylcholine o History suggestive of some type of muscle dystrophy,o Sch can cause dangerous hyperkalemia in Muscular dystrophy.Succinylcholineo SCh is a depolarising skeletal muscle relaxant.o It causes sustained partial depolarization of muscle end plate - intially produce twitching and fasciculation followed by flaccid paralysis.o It is the shortest and fastest acting skeletal muscle relaxant.o It is the only muscle relaxant which stimulate autonomic ganglia and vagus.o SCh is the most commonly used muscle relaxant for passing endotracheal tube (mivacurium and rocuronium are alternatives).o SCh is rapidly hydrolysed by plasma cholinesterase, some patients have genetically determined abnormality or deficiency of pseudocholinesterase, in them, SCh causes phase II block,o It can cause muscle fasiculations and soreness, change in BP and HR, arrythmia, histamine release and K+ efflux from muscles.o Dangerous hyperkalemia can occur in patients with burn, crush injury, muscular dystrophy, GB. Syndrome, paraplegia or hemiplagia, mysthenia gravis and rhabdomyolysis - contraindicated in such patients.o It can accentuate malignant hyperthermia caused by halothane.o SCh causes increase in all pressures - inraocular, intracranial, BP, and intrabdominal - contraindicated in glaucoma, head injury. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 artery supplies lower 2/3rd of thyroid lobe, trachea, thymus and explain in detail? | Superior thyroid artery is the first anterior branch of external carotid artery. It is intimately related to external laryngeal nerve. The superior thyroid artery supplies upper one third of thyroid lobe and the upper half of isthmus.
The inferior thyroid artery is a branch of thyro cervical trunk, which arises from subclavian artery. Its terminal part is related to recurrent laryngeal nerve. The inferior thyroid artery mainly supplies lower 2/3rd' of thyroid lobe and lower half of isthmus, trachea, parathyroid and thymus. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is After 50 gm of glucose is feed orally: and explain in detail? | C i.e. Decreased gluconeogenesis |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Agoraphobia is: and explain in detail? | Fear of getting caught in places from where escape would be difficult - Fear of open spaces Fear of crowded places Fear of enclosed places Fear of travelling alone Fear of public transpo Patient is usually home bound Agarophobia and panic disorder are usually comorbid Fear of heights is Acrophobia Fear of closed spaces is Claustrophobia Fear of animals is Zoophobia |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 advantage of epidural anaesthesia over spinal anaesthesia except – and explain in detail? | Duration of action of epidural anesthesia is longer than spinal anesthesia. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Lymphatics from the spongy urethra drain into which of the following lymph nodes? and explain in detail? | Lymphatics from glans penis, prostatic urethra, spongy urethra and superficial inguinal nodes drains into deep inguinal lymph nodes. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Slow wave sleep is known as: and explain in detail? | This is a straight forward memory question. There are two kinds of sleep: rapid eye movement (REM) sleep and non-REM (NREM), or slow-wave sleep. Ref: Ganong's Review of Medical Physiology 23rd edition, Chapter 15. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Zonules of zinn: and explain in detail? | Zonules of zinn suspend the lens and enable the ciliary muscles to act upon them. Suspensory ligaments of lens : Also called zonules of zinn & ciliary zonules. Consist of fibres passing from ciliary body to lens. Extend from ora serrata to edge of the lens. Hold the lens in position. Enable the ciliary muscles to act upon them in accommodation. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 the following is the t/t of choice for dermatitis herpetiformis: and explain in detail? | Ans. a. DapsoneTOC for dermatitis herpetiformis is gluten free diet DOC Dapsone |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Apo B48 & Apo B100 is synthesized from the same mRNA; the difference between them is due to: and explain in detail? | Ans is 'c' i.e. Deamination of cytidine to Uridine.Apo B-48 and apo B-100 are synthesized from the same mRNA.Apo B-100 is synthesized in Liver and forms part of LDL, VLDL and IDL.Apo B-48 is synthesized in Intestines and forms part of chylomicrons and chylomicron remnants.Apo B-100 is the full length translation of corresponding mRNA. Apo B-48 is a shorter form of Apo B-100 (48% of B-100) formed by only partial translation of the same mRNA. It comprises the N-terminal 48% of apo B-100.Apo B-48 is produced due to posttranscriptional mRNA editing in which codon at 2153 position is edited- codon CAA is deaminated to UAA.CAA is a sense codon (coding for glutamine) and deamination changes it to UAA, which is a nonsense codon or stop codon. This stops the translation of mRNA almost midway resulting in a shorter protein B-48 (representing 48 percent of the message). |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is You are posted as an EMO on duty. You receive a call at 11:30 PM, regarding an unconscious patient who arrives in an ambulance after 15 minutes. On assessment, you barely feel the radial pulse. No evidence of trauma noted. SBP is 58 mm Hg. You note the following finding while ECG is carried out. Patient had the following USG film . Which electrolyte abnormality is likely to cause the above clinical scenario? and explain in detail? | The patient has sinusoidal ventricular rhythm, which is due to electrolyte abnormality in above case. The patient has USG repo suggestive of CKD due to raised coical echogenicity. AV fistula in forearm is suggestive that patient undergoes dialysis but may have missed and landed up in hyperkalemia. As a pa of management, defibrillation and control of hyperkalemia is priority while emergency hemodialysis is being readied. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Subpubic angle in female is and explain in detail? | Ans. is 'b' i.e., 90 degrees PELVISTraitMaleFemale1) Bony frameworkMassive, rougher, marked muscle sites. Stands higher and more erect.Less massive, slender, smoother.Less muscle marking.2) GeneralDeep funnel.Flat bowl.3) IliumLess vertical; curve of iliac crest reaches higher level and is more prominent.More vertical; distance between iliac crests is less; iliac fossae shallow; curves of crest well marked.4) Preauricular sulcus (attachment of anterior sacroiliac ligament)Not frequent; narrow, shallow.More frequent, broad and deep5) AcetabulumLarge, 52 mm. in diameter; directed laterallySmall, 46 mm. in diameter; directed anterolaterally.6) Obturator foramenLarge, often oval with base upwardsSmall, triangular with apex forwards.7) Greater sciatic notchSmaller, narrower, deeper.Larger, wider, shallower.8) Illeo-pectineal lineWell marked and rough.Rounded and smooth.9) Ischial tuberosityInvertedEverted; more widely separated10) Body of pubisNarrow, tirangular, thick; short is chial ramus.Broad, square; ischial ramus is lengthened and narrowed; pits on posterior surface if borne children.11) Ramus of pubisIt is like continuation of body of pubis.Has a constricted or narrowed appearance and is short and thick.12) Ischiopubic ramiMore everted, thicker and rougher.Less everted, thinner and smoother.13) SymphysisHigher, bigger and narrow in width.Margins of pubic arch everted.Lower, wider and rounded, margins of pubic arch not everted; distance between two pubic tubercles greater. The dorsal border is irregular and shows depressions or pits (scars of parturition).14) Subpubic angleV-shaped, sharp angle 70deg to 75deg.U-shaped, rounded, broader angle 90deg to 100deg15) Pelvic brim or inletHeart-shapedCircular or elliptical; more spacious; diameters longer.16) Pelvic cavityConical and funnel-shapedBroad and round17) Pelvic outletSmallerLarger18) Sacroiliac articulationLarge, extends to 2 1/2 to 3 vertebrae.Small, oblique, extends to 2 to 2 1/2 vertebrae.19) Sacroliliac joint surfaceLarge and less sharply angulated.L-shaped and elevated anteriorly.20) SacrumLonger, nanrower, with more evenly distributed curvature; promontory well marked. Body of first sacral vertebra larger.Shorter, wider; upper half almost straight, curve forward in lower half; promontory less marked.Body of first sacral vertebra small.21) CoccyxLess movableMore movable22) Ischiopubic index73 to 9491 to 115 Public length in mm.------------------Ischial length in mm.x 100 23) Sciatic notch index4 to 55 to 6 Width of notch index------------------Depth of sciatic notchx 100 24) Pubic ramus ratio1:12 : 1 or greater |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Component of TOF include A/E and explain in detail? | Ans. is 'b' i.e., ASD |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 symptoms do you expect to see in a patient diagnosed with acute pyelonephritis and explain in detail? | Costovertebral angle tenderness, flank pain, and chills are symptoms of acute pyelonephritis.
Option A: Jaundice indicates gallbladder or liver obstruction.
Option C: A burning sensation on urination is a sign of lower urinary tract infection. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is rug used in estrogen dependent breast cancer and explain in detail? | Ans. is 'a' i.e., Tamoxifen Hormonal drug therapy for breast cancer targets estrogen receptor positive breast cancer. It aims at blocking the action of estrogen on estrogen receptor positive breast cells. The hormonal therapy of choice for breast cancer in premenopausal women is Tamoxifen. Tamoxifen belongs to class of drugs known as "Selective Estrogen Receptor Modulator". Tamoxifen binds to the estrogen receptors on tumours and blocks the effect of estrogen on these cells. Tamoxifen is only effective in treating estrogen receptor positive breast cancers. - Therefore the tumour's hormone receptor status should be determined before deciding on treatment option for breast cancer. Tamoxifen is used to treat patients with early stage breast cancer as well as those with metastatic breast cancer Adjuvant therapy with Tamoxifen - Chemotherapy after primary t/t to increase the chance of cure. It helps in preventing the recurrence and also helps to prevent the development of new cancers in the other breast. When used as adjuvant chemotherapy it is usually taken for 5 years. When taken for 5 years if reduces the chance of the original breast cancer coming back in the same breast or elsewhere. It also reduces the risk of developing secondary primary cancer. Metastatic cancer therapy with Tamoxifen - As a treatment for metastatic breast cancer, the drug slows or stops the growth of cancer cells that are present in the body. Patient with metastatic breast cancer may have to take tamoxifen for varying lengths of 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 The pattern of fingerprint demonstrated here is and explain in detail? | Loop Fingerprint patterns and their relative frequency: Loop - 67% Whorls - 25% Arches - 6-7% Composite - 1-2% |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Retinoblastoma arises from: and explain in detail? | Ans. Any nucleated retinal layer |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 many episodes of vulval candidiasis per year were needed for diagnosis of recurrent vulvovaginal candidiasis? and explain in detail? | Vulvovaginal candidiasis:Vulvovaginal candidiasis is considered recurrent when at least four specific episodes occur in one year At least three episodes unrelated to antibiotic therapy occur within one year(Ref: www.aafp.org ) |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Waste types not to be incinerated are and explain in detail? | Categories of bio-medical waste in IndiaCategory NoWaste category1Human anatomical waste2Animal waste3Microbiology and biotechnology waste4Sharps5Discarded medicines and cytotoxic drugs6Solid waste 7Solid waste 8Liquid waste9Incineration ash10Chemicals used in the production of biologicalsColor codingType of containerWaste categoryTreatment optionsYellowPlastic bagCat 1, 2, 3 & 6Incineration/deep burialRedDisinfected container/plastic bagCat 3, 6 & 7Autoclaving/Microwaving/Chemical treatmentBlue/White translucentPlastic bag/Puncture proof containerCat 4 & 7Autoclaving/Microwaving/Chemical treatment and Destruction/ShreddingBlackPlastic bagCat 5, 9 & 10 Disposal in secured landfillRef: Park; 23rd ed; Pg 793, 794 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 included in Virchow's triad of thrombus formation? and explain in detail? | The three primary abnormalities that lead to thrombus formation (called Virchow's triad) are (1) endothelial injury, (2) stasis or turbulent blood flow, and (3) hypercoagulability of the blood. Ref: Robbins 8th edition Chapter 4. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is 1729. A 28 yr old female presented with malaise and generalised weakness since 6 month. Her appetite Is reduced and she has giddiness and palpitations on and off. There was no organomegaly. Laboratory Study showed normochromic to hypochromic anaemia and MCV-80. What Is the diagnosis and explain in detail? | <p> Iron deficiency anemia is much more common in women between the age of 20 & 45 yrs than in men.The onset of this anemia is generally slow .The usual symptoms are weakness ,fatigue ,palpitations ,dyspnoea on exeion & pallor of skin, sclera & mucous membrane.</p><p>Also MCV will be less than 80fl in iron deficiency anemia .</p><p>Reference :Harsh mohan textbook of pathology sixth edition pg no 298.</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 Shell teeth are more common in the_______type of dentinogenesis imperfecta(According to Sheild's classification) and explain in detail? | In type I and type II, the interlocking at DEJ is absent.
Enamel chipps off easily. The defective dentine undergoes rapid attrition, but teeth are not susceptible to caries.
The most striking feature is the partial or total precocious obliteration of pulp chambers by continuous deposition of dentine.
"Shell teeth" refers to a type III - Valiant with thin shell of defective dentine underlying normal enamel. The pulp chambers are wide and large. (Type II according to revised classification)
The features may also resemble as in Type I and Type II. Roots are short with nb signs of resorption.
Shell teeth are more common in this variant of dentinogenesis imperfecta ___ (Kar 01) (Type III)
Absence of pulp chambers is seen in __(Man 97) (Dentinogenesis imperfect) |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 has multiple, pearly papules on the face. Biopsy shows a malignant tumor. Which of the following features would most likely be seen on microscopic examination? and explain in detail? | The malignant skin tumor that forms "pearly papules" on sun-exposed skin is basal cell carcinoma. A characteristic feature of this tumor is palisading of the basal cell-like nuclei at the edge of clusters of cells penetrating into the dermis. Basal cell carcinomas almost never metastasize, but can be very locally destructive, and resection of large ones on the face may produce disfiguring scars. Viral cytoplasmic inclusions are a feature of the infectious lesion molluscum contagiosum. Keratin pearls are a feature of squamous cell carcinoma. Melanin and S-100 positivity with immunohistochemical stains are features of melanoma Ref: Robbins Basic Pathology, 8th Ed, page 852-855 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 35 years old lady has chromosomal translocation 21/21. The risk of down syndrome in the child is – and explain in detail? | Cvtogenetic aspects of own's syndrome -
The most common finding is trisomy 21.
Molecular studies have revealed that the additional number 21 chromosome is derived from the mother in 95% of Cases. (The recurrence risk in these families is approximately 1%.)
If a female with Down syndrome due to trisomy 21 conceives then there is a risk of 50% that the baby will also have trisomy 21.
Males with Down syndrome have rarely if ever reproduced.
Chromosome findings in Down syndrome
Trisomy 21, e.g. 47, XY, + 21 - 95%
Mosaicism, e.g. 46, XX, / 47, XX, + 21 - 2%
Robertsonian translocation,
e.g. 46 XX, - 15,+ t (15q21q) - 3%
Inheritence in Mosaic if own's syndrome
Children with mosaic Down syndrome are usually less severely affected than in the full-blown syndrome, and if only a small proportion of cells are trisomic then these individuals may lead normal lives.
In the event of reproduction, of these individuals there is a relatively high risk that the baby will have full trisomy 21 with the precise risk equalling the proportion of gametes which carry an additional number 21 chromosome.
Inheritance in Down's syndrome with tranclocation
When a child has Down syndrome as a result of an unbalanced Robertsonian translocation, there is a probability of around 25% that one of the parents will carry this in a balanced form. The remaining 75% of cases arise as de novo events and convey a low recurrence risk of approximately 1%
If, however, a parent is shown to be a carrier then there will be a significant risk that a future child will be affected, usually of the order of 2-5% for a carrier male and 10-15% for a carrier female.
In the very rare event that a parent carries a balanced 21q21e Robertsonian translocation, the risk of Down's drome in liveborn offs rin• will be 100%.
Risk of abnormal offspring for a carrier of a balanced translocation |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Symblepharon and explain in detail? | A symblepharon is a partial or complete adhesion of the palpebral conjunctiva of the eyelid to the bulbar conjunctiva of the eyeball |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Use of tamoxifen for breast cancer can cause all of the following adverse effects, except: and explain in detail? | Ans. c. Carcinoma in contralateral breast Tamoxifen is associated with reduced risk of cancer in the contralateral breast."Tamoxifen is approved for primary prophylaxis of breast cancer in high risk women. If reduces the recurrence rate of breast cancer in ipsilateral as well contralateral breastTamoxifen is associated with reduced risk of cancer in the contralateral breast."Tamoxifen is used to treat hormone- responsive breast cancer.Tamoxifen is a competitive inhibitor of estradiol, binding to the estrogen receptor. It has become a standard agent as a result of its anti-cancer activity and good tolerability profile. Tamoxifen is prescribed for the prevention of breast cancer in high-risk patients, for the adjuvant therapy of early stage breast cancer, and for the therapy of advanced breast cancer. It also prevents development of breast cancer in woman at high risk based on a strong family history, prior non-malignant breast pathology, or inheritance of the BRCA1 or BRCA2 genes."- Goodman and Gilman 12/e p1756-1757TamoxifenTamoxifen is a standard hormonal treatment of breast cancer in both premenopausal and postmenopausal womenQTamoxifen is effective in Estrogen Receptor (ER) positive breast carcinoma but some ER negative tumors also respond to tamoxifenQ.Tamoxifen is approved for primary prophylaxis of breast cancer in high risk womenQIf reduces the recurrence rate of breast cancer in ipsilateral as well contralateral breastQTamoxifen is associated with reduced risk of cancer in the contralateral breastQ.Dose: 10 mg BD X 5-yearsQWhile tamoxifen blocks estrogen receptors on the breast, it stimulates these receptors in the uterus (because tamoxifen is a partial against of ER), may lead to endometrial hyperplasia and endometrial cancerQPotent antagonist in breast carcinoma cells, blood vessels and at some peripheral sitesQQPartial agonist in the uterus, bone, liver and pituitaryAdverse Effects of Tamoxifen* Hot flushes, nausea and vomiting (MC)* Menstrual irregularities, vaginal bleeding, discharge, pruritus vulvae and dermatitis* Endometrial cancer* Thromboembolism* Cataract* Retinal deposits and decreased visual acuity |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 movements are performed by a non — working condyle? and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A 12-year-old boy is rushed to the emergency room in a coma after falling from an upper story window of his home. MRI shows a subdural hematoma over the left hemisphere. What is the most likely source of intracranial bleeding in this patient? and explain in detail? | Subdural hematoma reflects torn bridging veins in the subdural space. Unlike the epidural space, the subdural space can expand. Because bleeding in this situation is from veins, it usually stops spontaneously after an accumulation of 25 to 50 mL because of a local tamponade effect. However, this effect also can compress severed bridging veins and cause thrombosis. Because the brain is symmetric and a force applied in the sagittal plane similarly affects both cerebral hemispheres, it is not surprising that subdural hematomas are frequently bilateral. Tearing of the middle meningeal artery (choice D) causes epidural hemorrhage.Diagnosis: Subdural hematoma |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Treatment of choice for Pars planitis (Intermediateuveitis) - and explain in detail? | Ans. is 'b' i.e., Corticosteroids Drugs used in acute anterior uveitis (iridocyclitis)o Topical steroids (Drugs of choice)o Mydriatic - cycloplegics: Atropine (Drug of 2nd choice), Homatropine, cyclopentolate, tropicamide, mydricain (mixture of atropine, adrenaline & procaine)o Systemic steroidso NS AIDso Systemic immunosuppressives cyclosporine, methotrexate, cyclophosphamide Intermediate uveitiso Systemic steroids are the drug of choicePosterior uveitis (choroiditis)o Systemic steroids are the drug of choice |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Muscle pain, nephropathy with proximal tubule proteinuria caused by which metal poisoning? and explain in detail? | (B) Cadmium[?]CADMIUM POISONINGoThe disorder of reabsorption proteins appears as a tubular proteinuria.oIt is observed in case cadmium poisoning, hypoxia, burns, septicemia.oModerate tubular in sufficiency is characterized by rather albumins & other proteins with weight up to 40 kD is characterized in urine (selective proteinuria).oIn case of rough dystrophic canaliculuc defeats, there are proteins in urine with molecular weight more 40 kD (un selective proteinuria).[?]Renal Toxicity of Cadmium Ions:oThis may cause the tubular damage & proteinuria characterized by an increased urinary excretion of low molecular weight proteins, which come from the glomerular filtrate but are not reabsorbed.oSome evidence suggests that cadmium-induced protenuria may also be the result of glomerular damage.oThe first detectable adverse effect of cadmium on the kidney is an increased excretion of specific proteins in the urine.oEarly kidney damage and proteinuria seen in people, occupationally or environmentally exposed to cadmium.)[?]Acute Tubular Necrosis (ATN)oATN due to poisoning most obviously effects the proximal tubule --Necrosis and occlusions.[?]Children & Heavy Metals:oCadmium - Chronic Toxicity:oRespiratory:-Pneumonitis, destruction of mucous membranes.-Chronic obstructive lung disease (COPD)-Lung fibrosis (restrictive); Lung canceroRenal:-Proximal tubular necrosis, Proteinuria, secretion of beta 2 microglobulin-Proteinuria, kidney stones, glomerular & tubular damageoSkeletal:-Loss of bone density and mineralisation, Itai-Itai disease.-Osteomalacia & Osteoporosis; Bone pain (Itai-Itai)oCardiovascular: hypertensionoCancer: Lungs, kidney, prostate & stomachoReproductive System:-Testicular necrosis, estrogen - like effects, affection of steroid-hormone synthesis.oOther: AnosmiaOther Options[?]Arsenic:-Renal symptoms include - Oliguria, uraemia, urine contains albumen, red cells & casts, pain during micturition.-In Narcotic form, gastrointestinal symptoms are very slight, giddiness, formication, tenderness of muscle, delirum, coma, and death and rarely there complete paralysis of the extremities.-Late sequalae of acute Arsenic exposure leads to hematuria, and acute tubular necrosis.-Chronic Arsenic poisoning shows Raindrop type of pigmentation, Aldrich-mees on finger nails are characteristic.[?]Mercury:-In first phage of poisoning, hot burning pain in the mouth, extending down to stomach and abdomen, followed by nausea, retching and vomiting with blood stain material.-Diarrhea, blood stained stools, tenismus, circulatory collapse occurs soon.-Renal tubule shows necrosis, and produce transient polyuria, albuminuria, cylindruria, uraemia, and acidosis.-Hatter's shakes or glass-blower's shakes, Danbury tremors, concussion mercuralis & Mercurial erethism are seen in chronic Mercury Poisoning.[?]Lead:-Abdominal pain, nausea, vomiting, diarrhea, peripheral circulatory collapse, headache, insomnia, paraesthesias, depression, coma and death.-Lead poisoning shows facial pallor, Siderobalstic anaemia, Punctate basophilia or Basophilic stippling, Eosino- philiea, lead line or Burtonian line and lead palsy & Lead encephalopathy |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 associated with the gall stones except: March 2005 and explain in detail? | Ans. C: Acute appendicitis Effects and complications of gall stones: In the gall bladder - Biliary colic - Acute cholecystitis Chronic cholecystitis - Empyema of gall bladder - Mucocele - Perforation In the bile ducts - Biliary obstruction - Acute cholangitis - Acute pancreatitis In the intestine - Intestinal obstruction (gallstone ileus) - Cancer of the gallbladder (rarely) - Jaundice - Pancreatitis |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following is an example of Labile tissue? and explain in detail? | The ability of tissues to repair themselves is determined, in part, by their intrinsic proliferative capacity. In some tissues called labile tissues, cells are constantly being lost and must be continually replaced by new cells that are derived from tissue stem cells and rapidly proliferating immature progenitors. These types of tissues include hematopoietic cells in the bone marrow and many surface epithelia, such as the basal layers of the squamous epithelia of the skin, oral cavity, vagina, and cervix; the cuboidal epithelia of the ducts draining exocrine organs (e.g., salivary glands, pancreas, biliary tract); the columnar epithelium of the gastrointestinal tract, uterus, and fallopian tubes; and the transitional epithelium of the urinary tract. These tissues can readily regenerate after injury as long as the pool of stem cells is preserved.
Robin’s Textbook of pathology 10th ed Page 88 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Commonest salivary gland to get stones : and explain in detail? | Ans. is 'b' ie. Submandibular Gland [Ref. Bailey & love, 25/e p755 (24/e p. 723, 23/e. p 655)) "Eighty percent of all salivary stones occur in the submandibular gland, 10% occur in parotid, 7% in the sublingual and the remainder occurs in minor salivary glands Bailey & love 23/e |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is What is angle of detion in Infantile Esotropia and explain in detail? | Convergent squint - Inward detion of the eye and is the most common type of squint in children Convergent squint is classified into following type I. Infantile squint Age of onset is usually 2-4 months of age but occur any time in first 6 months of life Angle of detion is usually constant and fairly large > 35' Amblyopia develop in 25-40 % cases Surgery should be done between 6 months to 2 years ( preferably before one year of age) II. Accommodative esotropia Develops around 2 - 3 years of age Associated with high hypermetropia Requires refractive correction III. Acquired non accommodative esotropia Amount of detion is not affect by the sate of accommodation IV. Sensory esotropia Result from monocular lesions in childhood V. Consecutive esotropia - Result from surgical overcorrection of exotropia |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 the risk factors associated with macrosomia except : and explain in detail? | Macrosomia is the term used to describe a large fetus. Risk factors: Maternal diabetes Maternal obesity Previous large baby Post-term pregnancy Multiparity TEXTBOOK OF OBSTETRICS, Sheila Balakrishnan, 2nd edition, Page no.389 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 defence mechanisms of ego except and explain in detail? | D i.e. Transference |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Soft S1 is seen in all except: and explain in detail? | MS: | Trans-valvular gradient, faster opening and faster elastic recoil - l/t loud S1 Option A- Causes bradycardia l/t soft S1 Option B- Blood comes black in LV, so increased volume in L.V during diastole d/t defective aoic valve closure blood comes back into the ventricle.The gradient stas reducing so l/t soft S1 sound. Option C -S1 become Soft once valve get calcified. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Bone marrow biopsy is useful in the diagnosis of -( and explain in detail? | Ans. is 'c' i.e., Aleukemic leukemia |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Concentration of fluoride in community water supplies as proposed by WHO in 1969 was- and explain in detail? | In 1969, WHO advocated that 1 ppm of fluoride in community water supplies was a practical and effective public health measure. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 basic amino acid among the following is: and explain in detail? | Acidic Amino Acid
Aspartic Acid (Aspartate)
Glutamic Acid (Glutamate)
Basic Amino Acid
Arginine (Most Basic Amino acid)
Lysine |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 gene frequency for an X-linked recessive disease is 1 in 1,000 in the general population. What is the frequency of affected males in this population? and explain in detail? | If the disease frequency in the population is 1 in 1,000, and the disorder is X linked, that means that out of 1,000 men, 1 would have the disease because each man contains one X chromosome. Because women contain two X chromosomes, the carrier frequency is 1 in 500 because 500 women would contain 1,000 X chromosomes, one of which would contain the mutated allele. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Human B-cell lymphotropic virus belongs to: and explain in detail? | Ans. d. Herpes virus |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is The following X ray is diagnostic of: and explain in detail? | Ans. A. RicketsVitamin D deficiency results in Rickets. Major sources of vitamin D is its synthesis in the skin following exposure to ultraviolet (UVB) solar irradiation. The dermal concentration of melanin regulates the amount of UV rays that reach the epidermal layers. A lack of adequate mineralization of growing bones results in rickets. Rickets is treated by administration of 60,000IU of vitamin D given on weekly basis for 6 weeks (Through oral route). Radiographic features of rickets include: Widening and cupping of the metaphyseal regions, fraying of the metaphysis, Craniotabes, Bowing of long 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 Optical urethroplasty is done in and explain in detail? | Congenital Urethral Stricture-this rare condition may be associated with duplication of the urethra. Usually, symptoms are delayed until adolescence, when it may be indistinguishable from a stricture due to unrecognised urethral injury in childhood. A single treatment by optical urethrotomy(Direct visual internal urethrotomy) or dilatation is usually effective.Reference : page1362 Bailey and Love's sho practice of surgery 25th 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 Most common complication seen after Block 2 is and explain in detail? | Hypotension (Block 2 is Spinal block) |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Investigation of choice for small intestine tumor - and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is The second largest aery to the stomach is the right gastroepiploic aery. It is a branch of: and explain in detail? | The second largest aery to the stomach is the right gastroepiploic aery, which arises consistently from the gastroduodenal aery behind the first poion of the duodenum. The greater curvature is supplied by the right gastroepiploic aery and the left gastroepiploic aery (a branch of the splenic aery). Ref: Dempsey D.T. (2010). Chapter 26. Stomach. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Succinylcholine can cause: and explain in detail? | Administration of succinylcholine to an otherwise well individual for an elective surgical procedure increases plasma potassium levels by approximately 0.5 mEq/dL. This increase in potassium is due to the depolarizing action of the relaxant. With activation of the acetylcholine channels, movement of sodium into the cells is accompanied by movement of potassium out of the cells. Ref: Miller's anesthesia-7th ed, Chapter 29. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 healing contusion shows green color due to the presence of: and explain in detail? | COLOR CHANGE PRESENCE OF AGING of contusion RED OXY-HEMOGLOBIN FEW HOURS BLUE DEOXY-HEMOGLOBIN FEW HOURS-3 DAYS BROWN HEMOSIDERIN 4-5 DAYS GREEN BILIVERDIN 6-7 DAYS YELLOW BILIRUBIN 7-12 DAYS |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Blow-out fracture of orbit is characterized by all except: and explain in detail? | Ans. Exophthalmos |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 Gaucher's disease there is accumulation of --- inside the cells – and explain in detail? | Lysosomal storage diseases
Lysosomes are key components of the intracellular digestive tract.
They contain a battery of hydrolytic enzymes.
These hydrolytic enzymes catalyze the breakdown of a variety of complex macromolecules.
With an inherited deficiency of a functional lysosomal enzyme, catabolism of its substrate remains incomplete, leading to accumulation of the partially degraded insoluble metabolite within the lysosomes.
Stuffed with incompletely digested macromolecules, these organelles become large and numerous enough to
interfeie with normal cell functions, giving rise to the lysosomal storage disorders.
Important lysosomal storage diseases |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 site of salivary gland calculi is? and explain in detail? | ANSWER; (B) SubmandibularREF: Bailey and love 24th ed p. 723"Eighty percent of all salivary gland stones occur in submandibular salivary glands" |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Pipkin classification is used for and explain in detail? | COMMON FRACTURES CLASSIFICATION FRACTURECLASSIFICATIONOpen fracturesGustilo & Anderson Supracondylar Humerus Galand ( based on displacement )Proximal Humerus Neer ( 4 pa fractures )Distal Radius Frykman , FermandezPelvis Young & Burgess, TileFemoral head Pipkin's classificationFemoral neck ( Pediatric )Delbet classificationFemoral neck ( Adult )Pauwel ( Based on fracture angle )Garden ( Based on displacement )Interochanteric Boyd & Griffin , Evans Femoral shaft Winquist & Hansen ( Based on degree of communition ) Tibial plateau SchatzkerPilon fracture Ruedi -AllgowerAnkle Lauge -Hansen , Danis- Weber Talar neck Hawkin Calcaneum Essex -Lopresti , Sanders ( Based on CT findings )Physeal injuries Salter - Harris Classification (Refer: Mohindra's Fundamentals of Ohopedics, 2nd edition, pg no. 125) |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 not given for malaria prophylaxis 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 Estimation of FiO2 calculation during the use of nasal cannula in a child is and explain in detail? | Answer: c) 21% + (Nasal Cannula flow (L/min) X 3)Oxygen delivery systems for infants and childrenSystemPercent oxygen deliveredIndicationsCommentsBlow byLess than 30 percentUse for spontaneously breathing children who require low doses of oxygen and do not tolerate a maskMonitor pulse oximetryNasal cannula25 to 40 percentUse to deliver low dose oxygen to spontaneously breathing patientsPercent oxygen delivered affected by respiratory rate, tidal volume, and extent of mouth breathing. Flow rate 2L/min or less for infants Fio2=21% + (Nasal Cannula flow (L/min) X 3)Simple mask35 to 50 percentUse to deliver low dose oxygen to spontaneously breathing patientsPercent oxygen delivered affected by mask fit and respiratory ratePartial rebreather Mask50 to 60 percentUse to conserve oxygen Non rebreather maskUp to 95 percentUse to deliver high dose oxygen to spontaneously breathing patientsTight mask fit required to deliver higher concentrations of oxygenHood80 to 90 percentInfants less than one year of ageNoisy for patientTentLess than 50 percentUse for children who require 30 percent oxygen or lessMist may obscure view of patient. Noisy for patient.Self-inflating ventilation bag95 to 100 percent, with reservoirUse to provide assisted ventilation and oxygenDo not use to provide blow by. Must use with a reservoir to provide higher oxygen concentrations.Flow-inflating ventilation bag100 percentUse to provide assisted ventilation and oxygenMay use to provide blow by. Requires experience to use reliably. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 causes motor nerve paralysis except and explain in detail? | Diphtheria infected individuals present with flulike symptoms of generalized myalgias, headache, fatigue, low-grade fever, and irritability within a week to 10 days of the exposure. About 20-70% of patients develop a peripheral neuropathy caused by a toxin released by the bacteria. Three to 4 weeks after infection, patients may note decreased sensation in their throat and begin to develop dysphagia, dysahria, hoarseness, and blurred vision due to impaired accommodation. A generalized polyneuropathy may manifest 2 or 3 months following the initial infection, characterized by numbness, paresthesias, and weakness of the arms and legs and occasionally ventilatory failure.CSF protein can be elevated with or without lymphocytic pleocytosis. EDx suggests a diffuse axonal sensorimotor polyneuropathy. Antitoxin and antibiotics should be given within 48 h of symptom onset. Although early treatment reduces the incidence and severity of some complications (i.e., cardiomyopathy), it does not appear to alter the natural history of the associated peripheral neuropathy. The neuropathy usually resolves after several months.Ref: Harrison's 18/e p3460 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Saffron coloured meconium is seen in: and explain in detail? | Postmaturity syndrome is the description of a clinical syndrome in which fetus experiences placental insufficiency and resultant growth restrictions.The classical syndrome describes a neonate with wrinkled ,peeling skin coated with meconium,overgrown nails ,well developed palm and sole creases ,reduced subcutaneous fat and a wizened old man appearance (refer pgno:218 sheila textbooks of obstetrics 2 nd 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 Access cavity shape in mandibular 1st molar with 4 canals 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 Apple jelly nodules on the nasal septum are found in cases of - and explain in detail? | Characteristic feature of lupus vulgaris is the presence of apple- jelly nodules (Brown gelatinous nodules) in skin. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Renal replacement therapy replaces all except - and explain in detail? | Renal replacement therapy does not replace the endocrine and metabolic functions of the kidney . It maintains plasma biochemistry (uraemic toxins, electrolytes acid base) It also removes fluid from the circulation (ultrafiltration) to maintain the plasma volume. Ref Harrison20th edition pg 290 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Ampicillin and explain in detail? | Ampicillin is an antibiotic used to prevent and treat a number of bacterial infections, such as respiratory tract infections, urinary tract infections, meningitis, salmonellosis, and endocarditis. It may also be used to prevent group B streptococcal infection in newborns. It is used by mouth, by injection into a muscle, or intravenously.
Common side effects include rash, nausea, and diarrhea. It should not be used in people who are allergic to penicillin. Serious side effects may include Clostridium difficile colitis or anaphylaxis. While usable in those with kidney problems, the dose may need to be decreased. Its use during pregnancy and breastfeeding appears to be generally safe.Ampicillin was discovered in 1958 and came into commercial use in 1961. It is on the World Health Organizations List of Essential Medicines. The World Health Organization classifies ampicillin as critically important for human medicine. It is available as a generic medication.
Medical uses
Diseases
Bacterial meningitis; an aminoglycoside can be added to increase efficacy against gram-negative meningitis bacteria
Endocarditis by enterococcal strains (off-label use); often given with an aminoglycoside
Gastrointestinal infections caused by contaminated water or food (for example, by Salmonella)
Genito-urinary tract infections
Healthcare-associated infections that are related to infections from using urinary catheters and that are unresponsive to other medications
Otitis media (middle ear infection)
Prophylaxis (i.e. to prevent infection) in those who previously had rheumatic heart disease or are undergoing dental procedures, vaginal hysterectomies, or C-sections. It is also used in pregnant woman who are carriers of group B streptococci to prevent early-onset neonatal infections.
Respiratory infections, including bronchitis, pharyngitis
Sinusitis
Sepsis
Whooping cough, to prevent and treat secondary infectionsAmpicillin used to also be used to treat gonorrhea, but there are now too many strains resistant to penicillins.
Bacteria
Ampicillin is used to treat infections by many gram-positive and gram-negative bacteria. It was the first "broad spectrum" penicillin with activity against gram-positive bacteria, including Streptococcus pneumoniae, Streptococcus pyogenes, some isolates of Staphylococcus aureus (but not penicillin-resistant or methicillin-resistant strains), Trueperella, and some Enterococcus. It is one of the few antibiotics that works against multidrug resistant Enterococcus faecalis and E. faecium. Activity against gram-negative bacteria includes Neisseria meningitidis, some Haemophilus influenzae, and some of the Enterobacteriaceae (though most Enterobacteriaceae and Pseudomonas are resistant). Its spectrum of activity is enhanced by co-administration of sulbactam, a drug that inhibits beta lactamase, an enzyme produced by bacteria to inactivate ampicillin and related antibiotics. It is sometimes used in combination with other antibiotics that have different mechanisms of action, like vancomycin, linezolid, daptomycin, and tigecycline.
Available forms
Ampicillin can be administered by mouth, an intramuscular injection (shot) or by intravenous infusion. The oral form, available as capsules or oral suspensions, is not given as an initial treatment for severe infections, but rather as a follow-up to an IM or IV injection. For IV and IM injections, ampicillin is kept as a powder that must be reconstituted.IV injections must be given slowly, as rapid IV injections can lead to convulsive seizures.
Specific populations
Ampicillin is one of the most used drugs in pregnancy, and has been found to be generally harmless both by the Food and Drug Administration in the U.S. (which classified it as category B) and the Therapeutic Goods Administration in Australia (which classified it as category A). It is the drug of choice for treating Listeria monocytogenes in pregnant women, either alone or combined with an aminoglycoside. Pregnancy increases the clearance of ampicillin by up to 50%, and a higher dose is thus needed to reach therapeutic levels.Ampicillin crosses the placenta and remains in the amniotic fluid at 50–100% of the concentration in maternal plasma; this can lead to high concentrations of ampicillin in the newborn.While lactating mothers secrete some ampicillin into their breast milk, the amount is minimal.In newborns, ampicillin has a longer half-life and lower plasma protein binding. The clearance by the kidneys is lower, as kidney function has not fully developed.
Contraindications
Ampicillin is contraindicated in those with a hypersensitivity to penicillins, as they can cause fatal anaphylactic reactions. Hypersensitivity reactions can include frequent skin rashes and hives, exfoliative dermatitis, erythema multiforme, and a temporary decrease in both red and white blood cells.Ampicillin is not recommended in people with concurrent mononucleosis, as over 40% of patients develop a skin rash.
Side effects
Ampicillin is comparatively less toxic than other antibiotics, and side effects are more likely in those who are sensitive to penicillins and those with a history of asthma or allergies. In very rare cases, it causes severe side effects such as angioedema, anaphylaxis, and C. difficile infection (that can range from mild diarrhea to serious pseudomembranous colitis). Some develop black "furry" tongue. Serious adverse effects also include seizures and serum sickness. The most common side effects, experienced by about 10% of users are diarrhea and rash. Less common side effects can be nausea, vomiting, itching, and blood dyscrasias. The gastrointestinal effects, such as hairy tongue, nausea, vomiting, diarrhea, and colitis, are more common with the oral form of penicillin. Other conditions may develop up several weeks after treatment.
Overdose
Ampicillin overdose can cause behavioral changes, confusion, blackouts, and convulsions, as well as neuromuscular hypersensitivity, electrolyte imbalance, and kidney failure.
Interactions
Ampicillin reacts with probenecid and methotrexate to decrease renal excretion. Large doses of ampicillin can increase the risk of bleeding with concurrent use of warfarin and other oral anticoagulants, possibly by inhibiting platelet aggregation. Ampicillin has been said to make oral contraceptives less effective, but this has been disputed. It can be made less effective by other antibiotic, such as chloramphenicol, erythromycin, cephalosporins, and tetracyclines. For example, tetracyclines inhibit protein synthesis in bacteria, reducing the target against which ampicillin acts. If given at the same time as aminoglycosides, it can bind to it and inactivate it. When administered separately, aminoglycosides and ampicillin can potentiate each other instead.Ampicillin causes skin rashes more often when given with allopurinol.Both the live cholera vaccine and live typhoid vaccine can be made ineffective if given with ampicillin. Ampicillin is normally used to treat cholera and typhoid fever, lowering the immunological response that the body has to mount.
Pharmacology
Mechanism of action
Ampicillin is in the penicillin group of beta-lactam antibiotics and is part of the aminopenicillin family. It is roughly equivalent to amoxicillin in terms of activity. Ampicillin is able to penetrate gram-positive and some gram-negative bacteria. It differs from penicillin G, or benzylpenicillin, only by the presence of an amino group. This amino group, present on both ampicillin and amoxicillin, helps these antibiotics pass through the pores of the outer membrane of gram-negative bacteria, such as E. coli, Proteus mirabilis, Salmonella enterica, and Shigella.Ampicillin acts as an irreversible inhibitor of the enzyme transpeptidase, which is needed by bacteria to make the cell wall. It inhibits the third and final stage of bacterial cell wall synthesis in binary fission, which ultimately leads to cell lysis; therefore, ampicillin is usually bacteriolytic.
Pharmacokinetics
Ampicillin is well-absorbed from the GI tract (though food reduces its absorption), and reaches peak concentrations in one to two hours. The bioavailability is around 62% for parenteral routes. Unlike other penicillins, which usually bind 60–90% to plasma proteins, ampicillin binds to only 15–20%.Ampicillin is distributed through most tissues, though it is concentrated in the liver and kidneys. It can also be found in the cerebrospinal fluid when the meninges become inflamed (such as, for example, meningitis). Some ampicillin is metabolized by hydrolyzing the beta-lactam ring to penicilloic acid, though most of it is excreted unchanged. In the kidneys, it is filtered out mostly by tubular secretion; some also undergoes glomerular filtration, and the rest is excreted in the feces and bile.
Hetacillin and pivampicillin are ampicillin esters that have been developed to increase bioavailability.
History
Ampicillin has been used extensively to treat bacterial infections since 1961. Until the introduction of ampicillin by the British company Beecham, penicillin therapies had only been effective against gram-positive organisms such as staphylococci and streptococci. Ampicillin (originally branded as "Penbritin") also demonstrated activity against gram-negative organisms such as H |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 attachment at ischial tuberosity and explain in detail? | Muscle Origin Semitendinosus Inferomedial impression on upper pa of ischial tuberosity Semimembranosus Superolateral impression on upper pa of ischial tuberosity. Biceps femoris Long head: inferomedial impression on upper pa of ischial tuberositysho head:lateral lip of linea aspera Adductor magnus Lower lateral pa of ischial tuberosity, ramus of ischium, lower pa of inferior ramus of pubis. fig:-ischial tuberosity attachment of muscles |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 person riding a mountain bike on a rustic trail hits a rut, the fork of the bike breaks and the person is thrown into a tree, severely fracturing the upper end of his humerus. During the repair the surgeon ties off the aery traveling through the quadrangular space to stop the hemorrhage. Which aery did he ligate? and explain in detail? | The quadrangular space is bounded medially by the long head of the triceps tendon, laterally by the humerus, superiorly by teres major, and inferiorly by teres minor. It is traversed by the axillary nerve and the posterior humeral circumflex aery. The triangular space is medial to the quadrangular space and it is bounded laterally by the tendon of the long head of the triceps, superiorly by teres minor, and inferiorly by teres major. The circumflex scapular aery, which is a branch of the subscapular aery, traverses this space. The dorsal scapular aery and suprascapular aery contribute to the scapular anastomosis with the circumflex scapular aery, but neither of these vessels are in the quadrangular or triangular spaces. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Hyperkalemia and explain in detail? | Hyperkalemia is an elevated level of potassium (K+) in the blood. Normal potassium levels are between 3.5 and 5.0 mmol/L (3.5 and 5.0 mEq/L) with levels above 5.5 mmol/L defined as hyperkalemia. Typically hyperkalemia does not cause symptoms. Occasionally when severe it can cause palpitations, muscle pain, muscle weakness, or numbness. Hyperkalemia can cause an abnormal heart rhythm which can result in cardiac arrest and death.Common causes of hyperkalemia include kidney failure, hypoaldosteronism, and rhabdomyolysis. A number of medications can also cause high blood potassium including spironolactone, NSAIDs, and angiotensin converting enzyme inhibitors. The severity is divided into mild (5.5–5.9 mmol/L), moderate (6.0–6.4 mmol/L), and severe (>6.5 mmol/L). High levels can be detected on an electrocardiogram (ECG). Pseudohyperkalemia, due to breakdown of cells during or after taking the blood sample, should be ruled out.Initial treatment in those with ECG changes is salts, such as calcium gluconate or calcium chloride. Other medications used to rapidly reduce blood potassium levels include insulin with dextrose, salbutamol, and sodium bicarbonate. Medications that might worsen the condition should be stopped and a low potassium diet should be started. Measures to remove potassium from the body include diuretics such as furosemide, potassium-binders such as polystyrene sulfonate and sodium zirconium cyclosilicate, and hemodialysis. Hemodialysis is the most effective method.Hyperkalemia is rare among those who are otherwise healthy. Among those who are hospitalized, rates are between 1% and 2.5%. It is associated with an increased mortality, whether due to hyperkalaemia itself or as a marker of severe illness, especially in those without chronic kidney disease. The word hyperkalemia comes from hyper- high + kalium potassium + -emia blood condition.
Signs and symptoms
The symptoms of an elevated potassium level are generally few and nonspecific. Nonspecific symptoms may include feeling tired, numbness and weakness. Occasionally palpitations and shortness of breath may occur. Hyperventilation may indicate a compensatory response to metabolic acidosis, which is one of the possible causes of hyperkalemia. Often, however, the problem is detected during screening blood tests for a medical disorder, or after hospitalization for complications such as cardiac arrhythmia or sudden cardiac death. High levels of potassium (> 5.5 mmol/L) have been associated with cardiovascular events.
Causes
Ineffective elimination
Decreased kidney function is a major cause of hyperkalemia. This is especially pronounced in acute kidney injury where the glomerular filtration rate and tubular flow are markedly decreased, characterized by reduced urine output. This can lead to a dramatically elevated potassium in conditions of increased cell breakdown as the potassium is released from the cells and cannot be eliminated in the kidney. In chronic kidney disease, hyperkalemia occurs as a result of reduced aldosterone responsiveness and reduced sodium and water delivery in distal tubules.Medications that interfere with urinary excretion by inhibiting the renin–angiotensin system is one of the most common causes of hyperkalemia. Examples of medications that can cause hyperkalemia include ACE inhibitors, angiotensin receptor blockers, non-selective beta blockers, and calcineurin inhibitor immunosuppressants such as ciclosporin and tacrolimus. For potassium-sparing diuretics, such as amiloride and triamterene; both the drugs block epithelial sodium channels in the collecting tubules, thereby preventing potassium excretion into urine. Spironolactone acts by competitively inhibiting the action of aldosterone. NSAIDs such as ibuprofen, naproxen, or celecoxib inhibit prostaglandin synthesis, leading to reduced production of renin and aldosterone, causing potassium retention. The antibiotic trimethoprim and the antiparasitic medication pentamidine inhibits potassium excretion, which is similar to mechanism of action by amiloride and triamterene.Mineralocorticoid (aldosterone) deficiency or resistance can also cause hyperkalemia. Primary adrenal insufficiency are: Addisons disease and congenital adrenal hyperplasia (CAH) (including enzyme deficiencies such as 21α hydroxylase, 17α hydroxylase, 11β hydroxylase, or 3β dehydrogenase).
Type IV renal tubular acidosis (aldosterone resistance of the kidneys tubules)
Gordons syndrome (pseudohypoaldosteronism type II) ("familial hypertension with hyperkalemia"), a rare genetic disorder caused by defective modulators of salt transporters, including the thiazide-sensitive Na-Cl cotransporter.
Excessive release from cells
Metabolic acidosis can cause hyperkalemia as the elevated hydrogen ions in the cells can displace potassium, causing the potassium ions to leave the cell and enter the bloodstream. However, in respiratory acidosis or organic acidosis such as lactic acidosis, the effect on serum potassium are much less significant although the mechanisms are not completely understood.Insulin deficiency can cause hyperkalemia as the hormone insulin increases the uptake of potassium into the cells. Hyperglycemia can also contribute to hyperkalemia by causing hyperosmolality in extracellular fluid, increasing water diffusion out of the cells and causes potassium to move alongside water out of the cells also. The co-existence of insulin deficiency, hyperglycemia, and hyperosmolality is often seen in those affected by diabetic ketoacidosis. Apart from diabetic ketoacidosis, there are other causes that reduce insulin levels such as the use of the medication octreotide, and fasting which can also cause hyperkalemia. Increased tissue breakdown such as rhabdomyolysis, burns, or any cause of rapid tissue necrosis, including tumor lysis syndrome can cause the release of intracellular potassium into blood, causing hyperkalemia.Beta2-adrenergic agonists act on beta-2 receptors to drive potassium into the cells. Therefore, beta blockers can raise potassium levels by blocking beta-2 receptors. However, the rise in potassium levels is not marked unless there are other co-morbidities present. Examples of drugs that can raise the serum potassium are non-selective beta-blockers such as propranolol and labetalol. Beta-1 selective blockers such as metoprolol do not increase serum potassium levels.Exercise can cause a release of potassium into bloodstream by increasing the number of potassium channels in the cell membrane. The degree of potassium elevation varies with the degree of exercise, which range from 0.3 meq/L in light exercise to 2 meq/L in heavy exercise, with or without accompanying ECG changes or lactic acidosis. However, peak potassium levels can be reduced by prior physical conditioning and potassium levels are usually reversed several minutes after exercise. High levels of adrenaline and noradrenaline have a protective effect on the cardiac electrophysiology because they bind to beta 2 adrenergic receptors, which, when activated, extracellularly decrease potassium concentration.Hyperkalemic periodic paralysis is an autosomal dominant clinical condition where there is a mutation in gene located at 17q23 that regulates the production of protein SCN4A. SCN4A is an important component of sodium channels in skeletal muscles. During exercise, sodium channels would open to allow influx of sodium into the muscle cells for depolarization to occur. But in hyperkalemic periodic paralysis, sodium channels are slow to close after exercise, causing excessive influx of sodium and displacement of potassium out of the cells.Rare causes of hyperkalemia are discussed as follows. Acute digitalis overdose such as digoxin toxicity may cause hyperkalemia through the inhibition of sodium-potassium-ATPase pump. Massive blood transfusion can cause hyperkalemia in infants due to leakage of potassium out of the red blood cells during storage. Giving succinylcholine to people with conditions such as burns, trauma, infection, prolonged immobilisation can cause hyperkalemia due to widespread activation of acetylcholine receptors rather than a specific group of muscles. Arginine hydrochloride is used to treat refractory metabolic alkalosis. The arginine ions can enter cells and displace potassium out of the cells, causing hyperkalemia. Calcineurin inhibitors such as cyclosporine, tacrolimus, diazoxide, and minoxidil can cause hyperkalemia. Box jellyfish venom can also cause hyperkalemia.
Excessive intake
Excessive intake of potassium is not a primary cause of hyperkalemia because the human body usually can adapt to the rise in the potassium levels by increasing the excretion of potassium into urine through aldosterone hormone secretion and increasing the number of potassium secreting channels in kidney tubules. Acute hyperkalemia in infants is also rare even though their body volume is small, with accidental ingestion of potassium salts or potassium medications. Hyperkalemia usually develops when there are other co-morbidities such as hypoaldosteronism and chronic kidney disease.
Pseudohyperkalemia
Pseudohyperkalemia occurs when the measured potassium level is falsely elevated. This condition is usually suspected when the patient is clinically well without any ECG changes. Mechanical trauma during blood drawing can cause potassium leakage out of the red blood cells due to haemolysis of the blood sample. Repeated fist clenching during the blood draw can cause a transient rise in potassium levels. Prolonged length of blood storage can also increase serum potassium levels. Hyperkalemia may become apparent when a persons platelet concentration is more than 500,000/microL in a clotted blood sample (serum blood sample). Potassium leaks out of platelets after clotting has occurred. A high white cell count (greater than 120,000/microL) in people with chronic lymphocytic leukemia increases the fragility of red blood cells, thus causing pseudohyperkalemia during blood processing. This problem can be avoided by processing serum samples, because clot formation protects the cells from haemolysis during processing. A familial form of pseudohyperkalemia, a benign condition characterised by increased serum potassium in whole blood stored at cold temperatures, also exists. This is due to increased potassium permeability in red blood cells.
Mechanism
Physiology
Potassium is the most abundant intracellular cation and about 98% of the bodys potassium is found inside cells, with the remainder in the extracellular fluid including the blood. Membrane potential is maintained principally by the concentration gradient and membrane permeability to potassium with some contribution from the Na+/K+ pump. The potassium gradient is critically important for many physiological processes, including maintenance of cellular membrane potential, homeostasis of cell volume, and transmission of action potentials in nerve cells.Potassium is eliminated from the body through the gastrointestinal tract, kidney and sweat glands. In the kidneys, elimination of potassium is passive (through the glomeruli), and reabsorption is active in the proximal tubule and the ascending limb of the loop of Henle. There is active excretion of potassium in the distal tubule and the collecting duct; both are controlled by aldosterone. In sweat glands potassium elimination is quite similar to the kidney, its excretion is also controlled by aldosterone.Regulation of serum potassium is a function of intake, appropriate distribution between intracellular and extracellular compartments, and effective bodily excretion. In healthy individuals, homeostasis is maintained when cellular uptake and kidney excretion naturally counterbalance a patients dietary intake of potassium. When kidney function becomes compromised, the ability of the body to effectively regulate serum potassium via the kidney declines. To compensate for this deficit in function, the colon increases its potassium secretion as part of an adaptive response. However, serum potassium remains elevated as the colonic compensating mechanism reaches its limits.
Elevated potassium
Hyperkalemia develops when there is excess production (oral intake, tissue breakdown) or ineffective elimination of potassium. Ineffective elimination can be hormonal (in aldosterone deficiency) or due to causes in the kidney that impair excretion.Increased extracellular potassium levels result in depolarization of the membrane potentials of cells due to the increase in the equilibrium potential of potassium. This depolarization opens some voltage-gated sodium channels, but also increases the inactivation at the same time. Since depolarization due to concentration change is slow, it never generates an action potential by itself; instead, it results in accommodation. Above a certain level of potassium the depolarization inactivates sodium channels, opens potassium channels, thus the cells become refractory. This leads to the impairment of neuromuscular, cardiac, and gastrointestinal organ systems. Of most concern is the impairment of cardiac conduction, which can cause ventricular fibrillation and/or abnormally slow heart rhythms.
Diagnosis
To gather enough information for diagnosis, the measurement of potassium must be repeated, as the elevation can be due to hemolysis in the first sample. The normal serum level of potassium is 3.5 to 5 mmol/L. Generally, blood tests for kidney function (creatinine, blood urea nitrogen), glucose and occasionally creatine kinase and cortisol are performed. Calculating the trans-tubular potassium gradient can sometimes help in distinguishing the cause of the hyperkalemia.Also, electrocardiography (ECG) may be performed to determine if there is a significant risk of abnormal heart rhythms. Physicians taking a medical history may focus on kidney disease and medication use (e.g. potassium-sparing diuretics), both of which are known causes of hyperkalemia.
Definitions
Normal serum potassium levels are generally considered to be between 3.5 and 5.3 mmol/L. Levels above 5.5 mmol/L generally indicate hyperkalemia, and those below 3.5 mmol/L indicate hypokalemia.
ECG findings
With mild to moderate hyperkalemia, there is prolongation of the PR interval and development of peaked T waves. Severe hyperkalemia results in a widening of the QRS complex, and the ECG complex can evolve to a sinusoidal shape. There appears to be a direct effect of elevated potassium on some of the potassium channels that increases their activity and speeds membrane repolarisation. Also, (as noted above), hyperkalemia causes an overall membrane depolarization that inactivates many sodium channels. The faster repolarisation of the cardiac action potential causes the tenting of the T waves, and the inactivation of sodium channels causes a sluggish conduction of the electrical wave around the heart, which leads to smaller P waves and widening of the QRS complex. Some of potassium currents are sensitive to extracellular potassium levels, for reasons that are not well understood. As the extracellular potassium levels increase, potassium conductance is increased so that more potassium leaves the myocyte in any given time period. To summarize, classic ECG changes associated with hyperkalemia are seen in the following progression: peaked T wave, shortened QT interval, lengthened PR interval, increased QRS duration, and eventually absence of the P wave with the QRS complex becoming a sine wave. Bradycardia, junctional rhythms and QRS widening are particularly associated with increased risk of adverse outcomesThe serum potassium concentration at which electrocardiographic changes develop is somewhat variable. Although the factors influencing the effect of serum potassium levels on cardiac electrophysiology are not entirely understood, the concentrations of other electrolytes, as well as levels of catecholamines, play a major role.ECG findings are not a reliable finding in hyperkalemia. In a retrospective review, blinded cardiologists documented peaked T-waves in only 3 of 90 ECGs with hyperkalemia. Sensitivity of peaked-Ts for hyperkalemia ranged from 0.18 to 0.52 depending on the criteria for peak-T waves.
Prevention
Preventing recurrence of hyperkalemia typically involves reduction of dietary potassium, removal of an offending medication, and/or the addition of a diuretic (such as furosemide or hydrochlorothiazide). Sodium polystyrene sulfonate and sorbitol (combined as Kayexalate) are occasionally used on an ongoing basis to maintain lower serum levels of potassium though the safety of long-term use of sodium polystyrene sulfonate for this purpose is not well understood.High dietary sources include vegetables such as avocados, tomatoes and potatoes, fruits such as bananas, oranges and nuts.
Treatment
Emergency lowering of potassium levels is needed when new arrhythmias occur at any level of potassium in the blood, or when potassium levels exceed 6.5 mmol/L. Several agents are used to temporarily lower K+ levels. The choice depends on the degree and cause of the hyperkalemia, and other aspects of the persons condition.
Myocardial excitability
Calcium (calcium chloride or calcium gluconate) increases threshold potential through a mechanism that is still unclear, thus restoring normal gradient between threshold potential and resting membrane potential, which is elevated abnormally in hyperkalemia. A standard ampule of 10% calcium chloride is 10 mL and contains 6.8 mmol of calcium. A standard ampule of 10% calcium gluconate is also 10 mL but has only 2.26 mmol of calcium. Clinical practice guidelines recommend giving 6.8 mmol for typical EKG findings of hyperkalemia. This is 10 mL of 10% calcium chloride or 30 mL of 10% calcium gluconate. Though calcium chloride is more concentrated, it is caustic to the veins and should only be given through a central line. Onset of action is less than one to three minutes and lasts about 30–60 minutes. The goal of treatment is to normalise the EKG and doses can be repeated if the EKG does not improve within a few minutes.Some textbooks suggest that calcium should not be given in digoxin toxicity as it has been linked to cardiovascular collapse in humans and increased digoxin toxicity in animal models. Recent literature questions the validity of this concern.
Temporary measures
Several medical treatments shift potassium ions from the bloodstream into the cellular compartment, thereby reducing the risk of complications. The effect of these measures tends to be short-lived, but may temporise the problem until potassium can be removed from the body.
Insulin (e.g. intravenous injection of 10 units of regular insulin along with 50 mL of 50% dextrose to prevent the blood sugar from dropping too low) leads to a shift of potassium ions into cells, secondary to increased activity of the sodium-potassium ATPase. Its effects last a few hours, so it sometimes must be repeated while other measures are taken to suppress potassium levels more permanently. The insulin is usually given with an appropriate amount of glucose to help prevent hypoglycemia following the insulin administration, though hypoglycaemia remains common especially in the context of acute or chronic renal impairment and capillary blood glucose measurements should be taken regularly after administration to identify this.
Salbutamol (albuterol), a β2-selective catecholamine, is administered by nebuliser (e.g. 10–20 mg). This medication also lowers blood levels of K+ by promoting its movement into cells, and will work within 30 minutes. It is recommended to use 20 mg for maximum potassium lowering effect, but to use lower doses if the patient is tachycardic or has ischaemic heart disease. Note that 12-40% of patients do not respond to salbutamol therapy for reasons unknown, especially if on beta-blockers, so it should not be used as monotherapy
Sodium bicarbonate may be used with the above measures if it is believed the person has metabolic acidosis, though time to effectiveness is longer and its use is controversial.
Elimination
Severe cases require hemodialysis, which are the most rapid methods of removing potassium from the body. These are typically used if the underlying cause cannot be corrected swiftly while temporising measures are instituted or there is no response to these measures.
Loop diuretics (furosemide, bumetanide, torasemide) and thiazide diuretics (e.g., chlortalidone, hydrochlorothiazide, or chlorothiazide) can increase kidney potassium excretion in people with intact kidney function.Potassium can bind to a number of agents in the gastrointestinal tract |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following is caused by congenital A-17 hydroxylase deficiency: and explain in detail? | 17 -hydroxylase (17 -OH) deficiency syndrome is a rare genetic disorder of steroid biosynthesis causing decreased production of glucocoicoids and sex steroids and increased synthesis of mineralocoicoid precursors. Reduced or absent levels of both gonadal and adrenal sex hormones result in sexual infantilism in 46, XX females and ambiguous genitalia in 46, XV males. Excessive mineralocoicoid activity produces varying degrees of hypeension Q and hypokalemia Q. Patients usually are diagnosed with this condition during an evaluation of delayed pubey. absent secondary sexual characteristics or primary amenorrhea. REF : OP-GHAI 9th 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 Lung disease seen in Coal & Rock miners? and explain in detail? | Ans. (a) AnthracosisRef: Harrison's 18th ed ch:255 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 about the valves of Houston is true? and explain in detail? | A i.e. They disappear after mobilization of rectum |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 nerve used for nerve conduction study in H reflex - and explain in detail? | The H-reflex (or Hoffmann&;s reflex) is a reflectory reaction of muscles after electrical stimulation of sensory fibers (Ia afferents stemming from muscle spindles) in their innervating nerves (for example, those located behind the knee- Tibial nerve). The H-reflex test is performed using an electric stimulator, which gives usually a square-wave current of sho duration and small amplitude (higher stimulations might involve alpha fibers, causing an F-wave, compromising the results), and an EMG set, to record the muscle response. REF : MAHESWARI 9TH ED |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is In the WHO recommended EPI Cluster sampling for assessing primary immunization coverage, the age group of children to be surveyed is:- and explain in detail? | Cluster random sampling: Used for immunization coverage evaluation Error rate for immunization coverage evaluation - +- 5% WHO recommended technique - 30 x 7 Total sample size - 210 Intercluster disparity - even the cluster are not comparable to each other; To remove intercluster disparity, we use DESIGN effect 30 clusters selected by systematic random sampling |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following statements is true about isotypic variation ? and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A 62-year-old man is admitted to the hospital with dull, diffuse abdominal pain. A CT scan reveals a tumor at the head of the pancreas. The abdominal pain is mediated by afferent fibers that travel initially with which of the following nerves? and explain in detail? | The afferent fibers mediating the pain from the head of the pancreas run initially with the greater thoracic splanchnic nerves. The greater splanchnic nerves arise from sympathetic ganglia at the levels of T5 to T9 and innervate structures of the foregut and thus the head of the pancreas. Running within these nerves are visceral afferent fibers that relay pain from foregut structures to the dorsal horn of the spinal cord. Also entering the dorsal horn are the somatic afferents from that vertebral level, which mediate pain from the body wall. Intercostal nerves T1 to T12 provide the terminal part of the pathway to the spinal cord of visceral afferents for pain from the thorax and much of the abdomen. Therefore, pain fibers from the pancreas pass by way of the splanchnic nerves to the sympathetic chains and then, by way of communicating rami, to ventral rami of intercostal nerves, finally entering the spinal cord by way of the dorsal roots. The phrenic nerve innervates the diaphragm and also carries visceral afferents from mediastinal pleura and the pericardium, but it does not carry with it any visceral afferent fibers from the pancreas. The vagus nerve innervates the pancreas with parasympathetic fibers and ascends all the way up to the medulla where it enters the brain. It has no visceral afferent fibers for pain. The subcostal nerve is from the level of T12 and innervates structures below the pancreas and carries no visceral afferents from the pancreas. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Pupil condition in opium poisoning: NEET 13 and explain in detail? | Ans. Miosis |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Middle cerebellar peduncle transmits fibres of - and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A child is presenting with watery stools, gram staining is showing comma shaped bacilli. The isolated organism will show which type of motility- and explain in detail? | Ans. is 'b' i.e., Darting * Water diarrhea by comma shaped bacilli is suggestive of V. cholerae infection.* V. cholerae shows darting motility. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is CRF with anemia best treatment - and explain in detail? | Ans. is 'b' i.e., Erythropoietin o Chronic kidney disease leads to normocyih normochronic anemiaThe kidney is the primary' site of erythropoietin production in the adult. Erythropoietin enhances the growth and differentiation of erythropoietin progenitors.With increasing renal dysfunction decreased level of erythropoietin are produced resulting in progressive anemia,o The primary therapeutic options for anemia of chronic kidney disease areo Red blood cell transfusionso Erythropoietin stimulating agentso Androgen (to a much lesser degree)o Erythropoietin administration is considered the mainstay of the treatment of anemia of chronic disease in renal failureThe administration of erythropoietin stimulating agent is particularly attractive because they have substantially reduced the need for red cell transfusion with an attendant decrease in and for risk for transfusion related complications.# The erythropoietin deficiency can be corrected by the exogenous administration of erythropoietin stimulating agentsTwo such agents available in the united statesEpoetin afla (recombinant human erythropoietin)Darbepoetin alfaEpoetin alfa (recombinant human erythropoietin E.P.O.)o Provides effective treatment for anemia in patients, when administered, once weekly Has become standard care.o However, one problem with epoeitin alfa is that the need for the weekly dose can place a considerable burden on both patients and healthcare staff.Darbepoetin alfao Another erythropoiesis stimulator i.e.darbepoeitin alfa can provide an alternative as it has three fold longer half life.o The dose of darbepoeitin can be scheduled once weekly or twice weekly or may be monthly.Peginasatideo It is a synthetic peptide that activates EPO receptor. Peginesatide stimulates erythroid colony growth, reticulocyte count and hematocriiRed blood cell transfusionso RBC transfusion are universally sussessful in raising hemoglobin levels.o Transfusions often can ameliorate the patient s symptoms and improve health related quality of life .o However they may be associated with significant complications that include transfusion transmitted infection, immunological sensif cation, iron overload syndromes volume overload! transfusion reactionsAndrogenso Prior to the availability of erythropoietin stimulating agents, androgens were used regularly in the treatment of anemia in dialyses patients. Androgens may increae endogenous erythorpoietin production sensitivity of erythroid progenitors and red blood cell sunivat. However the role of androgen was limited because of side effects which was virilisation, priapism, peliosis hepatic, liver function and risk of hepatocellular Ca |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Calcitonin is a marker of - and explain in detail? | Harshmohan textbook of pathology 7th edition. medulla carcinoma is a less frequent type derived from para follicular or C cells present in the thyroid. Like normal C cells tumor cells of medullary carcinoma secrete calcitonin the hypo calcimic hormone. So calcitonin is an impoant tumor marker of medullary carcinoma of thyroid. . |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Tyrosine enters gluconeogenesis by forming which substrate? and explain in detail? | GLUCONEOGENESIS 1. Definition - It is the process by which glucose molecules are produced from non-carbohydrate precursors. These include lactate, glucogenic amino acids (Alanine, glutamic acid, aspaic acid, etc), glycerol pa of fat and propionyl CoA derived from odd chain fatty acids. 2. Site - Gluconeogenesis occurs mainly in the liver, and to a lesser extent in the renal coex. The pathway is paly mitochondrial and paly cytoplasmic. 3. Key Gluconeogenic Enzymes Pyruvate carboxylase Phosphoenol pyruvate carboxy kinase Fructose-1-6-bisphosphatase Glucose-6-phosphatase . The amino acids like phenyl alanine, tyrosine, aspeate,aspargin (Glucogenic amino acids) 1st conve into Fumerate then enters into gluconeogenesis. Ref: DM VASUDEVAN TEXTBOOK OF BIOCHEMISTRY,EIGHTH EDITION,PG.NO.,135,136. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 H3 receptor agonist exhibits all of the following actions except and explain in detail? | H3 receptors act as presynaptic receptors and decrease the release of histamine and other neurotransmitters. this antagonize H1 mediated wakefulness and bronchoconstriction. these also decrease gastrin release and produced negative chronotropic effect inverse agonist and H3 receptor(tiprolisant) is proved for narcolepsy. Refer KDT 6/e p153 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 best method for routine monitoring of air pollution 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 Congenital anamolies are most severe in and explain in detail? | Ans. is 'a' Rubella infectionRubella causes numerous serious defects in the fetus, but nowhere is it specifically written that it causes most severe congenital deformities. Just have a look at the various defects caused by Rubella and you won't need any further confirmation for the answer.Various fetal defects caused d/t RubellaCardiac malformations* PDA (most common)* VSD, PS, (Coarctation of Aorta is not present)*Deafness*Cataract*Glaucoma*Retinopathy*Microcephaly*Cerebral palsy*1UGRHepatosplenomegalyMental & Motor retardationThese defects occuring singly or in combination are known as "Congenital Rubella Syndrome" |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is If there are 4 nucleotides instead of 3 in codon, how many amino acids may be formed? and explain in detail? | C i.e. 256 |