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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 The radiation tolerance of whole liver is: and explain in detail? | Maximal tolerance dose (TD50/5) of liver is 40 Gy. Ref: X. Allen Li (2011), Chapter 20, "Adaptive Radiation Therapy for Liver Cancer", In the Book, "Adaptive Radiation Therapy", USA, Page 317 ; Clinical Radiation Oncology By Gunderson and Tepper, Page 715 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 these may be considered for a classical caesarean section, EXCEPT? and explain in detail? | LEARNING TIP: ANY CONDITION WHERE APPROACH TO LOWER SEGMENT IS DIFFICULT, WE CAN GIVE AN INCISION IN THE UPPER SEGMENT, A CLASSICAL CAESAREAN SECTION When placenta is placed posteriorly there is no difficulty in approach to lower segment, hence an LSCS would be preferable here as it is associated with less incidence of scar morbidity in next pregnancy, compared to classical cesarean section Following are indications of classical caesarean section: Difficulty in safely entering the lower uterine segment because the bladder is densely adherent from previous surgery, a myoma occupies the lower uterine segment, or the cervix has been invaded by cancer. Transverse lie of a large fetus, especially if the membranes are ruptured and the shoulder is impacted in the bih canal Some cases of placenta pre with anterior implantation, especially in the case where the placenta has grown through a prior uterine incision (placenta percreta) |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Watery diarrhea in children is caused by ? and explain in detail? | Ans. is 'b' i.e., EPEC |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Best management in Mento-posterior presentation: and explain in detail? | Caesarean section |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Malleus and incus are derived from ? and explain in detail? | Ans. is 'a' i.e., 1st Arch |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is The adverse effect of clozapine - and explain in detail? | Side effects of clozapine
Agranulocytosis
Urinary incontinence
Unstable BP & Tachycardia
Hypersalivation (sialorrhoea)
Worsening of diabetes
Weight gain
Seizures
Sedation |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is On mammogram all of the following are the features of a malignant tumor except: and explain in detail? | Benign Malignant Opacity Smooth margin Low density Homogeneous Thin halo Ill definedQ margin Irregular stellate, spiculatedQ margin, comet tailQ High densityQ Heterogeneous Wide haloQ Calcification MacrocalcificationQ (>0.5 mm in diameter) MicrocalcificationQ (<0.5 mm in diameter) |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Pyometra is a complication associated with all of the following conditions except : and explain in detail? | Ans. is a i.e. Carcinoma vulva |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Psychosurgery is indicated in- and explain in detail? | Ans. is 'd'i.e., OCDo Phototherapy is primarily indicated in the treatment of seasonal depressions.o In addition to seasonal depression, the other major indication for phototherapy may be in sleep disorders.BIOLOGICAL THERAPYBiological therapy is a treatment designed to change the biological functioning of the body in order to produce more adaptive behaviour and less suffering. In the treatment of mental disorders, biological therapies are designed to change the functioning of brain.Biological therapies include :-Drugs (Pharmocotherapy) :-Will be discussed in another chapter.Phototherapy :-Seasonal affective disorder, sleep disorders, jet lag, OCD with seasonal variation.Transcranial magnetic stimulation :-OCD, PTSD, Resistant major depression,iv) Yragal stimulation :-Chronic recurrent major depression.Sleep deprivation :-Depression.Psychosurgery :-Cingulotomy and subcaudatetractotomy for OCD. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Eukaryotic mRNA attaches to ribosome during translation due to: and explain in detail? | Ans. (C) 7-methylguanosine cap(Ref: Harpers Illustrated Biochemistry 31st Ed; Page No- 396)Eukaryotic mRNA has 7-methylguanosine cap at 5' end and poly-A tails at 3' end. The 7-methylguanosine caps help the ribosome to recognize the site of attachment to the mRNA.Once the ribosome binds the 5' end, they then scan downstream until they encounter an AUG Codon (Start codon)AAUAAA is present at the 3' end, is the polyadenylation sequence (Poly A tail); they help stabilize the mRNA, facilitate its exit from the nucleus and aid in translation. After the mRNA enters the cytosol, the poly-A tails is gradually shortened.tRNA molecule serve as adaptors for the translation of the information in the sequence of nucleotides of the mRNA into specific amino acids.Extra EdgeDifferences between Eukaryotes and Prokaryotes in the Initiation of Protein Synthesis EukaryotesProkaryotesInitiation factorseIFs (12 or more)IFs (3)Ribosomes80S (40S and 60S subunits)70S (30S and 50S subunits)Binding of mRNA to small ribosomal subunitCap at 5'-end of mRNA binds elFs and 40S ribosomal subunit containing methionyl tRNAiMet. mRNA is scanned for AUG start codon within the Kozak consensus sequenceShine-Dalgarno sequence upstream of initiating AUG binds to complementary sequence in 16S rRNAFirst amino acidMethionineFormyl-methionine |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Chronic hemodialysis in ESRD patient is done and explain in detail? | Ans. (c) Thrice per weekRef : Harrison 19th ed. /1823For the majority of patients with ESRD, between 9 and 12 h of dialysis are required each week, usually divided into three equal sessions.Current Targets of Hemodialysis* Urea reduction ratio (the fractional reduction in blood urea nitrogen per hemodialysis session) of >65-70%.* Body water-indexed clearance x time product (KT/V) above 1.2 or 1.05.REMEMBERHypotension is the most common acute complication of hemodialysis. Since the introduction of bicarbonate- containing dialysate, dialysis-associated hypotension has become less common. The management of hypotension during dialysis consists of discontinuing ultrafiltration, the administration of 100-250 mL of isotonic saline or 10 mL of 23% saturated hypertonic saline, or administration of salt-poor albumin. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 tumors is not derived from meninges - and explain in detail? | Meningeal tumors
Meningothelial tumor : Meningioma (most common meningeal tumor).
Mesenchymal non-meningothelial tumors : Meningeal solitary fibrous tumor, hemangiopericytoma, meningeal sarcoma, fibrous histiocytoma, meningeal melanocytoma, (melanocytic tumor) |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 diseases is not covered under WHO International Health regulation: September 2010 and explain in detail? | Ans.D i.e. None of the option |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 among the following is best method to assess intake of fluid in Polytrauma pt: and explain in detail? | Ans. is 'a' ie urine output Lets see each option one by oneUrine output "Urine output is a quantitative and relatively reliable indicator of organ perfusion. Adequate urine output is 0.5 ml/kg/ h in an adult, lml/kg/h in a child and 2ml/kg/h in an infant less than lyr. of age."Pulse - "Although tachycardia may be the earliest sign of hypovolemia, individuals in good physical condition, particularly trained athletes with a low resting pulse rate, may manifest only a relative tachycardia, pts on blocking medication may not be able to increase their heart rate. In children, bradycardia or relative bradycardia can occur with severe blood loss. Conversely, hypoxia, pain, apprehension and stimulant drugs produce a tachycardia"B.P. -Hypotension is not a reliable early sign of hypovolemia, in healthy pts.Blood volume must decrease by 30 to 40 percent before hypotension occurs.Younger pts with good sympathetic tone can maintain systemic blood pressure with severe intravascular deficit until they are on the verge of cardiac arrest.CVP-CVP measurement helps in distinguishing b/w cardiogenic shock and hypovolemic shock."A central venous catheter can give information about the relationship b/w intravascular volume and right ventricular function but should not be used to assess either factor independently." - Schwartz pretest based on 7/e, Q no 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 Test for reversible cardiac ischemia aEUR' and explain in detail? | Thallium scan Thallium scanning Principle Thallium is a monovalent cation which acts as potassium analogue. It is taken up by ble cells - not dead ones. It is distributed to all pas of the body, largely in propoion to the regional blood flow. The concentration of thallium in the myocardium is propoional to the coronary blood flow over a wide range of flows. Once inside the myocardial cell, the thallium does not stay there. There is constant and continuous thallium exchange. Over a period of time thallium washes out of the normal cells and some thallium is extracted by the hypoperfusedareas. This unique propey is taken advantage of clinically during thallium stress testing and is the basis for the redistribution or late 4 hour image. Clinical application : Exercise is the most. frequently used form of stress in the testing of cardiac .function. During exercise myocardial blood flow normally increases by upto 3-4 folds to supply the increase in 0, demand. If coronary flow is limited by a stenosis there will be less thallium extracted .from the blood by the myocardium in the territoy of that aery compared with the normal, surrounding myocardium. This will cause a perfusion defect. Over 2-4 hours, this perfusion defect will redistribute or fill in as thallium washes out of the normally perfused cells and some more thallium is extracted by the hypoperfused myocardial cells Hence in ischemia the thallium perfusion defect disappears with time and is called a reversible defect. By contrast, areas of scar tissue or infarction do not change with time and appear as fixed defects. Clinical utility - interpretation No ischemia : In a patient without significant CAD, there will be uniform distribution of thallium in all myocardial segment's in the immediate post stress and 4 hour redistribution image. if the thallium scan is normal there is usually a very low probability, of angiographically significant CAD. Ischemia present : In a patient with significant CAD, (a stenosis of at least 70%), myocardial thallium uptake will be reduced causing a perfusion defect in the distribution of the stenosed vessel in the immediate poststress image. After 4 hours, the perfusion defect will 'fill in' or redistribute giving a unifonn thallium distribution, throughout the myocardium,, on reimagingo. Some perfusion defects only paially redistribute or do not "fill in' at all by 4 hours. These patient are now re-injected with a smaller dose of thallium and reimaged after 30 minutes or alternatively reimaged at 24 hours without reinjection. Following reinjection and /or delayed imaging patients with severe ischemia usually demonstrate ,full or paial redistribution. Fixed defects which do not show redistribution are interpreted as scar tissue from myocardial infarction or nonble myocardium, which would at not benefit from revascularisatioe Viability The question of whether myocardium is ble can also be addressed, using rest and redistribution imaging. Following thallium injection, coronary blood flow at rest is assessed immediately and again at 4 hour. In a patient with a critical stenosis there will be very low flow at rest, producing a perfusion defect of varying severity. If there is ble myocardium present, the defect will resdistribute over 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 In the fasting state, which one of the following is utilized by the liver for gluconeogenesis? and explain in detail? | Carbons from lactate, propionate (from odd-chain fatty acids and certain amino acids), glycerol (from fat stores), and amino acids (from muscle) can be used for gluconeogenesis. Fatty acids and ketone bodies are directly utilized for energy and are not used for gluconeogenesis. The end product of even-chain fatty acid oxidation is acetylCoA, which cannot be used as a precursor for net glucose production. Liver glycogen produces glucose through glycogenolysis. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Dental cuticle refers to and explain in detail? | Reduced enamel epithelium is formed from the outer enamel epithelium and stellate reticulum after the completion of enamel formation.
Coronal cementum is the acellular afibrillar cementum (AAC), which is a mineralized ground substance containing no cells and is devoid of extrinsic and intrinsic collagen fibers. It is formed due to the premature toss of the reduced enamel epithelium protecting the newly formed enamel at the cervical region.
The ameloblasts are replaced by the oral epithelial cells during the tooth eruption. These cells form the secondary enamel cuticle which extends over the cementum called cemental cuticle. Secondary enamel cuticle and cemental cuticle are together referred as dental cuticle. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 rickshaw tyre passed on a 8 years old children. Marking of tyre was found on body. It is an example of – and explain in detail? | the synopsis for forensic medicine & toxicology |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Sister Mary Joseph nodule is most commonly seen in which of the following malignancies? and explain in detail? | Sites for spread of gastric cancer most commonly involve the following: Supraclavicular sentinel lymph node Virchow node Periumbilical lymph nodes Sister Mary Joseph nodule Left axillary lymph node Irish node The pouch of Douglas Blumer shelf Ovary Krukenberg tumor |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Inner mitochondrial membrane contains protein to lipid ratio as and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Allergic condition which leads to gingival enlargement , this type of gingivitis is known as: 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 Endemic ascites is caused by – and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following about phenytoin is true ? and explain in detail? | Ans. is 'a' i.e., It follows zero order kinetics Phenytoin is metabolized in liver by hydroxylation and glucuranide conjugation (option 'c' is incorrect) o This drug follows saturation kinetics (kinetics changes from first order to zero order within therapeutic concentrations) Phenytoin is an enzyme inducer and induces the metabolism of many drugs. Phenytoin is a known teratogenic and produces fetal hydantoin 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 A point that falls on horopter excites: and explain in detail? | Ans. Corresponding retinal points |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 formed by spray atomization and chemical precipitation of molten gold? and explain in detail? | |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which number blade is useful for Crevicular incision : and explain in detail? | Crevicular incision is also known as Second incision for which 12 number blade is used. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 cartilage shown in the colour plate: and explain in detail? | There are three types of cartilage:
Hyaline—most common; matrix contains a moderate amount of collagen fibers (e.g., articular surfaces of bones)
Elastic—matrix contains collagen fibers along with a large number of elastic fibers (e.g., external ear)
Fibrocartilage—matrix contains a limited number of cells and ground substance amidst a substantial amount of collagen fibers (e.g., intervertebral discs). |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Change in incidence of an infective disease is best judged in relation to incidence in the past as reflected in monthly incidence records; Mild incidence will be considered if: and explain in detail? | 1-3 new cases/100,000/week occur The following terms are used to express various grades of incidence and prevalence of communicable diseases in a community. 1. Mild incidence: When less than 3 new cases per week are repoed in 100,000 population. 2. Considerable incidence: When 3 to 5 new cases/ 100,000/week occur. 3. Heavy incidence: When 5 to 10 new cases/100,000/ week are repoed. 4. Epidemic: When the number rises to ten or more 100,000/week. 5. Outbreak: When there is sudden repoing of a large number of new cases, the population having been absolutely free earlier. Food poisoning and cholera often breakout suddenly. 6. Endemic: When the infectious agent has taken a foothold in a population which is naturally and, paially protected because of occurrence of the disease over a period. Examples are typhoid, diphtheria and infective hepatitis. When the incidence rises due to changes in the agent, host or environment factors, it becomes an epidemic. 7. Sporadic: When only isolated cases are repoed here and there, now and then. This may happen in case of meningitis and poliomyelitis. 8. Pandemic: When an epidemic appears simultaneously or successively in more than one country, e.g., the swine Flu pandemic 2009. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Latest treatment in BPPV is: and explain in detail? | Epley's manoeuvre or the repositioning manoeuvre involves repositioning the debris from posterior semicircular canal back into the utricle by placing the patient's head in a sequence of five positions. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is COX 2 inhibits the following step in inflammation: and explain in detail? | COX-1, expressed constitutively in most cells, is the dominant source of prostanoids for housekeeping functions, such as gastric epithelial cytoprotection and hemostasis. Conversely, COX-2, induced by cytokines, shear stress, and tumor promoters, is the more impoant source of prostanoid formation in inflammation. COX-2 is found in endothelial cells and inflammatory cells. In endothelial cells, COX-2 initiates the synthesis of prostacyclin, a potent vasodilator and inhibitor of platelet aggregation. Ref: Weitz J.I. (2012). Chapter 118. Antiplatelet, Anticoagulant, and Fibrinolytic Drugs. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 considered a contraindication for functional appliance treatment? 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 True statements about congenital megacolon include all of the following except: and explain in detail? | S. Das writes - "The symptoms appear within 3 days of birth and the presenting features are as follows:
Constipation
Abdominal distention"
Nelson writes - "The clinical symptoms of Hirschprung disease usually begin at birth with the delayed passage of meconium."
Loud borborygmi are heard due to intestinal obstruction.
About stool, Nelson writes -
"The stools when passed may consist of small pellets, maybe ribbon-like or may have fluid consistency; the large stools and faecal soiling of patients with functional constipation are absent."
Also, know
a large faecal mass may be palpable in the left lower abdomen, but on rectal examination, the rectum is usually empty of faeces (faeces in rectum are found in functional constipation). |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Coefficient of thermal expansion of amalgam 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 Pain-sensitive intracranial structure is and explain in detail? | Intracranial structures sensitive to pain are scalp, anponeurotica, duramater around venous sinuses & vessels, falx & tentorium cerebri, cranial venous sinuses, some arteries. Intracranial structures insensitive to pain are brain parenchyma, ventricular ependyma, duramater over convexity of skull, piameter, pial veins, arachnoidmater and choroids plexus. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is An asymptomatic patient on regular health checkup has platelet counts of 8,00,000. Next line of management is: and explain in detail? | A i.e. Follow-up and observeRef: Harrison's Principles of Internal Medicine, 19th edition, page 678Explanation:An elevated platelet count in an asymptomatic patient without cardiovascular risk factors requires no therapy.When the platelet count rises above 1 x 106/pL, a substantial quantity of high-molecular-weight von Willebrand multimers are removed from the circulation and destroyed by the enlarged platelet mass, resulting in an acquired form of von Willebrand's disease.THROMBOCYTOSISThrombocytosis, also called thrombocythemia, is generally defined as a platelet count greater than a defined upper limit of normal that may vary between 350,000/pl to 600,000/pl, depending on the laboratory or medical reference. The most common cut off for normal is <450,000/pl.Elevated platelet counts are often an incidental or unexpected finding on a complete blood count (CBC) conducted to evaluate an unrelated condition.For those individuals found to have thrombocytosis without associated bleeding or thrombosis, the first challenge is to find the cause.The causes of thrombocytosis are separated into two categories:Autonomous (primary) thrombocytosisOccurs as a result of myeloproliferative disorders, myelodysplastic disorders, or rarely as a result of a hereditary condition.Reactive (secondary) thrombocytosis is:Most often a normal physiologic response to coexistent inflammatory condition (e.g., infection, chronic inflammatory condition).Management of essential thrombocytosis by risk factorsRisk categoryRisk factorsManagementLowAge <60 and no prior cardiovascular eventNil. Follow-up and observeIntermediateGeneric cardiovascular risk factorsLow dose aspirin (no consensus)HighAge >60 and/or prior cardiovascular eventsMyelosuppression + Low dose aspirin |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Value of Pa02/ Fi02 chracteristic of ARDS is and explain in detail? | Answer- A. < 200 mmHgAcute respiratory distress syndrome (ARDS) is a clinical symdrome of severe dyspnea of rapid onset, hypoxemia, and diffirse pulmonary infiltrates leading to respiratory failure.The aerial PaO, (in mmHg)/FiO, (inspiratory O, fraction) <200 mmHg is characteristic of ARDS, while a PaO, /FiO, between 200 and 300 identifies patients with ALI who are likely to benefit from aggressive therapy. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following physical signs is seen in a patient with severe aoic stenosis: and explain in detail? | Answer is D (Delayed peak of systolic murmur) The ejection systolic murmur stas after the ejection click reaches a peak in midsystole. With increasing severity of aoic stenosis the peak gets delayed so that the maximum intensity of the murmur is closer to the end rather than being midsystolic. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 primates; a tooth with single conical cusp and
single root is seen in: and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is The walls of the orbit which are removed in the two wall decompression for proptosis of thyroid ophthalmopathy include pa of: and explain in detail? | Ans. Orbital floor and medial wall |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Dissociative anesthetic agent? and explain in detail? | Ans. b (Ketamine) (Ref: KD Tripathi, Pharmacology 6th, ed., 376; 344)Ketamine and tiletamine are the two dissociative anesthetics currently available.Ketamine is pharmacologically related to the hallucinogen phencyclidine; induces a so called 'dissociative anaesthesia' characterized by profound analgesia, immobility, amnesia with endoscopic, light sleep and feeling of dissociation from ones own body and the surroundings. The primary site of action is in the cortex and subcortical areas; not in the reticular activating system (unlike barbiturates). Respiration is not depressed, airway reflexes are maintained.KETAMINE (dissociative anaesthesia)# Phencyclidine (PCP) derivative.2# Primary site of action is thalamoneocortical projection.# Fast onset.# Dose-related unconsciousness and dissociative state analgesia.# Strong analgesic.2# Not as amnestic as benzodiazepines.# No suppression of the CVS and RS.# May cause hallucinations and disturbing dreams, especially in adults and is its most common side-effect.# Intracranial tension is highly increased. 0# Potent bronchodilator.0# Dilates pupils and triggers nystagmus.# Increased salivation.# Increased muscle tone and purposeless movements of the extremities# Increased cerebral blood flow and intracranial pressure.# Dose:- IV: 2 mg/kg- IM:5-10 mg/kg0# Induction of choice for:- Asthmatics- Shock- Children (by intramuscular route) as an alternative to inhalational induction (inhalational is the method of choice for induction in children).- Constrictive pericarditis, cardiac tamponade, and right-to-left shunts.- Can be used as a sole agent for minor procedures (like I and D), burn dressings.- Preferred agent for patients with full stomach (pharyngeal and laryngeal reflexes are preserved).- Poor risk patients (ASA IV) (because of safety).- Depressed patients (they have better recovery after ketamine).PROPOFOL# Propofol preparation is derived from egg- extract.# It can induce nausea & vomiting# PROPOFOL should not be used as induction agent in the following situations:- Allergies: Patients with a history of previous allergic reaction to propofol or allergies to soybeans and eggs.- Pregnancy.- Hypercholesterolemia.- Muscle relaxants: There have been reports of severe bronchospasm in patients receiving atracurium after propofol. It is best to administer nonhistamine-releasing muscle relaxants.- Cardiovascular-challenged patients: Patients who are hypovolemic (i.e., trauma, dialysis) or who have cardiovascular disease may not tolerate the decrease in MAP and myocardial depression associated with propofol.# It is not contraindicated in porphyria. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 aspirin poisoning most impoant step is ? and explain in detail? | Ans. is 'a' i.e., Fluids o Treatment of aspirin poisoning is symptomatic and suppoive. o Most impoant is external cooling and i.v. fluid with Na+-, HCO3- and glucose : according to need determined by repeated monitoring. o Gastric lavage to remove unabsorbed drug; alkaline diuresis or haemodialysis to remove absorbed drug is indicated in severe cases. o Blood transfusion and Vitamin K should be given if bleeding occurs. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is In a foetus, thyroxine secretion begins by? and explain in detail? | Thyroxine secretion begins by 10th to 12th weeks. Glucagon secretion begins by 8th week. Insulin containing granules can be identified in the human foetal pancreas by 9 to 10 weeks. and insulin in foetal plasma is detectable at 12 weeks. Ref: Williams Obstetrics, 22/e, Page 108 ; Dutta Obstetrics 6/e, Page 43 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 are the findings in U/S, which suggests incompetent os : and explain in detail? | Ans. is a, b and c i.e. Cervical length; Internal os; and Funneling of amniotic sac Cervical incompetence : Cervical incompetence is characterised by painlessdeg cervical dilatation in the seconddeg or early third trimesterdeg with ballooning of the amniotic sac into the vaginadeg, followed by rupture of membranes and expulsion of a usually live fetus. It usually occurs in 16 - 24 weeks. Diagnosis : History : The typical history of painless rupture of membranesdeg followed by the quick delivery of a live fetus in midtrimester is very suggestive.deg Non pregnant state : Internal os allows the passage of a No. 8 Heger's cervical dilator or Foley's catheter filled with 1 ml water without resistance.deg Premenstrual Hysterocervicography will show the typical funneling of the internal osdeg. In Pregnancy : - Transvaginal ultrasound is the ideal method to detect early incompetence. - The normal cervical length at 14 weeks is 35 - 40 mm and the internal os diameter is less than 20 mm. A cervical length less than 30 mm and an internal os diameter more than 20 mm is suggestive of cervical incompetence. - Other findings on ultrasound are funneling of the os.deg Serial scans may be necessary. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Remote after loading technique useful for and explain in detail? | Ans. Teletherapy |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 aminoglycoside with least toxic effect 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 Best prognosis in liver transplantation is observed, if indication for transplant was? and explain in detail? | Acute liver injury may present with non-specific symptoms of fatigue and abnormal LFTs, or with jaundice and acute liver failure. * Chronic liver injury is defined as hepatic injury, inflammation and/or fibrosis occurring in the liver for more than 6 months. In the early stages, patients can be asymptomatic with fluctuating abnormal LFTs. With more severe liver damage, however, the presentation can be with jaundice, poal hypeension or other signs of cirrhosis and hepatic decompensation . Patients with clinically silent chronic liver disease frequently present when abnormalities in liver function are observed on routine blood testing, or when clinical events, such as an intercurrent infection or surgical intervention, cause the liver to decompensate. Patients with compensated cirrhosis can undergo most forms of surgery without significantly increased risk, whereas decompensation can be a complication in all cases and the presence of poal hypeension with intra-abdominal varices can make abdominal surgery more hazardous. The possibility of undiagnosed liver disease should be borne in mind in all patients in at-risk groups undergoing significant surgery. Ref Davidson edition23rd pg856 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 Sphenopalatine foramen is formed by all of the following structures, EXCEPT? and explain in detail? | Sphenopalatine foramen is formed by the junction of the sphenopalatine incisure of the palatine bone with the sphenoid bone, located immediately posterior to the middle turbinate. This is the principal foramen through which branches of the sphenopalatine aery and maxillary nerve pass from the pterygopalatine fossa into the nasal cavity. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 following head injury was admitted in intensive care ward with signs of raised intracranial pressure. He was put on ventilator and ataed on intravenous fluids and diuretics. Twenty four hours later his urine output was 3.5 litres, serum sodium 156 mEq/l and urine osmolality of 316 mOsm/kg. The most likely diagnosis based on these parameters is and explain in detail? | Answer is A (High output due to diuretics): Presence of high urine osmolality >300 (316 mosmol/Kg) along with increased serum Na suggest a diagnosis of solute diuresis. The patient inquestion has sustained head injury and mannitol is often used insuch cases to reduce the intracranial pressure. Solute diuresis secondary to use of mannitol (diuretic) explains the parameters of the patient in question. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is First polar body is formed after ? and explain in detail? | Ans. is 'b' i.e., First meiosis Oogenesis Oogenesis refers to the process of formation of ova from the primitive germ cells. Unlike fetal testis (in which spermatogenesis beings at pubey), the fetal ovary begins oogenesis by 10 weeks of gestation. o The sequence of events in oogenesis are : i) The primitive germ cells undergo mitotic divisions to form oogonia (diploid Oogonium is unique in that it is the only female cell in which both 'X' chromosomes are active. ii) The oogonia proliferate by mitosis to form primary oocytes (diploid cells). iii) Primary oocytes formed from the oogonia enter a prolonged prophase (diplotene stage) of the first meiotic division and remain in this stage until ovulation occurs after pubey. iv) Primary oocytes completes the first meiotic division at pubey just before ovulation to form secondary oocyte (haploid cell) and 1st polor body. v) Secondary oocyte immediately begins second meiotic division but this division stops at metaphase and is completed only if the mature ovum (ootid) is feilized with sperm. At that time second polor body (polocyte) is extruded and the feilized ovum proceeds to form a new individual. Feilization normally occurs in the ampulla of fallopian tube. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 prayer Willi syndrome, which of the following is increased and explain in detail? | Ghrelin is a growth hormone secreatagogue and the only gut harmone with orexigenic propey It is primarily produced in the stomach. In children ,it's value is inversely related with body mass index and insulin values. robbins 8/e 441-2 9/e 444 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 metastasis in skeleton ? and explain in detail? | Ans. is 'c' i.e., Veebrae Metastasis Metastatic bone disease is the commonest malignancy of bones and is much more common than primary bone tumors. The commonest sites for bone metastases are veebrae (most common), pelvis, the proximal half of the femur and the humerus. Extremities distal to elbow and knee are least commonly involved sites. Spread is usually the blood stream; occasionally, visceral tumors spread directly into adjacent bones e.g., the pelvis and ribs. Ceain tumors are known to be common sources of bone metastasis. The following primary tumors are the most common to metastasize in the bone; breast, prostate, lung, thyroid, kidney, and gastrointestinal tract. The commonest source of metastatic bone disease is carcinoma of the breast. In males most common source is prostate carcinoma. Bladder and uterine carcinomas are less common sources. In children, skeletal metastases originate from neuroblastoma, Ewing's sarcoma, and osteosarcoma. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 was diagnosed with cystic fibrosis and was prescribed an inhaled agent to dissolve mucus plugging the airways. This agent is also used as an antidote to reverse the toxicity of wof drugs? and explain in detail? | Acute paracetamol poisoning :- occurs especially in small children who have low hepatic glucoronide conjugating ability and also with over dosage. Clinical Manifestations:- nausea, vomi ting, abdominal pain and liver tenderness with no impairment of consciousness. After 12-18 hours centrilobular hepatic necrosis occurs which may be accompanied by renal tubular necrosis and hypoglycaemia that may progress to coma.Jaundice stas after 2 days. Fuher course depends on the dose taken. Fulminating hepatic failure and death are likely if the plasma levels are above the line joining 200 ug/ml at 4 hours and 30 ug/ml at 15 hours. If the levels are lower recovery with suppoive treatment is the rule. Mech of toxicity:- N acetyl- p-benzoquinoneimine (NAPQI) is a minor metabolite of paracetamol which is detoxified by conjugation with glutathione. When a very large dose of paracetamol is taken, glucuronidation capacity is saturated, more of the minor metabolite is formed--hepatic glutathione is depleted and this metabolite binds covalently to proteins in liver cells (and renal tubules) causing necrosis. In chronic alcoholics even 5-6 g taken in one day can result in hepatotoxicity because alcoholism induces CYP2E1 that metabolises paracetamol to NAPQI. Paracetamol is not recommended in premature infants (< 2 kg) for fear of hepatotoxicity. Treatment:- If the patient is brought early, vomiting should be induced or gastric lavage done. Activated charcoal is given orally or through the tube to prevent fuher absorption. specific antidote:- N-acetylcysteine(MUCOMIX, ANTIFEN) infused over i.v for 15 mins..Acetylcysteine It opens disulfide bonds in mucoproteins present in sputum--makes it less viscid, but has to be administered directly into the respiratory tract.(used in cystic fibrosis) mech of action of antidote:-It replenishes glutathione stores of liver and prevents binding of the toxic metabolite to other cellular constituents. Ref:- kd tripathi; pg num:- 206,207,219 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is All of the following side effects are produced by Cisplatin except and explain in detail? | Cisplatin can cause ototoxicity, nephrotoxicity, coasting effect (peripheral neuropathy) and severe nausea and vomiting.
Pulmonary fibrosis is seen with Bleomycin and Busulfan. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Conscious sedation is - and explain in detail? | Ans. is 'c' i.e., Sedation with ability to respond to command o Conscious sedation is a technique in which drugs are used to produce a state of CNS depression (but not unconsciousness), enabling surgical procedure to be carried out while maintaining communication with the patient who is able to respond purposefully to commands and maintain a patent airway throughout.o The protective airway reflexes are not lost, therefore conscious sedation is safer.o However, by itself, it is not able to suppress pain of dental procedures; local anaesthetic must be injected in addition,o Drugs used for conscious sedation are -n2ODiazepam or midazolamPropofol1M promethazineIVfentanyl |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is All of the following are true about carcinoid crisis, EXCEPT: and explain in detail? | One of the most immediate life-threatening complications of the carcinoid syndrome is the development of a carcinoid crisis. This is more common in patients who have intense symptoms or have greatly increased urinary 5-HIAA levels (i.e., >200 mg/d). The crises may occur spontaneously or be provoked by stress, anesthesia, chemotherapy, or a biopsy. Patients develop intense flushing, diarrhea, abdominal pain, cardiac abnormalities including tachycardia, hypeension, or hypotension. If not adequately treated, this can lead to death. Ref: Endocrine Tumors of the Gastrointestinal Tract and Pancreas. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Most common cause of secondary postpaum hemorrhage:- and explain in detail? | Most common cause of secondary postpaum hemorrhage is retained tissues Secondary postpaum hemorrhage is bleeding 24 hours to 12 weeks after delivery. Causes of PPH(10 and 20) : Uterine atonicity Injury to any pa of genital tract Coagulopathy (von Willebrand's disease) Retained tissues - MCC of 20PPH |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which is NOT true about femoral aery cannulation? and explain in detail? | Single wall puncture is indicated in those with normal coagulation profile Single wall puncture is indicated in those with coagulopathy as there is more risk of bleeding in double wall puncture technique. Aerial access is obtained for hemodynamic monitoring (blood pressure monitoring, blood gases monitoring) in an intensive care unit, or for the purpose of aeriography and intervention as in vascular surgical patients. The femoral aery is one of the most frequently cannulated aeries in the body. It is commonly used for aerial access for the purpose of aeriography in the vascular surgical patient. It is a large-caliber vessel that is appropriate for using the larger-profile devices for angioplasty and stenting of the peripheral vessels. It is also commonly used in cardiac catheterization for the purpose of coronary angiography and for coronary interventions. The radial aery is the most frequently used site of aerial cannulation for hemodynamic monitoring because it is technically easy to cannulate and has a low complication rate, in pa due to the good collateral circulation of the hand. The femoral aery is the second most cannulated aery for haemodynamic monitoring. It provides a more accurate estimation of central (aoic) pressure than the radial aery. Its large-caliber is appropriate for using the larger-profile devices for angioplasty and stenting of the peripheral vessels. Femoral aery catheter complications are infrequent but are more complicated than that of the radial aery. For femoral aerial access, the puncture is made in the common femoral aery. A puncture site above the inguinal ligament, in the external iliac aery, or distally in the superficial femoral or profunda femoris aery is problematic. Disadvantage of external iliac aery: - The external iliac aery is located in the retroperitoneal space, making this aery difficult, to compress and achieve postprocedure hemostasis. (a puncture in this region can result in potentially catastrophic complication of retroperitoneal hemorrhage.) Disadvantage with superficial femoral or external iliac aery: - these aeries are substantially smaller in caliber and have a higher incidence of postprocedure thrombosis. - higer incidence of pseudoaneurysm - Additionally, the superficial .femoral aery is often heavily diseased. Localization of Common femoral aery (CFA): The CFA begins immediately behind the inguinal ligament, midway between the anterior superior spine of the ilium and the symphysis pubis. (A line connecting these two bony structures represents the inguinal ligament) Just below the inguinal ligament (one to two fingerbreadths distal to the inguinal ligament) the aery is closest to the surface of the skin and easily accessible. This is the optimal location of cannulation. The femoral aery is identified in the inguinal region by its pulsation. If fluoroscopy is being used, the femoral aery is typically located over the medial third of the femoral head. Note that the groin crease is unreliable in locating the ideal site of puncture and should not be used as a landmark. Femoral aery cannulation can be done using the Seldinger technique. The Seldinger technique is a medical procedure to obtain safe access to blood vessels (both aeries and veins) and other hollow organs. There are two methods of aerial wall puncture: the double-wall puncture and the single-wall puncture. The double-wall puncture involves penetrating both the anterior and posterior walls with the needle and then withdrawing the needle slowly until pulsatile blood flow is confirmed. This method is associated with a higher incidence of complications but is relatively easier. In the single-wall puncture technique, only the anterior wall of the aery is punctured with the needle, which is confirmed by pulsatile blood flow through the needle. Single wall puncture is usually the recommended technique. These two techniques can be used interchangeably and depends on the operator's preference, however-Single wall puncture is indicated in patients with coagulopathy or if thrombolysis is planned because of the increased risk of bleeding in double wall technique. Complications of femoral aery cannulation: - haemorrhage - Aeriovenous.fistulae - aerial dissection - pseudoaneurysm - aerial thrombosis |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Fuel utilized by brain in starvation - and explain in detail? | Ans. is 'a' i.e., Ketone bodies o There is no stored fuel in brain, but it utilized 60% of total energy under resting conditions.o Glucose is virtually the sole fuel for the brain, except in prolonged starving when ketone bodies are the major source.o Fatty acids do not serve as fuel for the brain, because they are bound to albumin in plasma; hence cannot cross blood-brain barrier.ORGANFEDFASTINGSTARVATIONBrainGlucoseGlucoseKetone bodiesHeartFatty acidsFatty acidsKetone bodiesLiverGlucoseFatty acidsAmino acidsMusclesGlucoseFatty acidsFatty acids & ketone bodiesAdipose tissueGlucoseFatty acidsFatty acids & ketone bodiesRBCsGlucoseGlucose |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Drug of choice for anaphylactic shock ? and explain in detail? | Ans. is 'a' i.e., Adrenaline o First adrenaline should be given im to raise the blood pressure and to dilate the bronchi. o If the treatment is delayed and shock has developed, adrenaline should be given i.v. by slow injection. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Bull's eye lesion in the macula is seen with : a) Chloroquine b) Hydroxychloroquine c) Quinine d) Sulfamethoxazole e) Primaquine 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 TheLab investigation of a patient shows excess T4 and decreased TSH. Which of the following is the most likely diagnosis- and explain in detail? | In Graves' disease, your thyroid-stimulating hormone (TSH) level will probably be very low because the pituitary gland will try to compensate for the excess T3 and T4 hormones in the blood. It'll stop producing TSH in an attempt to stop production of the thyroid hormones. Ref - pubmed.com |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Spectroscopy is used for interaction of - 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 Sister and explain in detail? | A sister is a woman or a girl who shares one or more parents with another individual; a female sibling. The male counterpart is a brother. Although the term typically refers to a familial relationship, it is sometimes used endearingly to refer to non-familial relationships. A full sister is a first degree relative.
Overview
The English word sister comes from Old Norse systir which itself derives from Proto-Germanic *swestēr, both of which have the same meaning, i.e. sister. Some studies have found that sisters display more traits indicating jealousy around their siblings than their male counterparts, brothers. In some cultures, sisters are afforded a role of being under the protection by male siblings, especially older brothers from issues ranging from bullies or sexual advances by womanizers. In some quarters the term sister has gradually broadened its colloquial meaning to include individuals stipulating kinship. In response, in order to avoid equivocation, some publishers prefer the usage of female sibling over sister. Males with a twin sister sometimes view her as their female alter ego, or what they would have been like, if they had two X chromosomes. A study in Perth Australia found that girls having only youngers brothers resulted in a chastity effect, losing their virginity on average more than a year later than average |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is All are true about adenoids except - and explain in detail? | Crypta magna is seen in palatine tonsils.
Adenoids (nasopharyngeal tonsil)
Adenoid is a subepithelial collection of lymphoid tissue at the junction of roof and posterior wall of the nasopharynx.
Unlike tonsils, adenoids have no crypts and no capsule.
Adenoid tissue is present at birth, shows physiological enlargement up to the age of six years and then tends to atrophy at puberty and almost completely disappears by the age of 20.
Adenoids receive their blood supply from :
Ascending palatine branch of facial.
Ascending pharyngeal branch of external carotid.
Pharyngeal branch of the third part of the maxillary artery.
Ascending cervical branch of inferior thyroid artery of thyrocervical trunk. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Increased gastrin is seen in : and explain in detail? | Most sensitive & specific method for identifying Zollinger Ellison syndrome is demonstration of an increased fasting serum gastrin concentration (> 150 pg/mL) |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Sensorineural deafness may be feature of all of the following conditions, EXCEPT: and explain in detail? | Alpo syndrome, Bater syndrome and distal renal tubular acidosis are all associated with sensorineural hearing loss. Alpo syndrome consist of nephritis and progressive sensorineural hearing loss. Bater syndrome consist of hypokalemia, metabolic alkalosis and sensorineural hearing loss. Distal renal tubular acidosis is associated with growth retardation and hearing loss. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Absolute contraindication for IUCD includes all of the following except : and explain in detail? | Ans. is c i.e. Congenital malformation of uterus |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Non-pitting oedema which does not reduce on elevation of limb belongs to which grade of lymphoedema and explain in detail? | Brunner's grading of Lymphoedema:-
Latent = Subclinical
Grade I = Spontaneously reversible lymphoedema
Grade II = Spontaneously irreversible lymphoedema
Grade III = Irreversible skin changes like-fibrosis, fissuring in lymphoedema. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Nasal angiofibroma is commonly seen in which age group? and explain in detail? | Juvenile nasopharyngeal angiofibroma uMC nasopharyngeal benign tumoruTestosterone dependent tumor uMC site of JNA - Sphenopalatine foramen uMC in adolescent boys of 10 - 20 years of age uLocally invasive and vasoformative tumor uClinical features Symptoms Signs oSpontaneous profuse & recurrent epistaxis oProgressive U/L nasal obstruction oHyposmia/AnosmiaoOtalgia, Conducting hearing loss & Serous OM oPink, purplish mass obstructing choanae oSplaying of nasal bones oProptosis & frog face deformity oDiplopia with diminished vision oCN involvement - 2, 3, 4, 5, 6uDiagnosis oIOC of JNA - CECT scan oPathognomonic of JNA - Antral sign or Holmer Miller sign (MRI scan)oCarotid angiography - Shows the tumour extent, vascularity & feeding vessel oBiopsy is contraindicated as it lacks muscular coat uTreatment Surgical RxMinimally invasive Adjunct Rx oTranspalatineoTranspalatine + Sublabial (Sardana approach)oLateral rhinotomy facial incisionoExtended Denker approachoCraniofacial resection approach infratemporal fossaoEndoscopicoTrans maxillary (Le Fo I)oMaxillary swing approachoCarotid angiography with embolization of the feeding vessel, preop stilbestrol, preop radiation therapy and cryotherapyoRadiationoDiethylstilbestrol + Flutamide oChemotherapy with doxorubicin + vincristine + dacarbazine Ref: PL Dhingra, Diseases of Ear, Nose & Throat, 7th edition, pg no. 228 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Scarring alopecia is seen in – and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Amaurosis fugax may occur in all of the following conditions except: and explain in detail? | Ans. Papillitis |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 statement is false about loculated pleural effusion? and explain in detail? | Air bronchogram is the bronchi filled with air visualised against the surrounding opacified alveoli. Ref: Perinatal and Pediatric Respiratory Care By Brian K. Walsh, Michael P. Czervinske, Robe M. DiBlasi, 2009, Page 445 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 low ovarian reserve, Anti Mullerian hormone level will be:- and explain in detail? | Ovarian Reserve < 1 is low , more than 2 is normal Markers of a REDUCED ovarian reserve are: Increasing age, especially beyond 35 Decreased ovarian volume Decrease estrogen Decrease Antral Follicular count High serum FSH, especially more than 15 Reduced Inhibin, especially lesser than 45 pg/ml Low AMH - (SINGLE BEST TEST ) |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Complications in Diabetics mellitus type-II occurs around: September 2005 and explain in detail? | Ans. D: 20 years of onset The risk of chronic complications increases as a function of the duration of hyperglycemia; they usually become apparent in the second decade of hyperglycemia. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is False regarding restrictive cardiomyopathy is- and explain in detail? | Ref: Harrison's 19th E pg: 1566 Both atria are enlarged, sometimes massively. Modest left ventricular dilation can be present, usually with an enddiastolic dimension <6 cm. End-diastolic pressures are elevated in both ventricles, with preservation of cardiac output until late in the disease. Subtle exercise intolerance is usually the first symptom but is often not recognized until after clinical presentation with congestive symptoms. The restrictive diseases often present with relatively more rightsided symptoms, such as edema, abdominal discomfo, and ascites, although filling pressures are elevated in both ventricles. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Principle building block in fatty acid synthesis: and explain in detail? | Ans. (a) Acetyl CoA* Principle building block in fatty acid synthesis: Acetyl CoA* Cofactors required: NADPH, ATP, Mn2+ and HCO3 * Source of Acetyl CoA: From mitochondria (after aerobic glycolysis and Fatty acid oxidation)* Site of FA synthesis: Liver, Kidney, Brain, Lungs, Adipose tissue, Lactating breast # Organelle: Extra-mitochondrial system in cytosol* Enzyme:# Acetyl CoA carboxylase-rate limiting enzyme# Fatty acid synthase |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Hepatitis is caused by: and explain in detail? | B i.e. Halothane |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A 60-year-old man with hypeension presents to the emergency depament complaining of veigo, nausea, vomiting and postural instability. His veigo began suddenly 2 hours ago and has been constant.Upon examination, the man cannot walk due to severe instability. The head impulse test is negative. There is left beating nystagmus on left lateral gaze and right beating nystagmus on right lateral gaze. Skew detion is present with quick, veical movements as each eye is uncovered. What is the most likely diagnosis? and explain in detail? | Head Impulse test +ve in: Meniere's disease Vestibular neuritis BPPV Based on the clinical findings, the patient is likely to have central veigo. The other options (A,C & D) are causes of peripheral veigo, cerebellar infarction is the only option that might present with central veigo. Veigo Peripheral causes Central causes Nystagmus Unidirectional, horizontal with some torsion nystagmus that beats towards affected side and never change direction. Can change direction & can be in any direction Presence of neurological deficit None Neurological deficits like diplopia, weakness, paraesthesia and dysahria present Postural instability Pt. lean to the affected side lPt. falls randomly and unable to walk. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Berger flap procedure is used for 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 Hypophosphatasia and explain in detail? | Hypophosphatasia (; also called deficiency of alkaline phosphatase, phosphoethanolaminuria, or Rathbuns syndrome; sometimes abbreviated HPP) is a rare, and sometimes fatal, inherited metabolic bone disease. Clinical symptoms are heterogeneous, ranging from the rapidly fatal, perinatal variant, with profound skeletal hypomineralization, respiratory compromise or vitamin B6 dependent seizures to a milder, progressive osteomalacia later in life. Tissue non-specific alkaline phosphatase (TNSALP) deficiency in osteoblasts and chondrocytes impairs bone mineralization, leading to rickets or osteomalacia. The pathognomonic finding is subnormal serum activity of the TNSALP enzyme, which is caused by one of 388 genetic mutations identified to date, in the gene encoding TNSALP. Genetic inheritance is autosomal recessive for the perinatal and infantile forms but either autosomal recessive or autosomal dominant in the milder forms.
The prevalence of hypophosphatasia is not known; one study estimated the live birth incidence of severe forms to be 1:100,000. and some studies report a higher prevalence of milder disease.
Symptoms and signs
There is a remarkable variety of symptoms that depends, largely, on the age of the patient at initial presentation, ranging from death in utero to relatively mild bone problems with or without dentition symptoms in adult life although neurological and extra-skeletal symptoms are also reported. The stages of this disease are generally included in the following categories: perinatal, infantile, childhood, adult, benign prenatal and odontohypophosphatasia. Although several clinical sub-types of the disease have been characterized, based on the age at which skeletal lesions are discovered, the disease is best understood as a single continuous spectrum of severity.As the presentation of adult disease is highly variable, incorrect or missed diagnosis may occur. In one study, 19% of patients diagnosed with fibromyalgia had laboratory findings suggestive of possible hypophosphatasia.One case report details a 35-year old female with low serum ALP and mild pains but no history of rickets, fractures or dental problems. Subsequent evaluation showed osteopenia and renal microcalcifications and an elevation of PEA. The genetic mutations found in this case were previously reported in perinatal, infantile and childhood hypophosphatasia, but not adult hypophosphatasia.
Perinatal hypophosphatasia
Perinatal hypophosphatasia is the most lethal form. Profound hypomineralization results in caput membranaceum (a soft calvarium), deformed or shortened limbs during gestation and at birth, and rapid death due to respiratory failure. Stillbirth is not uncommon and long-term survival is rare. Neonates who manage to survive suffer increasing respiratory compromise due to softening of the bones (osteomalacia) and underdeveloped lungs (hypoplastic). Ultimately, this leads to respiratory failure. Epilepsy (seizures) can occur and can prove lethal. Regions of developing, unmineralized bone (osteoid) may expand and encroach on the marrow space, resulting in myelophthisic anemia.In radiographic examinations, perinatal hypophosphatasia can be distinguished from even the most severe forms of osteogenesis imperfecta and congenital dwarfism. Some stillborn skeletons show almost no mineralization; others have marked undermineralization and severe osteomalacia. Occasionally, there can be a complete absence of ossification in one or more vertebrae. In the skull, individual bones may calcify only at their centers. Another unusual radiographic feature is bony spurs that protrude laterally from the shafts of the ulnae and fibulae. Despite the considerable patient-to-patient variability and the diversity of radiographic findings, the X-ray can be considered diagnostic.
Infantile hypophosphatasia
Infantile hypophosphatasia presents in the first 6 months of life, with the onset of poor feeding and inadequate weight gain. Clinical manifestations of rickets often appear at this time. Although cranial sutures appear to be wide, this reflects hypomineralization of the skull, and there is often “functional” craniosynostosis. If the patient survives infancy, these sutures can permanently fuse. Defects in the chest, such as flail chest resulting from rib fractures, lead to respiratory compromise and pneumonia. Elevated calcium in the blood (hypercalcemia) and urine (hypercalcenuria) are also common, and may explain the renal problems and recurrent vomiting seen is this disease.Radiographic features in infants are generally less severe than those seen in perinatal hypophosphatasia. In the long bones, there is an abrupt change from a normal appearance in the shaft (diaphysis) to uncalcified regions near the ends (metaphysis), which suggests the occurrence of an abrupt metabolic change. In addition, serial radiography studies suggest that defects in skeletal mineralization (i.e. rickets) persist and become more generalized. Mortality is estimated to be 50% in the first year of life.
Childhood hypophosphatasia
Hypophosphatasia in childhood has variable clinical expression. As a result of defects in the development of the dental cementum, the deciduous teeth (baby teeth) are often lost before the age of 5. Frequently, the incisors are lost first; occasionally all of the teeth are lost prematurely. Dental radiographs can show the enlarged pulp chambers and root canals that are characteristic of rickets.Patients may experience delayed walking, a characteristic waddling gait, stiffness and pain, and muscle weakness (especially in the thighs) consistent with nonprogressive myopathy. Typically, radiographs show defects in calcification and characteristic bony defects near the ends of major long bones. Growth retardation, frequent fractures, and low bone density (osteopenia) are common. In severely-affected infants and young children, cranial bones can fuse prematurely, despite the appearance of open fontanels on radiographic studies. The illusion of open fontanels results from hypomineralization of large areas of the calvarium. Premature bony fusion of the cranial sutures may elevate intracranial pressure.
Adult hypophosphatasia
Adult hypophosphatasia can be associated with rickets, premature loss of deciduous teeth, or early loss of adult dentation followed by relatively good health. Osteomalacia results in painful feet due to poor healing of metatarsal stress fractures. Discomfort in the thighs or hips due to femoral pseudofractures can be distinguished from other types of osteomalacia by their location in the lateral cortices of the femora. The symptoms of this disease usually begin during middle age of an adult patient and can include bone pain, and hypomineralization.Some patients suffer from calcium pyrophosphate dihydrate crystal depositions with occasional attacks of arthritis (pseudogout), which appears to be the result of elevated endogenous inorganic pyrophosphate (PPi) levels. These patients may also suffer articular cartilage degeneration and pyrophosphate arthropathy. Radiographs reveal pseudofractures in the lateral cortices of the proximal femora and stress fractures, and patients may experience osteopenia, chondrocalcinosis, features of pyrophosphate arthropathy, and calcific periarthritis.
Odontohypophosphatasia
Odontohypophosphatasia is present when dental disease is the only clinical abnormality, and radiographic and/or histologic studies reveal no evidence of rickets or osteomalacia. Although hereditary leukocyte abnormalities and other disorders usually account for this condition, odontohypophosphatasia may explain some “early-onset periodontitis” cases.
Causes
Hypophosphatasia is associated with a molecular defect in the gene encoding tissue non-specific alkaline phosphatase (TNSALP). TNSALP is an enzyme that is tethered to the outer surface of osteoblasts and chondrocytes. TNSALP hydrolyzes several substances, including mineralization-inhibiting inorganic pyrophosphate (PPi) and pyridoxal 5’-phosphate (PLP), a major form of vitamin B. A relationship describing physiologic regulation of mineralization has been termed the Stenciling Principle of mineralization, whereby enzyme-substrate pairs imprint mineralization patterns locally into the extracellular matrix (most notably described for bone) by degrading mineralization inhibitors (e.g. TNAP/TNSALP/ALPL enzyme degrading the pyrophosphate inhibition of mineralization, and PHEX enzyme degrading the osteopontin inhibition of mineralization). The Stenciling Principle for mineralization is particularly relevant to the osteomalacia and odontomalacia observed in hypophosphatasia (HPP) and X-linked hypophosphatemia (XLH).6.
When TSNALP enzymatic activity is low, inorganic pyrophosphate (PPi) accumulates outside of cells in the extracellular matrix of bones and teeth, and inhibits formation of hydroxyapatite mineral, the main hardening component of bone, causing rickets in infants and children and osteomalacia (soft bones) and odontomalacia (soft teeth) in children and adults. PLP is the principal form of vitamin B6 and must be dephosphorylated by TNSALP before it can cross the cell membrane. Vitamin B6 deficiency in the brain impairs synthesis of neurotransmitters, which can cause seizures. In some cases, a build-up of calcium pyrophosphate dihydrate (CPPD) crystals in the joint can cause pseudogout.
Genetics
Perinatal and infantile hypophosphatasia are inherited as autosomal recessive traits with homozygosity or compound heterozygosity for two defective TNSALP alleles. The mode of inheritance for childhood, adult, and odonto forms of hypophosphatasia can be either autosomal dominant or recessive. Autosomal transmission accounts for the fact that the disease affects males and females with equal frequency. Genetic counseling is complicated by the disease’s variable inheritance pattern, and by incomplete penetration of the trait.Hypophosphatasia is a rare disease that has been reported worldwide and appears to affect individuals of all ethnicities. The prevalence of severe hypophosphatasia is estimated to be 1:100,000 in a population of largely Anglo-Saxon origin. The frequency of mild hypophosphatasia is more challenging to assess because the symptoms may escape notice or be misdiagnosed. The highest incidence of hypophosphatasia has been reported in the Mennonite population in Manitoba, Canada where one in every 25 individuals are considered carriers and one in every 2,500 newborns exhibits severe disease. Hypophosphatasia is considered particularly rare in people of African ancestry in the U.S.
Diagnosis
Dental findings
Hypophosphatasia is often discovered because of an early loss of deciduous (baby or primary) teeth with the root intact. Researchers have recently documented a positive correlation between dental abnormalities and clinical phenotype. Poor dentition is also noted in adults.
Laboratory testing
The symptom that best characterizes hypophosphatasia is low serum activity of alkaline phosphatase enzyme (ALP). In general, lower levels of enzyme activity correlate with more severe symptoms. The decrease in ALP activity leads to an increase in pyridoxal 5’-phosphate (PLP), which is the major form of Vitamin B6, in the blood, although tissue levels of Vitamin B6 may be unremarkable and correlates with disease severity. Urinary inorganic pyrophosphate (PPi) levels are elevated in most hypophosphatasia patients and, although it remains only a research technique, this increase has been reported to accurately detect carriers of the disease. In addition, most patients have an increased level of urinary phosphoethanolamine (PEA) although some may not. PLP screening is preferred over PEA due to cost and sensitivity.Tests for serum tissue-non-specific ALP (sometimes referred to as TNSALP) levels are part of the standard comprehensive metabolic panel (CMP) that is used in routine exams, although bone-specific ALP testing may be indicative of disease severity.
Radiography
Despite patient-to-patient variability and the diversity of radiographic findings, the X-ray is diagnostic in infantile hypophosphatasia. Skeletal defects are found in nearly all patients and include hypomineralization, rachitic changes, incomplete vertebrate ossification and, occasionally, lateral bony spurs on the ulnae and fibulae.In newborns, X-rays readily distinguish hypophosphatasia from osteogenesis imperfecta and congenital dwarfism. Some stillborn skeletons show almost no mineralization; others have marked undermineralization and severe rachitic changes. Occasionally there can be peculiar complete or partial absence of ossification in one or more vertebrae. In the skull, individual membranous bones may calcify only at their centers, making it appear that areas of the unossified calvarium have cranial sutures that are widely separated when, in fact, they are functionally closed. Small protrusions (or "tongues") of radiolucency often extend from the metaphyses into the bone shaft.
In infants, radiographic features of hypophosphatasia are striking, though generally less severe than those found in perinatal hypophosphatasia. In some newly diagnosed patients, there is an abrupt transition from relatively normal-appearing diaphyses to uncalcified metaphases, suggesting an abrupt metabolic change has occurred. Serial radiography studies can reveal the persistence of impaired skeletal mineralization (i.e. rickets), instances of sclerosis, and gradual generalized demineralization.
In adults, X-rays may reveal bilateral femoral pseudofractures in the lateral subtrochanteric diaphysis. These pseudofractures may remain for years, but they may not heal until they break completely or the patient receives intramedullary fixation. These patients may also experience recurrent metatarsal fractures. DXA may show abnormal bone mineral density which may correlate with disease severity, although bone mineral density in HPP patients may not be systemically reduced.
Genetic analysis
All clinical sub-types of hypophosphatasia have been traced to genetic mutations in the gene encoding TNSALP, which is localized on chromosome 1p36.1-34 in humans (ALPL; OMIM#171760). Approximately 388 distinct mutations have been described in the TNSALP gene. "The Tissue Nonspecific Alkaline Phosphatase Gene Mutations Database". About 80% of the mutations are missense mutations. The number and diversity of mutations results in highly variable phenotypic expression, and there appears to be a correlation between genotype and phenotype in hypophosphatasia” |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Pleural reflection on left mid axillary line is in the following intercostal space: and explain in detail? | The lines, which indicate the limits of the parietal pleura where it lies close to the body surface, are referred to as the lines of pleural reflection. The lower border of the pleura on both sides follows a curved line, which crosses the 8th rib in the midclavicular line and the 10th rib in the mid axillary line, and reaches the 12th rib adjacent to the veebral column-that is, at the lateral border of the erector spinae spinae muscle. Ref: Clinical Anatomy by Regions By Richard S. Snell, 2008, Page 72. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 anatomy of right ventricle and explain in detail? | Forms the major poion of the anterior surface of the hea Right ventricle is divided into 2 pas: an inflow poion named "the sinus" and an outflow poion named "the conus" separated by the crista supraventricularis. As opposed to the normal left ventricle, the right ventricle is highly trabeculated the right ventricle is triangular when viewed longitudinally and is crescent shaped when viewed transversally Ref - BDC 6th edition vol 1 pg 256 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Rapid diagnostic test for gram negative bacterial Meningitis is and explain in detail? | Limulus amebocyte lysate reacts with bacterial endotoxin lipopolysaccharide, which is a membrane component of gram - negative bacteria. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 responsible for Ataxia Telangiectasia is located on: and explain in detail? | ATAXIA-TELANGIECTASIA This is a hereditary condition transmitted in the autosomal recessive mode combined immunodeficiency is associated with cerebellar ataxia, telangiectasia, ovarian dysgenesis & chromosomal abnormalities. Genetic features : Gene responsible on chromosome 11 Gene product may play a role in DNA repair ATM gene encodes Atm protein kinase, a member of phosphatidyl inositol 3-kinase family Clinical features :- ataxia & chorioathetoid movements noticed in infancy. Telangiectasia involving the conjuctiva & face appears at 5 or 6 years of age. The disease is progressive, with both neurological defects & immunodeficiency becoming severe with time. Death occurs due to sinopulmonary infection early in life , or malignancy in 2nd or 3rd decade. Ref: Kuby Immunology; 6th 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 Budd-chiari syndrome is most commonly due to: and explain in detail? | Answer is A (Hepatic vein obstruction): Budd chiari syndrome by definition is 'occlusion of hepatic vein' Obstruction of two or more major hepatic veins produces Budd chiari syndrome It is a clinical complex characterized by - - Liver enlargement (hepatomegaly) - Ascitis - Abdominal pain It is produced as a result of obstruction of two or more major hepatic veins and results from increased intrahepatic blood pressure and an inability of the massive hepatic blood from to shunt around the blocked outflow tract The most common cause of hepatic vein obstruction producing Budd chiari syndrome is hepatic vein thrombosis. Obstruction of a single main hepatic vein by thrombosis is clinically silent Budd Chiari Syndrome: It may also result from occlusion of IVC such as invasion by a tumour hut this is ceainly less common. Idiopathic membranous obstruction of IVC is the most common cause of this syndrome in Japan. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 statement regarding ectopic pregnancy:a) Pregnancy test positiveb) hCG levels should be >1000 mlU/ml for earliest detection of gestational sac by TVSc) hCG levels should be <1000 mlU/ml for earliest detection of gestational sac by TVSd) Methotrexate is used and explain in detail? | Lets see each option separately-
Option a-
“Urine pregnancy test - ELISA is sensitive to 10-50 MIU/ml and are positive in 95% of ectopic pregnancies.”
Dutta Obs. 7/e, p 182
“Current serum and urine pregnancy test that use enzyme - linked immunosorbent assays (ELISA) for -hcG are sensitive of levels of 10 to 20 MIU/ml and are positive in greater than 99% of ectopic pregnancies.”
Williams Obs. 23/e, p 242,
Thus option ‘a’ is correct.
“The lowest level of serum hCG at which a gestation sac is consistently visible using TVS (discriminatory zone) is 1500 IU/L. the corresponding value of serum hCG for TAS is 6000 IU/L. When the hCG value is greater than 1500 IU/L and there is an empty uterine cavity, ectopic pregnancy is more likely”.
Ref Dutta Obs. 7/e, p 183
“A number of investigation have described discriminatory hCG levels above which failure to visualize a uterine pregnancy indicates with high reliability that pregnancy is not alive or ectopic. Banhart and colleagues (1994) reported that an empty uterus with serum hCG concentration 1500 MIU/ml was 100% accurate in excluding a live pregnancy.'"
Williams Obs. 23/e, p 244
Thus option ‘b’ is correct and option ‘c’ incorrect. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A 70-year-old male presented with lumps felt in axilla. On examination, axillary lymphadenopathy was noted. Biopsy was planned with the following HPE. No RS cells were seen. Flow cytometry revealed CD15 and CD30 negative. Following the histopathological confirmation of the disease, the patient was staed on chemotherapy regimen. After few days, the patient develops dysuria and urine examination was done. Supplementation of which drug could have prevented this condition? and explain in detail? | HPE reveals that patient is suffering from non-Hodgkin lymphoma and the chemotherapy includes R-CHOP regimen. R - CHOP regimen includes Rituximab Cyclophosphamide Hydroxydaunorubicin Oncovin or vincristine Prednisolone After staing R - CHOP regimen, the patient developed haemorrhagic cystitis due to acrolein metabolite of cyclophosphamide. Mesna assists in detoxifying acrolein metabolites and therefore, used in prevention of haemorrhagic cystitis due to cyclophosphamide. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 pathologist examines a renal biopsy from a 45 year old man with nephrotic syndrome and requested a congo red stain to confirm the nature of an amorphous acidophillic extracellular hyalin substances localized within the mesengial matrix of the glomeruli A positive test confirms the presence of and explain in detail? | The answer is B. A positive congo red test confirms the presence of amyloid. Apple green birefringence is abserved under polarized light. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 mural thrombi 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 23-year-old female underwent kidney transplantation. After 8 days, she suffered from acute humoral rejection. She was successfully managed with tacrolimus and one more drug that suppressed B and T lymphocytes. Drug which target both B and T lymphocytes inhibiting de novo synthesis of purines is? and explain in detail? | Mycophenolic acid is formed from mycophenolate mofetil. It inhibits inosine monophosphate dehydrogenase, the rate limiting enzyme in the de novo pathway of purine synthesis. This action suppresses both B and T-lymphocytes. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 that binds bile acids in the intestine and prevents their return to liver the enterohepatic circulation is- and explain in detail? | Ans. is 'c' i.e., Cholestyramine "Chlestyramine is a bile acid sequesterant" |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Burkitt's lymphoma is associated with (Repeat) - and explain in detail? | Ans: A- t(8,14) Ref: Robbins Pathologic Basis of Disease, 8th edition.Bone misc tumors chapterExplanation:BURKETT LYMPHOMAThere are three clinical typesAfrican (endemic) Burkitt lymphoma,Sporadic (nonendemic) Burkitt lymphomaAggressive lymphomas associated with HIV.These 3 types are histologically identicalMorphologyThe tumor exhibits a high mitotic index and contains numerous apoptotic cells, the nuclear remnants of which are phagocytosed by interspersed benign macrophages.These phagocytes have abundant clear cytoplasm, creating a characteristic "starry sky" pattern.ImmunophenotypeThese are tumors of mature B cellsIt expresses surface IgM, 0)19. CD20, 0)10, and BCL6. a phenotype consistent with a germinal center B-cell origin.Unlike other tumors of germinal center origin, this does not express anti-apoptotic protein BCL2.Molecular PathogenesisAll forms of Burkitt lymphoma are associated with translocations of the c-MYC gene on chromosome 8.The translocation partner is usually the IgH locus or g light-chain loci.All endemic tumors are latently infected with EBV. which is also present in about 25% of HIV- associated tumors and 15% to 20% of sporadic cases.Clinical FeaturesEndemic Burkitt lymphoma often presents as a mass involving the mandible and shows an unusual predilection for involvement of abdominal viscera, particularly the kidneys, ovaries, and adrenal glands.Sporadic Burkitt lymphoma most often appears as a mass involving the ileocecum and peritoneum.Burkitt lymphoma is very aggressive but responds well to intensive chemotherapy. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 deltoid ligament is a strong ligament. It is attached to all of the following structures, EXCEPT: and explain in detail? | Medial collateral ligament (deltoid ligament) attaches to the medial malleolus of the tibia and the navicular, talus, and calcaneus bones. This ligament prevents medial distraction (eversion) and excessive range of motion. It is subdivided into four pas:Tibionavicular pa attaches the margin of the plantar calcaneonavicular ligament (spring ligament)Tibiocalcaneal pa attaches to the sustentaculum tali of the calcaneus bonePosterior tibiotalar pa attaches to the medial side and medial tubercle of the talusAnterior tibiotalar pa attaches to the medial surface of the talus Ref: Gray's Basic Anatomy By Richard Drake, A. Wayne Vogl, Adam W. M. Mitchell, 2012, Page 320. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following statements about High Density Lipoprotein (HDL) is false - and explain in detail? | Ans. A. HDL increases oxidation of LDL The reverse cholesterol transport system:-a. HDL serves as a chemical shuttle that transports excess cholesterol from peripheral tissues to the liver. This pathway is called the reverse cholesterol transport system. In this system, plasma HDL takes up cholesterol from the peripheral tissues, such as fibroblasts and macrophages.b. This may occur by passive diffusion or may be mediated by the adenosine triphosphate (ATP) - binding cassette transporter 1. The latter interacts directly with free Apo A-1, generating nascent, or so-called discoidal, HDL. Cholesterol undergoes esterification by lecithin-cholesterol acyltransferase (LCAT) to produce cholesteryl ester, which results in the production of the mature spherical HDL.c. Cholesterol is also taken up from triglyceride-rich lipoproteins in a process mediated by a phospholipid transfer protein (ie, CETP).d. Cholesterol is then returned to the liver by multiple routes. In the first route, cholesterol esters may be transferred from HDL to the Apo B-containing lipoproteins, such as very low-density lipoprotein (VLDL) or intermediate-density lipoprotein (IDL), by CETP. These lipoproteins undergo metabolism and subsequent uptake by the liver, primarily by a process mediated by the B, E receptor.e. In the second route, HDL particles may be taken up directly by the liver. In the third, free cholesterol may be taken up directly by the liver. Finally, HDL cholesterol esters may be selectively taken up via the scavenger receptor SR-B1. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is 5&;TTACGTAC-3&; after transcription what will be the RNA and explain in detail? | After transcription, the RNA will exchange order from 5&; to 3&; and 3&; to 5&; and T will be substituted by A, A by U, C by G. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Craniotabes is seen in following except – and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A man presented with fractures of 4th to 10 th ribs and paradoxical respiration after RTA. He is diagnosed to have flail chest and a PaO2 of <70%. Management is and explain in detail? | Flail chest in fracture of 3 or more continuous ribs.
Paradoxical respiration is when during inspiration chest moves inwards and vice versa. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why 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 lady complains of headache, nausea and tenderness in temporal region with migraine. On microscopic investigation what will be seen 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 Indications off steroids in SLE are all except - and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Amyloid deposits stain positively with all of the following except- and explain in detail? | The histologic diagnosis of amyloid is based almost entirely on its staining characteristics. The most commonly used staining technique uses the dye Congo red, which under ordinary light impas a pink or red color to amyloid deposits. Under polarized light the Congo red-stained amyloid shows so- called apple-green birefringence . This reaction is shared by all forms of amyloid and is caused by the crossed b-pleated configuration of amyloid fibrils. Confirmation can be obtained by electron microscopy, which reveals amorphous nonoriented thin fibrils. AA, AL, and ATTR types of amyloid also can be distinguished from one another by specific immunohistochemical staining. Robbins 9 th edition page no. 156 |