Datasets:

ardneebwar

/

medmcqa-and-race

like 0

<s>[INST] context: HIV infection does not always progress to ove AIDS. In a few founate individuals (called non-progressors), the infection remains asymptomatic, with a stable CD4 cell count and low or undetectable viremia. It is not entirely clear whether these patients will eventually develop AIDS. Some are resistant to HIV infection because they carry two defective copies of the gene encoding the CCR5 coreceptor. There are 15 known coreceptors, of which CCR5 and CXCR4 are the best characterized. CCR5 is a receptor for b-chemokines and serves as a coreceptor for HIV internalization. Approximately one percent of Caucasians in the U.S. is homozygous for such a protective CCR5 variant, and 20% are heterozygotes. HIV infection follows a slower course in heterozygotes. Homozygotes for this protective CCR5 variant are not present among Black and Asian populations. Recently, a variant haplotype of CXCR1 (a leukocyte receptor for fractalkine) has been linked to rapid progression of HIV infection in homozygous individuals. Thus, investigations on HIV coreceptors are beginning to explain the variability in progression and severity of HIV infection among individuals. CD4 (2nd Choice) is an impoant receptor of helper T lymphocytes, macrophages, and Langerhans cells. It acts as the primary receptor for HIV binding. Binding to CD4, however, is not sufficient for the entry of HIV into the cells. The viral envelope gp120 protein (4th Choice) first binds CD4. This results in a conformational change in gp120 that allows this protein to bind coreceptors. Such coreceptors are present on lymphocytes and macrophages and normally serve as binding sites for chemokines. Once gp120 binds to CD4 and a coreceptor, a second viral protein, gp41, facilitates fusion of the viral envelope with the plasma membrane, allowing "injection" of the viral core into the cell. Neither CD8 (5th Choice) nor the receptor for TNF-a plays a role in HIV binding to cells. [/INST] question: A 38-year-old man has been HIV-positive since the age of 26 but has refused antiretroviral prophylaxis. His CD4 cell count, however, is still within normal limits, and the virus is undetectable in the blood. Genetic investigations clarify this apparent puzzle, demonstrating that this subject is homozygous for a mutation affecting a chemokine receptor necessary for HIV entry into the cell. Which of the following receptors is most likely involved? | options: A: CCR5 B: CD4 C: CD8 D: Gp120 | answer: A </s>

<s>[INST] context: Across the planet there are millions of people who engage in some type of meditation, the practice of concentrating and clearing the mind to bring the body into a state of peace, at least a semi-regular basis. For some, particularly among practitioners of Eastern religions such as Buddhism and Hinduism, this is _ of their religious practice. For others, particularly in Western cultures, meditation tends to be a response to stress. With the world economy approaching meltdown and people worried about their job or their ability to keep their home, it's a way for people to attain a state of peace of mind and well-being. For those interested in taking up the practice, instruction in meditation for beginners can be found in literally thousands of sources. One of the most popular styles of mediation in the West, with classes offered in most major cities, is called Transcendental Meditation. TM, as it is known among its practitioners, first came to worldwide attention when the Beatles began practicing it in 1967. For direct, guided, personal instruction in meditation for the beginner, TM may be the hallmark. Part of the confusion about how to practice meditation effectively is due to the fact that there are literally hundreds of techniques championed by various groups and individuals. As a general principle, it might be said that all meditation techniques seek to have the practitioner attain a state of consciousness that is different to our ordinary state of awareness. They attempt to train people to clear their minds and achieve a sense of inner peace. It sounds simple enough, but of the huge number of people experiment with meditation, very few are able to maintain its practice over the long haul. In most cases, this is due to frustration over the inability to experience any dramatic, instantly recognizable effects. This is quite a sad state of affairs, that so few these days are willing or equipped to persist in something that doesn't provide immediate life-changing results. It reflects a culture in which demands for discipline and sustained effort are considered unnecessary or even unfair. It is no surprise therefore that many people abandon their efforts at meditation before they have a chance to bear fruit. But for anyone who does decide to take up this worthwhile practice, please remember. You must clear your mind, relax and "take it as it comes". Maintain the practice with a sense of discipline and devotion, and eventually benefits of inner peace and calm will be yours. [/INST] question: The goal of meditation is _ . | options: A: to clear the mind B: to practice a religion C: to develop a technique D: to carry out an experiment | answer: A </s>

<s>[INST] context: To get to the answer, we will look at the options one by one. Hypocalcemia Serum calcium in this boy is 7.5 mg/dL. Hypocalcemia can result in seizures but the level should be very low. Further, if we correct calcium with serum albumin, it will come in normal range. Corrected calcium level in the serum can be calculated by adding 0.8 mg/dL With every 1.0 g/dL decrease in serum albumin below the normal value of 4.0 g/dL. Hence, in this patient, corrected serum calcium level will be 7.5 + 0.8 x (4.0 - 1.5) = 9.5 mg/ dL It is in the normal range (8.5-10.5 mg/dL) and thus cannot be the cause of seizures in this person. Uremia Although blood urea is elevated (78 mg/dL as compared to normal value of 15-40 mg/dL) but serum creatinine is normal (0.5 mg/dL). For diagnosis of uremia, serum creatinine must be 3 times the normal value. Thus, uremia cannot be the answer. Hyponatremia Serum sodium is at lower normal value (136-152 mEq/L). For causing seizures, serum sodium should be less than 125 mEq/L. Therefore, this option can also be ruled out. Tacrolimus toxicity This child is on tacrolimus therapy. It is a known neurotoxin and can cause seizures. It also can cause renal failure. Further by ruling out other options, the most likely cause seems to be tacrolimus toxicity. [/INST] question: A 5-year old child of severe nephrotic syndrome on treatment with tacrolimus, frusemide and prednisolone developed seizures. The investigations revealed: Serum Na+ = 136 mEq/L Blood urea = 78 mg/dL Serum creatinine = 0.5 mg/dL Serum albumin = 1.5 g/dL Serum total Ca = 7.5 mg/dL Urine albumin = 2g What is the likely cause of symptoms in this baby? | options: A: Hypocalcemia B: Tacrolimus toxicity C: Uremia D: Hyponatremia | answer: B </s>

<s>[INST] context: The winter Vacation is just around the corner.With such along holiday to spend,have you decided where to get yourself relaxed from the great pressure of school study? Our company specializes in civil tours.we take pride in offering you the best services and in providing you with a vacation that will be fondly remembered.The following places can be your unforgettable destinations in our country. A.The Australian Museum The Australian Museum has an international reputation in the fields of natural history and indigenous studies research and exhibitions.The museum was established in 1827 and is Australia's first museum of natural science and cultural artifacts. B.Sydney Olympic Park Home of the Best Games Ever and 2003 Rugby World,Sydney Olympic Park is a gold medal attraction and continues to serve as a major sport and social venue. Apart from its ultra-modern sport venues,Sydney Olympic Park is set in extensive parklands. Bicentennial Park,one of Sydney's most popular recreational areas,is cris-crossed with walking and bicycle tracks C.Art Gallery of New South Wales Located within a short walking distance from Sydney's CBD,the Art Gallery of New South Wales is one of Australia's foremost art museums housing some of the finest works of art in the country. The Gallery has a rich and diverse collection including key works of the Heidelberg School and favorite modern Australian artists including Brett Whiteley and Margaret Preston,as well as permanent Australian,European,Asian,contemporary and photographic galleries. D.Koalas Park Sanctuary. Koalas are on show every day.Shows are at 10:20 AM,11:20 A.M,2:00 RM,3:00 P.M.where you can cuddle,feed,pat and have your photo taken with the Koalas. See free roaming Koalas as well,10 acres of rainforest.Walk in and pat our kangaroos. [/INST] question: How long has the Australian Museum been built? | options: A: Around 220years B: Around 190 years C: Around 140 years D: Around 100 years | answer: B </s>

<s>[INST] context: Different countries have different customs. When you travel to another countries, please follow their customs, just as the saying goes, " _ ." Very often people who travel to the United States forget to tip. It is usual to tip _ who help carry your bags, taxi drivers and waiters. Waiters expect to get a 15% tip on the cost of your meal. Taxi drivers expect about the same amount. In England, make sure to stand in line even if there are only two of you. It's important to respect lines there. It's a good idea to talk about the weather. It's a favorite subject of conversation with the British. In Spain, it's a good idea to have a light meal in the afternoon if someone invites you for dinner. People have dinner very late, and restaurants do not generally open until after 9 pm. In Arab countries, men kiss one another on the cheek. Your host may welcome you with a kiss on both cheeks. It is polite for you to do the same. In Japan, people usually give personal or business cards to each other when they meet for the first time. When a person gives you a card, don't put it into your pocket right away. The person expects you to read it. Don't forget to be careful of your body language to express something in conversation. A kind of body language that is acceptable in one culture may be impolite in another. [/INST] question: When you travel to the USA, you don't need to tip _ . | options: A: porters B: waiters C: teachers D: taxi drivers | answer: C </s>

<s>[INST] context: Monarch Butterflies One of the last West Coast homes of the Monarch butterfly,a type of insect ,may soon disappear.Strangely,it is in a town that calls itself Butterfly U.S.A,Pacific Grove, California. The town of Pacific Grove loves the butterflies.Every year they have a parade and hundreds of children dress up as butterflies.Monarch butterflies are the town _ .Tourism is very important,and many people come to see the butterflies.The butterflies are good for the development of the town. In 1981 there were so many butterflies it looked like it was raining butterflies.Tens of thousands of Monarchs stayed on tree branches near Pacific Grove.Now there are not so many. The building goes on a little bit at a time,and you don't notice it day by day.Over time,you can see that there has been a lot of development.As new buildings go up,many trees are cut down. This reduces the natural homes for the butterflies. Monarchs travel hundreds of miles each year,returning to the same woods,often to the same trees.The female Monarchs need milkweed to lay their eggs;the males will follow the females. Millions of Monarchs have traveled regularly along the same path for thousands of years.They start their trip in the mountains of Mexico and travel to the middle part of America.If the woods where the butterflies live are destroyed,the whole species could be lost.There have been Monarch butterflies along the coast of California for as long as man can remember,but no one is sure how much longer they will last. [/INST] question: Why are Monarch butterflies important to Pacific Grove? | options: A: They may disappear B: They come to stay every year C: They help develop the town's tourism D: They give a name to Pacific Grove | answer: C </s>

<s>[INST] context: The earth is 4 600 million years old. We humans have lived on earth for only 35 000 years, but during this period we have changed our planet a lot in many ways. Some things we've done are very good for the earth while some are bad. All over the world, people have cut down millions of trees. When it rains or when the wind blows, the earth is taken away. Forests have become deserts, so more and more sorts of animals and plants are disappearing. In big cities, cars and buses have polluted the air. Many people in cities now have health problems. Factories have also polluted the land and the water. As a result, many rivers and lakes are now dead. Around the earth, there's a special kind of oxygen called "ozone"(O3). It is important to the earth. But now air pollution is destroying it and that has made a very big hole in the ozone layer. Too much harmful radiation from the sun passes through the hole and reaches the earth directly. This is very dangerous because this kind of radiation can cause cancer. Carbon dioxide (CO2) in the air has increased a lot. It mainly comes from burning oil, coal and wood. This has formed a "blanket" around the earth. The heat from the sun can't escape so the temperature is rising. This is called "the greenhouse effect". It causes the level of the oceans to rise and the climate of the earth to change. All these problems are very serious, so we must do something now. ,A, B, C, D. [/INST] question: What does our planet mean here? | options: A: The sun B: Mars C: The moon D: The earth | answer: D </s>

<s>[INST] context: There is no doubt that to study abroad gives you an excellent opportunity to learn things which are very helpful in your career building. Today Canada has earned a good name in providing quality education and safe healthy environment for its students. That is why more than 130,000 international students enroll every year in famous Canadian universities. It is an ideal education destination and gives students a unique experience of education and its versatile arts and culture. Canada spends a lot on education and is ranked the highest in G-8 countries. To study in Canada is very cost effective. These universities are affordable compared to other universities in the world such as in the US, New Zealand and UK where cost of education and living is very high. According to a survey in 2006, "Canada offered the lowest tuition fees for foreign students compared to UK and Australia." The low rate of crimes and the peaceful safe environment of the country also attracts a lot of international students to Canadian universities. Canada has 92 universities and 175 community colleges and university degrees have three levels--Bachelor's , Master's and Doctoral . A Bachelor's degree in Canada is for three or four years' full-time study depending on the nature of the program you are doing. On the other hand, a Master's degree consists of two years of study. For a Doctoral program in Canadian universities, you require a minimum (/) of three to four or sometimes five years of research and study. You can also find many diploma and certification program in Canadian universities where the time is generally one year. Some of the Canadian universities are well-regarded worldwide and the degree and diploma obtained from these Canadian universities are recognized globally and promise bright future. After the completion of studies, a person could also find great job offers in Canada itself. International students require a work permit to work on campus. [/INST] question: How long will you spend at least in total if you want to finish your Bachelor's, Master's and Doctoral degrees in Canada? | options: A: 11 years B: 9 years C: 8 years D: 7 years | answer: C </s>

<s>[INST] context: Want to be a volunteer for Beijing Olympics in 2008? Recently, the recruiting started. The recruiting of Beijing Olympics Volunteer starts from Aug 28, 2006 to end of March 2008. Stage 1: Beijing Volunteers From August 28, 2006, the program opens to applicants in Beijing (and Beijing only). Stage 2: China Volunteers From Dec, 2006, people from outside Beijing can submit their application. Stage 3: Overseas Volunteers By March 2007, people from outside China (including in other countries) can apply for volunteering in Olympics 2008. The Program Travel, hotel are not provided. Only working meal is available for volunteers (makes sense, isn't it?) If you have any questions, just call Olympics Volunteer hotline: +86-10-12308 According to news, 100k college students have applied for the position after three days of recruiting. 50,000 to 100,000 volunteers are needed for the game. If you want to participate, just call the number and ask more questions about the program. However, my guess is, to be admitted to the program is not easy. [/INST] question: Who has the most time to apply for volunteering in Olympics 2008 ? | options: A: Liling from Beijing B: Wangbing from Tianjin C: Jane from Australia D: Dongdong from Yunnan | answer: C </s>

<s>[INST] context: Aschners reflex is called oculocardiac reflex. TheOculocardiac reflex, also known asAschner phenomenon, Aschner reflex, or Aschner-Dagnini reflex, is a decrease in pulse rate associated with traction applied to extraocular muscles and/or compression of the eyeball. The reflex is mediated by nerve connections between the ophthalmic branch of the trigeminal cranial nerve the ciliary ganglion, and the vagus nerve of the parasympathetic nervous system. Nerve fibres from the maxillary and mandibular divisions of the trigeminal nerve have also been documented. These afferents synapse with the visceral motor nucleus of the vagus nerve, located in the reticular formation of the brain stem. The efferent poion is carried by the vagus nerve from the cardiovascular centerof the medulla to the hea, of which increased stimulation leads to decreased output of the sinoatrial node. This reflex is especially sensitive in neonates and children, paicularly during strabismus correction surgery.However, this reflex may also occur with adults. Bradycardia, junctional rhythm and asystole all of which may be life-threatening,can be induced through this reflex. This reflex has been seen to occur during many pan facial trauma surgeries due to stimulation of any of the three branches of trigeminal nerve. [/INST] question: A five year old is scheduled for strabismus surgery. As the surgeon grasps medial rectus muscle anesthesiologist carefully monitors the pulse. This is for | options: A: Assessing the depth of anesthesia B: Detecting Aschners reflex C: Rule out ventricular dysrrhythmias D: Detecting hypotension | answer: B </s>

<s>[INST] context: Domestic horses now pull ploughs, race in the Kentucky Derby, and carry police. But early horses weren't tame enough to perform these kinds of tasks. Scientists think the first interactions humans had with horses were far different from those today. Thousands of years ago, people killed the wild horses that lived around them for food. Over time, people began to catch the animals and raise them. This was the first step in domestication. As people began to tame and ride horses, they chose to keep those animals that had more desirable characteristics. For example, people may have chosen to keep horses that had a gentle personality so they could be ridden more easily. People who used horses to pull heavy loads would have chosen to keep stronger animals. Characteristics like strength are partly controlled by the animals' genes. So as the domesticated horses reproduced, they passed the characteristics on to their young. Each new generation of houses would show more of these chosen characteristics. Modern day horse breeds come in a wide variety of shapes and sizes. This variety didn't exist in the horse population before domestication. The Shetland horse is one of the smallest breeds--typically reaching only one meter tall. With short, strong legs, the animals were bred to pull coal out of mine shafts with low ceilings. Huge horses like the Clydesdale came on the scene around 1700. People bred these heavy, tall horses to pull large vehicles used for carrying heavy loads. The domestication of horses has had great effects on societies. For example, horse were important tools in the advancement of modern agriculture. Using them to pull ploughs and carry heavy loads allowed people to farm more efficiently. Before they were able to ride horses, humans had to cross land on foot. Riding horses allowed people to travel far greater distance in much less time. That encouraged populations living in different areas to interact with one another. The new from of rapid transportation helped cultures spread around the world. [/INST] question: Before domestication horses were _ . | options: A: caught for sports B: hunted for food C: made to pull ploughs D: used to carry people | answer: B </s>

<s>[INST] context: Can you imagine living in a house built by recycled waste? Texas home builder Dan Phillips transforms trash into artful treasures, creating beautiful floors with wood pieces, kitchen counters from ivory -colored bones and roofs out of license plates . The fantastic houses which spring from his imagination are made almost entirely of materials which would otherwise have ended up in a garbage area. " People have been doing this for hundreds of thousands of years; using whatever is available to build shelter, " Phillips said."If you think about carefully what could be used, then building materials are everywhere. The thirteen homes he has built so far would fit better in an art museum than the residential streets of Huntsville, a conservative town of about 35 ,000 people. Living in these houses is a bit like living in a roadside attraction."Almost every day, somebody knocks on the door and says ' Is there any way that we could see?' "said Edie Wells, an artist who rents a room in the Bone House.Her home features a stairway made of bones, floors covered in wine corks and beer bottle caps.Wells said visitors are most impressed when they see a bathroom with its walls, floor and ceiling entirely covered with broken mirror pieces. In addition, each house is highly energy efficient with plenty insulation , an on-demand solar hot water heater and a system that can collect and recycle rainwater to clean the toilet and wash clothes. Phillips founded Phoenix Commotion 12 years ago with the aim of creating a new model for sustainable housing.For as little as $ 10,000 it builds affordable homes for single parents, low-income families and artists. The company has used hundreds of tons of construction waste by recycling the materials into habitable buildings. Phillips tries to spread his recycled-house idea by speaking at events across the United States, and by using the Internet to reach out to like-minded individuals.Phillips said: "I'm not going to be saving the world anytime soon.But there needs to be at least some visibility for this model in this century. [/INST] question: Which of the following is NOT the advantage of the homes built by Phillips? | options: A: environmentally-friendly B: energy efficient C: convenient D: cheap | answer: C </s>

<s>[INST] context: The increase in blood glucose after a test dose of a carbohydrate compared with that after an equivalent amount of glucose is known as the glycemic index. Glycemic Index decreasing order: Corn flakes> whole wheat bread>Brown rice>Ice cream Most varieties of legumes, pasta, fruits, and dairy products are low-GI foods (55 or less on the glucose reference scale). Breads, breakfast cereals, rice, and snack products, including whole-grain versions, are available in both high- (70 or greater) and low-GI forms. Glucose and galactose have an index of 1 (or 100%), as do lactose, maltose, isomaltose, and trehalose, which give rise to these monosaccharides on hydrolysis. Fructose and the sugar alcohols are absorbed less rapidly and have a lower glycemic index, as does sucrose. The glycemic index of starch varies between near 1 (or 100%) and near 0 as a result of variable rates of hydrolysis, and that of non-starch polysaccharides is 0. Foods that have a low glycemic index are considered to be more beneficial since they cause less fluctuation in insulin secretion. [/INST] question: Among the following food items, which one has the highest "Glycemic Index"? | options: A: Corn flakes B: Brown rice C: Ice-cream D: Whole wheat bread | answer: A </s>

<s>[INST] context: Treatment of asthma Treatment of asthma can be divided into - A) Treatment of chronic asthma B) Treatment of acute exacerbation - Treatment of mild, moderate or severe exacerbation Treatment of life-threatening exacerbation (status asthmaticus) Treatment of chronic asthma Treatment of chronic asthma is given to control asthma and to prevent acute exacerbation. Severity of asthma is classified on the basis of - The frequency of daytime symptoms      The frequency of nighttime symptoms  The degree of airflow obstruction (FEV1) Peak expiratory flow (PEF) variability For children less than 5 years of age, severity is classified on the basis of (1) and (2) only because young children cannot perform the manoeuvre required for lung function measurement ((3) & (4)). I) Mild intermittent                                   Symptoms for ≤ 2 days/week                            Symptoms for 5 ≤ 2 night/month                   FEV1 80%                                                  PEF variability < 20%            2) Mild persistent     Symptoms > 2days / week   PEF variability 20-30%      Symptoms >2 night / months     FEV1 80%         3) Moderate persistent                                 Day symptoms daily                                     Symptoms > I night/week                             FEV1 > 60% - < 80%                                  PEF variability >30%                                   A stepwise pharmacological therapy is indicated.   4) Severe persistent Continuous day symptoms Frequent night symptoms FEVi 60% PEF variability >30% [/INST] question: A most common mode of treatment of a 1-year-old child with asthma is – | options: A: Inhaled short acting beta 2 agonist B: Oral short acting theophylline C: Oral ketotifen D: Leukotriene agonist | answer: A </s>

<s>[INST] context: Primary Closure Also known as healing by primary intention Have a small, clean defect that minimizes the risk of infection Requires new blood vessels and keratinocytes to migrate only a small distance Surgical incisions, paper cuts and small cutaneous wounds usually heal by primary closure. Fastest type of closure by simple suturing, skin grafting or flap closure Secondary Closure Also known as healing by secondary intention Healing of a wound in which the wound edges cannot be approximated Requires a granulation tissue matrix to be built to fill the wound defect Requires more time and energy than primary wound closure Creates more scar tissue The majority of wounds close by secondary wound closure. Delayed Primary Closure Also known as healing by tertiary intention. Combination of healing by primary and secondary intention The wound is first cleaned and observed for a few days to ensure no infection is apparent, before it is surgically closed. E.g. traumatic injuries such as dog bites or lacerations involving foreign bodies. [/INST] question: Would closure for clean wounds within 6 hours of injury without risk of contamination | options: A: Primary closure B: Delayed primary closure C: Secondary closure D: Tertiary closure | answer: A </s>

<s>[INST] context: Joseph Rudyard Kipling, who enjoyed early success with his poems, was born on 30 December 1865 in Bombay, India. Some of Kipling's earliest and fondest memories are of his and sister Alice's trips to the fruit market with their woman servant, or walking with his parents alongside the sea at night. The beautiful days were to end when in 1871 Rudyard and Alice were sent to school in Southsea, England, to live with Captain Holloway and his wife. She ruled the boarding house with punishment and Kipling was often beaten by her and her son. "Then the old Captain died, and I was sorry, for he was the only person in that house as far as I can remember who ever threw me a kind word." So he wrote in his later books. Kipling soon learned to read and found comfort in literature and poetry. Freedom from the Holloway household was gained when he spent one month a year in London with his mother's kind sister Aunt Georgie and her husband, pre-Raphaelite painter Edward Burne Jones and their children. _ In 1877 Kipling's mother returned to England and collected him so that he could attend the United Services College in Devon. Now he was able to settle into the life of a student and in his second year started writing his own Schoolboy Lyric poems printed by his parents. In 1878 his father took him to the Paris Exhibition where he was allowed to wander freely and gained much appreciation for French culture which he wrote about in "Souvenirs of France". [/INST] question: Kipling first left his parents in _ . | options: A: 1865 B: 1871 C: 1877 D: 1878 | answer: B </s>

<s>[INST] context: A research by the National Center for Health Statistics is seen as an important confirmation of the"Hispanic mortality paradox ." On average,Hispanics _ whites by 2.5 years and blacks by 7.7 years. Their life expectancy at birth in 2006 was 80.6 years,compared with 78.1 for whites,72.9 for blacks and 77.7 years for the total population. The report shows that the Hispanic population has higher life expectancy at birth and at almost every age despite a socioeconomic status lower than that of whites."Mortality is very correlated with income,education and health care access,"says Elizabeth Arias,author of the report."You would expect the Hispanic population would have higher mortality,"in line with the black population. The Hispanic paradox has been documented for more than two decades,but this is the first time the government has had enough data to issue national numbers. Researchers are struggling to explain why Hispanics live longer. "We don't know,"says David Hayes-Bautista,director of the Center for the Study of Latino Health and Culture at UCLA's David Geffen School of Medicine."We thought it was a problem in the data,but we can pretty much say this is real." Potential factors: *Culture and lifestyle. Support from extended family and lower rates of smoking and drinking.Latino groups in particular have very strong family and social ties. *Migration. The"healthy migrant effect"argues that healthy people are more likely to emigrate. And when immigrants become ill,they might return home and die there. Solving the puzzle may help the nation deal with health care issues because Hispanics use health services less--they make fewer doctors visits and spend less time in hospitals,Hayes-Bautista says."It's clearly something in the Latino culture,"he says. [/INST] question: In 2006,Hispanics'life expectancy is _ years longer than the average of the total population. | options: A: 2.5 B: 7.7 C: 2.9 D: 80.6 | answer: C </s>

<s>[INST] context: The cause of sacrococcygeal teratomas is unknown. Sacrococcygeal teratomas are germ cell tumors. Germ cells are the cells that develop into the embryo and later on become the cells that make up the reproductive system of men and women. Most germ cell tumors occur in the testes or ovaries (gonads) or the lower back. When these tumors occur outside of the gonads, they are known as extragonadal tumors. Researchers do not know how extragonadal germ cell tumors form. One theory suggests that germ cells accidentally migrate during to unusual locations early during the development of the embryo (embryogenesis). Normally, such misplaced germ cells degenerate and die, but in cases of extragonadal teratomas researchers speculate that these cells continue to undergo mitosis, the process where cells divide and multiply, eventually forming a teratoma. Sacrococcygeal teratomas are thought to arise from an area under the coccyx called "Henson's Node". This is an area where primitive cells persist (germ cells) that can give rise to cells of the three major tissue layers of an embryo: ectoderm, endoderm, and mesoderm. These embryonic layers eventually give rise to the various cells and structures of the body. Sacrococcygeal teratomas can contain mature tissue that looks like any tissue in the body, or immature tissue resembling embryonic tissues. Ref- <a href=" [/INST] question: Sacrococcgeal teratoma arises from ? | options: A: Primitive streak B: Neural plate C: Cloacal membrane D: Posterior neuropore | answer: A </s>

<s>[INST] context: Streptococcus pyogenes, or Group A Streptococcus (GAS), produces a number of virulence factors. The M protein (d) is the organism's most important antiphagocytic factor, and it conveys serologic specificity-over 100 serotypes are now known. In the early stages of growth, the bacteria have hyaluronic acid (b) capsules. This capsule (similar to human hyaluronic acid structure) is rapidly destroyed by the organism's own hyaluronidase. Also known as spreading factor, hyaluronidase plays a role in GAS cellulitis. Erythrogenic toxin (a) is a superantigen produced by some strain of GAS lysogenized by a bacteriophage carrying the toxin gene; it causes the rash of scarlet fever. A second superantigen, streptococcal pyrogenic toxin, causes streptococcal toxic shock syndrome. Streptolysin O (e) an oxygen-labile hemolysin is useful for identification of the organism and is antigenic so antistreptolysin antibodies can be used to diagnosis rheumatic fever, a sequelae of GAS infection. Lipoteichoic acid (c) is a component of the cell wall that is involved in binding of the bacterium to host fibronectin. [/INST] question: A child attending classes in a preschool is noted by his teacher to have several skin lesions on his arms. The lesions are pustular in appearance and some have broken down and are covered with a yellow crust. Which of the following protects the most likely etiologic agent of this child's infection from phagocytosis and provides serologic specificity? | options: A: Erythrogenic toxin B: Hyaluronic acid C: Lipoteichoic acid D: M protein | answer: D </s>

<s>[INST] context: (Mesoderm) (8-9-Khurana 4th) (5-Parson 20th)Structures derived from the Embryonic layers1. Surface ectoderm2. Neural ectoderm(a) The crystalline lens(b) Epithelium of the cornea(c) Epithelium of the conjunctiva(d) Lacrimal glands(e) Epithelium of eyelids and its derivatives, viz.: cilia, tarsal glands, and conjunctival glands.(f) Epithelium lining the lacrimal apparatus (Lacrimal glands, Tarsal glands)(a) Retina with its pigment epithelium(b) Epithelial layers of ciliary body(c) Epithelial layers of iris(d) * Sphincter and dilator papillae muscles(e) Optic nerve (neuroglia and nervous elements only)(f) Melanocytes - Retinal pigment epithelium(g) Secondary vitreous(h) Ciliary zonules3. Associated paraxial mesoderm(a) ** Blood vessels of choroid, iris, ciliary vessels, central retinal artery, other vessels (Vascular endothelium of eye and orbit)(b) Primary vitreous(c) Substantia propria, Descemet's membrane, and endothelium of cornea(d) The sclera(e) Stroma of iris(f) Ciliary muscle(g) Sheaths of optic nerve(h) Extraocular muscle(i) Fat, ligaments and other connective tissue structures of the orbit(j) Upper and medial walls of the orbit(k) Connective tissue of the upper eyelid4. Visceral mesoderm of maxillary process below the eye(a) Lower and lateral walls of orbit(b) Connective tissue of the lower eyelid. [/INST] question: The embryonic vascular layer of the eye is derived from | options: A: Neural crest B: Mesoderm C: Ectoderm D: Surface ectoderm | answer: B </s>

<s>[INST] context: Canada geese are large blue and white birds .When autumn arrives ,they have to fly south where the weather is warmer .The winters are so cold in Canada that the birds will die if they stay there . Last spring ,Bill Lishman found sixteen young Canada geese on his farm "They had lost their parents , "Bill thought . "These young birds won't know what to do in the autumn . Bill had a small plane and he decided to teach the birds to follow him .All through the summer ,he went on short trips in his plane and the young geese flew after him ." When the cold weather arrived in autumn ,Bill flew to Virginia in the United States ,600 miles south from his home in Canada .The geese follwed him all the way .Bill flew to Virginia and returned home . This spring ,Bill was waiting for the birds to come back .They didn't arrive ,so Bill flew to Virginia to get them .He looked for them for two weeks but he couldn't find them . When he arrived back home ,Bill found the geese waiting for him .Then had found the way home without him ! [/INST] question: Canda geese have to flly south _ . | options: A: in spring B: before autumn C: in the winter D: after summer | answer: D </s>

<s>[INST] context: Everybody has one of those days when everything goes wrong. This is what happened to Harry. He got up one morning very late because he had forgotten to wind up his alarm clock . He tried to shave quickly and cut himself. When he got dressed he got blood all over his clean shirt, so he had to find another one. The only other shirt that was clean needed ironing , so he ironed it. While he was ironing it, there was a knock at the door. It was the man to read the electricity meter . He showed him where the meter was, said good-bye and found that the iron had burnt a hole in his shirt. So he had to wear the one with the blood on it after all. By this time it was very late, so he decided he couldn't go to work by bus. He telephoned for a taxi to take him to work. The taxi arrived and Harry got in and began to read the newspaper. In another part of the town, a man had killed a woman with a knife and was seen to run away in a taxi. When Harry's taxi stopped outside his office, a policeman happened to be standing there. He saw the blood on Harry's shirt, and took him to the police station. He was kept till 3 o'clock in the afternoon before the police were sure that he was not the man they wanted. When he finally arrived at the office at about four, his boss took a look at him and told him to go away and find another job. [/INST] question: Harry had _ . | options: A: a lucky day B: an unlucky day C: a busy day D: a good day | answer: B </s>

<s>[INST] context: The Appleton Club is the focal point of undergraduate ministry in The Memorial Church. The Appleton Club provides a safe, inclusive, and welcoming space for undergraduates to grow and develop as faithful Christians as they grow and develop as intellectuals and professionals. We focus on building community through worship, study, and service, as well as through social gatherings and outings. All are welcome! For details on all the activities of The Appleton Club, or to be added to our e-mail list, contact _ or 617-496-1426. You can also visit us on Facebook at _ Our life together is centered around three weekly gatherings: Sunday Night Student Service 9:00 p.m., Appleton Chapel Every Sunday night we gather for a "come as you are" worship service that includes the celebration of Holy Communion. The service is designed to provide a peaceful and contemplative space to find peace and encounter the divine at the start of the week. Following the service, we gather downstairs in the Buttrick Room for food and some social time together. Wednesday Night Discussion Group 9:00 p.m., Sparks House, 21 Kirkland Street, Cambridge Throughout the academic year we will come together during the middle of the week to read and discuss the works of the late Reverend Professor Peter J. Gomes. This spring we will continue discussing his best-selling book The Good Book: Reading the Bible with Mind and Heart as an entry point to conversations about what scripture is, what it isn't, and what it means for our lives as faithful contemporary Christians of the 21st century. Food will be provided. Friday Afternoon Social Gatherings 4:00 p.m., Sparks House, 21 Kirkland Street, Cambridge Every Friday afternoon we gather as a community to check in and wind down from the busy week. This is our time to plan special events, service trips, and retreats, as well as a safe place to ask those burning questions about faith, theology, and scripture that you've always wanted to know about but have been afraid to ask. [/INST] question: If you want to know some activities of The Appleton Club, there are at least _ ways. | options: A: 4 B: 3 C: 2 D: 5 | answer: B </s>

<s>[INST] context: USG: Ultrasound is the most readily available, least costly imaging technique to diagnose fibroid. It checks the number, location, and size of fibroids and helps to reduce overlooking small fibroids during surgery (which might lead to persistence or recurrence of symptoms). Sonohysterography – is instillation of saline into endometrial cavity during TVS Hysteroscopy or hysterosalpingography: These methods are useful to detect submucous fibroid in unexplained infertility and repeated pregnancy wastage. The presence and site of submucous fibroid can be diagnosed by direct visualization during hysteroscopy or indirectly as a filling defect on HSG. Hysteroscopy also allows its excision under direct vision. Uterine Curettage: It can also help in diagnosis of submucous fibroid by feeling of a bump during curettage. Laparoscopy: is helpful if uterine size is less than 12 weeks, for detection of subserous fibroid and not submucous. It can also differentiate a pedunculated fibroid from an ovarian tumor not revealed by clinical examination and ultrasound. [/INST] question: Submucosal fibroid is detected by | options: A: Hysteroscopy B: Hysterosalpingography C: USG(Transabdominal) D: Laparoscopy | answer: A </s>

<s>[INST] context: Where did that number come from? Eleven and Twelve The reason behind the change in number naming is that eleven comes from the German term ainlif, which translates to "one left". Twelve follows the same rule. It comes from twalif--"two left". Why teen is used instead of lif for 13 through 19? There is something sadly lost in history. 911 for US Emergency Calls Early phones didn't use phone numbers--the operator had to connect your call by hand--and this led to the need for an emergency code . But later phone numbers became popular, that changed. In 1967, 911 was chosen as the nationwide emergency call because it was easy to remember and could be quickly dialed on the phone. 26.2 Miles in a Marathon The story began with an ancient Greek soldier carrying message from a battlefield in Marathon to Athens. The modern marathon was born as a flagship event in the first Olympic Games, in 1896, with a distance of about 25 miles (40 km), as long as the distance from Marathon to Athens. But race organizers for the 1908 Olympic Games in London wanted to add something special. The race began at Windsor Castle and ended at White City Stadium, with runners finishing only after passing the royal box. The distance was 26.2 miles (42.1 km). And since 1924 this distance has been kept in marathon. 28 Days in February Before using the Gregorian calendar that we use today, one of the first Roman calendars had only 304 days and ten months (March through December), with six months of 30 days and four of 31 days. The second king of Rome improved the old calendar. He added 50 days for January and February. To make the new months longer, he took one day from each of the 30-day months, making 56 days to divide between January and February (or 28 days each). Later January was given one more day to add up to 355 days a year, but February still had 28 days. That's how it became the shortest month and it stayed that way ever since. [/INST] question: Which language do eleven and twelve come from? | options: A: English B: German C: French D: Russian | answer: B </s>

<s>[INST] context: Habits, whether good or bad, are gradually formed. When a person does a certain thing again, he is driven by some unseen force to do the same thing repeatedly, then a habit is formed. Once a habit is formed, it is difficult, and sometimes impossible, to get rid of. It is therefore very important that we should pay great attention to the formation of habits. Children often form bad habits, some of which remain with them as long as they live. Older persons also form bad habits lasting as long as they live, and sometimes become ruined by _ . There are other habits which, when formed in early life, are of great help. Many successful men say that much of their success has something to do with certain habits in early life, such as early rising, honesty and so on. Among the habits which children should not form are laziness, lying, stealing and so on. These are all easily formed habits. Unluckily older persons often form habits which could have been avoided. We should keep away from all these bad habits, and try to form such habits as will be good for ourselves and others. [/INST] question: _ are formed litde by little. | options: A: Good habits B: Bad habits C: Both good habits and bad habits D: Either good habits or bad habits | answer: C </s>

<s>[INST] context: Authorities will continue to take a hard line on Internet-based rumors and punish those creating fake information, a senior official said on Thursday. Authorities have removed more than 210,000 online posts and shut down 42 websites since mid-March in their latest crackdown on online rumors, said Liu Zhengrong, a senior official with the State Internet Information Office. Fake information or rumors spread through the Internet, especially on micro blogs, have harmed social order and residents' daily lives, he said at a news briefing in Beijing. Before the crackdown, six people who allegedly fabricated rumors about "military vehicles entering Beijing" had been detained and 16 websites closed for fake online information, according to police authorities. "What we've done and will do is to make sure residents can know what they want to know, say what they think and supervise our management in a reliable and useful network environment," Liu said. Liu disagreed that the Internet can police itself against rumors, and told China Daily that some netizens can't distinguish truth from fiction, "requiring government departments and website companies to take measures". On Monday, the Internet Society of China posted a proposal calling on Internet companies and websites to strengthen self-discipline and prevent the spread of online rumors. In response, three main Internet companies in the country - Sina, Baidu and Tencent - said they will target fake information with advanced technology and invest in manpower to supervise online information. Zhao Zhiguo, deputy director of the Telecommunications Administration under the Ministry of Industry and Information Technology, said stricter self-management of websites will help banish online rumors. "Internet companies should take legal responsibility when operating their websites. They should not become a hotbed for rumors and provide opportunities for fake information," Zhao said, adding they will launch similar crackdowns to close illegal website companies and punish those responsible. Currently, people who make or spread rumors related to terrorism and securities trading, or information affecting State security and companies' commercial reputations, will face criminal punishment. Liu Honghui, a Beijing lawyer specializing in online cases, said he welcomed the government's action to curb online rumors. "Residents used online banks to shop or book flights, which needs a safe platform without fake information," he said. Yu Guofu, another lawyer from Sheng Feng Law Firm, said the key to reducing rumors is netizens themselves. "If micro-bloggers think twice before forwarding information, rumors will decrease." [/INST] question: How many websites were shut down before mid-March in the latest crackdown on online rumors? | options: A: 42 B: 58 C: 16 D: 18 | answer: C </s>

<s>[INST] context: SHANGHAI, June 7(AP)--A 16-year-old girl's suicide after she was barred from a key exam draw attention to increasing worries over academic pressures, as millions of Chinese students began annual college entrance tests on Wednesday. The three-day exam, viewed as important to future career and financial success, has a record 9.5 million high school students across prefix = st1 /Chinacompeting for just 2.6 million university places. For kids and parents alike, it's a difficulty that experts say causes extreme emotional distress. "Pressure from study and exams is a top reason for psychological problems among Chinese youth," said Jin Wuguan, director of the Youth Psychological Counseling Center at Shanghai'sRuijinHospital. In China's increasingly success oriented, pressure-cooker cities, academic stress is seen as a rising cause of youth suicides and even murders of parents by children who are driven crazy by intolerable pressure to perform. According to her family and newspaper accounts, 16-year-old Wu Wenwen drowned herself after she was stopped at the exam room door because her hair wasn't tied back as her school required. Returning in tied hair, she was then told the end-of-term exam had already started and she was too late to take it. In tears, Wu called her mother, and then disappeared. Her body was found the same night in a nearby lake. China doesn't keep comprehensive statistics on student suicides, but Jin said health care professionals see the problem worsening, even among elementary students. Most Chinese schools still lack advisers and teachers receive little training in spotting symptoms of emotional distress, Jin said. Parents are little help, often piling on pressure while ignoring their children's emotional development, he said. "It's a basic unwillingness or inability to recognize and deal with with emotional problems," Jin said. Wang Yufeng, of Peking University's Institute of Mental, estimates the rate of emotional disorders such as depression among Chinese students under age 17 at up to 32 percent , a total of 30 million students. Others say that figure may be as high as 50 percent. A survey last year by the government's China Youth and ChildrenResearchCentershowed 57.6 percent of students felt highly distressed by academic pressures. [/INST] question: The 16-year-old girl committed suicide because _ . | options: A: she did not tied back her hair as required B: she couldn't get high mark in the exam C: she had an unpleasant talk with her mother D: she wasn't allowed to attend the examination | answer: D </s>

<s>[INST] context: The porter brings your bags to your room and helpfully explains all you want to know.Then he points to the phone and says:"If there's anything else you need, just call."All this time you have been thinking of one thing:"How much should I tip him?" To make your next trip a little easier, here's guide to tipping across some Asian countries. Bangkok In general, the more westernized the place is, the more likely you will be expected to leave a tip.Some top-end restaurants will add a 10% service charge to the bill.If not, waiters will appreciate your tacking on the 10% yourself.However, if you're eating at a lower-end restaurant, a tip is not necessary.If you're staying at one of Bangkok's many five-star hotels, expect to tip the porter 20 to 50 baht ,depending on how many bags you have.Taxis are now metered in Bangkok.Local custom is to round up the fare to the nearest five baht. Hong Kong Tipping is customary in this money-mad metropolis .Most restaurants add a 10% service charge to the bill, but the extra money often ends up in the pocket of the owner. If the service is good, add another 10% to the bill, up to HKMYMl00 in an especially nice restaurant.For HK MYM10 hotel porters should do it at all but the nicest hotels where a new HKMYM20 bill may be more acceptable.When in a taxi, round up to the nearest dollar. Kuala Lumpur Tipping in Malaysia is limited to the expensive westernized hotels, which often add a 10% service charge to your meal or hotel room.If you are at a hotel restaurant, expect a 10% service charge. But at local restaurants, there's no need to add a tip. At five-star hotels, one or two ringgit will satisfy a porter. At lower-end buildings don't feel you have to tip Like Bangkok, many taxis are now metered so you can just round up to the nearest ringgit. Seoul Tipping is not part of Korean culture, although it has become a matter of course in international hotels where a 10% service charge is often added.If you're at a Korean barbecue joint , there's no need to add anything extra.But a nice Italian restaurant may require a 10% contribution. If you're at a top-end hotel, so expect to pay 500~l,000 won per bag.Taxi drivers don't accept a tip.Keep the change for yourself. [/INST] question: Which of the following is NOT the unit of money?. | options: A: Charge B: Baht C: Won D: Ringgit | answer: A </s>

<s>[INST] context: Not all bodies of water are so evidently alive as the Atlantic Ocean, an S-shaped body of water covering 33 million square miles. The Atlantic has, in a sense, replaced the Mediterranean as the inland sea of Western civilization. Unlike real inland seas, which seem strangely still, the Atlantic is rich in oceanic liveliness. It is perhaps not surprising that its vitality has been much written about by ancient poets. "Storm at Sea", a short poem written around 700, is generally regarded as one of mankind's earliest artistic representations of the Atlantic. When the wind is from the west All the waves that cannot rest To the east must thunder on Where the bright tree of the sun Is rooted in the ocean's breast. As the poem suggests, the Atlantic is never dead and dull. It is an ocean that moves, impressively and endlessly. It makes all kinds of noise--it is forever thundering, boiling, crashing, and whistling. It is easy to imagine the Atlantic trying to draw breath--perhaps not so noticeably out in mid-ocean, but where it meets land, its waters bathing up and down a sandy beach. It mimics nearly perfectly the steady breathing of a living creature. It is filled with _ existences, too: unimaginable quantities of creatures, little and large alike, mix within its depths in a kind of oceanic harmony, giving to the waters a feeling of heartbeat, a kind of sub-ocean vitality. And it has a psychology. It has personalities: sometimes peaceful and pleasant, on rare occasions rough and wild; always it is strong and striking. [/INST] question: Unlike real inland seas, the Atlantic Ocean is _ . | options: A: always energetic B: lacking in liveliness C: shaped like a square D: favored by ancient poets | answer: A </s>

<s>[INST] context: Laboratory diagnosis of syphilis  Lab. diagnosis of syphilis consists of: - A) Demonstration of spirochetes under microscopy  Microscopy is applicable only in the primary & secondary stage as spirochetes are abundant during the primary, and secondary stage (maximum number of spirochetes and infectivity). Microscopy used are Dark field microscopy, and immunofluorescence microscopy (Direct fluerecent antibody test - DFA-TP). B) Serological tests  These tests form the mainstay of laboratory diagnosis. Serological tests are: - 1) Non-specific tests (reagin antibody or standard tests):- Kahn test, VDRL, Rapid plasma reagin (RPR), automated VDRL-ELISA, Washermann test. These tests measure IgG & IgM against cardiolipin. 2) Group-specific test: - CFT 3) Species-specific tests: - Treponema pallidum particle agglutination (TPPA) test, Treponema pallidum immobilization (TP1), Treponema pallidum hemagglutination assay (TPHA), ELISA.  Specific treponemal tests (FTA-ABS, TPHA, TPI) are of little value as indicators of clinical cure, as they tend to remain positive inspite of Treatment. Nontreponemal tests (eg VDRL) will become nonreactive or will be reactive at lower titers after therapy, so can be used for monitoring patient's response to treatment These tests usually become negative 6-18 months after effective treatment of syphilis  A four-fold or greater decrease in antibody titre indicates a response to therapy [/INST] question: VDRL test is used for- | options: A: Chanchroid B: LGV C: Granuloma inguinale D: Syphilis | answer: D </s>

<s>[INST] context: Jane Austen, a famous English writer, was bom at Steventon, Hampshire, on December 16, 1775, and died on July 18, 1817. She began writing early in life, although the prejudices of her times forced her to have her books published anonymously . But Jane Austen is perhaps the best known and best loved of prefix = st1 /Bath's many famous local people and visitors. She paid two long visits here during the last five years of the eighteenth century and from 1801 to 1806,Bathwas her home. Her deep knowledge of the city is fully seen in two of her novels, Northanger Abbey and Persuasion, which are largely set inBath. The city is still very much as Jane Austen knew it, keeping in its streets and public buildings the well-ordered world that she described so well in her novels. Now the pleasure of learning Jane Austen's Bath can be enhanced by visiting the Jane Austen Centre in Gay Street. Here, in a Georgian town house in the heart of the city, you can find out more about Bath in Jane Austen's time and the importance of Bathin her life and work. The Centre has been set up with the help and guidance of members of the Jane Austen Society. After your visit to the Centre, you can look round the attractive shop, which offers a huge collection of Jane Austen related books, cards and many specially designed gifts. Jane Austen quizzes are offered to keep the children busy. You can also have walking tours of Jane Austen'sBath, which is a great way to find out more about Jane Austen and discover the wonderful Georgian city of Bath. The tour lasts about one and a half hours. The experienced guides will take you to the places where Jane lived, walked and shopped. [/INST] question: Jane Austen paid two long visits to Bath _ . | options: A: in her early twenties B: in her early teens C: in her late twenties D: in her late teens | answer: A </s>

<s>[INST] context: Urine microscopy for malignant cytology "Painless haematuria is by far the most common symptom of bladder cancer and should be regarded as indicative of a bladder carcinoma until proven otherwise." Bailey & Love 25/e p1336 (24/e p1363) Cigarette smoking is the main etiological factor and accounts ,for about 50% of bladder cancers Among the given options 'urine microscopy' is the best choice for investigating a pt. with high suspicion for bladder ca. This is not a good screening test but a positive result is highly specific. The best investigation would be cystoscopy & biopsy. Investigations for bladder cancer 1. Urinary cytology - Exfoliated cells from both normal and neoplastic urothelium can be readily identified in voided urine. Examination of cytological specimens can detect the malignant cells either at the time of initial presentation or during follow-up. Cytological examination may be especially useful in screening high-risk population and assessing the response to treatment. 2. Cystourethroscopy and tumor resection - The diagnosis and initial staging of bladder cancer is made by cystoscopy and transurethral resection. 3.Imaging (IVP, CT, MRI) - Although various imaging techniques can detect bladder cancer, its presence is confirmed by cystoscopy & biopsy. - Therefore imaging modalities are used to image the upper urinary tract and, when infiltrating bladder tumors are detected to assess the depth of muscle wall infiltration and the presence of local & distant metastasis. - Intravenous urography remains one of the most common imaging tests for the evaluation of hematuria. However, intravenous pyelography is increasingly being replaced by computed tomography (CT) urography, which is more accurate, for evaluation of the entire abdominal cavity, renal parenchyma, and ureters in patients with hematuria. Bladder tumors may be recognized as pedunculated, radiolucent filling defects projecting into the lumen; nonpapillary, infiltrating tumors may result in fixation or flattening of the bladder wall. 4. Urinary tumor markers - - Several new tests have been developed in order to overcome the shocomings of urinary cytology such as the low sensitivity for low-grade superficial tumors and inter-observer variability. - Commercially available tests include, the BTA test, the BTA stat test, the BTA TRAK assay determination of urinary nuclear matrix protein (NMP22), Immunocyt and UroVysion . - These tests can detect cancer specific proteins in urine (BTA/NMP22) or augment cytology by identifying cell surface or cytogenetic markers in the nucleus. Other tests under investigation include identification of the Lewis X antigen on exfoliated urothelial cells, and the determination of telomerase activity in exfoliated cells. - These tests have been demonstrated to enhance detection of bladder cancer when used either individually or in combination with cytology. They have been used to detect both new index tumors as well as recurrent tumors. [/INST] question: A 60 yr old chronic smoker presents with painless gross hematuria of 1 day duration. Investigation of choice to know the cause of hematuria | options: A: USG B: X-ray KUB C: Urine routine D: Urine microscopy for malignant cytology cells | answer: D </s>

<s>[INST] context: Brave Frenchman Found Half-way Around the World (NEW YORK) A French tourist highly praised for rescuing a two-year-old girl in Manhattan said he didn't think twice before diving into the freezing East River. Tuesday's Daily News said 29-year who left the spot quickly after the rescue last Saturday. He lifted the little girl out of the water after she fell off the bank at the South Street Scaport museum. He handed the girl to her father, David Anderson, who had dived in after him. "I didn't think at all," Duret told the Daily News. "It happened very fast. I reacted very fast. " Duret, an engineer on vacation ,was walking with his girlfriend along the pier when he saw something falling into the water . He thought it was a doll, but realized it was a child when he approached the river. In an instant ,he took off his coat and jumped into the water. When he reached the girl, she appeared lifeless, he said . Fortunately, when she was out of the water, she opened her eyes. Anderson said his daughter slipped off the bank when he was adjusting his camera. An ambulance came later for her, said Duret, who was handed dry clothes from cookers. Duret caught a train with his girlfriend shortly after. The rescue happened on the day before he left for France. Duret said he didn't realize his tale of heroism until he was leaving the next morning . "I don't really think I'm a hero," said Duret. "Anyone would do the same ting. " [/INST] question: Why was Duret in New York? | options: A: To meet his girlfriend B: To work as an engineer C: To spend his holiday D: To visit the Andersons | answer: C </s>

<s>[INST] context: LONDON, England(CNN)-- The youngest person to sail solo around the world returned home Thursday from his 30,000-mile, 282-day ocean journey. Mike Perham, 17, sailed into Lizard Point in Cornwall, the southernmost point in Britain, at 9:47 a.m., his race team said. "It feels ly brilliant," Mike told CNN by phone hours before crossing the finish line. "I'm really, really excited to be going across the line at last. It doesn't feel like long since I crossed it first." Mike set off on his round-the-world trip on November 18, 2008. He has been sailing his yacht, TotallyMoney.com, single-handedly, though a support team has been sailing next to him along the way. ks5u The teen has now achieved the title of Youngest Sailor to Circumnavigate the Globe Solo, according to the Guinness World Records. Mike learned how to sail when he was seven years old from his father, Peter and at age 14, he sailed across the Atlantic alone. The teenager's school -- which Mike describes as "highly supportive" of his trip -- has redesigned his coursework to fit in with his trip. It also gave him some coursework to do during "quiet moments," according to Mike's Website. There haven't been many of those quiet moments. Repeated autopilot failures forced him to stop for repairs in Portugal, the Canary Islands, South Africa, and twice in Australia, according to his Web site. Bad weather in the Southern Ocean -- between Australia and Antarctica -- forced Mike to battle 50ft waves and 57 mph winds. He said at one point, a "freak wave" picked up the boat and turned it on its side. "My feet were on the ceiling at the time," he told CNN. "That was a really hairy moment, and I was certainly thinking, 'Why am I here?' But we took the sails off and the day after I thought, 'This is brilliant!'" Mike describes his father as his biggest hero, always supportive of what he wanted to achieve. Peter Perham said he wasn't too worried about his son facing dangerous situations at sea, as long as he knew what to do and stayed safe. [/INST] question: Mike Perham returned to Britain in _ . | options: A: September B: August C: October D: November | answer: B </s>

<s>[INST] context: The earth is about 4,600 million years old. Modern man has lived on the earth for only 35,000 years, but during that time, we have changed our planet in many ways. Many of the things that we have done are good, but more are not good for the earth. Water pollution A lot of people, birds and fish die each day because of water pollution. Factories have polluted the land and the water. As a result, many rivers and lakes are now dead. Air pollution In big cities, factories, as well as cars, trucks and buses are the main cause of air pollution. Many people in cities now have serious health problems. For example, Mexico city used to be a beautiful sunny capital, but today it is always covered by thick brown clouds. Soil pollution In order to have a good harvest, most of the farmers use chemicals too much in their fields. That's bad for the soil. But this kind of pollution is difficult to stop. Hope for the future These problems are very serious for our future, so all of us should do something to improve our environment. If we can stop pollution, our planet will become more and more beautiful and our health will be better. Let's be greener people! ,. [/INST] question: _ have made the earth change a lot. | options: A: Human beings B: Animals C: Plants D: People in other planets | answer: A </s>

<s>[INST] context: Human papillomaviruses (HPV) are the causative agents of cutaneous warts as well as proliferative squamous lesions of mucosal surfaces. Although most infections by human papillomavirus are benign, some undergo malignant transformation into in situ and invasive squamous cell carcinoma. Both HPV and polyomavirus have icosahedral capsids and DNA genomes. JC virus, a polyomavirus, was first isolated from the diseased brain of a patient with Hodgkin's lymphoma who was dying of progressive multifocal leukoencephalopathy (PML). This demyelinating disease occurs usually in immunosuppressed persons and is the result of oligodendrocyte infection by JC virus. JC virus has also been isolated from the urine of patients suffering from demyelinating disease. Cryotherapy and laser treatment are the most popular therapies for warts, although surgery may be indicated in some cases. At the present time, there is no effective antiviral therapy for treatment of infection with polyomavirus or HPV West Nile virus is an arbovirus. While prevalent in Europe, Africa, and the Middle East, it was not seen in the United States until the summer of 1999. It is transmitted by mosquitoes and birds, especially crows; these animals are a reservoir. WNV causes a rather mild encephalitis in humans, the exception being older patients or those who may be immunocompromised. [/INST] question: This virus is transmitted by the same arthropod that transmits babesiosis and ehrlichiosis. | options: A: Human papillomavirus B: West Nile virus C: Tick-borne encephalitis virus D: Polyomavirus | answer: C </s>

<s>[INST] context: Hello, Listeners. Welcome to Henton Hospital Radio. Before our music programme at four, I'm going to repeat some of our hospital rules. The hospital can sleep 800 patients. There're 8 beds in each ward . The visiting hours are in the afternoon from 2:30 to 3:30 and in the evening from 7:00 to 8:00. But remember only two people can see you at the same time. Sorry about that, but you can see what would happen if we didn't have these rules. The other rules are about our hours. We start quite early---you might not be used to that. We wake you at 6 o'clock, and breakfast is at 8 o'clock, lunch is at noon. There's tea at 3:30 and supper is at 6 o'clock. You can see the non-smoking sign---we don't allow smoking in the wards. I'm sure you understand why. However, if you do need to smoke, there are some smoking rooms where it is allowed. You will find the radio switch on the wall near your bed, with your own headphones, if you want to listen. It's our own hospital radio wishing you a quick recovery. [/INST] question: Who do you think the listeners might be? | options: A: Patients B: Visitors C: Doctors D: Nurses | answer: A </s>

<s>[INST] context: During surgery 1. Hypotension most common complication Rx. Prophylactic preloading with 1-1.5L of fluids (colloid preferred) Curative: a Foot end elevation b Infusion of fluids (colloids better than crystalloids) c Vasopressors Mephentermine Ephedrine Phenyl Ephrine Dopamine (if not controlled) 2. Bradycardia Rx-Atropine 3. High Spinal complications depends on levels of block up to cardio-accelrator fibres then bradycardia & hypotension, if involves cervical Diaphragmatic paralysis occur Rx. IPPV 4. Resp. paralysis (Apnea) 5. Nausea & Vomiting Rx- oxygenation Correct hypotension Metoclopramide/ Ondansetron (if not C/I) 6. Apprehension & anxiety Rx-sedate the patient Post op. 1. urinary retention 2. Neurological complications A. Post spinal headache B. Cauda equina syndrome C. Paraplegia (mostly because of epidural haematoma) Rs: Exploration & drainage of haematoma D. Paralysis of cranial N. 6th most commonly (1st ,9th, 10th are not involved) E. Anterior spinal A. syndrome F. Meningitis 3. Backache [/INST] question: The most common complication in spinal anaesthesia is | options: A: Post spinal headache B: Hypotension C: Meningitis D: Arrhythmia | answer: B </s>

<s>[INST] context: Tigers are among the most admired and most feared animals in the world . When we think of a tiger, we think of danger. We think of the big teeth and large feet of it. We also think of beauty. The tiger is a hunter that hunts alone. In fact , tigers are probably better than any other land mammal at catching large animals without help. Even so, the life of this big-game hunter isn't easy. Finding food can be difficult, especially for a tiger that is old or weak. Most of the animals it tries to attack get away. A tiger sometimes goes weeks without eating. When that happens, it may hunt animals that can be dangerous even for a tiger. When they are in a bad situation, some tigers may even attack humans. But in fact, tigers kill very few people each year. Most tigers run away when they see people. What tigers have done to people can't compare to what people have done to tigers. Over the last 200 years, we have almost killed tigers in the wild . Today, the tiger is one of the most endangered animals on Earth. A tiger may live 20 years or more, if it is not disturbed by humans. Female tigers usually live longer than male tigers, because the males live more dangerously. It isn't easy for people to tell a male from a female unless the female happens to be with her babies.Only females take care of the young. The big difference between males and females is size. Male tigers are much bigger. Tigers are big eaters. In a single year, one tiger must eat about 70 deer or other large animals. That is one reason why tigers hunt alone. If they lived in big groups, they could never find enough animals to feed them all. [/INST] question: The easiest way to tell a male tiger from a female one is by looking at their _ | options: A: size B: running speed C: way of hunting D: claws | answer: A </s>

<s>[INST] context: CSDT writes - "Regardless of the cause, if bleeding recurs after it has once stopped, the chances of success without operation are low. Most patients who rebleed in the hospital should have surgery. In 85% of patients, bleeding stops within a few hours of admission. About 25% of patients rebleed once bleeding has stopped. Rebleeding episodes are concentrated with the first 2 days of hospitalization, and if the patient has had no further bleeding for a period of 5 days, the chances of rebleeding is only 2%. Rebleeding is most common in patients with varices, peptic ulcer, anemia or shock. About 10% of patients require surgery to control bleeding, and most of these patients have bleeding ulcers, or less commonly, esophageal varices. The death rate is 30% among pts who rebleed and 3% among those who do not. The mortality rate is also high in the elderly and in patients who are already hospitalized at the onset of bleeding. Analysis of large series of patients suggests that a number of those who died would not have done so if operations had been performed earlier and more often." [/INST] question: A patient comes with hematemesis and malena. On the upper GI endoscopy there was no significant finding. 2-days later the patient rebleeds. Next line of investigation is | options: A: Emergency angiography B: Repeat upper GI endoscopy C: Enteroscopy D: Laprotomy | answer: D </s>

<s>[INST] context: Do you know that it is your own immune system working against the virus that makes you uncomfortable when getting a cold, but not the virus itself? So when you have got a strong immune system and the virus is strong enough too, you will possibly get terrible cold symptoms( ) ? Vitamin C won't stop a cold It is claimed that Vitamin C helps by increasing white blood cells. However, many tests have shown that it does not prevent colds. At best, it only slightly reduces the rime of symptoms. Staying indoors won't protect you One of the most likely sources of cold viruses is your computer mouse or desk. A study of the cold virus in offices found that 47% of desktops, 46% of computer mice and 45% of telephones had cold viruses on them. Wrapping up warm won't protect you Colds are more common in autumn and winter. That's because the cool, wet and cold weather drives people indoors, where viruses may more easily jump from one person to another. And the distinct peak in colds is in September and early January, which is likely due to the return of students to schools and colleges after the summer and winter vacation. Old granny's chicken soup is right Granny's chicken soup is an old cure for colds since a long time ago. Scientists say it is true. Chicken soup does help cure a cold. Many canned soups are just efficient as homemade ones. [/INST] question: It is _ that makes you uncomfortable when getting a cold. | options: A: the virus itself B: Vitamin C C: the terrible cold symptom D: your own immune system | answer: D </s>

<s>[INST] context: Hit song Little Apple became so popular after it came out in late May. In China, you may hear it on a bus, or even in a small village. Little Apple is a song for the movie Old Boys: The Way of Dragon. The song's huge success has also made more people see the movie. The comedy took US $17 million in its opening four days. The song Little Apple is so popular. "After hearing it, it's like "I'm brainwashed " by the song. So I came to see the film." a man said. "It's a good story. But the reason I'm here at the cinema is the song Little Apple." Hui Qing, a college student, said. "Many people have come to see the movie, so we added more screenings for it. The film now accounts for 20 percent of the total screenings -- It's quite a good performance for a home-grown movie," a cinema clerk said. Old Boys: The Way of Dragon is based on an online short film called Old Boys. The 40-minute film about youth and dreams got nearly 70 million views on a video website, and was popular among people born in the 1980s or later. "What is popular online is a good indication of what will be popular with young people. And this movie is a good example," businessman Chen Su said. Some have criticized Little Apple for its low quality, but the song continues keeping popular. [/INST] question: The movie Old Boys is a _ . | options: A: comedy B: soap opera C: sad movie D: talk show | answer: A </s>

<s>[INST] context: John Brown, an office worker, lives in Washington. He inherited $1 000 000 when he was 23. He didn't feel happy at all. His college friends were looking for their first jobs, but he didn't tell any of his friends and gave $ 1 000 000 of his money to a charity that helped poor children to live better lives. Today he is 36, he still wears cheap shoes and clothes and owns a small car only, but he is much happier. Up to now, John has helped 15 children from poor countries all over the world, $200 a month for each. The money is used to afford the child's education, food, medical care and clothing. John receives a report each year on the child's progress. They can write to each other, but usually the children do not speak English. Once John went to meet a little girl in Africa. He said that the meeting was very exciting. "When I met her, I felt very happy." he said. "I saw that the money was used for a very good plan. It brought me closer to the child. I will do everything I can to help those children in need." he added. ,A, B, C, D,. [/INST] question: What does John Brown do? | options: A: A boss B: A teacher C: An office worker D: An artist | answer: C </s>

<s>[INST] context: When many people are worried that there are no more heroes in the modern era two university students who lost their lives to rescue drowning children have shown that heroes still exist . According to the Inner Mongolia Morning Post, the tragedy occurred on the afternoon of December 14, 2002 when three school students skating on a frozen lake in Qingcheng Park in Hohhot fell through the ice into the freezing water. More than 20 university students who happened to be near the spot immediately went to the rescue of the children. Two children were quickly rescued, but the third died. The child's body was not found for three hours. Two of the rescuers, Liu Ye and Hao Longbiao, also died of cold and exhaustion . The body of Hao and who took the lead in jumping into the lake was not found until the next day. A student who was unwilling to tell his name said he and his classmates from the local college were taking photos at the lake. When they heard the children's cries for help, they went to the ice hole hand in hand to rescue the children. But the ice kept breaking, causing most of then to fall into the icy water. Local residents held mourning ceremonies at the lake. Eight of the students were seriously affected by the freezing water and were being kept in hospital for further observation, but their lives were no longer in danger. [/INST] question: When the three students fell into water,the university students were _ . | options: A: skating on the ice B: taking photos at the lake C: having a picnic D: walking along the lake | answer: B </s>

<s>[INST] context: The One and Only Ivan [hardcover] Katherine Applegate (Author) Patricia Castelao (Illustrator) 4.6 out of 5 stars See all reviews (117 customer reviews) / Like (58) List Price: $16.99 Price: $9.34 (for total orders over 25.) Usually ships within 1 to 3 weeks. Ships from and sold by Amazon. com. Gift-wrap available. Product Details Reading level: Ages 8 and up Hardcover: 320 pages Publisher: Harper Collins Languages: English ISBN-10: 0061992254 ISBN-13: 978-0061992254 Shopping weight: 15.2 ounces (View shipping rates and policies) Book Description Release Date: January 17, 2012 Age level: 8 and up Grade Level: 3 and up Ivan is an easy-going gorilla. Living at the Exit 8 Big Top Mall and Video Arcade, he has grown accustomed to human watching him. He rarely misses his life in the jungle. Instead, Ivan thinks about TV shows he's seen and about his friends. But mostly Ivan thinks about art and how to capture the taste of a mango. Then he meets Ruby, a baby elephant, and she makes Ivan see their home--and his own art--through new eyes. When Ruby arrives, change comes with her, and it is up to Ivan to make it a change for the better. Katherine Applegate blends humor and poignancy to create Ivan's unforgettable first-person narration in a story of friendship, art and hope. [/INST] question: The book is suitable for readers who are _ . | options: A: 3-5years old B: 5-7 years old C: 7-8 years old D: more than 8 years old | answer: D </s>

<s>[INST] context: Infiniti, Nissan's luxury brand, continues to show off ideas for the future. The Q80 Inspiration here in Paris is an excellent piece of work, perhaps a concept elegant enough to make us forget that Infiniti's former Hong Kong-based president, Johan de Nysschen, moved to take over General Motors' Cadillac car brand in July and Infiniti chairman Andy Palmer is the new CEO at Aston Martin, the British luxury car brand. The Q80, if it becomes reality, will be brought to market by Infiniti's new boss, former BMW (another famous car brand )executive Roland Kruger. He should focus on this, at least until he is head-hunted to another company. The Q80 Inspiration is a low and sexy four-door fastback, and it is also a showcase for technology - from autonomous driving to eco-friendly power trains. Here in Paris, the Infiniti people say the hybrid drive in this concept suggest exactly where the brand is going in the future. The company says the Q80 speaks to how Infiniti plans to pull people into more expensive cars - cars that compete with the Porsche Panamera, for instance. Alfonso Albaisa, Infiniti Executive Design Director, said the car "delivers feminine elegance and muscular menace in equal measure and strikes big in terms of styling, craftsmanship, choice of materials and attention to detail." Most importantly, for luxury cars buyers who are increasingly puzzled by all the technology, the designers focused on making things simple. "There is a tendency with modern design that every time you add interior features and technology you add complexity," said Albaisa, pointing to the concept's easy-to -understand -and -operate infotainment interface. As for power, the Q80 Inspiration gets 550 horsepower from a twin turbocharged 3.0-litre V-6 combined with a hybrid electric power train. Fuel economy could be as good as 5.5 litres/100 km. [/INST] question: Who will take charge of the launch of the Q80 Inspiration? | options: A: Andy Palmer B: Alfonso Albaisa C: Johan de Nysschen D: Roland Kruger | answer: D </s>

<s>[INST] context: Why is pink or purple a color1 for girls and blue or brown for boys? The answer depends largely on cultural values as well as personal experiences. To the Egyptians, green was a color1 that represented the hope and joy of spring, while for Muslims, it means heaven. Red is a symbol of good luck in many cultures. In China, children are given money in a red envelope to bring good fortune in the New Year. For many nations, blue is a symbol of protection and religious beliefs. Greek people often wear a blue necklace hoping to protect themselves against evils . People's choice of color1s is also influenced by their bodies' reactions toward them. Green is said to be the most restful color1. It has the ability to reduce pain and relax people both mentally and physically. People who work in green environment have been found to have fewer stomach aches. Red can cause a person's blood pressure to rise and increase people's appetites . Many decorators will include different shades of red in the restaurant. Similarly, many commercial websites will have a red "Buy Now" button because red is a color1 that easily catches a person's eye. Blue is another calming color1. Unlike red, blue can cause people to lose appetite. So if you want to eat less, some suggest that eating from blue plates can help. The next time you are deciding on what to wear or what color1 to decorate your room, think about the color1 carefully. [/INST] question: Muslims regard green as a symbol of heaven mainly because of their_. | options: A: commercial purposes B: cultural values C: personal experiences D: physical reactions to the color1 | answer: B </s>

<s>[INST] context: Museum of Fine Arts, Boston HOURS The MFA is open 7 days a week. Monday and Tuesday: 10 am - 4:45 pm Wednesday - Friday: 10 am - 9:45 pm Saturday and Sunday: 10 am - 4:45 pm HOLIDAYS AND CLOSINGS The Museum will be closed on the following holidays: New Year's Day, Patriots' Day (third Monday in April), Independence Day (July 4), Thanksgiving, and Christmas Day. The Museum will close early on Wednesday, at 4:45 pm, June 11, and Thursday, July 24. ADMISSION Adults: $25 Seniors (65+): $23 Students (18+): $23 Youths 7 - 17*: FREE* Children 6 and under: FREE *Weekdays after 3 pm, weekends, and Boston public school holidays; otherwise $10. PUBLIC TRANSPORTATION Take the T! Because our limited parking fills up quickly - especially during popular exhibitions, holidays, and school vacation weeks - we encourage you to take advantage of the MBTA, Boston's public transportation system (known by natives as the "T"). Subway Take the Green Line E train to the Museum of Fine Arts stop, or the Orange Line train to the Ruggles stop. Bus Take the 39 bus to the Museum of Fine Arts stop, or the 8, 47, or CT2 buses to the Ruggles stop. The MFA strives to maintain a safe, comfortable, and respectful environment for all visitors. We also take our role as guardians of the objects in our collection very seriously. Please enjoy all that the Museum has to offer and observe the policies listed here to help protect and preserve the art on view in the Museum. When Visiting the MFA Please Refrain from the Following: Touching any art objects Getting closer than 12 inches to any unprotected artwork Gesturing within 2 feet of any artwork Smoking Chewing gum Running, yelling, or disruptive behavior Cell phone usage in the galleries Flash photography [/INST] question: What day can you spend the longest at the museum? | options: A: On Mondays B: On Fridays C: On Sundays D: On Independence Day | answer: B </s>

<s>[INST] context: Despite all the treatments now available, the outcome for patients with diabetes remains disappointing. Longterm complications of diabetes still cause significant morbidity and moality (Boxes 21.31 and 21.32). Excess moality in diabetes is caused mainly by large blood vessel disease, paicularly myocardial infarction and stroke. Macrovascular disease also causes substantial morbidity from myocardial infarction, stroke, angina, cardiac failure and intermittent claudication. The pathological changes of atherosclerosis in diabetic patients are similar to those in the non-diabetic population but occur earlier in life and are more extensive and severe. Diabetes amplifies the effects of the other major cardiovascular risk factors: smoking, hypeension and dyslipidaemia (Fig. 21.11). Moreover, patients with type 2 diabetes are more likely to have additional cardiovascular risk factors, which co-segregate with insulin resistance in the metabolic syndrome (p. 805). Disease of small blood vessels is a specific complication of diabetes and is termed diabetic microangiopathy. It contributes to moality through renal failure caused by diabetic nephropathy, and is responsible for substantial morbidity and disability: for example, blindness from diabetic retinopathy, difficulty in walking, chronic ulceration of the feet from peripheral neuropathy, and bowel and bladder dysfunction from autonomic neuropathy. The risk of microvascular disease is positively correlated with the duration and degree of sustained hyperglycaemia, however caused and at whatever age it develops. DAVIDSONS PRINCIPLES AND PRACTICE OF MEDICINE 22ND EDITION PAGE NO-826 [/INST] question: A 65-year-old woman with history of type 2 diabetes mellitus for the last 8 years dies in a hospital She had no other significant medical history. Which of the following is the most likely cause of her death? | options: A: Diabetic ketoacidosis B: Myocardial infarction C: Renal failure D: Stroke | answer: B </s>

<s>[INST] context: Things Your Pilot Won't Tell You You may not be getting the airline you paid for. You may go to an airline website and buy a ticket, and get onto an airplane that has a similar name painted on it, but half the time, you're really on a regional airline.The regionals aren't held to the same safety standards as the majors: their pilots aren't required to have as much training and experience, and the public doesn't know that. --Captain at a major airline If you're a nervous flier, book a morning flight. The heating of the ground later causes bumpier air, and it's much more likely to thunderstorm in the afternoon. --Jerry Johnson , pilot, Los Angeles The smoothest place to sit is often over or near the wing. The bumpiest place to sit is in the back.If you're in the middle, you don't move as much. --Patrick Smith, pilot, and author of Cockpit Confidential Sit in the front if you want fresher air. The general flow of air in any airplane is from front to back.So if you're really concerned about breathing the freshest possible air or not getting too hot, sit as close to the front as you can.Planes are generally warmest in the back. --Tech pilot at a regional airline, Texas You never know where the safest seat is. There is no safest place to sit.In one accident, the people in the back are dead; in the next, it's the people up front. --John Nance, aviation safety analyst and retired airline captain, Seattle I've been struck by lightning twice. Most pilots have.Airplanes are built to take it.You hear a big boom and see a big flash and that's it.You're not going to fall out of the sky. --Charlotte, pilot for a regional earner,.North Carolina People don't understand why they can't use their cell phones. Well, what can happen is 12 people will decide to call someone just before landing, and I can get a false reading on my instruments saying that we are higher than we ideally are. --Jim Tilmon, retired American Airlines pilot, Phoenix [/INST] question: Jerry Johnson advises nervous fliers to _ . | options: A: sit in the back B: fly in the morning C: fly with major airlines D: avoid flying in bad weather | answer: B </s>

<s>[INST] context: Do you know how to be a healthy kid? Here are some rules you should follow. First, eat different food, especially fruits and vegetables. You may have a favorite food, but you'd better eat something different. If you eat diff You can't watch TV for more than two hours a day errant food, you will probably get more nutrients your body needs. Second, drink water and milk as often as possible. When you are really thirsty, cold water is the No. 1 choice. Milk is a great drink that can give you more calcium your body needs to grow strong bones. Third, listen to your body. How do you feel when you are ill? When you're eating, notice how your body feels and when your stomach feels comfortably full. Eating too much will not make you feel comfortable and make you feel fat. Fourth, limit screen time. Screen time is the time you watch TV, DVDs and videos, or using computers. It is good to take more exercise such as basketball, bike riding and swimming. You can't watch TV for more than two hours a day. Fifth, be active. One thing you'd like to do, as a kid, is to find out which activity you like best. Find ways to be active every day. [/INST] question: You shouldn't watch TV for _ a day. | options: A: more than two hours B: less than two hours C: more than three hours D: four hours | answer: A </s>

<s>[INST] context: It seems that the Great Wall is the place to rock . There will be two parties held on the Great Wall this month. Great Wall I The latest Great Wall party is sponsored by the Club and Elektrobeat and held at Jinshanling. Local DJ Mark, as well as guests Slab from Australia, Usami and Bobby from Hong Kong will sing at the party. All drinks are priced at 20 yuan($ 2.4). Tickets: 200yuan($ 24), including bus ride there and back plus entrance fee to the Great Wall. T/D: 8p.m. to 2 a.m., Sept. 20. Pre-sale tickets are to be booked at: Public Space: 6416-0759; Neo Lounge: 6416-1077. Buses: Leave at 5 p.m. on Saturday, Sept. 20 from Neo Lounge, 99 Xinfuncun Zhonglu, Sanlitun, Chaoyang District. For more info: www. elektrobeat. com Great wall II The other party at the end of this month at Jinshanling will be started with live performances by Askar, Brain Failure, Longkuan, Supermarket, Mr. Zhou, Beijing Talking and the Yi band. Dance till dawn to the wonderful sounds of DJs Ben, Mickey Zhang, Will, Cheese, Gao Hu and Huang Weiwei. T/D: 8 p.m. to 2 a.m., Sept. 27. Tickets: 350 yuan ($ 42) or 300 yuan ($ 36) for groups of 10 or more, 500 yuan ($ 60) at the door and VIP tickets 800 yuan ($ 72), transportation included. Buses: Depart from the north gate of Wbrkers' Stadium at noon, 2 p.m., 4 p.m., Sept. 27. For more info: contact Li Zhenhua at lah@msgp. Org or call 133-2119-1731. [/INST] question: If you want to book tickets for Great Wall I in advance, you can phone _ . | options: A: 6146-0759 B: 6146-1077 C: 6416-0759 D: 133-2119-1731 | answer: C </s>

<s>[INST] context: Kung Fu Panda is a 2008 American computer-animated action comedy movie made by DreamWorks. It was directed by John Stevenson and Mark Osborne. It tells the story about a big fat panda named Po who is a kung fu fan. The movie came out in 2008 and stars Jack Black as Po. It received critical acclaim and became a box office success. A successful sequel , Kung Fu Panda 2 was released in 2011. A big, fat panda named Po the panda dreams of becoming a kung fu master, but he doesn't know kung fu. One day, kung fu teacher Master Shifu holds a competition to see who will become the Dragon Warrior , the most powerful kung fu master in the land. Everyone thinks one of Shifu's students, the Furious Five will become the Dragon Warrior, but Po is chosen instead and begins learning kung fu. Shifu and the Furious Five don't like Po the panda and try to make him quit, but he becomes friends with them. When Master Shifu learns that the evil Tai Lung the snow leopard is coming to the land, he quickly teaches Po kung fu so he can be given the Dragon Scroll that will help him beat Tai Lung. Nothing is written on the scroll, but Po finds out that he doesn't need the scroll to be the Dragon Warrior and beats Tai Lung without it. Po becomes a kung fu master and Dragon Warrior loved by everyone and peace returns to the land. [/INST] question: When did the movie Kung Fu Panda first published? | options: A: 2008 B: 2009 C: 2010 D: 2011 | answer: A </s>

<s>[INST] context: To us, it seems so natural to put up an umbrella to keep the water off when it rains. But in fact the umbrella was not invented as protection against the rain. Its first use was as a shade against the sun. Nobody knows who first invented it, but the umbrella was used in very ancient times. Probably the first to use it were the Chinese, back in the eleventh century BC. We know that the umbrella was used in ancient Egypt and Babylon as a sunshade. And there was a strange thing connected with its use : it became a symbol of honor and power . In the Far East in ancient times, the umbrella was allowed to be used only by those in high office or by royal people such as the kings or queens. In Europe, the Greeks were the first to use the umbrella as a sunshade. The umbrella was in common use in ancient Greece, but it is believed that the first people in Europe to use the umbrella as protection against the rain were the ancient Romans. During the middle ages in Europe, the use of the umbrella almost disappeared. Then it appeared again in Italy in the late sixteenth century. And again it became a symbol of power. Umbrellas have not changed much in style during all this time, though they have become much lighter in weight. It wasn't until the twentieth century that the umbrellas for women began to be made in all kinds of colors. [/INST] question: Ancient people first used umbrellas as _ . | options: A: a symbol of honor B: protection against the sun C: a symbol of power D: protection against the rain | answer: B </s>

<s>[INST] context: Livescribe Echo Smartpen, $79.99 This pen not only records audio, but also records whatever the user writes and even draws. This translates to almost two hours of full audio, or 32000 pages of written text. When using a Livescribe notebook, a college or high school student can easily edit notes without the disturbance of a laptop or tablet. This is perfect for the classrooms that don't allow the use of electronics. Best of all, it allows users to quickly deliver their notes to a computer or laptop. Logitech Bluetooth Keyboard, $107.53 It is a great choice for those who own many different devices and want to use a keyboard over the ones that come with the device. It works on tablets, PCs and even smartphones. It offers four different settings for each device, so changing from one to the other is as easy as turning a knob . It even has a cradle to hold a tablet at the perfect angle, so typing is much easier and faster. ILUV Syren Pro, $ 93.84 It is weather resistant and has a powerful sound engine that works in a full 360 degrees. This allows it to be used outdoors, next to pools and in other activities that are too risky to use other speakers. It offers Bluetooth support and works with iPhones, iPads and many other devices. With its top-mounted controls and wireless capabilities, it can be operated remotely. Cobra JumPak $92.88 It can not only charge phones, but also do the same for most cars. It contains a built-in LED flashlight and a 7500mAh battery, as well as a USB port for charging phones. Best of all, it can be stored inside a backpack, so it is perfect for emergency situation and can even be stored in car console . [/INST] question: Which device will a high school student choose to use in the classrooms ? | options: A: Livescribe Echo Smartpen B: Logitech Bluetooth Keyboard C: ILUV Syren Pro D: Cobra JumPak | answer: A </s>

<s>[INST] context: Characteristics includelarge, soft, friable, easily detached vegetations consisting of fibrin and intermeshed inflammatory cells and bacteria. Complications may includeulceration, often with perforation, of the valve cusps or rupture of one of the chordae tendineae. 2. Classification Acute endocarditis is caused by pathogens, such as Staphylococcus aureus (50% of cases). This type of endocarditis is often secondary to infection occurring elsewhere in the body. Subacute (bacterial) endocarditis is caused by less virulent organisms, such as Streptococcus viridans (more than 50% of cases). This type of endocarditis tends to occur in patients with congenital hea disease or preexisting valvular hea disease, often of rheumatic origin. 3. Clinical features a. Valvular involvement The mitral valve is most frequently involved. The mitral valve along with the aoic valve is involved in about 40% of cases. The tricuspid valve is involved in more than 50% of cases of endocarditis of intravenous drug users, in whom endocarditis is most often caused by staphylococcal infection. b. Complications Distal embolization occurs when vegetations fragment. Embolization can occur almost anywhere in the body and can result in septic infarcts in the brain or in other organs. The renal glomeruli may be the site of focal glomerulonephritis (focal necrotizing glomerulitis) caused by immune complex disease or by septic emboli. [/INST] question: Irregular, bulky and friable vegetation in cardiac valve are a finding of which of the following disorders? | options: A: Infective endocarditis B: Rheumatic endocarditis C: Libman sack endocarditis D: Non bacterial endocarditis | answer: A </s>

<s>[INST] context: John Wesley Powell(1834--1902)Was a famous explorer of the American West.When he Was young,his mother put him under the guidance of George Crookham,a self-taught scientist,from whom he received a wide,but informal,education.Young John learned many things about the natural sciences.But his father preferred him to study religion.The argument continued for three years.Then John decided to leave home to seek further education.He soon discovered that he knew more about science than any teacher he met.He realized that the only good scientific education in the country came from colleges in the east,like Harvard and Yale.But he Was too poor to go to them,SO he got work as a school teacher in Illinois.Whenever possible,he went on scientific trips of his own. In 1861,civil war broke out in the United States.John joined the Union forces of the North.At the battle of Shiloh Powell lost his right arm.Despite his disability, he began his famous exploration of the Colorado River on May 24 1869. It Was one of the greatest trips of discovery in the history of America.Never before had any white men traveled to that area.The trip Was far more dangerous than expected.The rivers were filled with rocky areas and waterfalls.Sometimes,the boats overturned or broke into pieces against big rocks.All along the way, Powell measured distances,temperatures,heights,depths and currents.He examined soils,rocks and plant life.Powell'S explorations led to the creation of US Geological Survey, which became responsible for all mapping and scientific programs of American lands. Powell's scientific studies of western lands shaped his ideas of how those lands should be used.He suggested programs to control both crop farming and cattle raising.He Was especially concerned about water supplies.Many of his ideas were rejected at first and were not signed into law until years after his death because they were far ahead of his time. [/INST] question: Who do you think had a major influence on John Wesley Powell'S life? | options: A: His mother B: George Crookham C: His father D: The teachers in Harvard and Yale | answer: B </s>

<s>[INST] context: Hypopigmented anaesthetic patch in a child, who is coming from endemic zone of Leprosy, can be leprosy. Here the option provided is intermediate leprosy. Higher incidence of leprosy is seen in Assam, West Bengal, Bihar, Orissa, Madhya Pradesh, Madras, Andhra, and Kerala. In intermediate or dimorphous leprosy, the lesions are slow growing, indeterminate, paly anaesthetic macules and sometimes with satellite lesions. Later lesions resemble those of tuberculoid or lepramoatous leprosy or both. Peripheral nerves are involved early and severely. Pityriasis alba is a form of atopic dermatitis. It presents as ill-defined, hypopigmented, round patches on the face, neck, and trunk. Nevus anemicus is a congenital vascular anomaly that appears as a permanently pale, mottled lesion that occurs most often on the trunk. The lesions appear hypopigmented but contain normal amounts of pigment. Nevus achromicus or depigmentosus is a hypopigmented patch occurring as long linear streaks or as well circumscribed isolated patches. Affected areas are usually unilateral and may be small. [/INST] question: A 7 year old child from Bihar has a hypo pigmented anesthetic patch on his face. What is the most probable diagnosis? | options: A: Intermediate leprosy B: Pityriasis alba C: Nevus anemicus D: Nevus achromicus | answer: A </s>

<s>[INST] context: RichardSolo 1800 Rechargeable Battery In just minutes a day, plug in and charge your iPhone quickly! Just plug RichardSolo 1800 into your iPhone once or twice a day, for fifteen minutes, and keep your iPhone charged up. At your desk, or at dinner, plug RichardSolo into iPhone to instantly transfer change. No more battery worries. RichardSolo will charge iPhone to full 1.5 time, and it is good for 3-5 years of recharges. Use the iPhone while charging it. Even charge the RichardSolo 1800 and iPhone together at the same time. Take only one charger when traveling and wake up in the morning with the RichardSolo and the iPhone charged. RichardSolo 1800 is largest in its class and holds its charge for months. Works with almost all iPhone cases. Your satisfaction is guaranteed, with our 30-day return privilege. If you're not satisfied for any reason, we'll email you a pre-paid return label. Actual customer comments: To have your company exhibit such good service is unbelievably refreshing. ---P.S. This is what I call great customer support. I wish more companies would figure this out these days. Thank you so much.---D.C. You have provided me one of the best services I have ever seen on any online/telephone shopping.--T.K. You must have the fastest processing and shipping in the industry!!--M.C. This is the best customer service experience I have had in a long time.---L.L. I've read online about your amazing customer service, and I must say I'm now a true believer.---B.L. [/INST] question: How long does it take the battery to charge up an iPhone? | options: A: 15 minutes B: 30 minutes C: 1.5 hours D: 3 hours | answer: A </s>

<s>[INST] context: Bronchioloalveolar carcinoma It is a histological type of adenocarcinoma. It occurs in the pulmonary parenchyma in the terminal bronchioloalveolar pattern. The tumor is almost always in the peripheral portion of the lung. More often it occurs as multiple diffuse nodules that sometimes coalesce to produce a pneumonia-like consolidation. The key feature of bronchioloalveolar carcinomas is their growth along preexisting structures without destruction of the alveolar architecture. This growth pattern has been termed "lepidic" an allusion to the neoplastic cells resembling butterflies sitting on a fence. Stromal, vascular or pleural invasion is characteristically absent. Bronchioloalveolar carcinoma consists of mucin-secreting bronchiolar cells, Clara cells, or rarely type II pneumocytes. These tend to have aerogenous spread and patient usually dies of suffocation (not by metastatic spread). Bronchioloalveolar carcinoma has two subtypes - i) Non-mucinous → Rare aerogenous spread and therefore amenable to surgical resection. ii) Mucinous → Tend to spread aerogenously, forming satellite tumors. [/INST] question: Histopathology of a lung cancer shows 'Clara cells' probable diagnosis is - | options: A: Squamous cell cancer B: Bronchio alveolar cancer C: Large cell cancer D: Papillary carcinoma | answer: B </s>

<s>[INST] context: Rabindranath Tagore was an Indian writer and poet, who was the first non-European to win the Nobel Prize in Literature in 1913. Composed of 326 short verses, Stray Birds is a collection of short verses translated from Bengali into English by the poet himself, where Tagore spiritualizes nature into the experiences of human existence while demonstrating his love for nature and simplicity through poetic words. Now read the following verses taken from Stray Birds(1916) and try to answer the questions. *Man does not reveal himself in his history, he struggles up through it. (verse 52) *The cloud stood humbly in a corner of the sky. The Morning crowned it with splendour . (verse 100) *Man is worse than an animal when he is an animal. (verse 248) *Bees sip honey from flowers and hum their thanks when they leave. The gaudy butterfly is sure that the flowers owe thanks to him. (verse 127) *The stream of truth flows through its channels of mistakes. (verse 243) *Let him only see the thorns who has eyes to see the rose. (verse 230) *Set bird's wings with gold and it will never again soar in the sky. (verse 231) *Men are cruel, but Man is kind. (verse 219) *Let me not put myself wrongly to my world and set it against me. (verse 206) *Wrong cannot afford defeat but right can. (verse 68) *"I give my whole water in joy," sings the waterfall. "though little of it is enough for the thirsty." (verse 69) *The woodcutter's axe begged for its handle from the tree. The tree gave it. (verse 71) *Thank the flame for its light, but do not forget the lampholder standing in the shade with constancy of patience. (verse 64) [/INST] question: Which of the verses sing praise for those who are ready to sacrifice themselves without asking anything in return? | options: A: verse 248 &69 B: verse 71 & 100 C: verse 69 & 71 D: verse 100& 52 | answer: C </s>

<s>[INST] context: Those accustomed to browsing through thousands of books in large bookstores may find Japan's Morioka Shoten a little strange. That's because this tiny bookstore that is located in Ginza, Tokyo sells only a single book at a time. Opened in May 2015, Morioka Shoten is the brainchild of Yoshiyuki Morioka. He began his career as a bookstore clerk in Tokyo's Kanda district before branching out to open his own store. It was here while organizing book reading and signing that he realized that customers usually came into the store with one title in mind. Morioka began to wonder if a store could exist by selling multiple copies of just one single book. In November 2014, he partnered with Masamichi Toyama to establish a unique bookstore with the philosophy of "A Single Room with a Single Book". The selections that are picked by Morioka change weekly and vary widely to attract customers with different interests. Recent choices include The True Deceiver, an award-winning Swedish novel by Tove Jansson, Hans Andersen's Fairy Tales, and a collection of Karl Blossfeldt's photography of plants. Morioka has also selected books written by a famous Japanese author Mimei Ogawa. To highlight his only offering, Morioka often uses clever tricks. For example, when selling a book about flowers, the storekeeper decorated his shop with the ones that had been mentioned in the book. He also encourages authors to hold talks and discussions so they can connect with customers. Morioka says his goal is for the customers to experience being inside a book, not just a bookstore. Risky as the idea might seem, things appear to be going well. The storekeeper says he has sold over 2,100 books. Things can get better given that his bookstore is becoming increasingly popular not just among the locals but also visitors form other countries. [/INST] question: What inspired Morioka to open such a bookstore? | options: A: A Swedish novel B: His present partner C: A bookstore clerk D: His working experience | answer: D </s>

<s>[INST] context: American researchers have discovered that human brains and sleep patterns are confused by devices that give out bright lights. Electronics, such as laptops, mislead our minds into thinking that it is still daytime, preventing sleep and increasing the risk of _ . Sleep experts say human's natural body clock begins to rest and relax from the day between 9 and 10 pm but the use of computers confuses it. A person's brain biologically becomes awake when the sun is out because bright light after dark causes the brain to stop producing the hormone called melatonin that makes us sleepy. Researchers say blue light from devices such as iPads, which is expected to become a popular reading tool when it comes out later this month, is particularly disruptive during the night when the brain thinks it should be dark. Experts say a good book is a far better way of resting the brain and ensuring a good night's sleep because the bedside lamp light doesn't affect the brain as it does not look straight into a person's eyes. "Potentially, yes, if you're using an iPad or a laptop close to bedtime... that light can be stimulating to the brain to make it more awake and delay your ability to sleep," Phyllis Zee, a professor at Northwestern University and director of the school's Centre for Sleep & Circadian Biology, told CNN. "And I think more importantly, it could also be enough to affect your circadian rhythm. This is the clock in your brain that determines when you sleep and when you wake up. " Alon Avidan, associate director of the Sleep Disorders Center at the University of California Los Angeles, added, "I wish people would just take a boring book -- an oldfashioned book -- and read by a lamp." [/INST] question: Melatonin is the hormone that _ . | options: A: makes us sleepy B: helps us relaxed C: prevents us from waking up D: makes us excited | answer: A </s>

<s>[INST] context: A new study done by the Higher Education Quality Council of Ontario (HEQCO) shows that it doesn't make much of a difference that parents reward their children with cash for their better marks. Many parents have offered cash to their children in the hope that it would improve marks and possibly raise their children's interest in achieving higher marks. The study, conducted by researchers from the University of Toronto (UT) and the Massachusetts Institute of Technology (MIT) to learn more about the potential for financial encouragement as motivation for improved marks, involved first and second year students receiving financial aid in 2008-2009 at the University of Toronto Scarborough. The top students participating in the study who said they were "very concerned" about having enough money to complete their degrees were to receive $100 for getting a grade of 70 per cent for each one-semester course, plus $20 for every percentage point beyond that.It was imaginable that a student could earn as much as $700 for achieving 100 percent in a course. Harvey Weingarten, president and CEO of HEQCO said, "In its efforts to help disadvantaged students by exploring the idea of paying them to attend school, the Toronto District School Board (TDSB) is asking the same question many other districts are asking about how to improve student participation and performance.Our study and others to date indicate that has little effect if any in those situations where it has been tested." The authors of the study suggest that ineffective study habits may be a barrier to academic achievement and that the real problem may be more a lack of academic preparation than a lack of effort or motivation.They note that the availability of peer advising does not appear to have helped greatly.They conclude that other potential avenues to improving performance, or other approaches of teaching, are needed at the high school and postsecondary levels. [/INST] question: If a student gets a grade of 85% in a course, he will get _ . | options: A: $100 B: $300 C: $400 D: $700 | answer: C </s>

<s>[INST] context: Tribadism or Tribbing Is female-to-female genital sex. Two women rub their vulvae together to stimulate each other's clitoris to orgasm. Female homosexuality is known as tribadism or lesbianism. Sexual perversions are: Exhibitionism: Recurrent urge or behavior to expose one's genitals to an unsuspecting person. Fetishism: Use of non-sexual or non living objects or pa of a person's body to gain sexual excitement. Paialism refers to fetishes specifically involving nonsexual pas of the body. Frotteurism: Recurrent urge or behavior of touching or rubbing against a nonconsenting person. Masochism: Recurrent urge or behavior of wanting to be humiliated, beaten, bound, or otherwise made to suffer. Pedophilia: Sexual attraction to prepubescent children. Sadism: Recurrent urge or behavior involving acts in which the pain or humiliation of the victim is sexually exciting. Transvestic fetishism: A sexual attraction towards the clothing of the opposite gender. Voyeurism: Recurrent urge or behavior to observe an unsuspecting person who is naked, disrobing or engaging in sexual activities. Other options: Sexual intercourse by a human being with a lower animal is called Bestiality. Sexual intercourse between two males is male homosexuality. Anal intercourse between two men or between a male and female. [/INST] question: Tribadism means | options: A: Sexual relationship between two female B: Sexual relationship between female and animal C: Sexual relationship between two males D: Anal intercourse male with female | answer: A </s>

<s>[INST] context: Audrey Hepburn is one of Hollywood's all-time greatest actress. She is famous not only in the USA, but also in other parts of the world. Hepburn was born in Belgium on May 4, 1929. She began taking ballet lessons at a very young age. She loved dancing and her dream was to become a successful ballet dancer. She had put most of her effort into ballet training before she entered the film industry. In 1951, Hepburn was chosen to play the lead role of a young princess in the Hollywood film Roman Holiday. It was a big success and Hepburn became famous immediately. She won an Oscar for Best Actress for her role in this film. During her life time, Hepburn earned four more Oscar nominations . Some well-known films that she acted in include Funny Face, Breakfast at Tiffany and My Fair Lady. Hepburn also devoted much of her time to charity . She spent the last few years of her life working closely with UNICEF to help poor children in different parts of the world. She was honoured with a number of awards because of her efforts in helping them. [/INST] question: Hepburn was born in _ . | options: A: USA B: Belguim C: Italy D: England | answer: B </s>

<s>[INST] context: The Christmas Eve meal is very important in most European countries. While other Christian families around the world celebrate this great meal with different kinds of meat, it is a tradition for Italians to eat seven different kinds of fish. Such a meal is called the "Feast of the Seven Fishes". It's also considered traditional that there may be nine, eleven, or even thirteen fishes for the meal. This kind of celebration is held to remember the birth of the baby Jesus. The Feast of the Seven Fishes was held just by southern Italians as a custom at first, but today Italians all over the world hold it. Although the Feast of the Seven Fishes has been regarded as an Italian custom, no one _ knows the meaning of it. There are lots of explanations for it. Some people believe that seven fishes are served because it took God seven days to create the world. Other explanations mention the Seven Hills of Rome. For the Feast of the Seven Fishes, it's not certain that which kinds of fish should be served. At the Feast of the Seven Fishes, the meal usually begins with antipasto and ends with delicious desserts. The Feast of the Seven Fishes has been a tradition since ancient times, and it will continue or even change as life changes. However, for Italians all over the world, the cultural meaning of the tradition is more important than anything else. [/INST] question: Italian families celebrate the Christmas Eve meal with different kinds of _ . | options: A: meat B: fish C: desserts D: antipasto | answer: B </s>

<s>[INST] context: Sport is very popular in England. In other words lots of English people like the idea of sport. A lot watch sport on TV. But the number who take part in sport is quite small. On the whole English people prefer to be fat rather than thin. The most popular sport in England is football. Football is played on Saturday afternoon in most towns and the supporters of a certain team will travel from one end of the country to the other to see their team play. There are four divisions of the football league.Not surprisingly the best teams are in the first division. But the best supporters are often in the fourth division. You have to be a good supporter to watch the fourth division football! Many other sports are also played in England, such as golf, in which you try to knock a ball into a hole; basketball, in which you try to got a ball through a net ; tennis, in which you try to hit a ball so that your opponent can not hit it. As you see, if the ball had not been invented, there would have been no sport. Actually , that is not quite true. Athletics isn't played with a ball; nor horseracing . Perhaps that is why they are not so popular as football! [/INST] question: _ is the most popular sport in England. | options: A: Basketball B: Football C: Golf D: Tennis | answer: B </s>

<s>[INST] context: C. Coagulase negativeb hemolysis and bacitracin resistance occur in bothStaphylococcus AureusCoagulase Positive: Ananthanarayan Whf2l0Beta type of hemolyisis on blood agar-Microbiology by Baveja 5th/175"Streptococci- coagulase negative" Ananthanarayan lQ7h/218 "Lancefield group B consists of a single species, S. agalactiae, which is definitively identified with specific antiserum to the group B cell wall-associated carbohydrate antigen. A streptococcal isolate can be classified presumptively as GBS on the basis of biochemical tests, including hydrolysis of sodium hippurate (in which 99% of isolates are positive), hydrolysis of bile esculin (in which 99-100% are negative), bacitracin susceptibility (in which 92% are resistant), and production of CAMP factor (in which 98-100% are positive). CAMP factor is a phospholipase produced by GBS that causes synergistic hemolysis with p lysin produced by certain strains ofS. aureus'-Harrison 19th/969Staphylococci produce catalase, which converts hydrogen peroxide into water and oxygen. The catalase test differentiates the staphylococci, which are positive, from the streptococci, which are negative- Jawetz 27th/205Ananthanarayan 10th/210Species or common nameLancefield groupHemolysisLaboratory testS. pyogenesABetaBacitracin-sensitive, PYR test-positive; Ribose not fermntedS. agalactiaeBBetaCAMP test, Hippurate hydrolysisBacitracin Test microbeonline.com Positive: Streptococcus pyogenes Negative: Streptococcus agalactiaeThe bacitracin test is useful for differentiating b-hemolytic Group A streptococci from b-hemolytic non-Group A streptococci. This is important because most streptococcal diseases are caused by Group A streptococci. The bacitracin test can also be used to differentiate the bacitracin-resistant Staphylococcus from the bacitracin-susceptible Micrococcuswww.austincc.edu [/INST] question: Which of the following is/are feature of streptococcus agalactiae rather than staphylococcus aureus? | options: A: Catalase positive B: Bacitracin resistant C: Coagulase negative D: a hemolysis | answer: C </s>

<s>[INST] context: He was struggling to tie his shoes. I was struggling with whether I should help him. I did, and he was grateful. "Thank you," he said. "I'm glad I could help. I just thought it would be easier for me to reach," I said. He was a disabled man, and forced to look down most of the time. His arms and legs were twisted terribly, and he couldn't do what the rest of us would consider easy tasks. He always managed to look up to see how you reacted to his words, however. He had a big smile, making me feel comfortable. I was still on my knees by his wheelchair. " Nice shoes," he said. "Thanks. No one ever complimented me on them before," I said. "No one has the same view of the world as I do," he replied. "Tell me about the world as you see it," I said smiling. "Most people can see if someone is comfortable with them or not in their eyes. I see it in their feet." he said. "If people keep moving their feet, I just let them go, because I know they're impatient with me. I don't want to make people uncomfortable. "What about me? I asked. "I could see your _ And then you came down to my level. I was the one who was nervous." he said. "I don't normally have someone look me in the eye." "They don't know what they're missing," I told him. "My old face is nothing to brag about." he said. "But that smile is so big." Yes, and it's not only a big smile but an attitude. [/INST] question: The disabled man knew people were impatient mostly by their _ . | options: A: words B: eyes C: feet D: smile | answer: C </s>

<s>[INST] context: Mike found a job in a bookstore after he finished middle school. He wouldn't do anything but wanted to get rich. It was a cold morning. It snowed and there was thin ice on the streets. Few people went to buy books and the young man had nothing to do. He hated to read, so he watched the traffic. Suddenly he saw a bag fall off a truck and it landed by the other side of the street. "It is full of expensive things." Mike said to himself. "I have to get it right now, or others will take it away." He went out of the bookstore and ran across the street. A driver saw him and began to whistle , but he didn't hear it and went on running. The man drove to the side, hit a big tree and hurt himself in the accident. Two weeks later, Mike was taken to the court . A judge asked if he heard the whistle when he was running across the street. He said that something was wrong with his ears and he could hear nothing. "But you heard me this time," said the judge. "Oh, I'm sorry. Now I can hear with one ear." "Cover the ear with your hand and listen to me with your deaf one. Well, can you hear me?" "No, I can't , sir." "You told a lie. There is nothing wrong with either of your ears," the judge said. [/INST] question: Mike found a job as a _ when he left school. | options: A: driver B: judge C: policeman D: bookseller | answer: D </s>

<s>[INST] context: When talking about picking a right school, a mother and teacher gave some pieces of advice. In the latest issue of Youth magazine, the mother shared the school advice she gave her daughters with young people across the country. "I've told my daughters many times that I don't want them to choose a name," the mother said. "I don't want them to think, 'Oh, I should go to these top schools.' We live in a country with hundreds of excellent universities. So the first question is: what's going to work for me?" "When it was time to prepare for picking schools, nobody around me believed I could get into Xiamen University. But through hard work I finally made it," she continued. "So, my second piece of advice is: believe in yourself, no matter what other people might say. Once your goal is set, you only need to try your best to make it come true." "The last piece of advice is not to be worried even if your dreams don't come true. As I've said above, there are so many good universities out there. So it's important for everybody to understand that you can always find a university that gives you a great education." [/INST] question: The mother shared her advice _ . | options: A: with her students B: with her husband C: in Youth magazine D: in Xiamen University | answer: C </s>

<s>[INST] context: When Russell Lyons volunteered for the first time, he read Goodnight Moon to a class of San Diego preschoolers. And it wasn't reading-he'd memorized the book and was reciting it out loud. He was 4. Still, he said it felt good up there, in front of the other kids, lending a hand. He wanted more of that feeling. Thirteen years later, he's getting a lot of it. He's on a five-month road trip across America-not sightseeing, but volunteering. The University City resident has spent time at an animal reserve in Utah, a women's shelter in St. Louis, a soup kitchen in New York, a retirement home in Tucson. This week he's in Los Angeles, at a program that supports disabled youth. "I just like helping people and feeling that something I do is making a difference," he said. He resists the idea that his "Do Good Adventure" is all that unusual. It bothers him that the media often describes young people as lazy, self-centered and materialistic. So he sees his trip as a chance to make a statement, too. "About 55 percent of teens do volunteer work, higher than the rate of adults," he said, according to a 2002 study. "Not everybody knows that." Of course, some teens do volunteer work because it looks impressive on their college applications. Lyons said he mentioned his trip on his submissions. But charity work is a habit with him. Even before the cross country trip, he was volunteering abut 200 hours a year at various places. He's made sandwiches for homeless families in Washington D.C.. He's taught math to fifth-graders in Cuernavaca, Mexico. He gets some of that drive from his mother, Leslye Lyons, who has been involved in nonprofits for much of her life. She was there when her son "read" to the preschoolers-a memory of hers "that will never go away." [/INST] question: What did Russell Lyons think of his first volunteering? | options: A: Creative B: Impressive C: Persuasive D: Imaginative | answer: B </s>

<s>[INST] context: Last week I visited my friend Pete in the new home where he lives with his wife and daughter. Pete used to spend his holidays travelling the world, visiting the pyramids in Egypt or scuba diving in the Caribbean. Nowadays he prefers to spend his holidays and weekends making his house look more beautiful. Like hundreds of thousands of other British people, he has discovered the joy of DIY (Do It Yourself), which means if there are any things that need fixing around the house, he will try to do the job himself. As he showed me the new kitchen he put together by himself and the newly painted walls, I asked Pete where he got his inspiration from. He told me that his favorite source of ideas was a DIY program on TV. This got me thinking about the great popularity of DIY programs in the UK. Each major channel has at least one home or garden improving show and there's even a satellite channel completely about the subject. I guess it is not really surprising that DIY programs are so popular. Two common sayings in Britain- 'an Englishman's home is his castle' and 'there's no place like home'-show how important our houses are to us. With the present economic downturn, many people can't afford to buy a bigger house so they are looking at how they can make their house better without spending a lot of money. DIY is the perfect choice. But be careful! I read a report that said over 230,000 people were injured while doing home improvements in the UK in just one year, including 41,000 who fell off ladders and 5,800 who were seriously hurt by hammers. So I won't be going down to the hardware store. [/INST] question: How did Pete spend his holiday in the past? | options: A: Visiting his friends B: Diving C: Travelling around the world D: Making his house beautiful | answer: C </s>

<s>[INST] context: Monkeys That Lend a Hand Have you ever dropped something while both your hands were full and wished you had another hand to pick it up? Some people cannot use their arms or hands to do simple jobs because they have been hurt or are sick. Usually they depend on other people to help them. This problem made two women think about how they could help people who cannot do everyday things for themselves. In 1979 Dr. M. J. Willard and Judi Zazula began looking at some small, friendly monkeys called capuchin monkeys. These monkeys have hands like people's hands, and they like to be around people. Could the monkeys be trained to do things that people could not do for themselves? The women wanted to find out if their idea would work. So they spent a long time training some capuchin monkeys, and they found that these animals made great helpers. Today the first step in training a young capuchin monkey is to have it stay home with people and watch how they live. The monkeys learn how to _ around people. Then the monkeys go to a special school in Boston. There they learn how to do many easy chores. They are taught how to carry food and pick up dropped objects. They learn how to open doors and turn light switches on and off. They even learn how to use CD players and VCRs. After a monkey finishes its training, it goes to live with a person who needs help. If the person wants a light turned on, the monkey does it. If the person needs a glass of water, the monkey brings it. If the person wants to watch TV, the monkey turns it on. The monkey becomes a very important part of that person's life. In fact, the monkey often becomes the person's good friend. [/INST] question: Capuchin monkeys are people's great helpers because _ . | options: A: they learn more quickly than other monkeys B: they have hands like people's hands C: they like to watch how people live D: they are small, cute and naughty | answer: B </s>

<s>[INST] context: (one day Alice runsafter a strange rabbit and falls into a deep hole.She becomes smaller after she drinks something.She finds herself in a wonderland with many amazing things inside.) Caterpillar and Alice look at each other in silence.Then they begin to talk. Caterpillar:(In a tired,sleepy voice)Who are you? Alice:(Rather shyly)I--hardly know,sir,just at present--at least I know who Iwas when I got up this morning.but l think I must have been changed several times since then. Caterpillar:What do you mean by that?Explain yourself! Alice:I can't explain myself, I'm afraid.sir,because I'm not myself,you see. Caterpillar:I don't see. Alice:(very politely)I'm afraid I can't put it more clearly,for I can't understand it myself.And being so many different sizes in a day is very puzzling . Caterpillar:It isn't. Alice:(Feeling uncomfortable)well,perhaps you haven't found it so yet.But when you have to turn into a chrysalis you will some day,you know--and then after that into a butterfly,I think you'11 feel it a little stranger,won't you? Caterpillar:Not a bit. Alice:Well,perhaps your feelings may be different.All l know is it would make me feel very strange. Caterpillar: (At the top of his voice)You!Who are you? Alice:(Angrily)I think you ought to tell me who you are first. Caterpillar:Why? (Here is another puzzling question.As Alice cannot think out any good reasons and Caterpillar seems to be very unpleasant,she turns away.) Caterpillar:Come back!I have something important to tell you! (Alice turns and comes back again) [/INST] question: Where may their talk take place? | options: A: In a wonderland B: In the field C: In the tree D: Outside the hole | answer: A </s>

<s>[INST] context: Chest X-ray with pleural effusion Obliteration of CP angle Distinct border Concave upward curve called ELLIS CURVE 150-200 ml on PA view > 5 ml lateral view 15-20 ml on lateral decubitus view Right Pleural Effusion Pneumothorax: ON CXR: - Absent bronchoalveolar markings - Visceral pleural reflection - Deep sulcus sign in supine patient - Best view: expiratory view - IOC: CT USG of pneumothorax: - Hypoechoic pleural line - SEASHORE sign present in Normal lung Absent = pneumothorax: M mode USG: BARCODE/ STRATOSPHERE sign Tension pneumothorax: Pneumothorax with mediastinal shift Tension pneumothorax: Pneumothorax with mediastinal shift - Absent bronchoalveolar markings - Visceral pleural reflection - Lung Collapses towards hilum FALLEN LUNG sign: Fracture of bronchus - Lungs fall down inferiorly and laterally - If point supine - fall posteriorly Hydropneumothorax: Horizontal Air Fluid Levels CONSOLIDATION: Opacity not obscuring CP Angle Ill-defined fluffy borders No mediastinal shift Consolidation of Right Middle Lobe: SILHOUETTING of Right Hea Border. SILHOUETTING of Left Hea Border: Lingular Pathology [/INST] question: A patient presented with complaints with dyspnoea. The shown X- ray is suggestive of:- | options: A: Consolidation B: Exudative pleural effusion C: Pneumothorax D: Hydropneumothorax | answer: B </s>

<s>[INST] context: Uses of Prostaglandin Analogs- 1.Aboion- Dinoprostone - PGE2. SSInduction of mid-term aboion SSCervical ripening & induction of labor at full term. SSNot used for menstrual regulation/early aboion. Carboprost - PGF2a SSUsed for mid-term aboion. Misoprostol -PGE1 SSused for aboion-200mg.BD/orally. SSalong with mifepristone to induce aboion in 1st few wks of pregnancy. 2.Facilitation of labor, cervical priming & PPH- 1.Dinoprostone - PGE2. SSOrally - to augmenting labor & to check PPH. SSVaginally- softens the cervix before labor induction. SSPreferred over oxytocin for labor induction in pre-eclampsia, eclampsia, cardiac & renal disease. SSIntrauterine fetal deaths / along with oxytocin. 2. Carboprost - PGF2a - RX PPH-intra-amniotic inj. 3.Ulcer healing- -Misoprostol -PGE1 SSUlcer protective agent-200mg orally QID -Enprostil - PGE2. SSUsed in NSAID's induced P.U & Chronic smokers. 4) To prevent platelet aggregation- OEpoprostenol- SSPGI2- Haemodialysis & Cardiopulmonary bypass. SSPGE2 & PGI2- used to store platelets for transfusion. 5. To treat pulmonary HTN- OEpoprostenol (PGI2)-I.V - pulmonary & coronary resistance. OTreprostinil -longer acting. 6.Patency of Ductus aeriosus- OEpoprostenol (PGI2) or Alprostadil (PGE1)- I.V infusion. 7.P.V.D- OBeraprost (PGI2)-orally ,T.I.D. 8.Glaucoma- OLatanoprost (PGF2a) - Reduces I.O.P. 9.Male impotence- Alprostadil to RX E.D. -2.5-25mcg intracavernosal inj. ESSENTIALS OF MEDICAL PHARMACOLOGY;7TH EDITION;KD TRIPATHI;PAGE NO 190 [/INST] question: which of the following prostaglandin analog is used in glaucoma? | options: A: Misoprostol B: Latanoprost C: Enprostil D: Rioprostil | answer: B </s>

<s>[INST] context: Helen loved small animals. One morning while she was walking in the forest, she found two weak birds in the grass. She took them home and put them in a small cage. She looked after them with love and the birds both grew well. They thanked her with a wonderful song every morning. But something happened one day. Helen left the door of the cage open. The larger bird flew from the cage. She thought that it would fly away, so she _ it. She was very excited to catch it. Suddenly she felt strange. She opened her hand and looked sadly at the dead bird. Her great love had killed the bird! The other bird was moving back and forth in the cage. Helen could feel the bird want to go out. It wanted to fly into the blue sky. At once, Helen took the bird out of the cage and let it fly away. The bird circled, twice, three times... Helen enjoyed watching the bird flying and singing happily. Suddenly the bird flew closer and landed softly on her head. It sang the sweetest song that she had ever heard. The easiest way to lose love is to hold too tight. The best way to keep love is to give it freedom. [/INST] question: What was Helen doing when she found two weak birds? | options: A: Singing B: Walking C: Dancing D: Playing | answer: B </s>

<s>[INST] context: Snow-melting Agent A heavy snow can kill pests and this means a good harvest next year.This will bring as well as trouble to urbanites. On Nov.16,2003,a cold air current brought a heavy snow to Beijing.To prevent traffic jams,related government departments mobilized people to clear off snow on streets. One of the most effective ways to clear off snow on roads is to scatter snow-melting agent on the roads.The major component of the snow-melting agent is salt.The snow-melting agent can make snow stop from freezing,make it easier to clear off the road,and allow traffic to flow smoothly.But it also brings about some hidden dangers.In the spring of 2003,over 300 000 trees in Beijing urban districts died.After analyzing soil around these trees,experts discovered that the salt content of these soils was 392 times higher than normal.Where did the excessive salt come from?After investigating,forestry experts found that when clearing snow in the winter,people usually heap snow containing snow-melting agent at trees' roots,and that when the snow melts,this agent penetrates the soil and increases its salt content.The snow-melting agent indirectly killed the trees. Statistics show that during a heavy snow in 2002,over 1000 tons of snow-melting agent was scatterred on streets in Beijing.Snow water containing a large amount of snow-melting agent got into the soil through sewers. In addition,salt in the snow-melting agent can expedite the corrosion of steel bars in concrete buildings and cause the concrete to crack and peel,shortening the life of roads. Scientists and government officials are required to solve traffic problems caused by heavy snows as soon as possible and at the same time try to reduce the negative effects of the snow-melting agent.This is a difficult problem placed before them.Related authorities have framed some local criteria to regulate the production and use of snow-melting agents. Now,more harmless snow-melting agents are being developed.Now that even snow-melting agents that meet today's criteria must still be used carefully,we have to rely more on our manpower and machines to clear off snow. This year,in addition to using snow-melting agents,Beijing will use a large number of snow vehicles to clear snow on roads.In more places,citizens are mobilized to clear snow with their hands.This may be a test of a city's civilization level. [/INST] question: Salt is a snow-melting agent while _ is a cleaning agent. | options: A: water B: soap C: a washing-machine D: a housewife | answer: B </s>

<s>[INST] context: Corynebacterium urealyticum (CU) (formerly Corynebacterium group D2) is a gram-positive bacillus with a strong urease activity that can infect the lower (acute or chronic cystitis) and upper (pyelonephritis and encrusted pyelitis) urinary tract. CU is a commensal skin organism that an estimated 12% of healthy individuals carry and it has been isolated in 30% of hospitalized patients. CU conves urea into ammonia, creating alkaline urine, which precipitates struvite and calcium phosphate crystals, forming stones and encrustations on the infected mucosa. Prolonged vesical and ureteral catheterization is considered the most impoant risk factor for developing encrusted cystitis (EC) and encrusted pyelitis (EP); these procedures not only carry CU or other urea-splitting micro-organisms into the urinary tract, but may also create conditions, e.g. urothelial trauma, that increase the risk of simple urinary tract infections turning into EC or EP . Bladder wall histology following resection of calcified encrustations reveals three distinct zones: a necrotic layer containing calcified encrustations revealed by Von Kossa stain; an inflammatory layer containing bacterial colonies, lymphocytes and polymorphonuclear cells; and normal tissue [/INST] question: Encrusted cystitis is caused by: | options: A: Corynebacterium xerosis B: Corynebacterium urealyticum C: Corynebacterium renale D: Corynebacterium pseudotuberculosis | answer: B </s>

<s>[INST] context: Americans won't live without cars! Each year there is an increasing number of cars on roads and streets, as millions of new cars are produced. One out of every six Americans work at putting together the parts of cars, driving trucks, building roads or filling cars with gas. Most Americans find it hard to think what life would be without a car. However, some have realized the serious problem of air pollution by cars. The polluted air is poisonous and dangerous to health. One way to get rid of the polluted air is to design a new car that does not pollute. That's what several large car factories are trying to do. But to build the new car is easier said than done. Progress in this field has been slow. Another way is to take place of the car engine by something else. Engineers are now working on some new cars. Many makers believe that it will take years to develop a practical model that pleases man. To prevent the world from being polluted by cars, we'll have to make some changes in the way many of us live. Americans, for example, have to cut down the number of their cars they are encouraged to travel and go to work by bike. Riding a bike is thought to help keep the air clean. But this change does not come easily, a large number of workers may find themselves with no jobs if a car factory closes down. And the problem of air pollution would become less important than that of unemployment. [/INST] question: If the number of cars is cut down, the most serious problem in American workers is _ . | options: A: to keep the air clean B: to have no work to do C: to get a better life D: to go to work by bike | answer: B </s>

<s>[INST] context: Tophi are pathognomonic of gout. They are formed by large aggregations of urate crystals. The urate crystals are surrounded by a. Macrophages b. Lymphocytes c. Large foreign body giant cells They are seen in them. a. Articular cartilages of joints * b. Periarticular ligaments* c. Tendons and soft tissues* d. Achilles tendon* e. Earlobes* Also, remember these very important points related to Gout- Hyperuricemia is present in approximately 5% of individuals. Most of them are asymptomatic with regard to their hyperuricemia and are at no clinical risk. The most recognized complication of Hyperuricemia is Gouty arthritis. The higher the serum level of urate the more likely an individual is to develop Gout. Acute attack of gout occurs without any precipitating cause or may occur following rapid fluctuations in serum urate levels. Most common joint involved in Gout is Big toe (First metatarsophalangeal) Diagnosis of Gout- - By observing monosodium urate crystals in polarized light. These are needle-shaped* and strongly negative birefringent crystal [/INST] question: “Tophus” is the pathognomonic lesion of which of the following condition: | options: A: Multiple myeloma B: Cystinosis C: Gout D: Eales disease | answer: C </s>

<s>[INST] context: Anyone who ever wondered why a dying plant, say, a freshly-cut red rose may appeal to a lady friend, might take some comfort in science, which once again offers us a reasonable answer to one of the world' s great mysteries. Beyond a common preference in people for blue, "the long history of color preference studies has been described as 'confusing and contradictory '," write scientists Anya Hurlbert and Yazhu Ling of England' s Newcastle University, authors of a new study in the journal Current Biology. "This fact is perhaps surprising," they said, "though the popularity of the concept that little girls differ from boys in preferring pink." But the scientists believe they have an answer to this scientific mystery, discovering women's preference for red, hidden above the average liking for blue. In their study, the pair quickly flashed color cards, displaying many different aspects, at 208 volunteers, mostly Britishers but with a number of Han Chinese, who moved to the United Kingdom recently. Tested in three different experiments, the researchers found out a small but significant preference for reddish colors in the female volunteers. Puzzled, the authors realized that most of the difference between men and women came in the form of a preference for green VS red in the color cards, regardless of the other slight differences such as the slightly blue ones that everyone liked. Why might this be? Evolution might offer an answer, they reason. Human color perception , the assessment of three separate color types -- red -- green -- blue-- in our vision is a relatively recent addition to our line of mammals Adding weight to their argument, they found the women who are most typically feminine on a psychological survey also had the biggest preference for reddish colors. "My love is like a red, red rose," wrote the Scottish poet Rober Burns in 1794. [/INST] question: The word "pair" in Para.4 refers to _ . | options: A: boy and girl B: the two authors C: research and result D: pink and blue | answer: B </s>

<s>[INST] context: "The Book That Can't Wait" is a great new idea that seeks to strengthen bonds between first time writers and their readers by getting their books read quickly. Argentinean independent publishers Eterna Cadencia are publishing a collection of short stories by new South American authors using special ink that slowly disappears once it comes in contact with sun and air, completely vanishing within 2 months after the book has been opened. This makes for an interesting approach to motivating book buyers to read books more quickly, giving first-time authors the attention they need to survive. "The Book That Can't Wait" tackles an important problem for new authors: How to get readers. The creative independent publishers teamed up with DRAFTFCB in the city of Buenos Aires to develop this project. "Books are very patient objects. We buy them, and then they wait for us to read them. Days, months, even years. That's OK for books, but not for new authors. If people don't read their first book, they'll never make it to a second," says the project coordinator Tito Santana. That's why Etema Cadencia, which also runs its own bookstore, has decided to create something different to launch its new authors into the market. It presented its first "The Book That Can't Wait" for the critics and the press last month. The invention is a success. Hundreds of people came to the bookstore to pick up a copy. To help spread the word, they gave away the first edition to customers for free. The very same day it was released, the publishing house claimed that it received thousands of requests for more copies of the book. So it will print a new edition later this month to satisfy the demand. And the best result? This time they have the guarantee that their new authors will be read. The company plans to use the book as a platform for other titles, because they believe there is a lot of literature out there that doesn't deserve to wait on the shelf. And these books won't wait at all. [/INST] question: The main purpose of publishing "The Book That Can't Wait" is to _ . | options: A: sell more books B: make it fun to read C: invent a new kind of book D: get new authors' books read quickly | answer: D </s>

<s>[INST] context: The Winter Olympics proved no match for television's gold-medal winner, "American Idol". Fox's unbelievable successful contest crashed the Olympics in head-to-head competition on Tuesday night, 27 million viewers to 16.1 million, according to Nielsen Media Research. The Olympics recovered a bit after "Idol" went off the air, but its overall audience of 18.6 million was the least-watched winter Olympics telecast since Nagano's closing ceremonies in 1998, Nielsen said. Since its opening on Friday, the Turin games have been running well below the 2002 Salt Lake City games in viewership interest. Much of that was expected, but Tuesday's rating was the first alarming sign for NBC that increased TV competition has _ . "The competition from 'Idol' is heavier than the Olympics has ever seen," said NBC Sports spokeswoman Alana Russo. It doesn't figure to get any easier, with "Idol" and ABC's "Lost" on the air Wednesday. CBS' "Survivor" and "CSI: Crime Scene Investigation" offer more competition on Thursday. Even figure skating, the most popular winter Olympics sport for viewers, didn't help much on Tuesday. NBC filled about two-thirds of the hour during which it competed with "American Idol" with tape of the men's figure-skating competition. Through five nights of Olympics coverage, NBC's average prime time rating is 12.7 ( a rating point represents 1,102, 000 households, or 1 percent of the nation's estimated 110.2 million TV homes). NBC said before the games started that it had promised its advertisers a rating of between 12 and 14. If it slips below that, NBC will have to make it up to advertisers with free commercial time. " 'American Idol' is clearly a phenomenon," said Randy Falco, president of the NBC Universal Television Group. "But we expected it and are tracking fight where we planned to be at this point." Between NBC and its networks, about 65 percent of the nation's television homes have tuned in at least some of the games. [/INST] question: How many viewers watched the Winter Olympics on Tuesday night? | options: A: 110.2 million B: 12.7 million C: 27million D: 16.1million | answer: D </s>

<s>[INST] context: Approach for Post menopausal Bleeding in a woman Office endometrial aspiration biopsy is the accepted first step in evaluating a patient with abnormal uterine bleeding or suspected endometrial pathology. The diagnostic accuracy of office-based endometrial biopsy is 90% to 98% whencompared with subsequent findings at dilation and curettage (D&C) or hysterectomy TVS is at best an adjuvant which helps in the diagnosis of endometrial cancer but 'NOT' the best first step Novaks Gynecology: Transvaginal ultrasonography may be a useful adjunct to endometrial biopsy for evaluating abnormal uterine bleeding and selecting patients for additional testing. Transvaginal ultrasonography, with or without endometrial fluid instillation (sonohysterography), may be helpful in distinguishing between patients with minimalendometrial tissue whose bleeding is related to perimenopausal anovulation or postmenopausal atrophy and patients with significant amounts of endometrial tissue or polyps who are in need of fuher evaluation. The finding of an endometrial thickness greater than 4 mm, a polypoid endometrial mass, or a collection of fluid within theuterus requires fuher evaluation. Hysteroscopy guided biopsy, if utilized, is the single best investigation for assesment of the uterus [/INST] question: Most useful investigation in a 55-year-old postmenopausal woman with DM and HTN who has presented with postmenopausal bleeding is: | options: A: Pap smear B: Endometrial Biopsy C: Transvaginal ultrasound D: Ca-125 estimation | answer: B </s>

<s>[INST] context: Look at your classmates around you. You all wear the same uniform and similar sneakers. Do you want to stand out among them? A fashionable and useful backpack can be a great idea! Backpacks are lightweight and easy to carry. They are great tools for students. They help you to stay organized. You can keep school things, books and personal items like cell phones and keys neatly . With a _ backpack, you can also stand out among your classmates. Tourists also love backpacks. With convenient backpacks, backpackers can move freely from one place to another. Meanwhile, they can also free their hands to do other things like taking photos. But in the very beginning backpacks were not what we see today. It is thought that US hiker Dick Kelty invented the first modern backpack in 1951. He used nylon and aluminum tubing to make backpacks lightweight. Then he added shoulder straps and waist straps to transfer much of the weight to the hips . Today, backpacks come in different styles. Rolling backpacks have wheels on the bottom. Users can pull them along the ground if they are too heavy to carry on their shoulders. And with more people bringing laptops to school and work, backpacks also offer space for lightweight electronics. [/INST] question: Backpacks are useful for tourists because _ . | options: A: they have wheels on the bottom B: it frees tourists' hands to do other things C: tourists can feel fashionable D: they make tourists feel special | answer: B </s>

<s>[INST] context: Some people were killed when a huge explosion hit an industrial area of China, injuring hundreds of people. The explosion is believed to have come from a shipment of explosive inside a warehouse at about 11:30 pm local time (5:30pm in Britain) in the north-eastern city of Tianjin. Videos of the accident showed fires lighting up the night sky, raising dust dozens of feet into the air, and people nearby said the explosion had broken windows. Tianjin resident Zhang Siyu, who lives several miles away from the accident site, said, "I thought it was an earthquake, so I rushed downstairs without my shoes on. Only once I was outside did I realize it was an explosion. There was the huge fireball in the sky with thick clouds. Everybody could see it." Post on Chinese social network Weibo showed a fireball shooting into the air and as least two separate explosions, while photos showed people in the street apparently covered in blood. Others image showed children being carried in blankets to safety. It was reported that the two explosions happened within 30 seconds of each other and about 100 fire trucks were sent to the scene, with most of the injuries caused by broken glass and stones. The firm running the warehouse was named by local media as Ruihai Logistics. The company says on its website that it was set up in 2011. It says it handles one million tons of cargos per year. The National Earthquake Bureau reported two major explosion before midnight local time---the first with an amount of 3 tons of TNT , and the second with an amount of 21 tons. Six thousand firefighters brought the terrible fire under control, although it was still buring . It was reported that the firefighters were combing the neighborhood for the possible injured. [/INST] question: When did the fire break out by Beijing time? | options: A: At 11:30 am B: At 11:30 pm C: At 5:30 pm D: At 5:30 am | answer: B </s>

<s>[INST] context: Of all the famous English writers, probably the best known is William Shakespeare. He was born in Stratford-upon-Avon in 1564 on April the 23rd. His father was an important man in town so Shakespeare had a good upbringing. Shakespeare probably went to school (although no records survive to prove this) but not university. He got married when he was 18 to Anne Hathaway and the couple had 3 children. Shakespeare wrote 38 plays and 154 sonnets (a sonnet is a kind of poem). He began working in his home town of Stratford but by 1592 was writing in London. He became rich enough to buy a house in the capital and one in Stratford. He wrote sad stories called tragedies, like Romeo and Juliet, funny stories or comedies, romantic stories and stories about historical figures such as Julius Caesar. Shakespeare died on his birthday in 1616, almost 400 years ago. But why is his work still popular today? His work looked at common human themes, such as betrayal, murder, lust, power, ambition and love. These themes are as much a part of human nature today as they were all those years ago and are the themes we see in modern soap operas and Hollywood films. Even though his theatre, The Globe, burned down in 1613 it was rebuilt in London in 1997 and you can still see his plays performed there today. Shakespeare's influence on the English language can still be felt today. We talk about "fair play", meaning honest behaviour but this phrase was first used by Shakespeare. He coined the phrase "you can have too much of a good thing". And it was Shakespeare who came up with the expression to disappear "into thin air" which we still use today when we lose something. Shakespeare's work has been translated into every major language in the world. And perhaps we'll still be as fascinated by his work 400 years from now as we've been for the last 400. [/INST] question: How old was Shakespeare when he died? | options: A: 18 B: 28 C: 49 D: 52 | answer: D </s>

<s>[INST] context: CALCIUM CHANNEL BLOCKERS-Patients who respond to shoacting vasodilators at the time of cardiac catheterization (a fall in mean pulmonary aerial pressure >=10 mmHg and a final mean pressure <40 mmHg) should be treated with calcium channel blockers. Typically, these patients require high doses (e.g., nifedipine, 240 mg/d, or amlodipine, 20 mg/d). Patients may have dramatic reductions in pulmonary aery pressure and pulmonary vascular resistance associated with improved symptoms,regression of RV hyperophy, and improved survival now documented to exceed 20 years. ENDOTHELIN RECEPTOR ANTAGONISTS The endothelin receptor antagonists bosentan and ambrisentan are approved treatments of PAH.Because of the high frequency of abnormal hepatic function tests associated with these drugs, primarily an increase in transaminases, it is recommended that liver function be monitored monthly throughout the duration of use.Bosentan is contraindicated in patients who are on cyclosporine or glyburide concurrently. PHOSPHODIESTERASE-5 INHIBITORS Sildenafil and tadalafil , phosphodiesterase-5 inhibitors, are approved for the treatment of PAH. Phosphodiesterase-5 is responsible for the hydrolysis of cyclic GMP in pulmonary vascular smooth muscle, the mediator through which nitric oxide lowers pulmonary aery pressureand inhibits pulmonary vascular growth. PROSTACYCLINS I loprost, a prostacyclin analogue, is approved inhalation for PAH. It has been shown to improve a composite measure of symptoms and exercise tolerance by 10% ref:Harrison&;s principles of internal medicine,ed 18,pg no 2079. [/INST] question: Drug Not used in pulmonary hypeension - | options: A: Calcium channel blocker B: Endothelin receptor antagonist C: Alpha blocker D: Prostacyclin | answer: C </s>

<s>[INST] context: Chloral Hydrate is an aldehyde compound that is metabolized by alcohol dehydrogenase in the liver to its active metabolite, trichloro ethanol. In vitro studies have suggested that trichloroethanol acts upon GABA receptors in a manner similar to barbiturates and benzodiazepines. It is a chemical irritant to the skin and mucous membranes and is associated with a high rate of nausea and vomiting, particularly when administered on an empty stomach. After oral administration, the drug was characterized by a slow onset time (30 to 60 minutes) and had a duration of action of 4 to 8 hours, with an elimination half-life of 8 to 11 hours. Children given chloral hydrate would often enter a period of disinhibition resulting in excitement and irritability before reaching a level of clinically useful sedation. Large doses sensitize the myocardium to the effects of epinephrine, resulting in arrhythmias. The lethal dose of chloral hydrate is stated to be 10 g in adults, yet ingestion of 4 g has been associated with a fatal outcome. Chloral hydrate is no longer available commercially in the United States, but is included here because of its history in pediatric dentistry and references in the pediatric dentistry literature. [/INST] question: A 5 year old male patient presents with a complaint of multiple decayed teeth. His previous dental treatment was deferred because of uncooperative behavior. Which of the following drugs cannot be used for the pharmacological management of the patient’s behavior? | options: A: Midazolam B: Chloral hydrate C: Fentanyl D: Naloxone | answer: B </s>

<s>[INST] context: Micro blogs like Weibo are nothing new for the young Chinese. A newspaper in Chengdu did a survey last month. It found that 90 percent of junior high school students use micro blogs. They give students an outlet for emotion. "I use micro blogs to record my life. I let everyone 'see' my feelings and complaints ," said Liu Fangyue, 14, from Xiamen No. 1 Middle School. They have fun with classmates even after school. "I would send a message to praise someone who came first in the exam," said Liu. Teachers also join in the fun. "When I sit down to talk to my students, they may not tell me their real thoughts," said Lu Dongping at Nanning No. 2 Middle School. "But on micro blogs, they are more relaxed. They even make fun of me." You would be wrong if you think micro blogs are all about fun. Zhong Yun from Xiamen Haicang Experimental School sees it as a tool to learn English. The 13-year-old girl follows foreign stars such as Avril Lavigne and Justin Bieber. "In order to understand their English posts, I have to check the dictionary and learn many new words," said Zhong. "Micro blogs widen students' perspectives , but there are rules to follow," said Shi Zhongying, a professor from Beijing Normal University. He shares some of them with micro bloggers. "Manage your time, and don't let micro-blogging affect your studies and health," said Shi. "Don't give out your name, family address or phone number on micro blogs. You should also respect truth and other people's privacy ." [/INST] question: Lu Dongping thinks students are _ on micro blogs. | options: A: less serious B: less relaxed C: more stressed D: more nervous | answer: A </s>

<s>[INST] context: Mr. Evens works in Sydney. Last week he had a two weeks' holiday, but he didn't know where to go. He said to his friend Robert, "I hate the hot weather here, but I can't find a cool place in Australia. How will I take my holiday?" "That's easy," said Robert. "You'd better go to Moscow. Snow and ice are covering the ground now." Mr. Evens agreed with his friend. He bought an air ticket and soon arrived in Moscow. He made a happy journey there. But one day He got into trouble. After lunch he went to a park outside the city. He saw a dog following him while he was walking past a house. It was hungry and wished him to give it some food to eat. Bad luck! He had no piece of bread or cake in his pockets. He tried to send it away, but it began to bark at him. He wanted to look for a stick but couldn't find anything except snow and ice. Suddenly he saw a stone in the ground. He tried to pick it up but he failed. "How strange Russians are!" Mr. Evens said to himself. "They do not tie their dogs, but firmly tie the ground!" [/INST] question: Mr. Evens is _ . | options: A: an American B: an Englishman C: a Russian D: an Australian | answer: D </s>

<s>[INST] context: The malls were filled with people seeking gifts for their loved ones. Some of the malls remained open around the clock, partly to satisfy our needs to buy gifts. Behind the materialistic aspect of shopping for gifts lies the idea of caring, being attentive to the desires of special people in our lives. However, to use a well-worn play on words: it is our presence, not our presents, that truly counts. Many of us, unfortunately, can be so inattentive, even in the presence of our loved ones, that we might as well not be there at all. Attention is one of the greatest gifts we can give each other. Companies around the globe spend billions every year on advertising to catch our attention for just a short moment at a time. Whole industries - media, entertainment, education - rely on the precious gift of our attention for their continued existence. A baby lacking attention for a long time is likely to he psychologically unhealthy. In earlier times, both diet and attention could be left unregulated without major cause for concern. There were natural checks and balances: limited availability of food meant few got fat, for example. Similarly, in bygone times we might have spent a few hours communicating with the village storyteller, today, watching an entire TV series, while speaking to nobody, is common. In traditional societies, with smaller population, everyone would get a fair deal of attention. On many issues we might go to see Grandma or Grandpa; now we have Google and Wikipedia. "She just wants attention." people tend to think little of those doing things simply for attention. But the truth is that human beings need attention, and giving attention to each other is, to a large extent, what human civilization is based upon. This perhaps explains the runaway success of social networking sites such as Twitter and Facebook. While we use such sites for "micro blogging", "idea voicing" and "status updates" - the reality is that we are often doing no more or less than fulfilling our basic human drive for attention exchange. I friend you, you friend me, I retweet you, you retweet me. The charming case with which we can now get and give attention is why many people appear overly attached to their smartphones. It is also a vicious circle. As ever more people are busy exchanging attention online, there is increasingly less attention to be paid in the real world, which forces more people to seek their attention exchange online, or else risk attention-starvation. The very nature of attention exchange is being rapidly transformed, and there is a danger that some of us will develop unhealthy practices. Just as eating red meat every day is a bad idea, so it is with too much attention exchange. The biological consequences of our technological advancement in food production are highly visible; heart disease, diabetes and obesity. The consequences of our transformed attention exchanges will be psychological and social, and so may take longer to identify, but they will be equally damaging. Face-to-face attention is becoming rarer, and therefore more valuable. In a sense it is priceless. And it is a gift that can be given all-year-round. [/INST] question: People use social networking sites such as Twitter and Facebook to _ . | options: A: obtain information B: give attention to others C: voice their opinions D: notice and get noticed | answer: D </s>

<s>[INST] context: (a) Germ tube formationCandidiasis* Candidiasis MC fungal infection in humans both in HIV and non-HIV infected people.* Caused by Candida, a yeast like fungus that produces pseudohyphae.Various species of Candida include:* Candida albicans: The most common and most pathogenic species* Other rare species are C. tropicalis, C. Glabrata, C. Krusei, C. parapsilosis, C. dubliniensis, C. kejyr, and C. viswanathii.Predisposing factors that are associated with increased risk of infection with Candida include-* Physiological state: Extremes of age (infancy, old age), pregnancy* Low immunity: Patients on steroid or immunosuppressive drugs, post transplantation, malignancy, HIV* Patients on broad spectrum antibiotics suppresses the normal flora* Diabetes mellitus, febrile neutropenia and zinc or iron deficiency.Clinical ManifestationsCandida species are a part of normal flora of the skin and mucosa including gut flora. In presence of opportunistic conditions, they can cause various infections.1. Mucosal candidiasis:* Oropharyngeal candidiasis (oral thrush) presents as white, adherent, painless patches in the mouth* Candidal vulvovaginitis thin whitish curd like vaginal discharge* Balanitis and balanoposthitis (occurring in uncircumcised males)* Esophageal candidiasis* Angular stomatitis and denture stomatitis* Chronic mucocutaneous candidiasis: Seen in infants with deficient CMI, resistant to treatment.2. Cutaneous candidiasis:* Intertrigo, Paronychia and onychomycosis (fungal infection of nail)* Diaper candidiasis in infants, Perianal candidiasis* Erosio interdigitalis blastomycetica, an infection between the digits of the hands or toes* Generalized disseminated cutaneous candidiasis, seen in infants.3. Invasive candidiasis: Results from hematogenous or local spread of the fungi. Various forms are:* UTI, Pulmonary candidiasis, meningitis, osteomyelitis and Hepatosplenic and disseminated candidiasis* Septicemia (C.albicans and C.glabrate).* Ocular: Keratoconjunctivitis and endophthalmitis* Nosocomial candidiasis (mainly by C. glabrata)4. Allergic candidiasis include:* Candida Vesicular lesions in the web space of hands, similar to that of dermatophytid reaction (both conditions are together called 7D' reaction)* Other allergic reactions include: Gastritis, irritable bowel syndrome and eczema.Laboratory Diagnosis* Direct microscopy: Gram-positive oval budding yeast cells (4-6 pm size) with pseudohyphae.* Culture on SDA: Colonies are described as creamy white, smooth, and pasty with typical yeasty odor.Tests for species identification:* Germ tube test: It is also called Reynolds Braude phenomenon, specific test for C. albicans.* It is differentiated from pseudohyphae as there is no constriction at the origin.* Though the test is specific for C.albicans, it may also be positive for C. dubliniensis.Note from Author: "The germ tube formation of Candida albicans was shown in the AIIMS Question PseudohyphaeTrue hyphaeSeptaConstrictedNo constrictionOrigin of branchesConstricted and SeptateNo constriction, No septum presentGrows byBuddingApical elongationTreatment* Cutaneous candidiasis or oral thrush- DOC is topical azole* Esophageal and vulvovaginal candidiasis- DOC is oral flucconazole* Disseminated candidiasis- DOC is Amphotericin B* C.glabrata and C.krusei exhibit intrinsic resistance to azoles and are refractory to treatment with azoles. [/INST] question: A patient presented with complaints of dysphagia. On UGI Endoscopy a diagnosis of esophageal candidiasis was made. The organism obtained from the sample was cultured on a specialized media and the below findings were visible on microscopy of the culture. What phenomenon is shown below? | options: A: Germ tube formation B: Spore formation C: Mould to yeast formation D: Budding | answer: A </s>

<s>[INST] context: Suppose you become a leader in an organization. It's very likely that you'll want to have volunteers to help with the organization's activities. To do so, it should help to understand why people undertake volunteer work and what keeps their interest in the work. Let's begin with the question of why people volunteer. Researchers have identified several factors that motivate people to get involved. For example, people volunteer to express personal values related to unselfishness, to expand their range of experiences, and to strengthen social relationships. If volunteer positions do not meet these needs, people may not wish to participate. To select volunteers, you may need to understand the motivations of the people you wish to attract. People also volunteer because they are required to do so. To increase levels of community service, some schools have launched compulsory volunteer programs. Unfortunately, these programs can shift people's wish of participation from an internal factor (e.g., "I volunteer because it's important to me") to an external factor (e.g., "I volunteer because I'm required to do so"). When that happens, people become less likely to volunteer in the future. People must be sensitive to this possibility when they make volunteer activities a must. Once people begin to volunteer, what leads them to remain in their positions over time? To answer this question, researchers have conducted follow-up studies in which they track volunteers over time. For instance, one study followed 238 volunteers in Florida over a year. One of the most important factors that influenced their satisfaction as volunteers was the amount of suffering they experienced in their volunteer positions. Although this result may not surprise you, it leads to important practical advice. The researchers note that attention should be given to "training methods that would prepare volunteers for troublesome situations or provide them with strategies for coping with the problem they do experience". Another study of 302 volunteers at hospitals in Chicago focused on individual differences in the degree to which people view "volunteer" as an important social role. It was assumed that those people for whom the role of volunteer was most part of their personal identity would also be most likely to continue volunteer work. Participants indicated the degree to which the social role mattered by responding to statements such as "Volunteering in Hospital is an important part of who I am." Consistent with the researchers' expectations, they found a positive correlation between the strength of role identity and the length of time people continued to volunteer. These results, once again, lead to concrete advice: "Once an individual begins volunteering, continued efforts might focus on developing a volunteer role identity.... Items like T-shirts that allow volunteers to be recognized publicly for their contributions can help strengthen role identity". [/INST] question: People volunteer mainly out of _ . | options: A: academic requirements B: social expectations C: financial rewards D: internal needs | answer: D </s>

<s>[INST] context: You may know your mother, but how well do you really know Mothers' Day? Cards, flowers, sales, TV specials, and a day off for someone who really deserves it -- those are what probably come to mind for many people when they think of Mothers' Day. But there's more to the story. The earliest Mothers' Day celebrations were held during spring in ancient Greece. The celebrations honored Rhea, the mother of the gods. During the 1600's, England celebrated a day called Mothering Sunday. On this day even servants were given the day off to spend with their families. A mothering cake was even served with the family meal. In the US, Mothers' Day began in 1872 when Julia Ward Howe, who wrote the words to the famous song The Battle Hymn of the Republic, suggested it as a day devoted to peace. But it didn't really become popular until 1907 when Anna Jarvis started a campaign to honor mothers. She believed that mothers could help people get over the pain they experienced during the Civil War. The US isn't alone in devoting a day to mothers. Many other countries including Denmark, Finland, Italy, Turkey, Australia, Japan, and Belgium also honor their mothers in May. Other countries honor their mothers at different times of the year. Learning more about Mothers' Day and celebrating Mothers' Day are important, but probably not as important as understanding what your own mother, or grandmother, or aunt has really done for you. And that will certainly be appreciated more than one day in year. [/INST] question: Where was the earliest Mothers' Day celebrated? | options: A: In ancient Greece B: In the US C: In England D: In Italy | answer: A </s>

<s>[INST] context: Carharts notch Bone conduction is normal in otosclerosis. In some cases there is a dip in bone conduction curve which is maximum at 2000 Hz / 2 KHZ called as Carharts notch. Carharts notch is seen only in bone conduction curve. It disappears after successful stapedectomy/stapedotomy. The reason why it disappears after successful surgery is that when the skull is vibrated by bone—conduction sound, the sound is detected by the cochlea via 3 routes: – Route (a)—is by direct vibration within the skull. – Route (b)—is by vibration of the ossicular chain which is suspended within the skull. – Route (c)—is by vibrations emanating into the external auditory canal as sound and being heard by the normal air-conduction route. In a conduction type of hearing loss (as in otosclerosis) the latter two routes are deficient but regained by successful reconstruction surgery. Hence bone conduction thresholds improve following surgery. ALSO KNOW Dip in noise induced hearing loss is seen at 4 KHZ. In noise induced hearing loss—Dip is seen in both air and bone conduction curves. Trough shaped audiogram is seen in congenital SNHL. Flat audiogram with moderate to severes SNHL is characteristic of presbycusis. [/INST] question: Carhart's notch in audiometery is seen in - | options: A: Ossicular discontinuity B: Haemotympanum C: Otomycosis D: Otosclerosis | answer: D </s>