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Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ketanserin is -, with the following options: A: 5-HT,1B antagonist, B: 5-HT2 antagonist, C: 5-HT1A antagonist, D: 5-HT1P. antagonist ### Response:

Ans. is 'b' i.e., 5-HT2 antagonist o Ketanserin and ritanserin are useful as antihypertensive agents. It is important to know that these drugs have additional a receptor blocking property and antihypertensive effect is due to a-blockade, not due to 5HT2A/2C blockade.SEROTONERGIC RECEPTORSo There are four families of 5-HT receptors -5HT1, 5HT2, 5HT3, 5HT4-7o All 5-HT receptors (except 5-HT3) are G protein coupled receptors. 5 HT3 is a ligand gated cation Na+, K+) channel - ionotropic receptor.1. 5HT1 (Five subtypes 5HT1A,B,D,E,F)o All types of 5-HT1 receptors inhibit adenylyl cyclase.o These receptors function primarily as autoreceptors in brain - inhibit 5-HT release or firing of 5-HT neurons.o The most important locations of 5HT1A receptor are raphe nuclei of brainstem and hippocampus.o Buspiron, ipsapirone, gepirone (antianxiety drugs) act as partial agonists on 5HT1A receptors.o 5HT1D regulates dopamenergic tone in substantia nigra basal ganglia.o 5TH1B/1D cause constriction of cranial blood vessels,o The antimigraine drug sumatriptan is a selective 5-HT1B/1D agonist.2. 5-HT2o Coupled to phospholipase lc' and function through IP3/DAGo 5 HT2A is the most widely expressed postjunctional 5-HT receptor.o 5HT 2A/2C receptor is responsible for most of the direct action of serotonine.o Important antagonists of these receptors are : -Ketanserin and ritanserin are useful as antihypertensive agents. It is important to know that these drugs have additional a receptor blocking property' and antihypertensive effect is due to a-blockade, not due to 5HT2A/2C blockade.Clozapine, resperidone are used as antipsychotics.Methylsergide is used in migraine.Cyproheptadine blocks 5HT2A, HI histaminic and muscarinic receptors. It increases appetite and can be used in children to promote weight gain.3. 5-HT3o It is the only 5-HT receptor which is a ligand gated cation Na+, K+ channel.o It mediates most of the indirect and reflex actions of 5-HT at:1. Area postrema and nucleus tractus solitarius in brain stem - nausea and vomiting.2. Nerve ending in myentric plexus - | peristalsis3. Somatic and autonomic nerve ending - pain, itch, coronaiy chemoreflex.o Stimulation of 5-HT3 receptor is responsible for vomiting induced by anticancer drugs.o 5-HT3 receptor antagonists (ondansetron, granisetron and tropisetron) are DOCs for chemotherapy induced vomiting.4. HT4o Present on mucosa, plexuses and smooth muscles of the gut - | intestinal secretion and peristalasis.o Cisapride, renzapride and tegaserod are selective 5-HT4 agonists - useful in gastroesophageal reflux disease.o Most direct actions of serotonin are mediated by 5 - HT2 receptors.o Most indirect and reflex actions of serotonin are mediated by 5-HT3 receptors.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ketanserin is -, with the following options: A: 5-HT,1B antagonist, B: 5-HT2 antagonist, C: 5-HT1A antagonist, D: 5-HT1P. antagonist ### Response: Ans. is 'b' i.e., 5-HT2 antagonist o Ketanserin and ritanserin are useful as antihypertensive agents. It is important to know that these drugs have additional a receptor blocking property and antihypertensive effect is due to a-blockade, not due to 5HT2A/2C blockade.SEROTONERGIC RECEPTORSo There are four families of 5-HT receptors -5HT1, 5HT2, 5HT3, 5HT4-7o All 5-HT receptors (except 5-HT3) are G protein coupled receptors. 5 HT3 is a ligand gated cation Na+, K+) channel - ionotropic receptor.1. 5HT1 (Five subtypes 5HT1A,B,D,E,F)o All types of 5-HT1 receptors inhibit adenylyl cyclase.o These receptors function primarily as autoreceptors in brain - inhibit 5-HT release or firing of 5-HT neurons.o The most important locations of 5HT1A receptor are raphe nuclei of brainstem and hippocampus.o Buspiron, ipsapirone, gepirone (antianxiety drugs) act as partial agonists on 5HT1A receptors.o 5HT1D regulates dopamenergic tone in substantia nigra basal ganglia.o 5TH1B/1D cause constriction of cranial blood vessels,o The antimigraine drug sumatriptan is a selective 5-HT1B/1D agonist.2. 5-HT2o Coupled to phospholipase lc' and function through IP3/DAGo 5 HT2A is the most widely expressed postjunctional 5-HT receptor.o 5HT 2A/2C receptor is responsible for most of the direct action of serotonine.o Important antagonists of these receptors are : -Ketanserin and ritanserin are useful as antihypertensive agents. It is important to know that these drugs have additional a receptor blocking property' and antihypertensive effect is due to a-blockade, not due to 5HT2A/2C blockade.Clozapine, resperidone are used as antipsychotics.Methylsergide is used in migraine.Cyproheptadine blocks 5HT2A, HI histaminic and muscarinic receptors. It increases appetite and can be used in children to promote weight gain.3. 5-HT3o It is the only 5-HT receptor which is a ligand gated cation Na+, K+ channel.o It mediates most of the indirect and reflex actions of 5-HT at:1. Area postrema and nucleus tractus solitarius in brain stem - nausea and vomiting.2. Nerve ending in myentric plexus - | peristalsis3. Somatic and autonomic nerve ending - pain, itch, coronaiy chemoreflex.o Stimulation of 5-HT3 receptor is responsible for vomiting induced by anticancer drugs.o 5-HT3 receptor antagonists (ondansetron, granisetron and tropisetron) are DOCs for chemotherapy induced vomiting.4. HT4o Present on mucosa, plexuses and smooth muscles of the gut - | intestinal secretion and peristalasis.o Cisapride, renzapride and tegaserod are selective 5-HT4 agonists - useful in gastroesophageal reflux disease.o Most direct actions of serotonin are mediated by 5 - HT2 receptors.o Most indirect and reflex actions of serotonin are mediated by 5-HT3 receptors. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The advantages of cryosurgery over electrocau-terization are all except:, with the following options: A: Less discomfort to the patient, B: Postoperative bleeding is much less, C: Postoperative vaginal discharge is also much less, D: Cervical stenosis is extremely rare ### Response:

After cryosurgery there will be profuse vaginal discharge for about 2–3 weeks

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The advantages of cryosurgery over electrocau-terization are all except:, with the following options: A: Less discomfort to the patient, B: Postoperative bleeding is much less, C: Postoperative vaginal discharge is also much less, D: Cervical stenosis is extremely rare ### Response: After cryosurgery there will be profuse vaginal discharge for about 2–3 weeks ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is a plasma expander similar to the albumin, has a molecular weight of 30,000 and causes less hypersensitivity reactions but should be used with caution?, with the following options: A: Hydroxy ethyl starch (HES), B: Dextran, C: Polygeline, D: Polypyrrolidone ### Response:

Ans. c. Polygeline Polygeline is a plasma expander similar to the albumin, has a molecular weight of 30,000 and causes less hypersensitivity reactions but should be used with caution. Polygeline Polypeptide with average MW 30,000Q Exes oncotic pressure similar to albuminQ Not antigenic, hypersensitivity reactions are rareQ but should be watched for. Does not interfere with grouping and cross matching of bloodQ Remains stable for three years. It is not metabolized in the body; excreted slowly by the kidney. Expansion of plasma volume lasts for 12 hours. It is more expensive than dextran It can also be used for priming of hea-lung and dialysis machines

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is a plasma expander similar to the albumin, has a molecular weight of 30,000 and causes less hypersensitivity reactions but should be used with caution?, with the following options: A: Hydroxy ethyl starch (HES), B: Dextran, C: Polygeline, D: Polypyrrolidone ### Response: Ans. c. Polygeline Polygeline is a plasma expander similar to the albumin, has a molecular weight of 30,000 and causes less hypersensitivity reactions but should be used with caution. Polygeline Polypeptide with average MW 30,000Q Exes oncotic pressure similar to albuminQ Not antigenic, hypersensitivity reactions are rareQ but should be watched for. Does not interfere with grouping and cross matching of bloodQ Remains stable for three years. It is not metabolized in the body; excreted slowly by the kidney. Expansion of plasma volume lasts for 12 hours. It is more expensive than dextran It can also be used for priming of hea-lung and dialysis machines ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is not a measure of stroke volume?, with the following options: A: Left ventricular end diastolic volume minus left ventricular end systolic volume, B: Ejection fraction times left ventricular end diastolic volume, C: Ejection fraction times cardiac output, D: Cardiac output/hea rate ### Response:

Stroke vol is the volume of blood pumped from left ventricle per beat SV can be calculated by 1) CO =SV*HR 2)Ejection fraction= SV/ End diastolic. volume 3) SV= EDV-ESV of each ventricle

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is not a measure of stroke volume?, with the following options: A: Left ventricular end diastolic volume minus left ventricular end systolic volume, B: Ejection fraction times left ventricular end diastolic volume, C: Ejection fraction times cardiac output, D: Cardiac output/hea rate ### Response: Stroke vol is the volume of blood pumped from left ventricle per beat SV can be calculated by 1) CO =SV*HR 2)Ejection fraction= SV/ End diastolic. volume 3) SV= EDV-ESV of each ventricle ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Excessive secretion of ACTH causes:, with the following options: A: Cushing's syndrome, B: Addison's disease, C: Myxoedema, D: Thyrotoxicosis ### Response:

Ans. A. Cushing's syndromeOverproduction of ACTH leads to Cushing's syndrome. It is characterized by hyper-pigmentation and increased production of adrenocorticosteroid. These symptoms lead to negative nitrogen balance, impaired glucose tolerance, hypertension, edema, muscle atrophy etc.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Excessive secretion of ACTH causes:, with the following options: A: Cushing's syndrome, B: Addison's disease, C: Myxoedema, D: Thyrotoxicosis ### Response: Ans. A. Cushing's syndromeOverproduction of ACTH leads to Cushing's syndrome. It is characterized by hyper-pigmentation and increased production of adrenocorticosteroid. These symptoms lead to negative nitrogen balance, impaired glucose tolerance, hypertension, edema, muscle atrophy etc. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: which of following statements are included in 2005 American Heart Association – a) Newborn CPR is applied from first hour after birth until the newborn leaves the hospitalb) Newborn CPR is applied from first hour after birth until first 24 hoursc) Child CPR guidelines for lay rescuer apply to children from 1 to 8 years of aged) Child CPR guidelines for healthcare providers apply to children from 1-8 years of agee) Hospital paediatric advanced life support guideline for paediatric patient extend age to 16–18 years, with the following options: A: acd, B: bde, C: ace, D: ade ### Response:

Age delineation according to AHA guidelines for CPR and ECC Differences in the etiology of cardiac arrest between child and adult victims necessitate some differences in the recommended resuscitation sequence for infant and child victims compared with the sequence used for adult victims. Because there is no single anatomic or physiologic characteristic that distinguishes a "child" victim from an "adult" victim and no scientific evidence that identifies a precise age to initiate adult rather than child CPR techniques, the ECC scientists made a consensus decision for age delineation that is based largely on practical criteria and ease of teaching. In these 2005 guidelines, the recommendations for newborn CPR apply to newborns in the first hours after birth until the newborn leaves the hospital. Infant CPR guidelines apply to victims less than approximately 1 year of age. Child CPR guidelines for the lay rescuer apply to children about 1 to 8 years of age, and adult guidelines for the lay rescuer apply to victims about 8 years of age and older. To simplify learning for lay rescuers retraining in CPR and AED apropos the 2005 guidelines, the same age divisions for children are used in the 2005 guidelines as in the ECC guidelines 2000. Child CPR guidelines for healthcare providers apply to victims from about 1 year of age to the onset of adolescence or puberty (about 12 to 14 years of age) as defined by the presence of secondary sex characteristics. Hospitals (particularly children's hospitals) or pediatric intensive care units may choose to extend the use of Pediatric Advanced Life Support (PALS) guidelines to pediatric advanced of all ages (generally up to about 16 to 18 years of age) rather than use onset of puberty for the application of ACLS versus PALS guidelines.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: which of following statements are included in 2005 American Heart Association – a) Newborn CPR is applied from first hour after birth until the newborn leaves the hospitalb) Newborn CPR is applied from first hour after birth until first 24 hoursc) Child CPR guidelines for lay rescuer apply to children from 1 to 8 years of aged) Child CPR guidelines for healthcare providers apply to children from 1-8 years of agee) Hospital paediatric advanced life support guideline for paediatric patient extend age to 16–18 years, with the following options: A: acd, B: bde, C: ace, D: ade ### Response: Age delineation according to AHA guidelines for CPR and ECC Differences in the etiology of cardiac arrest between child and adult victims necessitate some differences in the recommended resuscitation sequence for infant and child victims compared with the sequence used for adult victims. Because there is no single anatomic or physiologic characteristic that distinguishes a "child" victim from an "adult" victim and no scientific evidence that identifies a precise age to initiate adult rather than child CPR techniques, the ECC scientists made a consensus decision for age delineation that is based largely on practical criteria and ease of teaching. In these 2005 guidelines, the recommendations for newborn CPR apply to newborns in the first hours after birth until the newborn leaves the hospital. Infant CPR guidelines apply to victims less than approximately 1 year of age. Child CPR guidelines for the lay rescuer apply to children about 1 to 8 years of age, and adult guidelines for the lay rescuer apply to victims about 8 years of age and older. To simplify learning for lay rescuers retraining in CPR and AED apropos the 2005 guidelines, the same age divisions for children are used in the 2005 guidelines as in the ECC guidelines 2000. Child CPR guidelines for healthcare providers apply to victims from about 1 year of age to the onset of adolescence or puberty (about 12 to 14 years of age) as defined by the presence of secondary sex characteristics. Hospitals (particularly children's hospitals) or pediatric intensive care units may choose to extend the use of Pediatric Advanced Life Support (PALS) guidelines to pediatric advanced of all ages (generally up to about 16 to 18 years of age) rather than use onset of puberty for the application of ACLS versus PALS guidelines. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Preferred procedure for obtaining endometrial sample for histopathology is, with the following options: A: Dilatation and curettage, B: Dilatation and evacuation, C: Endometrial aspiration, D: Hysteroscopy ### Response:

Endometrial aspiration should be the preferred procedure for obtaining endometrial sample for histopathology. If endometrium is thick on imaging, but where HPE is inadequate or atrophic, hysteroscopy should be performed to rule out polyps. Dilatation and curettage should not be the procedure of choice for endometrial assessment. Reference: Novak's gynaecology; 14th edition; Chapter 14; Benign Diseases of the Female Reproductive Tract

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Preferred procedure for obtaining endometrial sample for histopathology is, with the following options: A: Dilatation and curettage, B: Dilatation and evacuation, C: Endometrial aspiration, D: Hysteroscopy ### Response: Endometrial aspiration should be the preferred procedure for obtaining endometrial sample for histopathology. If endometrium is thick on imaging, but where HPE is inadequate or atrophic, hysteroscopy should be performed to rule out polyps. Dilatation and curettage should not be the procedure of choice for endometrial assessment. Reference: Novak's gynaecology; 14th edition; Chapter 14; Benign Diseases of the Female Reproductive Tract ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In a suspected case of death due to which of the following poison cadaveric rigidity lasts longer than usual?, with the following options: A: Lead, B: Arsenic, C: Mercury, D: Copper ### Response:

Postmoem rigidity is prolonged in arsenic poisoning. Convulsions prior to death can cause prolongation of rigor mois, arsenic poison is found to cause convulsions resulting in prolongation of rigor mois. Ref: Forensic Medicine and Toxicology By John Dixon Mann, Page 453

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In a suspected case of death due to which of the following poison cadaveric rigidity lasts longer than usual?, with the following options: A: Lead, B: Arsenic, C: Mercury, D: Copper ### Response: Postmoem rigidity is prolonged in arsenic poisoning. Convulsions prior to death can cause prolongation of rigor mois, arsenic poison is found to cause convulsions resulting in prolongation of rigor mois. Ref: Forensic Medicine and Toxicology By John Dixon Mann, Page 453 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Aim of damage control laparotomy are:, with the following options: A: Arrest hemorrhage, B: Prevent Coagulopathy, C: Control contamination, D: All ### Response:

Ans is A(Arrest hemorrhage), B(Prevent Coagulopathy) & C(Control contamination)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Aim of damage control laparotomy are:, with the following options: A: Arrest hemorrhage, B: Prevent Coagulopathy, C: Control contamination, D: All ### Response: Ans is A(Arrest hemorrhage), B(Prevent Coagulopathy) & C(Control contamination) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Magistrate inquest not needed in: JIPMER 14, with the following options: A: Homicide, B: Exhumation, C: Police custody death, D: Dowry death ### Response:

Ans. Homicide

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Magistrate inquest not needed in: JIPMER 14, with the following options: A: Homicide, B: Exhumation, C: Police custody death, D: Dowry death ### Response: Ans. Homicide ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 19 year young patient with sclerotic lesion at diaphysis. What is the MOST likely diagnosis?, with the following options: A: Osteoid osteoma, B: Ewings sarcoma, C: Osteoclastoma, D: Metastasis ### Response:

This patient most likely has osteoid osteoma which is a benign bone forming tumor characterized by small size, limited growth potential and dispropoionate pain. It usually affects children and adolescents. It commonly involves diaphysis of long bones, paicularly in the proximal humerus. Patients usually presents with pain with nocturnal exacerbations. It is usually relieved with NSAIDS. On X ray it appears as dense coical sclerosis surrounding a radiolucent nidus. Ewing's sarcoma affects long bones such as femur, tibia or humerus in young and affects flat bones in young patients. In the long bones, tumor almost always affects the metaphysis or diaphysis. X ray shows onion peel appearance due to alternate layers of reactive new bone formation and the tumor tissue. Osteosarcoma is a highly malignant bone tumor, it affects metaphysis of long bones. Ref: Pathology and Genetics of Tumours of Soft Tissue and Bone edited by Christopher D. M. Fletcher, page 260. Sho Textbook of Surgery By Roy, page 387

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 19 year young patient with sclerotic lesion at diaphysis. What is the MOST likely diagnosis?, with the following options: A: Osteoid osteoma, B: Ewings sarcoma, C: Osteoclastoma, D: Metastasis ### Response: This patient most likely has osteoid osteoma which is a benign bone forming tumor characterized by small size, limited growth potential and dispropoionate pain. It usually affects children and adolescents. It commonly involves diaphysis of long bones, paicularly in the proximal humerus. Patients usually presents with pain with nocturnal exacerbations. It is usually relieved with NSAIDS. On X ray it appears as dense coical sclerosis surrounding a radiolucent nidus. Ewing's sarcoma affects long bones such as femur, tibia or humerus in young and affects flat bones in young patients. In the long bones, tumor almost always affects the metaphysis or diaphysis. X ray shows onion peel appearance due to alternate layers of reactive new bone formation and the tumor tissue. Osteosarcoma is a highly malignant bone tumor, it affects metaphysis of long bones. Ref: Pathology and Genetics of Tumours of Soft Tissue and Bone edited by Christopher D. M. Fletcher, page 260. Sho Textbook of Surgery By Roy, page 387 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Residual chlorine level after disaster like flood ?, with the following options: A: 0.7 mg/litre, B: 1.5 mg/litre, C: 2 mg/litre, D: 3 mg/litre ### Response:

Ans. is 'a' i.e., 0.7 mg/litre Principles of chlorination Water should be clear and free from turbidity. Turbidity impedes efficient chlorination. The chlorine demand of the water should be estimated. It is the amount of chlorine that is needed to destroy bacteria and to oxidize all the organic matter and ammoniacal substances present in water. Chlorine demand of water is the difference between the amount of chlorine added to the water and the amount of residual chlorine remaining at the end of specific period of contact (usually 60 minutes) at a given temperature and pH of the water. The point at which the chlorine demand of the water is met is called break point chlorination. If fuher chlorine is added beyond break point, free chlorine begins to appear in water. The presence of free residual chlorine for a contact period of at least one hour is esential to kill bacteria and virus. The minimum recommended concentration of free chlorine is 0.5mg/1 for one hour. This free residual chlorine provides margin of safety against subsequent microbial contamination. The sum of the chlorine demand of the specific water plus the free residual chlorine of .5 mg/L constitutes the correct does of chlorine to be applied. It is woh noting here that recommended residual chlorine level for drinking water is 0.5 mg/ litre, while for swimming pool sanitation it is 1.0 mg/ litre and for water bodies & post disaster it is 0.7 mg/litre.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Residual chlorine level after disaster like flood ?, with the following options: A: 0.7 mg/litre, B: 1.5 mg/litre, C: 2 mg/litre, D: 3 mg/litre ### Response: Ans. is 'a' i.e., 0.7 mg/litre Principles of chlorination Water should be clear and free from turbidity. Turbidity impedes efficient chlorination. The chlorine demand of the water should be estimated. It is the amount of chlorine that is needed to destroy bacteria and to oxidize all the organic matter and ammoniacal substances present in water. Chlorine demand of water is the difference between the amount of chlorine added to the water and the amount of residual chlorine remaining at the end of specific period of contact (usually 60 minutes) at a given temperature and pH of the water. The point at which the chlorine demand of the water is met is called break point chlorination. If fuher chlorine is added beyond break point, free chlorine begins to appear in water. The presence of free residual chlorine for a contact period of at least one hour is esential to kill bacteria and virus. The minimum recommended concentration of free chlorine is 0.5mg/1 for one hour. This free residual chlorine provides margin of safety against subsequent microbial contamination. The sum of the chlorine demand of the specific water plus the free residual chlorine of .5 mg/L constitutes the correct does of chlorine to be applied. It is woh noting here that recommended residual chlorine level for drinking water is 0.5 mg/ litre, while for swimming pool sanitation it is 1.0 mg/ litre and for water bodies & post disaster it is 0.7 mg/litre. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which one of the following influenza is most deadly?, with the following options: A: H1N1, B: H2N2, C: H3N2, D: H3N8 ### Response:

(A) H1N1 > Respiratory infection popularly known as SWINE FLU is caused by an influenza virus first recognized in spring 2009, near the end of the usual Northern Hemisphere flu season.> New virus, 2009 H1N1, spreads quickly and easily. A few months after the first cases were reported, rates of confirmed H1N1-related illness were increasing in almost all parts of the world. As a result, the World Health Organization declared the infection a global pandemic. That official designation remained in place for more than a year.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which one of the following influenza is most deadly?, with the following options: A: H1N1, B: H2N2, C: H3N2, D: H3N8 ### Response: (A) H1N1 > Respiratory infection popularly known as SWINE FLU is caused by an influenza virus first recognized in spring 2009, near the end of the usual Northern Hemisphere flu season.> New virus, 2009 H1N1, spreads quickly and easily. A few months after the first cases were reported, rates of confirmed H1N1-related illness were increasing in almost all parts of the world. As a result, the World Health Organization declared the infection a global pandemic. That official designation remained in place for more than a year. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Bitemporal hemianopia can be due to:, with the following options: A: Third ventricle tumour, B: Meningioma of sella diaphragmatica, C: Calcarine coex infarction, D: Aneurysm of basilar aery ### Response:

Ans. Meningioma of sella diaphragmatica

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Bitemporal hemianopia can be due to:, with the following options: A: Third ventricle tumour, B: Meningioma of sella diaphragmatica, C: Calcarine coex infarction, D: Aneurysm of basilar aery ### Response: Ans. Meningioma of sella diaphragmatica ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Flask shaped hea is seen in -, with the following options: A: Ebstein anomaly, B: Pericardial effusion, C: TOF, D: TAPVC ### Response:

Flask shaped hea / Pear shaped / Money shaped hea is seen in Pericardial effusion. Boot shaped / Coer-en-sabot hea is seen in TOF. Snowman hea / Figure of 8 appearance is seen in TAPVC. Pulmonary oligemia is an xray finding of Ebsteins anamoly.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Flask shaped hea is seen in -, with the following options: A: Ebstein anomaly, B: Pericardial effusion, C: TOF, D: TAPVC ### Response: Flask shaped hea / Pear shaped / Money shaped hea is seen in Pericardial effusion. Boot shaped / Coer-en-sabot hea is seen in TOF. Snowman hea / Figure of 8 appearance is seen in TAPVC. Pulmonary oligemia is an xray finding of Ebsteins anamoly. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Bilateral loss of ankle jerk and extensor plantar response is seen in:, with the following options: A: Amyotrophic lateral sclerosis, B: Freidrich's ataxia, C: Tabes dorsalis, D: Lead poisoning ### Response:

Answer is B (Friedrich's ataxia): Absent deep tendon reflexes despite coicospinal tract involvement with an extensor plantar reflex is characteristic of Friedrich's ataxia. Disorder Pyramidal tract Posterior column Deep tendon Planter Associations involvement involvement reflexes Neurological Others Friedrich's ataxia Present Present Areflexia" Extensor - Wide based - Cardiomyopathy (genetic) (Areflexia despite coicospinal involvement) Q ataxia - Nystagmus - Dysahria - Optic atrophy - Skeletal abnormality - Dysmetria - Diabetes mellitus SACD Present Present Exaggerated Extensor Spastic gait Low serum B12 (4, B12) usuallyQ (may be decreased increased or absent) (initially ataxic) megaloblastic anemia Tabes dorsalis Absent Absent AreflexiaQ Absent Argyll Atonic bladder (teiary syphilis) Robeson pupil

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Bilateral loss of ankle jerk and extensor plantar response is seen in:, with the following options: A: Amyotrophic lateral sclerosis, B: Freidrich's ataxia, C: Tabes dorsalis, D: Lead poisoning ### Response: Answer is B (Friedrich's ataxia): Absent deep tendon reflexes despite coicospinal tract involvement with an extensor plantar reflex is characteristic of Friedrich's ataxia. Disorder Pyramidal tract Posterior column Deep tendon Planter Associations involvement involvement reflexes Neurological Others Friedrich's ataxia Present Present Areflexia" Extensor - Wide based - Cardiomyopathy (genetic) (Areflexia despite coicospinal involvement) Q ataxia - Nystagmus - Dysahria - Optic atrophy - Skeletal abnormality - Dysmetria - Diabetes mellitus SACD Present Present Exaggerated Extensor Spastic gait Low serum B12 (4, B12) usuallyQ (may be decreased increased or absent) (initially ataxic) megaloblastic anemia Tabes dorsalis Absent Absent AreflexiaQ Absent Argyll Atonic bladder (teiary syphilis) Robeson pupil ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Least common quadrant of cancer breast, with the following options: A: Superior Outer, B: Inferior Outer, C: Sub areolar, D: Lower inner quadrant ### Response:

Ans. (d) Lower Inner Quadrant* MC site - Upper outer (60%)* Central/areolar (12%)* Upper Inner (12%)* Lower Outer (10%)* Least Common site - Lower Inner (6%)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Least common quadrant of cancer breast, with the following options: A: Superior Outer, B: Inferior Outer, C: Sub areolar, D: Lower inner quadrant ### Response: Ans. (d) Lower Inner Quadrant* MC site - Upper outer (60%)* Central/areolar (12%)* Upper Inner (12%)* Lower Outer (10%)* Least Common site - Lower Inner (6%) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following causes the opening of the eustachian tube, with the following options: A: Salpingopharyngeus, B: Levator veli palatini, C: Tensor veli palatini, D: None of the above ### Response:

The medial fibres of tensor veli palatini are attached to the lateral lamina of the tube and when they contract they help to open the tube lumen. These fibres also called dilator tube muscles.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following causes the opening of the eustachian tube, with the following options: A: Salpingopharyngeus, B: Levator veli palatini, C: Tensor veli palatini, D: None of the above ### Response: The medial fibres of tensor veli palatini are attached to the lateral lamina of the tube and when they contract they help to open the tube lumen. These fibres also called dilator tube muscles. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Floating teeth is seen in:, with the following options: A: Hyperparathyroidism, B: Hypoparathyroidism, C: Rickets, D: Scurvy ### Response:

Ans. Hyperparathyroidism

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Floating teeth is seen in:, with the following options: A: Hyperparathyroidism, B: Hypoparathyroidism, C: Rickets, D: Scurvy ### Response: Ans. Hyperparathyroidism ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Thickness of lead apron is, with the following options: A: 0.25 mm, B: 0.3 mm, C: 0.4 mm, D: 0.5 mm ### Response:

Thickness of lead apron is 0.5 mm.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Thickness of lead apron is, with the following options: A: 0.25 mm, B: 0.3 mm, C: 0.4 mm, D: 0.5 mm ### Response: Thickness of lead apron is 0.5 mm. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Neurolathyrism is due to ingestion of -, with the following options: A: Ergot alkaloid, B: Crotolaric seeds, C: Khesari Dal, D: Sanguinarine ### Response:

Ans. is 'c' i.e., Khesari Dal DiseaseToxinAdulterantLathyrismBOAAKhesari Dal (Lathyrus sativus)Epidemic DropsySanguinarineArgemone mexicana (oil)Endemic AscitesPyrrolizidine alkaloidsCrotolaria seeds (,Jhunjhunia)AflatoxicosisAflatoxinAspergillus flavus/parasiticusErgotismClavine alkaloidsClaviceps fusiformis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Neurolathyrism is due to ingestion of -, with the following options: A: Ergot alkaloid, B: Crotolaric seeds, C: Khesari Dal, D: Sanguinarine ### Response: Ans. is 'c' i.e., Khesari Dal DiseaseToxinAdulterantLathyrismBOAAKhesari Dal (Lathyrus sativus)Epidemic DropsySanguinarineArgemone mexicana (oil)Endemic AscitesPyrrolizidine alkaloidsCrotolaria seeds (,Jhunjhunia)AflatoxicosisAflatoxinAspergillus flavus/parasiticusErgotismClavine alkaloidsClaviceps fusiformis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cusco's speculum is -, with the following options: A: Double bladed posterior vaginal speculum, B: Bivalve selfretaining vaginal speculum, C: Double bladed selfretaining posterior vaginal speculum, D: Bivalve double bladed vaginal speculum ### Response:

Ans. is 'b' i.e., Bivalve self retaining vaginal speculumCusco's self-retaining bivalved speculum is a surgical instrument used for vaginal and cervical examinationIt limits the visualization of the vaginal walls.It is used to visualize the cervix and the vaginal fornixes for the local cause of APH.It is also used for minor procedures like pap smear and IUCD inseion.It is also used to detect the leakage of liquor from the cervical os in case of suspected PROM.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cusco's speculum is -, with the following options: A: Double bladed posterior vaginal speculum, B: Bivalve selfretaining vaginal speculum, C: Double bladed selfretaining posterior vaginal speculum, D: Bivalve double bladed vaginal speculum ### Response: Ans. is 'b' i.e., Bivalve self retaining vaginal speculumCusco's self-retaining bivalved speculum is a surgical instrument used for vaginal and cervical examinationIt limits the visualization of the vaginal walls.It is used to visualize the cervix and the vaginal fornixes for the local cause of APH.It is also used for minor procedures like pap smear and IUCD inseion.It is also used to detect the leakage of liquor from the cervical os in case of suspected PROM. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which vessel causes Wallenburgs syndrome is:, with the following options: A: Pontine, B: Posterior Cerebral, C: Posterior inferior cerebellar aery, D: Veebral aery ### Response:

Posterior inferior cerebellar aery

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which vessel causes Wallenburgs syndrome is:, with the following options: A: Pontine, B: Posterior Cerebral, C: Posterior inferior cerebellar aery, D: Veebral aery ### Response: Posterior inferior cerebellar aery ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: An undifferentiated malignant tumour on immunohistochemical stain shows cytoplasmic positivity of most of the tumor cells for cytokeratin. The most probable tumor is:, with the following options: A: Sarcoma, B: Lymphoma, C: Carcinoma, D: Malignant Melanoma ### Response:

. Carcinoma

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: An undifferentiated malignant tumour on immunohistochemical stain shows cytoplasmic positivity of most of the tumor cells for cytokeratin. The most probable tumor is:, with the following options: A: Sarcoma, B: Lymphoma, C: Carcinoma, D: Malignant Melanoma ### Response: . Carcinoma ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common type of emphysema is: March 2013, with the following options: A: Centriacinar, B: Panacinar, C: Paraseptal, D: Irregular ### Response:

Ans. A i.e. Centriacinar Emphysema It is COPD. It is defined pathologically as an abnormal permanent enlargement of air spaces distal to the terminal bronchioles, accompanied by the destruction of alveolar walls and without obvious fibrosis. It frequently occurs in association with chronic bronchitis. Patients have been classified as having COPD with either emphysema or chronic bronchitis predominance. The 3 described morphological types of emphysema are centriacinar, panacinar, and paraseptal. Centriacinar emphysema begins in the respiratory bronchioles and spreads peripherally. Also termed centrilobular emphysema, this form is associated with long-standing cigarette smoking and predominantly involves the upper half of the lungs. - Panacinar emphysema destroys the entire alveolus uniformly and is predominant in the lower half of the lungs. Panacinar emphysema generally is observed in patients with homozygous alfal antitrypsin deficiency. In people who smoke, focal panacinar emphysema at the lung bases may accompany centriacinar emphysema. - Paraseptal emphysema, also known as distal acinar emphysema, preferentially involves the distal airway structures, alveolar ducts, and alveolar sacs. The process is localized around the septae of the lungs or pleura. Although airflow frequently is preserved, the apical bullae may lead to spontaneous pneumothorax. Giant bullae occasionally cause severe compression of adjacent lung tissue.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common type of emphysema is: March 2013, with the following options: A: Centriacinar, B: Panacinar, C: Paraseptal, D: Irregular ### Response: Ans. A i.e. Centriacinar Emphysema It is COPD. It is defined pathologically as an abnormal permanent enlargement of air spaces distal to the terminal bronchioles, accompanied by the destruction of alveolar walls and without obvious fibrosis. It frequently occurs in association with chronic bronchitis. Patients have been classified as having COPD with either emphysema or chronic bronchitis predominance. The 3 described morphological types of emphysema are centriacinar, panacinar, and paraseptal. Centriacinar emphysema begins in the respiratory bronchioles and spreads peripherally. Also termed centrilobular emphysema, this form is associated with long-standing cigarette smoking and predominantly involves the upper half of the lungs. - Panacinar emphysema destroys the entire alveolus uniformly and is predominant in the lower half of the lungs. Panacinar emphysema generally is observed in patients with homozygous alfal antitrypsin deficiency. In people who smoke, focal panacinar emphysema at the lung bases may accompany centriacinar emphysema. - Paraseptal emphysema, also known as distal acinar emphysema, preferentially involves the distal airway structures, alveolar ducts, and alveolar sacs. The process is localized around the septae of the lungs or pleura. Although airflow frequently is preserved, the apical bullae may lead to spontaneous pneumothorax. Giant bullae occasionally cause severe compression of adjacent lung tissue. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Malignant otitis externa affects which Cranial nerve:, with the following options: A: 7th, B: 8th, C: 9th, D: 10 ### Response:

Ans. (a) 7thRef: Dhingra's ENT 6th edJ 52-53* Malignant otitis externa is an inflammatory condition caused by pseudomonas infection usually in elderly diabetic & those on immune-compromised drugs.* Facial nerve paralysis is common.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Malignant otitis externa affects which Cranial nerve:, with the following options: A: 7th, B: 8th, C: 9th, D: 10 ### Response: Ans. (a) 7thRef: Dhingra's ENT 6th edJ 52-53* Malignant otitis externa is an inflammatory condition caused by pseudomonas infection usually in elderly diabetic & those on immune-compromised drugs.* Facial nerve paralysis is common. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A child undergone bilateral adrenalectom, later he developed headache, visual field defect, Hyper pigmentation of skin,what is the most probable diagnosis?, with the following options: A: Pitutary adenoma, B: Allgrove syndrome, C: Wolman syndrome, D: Nelson syndrome ### Response:

Nelsom syndrome :  It is complication after bilateral adrenalectomy due to rapid enlargement of pre - existing ACTH producing adenoma with above clinical features.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A child undergone bilateral adrenalectom, later he developed headache, visual field defect, Hyper pigmentation of skin,what is the most probable diagnosis?, with the following options: A: Pitutary adenoma, B: Allgrove syndrome, C: Wolman syndrome, D: Nelson syndrome ### Response: Nelsom syndrome :  It is complication after bilateral adrenalectomy due to rapid enlargement of pre - existing ACTH producing adenoma with above clinical features. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All of the following are the markers for malignant germ cell tumors of ovary except:, with the following options: A: CA-125, B: Alpha fetoprotein, C: HCG, D: LDH ### Response:

- most germ cell tumors secrete some tumor marker. - endodermal sinus tumors secrete alpha fetoprotein. - human chorionic gonadotrophin is secreted by choriocarcinoma. - tumors markers like placental alkaline phosphatase and lactic dehydrogenase may be elevated in dysgerminoma. - CA-125 is tumor marker in epithelial ovarian cancer. Reference : textbook of gynaecology Sheila balakrishnan, 2nd edition, pg no: 282 <\p>

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All of the following are the markers for malignant germ cell tumors of ovary except:, with the following options: A: CA-125, B: Alpha fetoprotein, C: HCG, D: LDH ### Response: - most germ cell tumors secrete some tumor marker. - endodermal sinus tumors secrete alpha fetoprotein. - human chorionic gonadotrophin is secreted by choriocarcinoma. - tumors markers like placental alkaline phosphatase and lactic dehydrogenase may be elevated in dysgerminoma. - CA-125 is tumor marker in epithelial ovarian cancer. Reference : textbook of gynaecology Sheila balakrishnan, 2nd edition, pg no: 282 <\p> ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: One-year-old male child presented with poor urinary stream since birth. The investigation of choice for evaluation is –, with the following options: A: Voiding cystourethrography (VCUG), B: USG bladder, C: Intravenous urography, D: Uroflowmetry ### Response:

Poor urinary stream since birth suggests urinary tract obstruction (usually intravesical). Most common cause of urinary tract obstruction in a male child is → posterior urethral valve. And the best diagnostic method for posterior urethral valve is voiding cystourethrogram.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: One-year-old male child presented with poor urinary stream since birth. The investigation of choice for evaluation is –, with the following options: A: Voiding cystourethrography (VCUG), B: USG bladder, C: Intravenous urography, D: Uroflowmetry ### Response: Poor urinary stream since birth suggests urinary tract obstruction (usually intravesical). Most common cause of urinary tract obstruction in a male child is → posterior urethral valve. And the best diagnostic method for posterior urethral valve is voiding cystourethrogram. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Doges Cap Sign is ?, with the following options: A: Air under Diaphragm, B: Air in Morrisons Pouch, C: Air on either side of Bowel Wall, D: Air under central tendon of Diaphgram ### Response:

A) Air in Morrisons Pouch - Doges Cap Sign. B) Air on either side of Bowel Wall - Riglers Sign. C) Air under central tendon of Diaphgram - Cupola Sign.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Doges Cap Sign is ?, with the following options: A: Air under Diaphragm, B: Air in Morrisons Pouch, C: Air on either side of Bowel Wall, D: Air under central tendon of Diaphgram ### Response: A) Air in Morrisons Pouch - Doges Cap Sign. B) Air on either side of Bowel Wall - Riglers Sign. C) Air under central tendon of Diaphgram - Cupola Sign. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Regarding furosemide true statement is, with the following options: A: Acute pulmonary edema is an indication, B: Acts on PCT, C: Mild diuresis, D: Given only by parenteral route ### Response:

Furosemide possesses vasodilatory action which is responsible for quick relief in LVF and pulmonary edema.It can be used orally as well as parenterally

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Regarding furosemide true statement is, with the following options: A: Acute pulmonary edema is an indication, B: Acts on PCT, C: Mild diuresis, D: Given only by parenteral route ### Response: Furosemide possesses vasodilatory action which is responsible for quick relief in LVF and pulmonary edema.It can be used orally as well as parenterally ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about TGA –, with the following options: A: Cyanotic disease, B: Aorta anterior to pulmonary artery, C: VSD, D: All of these ### Response:

In TGA aorta lies anterior and to the right of puhnonary artery. In patients with TGA the oxygenated pulmonary venous blood recirculates in the lungs whereas deoxygenated systemic venous blood recirculates in the systemic circulation --> Pulmonary artery saturation is always higher than aortic saturation (opposite to normal person). Because oxygenated blood is not available for systemic circulation, survival depends on the mixing available between the two circulation. So, patients with TGA can be divided into : - TGA with intact ventricular septum TGA with VSD. i) TGA with intact septum The mixing of blood depends on atrial communication. Most of the time atrial communication is a patent foramen ovale. As patent foramen ovale is very small communication, mixing of oxygenated blood with deoxygenated blood is inadequate —> Patients are symptomatic and cyanotic at birth, and CHF may develop during first week. ii) TGA with VSD Presence of VSD of adequate size results in good mixing of blood. a Patients become symptomatic, at 4-8 weeks when fetal pulmonary vasculature regresses maximally —> CHF develops at this time. The failing left ventricle and large pulmonary blood flow cause increase in left atrial pressure —> T back pressure Pulmonary venous hypertension and pulmonary plethora. The presence of a large VSD equalizes the pressure in the two ventricles as well as in two great vessels. Pulmonary artery carries large flow —) patients with TGA and large VSD develop pulmonary vascular obstructive disease (Eisenmenger physiology) early in life.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about TGA –, with the following options: A: Cyanotic disease, B: Aorta anterior to pulmonary artery, C: VSD, D: All of these ### Response: In TGA aorta lies anterior and to the right of puhnonary artery. In patients with TGA the oxygenated pulmonary venous blood recirculates in the lungs whereas deoxygenated systemic venous blood recirculates in the systemic circulation --> Pulmonary artery saturation is always higher than aortic saturation (opposite to normal person). Because oxygenated blood is not available for systemic circulation, survival depends on the mixing available between the two circulation. So, patients with TGA can be divided into : - TGA with intact ventricular septum TGA with VSD. i) TGA with intact septum The mixing of blood depends on atrial communication. Most of the time atrial communication is a patent foramen ovale. As patent foramen ovale is very small communication, mixing of oxygenated blood with deoxygenated blood is inadequate —> Patients are symptomatic and cyanotic at birth, and CHF may develop during first week. ii) TGA with VSD Presence of VSD of adequate size results in good mixing of blood. a Patients become symptomatic, at 4-8 weeks when fetal pulmonary vasculature regresses maximally —> CHF develops at this time. The failing left ventricle and large pulmonary blood flow cause increase in left atrial pressure —> T back pressure Pulmonary venous hypertension and pulmonary plethora. The presence of a large VSD equalizes the pressure in the two ventricles as well as in two great vessels. Pulmonary artery carries large flow —) patients with TGA and large VSD develop pulmonary vascular obstructive disease (Eisenmenger physiology) early in life. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Secretors are those who?, with the following options: A: Secrete enzymes in blood, B: Secrete immunoglobulin in intestine, C: Secrete blood group antigen in sweat/saliva, D: Secrete hormones in response to stress ### Response:

Ans. is'c'i.e., Secrete blood group antigen in sweat/saliva

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Secretors are those who?, with the following options: A: Secrete enzymes in blood, B: Secrete immunoglobulin in intestine, C: Secrete blood group antigen in sweat/saliva, D: Secrete hormones in response to stress ### Response: Ans. is'c'i.e., Secrete blood group antigen in sweat/saliva ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Lilliputian hallucinations are seen in, with the following options: A: Alcohol withdrawal, B: Opioid withdrawal, C: LSD withdrawal, D: Cocaine withdrawal ### Response:

Lilliputian hallucinations are the visual type where objects appear tiny than their usual size. delirium is a type of ORGANIC BRAIN SYNDROME it presents with clouding of consiousness the main cognitive function that is altered is attention impairment and disorientation the main hallucinations that presents in delirium is visual hallucinations the visual hallucinations sometimes presents lilliputian hallucinations, that is they can see small miniature animals and humans hitting them they have a phenomenon called as sun downing phenomenon, that is worsening of symptoms in the evening and night the delirium that is cahrecterstic of alcohol withdrawl is hyper active delirium it is also called as delirium tremens as it is assosiated with tremors. Reference: Kaplon and sadock, 11 th edition, synopsis of psychiatry, 11 th edition, pg no. 955

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Lilliputian hallucinations are seen in, with the following options: A: Alcohol withdrawal, B: Opioid withdrawal, C: LSD withdrawal, D: Cocaine withdrawal ### Response: Lilliputian hallucinations are the visual type where objects appear tiny than their usual size. delirium is a type of ORGANIC BRAIN SYNDROME it presents with clouding of consiousness the main cognitive function that is altered is attention impairment and disorientation the main hallucinations that presents in delirium is visual hallucinations the visual hallucinations sometimes presents lilliputian hallucinations, that is they can see small miniature animals and humans hitting them they have a phenomenon called as sun downing phenomenon, that is worsening of symptoms in the evening and night the delirium that is cahrecterstic of alcohol withdrawl is hyper active delirium it is also called as delirium tremens as it is assosiated with tremors. Reference: Kaplon and sadock, 11 th edition, synopsis of psychiatry, 11 th edition, pg no. 955 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All muscles of the palate are supplied by pharyngeal plexus, EXCEPT?, with the following options: A: Tensor veli palatine, B: Palatoglossus, C: Palatopharyngeus, D: None of the above ### Response:

With the exception of tensor veli palatini, which is supplied by the motor branch of the mandibular division of the trigeminal through the nerve to medial pterygoid, the muscles are supplied by the cranial pa of the accessory nerve the pharyngeal plexus.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All muscles of the palate are supplied by pharyngeal plexus, EXCEPT?, with the following options: A: Tensor veli palatine, B: Palatoglossus, C: Palatopharyngeus, D: None of the above ### Response: With the exception of tensor veli palatini, which is supplied by the motor branch of the mandibular division of the trigeminal through the nerve to medial pterygoid, the muscles are supplied by the cranial pa of the accessory nerve the pharyngeal plexus. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: What is the most common cause of skeletal abnormality in a case of renal osteodystrophy?, with the following options: A: Impaired synthesis of Vitamin D3, B: Hypocalcemia, C: Hypercalcemia, D: Hyperphosphatemia ### Response:

Renal osteodystrophy combines features of secondary hyperparathyroidism, rickets, osteomalacia, and osteoporosis. The primary retention of phosphate by abnormal kidneys results in hyperphosphatemia, which causes hypocalcemia, resulting in secondary hyperparathyroidism. Therefore, the spectrum of clinical and radiographic findings in renal osteodystrophy may be a manifestation of any of these disorders. The most common complication of renal osteodystrophy is fracture, which may be insufficiency fractures through osteomalacic bone or pathologic fractures through brown tumors or amyloid deposits. Dialysis patients may experience carpal tunnel syndrome, osteomyelitis, septic ahritis, and osteonecrosis. Renal transplant patients may experience osteonecrosis, tendinitis, tendon rupture, and fracture.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: What is the most common cause of skeletal abnormality in a case of renal osteodystrophy?, with the following options: A: Impaired synthesis of Vitamin D3, B: Hypocalcemia, C: Hypercalcemia, D: Hyperphosphatemia ### Response: Renal osteodystrophy combines features of secondary hyperparathyroidism, rickets, osteomalacia, and osteoporosis. The primary retention of phosphate by abnormal kidneys results in hyperphosphatemia, which causes hypocalcemia, resulting in secondary hyperparathyroidism. Therefore, the spectrum of clinical and radiographic findings in renal osteodystrophy may be a manifestation of any of these disorders. The most common complication of renal osteodystrophy is fracture, which may be insufficiency fractures through osteomalacic bone or pathologic fractures through brown tumors or amyloid deposits. Dialysis patients may experience carpal tunnel syndrome, osteomyelitis, septic ahritis, and osteonecrosis. Renal transplant patients may experience osteonecrosis, tendinitis, tendon rupture, and fracture. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Evidence not used in rape is, with the following options: A: Semen in vagina, B: Semen on clothes, C: Presence of smegma bacilli in vagina, D: Presence of smegma under prepuce ### Response:

In the uncircumcised penis the presence of smegma under the prepuce and on the corona glandis rules out complete penetration because smegma will be rubbed off during intercourse. Smegma usually requires 24 hours to redeposit. Presence of smegma indicates that no sexual intercourse with full penetration is taken place within 24 hours but absence of smegma will not indicate intercourse. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 305

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Evidence not used in rape is, with the following options: A: Semen in vagina, B: Semen on clothes, C: Presence of smegma bacilli in vagina, D: Presence of smegma under prepuce ### Response: In the uncircumcised penis the presence of smegma under the prepuce and on the corona glandis rules out complete penetration because smegma will be rubbed off during intercourse. Smegma usually requires 24 hours to redeposit. Presence of smegma indicates that no sexual intercourse with full penetration is taken place within 24 hours but absence of smegma will not indicate intercourse. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 305 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Best index of contraceptive efficacy is, with the following options: A: Pearl index, B: Chandelers index, C: Quetlet index, D: Broca index ### Response:

Pearl index is defined as the number of failures per 100 woman years of exposure (HWY) Failure rate per Hundred Women Years = Total accidental pregnancies X 1200/ Total months of exposure Reference : Park&;s textbook of preventive and social medicine, 23rd edition, Page no: 510

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Best index of contraceptive efficacy is, with the following options: A: Pearl index, B: Chandelers index, C: Quetlet index, D: Broca index ### Response: Pearl index is defined as the number of failures per 100 woman years of exposure (HWY) Failure rate per Hundred Women Years = Total accidental pregnancies X 1200/ Total months of exposure Reference : Park&;s textbook of preventive and social medicine, 23rd edition, Page no: 510 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Neurons of first order for visual sensations are:, with the following options: A: Rods and cones, B: Bipolar cells, C: Ganglion cells, D: None of the above ### Response:

Ans. Bipolar cells

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Neurons of first order for visual sensations are:, with the following options: A: Rods and cones, B: Bipolar cells, C: Ganglion cells, D: None of the above ### Response: Ans. Bipolar cells ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cause of Unilateral Hypertranslucent hemithorax, with the following options: A: Pleural effusion, B: Pneumonectony, C: Poland's syndrome, D: Collapse ### Response:

Poland's (U/L congenital absence of pectoral muscles) - thus hypertransluscency.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cause of Unilateral Hypertranslucent hemithorax, with the following options: A: Pleural effusion, B: Pneumonectony, C: Poland's syndrome, D: Collapse ### Response: Poland's (U/L congenital absence of pectoral muscles) - thus hypertransluscency. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 60 year old lady comes with blood stained discharge from the nipple with family history of breast cancer. Next best step for her will be, with the following options: A: Ductoscopy, B: Nipple discharge cytology, C: Sono-mammogram, D: MRI ### Response:

Ans. (d) MRI(Ref Schwart 10th edition Page 527)* Mammography - IOC for women >35 years* Mammography - IOC for Screening purpose* MRI- IOC for screening in High risk Women* Mammography - IOC for detecting Ductal carcinoma In-situ lesions* Mammography - IOC to detect Micro calcifications (Which is the only feature for DCIS)* USG - IOC for women <35 years* MRI - IOC for Implanted breasts* MRI - IOC for doing Breast Conservative surgery in Cancer breast* MRI - IOC for Scarred breast* PET scan - IOC for detecting local and distant recurrences

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 60 year old lady comes with blood stained discharge from the nipple with family history of breast cancer. Next best step for her will be, with the following options: A: Ductoscopy, B: Nipple discharge cytology, C: Sono-mammogram, D: MRI ### Response: Ans. (d) MRI(Ref Schwart 10th edition Page 527)* Mammography - IOC for women >35 years* Mammography - IOC for Screening purpose* MRI- IOC for screening in High risk Women* Mammography - IOC for detecting Ductal carcinoma In-situ lesions* Mammography - IOC to detect Micro calcifications (Which is the only feature for DCIS)* USG - IOC for women <35 years* MRI - IOC for Implanted breasts* MRI - IOC for doing Breast Conservative surgery in Cancer breast* MRI - IOC for Scarred breast* PET scan - IOC for detecting local and distant recurrences ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 45 day - old infant developed icterus and two days later symptoms and signs of acute liver failure appeared. Child was found to be positive for Hbs Ag. The mother was also HBs Ag carrier. The mother's hepatitis B serological profile is likely to be ?, with the following options: A: HBs Ag positive only, B: HBs Ag and Hbe Ag positivity, C: HBsAg and anti - HBe antibody positivity, D: Mother infected with mutant HBV ### Response:

Ans. is `b' i.e., HBs positive and Hbe Ag positive Perinatal transmission of HBV o Most impoant risk factor that determines perinatal transmission is HBe Ag. HBs Ag carrier mothers who are HBe Ag positive almost invariably (> 90%) transmit hepatitis B infection to their offspring, where as carrier mothers with anti HBe rarely (10 to 15%) infect their offspring. o Most common time of perinatal transmission is at the time of delivery. o Most of the infected neonates are asymptomatic carrier with increased chances of chronic hepatitis and hepatocellular carcinoma.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 45 day - old infant developed icterus and two days later symptoms and signs of acute liver failure appeared. Child was found to be positive for Hbs Ag. The mother was also HBs Ag carrier. The mother's hepatitis B serological profile is likely to be ?, with the following options: A: HBs Ag positive only, B: HBs Ag and Hbe Ag positivity, C: HBsAg and anti - HBe antibody positivity, D: Mother infected with mutant HBV ### Response: Ans. is `b' i.e., HBs positive and Hbe Ag positive Perinatal transmission of HBV o Most impoant risk factor that determines perinatal transmission is HBe Ag. HBs Ag carrier mothers who are HBe Ag positive almost invariably (> 90%) transmit hepatitis B infection to their offspring, where as carrier mothers with anti HBe rarely (10 to 15%) infect their offspring. o Most common time of perinatal transmission is at the time of delivery. o Most of the infected neonates are asymptomatic carrier with increased chances of chronic hepatitis and hepatocellular carcinoma. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is not an embryologic structure that contributes to the formation of the face, with the following options: A: Frontonasal prominence, B: Zygomatic prominence, C: Maxillary prominence, D: Mandibular prominence ### Response:

The face is derived from the following structures that contributes to the formation of the face. The face is derived from the following structures around the stomatodeum (primitive mouth): Mandibular prominences and maxillary prominences of the first arch. Frontonasal prominence formed by the prominence of mesenchyme ventral to the brain vesicles. It also gives rise to medial and lateral nasal prominence. Structures contributing to the development of face Prominence Structure formed Frontonasal Forehead, bridge of the nose, also forms the medial and lateral nasal prominences Medial nasal Philtrum of the upper lip, crest of the nose, and tip of the nose Lateral nasal Alae of nose Maxillary Upper pa of cheeks, lateral poion of the upper lip Mandibular Lower pa of cheeks, chin, lower lip Ref: Inderbir Singh&;s Human Embryology 11th edition Pgno: 153

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is not an embryologic structure that contributes to the formation of the face, with the following options: A: Frontonasal prominence, B: Zygomatic prominence, C: Maxillary prominence, D: Mandibular prominence ### Response: The face is derived from the following structures that contributes to the formation of the face. The face is derived from the following structures around the stomatodeum (primitive mouth): Mandibular prominences and maxillary prominences of the first arch. Frontonasal prominence formed by the prominence of mesenchyme ventral to the brain vesicles. It also gives rise to medial and lateral nasal prominence. Structures contributing to the development of face Prominence Structure formed Frontonasal Forehead, bridge of the nose, also forms the medial and lateral nasal prominences Medial nasal Philtrum of the upper lip, crest of the nose, and tip of the nose Lateral nasal Alae of nose Maxillary Upper pa of cheeks, lateral poion of the upper lip Mandibular Lower pa of cheeks, chin, lower lip Ref: Inderbir Singh&;s Human Embryology 11th edition Pgno: 153 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All cause viral hepatitis except -, with the following options: A: Measles, B: EBV, C: Rhinovirus, D: Reovirus ### Response:

Ans. is 'c' i.e., Rhinovirus Impoant viruses causing hepatitis:? 1) Hepatotropic viruses : HAV, HBV, HCV, HD V, HEV. 2) Herpes viruses : CMV, EBV, HSV-1, VZV. 3) Flaviviruses : Yellow fever, dengue fever. 4) Filoviruses : Marburg virus, Ebola virus. 5) Occasinal causes Measles virus, adenovirus, Echoviruses, Coxsackieviruses, influenza virus, parvoviruses, reoviruses, mumps virus.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All cause viral hepatitis except -, with the following options: A: Measles, B: EBV, C: Rhinovirus, D: Reovirus ### Response: Ans. is 'c' i.e., Rhinovirus Impoant viruses causing hepatitis:? 1) Hepatotropic viruses : HAV, HBV, HCV, HD V, HEV. 2) Herpes viruses : CMV, EBV, HSV-1, VZV. 3) Flaviviruses : Yellow fever, dengue fever. 4) Filoviruses : Marburg virus, Ebola virus. 5) Occasinal causes Measles virus, adenovirus, Echoviruses, Coxsackieviruses, influenza virus, parvoviruses, reoviruses, mumps virus. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Role of somatotropine in fat metabolism, with the following options: A: Antilipolytic, B: Lipolytic, C: Ketogenic, D: Glucogenic ### Response:

Growth Hormone (GH) - i. It is also called somatotropin. It is a single polypeptide chain with 191 amino acids. GH is synthesized by acidophils (somatotropic cells) of anterior pituitary. ii. Plasma concentration of GH is less than 2 ng/ml during day time, with secretory peak appearing 3 hr after meals. Maximum level of GH is seen during deep sleep. For measurement of serum GH, the samples are collected during sleep and also during waking hours to assess the circadian rhythm. iii. GH secretion is regulated by the balance between GHRH and GHIH (somatostatin). The regulation of secretion is predominantly inhibitory. Hypoglycemia stimulates GH secretion, and hyperglycemia suppresses it. The hypothalamic growth hormone releasing hormone (GHRH) stimulates GH synthesis and release. Ghrelin, a peptide derived from stomach induces GHRH and directly stimulates the release of GH. Somatostatin synthesized in the hypothalamus inhibits the GH secretion. iv. The metabolic effect of GH is paly mediated by somatomedin, also known as insulin-like growth factor1 (IGF-1). The growth of long bones is stimulated by this factor. IGF-1, the peripheral target hormone of GH exes feedback inhibition. v. GH increases the uptake of amino acids by cells; enhances protein synthesis, and produces positive nitrogen balance . The anti-insulin effect of GH causes lipolysis and hyperglycemia. The overall effect of GH is to stimulate growth of soft tissues, cailage and bone. It is anabolic. vi. Excess secretion by GH secreting tumor, leads to gigantism in children and acromegaly in adults. REF:DM VASUDEVAN TEXTBOOK OF BIOCHEMISTRY, SIXTH EDITION, PG.NO.,530.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Role of somatotropine in fat metabolism, with the following options: A: Antilipolytic, B: Lipolytic, C: Ketogenic, D: Glucogenic ### Response: Growth Hormone (GH) - i. It is also called somatotropin. It is a single polypeptide chain with 191 amino acids. GH is synthesized by acidophils (somatotropic cells) of anterior pituitary. ii. Plasma concentration of GH is less than 2 ng/ml during day time, with secretory peak appearing 3 hr after meals. Maximum level of GH is seen during deep sleep. For measurement of serum GH, the samples are collected during sleep and also during waking hours to assess the circadian rhythm. iii. GH secretion is regulated by the balance between GHRH and GHIH (somatostatin). The regulation of secretion is predominantly inhibitory. Hypoglycemia stimulates GH secretion, and hyperglycemia suppresses it. The hypothalamic growth hormone releasing hormone (GHRH) stimulates GH synthesis and release. Ghrelin, a peptide derived from stomach induces GHRH and directly stimulates the release of GH. Somatostatin synthesized in the hypothalamus inhibits the GH secretion. iv. The metabolic effect of GH is paly mediated by somatomedin, also known as insulin-like growth factor1 (IGF-1). The growth of long bones is stimulated by this factor. IGF-1, the peripheral target hormone of GH exes feedback inhibition. v. GH increases the uptake of amino acids by cells; enhances protein synthesis, and produces positive nitrogen balance . The anti-insulin effect of GH causes lipolysis and hyperglycemia. The overall effect of GH is to stimulate growth of soft tissues, cailage and bone. It is anabolic. vi. Excess secretion by GH secreting tumor, leads to gigantism in children and acromegaly in adults. REF:DM VASUDEVAN TEXTBOOK OF BIOCHEMISTRY, SIXTH EDITION, PG.NO.,530. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Orexins play an impoant role in people with eating disorders. All of the following are orexins, EXCEPT:, with the following options: A: Leptin, B: Orexin-A, C: Hypocretin 1, D: Hypocretin 2 ### Response:

Orexins (A and B) or Hypocretins (1 and 2): They are produced by neurons in the lateral hypothalamus perifornical area. Regulated by glucose, leptin, neuropeptide Y, and POMC neurons. They stimulate food intake. Leptin: It is produced in adipose tissue. Acts on neuropeptide Y, AgRP-containing neurons, and -MSH neurons in the arcuate nucleus of the hypothalamus to decrease food intake. Ref: Molina P.E. (2010). Chapter 10. Endocrine Integration of Energy & Electrolyte Balance. In P.E. Molina (Ed), Endocrine Physiology, 3e.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Orexins play an impoant role in people with eating disorders. All of the following are orexins, EXCEPT:, with the following options: A: Leptin, B: Orexin-A, C: Hypocretin 1, D: Hypocretin 2 ### Response: Orexins (A and B) or Hypocretins (1 and 2): They are produced by neurons in the lateral hypothalamus perifornical area. Regulated by glucose, leptin, neuropeptide Y, and POMC neurons. They stimulate food intake. Leptin: It is produced in adipose tissue. Acts on neuropeptide Y, AgRP-containing neurons, and -MSH neurons in the arcuate nucleus of the hypothalamus to decrease food intake. Ref: Molina P.E. (2010). Chapter 10. Endocrine Integration of Energy & Electrolyte Balance. In P.E. Molina (Ed), Endocrine Physiology, 3e. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Stereocilia and kinocilium are present in, with the following options: A: Tongue, B: Inner ear, C: Nose, D: Eye ### Response:

(B) Inner ear > A kinocilium is a special type of cilium on the apex of hair cells located in the sensory epithelium of the vertebrate inner ear. Stereocilia (or stereovilli) are apical modifications of the cell, which are distinct from cilia and microvilli, but closely related to the latter. They are found in three regions of the body: the ductus deferens, the epididymis and the inner ear.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Stereocilia and kinocilium are present in, with the following options: A: Tongue, B: Inner ear, C: Nose, D: Eye ### Response: (B) Inner ear > A kinocilium is a special type of cilium on the apex of hair cells located in the sensory epithelium of the vertebrate inner ear. Stereocilia (or stereovilli) are apical modifications of the cell, which are distinct from cilia and microvilli, but closely related to the latter. They are found in three regions of the body: the ductus deferens, the epididymis and the inner ear. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Release of histamine and leukotrienes from mast cells is prevented by:, with the following options: A: Zileuton, B: Nedocromil sodium, C: Zafirlukast, D: Fexofenadine ### Response:

nedocromil and sod.cromoglycate- mast cell stabilizers Sodium cromoglycate (Cromolyn sod.) is a synthetic chromone derivative which inhibits degranulation of mast cells (as well as other inflammatory cells) by trigger stimuli. Release of mediators of asthma-like histamine, LTs, PAF, interleukins, etc. are restricted. Nedocromil sodium has propeies similar to those of cromolyn Sodium Pharmacology and pharmacotherapeutics Satoskar 24th page no. 586 ESSENTIALS OF MEDICAL PHARMACOLOGY 7th EDITION KD TRIPATHI PG NO.229

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Release of histamine and leukotrienes from mast cells is prevented by:, with the following options: A: Zileuton, B: Nedocromil sodium, C: Zafirlukast, D: Fexofenadine ### Response: nedocromil and sod.cromoglycate- mast cell stabilizers Sodium cromoglycate (Cromolyn sod.) is a synthetic chromone derivative which inhibits degranulation of mast cells (as well as other inflammatory cells) by trigger stimuli. Release of mediators of asthma-like histamine, LTs, PAF, interleukins, etc. are restricted. Nedocromil sodium has propeies similar to those of cromolyn Sodium Pharmacology and pharmacotherapeutics Satoskar 24th page no. 586 ESSENTIALS OF MEDICAL PHARMACOLOGY 7th EDITION KD TRIPATHI PG NO.229 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Inheritence of ichthyosis vulgaris is :, with the following options: A: X linked dominant, B: X linked recessive, C: Autosomal dominant, D: Autosomal recessive ### Response:

C i.e. Autosomal dominant

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Inheritence of ichthyosis vulgaris is :, with the following options: A: X linked dominant, B: X linked recessive, C: Autosomal dominant, D: Autosomal recessive ### Response: C i.e. Autosomal dominant ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Fascia around nerve bundle of brachial plexus is derived from:, with the following options: A: Preveebral fascia, B: Clavipectoral fascia, C: Deep cervical fascia, D: Pectoral fascia ### Response:

The preveebral fascia forms a tubular sheath around the veebral column and the preveebral muscles, which are attached to the veebral column. It,Attaches superiorly from the base of the skull and inferiorly to the endothoracic fascia in the thorax.Extends laterally as the axillary sheath, which surrounds the axillary vessels and brachial plexus of nerves to the upper limb.Contains, within its connective tissue fibers, the cervical sympathetic trunk and ganglia.Ref: Moon D.A., Foreman K.B., Albeine K.H. (2011). Chapter 25. Overview of the Neck. In D.A. Moon, K.B. Foreman, K.H. Albeine (Eds), The Big Picture: Gross Anatomy.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Fascia around nerve bundle of brachial plexus is derived from:, with the following options: A: Preveebral fascia, B: Clavipectoral fascia, C: Deep cervical fascia, D: Pectoral fascia ### Response: The preveebral fascia forms a tubular sheath around the veebral column and the preveebral muscles, which are attached to the veebral column. It,Attaches superiorly from the base of the skull and inferiorly to the endothoracic fascia in the thorax.Extends laterally as the axillary sheath, which surrounds the axillary vessels and brachial plexus of nerves to the upper limb.Contains, within its connective tissue fibers, the cervical sympathetic trunk and ganglia.Ref: Moon D.A., Foreman K.B., Albeine K.H. (2011). Chapter 25. Overview of the Neck. In D.A. Moon, K.B. Foreman, K.H. Albeine (Eds), The Big Picture: Gross Anatomy. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Into how many segments, the infant's gum pad is divided?, with the following options: A: Two in each quadrant, B: Three in each quadrant, C: Two in each jaw, D: Five in each quadrant ### Response:

The Gum Pads  The alveolar arches of an infant at the time of birth are called Gum Pads. These are greatly thickened oral mucous membrane of the gums, which soon become segmented, and each segment is a developing tooth site. They are pink in color and firm in consistency. The pads get divided into a labio/buccal and a lingual portion which differentiates later. Transverse grooves separate the gum pads into 10 segments. The groove between the canine and the first molar region is called the lateral sulcus, which helps to judge the inter-arch relationship.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Into how many segments, the infant's gum pad is divided?, with the following options: A: Two in each quadrant, B: Three in each quadrant, C: Two in each jaw, D: Five in each quadrant ### Response: The Gum Pads  The alveolar arches of an infant at the time of birth are called Gum Pads. These are greatly thickened oral mucous membrane of the gums, which soon become segmented, and each segment is a developing tooth site. They are pink in color and firm in consistency. The pads get divided into a labio/buccal and a lingual portion which differentiates later. Transverse grooves separate the gum pads into 10 segments. The groove between the canine and the first molar region is called the lateral sulcus, which helps to judge the inter-arch relationship. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Epitheliod granuloma is characterstic of, with the following options: A: Sarcoidosis, B: Eosinohilia, C: T.B., D: Mycosis Fungoides ### Response:

A i.e. Sarcoidosis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Epitheliod granuloma is characterstic of, with the following options: A: Sarcoidosis, B: Eosinohilia, C: T.B., D: Mycosis Fungoides ### Response: A i.e. Sarcoidosis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Recall bias is more common with, with the following options: A: Coho study, B: Randomized control trial, C: Cross sectional study, D: Case control study ### Response:

When cases and controls are asked questions about their past history it may be more likely for the cases to recall the existence of ceain events or factors than the controls who are healthy. (refer pgno:73 park 23rd edition)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Recall bias is more common with, with the following options: A: Coho study, B: Randomized control trial, C: Cross sectional study, D: Case control study ### Response: When cases and controls are asked questions about their past history it may be more likely for the cases to recall the existence of ceain events or factors than the controls who are healthy. (refer pgno:73 park 23rd edition) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Delayed pubey seen in -, with the following options: A: Chronic disease, B: Hypothyroidism, C: Turner's syndrome, D: All ### Response:

Ans. is All Delayed pubey o Delayed pubey is defined as failure of development of signs of sexual development by the age of 14 years in boy and breast budding by 13 years of girls. o Etiology of Delayed Pubey : 1. Chronic systemic diseases : Gluten enteropathy, anorexia nervosa. 2. Constitutional delay in growth and pubeal development - most common cause. 3. Hypogonadotropic hypogonadism (Low FSH. LH). a) CNS causes : Congenital anomalies, intracranial tumors, inflammatory diseases, traumatic lesions of CNS : b)Primary gonadotropin deficiency : Hypopituitarism. c) Syndromes with gonadotropin deficiency : Kallmann, Prader-Willi; Laurence-Moon-Biedl-Bardet, Froehlich. d)Miscellaneous : Hypothyroidism, hyperprolactinemia. 4. Hypergonadotropic hypogonadism (high FSH, LH, Gonadal disorders) : a) Turner syndrome (45 XO), Noonan syndrome, Klinefelter syndrome (47 XXY). b) Anticancer therapy for neoplasms of gonads. c) Orchitis d) Vanishing testes syndrome. e) Testosterone biosynthetic defects. f) Infiltration and autoimmune disease of gonads.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Delayed pubey seen in -, with the following options: A: Chronic disease, B: Hypothyroidism, C: Turner's syndrome, D: All ### Response: Ans. is All Delayed pubey o Delayed pubey is defined as failure of development of signs of sexual development by the age of 14 years in boy and breast budding by 13 years of girls. o Etiology of Delayed Pubey : 1. Chronic systemic diseases : Gluten enteropathy, anorexia nervosa. 2. Constitutional delay in growth and pubeal development - most common cause. 3. Hypogonadotropic hypogonadism (Low FSH. LH). a) CNS causes : Congenital anomalies, intracranial tumors, inflammatory diseases, traumatic lesions of CNS : b)Primary gonadotropin deficiency : Hypopituitarism. c) Syndromes with gonadotropin deficiency : Kallmann, Prader-Willi; Laurence-Moon-Biedl-Bardet, Froehlich. d)Miscellaneous : Hypothyroidism, hyperprolactinemia. 4. Hypergonadotropic hypogonadism (high FSH, LH, Gonadal disorders) : a) Turner syndrome (45 XO), Noonan syndrome, Klinefelter syndrome (47 XXY). b) Anticancer therapy for neoplasms of gonads. c) Orchitis d) Vanishing testes syndrome. e) Testosterone biosynthetic defects. f) Infiltration and autoimmune disease of gonads. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Thyroid Ca not diagnosed by FNAC -, with the following options: A: Follicular, B: Medullary, C: Papillary, D: Anaplastic ### Response:

Ans. is 'a' i.e., Follicular o The diagnosis of follicular carcinoma cannot be made by FNA.o FNAB is unable to distinguish benigs follicular lesions from follicular carcinoma.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Thyroid Ca not diagnosed by FNAC -, with the following options: A: Follicular, B: Medullary, C: Papillary, D: Anaplastic ### Response: Ans. is 'a' i.e., Follicular o The diagnosis of follicular carcinoma cannot be made by FNA.o FNAB is unable to distinguish benigs follicular lesions from follicular carcinoma. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is not a content of adductor canal?, with the following options: A: Femoral artery, B: Femoral vein, C: Saphenous nerve, D: Nerve to vastus lateralis ### Response:

Ans: D (Nerve to vatus lateralis) Ref: Grays Anatomy 40th EdExplanation:Adductor canal/subsartorial canal/hunter's canalLocated at the middle of the thighExtends from apex of the femoral triangle to the opening of the adductor magnusBoundaries:Roof - SartoriusFloor - Adductor longusLaterally - Vastus medialisContents:1. Femoral arteryFemoral veinSaphenous nerveNerve to vastus medialisOccasionally posterior division of obturator nerve

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is not a content of adductor canal?, with the following options: A: Femoral artery, B: Femoral vein, C: Saphenous nerve, D: Nerve to vastus lateralis ### Response: Ans: D (Nerve to vatus lateralis) Ref: Grays Anatomy 40th EdExplanation:Adductor canal/subsartorial canal/hunter's canalLocated at the middle of the thighExtends from apex of the femoral triangle to the opening of the adductor magnusBoundaries:Roof - SartoriusFloor - Adductor longusLaterally - Vastus medialisContents:1. Femoral arteryFemoral veinSaphenous nerveNerve to vastus medialisOccasionally posterior division of obturator nerve ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A chronic alcoholic presents with regurgitation and retrosternal pain. Endoscopic biopsy confirms Barrett's oesophagus. What is most appropriate management in this case, with the following options: A: PPI, B: H. pylori treatment, C: Balloon dilatation, D: Endoscopic biopsy every 2 years ### Response:

Patients who are found to have Barrett's oesophagus may be submitted to regular surveillance endoscopy with multiple biopsies in the hope of finding dysplasia or in situ cancer rather.Annual endoscopy has been widely practised, but two-year intervals are probably adequate, provided no dysplasia has been detected.High-dose PPI treatment or an antireflux operation, these endoscopic ablation methods can result in a neosquamous lining. But there is no evidence yet that any of these methods are reliable in eliminating cancer risk.Bailey and Love 26th edition pg: 1002

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A chronic alcoholic presents with regurgitation and retrosternal pain. Endoscopic biopsy confirms Barrett's oesophagus. What is most appropriate management in this case, with the following options: A: PPI, B: H. pylori treatment, C: Balloon dilatation, D: Endoscopic biopsy every 2 years ### Response: Patients who are found to have Barrett's oesophagus may be submitted to regular surveillance endoscopy with multiple biopsies in the hope of finding dysplasia or in situ cancer rather.Annual endoscopy has been widely practised, but two-year intervals are probably adequate, provided no dysplasia has been detected.High-dose PPI treatment or an antireflux operation, these endoscopic ablation methods can result in a neosquamous lining. But there is no evidence yet that any of these methods are reliable in eliminating cancer risk.Bailey and Love 26th edition pg: 1002 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: FDA indications of inhaled NO is?, with the following options: A: Malignant hypeension, B: Pulmonary hypeension in newborn, C: Cyanotic CHD, D: None of the above ### Response:

Ans. is 'b' i.e., Pulmonary hypeension in newborn According to Goodman Oilman "Inhaled nitric oxide has been approved by FDA for use in newborns with persistent pulmonary hypeension and has become the first line therapy for this disease. In this disease state NO inhalation has been shown to reduce, significantly, the necessity for extracorporeal oxygenation"

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: FDA indications of inhaled NO is?, with the following options: A: Malignant hypeension, B: Pulmonary hypeension in newborn, C: Cyanotic CHD, D: None of the above ### Response: Ans. is 'b' i.e., Pulmonary hypeension in newborn According to Goodman Oilman "Inhaled nitric oxide has been approved by FDA for use in newborns with persistent pulmonary hypeension and has become the first line therapy for this disease. In this disease state NO inhalation has been shown to reduce, significantly, the necessity for extracorporeal oxygenation" ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following can be given as a single weight-based intravenous bolus over 10 seconds?, with the following options: A: Tissue plasminogen activator (tPA), B: Tenecteplase (TNK), C: Reteplase (rPA), D: Any of the above ### Response:

.Tenecteplase is an enzyme used as a thrombolytic drug. Tenecteplase is a tissue plasminogen activator produced by recombinant DNA technology using an established mammalian cell line. Tenecteplase is a tissue plasminogen activator (tPA) produced by recombinant DNA technology using an established mammalian cell line (Chinese hamster ovary cells). Tenecteplase is a 527 amino acid glycoprotein developed by introducing the following modifications to the complementary DNA (cDNA) for natural human tPA: a substitution of threonine 103 with asparagine, and a substitution of asparagine 117 with glutamine, both within the kringle 1 domain, and a tetra-alanine substitution at amino acids 296-299 in the protease domain. Tenecteplase is a recombinant fibrin-specific plasminogen activator that is derived from native t-PA by modifications at three sites of the protein structure. It binds to the fibrin component of the thrombus (blood clot) and selectively conves thrombus-bound plasminogen to plasmin, which degrades the fibrin matrix of the thrombus. Tenecteplase has a higher fibrin specificity and greater resistance to inactivation by its endogenous inhibitor (PAI-1) compared to native t-PA. pharmacokinetics: Distribution: approximates plasma volume Metabolism: Primarily hepatic Half-life elimination: Biphasic: Initial: 20-24 minutes; Terminal: 90-130 minutes Excretion: Clearance: Plasma: 99-119 mL/minute Ref Robbins 9/e pg 234

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following can be given as a single weight-based intravenous bolus over 10 seconds?, with the following options: A: Tissue plasminogen activator (tPA), B: Tenecteplase (TNK), C: Reteplase (rPA), D: Any of the above ### Response: .Tenecteplase is an enzyme used as a thrombolytic drug. Tenecteplase is a tissue plasminogen activator produced by recombinant DNA technology using an established mammalian cell line. Tenecteplase is a tissue plasminogen activator (tPA) produced by recombinant DNA technology using an established mammalian cell line (Chinese hamster ovary cells). Tenecteplase is a 527 amino acid glycoprotein developed by introducing the following modifications to the complementary DNA (cDNA) for natural human tPA: a substitution of threonine 103 with asparagine, and a substitution of asparagine 117 with glutamine, both within the kringle 1 domain, and a tetra-alanine substitution at amino acids 296-299 in the protease domain. Tenecteplase is a recombinant fibrin-specific plasminogen activator that is derived from native t-PA by modifications at three sites of the protein structure. It binds to the fibrin component of the thrombus (blood clot) and selectively conves thrombus-bound plasminogen to plasmin, which degrades the fibrin matrix of the thrombus. Tenecteplase has a higher fibrin specificity and greater resistance to inactivation by its endogenous inhibitor (PAI-1) compared to native t-PA. pharmacokinetics: Distribution: approximates plasma volume Metabolism: Primarily hepatic Half-life elimination: Biphasic: Initial: 20-24 minutes; Terminal: 90-130 minutes Excretion: Clearance: Plasma: 99-119 mL/minute Ref Robbins 9/e pg 234 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Radial keratotomy is used as a treatment modality for –, with the following options: A: Small degree in myopia, B: Progressive non healing ulcer, C: High astigmatism, D: High hypermetropia ### Response:

Radial keratotomy is used for low to moderate myopia (-2 to -6D).

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Radial keratotomy is used as a treatment modality for –, with the following options: A: Small degree in myopia, B: Progressive non healing ulcer, C: High astigmatism, D: High hypermetropia ### Response: Radial keratotomy is used for low to moderate myopia (-2 to -6D). ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are causes of Antepaum hemorrhage (APH) except, with the following options: A: Placenta pre, B: Abruptio placenta, C: Circumvallate placenta, D: Battledore placenta ### Response:

Causes of APH placenta prae abruptio placenta local causes like polyp,cancer cervix ,varicose veins and local trauma circumvallate placenta vasa prae unclassified or indeterminate haemorrhage (refer pgno:128 sheila textbook of obstetrics 2 nd edition)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are causes of Antepaum hemorrhage (APH) except, with the following options: A: Placenta pre, B: Abruptio placenta, C: Circumvallate placenta, D: Battledore placenta ### Response: Causes of APH placenta prae abruptio placenta local causes like polyp,cancer cervix ,varicose veins and local trauma circumvallate placenta vasa prae unclassified or indeterminate haemorrhage (refer pgno:128 sheila textbook of obstetrics 2 nd edition) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following indicators involve reproductive woman -, with the following options: A: Bih Rate, B: G.F.R, C: T.F.R, D: Maternal moality rate ### Response:

Ref: Park 25th edition Pgno : 540

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following indicators involve reproductive woman -, with the following options: A: Bih Rate, B: G.F.R, C: T.F.R, D: Maternal moality rate ### Response: Ref: Park 25th edition Pgno : 540 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 22-year-old woman nursing her newborn develops a tender erythematous area around the nipple of her left breast. A thick, yellow fluid is observed to drain from an open fissure. Examination of this breast fluid under the light microscope will most likely reveal an abundance of which of the following inflammatory cells?, with the following options: A: B lymphocytes, B: Eosinophils, C: Mast cells, D: Neutrophils ### Response:

The thick, yellow fluid draining from the breast fissure in this patient represents a purulent exudate. Purulent exudates and effusions are associated with pathologic conditions such as pyogenic bacterial infections, in which the predominant cell type is the segmented neutrophil (polymorphonuclear leukocyte). -Mast cells (choice C) are granulated cells that contain receptors for IgE on their cell surface. -B lymphocytes (choice A) and plasma cells are mediators of chronic inflammationDiagnosis: Acute mastitis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 22-year-old woman nursing her newborn develops a tender erythematous area around the nipple of her left breast. A thick, yellow fluid is observed to drain from an open fissure. Examination of this breast fluid under the light microscope will most likely reveal an abundance of which of the following inflammatory cells?, with the following options: A: B lymphocytes, B: Eosinophils, C: Mast cells, D: Neutrophils ### Response: The thick, yellow fluid draining from the breast fissure in this patient represents a purulent exudate. Purulent exudates and effusions are associated with pathologic conditions such as pyogenic bacterial infections, in which the predominant cell type is the segmented neutrophil (polymorphonuclear leukocyte). -Mast cells (choice C) are granulated cells that contain receptors for IgE on their cell surface. -B lymphocytes (choice A) and plasma cells are mediators of chronic inflammationDiagnosis: Acute mastitis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: IV fluid replacement in a trauma patient is determined by, with the following options: A: Urine output, B: Chest condition, C: CVP, D: BP ### Response:

Adequacy of fluid replacement should be checked with hemodynamic stability and urine output. When very large fluid shifts are expected and the patient has compromised renal insufficiency it is necessary to monitor fluid status using central venous pressure(CVP). Manipal manual of surgery-Shenoy,4th edition,pg

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: IV fluid replacement in a trauma patient is determined by, with the following options: A: Urine output, B: Chest condition, C: CVP, D: BP ### Response: Adequacy of fluid replacement should be checked with hemodynamic stability and urine output. When very large fluid shifts are expected and the patient has compromised renal insufficiency it is necessary to monitor fluid status using central venous pressure(CVP). Manipal manual of surgery-Shenoy,4th edition,pg ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pathology of endometriosis is best explained by, with the following options: A: Coelemic metaplasia, B: Endometrial hyperplasia, C: Retrograde menstruation, D: Intraperitoneal immunologic deficit ### Response:

Retrograde menstruation is the most acceptable theory

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pathology of endometriosis is best explained by, with the following options: A: Coelemic metaplasia, B: Endometrial hyperplasia, C: Retrograde menstruation, D: Intraperitoneal immunologic deficit ### Response: Retrograde menstruation is the most acceptable theory ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following in the natural course of disease has no reversal of the shunt, with the following options: A: ASD, B: VSD, C: TOF, D: PDA ### Response:

Ans. c. TOF Infants with acyanotic gradually become cyanotic as a result of worsening condition of the infundinular stenosis a.nd polycythemia Polycythemia develop secondary to cyanosis Hypoxic spells may develop in infants Growth retardation may be present if cyanosis is severe Brain abscess and cerebrovascular accidents rarely occur SABE is occasionally a complication Some patients, paicularly those with severe TOF develop AR Coagulopathy is a late complication of longstanding cyanosis Eisenmenger syndrome Eisenmenger syndrome was so named by Dr. Paul Wood after Dr. Victor Eisenmenger, who first described the condition in 1897. Congenital hea defects causing Eisenmenger syndrome Atrial septal defects Ventricular septal defects Patent ductus aeriosus More complex types of acyanotic hea disease

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following in the natural course of disease has no reversal of the shunt, with the following options: A: ASD, B: VSD, C: TOF, D: PDA ### Response: Ans. c. TOF Infants with acyanotic gradually become cyanotic as a result of worsening condition of the infundinular stenosis a.nd polycythemia Polycythemia develop secondary to cyanosis Hypoxic spells may develop in infants Growth retardation may be present if cyanosis is severe Brain abscess and cerebrovascular accidents rarely occur SABE is occasionally a complication Some patients, paicularly those with severe TOF develop AR Coagulopathy is a late complication of longstanding cyanosis Eisenmenger syndrome Eisenmenger syndrome was so named by Dr. Paul Wood after Dr. Victor Eisenmenger, who first described the condition in 1897. Congenital hea defects causing Eisenmenger syndrome Atrial septal defects Ventricular septal defects Patent ductus aeriosus More complex types of acyanotic hea disease ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which pathway can use propionic acid ?, with the following options: A: Glycolysis, B: Gluconeogenesis, C: Glycogenolysis, D: Glycogenesis ### Response:

Fats cannot be conveed to carbohydrates because link reaction is irreversible. EXCEPTIONS are: 1. Glycerol breaks down products of triglycerides 2. Propionic acid can be conveed into carbohydrate Odd chain fatty acid can act as substrates of Gluconeogenesis, sincePropionyl CoA,the product of their oxidationcan enter TCA cycle through formation of Succinyl CoA (see fig), hence can contribute towards glucose production.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which pathway can use propionic acid ?, with the following options: A: Glycolysis, B: Gluconeogenesis, C: Glycogenolysis, D: Glycogenesis ### Response: Fats cannot be conveed to carbohydrates because link reaction is irreversible. EXCEPTIONS are: 1. Glycerol breaks down products of triglycerides 2. Propionic acid can be conveed into carbohydrate Odd chain fatty acid can act as substrates of Gluconeogenesis, sincePropionyl CoA,the product of their oxidationcan enter TCA cycle through formation of Succinyl CoA (see fig), hence can contribute towards glucose production. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ketone body formation without glycosuria is seen in -, with the following options: A: Diabetes mellitus, B: Diabetes insipidus, C: Starvation, D: Obesity ### Response:

Ans. is 'c' i.e.. Starvation o Amongst the given options, DM and starvation are the causes of ketosisDiabetes Ketosis with hyperglycemia and glycosuriaProlonged starvation :- Ketosis with low or normal glucose and without glycosuria.o In diabetic Ketoacidosis:- (i) Positive Rothera's test (due to ketone bodies) (ii) Positive Benedict's test (due to presence of reducing sugar in urine)o In Starvation ketosis:- (i) Postive Rothera's test (due to ketone bodies), (ii) Negative Benedict's test (no sugar in urine)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ketone body formation without glycosuria is seen in -, with the following options: A: Diabetes mellitus, B: Diabetes insipidus, C: Starvation, D: Obesity ### Response: Ans. is 'c' i.e.. Starvation o Amongst the given options, DM and starvation are the causes of ketosisDiabetes Ketosis with hyperglycemia and glycosuriaProlonged starvation :- Ketosis with low or normal glucose and without glycosuria.o In diabetic Ketoacidosis:- (i) Positive Rothera's test (due to ketone bodies) (ii) Positive Benedict's test (due to presence of reducing sugar in urine)o In Starvation ketosis:- (i) Postive Rothera's test (due to ketone bodies), (ii) Negative Benedict's test (no sugar in urine) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All of the following are pneumatic bone EXCEPT:, with the following options: A: Maxilla, B: Frontal, C: Mandible, D: Ethmoid ### Response:

Ans. (c) MandibleRef: Gray's 38th ed./431* Pneumatic Bone: Some cranial bones have air filled cavities for making skull light weight, resonance of voice & air conditioning.* Maxilla, Mastoid, Ethmoid, Sphenoid & Frontal bones are pneumatic bones.Types of boneSesamoid bonesPneumatic bone (Mn: It has Maximum Spherical Front Mass)Membranous (Dermal) bone* Patella* Pisiform* Fabella* Ethmoid* Maxilla* Sphenoid* Frontal* Mastoid (temporal)* Skull vault bones* Facial bones

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All of the following are pneumatic bone EXCEPT:, with the following options: A: Maxilla, B: Frontal, C: Mandible, D: Ethmoid ### Response: Ans. (c) MandibleRef: Gray's 38th ed./431* Pneumatic Bone: Some cranial bones have air filled cavities for making skull light weight, resonance of voice & air conditioning.* Maxilla, Mastoid, Ethmoid, Sphenoid & Frontal bones are pneumatic bones.Types of boneSesamoid bonesPneumatic bone (Mn: It has Maximum Spherical Front Mass)Membranous (Dermal) bone* Patella* Pisiform* Fabella* Ethmoid* Maxilla* Sphenoid* Frontal* Mastoid (temporal)* Skull vault bones* Facial bones ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Buprenorphine is:, with the following options: A: paial agonist at mu Receptor, B: Paial agonist at kappa Receptor, C: Full Agonist at mu Receptor, D: Full Agonist at kappa Receptor ### Response:

Ref : Katzung 11/e p546 *Buprenorphine appears to be a paial agonist at mu Receptor and antagonist at kappa Receptor.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Buprenorphine is:, with the following options: A: paial agonist at mu Receptor, B: Paial agonist at kappa Receptor, C: Full Agonist at mu Receptor, D: Full Agonist at kappa Receptor ### Response: Ref : Katzung 11/e p546 *Buprenorphine appears to be a paial agonist at mu Receptor and antagonist at kappa Receptor. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Essential fatty acids, with the following options: A: Linoeic acid, B: Linolenic acid, C: Arachiconic acid Palmitic acid, D: Plamitic acid ### Response:

ESSENTIAL FATTY ACIDSThree polyunsaturated fatty acids, linoleic acid, linolenic acid and arachidonic acid are called "essential fatty acids" (EFA). They cannot be synthesised in the body andmust be provided in the diet. Lack of EFA in the diet can produce growth retardation and other deficiency manifestation symptoms.Which EFA is Impoant?Linoleic acid is most impoant as, arachidonic acid can be synthesised from linoleic acid by a three-stage reaction by addition of acetyl-CoA. Pyridoxal phosphate is necessary for this conversion. Biologically arachidonic acid is very impoant as it is precursor from which prostaglandins and leukotrienes are synthesised in the body.Why EFA cannot be Synthesised?Introduction of additional double bonds in unsaturated fatty acid is limited to the area between - COOH group and the existing double bond and that it is not possible to introduce a double bond between the - CH3 group at the opposite end of the molecule and the first unsaturated linkage. This would explain body's inability to synthesise an EFA from oleic acid.Functions of EFA: (Biomedical Impoance)Structural elements of tissues: Polyunsaturated fatty acids occur in higher concentration in lipids associated with structural elements of tissues.Structural element of gonads: Lipids of gonads also contain a high concentration of polyunsaturated fatty acids, which suggests impoance of these compounds in reproductive function.Synthesis of prostaglandins and other compounds: Prostaglandins are synthesised from Arachidonic acid by cyclooxygenase enzyme system. Leucotrienes are conjugated trienes formed from arachidonic acid in leucocytes by the Lipoxygenase pathway.Structural element of mitochondrial membrane: A deficiency of EFA causes swelling of mitochondrial membrane and reduction in efficiency of oxidative phosphorylation. This may explain for increased heat production noted in EFA deficient animals.Serum level of cholesterol: Fats with high content of polyunsaturated fatty acids tends to lower serum level of cholesterol.Effect on clotting time: Prolongation of clotting time is noted in ingestion of fats rich in EFA.Effect on fibrinolytic activity: An increase in fibrinolytic activity follows the ingestion of fats rich in EFA.Role of EFA in fatty liver: Deficiency of EFA produces fatty liver.Role in vision: Docosahexaenoic acid (22:6n-3) is the most abundant polyenoic fatty acids present in retinal photoreceptor membranes. Docosahexaenoic acid is formed from dietary linolenic acid. It enhances the electrical response of the photoreceptors to illumination. Hence linolenic acid is necessary in the diet for optimal vision.Deficiency manifestations: A deficiency of EFA has not yet been unequivocally demonstrated in humans. In weaning animals, symptoms of EFA deficiency are readily produced. They are Cessation of growth.Skin lesions: Acanthosis (hyperophy of prickle cells) and hyperkeratosis (hyperophy of stratum corneum). Skin becomes abnormally permeable to water. Increased loss of water increases BMR.Abnormalities of pregnancy and lactation in adult females.Fatty liver accompanied by increased rates of fatty acids synthesis lessened resistance to stress.Kidney damage.CLINICAL ASPECTHuman deficiency: Some cases ofEczema like dermatitis,Degenerative changes in aerial wall andFatty liver in man may be due to EFA deficiency.There are also some repos that administration of EFA in such cases may produce:Some improvement of eczema in children kept on skimmed milk,Prevent fatty liver (some cases) andLowering of cholesterol levels.Infants and babies with low-fat diet develop typical skin lesions which have shown to be improved with EFA (linoleic acid).Fate of EFA: EFA undergoes b-oxidation after necessary isomerisation and epimerisation, like other unsaturated fatty acids.CLINICAL ASPECTAbnormal Metabolism of EFAAbnormal metabolism of EFA, which may be concerned with dietary insufficiency, has been noted in a number of disease like cystic fibrosis, hepatorenal syndrome, Crohn's disease, acrodermatitis enteropathica, Sjogren's syndrome, Cirrhosis and Reye's syndrome.Ref: M.N. Chatterjee - Textbook of Biochemistry, 8th edition, page no: 48-49

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Essential fatty acids, with the following options: A: Linoeic acid, B: Linolenic acid, C: Arachiconic acid Palmitic acid, D: Plamitic acid ### Response: ESSENTIAL FATTY ACIDSThree polyunsaturated fatty acids, linoleic acid, linolenic acid and arachidonic acid are called "essential fatty acids" (EFA). They cannot be synthesised in the body andmust be provided in the diet. Lack of EFA in the diet can produce growth retardation and other deficiency manifestation symptoms.Which EFA is Impoant?Linoleic acid is most impoant as, arachidonic acid can be synthesised from linoleic acid by a three-stage reaction by addition of acetyl-CoA. Pyridoxal phosphate is necessary for this conversion. Biologically arachidonic acid is very impoant as it is precursor from which prostaglandins and leukotrienes are synthesised in the body.Why EFA cannot be Synthesised?Introduction of additional double bonds in unsaturated fatty acid is limited to the area between - COOH group and the existing double bond and that it is not possible to introduce a double bond between the - CH3 group at the opposite end of the molecule and the first unsaturated linkage. This would explain body's inability to synthesise an EFA from oleic acid.Functions of EFA: (Biomedical Impoance)Structural elements of tissues: Polyunsaturated fatty acids occur in higher concentration in lipids associated with structural elements of tissues.Structural element of gonads: Lipids of gonads also contain a high concentration of polyunsaturated fatty acids, which suggests impoance of these compounds in reproductive function.Synthesis of prostaglandins and other compounds: Prostaglandins are synthesised from Arachidonic acid by cyclooxygenase enzyme system. Leucotrienes are conjugated trienes formed from arachidonic acid in leucocytes by the Lipoxygenase pathway.Structural element of mitochondrial membrane: A deficiency of EFA causes swelling of mitochondrial membrane and reduction in efficiency of oxidative phosphorylation. This may explain for increased heat production noted in EFA deficient animals.Serum level of cholesterol: Fats with high content of polyunsaturated fatty acids tends to lower serum level of cholesterol.Effect on clotting time: Prolongation of clotting time is noted in ingestion of fats rich in EFA.Effect on fibrinolytic activity: An increase in fibrinolytic activity follows the ingestion of fats rich in EFA.Role of EFA in fatty liver: Deficiency of EFA produces fatty liver.Role in vision: Docosahexaenoic acid (22:6n-3) is the most abundant polyenoic fatty acids present in retinal photoreceptor membranes. Docosahexaenoic acid is formed from dietary linolenic acid. It enhances the electrical response of the photoreceptors to illumination. Hence linolenic acid is necessary in the diet for optimal vision.Deficiency manifestations: A deficiency of EFA has not yet been unequivocally demonstrated in humans. In weaning animals, symptoms of EFA deficiency are readily produced. They are Cessation of growth.Skin lesions: Acanthosis (hyperophy of prickle cells) and hyperkeratosis (hyperophy of stratum corneum). Skin becomes abnormally permeable to water. Increased loss of water increases BMR.Abnormalities of pregnancy and lactation in adult females.Fatty liver accompanied by increased rates of fatty acids synthesis lessened resistance to stress.Kidney damage.CLINICAL ASPECTHuman deficiency: Some cases ofEczema like dermatitis,Degenerative changes in aerial wall andFatty liver in man may be due to EFA deficiency.There are also some repos that administration of EFA in such cases may produce:Some improvement of eczema in children kept on skimmed milk,Prevent fatty liver (some cases) andLowering of cholesterol levels.Infants and babies with low-fat diet develop typical skin lesions which have shown to be improved with EFA (linoleic acid).Fate of EFA: EFA undergoes b-oxidation after necessary isomerisation and epimerisation, like other unsaturated fatty acids.CLINICAL ASPECTAbnormal Metabolism of EFAAbnormal metabolism of EFA, which may be concerned with dietary insufficiency, has been noted in a number of disease like cystic fibrosis, hepatorenal syndrome, Crohn's disease, acrodermatitis enteropathica, Sjogren's syndrome, Cirrhosis and Reye's syndrome.Ref: M.N. Chatterjee - Textbook of Biochemistry, 8th edition, page no: 48-49 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Daily Iodine requirement during pregnancy is, with the following options: A: 75mcg, B: 150mcg, C: 220mcg, D: 500mcg ### Response:

Recommendation of the daily requirement of iodine during pregnancy is 220mcg and during lactation is 290mcg.(Ref: William's Obstetrics; 25th edition)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Daily Iodine requirement during pregnancy is, with the following options: A: 75mcg, B: 150mcg, C: 220mcg, D: 500mcg ### Response: Recommendation of the daily requirement of iodine during pregnancy is 220mcg and during lactation is 290mcg.(Ref: William's Obstetrics; 25th edition) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following organism is the most common cause of acute meningitis in an AIDS patient?, with the following options: A: Streptococcus pneumoniae, B: Streptococcus agalactiae, C: Cryptococcus neoformans, D: Listeria monocytogenes ### Response:

Oppounistic infections of the CNS generally occur in HIV infected patients with CD4 counts below 200. Most common organism that causes acute meningitis in an AIDS patients is Cyptococcus neoformans. Cryptococcus neoformans is an encapsulated budding yeast that is found worldwide in soil and on dried pigeon dung. Infections are acquired by inhalation. In the lung, the infection may remain localized, heal, or disseminate. Progressive lung disease and dissemination occur in cases of cellular immunodeficiency. Ref: Current Medical Diagnosis and Treatment, 2012, Chapter 36

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following organism is the most common cause of acute meningitis in an AIDS patient?, with the following options: A: Streptococcus pneumoniae, B: Streptococcus agalactiae, C: Cryptococcus neoformans, D: Listeria monocytogenes ### Response: Oppounistic infections of the CNS generally occur in HIV infected patients with CD4 counts below 200. Most common organism that causes acute meningitis in an AIDS patients is Cyptococcus neoformans. Cryptococcus neoformans is an encapsulated budding yeast that is found worldwide in soil and on dried pigeon dung. Infections are acquired by inhalation. In the lung, the infection may remain localized, heal, or disseminate. Progressive lung disease and dissemination occur in cases of cellular immunodeficiency. Ref: Current Medical Diagnosis and Treatment, 2012, Chapter 36 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following drug is cell cycle phase specific?, with the following options: A: Ifosfamide, B: Bleomycin, C: Cisplatin, D: Chlorambucil ### Response:

Ans. is 'b' i.e., Bleomycin Bleomycin is specific for G2 phase. o Alkylating agents (Ifosfamide, chlorambucil) and platinum compound (cisplatin) are cell cycle nonspecific.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following drug is cell cycle phase specific?, with the following options: A: Ifosfamide, B: Bleomycin, C: Cisplatin, D: Chlorambucil ### Response: Ans. is 'b' i.e., Bleomycin Bleomycin is specific for G2 phase. o Alkylating agents (Ifosfamide, chlorambucil) and platinum compound (cisplatin) are cell cycle nonspecific. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Function of ubiquitin, with the following options: A: Binding, B: Transpo, C: Degradation, D: Assembely ### Response:

Ubiquitin plays a major role in protein destruction. (Ref: Textbook of physiology N Geetha 2nd edition page no.10)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Function of ubiquitin, with the following options: A: Binding, B: Transpo, C: Degradation, D: Assembely ### Response: Ubiquitin plays a major role in protein destruction. (Ref: Textbook of physiology N Geetha 2nd edition page no.10) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A patient with abdominal injury presents to the emergency department with signs of signs of peritonitis and shock. Airway and breathing were secured and IV fluids were started with 2 large bore cannulas. The next line of management should be, with the following options: A: FAST, B: Exploratory Laparotomy under general anesthesia, C: Insertion of abdominal drain followed by laparotomy, D: Laproscopy ### Response:

Treatment for abdominal injury includes Emergency laparotomy. Indications include  Frank haemoperitoneum Significant diagnostic peritoneal lavage Haemodynamically unstable patient U/S or CT scan shows significant intra-abdominal injuries

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A patient with abdominal injury presents to the emergency department with signs of signs of peritonitis and shock. Airway and breathing were secured and IV fluids were started with 2 large bore cannulas. The next line of management should be, with the following options: A: FAST, B: Exploratory Laparotomy under general anesthesia, C: Insertion of abdominal drain followed by laparotomy, D: Laproscopy ### Response: Treatment for abdominal injury includes Emergency laparotomy. Indications include  Frank haemoperitoneum Significant diagnostic peritoneal lavage Haemodynamically unstable patient U/S or CT scan shows significant intra-abdominal injuries ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Surfactant deficiency occurs in NOT RELATED, with the following options: A: Infant of diabetic mother, B: Meconium aspiration syndrome, C: Transient tachypnea of newborn, D: Bronchopulmonary dysplasia ### Response:

.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Surfactant deficiency occurs in NOT RELATED, with the following options: A: Infant of diabetic mother, B: Meconium aspiration syndrome, C: Transient tachypnea of newborn, D: Bronchopulmonary dysplasia ### Response: . ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pompholyx affects?, with the following options: A: Flexors, B: Extensors, C: Palms and soles, D: Face ### Response:

Ans. is 'c' i.e., Palms and soles Pompholyx (vesicular endogenous eczema/ dyshidrotic eczema)* It is a form of hands and feet eczema characterised by vesicles or bullae (blisters). It is sometimes subclassified as cheiropompholyx (hands) and pedopompholyx (feet).Predisposing factors* Females sex, palmoplantar hyperhidrosis, atopic eczema, tinea ('id* reaction)Clinical presentation* Presents as recurrent crops of deep-seated blisters on the palms and soles associated with intense itching and/ or a burning sensation. The blisters peel off and the skin then appears red, dry and has painful fissures (cracks). It can result in paronychia (nail fold swelling) and nail dystrophy with irregular pitting and ridges.* Secondary bacterial infection with Staphylococcus aureus and/or Streptococcus pyogenes is common in pompholyx, and results in pain, swelling and pustules on the hands and feet.TreatmentA. General measures -Wet dressings with dilute potassium permanganate, aluminium acetate or acetic acid, Cold packs, Soothing agents, antiperspirants at night, protective gloves, well-fitting footwearB. Medicines- Ultrapotent topical corticosteroid creams and ointments. Short courses of systemic corticosteroids, eg prednisone or prednisolone, for flare-ups. Other - Oral antistaphylococcal antibiotics, immune modulating medicines (severe cases). Alitretinoin is used for resistant chronic disease.C. Other options - Superficial radiotherapy, Botulinum toxin injections ,Phototherapy and photochemotherapy (PUVA) therapy

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pompholyx affects?, with the following options: A: Flexors, B: Extensors, C: Palms and soles, D: Face ### Response: Ans. is 'c' i.e., Palms and soles Pompholyx (vesicular endogenous eczema/ dyshidrotic eczema)* It is a form of hands and feet eczema characterised by vesicles or bullae (blisters). It is sometimes subclassified as cheiropompholyx (hands) and pedopompholyx (feet).Predisposing factors* Females sex, palmoplantar hyperhidrosis, atopic eczema, tinea ('id* reaction)Clinical presentation* Presents as recurrent crops of deep-seated blisters on the palms and soles associated with intense itching and/ or a burning sensation. The blisters peel off and the skin then appears red, dry and has painful fissures (cracks). It can result in paronychia (nail fold swelling) and nail dystrophy with irregular pitting and ridges.* Secondary bacterial infection with Staphylococcus aureus and/or Streptococcus pyogenes is common in pompholyx, and results in pain, swelling and pustules on the hands and feet.TreatmentA. General measures -Wet dressings with dilute potassium permanganate, aluminium acetate or acetic acid, Cold packs, Soothing agents, antiperspirants at night, protective gloves, well-fitting footwearB. Medicines- Ultrapotent topical corticosteroid creams and ointments. Short courses of systemic corticosteroids, eg prednisone or prednisolone, for flare-ups. Other - Oral antistaphylococcal antibiotics, immune modulating medicines (severe cases). Alitretinoin is used for resistant chronic disease.C. Other options - Superficial radiotherapy, Botulinum toxin injections ,Phototherapy and photochemotherapy (PUVA) therapy ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common cause of death in Klinefelter's syndrome is?, with the following options: A: Infections, B: Cardiovascular, C: Respiratory, D: suicide ### Response:

ANSWER: (A) InfectionsREF: www.ncbi.nlm.nih .gov/pubmed/15292313 None of the text books mention it directly.On searching various studies, it was found that only two studies by far have been conducted to find increased mortality in klienfelter's syndrome, there for a larger cohort study was done where patients were followed for a long time.The results of study are complicated with statastical tools and stuff; therefore i took help of stasticians and simplified it.The most common cause of death was found to be infections > neurological diseases > lung and circulatory diseases > suicide

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common cause of death in Klinefelter's syndrome is?, with the following options: A: Infections, B: Cardiovascular, C: Respiratory, D: suicide ### Response: ANSWER: (A) InfectionsREF: www.ncbi.nlm.nih .gov/pubmed/15292313 None of the text books mention it directly.On searching various studies, it was found that only two studies by far have been conducted to find increased mortality in klienfelter's syndrome, there for a larger cohort study was done where patients were followed for a long time.The results of study are complicated with statastical tools and stuff; therefore i took help of stasticians and simplified it.The most common cause of death was found to be infections > neurological diseases > lung and circulatory diseases > suicide ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Methionine is synthesised in human body from -, with the following options: A: Cysteine, B: Homocysteine, C: Cystine, D: Tryptophan ### Response:

Ans. is 'b' i.e., Homocysteine* Homocysteine in the presence of methionine synthase and methyl B12, gets converted to methionine.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Methionine is synthesised in human body from -, with the following options: A: Cysteine, B: Homocysteine, C: Cystine, D: Tryptophan ### Response: Ans. is 'b' i.e., Homocysteine* Homocysteine in the presence of methionine synthase and methyl B12, gets converted to methionine. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ascaris lumbricoides causes deficiency of:, with the following options: A: Iron, B: Vitamin B 12, C: Folic acid, D: Vitamin A ### Response:

Vitamin A

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ascaris lumbricoides causes deficiency of:, with the following options: A: Iron, B: Vitamin B 12, C: Folic acid, D: Vitamin A ### Response: Vitamin A ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Unconjugated hvperbilirubenemia is seen in all except, with the following options: A: Gilbert's syndrome, B: Dubin Johnson's syndrome, C: Criggle Najar syndrome, D: Neonatal physiological jaundice ### Response:

(B) Dubin Johnson's syndrome# Common causes of raised bilirubin and urobilinogen> Raised conjugated bilirubin (bilirubinuria)> Hepatocellular disease and post-hepatic or cholestatic disease (intrahepatic and extrahepatic), including drug toxicity as well as pancreatic causes of obstructive jaundice.> Inherited defects in excretion - eg, Dubin-Johnson syndrome, Rotor's syndrome.> Raised unconjugated bilirubin (no bilirubinuria) Gilbert's syndrome Haemolysis Post viral hepatitis Mild chronic hepatitis Crigler-Najjar syndrome> PHYSIOLOGIC JAUNDICE (non-pathologic unconjugated hyperbilirubinemia):1. Term Infants: 50-60 % of all newborns are jaundiced in the first week of life. Total serum bilirubin peaks at age 3-5 d (later in Asian infants). Mean peak total serum bilirubin is 6 mg/dL (higher in Asian infants).2. Preterm Infants: Incidence of visible jaundice is much higher than in term infants. Peak is later (5-7d). Because of ? risk of bilibubin encephalopathy (see below), "physiologic" jaundice is more difficult to define and jaundice should be followed closely.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Unconjugated hvperbilirubenemia is seen in all except, with the following options: A: Gilbert's syndrome, B: Dubin Johnson's syndrome, C: Criggle Najar syndrome, D: Neonatal physiological jaundice ### Response: (B) Dubin Johnson's syndrome# Common causes of raised bilirubin and urobilinogen> Raised conjugated bilirubin (bilirubinuria)> Hepatocellular disease and post-hepatic or cholestatic disease (intrahepatic and extrahepatic), including drug toxicity as well as pancreatic causes of obstructive jaundice.> Inherited defects in excretion - eg, Dubin-Johnson syndrome, Rotor's syndrome.> Raised unconjugated bilirubin (no bilirubinuria) Gilbert's syndrome Haemolysis Post viral hepatitis Mild chronic hepatitis Crigler-Najjar syndrome> PHYSIOLOGIC JAUNDICE (non-pathologic unconjugated hyperbilirubinemia):1. Term Infants: 50-60 % of all newborns are jaundiced in the first week of life. Total serum bilirubin peaks at age 3-5 d (later in Asian infants). Mean peak total serum bilirubin is 6 mg/dL (higher in Asian infants).2. Preterm Infants: Incidence of visible jaundice is much higher than in term infants. Peak is later (5-7d). Because of ? risk of bilibubin encephalopathy (see below), "physiologic" jaundice is more difficult to define and jaundice should be followed closely. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Iron supplementation in a healthy term breast fed baby should be staed at the age of -, with the following options: A: 2 weeks, B: 4 weeks, C: 8 weeks, D: None ### Response:

Ans. is NoneCorrect answer is 6 months.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Iron supplementation in a healthy term breast fed baby should be staed at the age of -, with the following options: A: 2 weeks, B: 4 weeks, C: 8 weeks, D: None ### Response: Ans. is NoneCorrect answer is 6 months. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Singers Alkali denaturation test is done with :, with the following options: A: Maternal Hb, B: Fetal Hb, C: Amniotic fluid, D: Menstrual fluid ### Response:

Ans. is b i.e. Fetal Hb Ref. Dutta Obs. 6/e, p 247-248: Williams Obs. 23/e, p 583, 584; Text book of Ohs. by Sheila Balakrishnan, p 167-168 Fetal hemoglobin can be distinguished from Adult hemoglobin by : Wright stain : On staining blood with wright stain if RBC's appear nucleateddeg the blood is of fetal origindeg. Singers alkali denaturation test : It is based on the fact that fetaldeg hemoglobin is more resistant to alkali denaturationdeg. Test -- Blood + Sodium hydroxide/ Potassium hydroxide

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Singers Alkali denaturation test is done with :, with the following options: A: Maternal Hb, B: Fetal Hb, C: Amniotic fluid, D: Menstrual fluid ### Response: Ans. is b i.e. Fetal Hb Ref. Dutta Obs. 6/e, p 247-248: Williams Obs. 23/e, p 583, 584; Text book of Ohs. by Sheila Balakrishnan, p 167-168 Fetal hemoglobin can be distinguished from Adult hemoglobin by : Wright stain : On staining blood with wright stain if RBC's appear nucleateddeg the blood is of fetal origindeg. Singers alkali denaturation test : It is based on the fact that fetaldeg hemoglobin is more resistant to alkali denaturationdeg. Test -- Blood + Sodium hydroxide/ Potassium hydroxide ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Subendothelial electron dense deposits within the glomerulus are seen -, with the following options: A: MPGN type I, B: Crescentic glomerulonephritis, C: Dense deposit disease, D: IgA nephropathy ### Response:

Repeated Question.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Subendothelial electron dense deposits within the glomerulus are seen -, with the following options: A: MPGN type I, B: Crescentic glomerulonephritis, C: Dense deposit disease, D: IgA nephropathy ### Response: Repeated Question. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is the causative organism for Baholin's cyst?, with the following options: A: Candida, B: Anaerobes, C: Neisseria gonorrhoeae, D: Trichomonas ### Response:

Ducts of Baholin's gland are lined with transitional epithelium and their obstruction secondary to inflammation may lead to the development of a Baholin's cyst or abscess. Infections are often polymicrobial; sexually transmitted Neisseria gonorrhoeae and C. trachomatis are often implicated. Abscesses usually present as acutely inflamed, exquisitely tender masses. Treatment consists of incision and drainage and placement of a Word catheter. Ref: Cain J., ElMasri W.M., Gregory T., Kohn E.C. (2010). Chapter 41. Gynecology. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is the causative organism for Baholin's cyst?, with the following options: A: Candida, B: Anaerobes, C: Neisseria gonorrhoeae, D: Trichomonas ### Response: Ducts of Baholin's gland are lined with transitional epithelium and their obstruction secondary to inflammation may lead to the development of a Baholin's cyst or abscess. Infections are often polymicrobial; sexually transmitted Neisseria gonorrhoeae and C. trachomatis are often implicated. Abscesses usually present as acutely inflamed, exquisitely tender masses. Treatment consists of incision and drainage and placement of a Word catheter. Ref: Cain J., ElMasri W.M., Gregory T., Kohn E.C. (2010). Chapter 41. Gynecology. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Laryngeal cailage forming complete circle is ?, with the following options: A: Thyroid, B: Cricoid, C: Corniculate, D: Arytenoid ### Response:

Ans. is 'b' i.e., CricoidCricoid cailage is the only cailage forming a complete ring, therefore is shaped like a ring.Laryngeal cailages Thyroid (unpaired)o It is the largest of all laryngeal cailages. It is 'V' shaped with right and left lamina. Both laminae (alae) meet anteriorly forming an angle of 90deg in males and 120deg in females and forms laryngeal prominence. Vocal cords are attached to the middle of thyroid angle. Upper border of thyroid cailage lies at C3-C4 junction (at upper border of C4). Thyroid cailage itself lies at C4-05 level.Cricoid (unpaired)It is the only cailage forming a complete ring, therefore is shaped like a ring. It aiculates with arytenoid cailage to form cricoarytenoid joint, a type of synol joint. It lies at the level of C6 veebra Epiglottis (unpaired)It is leaf-shaped elastic cailage (in adults). It is omega shaped in children. It forms the anterior wall of laryngeal inlet. It lies above glottis.Arytenoid cailage (paired)Each Arytenoid cailage is pyramidal in shape. Base aiculates with cricoid cailage, and apex suppos the corniculate cailage. A vocal process directed anteriorly and gives attachement to vocal cord. A muscular process directed laterally and gives attachment to intrinsic laryngeal muscles.Corniculate cailage (of Santorini) : PairedAiculates with apex of Arytenoid cailageCuneiform cailage (of Wrisberg) : PairedSituated in aryepiglottic fold in front of corniculate cailage.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Laryngeal cailage forming complete circle is ?, with the following options: A: Thyroid, B: Cricoid, C: Corniculate, D: Arytenoid ### Response: Ans. is 'b' i.e., CricoidCricoid cailage is the only cailage forming a complete ring, therefore is shaped like a ring.Laryngeal cailages Thyroid (unpaired)o It is the largest of all laryngeal cailages. It is 'V' shaped with right and left lamina. Both laminae (alae) meet anteriorly forming an angle of 90deg in males and 120deg in females and forms laryngeal prominence. Vocal cords are attached to the middle of thyroid angle. Upper border of thyroid cailage lies at C3-C4 junction (at upper border of C4). Thyroid cailage itself lies at C4-05 level.Cricoid (unpaired)It is the only cailage forming a complete ring, therefore is shaped like a ring. It aiculates with arytenoid cailage to form cricoarytenoid joint, a type of synol joint. It lies at the level of C6 veebra Epiglottis (unpaired)It is leaf-shaped elastic cailage (in adults). It is omega shaped in children. It forms the anterior wall of laryngeal inlet. It lies above glottis.Arytenoid cailage (paired)Each Arytenoid cailage is pyramidal in shape. Base aiculates with cricoid cailage, and apex suppos the corniculate cailage. A vocal process directed anteriorly and gives attachement to vocal cord. A muscular process directed laterally and gives attachment to intrinsic laryngeal muscles.Corniculate cailage (of Santorini) : PairedAiculates with apex of Arytenoid cailageCuneiform cailage (of Wrisberg) : PairedSituated in aryepiglottic fold in front of corniculate cailage. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Mode of inheritance of ichthyosis Vulgaris is:, with the following options: A: Autosomal dominant, B: Autosomal recessive, C: X-linked, D: Codominant gene ### Response:

Ichthyosis Vulgaris: Autosomal dominant Filaggrin synthesis is defective. At bih, skin may appear normal Skin gradually becomes dry, rough and scaly, with most signs and symptoms appearing by the age of 5 The scale is white or grey, small, flaky or branny, and semi-adherent with turned-up edges Most pronounced on the extensor surfaces of arms and lower legs Hyperlinearity of palms and soles Associated with atopic dermatitis and keratosis pilaris Improvement with warm and sunny weather Mode of inheritance Ichtyosis Vulgaris- Autosomal dominant X linked ichtyosis- X linked recessive Lamellar ichtyosis- Autosomal recessive Harlequin ichtyosis- Autosomal recessive

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Mode of inheritance of ichthyosis Vulgaris is:, with the following options: A: Autosomal dominant, B: Autosomal recessive, C: X-linked, D: Codominant gene ### Response: Ichthyosis Vulgaris: Autosomal dominant Filaggrin synthesis is defective. At bih, skin may appear normal Skin gradually becomes dry, rough and scaly, with most signs and symptoms appearing by the age of 5 The scale is white or grey, small, flaky or branny, and semi-adherent with turned-up edges Most pronounced on the extensor surfaces of arms and lower legs Hyperlinearity of palms and soles Associated with atopic dermatitis and keratosis pilaris Improvement with warm and sunny weather Mode of inheritance Ichtyosis Vulgaris- Autosomal dominant X linked ichtyosis- X linked recessive Lamellar ichtyosis- Autosomal recessive Harlequin ichtyosis- Autosomal recessive ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A patient has just been admitted to hospital for observation. Based on patient's laboratory results. What is the patient's primary problem?Hematocrit 45%Hemoglobin 16g/dlPlatelets 50×109/L, with the following options: A: Hemochromatosis, B: Deep vein thrombosis, C: Hepatic vein thrombosis, D: Recurrent nose bleeds ### Response:

Due to low platelet count of 50×109/L. There is recurrent nose bleeds Normal platelet count = 1,50,000 - 4,00,000/ L

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A patient has just been admitted to hospital for observation. Based on patient's laboratory results. What is the patient's primary problem?Hematocrit 45%Hemoglobin 16g/dlPlatelets 50×109/L, with the following options: A: Hemochromatosis, B: Deep vein thrombosis, C: Hepatic vein thrombosis, D: Recurrent nose bleeds ### Response: Due to low platelet count of 50×109/L. There is recurrent nose bleeds Normal platelet count = 1,50,000 - 4,00,000/ L ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: During which of the following prenatal stages, are leukocytes not present in the developing embryo?, with the following options: A: Hepatic stage, B: Bone marrow stage, C: Mesoblastic stage, D: Splenic stage ### Response:

Leukocytes are absent during the mesoblastic (yolk-cell) stage, but appear at approximately two months gestation in the liver and somewhat late in the spleen. The bone marrow first paicipates in hematopoiesis at approximately six months gestation and assumes an increasingly larger role thereafter. The liver and spleen cease to paicipate in hematopoiesis at about the time of bih, and this task is completely taken up by the red bone marrow. Ref: Kaushansky K. (2010). Chapter 16. Hematopoietic Stem Cells, Progenitors, and Cytokines. In J.T. Prchal, K. Kaushansky, M.A. Lichtman, T.J. Kipps, U. Seligsohn (Eds), Williams Hematology, 8e.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: During which of the following prenatal stages, are leukocytes not present in the developing embryo?, with the following options: A: Hepatic stage, B: Bone marrow stage, C: Mesoblastic stage, D: Splenic stage ### Response: Leukocytes are absent during the mesoblastic (yolk-cell) stage, but appear at approximately two months gestation in the liver and somewhat late in the spleen. The bone marrow first paicipates in hematopoiesis at approximately six months gestation and assumes an increasingly larger role thereafter. The liver and spleen cease to paicipate in hematopoiesis at about the time of bih, and this task is completely taken up by the red bone marrow. Ref: Kaushansky K. (2010). Chapter 16. Hematopoietic Stem Cells, Progenitors, and Cytokines. In J.T. Prchal, K. Kaushansky, M.A. Lichtman, T.J. Kipps, U. Seligsohn (Eds), Williams Hematology, 8e. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 23 year old male patient complains that his face appears too long. Extra-oral examination reveals a retrognathic mandible, steep mandibular plane angle and a prominent antegonial notch. Which of the following statements regarding this patient's condition is false?, with the following options: A: Growth of mandible is more posteriorly, B: Growth of mandible is more anteriorly, C: Rotation is backward, D: Rotation can be given a positive sign ### Response:

By convention, the rotation of either jaw is considered "forward" and given a negative sign if there is more growth posteriorly than anteriorly. The rotation is "backward" and given a positive direction if it lengthens, anterior dimensions more than posterior ones, bringing the chin downward and backward. Contemporary orthodontics, William Proffit, 4th edition page 116

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 23 year old male patient complains that his face appears too long. Extra-oral examination reveals a retrognathic mandible, steep mandibular plane angle and a prominent antegonial notch. Which of the following statements regarding this patient's condition is false?, with the following options: A: Growth of mandible is more posteriorly, B: Growth of mandible is more anteriorly, C: Rotation is backward, D: Rotation can be given a positive sign ### Response: By convention, the rotation of either jaw is considered "forward" and given a negative sign if there is more growth posteriorly than anteriorly. The rotation is "backward" and given a positive direction if it lengthens, anterior dimensions more than posterior ones, bringing the chin downward and backward. Contemporary orthodontics, William Proffit, 4th edition page 116 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The presence of large quantities of un-reabsorbed solutes in the renal tubule causes an increase in urine volume is called:, with the following options: A: Osmotic diuresis, B: Osmotic natriuresis, C: Water intoxication, D: Water dieresis ### Response:

Osmotic diuresis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The presence of large quantities of un-reabsorbed solutes in the renal tubule causes an increase in urine volume is called:, with the following options: A: Osmotic diuresis, B: Osmotic natriuresis, C: Water intoxication, D: Water dieresis ### Response: Osmotic diuresis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pavlov's experiment is an example of ?, with the following options: A: Operant conditioning, B: Classical conditioning, C: Learned helplessness, D: Modeling ### Response:

Ans. is 'b' i.e., Classical conditioningClassical conditioningIn classical conditioning, the conditioned stimulus (which usually does not produce the response), when paired with unconditioned stimulus (stimulus which usually produces a response), directly produces a response.The typical example of classical conditioning is pavlov's experiment. Normally food produces salivation in dog, Therefore salivation in response to food is called unconditioned response and the stimulus, i.e., food is called unconditioned stimulus. Under normal circumstances, a dog does not salivate at the sound of a bell. However, if the sound of bell is paired consistently with presentation of food, the dog begans to salivate to the sound of bell even if the food is not presented. This learned response, i.e., salivation to a sound of bell without food, is called conditioned response and the stimulus (sound of a bell) is called conditioned stimulus.There is a reverse side to classical conditioning, called counter conditioning. This amounts to reducing the intensity of conditioned response (e.g., anxiety) by establishing an incompatible response (e.g., relaxation) to a conditioned stimulus (i.e., snake). So anxiety symptoms can be reduced when the stimuli to anxiety are presented in graded order and systemically paired with a relaxation response. This process of reciprocal inhibition is called systemic desensitization.Other behavioral therapies based on classical conditioning principle (counter conditioning) are exposure with response prevention and aversion therapy.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pavlov's experiment is an example of ?, with the following options: A: Operant conditioning, B: Classical conditioning, C: Learned helplessness, D: Modeling ### Response: Ans. is 'b' i.e., Classical conditioningClassical conditioningIn classical conditioning, the conditioned stimulus (which usually does not produce the response), when paired with unconditioned stimulus (stimulus which usually produces a response), directly produces a response.The typical example of classical conditioning is pavlov's experiment. Normally food produces salivation in dog, Therefore salivation in response to food is called unconditioned response and the stimulus, i.e., food is called unconditioned stimulus. Under normal circumstances, a dog does not salivate at the sound of a bell. However, if the sound of bell is paired consistently with presentation of food, the dog begans to salivate to the sound of bell even if the food is not presented. This learned response, i.e., salivation to a sound of bell without food, is called conditioned response and the stimulus (sound of a bell) is called conditioned stimulus.There is a reverse side to classical conditioning, called counter conditioning. This amounts to reducing the intensity of conditioned response (e.g., anxiety) by establishing an incompatible response (e.g., relaxation) to a conditioned stimulus (i.e., snake). So anxiety symptoms can be reduced when the stimuli to anxiety are presented in graded order and systemically paired with a relaxation response. This process of reciprocal inhibition is called systemic desensitization.Other behavioral therapies based on classical conditioning principle (counter conditioning) are exposure with response prevention and aversion therapy. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is the most common cause of perforation of uterus in non-pregnant state?, with the following options: A: IUCD, B: Dilatation and curettage, C: Laparoscopy, D: Carcinoma Endometrium ### Response:

In the non pregnant state,perforation of the uterus occurs usually during dilatation and curettage Dilatation and curettage procedure is a primary tool for diagnostic evaluation and treatment of abnormal uterine bleeding. Perforation of the uterus is common during a state of pregnancy or malignancy ( Soft Uterus) The atrophic uterus of post menopausal woman may also be perforated easily during D&C IUCD inseion also cause perforation, especially if done in a hurry. In case of a perforation: If the uterus is empty and not malignant, simple observation will suffice. However in complicated cases hysterectomy is done. Often abdominal viscera prolapse through the perforation and hence a laparotomy is done to repair the defect and bowel .

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is the most common cause of perforation of uterus in non-pregnant state?, with the following options: A: IUCD, B: Dilatation and curettage, C: Laparoscopy, D: Carcinoma Endometrium ### Response: In the non pregnant state,perforation of the uterus occurs usually during dilatation and curettage Dilatation and curettage procedure is a primary tool for diagnostic evaluation and treatment of abnormal uterine bleeding. Perforation of the uterus is common during a state of pregnancy or malignancy ( Soft Uterus) The atrophic uterus of post menopausal woman may also be perforated easily during D&C IUCD inseion also cause perforation, especially if done in a hurry. In case of a perforation: If the uterus is empty and not malignant, simple observation will suffice. However in complicated cases hysterectomy is done. Often abdominal viscera prolapse through the perforation and hence a laparotomy is done to repair the defect and bowel . ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Compounds with a large amount of carbohydrate & small amount of protein -, with the following options: A: Glycoprotein, B: Glycosaminoglycan, C: Proteoglycan, D: Glycocalyx ### Response:

A large amount of carbohydrate small amount of protein → Proteoglycans. A large amount of protein small amount of carbohydrate → Glycoproteins.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Compounds with a large amount of carbohydrate & small amount of protein -, with the following options: A: Glycoprotein, B: Glycosaminoglycan, C: Proteoglycan, D: Glycocalyx ### Response: A large amount of carbohydrate small amount of protein → Proteoglycans. A large amount of protein small amount of carbohydrate → Glycoproteins. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Lisengang rings are present in, with the following options: A: CEOT, B: OKC, C: CGCG, D: All of the above ### Response:

Calcifying Epithelial Odontogenic Tumor (Pindborg tumor) is a rare, benign odontogenic lesion. This is rare benign tumor which was first described in 1955 by Dutch pathologist Or J J Pindborg.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Lisengang rings are present in, with the following options: A: CEOT, B: OKC, C: CGCG, D: All of the above ### Response: Calcifying Epithelial Odontogenic Tumor (Pindborg tumor) is a rare, benign odontogenic lesion. This is rare benign tumor which was first described in 1955 by Dutch pathologist Or J J Pindborg. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Following is the management of vulvar varices during pregnancy :, with the following options: A: Pressure, B: Cautery, C: Simple vulvectomy, D: Observation only ### Response:

Varicosities (lower leg, vulva, rectum) may appear for the first time or aggravate during pregnancy usually in later months Its due to obstruction in the venous return by the pregnant uterus. Specific treatment is better to be avoided Usually disappears following delivery Ref . Dutta Obs 6/e p103 Williams Obs 23/e p 210-211

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Following is the management of vulvar varices during pregnancy :, with the following options: A: Pressure, B: Cautery, C: Simple vulvectomy, D: Observation only ### Response: Varicosities (lower leg, vulva, rectum) may appear for the first time or aggravate during pregnancy usually in later months Its due to obstruction in the venous return by the pregnant uterus. Specific treatment is better to be avoided Usually disappears following delivery Ref . Dutta Obs 6/e p103 Williams Obs 23/e p 210-211 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All of the following comes under primordial prevention of myocardial infarction except, with the following options: A: Maintenance of normal body weight, B: Changes in the life style, C: Change in the nutritional health, D: Screening for hypeension ### Response:

A novel approach to primary prevention of CHD is primordial prevention. It involves preventing the emergence and spread of CHD risk factors and lifestyles that have not yet appeared or become endemic. Ref: Park; 23rd ed; Pg 370

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All of the following comes under primordial prevention of myocardial infarction except, with the following options: A: Maintenance of normal body weight, B: Changes in the life style, C: Change in the nutritional health, D: Screening for hypeension ### Response: A novel approach to primary prevention of CHD is primordial prevention. It involves preventing the emergence and spread of CHD risk factors and lifestyles that have not yet appeared or become endemic. Ref: Park; 23rd ed; Pg 370 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Lambda phage which of the following is true ?, with the following options: A: It causes mad cow disease, B: Lysogenic to lytic conversion cannnot occur, C: Lysogenic form incorporates in host DNA & remain dormant, D: Lytic phase incorporates in host DNA, proliferate & causes rupture of cell ### Response:

Ans. is 'c' i.e., lysogenic form incorporates in host DNA and remain dormant . Lambda phase is nothing else but prototype of bacteriophage. . It has already been explained in previous explaination that lysogenic form is incorporated into the host genome ( not in lytic phase). In lytic phase,there is replication of phage inside the bacteria that causes lysis of bacteria. . On exposure to ultraviolet light or other agents the lysogenic phase undergoes induction i.e., the phase DNA is excised from the host cell and it undergoes lytic cycle.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Lambda phage which of the following is true ?, with the following options: A: It causes mad cow disease, B: Lysogenic to lytic conversion cannnot occur, C: Lysogenic form incorporates in host DNA & remain dormant, D: Lytic phase incorporates in host DNA, proliferate & causes rupture of cell ### Response: Ans. is 'c' i.e., lysogenic form incorporates in host DNA and remain dormant . Lambda phase is nothing else but prototype of bacteriophage. . It has already been explained in previous explaination that lysogenic form is incorporated into the host genome ( not in lytic phase). In lytic phase,there is replication of phage inside the bacteria that causes lysis of bacteria. . On exposure to ultraviolet light or other agents the lysogenic phase undergoes induction i.e., the phase DNA is excised from the host cell and it undergoes lytic cycle. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of these Is not an FDA approved indication for use of modafinil as an adjunct?, with the following options: A: Major depression and associated lethargy, B: Narcolepsy, C: Obstructive sleep apnea, D: Shift work disorder ### Response:

Ref: KD Tripathi 7th edition Page no 487 Modafinil is a newer psychostimulant and it's approved indications are narcolepsy, sleep apnea syndrome and shift work syndrome. It is being evaluated as a drug to prevent relapse of cocaine dependence. It is not used for depression

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of these Is not an FDA approved indication for use of modafinil as an adjunct?, with the following options: A: Major depression and associated lethargy, B: Narcolepsy, C: Obstructive sleep apnea, D: Shift work disorder ### Response: Ref: KD Tripathi 7th edition Page no 487 Modafinil is a newer psychostimulant and it's approved indications are narcolepsy, sleep apnea syndrome and shift work syndrome. It is being evaluated as a drug to prevent relapse of cocaine dependence. It is not used for depression ### End