Datasets:

jesse-tong

/

medqa

like 0

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: For PCR which of the following is not required, with the following options: A: Taq polymerase, B: d-NTP, C: Primer, D: Radiolabelled DNA probe ### Response:

Taq polymerase: It is a heat stable enzyme used in polymerase chain reaction Primer: it is a small sequence of 20 t0 30 base pairs used in PCR dNTP s : they are deoxy nucleoside triphosphates which help in DNA synthesis Ref: Guyton and Hall textbook of medical physiology 12th edition, chapter : 20

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: For PCR which of the following is not required, with the following options: A: Taq polymerase, B: d-NTP, C: Primer, D: Radiolabelled DNA probe ### Response: Taq polymerase: It is a heat stable enzyme used in polymerase chain reaction Primer: it is a small sequence of 20 t0 30 base pairs used in PCR dNTP s : they are deoxy nucleoside triphosphates which help in DNA synthesis Ref: Guyton and Hall textbook of medical physiology 12th edition, chapter : 20 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In chronic inflammation confined to the portal tract with intact limiting membrane and normal lobular parenchyma, the histopathological diagnosis would be -, with the following options: A: Active hepatitis, B: Chronic active hepatitis, C: Chronic persistent hepatitis, D: Acoholic heaptitis ### Response:

Intact limiting membrane with inflammation confined to portal area is seen in chronic persistent hepatitis.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In chronic inflammation confined to the portal tract with intact limiting membrane and normal lobular parenchyma, the histopathological diagnosis would be -, with the following options: A: Active hepatitis, B: Chronic active hepatitis, C: Chronic persistent hepatitis, D: Acoholic heaptitis ### Response: Intact limiting membrane with inflammation confined to portal area is seen in chronic persistent hepatitis. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: LASIK (Laser assisted in situ keratomileusis) is useful in treatment of, with the following options: A: Myopia, B: Astigmatism, C: Hypermetropia, D: All of the above ### Response:

Ans. d (All of the above) (Ref. Khurana's ophthalmology, 2nd ed., p 77; Parson's 20th/pg. 76)EXCIMER LASER IN SITU KERATOMILEUSIS (LASER)# Principle:- Myopia is corrected with preservation of Bowman's layer.- A superficial corneal flap (approx. 160 pm) is created with a microkeratome.- The keratome is withdrawn, the flap is reflected, and the exposed underlying corneal stroma is ablated with an excimer laser to correct the myopia.- Then the flap is repositioned on the corneal bed and fixed in place by force of its own adhesion.# Indication:- Severe myopia (up to 10-12 diopters).- Photoablation:* Excimer laser produces photoablation.* It produces UV light of very short wavelength, which breaks chemical bonds of biologic materials, converting them into small molecules that diffuse away.- Photorefractive keratectomy:* LASIK for correcting refractive errors and* LASIK for phototherapeutic keratectomy for corneal disease like "band-shaped" keratopathy.# LASIK is superior to photorefractive keratectomy in that it:- Less painful procedure* As LASIK does not expose raw corneal surface at the end of surgery it is less painful.- Can be repeated by lifting the flap created if further refinement is necessary- Gives a faster visual rehabilitation- Has less myopic regression- Causes less scarring than photorefractive keratectomy- Can Rx higher myopia* It can also treat a higher myopia, causes less scarring and has less myopic regression. However, because a flap needed to be created, it has a higher potential risk.* Involves the use of microtome* Is contraindicated in patients with thin cornea# Side effects of LASIK:- Reduced corneal sensation- Inaccurate biometry if the patient requires cataract surgery in later life- Tear film abnormality- Erroneously high intraocular pressure with applanation tonometer.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: LASIK (Laser assisted in situ keratomileusis) is useful in treatment of, with the following options: A: Myopia, B: Astigmatism, C: Hypermetropia, D: All of the above ### Response: Ans. d (All of the above) (Ref. Khurana's ophthalmology, 2nd ed., p 77; Parson's 20th/pg. 76)EXCIMER LASER IN SITU KERATOMILEUSIS (LASER)# Principle:- Myopia is corrected with preservation of Bowman's layer.- A superficial corneal flap (approx. 160 pm) is created with a microkeratome.- The keratome is withdrawn, the flap is reflected, and the exposed underlying corneal stroma is ablated with an excimer laser to correct the myopia.- Then the flap is repositioned on the corneal bed and fixed in place by force of its own adhesion.# Indication:- Severe myopia (up to 10-12 diopters).- Photoablation:* Excimer laser produces photoablation.* It produces UV light of very short wavelength, which breaks chemical bonds of biologic materials, converting them into small molecules that diffuse away.- Photorefractive keratectomy:* LASIK for correcting refractive errors and* LASIK for phototherapeutic keratectomy for corneal disease like "band-shaped" keratopathy.# LASIK is superior to photorefractive keratectomy in that it:- Less painful procedure* As LASIK does not expose raw corneal surface at the end of surgery it is less painful.- Can be repeated by lifting the flap created if further refinement is necessary- Gives a faster visual rehabilitation- Has less myopic regression- Causes less scarring than photorefractive keratectomy- Can Rx higher myopia* It can also treat a higher myopia, causes less scarring and has less myopic regression. However, because a flap needed to be created, it has a higher potential risk.* Involves the use of microtome* Is contraindicated in patients with thin cornea# Side effects of LASIK:- Reduced corneal sensation- Inaccurate biometry if the patient requires cataract surgery in later life- Tear film abnormality- Erroneously high intraocular pressure with applanation tonometer. ### 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 direct content of the cavernous sinus?, with the following options: A: Ophthalmic division of trigeminal nerve, B: Trochlear nerve, C: Abducent nerve, D: Occulomotor nerve ### Response:

Structures passing through the medial aspect of the sinus: 1. Internal carotid aery with the venous and sympathetic plexus around it. 2. Abducent nerve: inferolateral to the internal carotid aery The structures in the infra lateral wall and on the Lasseter medial aspect of the sinus are separated from blood, by the way, endothelial lining. Ref.BDC volume 3;sixth edition pg 193

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 direct content of the cavernous sinus?, with the following options: A: Ophthalmic division of trigeminal nerve, B: Trochlear nerve, C: Abducent nerve, D: Occulomotor nerve ### Response: Structures passing through the medial aspect of the sinus: 1. Internal carotid aery with the venous and sympathetic plexus around it. 2. Abducent nerve: inferolateral to the internal carotid aery The structures in the infra lateral wall and on the Lasseter medial aspect of the sinus are separated from blood, by the way, endothelial lining. Ref.BDC volume 3;sixth edition pg 193 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The non-sedative antihistamines are all except one, with the following options: A: Cinnarizine, B: Desloratadine, C: Levocetirizine, D: Fexofenadine ### Response:

HIGHLY SEDATIVE Diphenhydramine Dimenhydrinate Promethazine Hydroxyzine MODERATELY SEDATIVE Pheniramine Cyproheptadine Meclizine Cinnarizine MILD SEDATIVE Chlorpheniramine Dexchlorpheniramine Triprolidine Clemastine SECOND GENERATION ANTIHISTAMICS Fexofenadine Loratadine Desloratadine Cetirizine Levocetirizine Azelastine Mizolastine Ebastine Rupatadine

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The non-sedative antihistamines are all except one, with the following options: A: Cinnarizine, B: Desloratadine, C: Levocetirizine, D: Fexofenadine ### Response: HIGHLY SEDATIVE Diphenhydramine Dimenhydrinate Promethazine Hydroxyzine MODERATELY SEDATIVE Pheniramine Cyproheptadine Meclizine Cinnarizine MILD SEDATIVE Chlorpheniramine Dexchlorpheniramine Triprolidine Clemastine SECOND GENERATION ANTIHISTAMICS Fexofenadine Loratadine Desloratadine Cetirizine Levocetirizine Azelastine Mizolastine Ebastine Rupatadine ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Lancefield group of streptococci belongs to:, with the following options: A: M-protein, B: Carbohydrate (C) antigen on cell- wall, C: Bile solubility, D: Sugar fermentation ### Response:

Carbohydrate (C) antigen on cell- wall (Ref: Ananthnarayan-6thEd/Pg 188) "Hemolytic streptococci were classified by Lancefield serologically into groups based on the nature of Carbohydrate antigen on the cell wall." There are 20 groups, A to V, identified (without I & J). * The great majority of hemolytic streptococci that produce human infections belong to group A * Hemolytic streptococci of group A are called as Streptococcus. Pyogen

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Lancefield group of streptococci belongs to:, with the following options: A: M-protein, B: Carbohydrate (C) antigen on cell- wall, C: Bile solubility, D: Sugar fermentation ### Response: Carbohydrate (C) antigen on cell- wall (Ref: Ananthnarayan-6thEd/Pg 188) "Hemolytic streptococci were classified by Lancefield serologically into groups based on the nature of Carbohydrate antigen on the cell wall." There are 20 groups, A to V, identified (without I & J). * The great majority of hemolytic streptococci that produce human infections belong to group A * Hemolytic streptococci of group A are called as Streptococcus. Pyogen ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Effect of efferent aeriole constriction and afferent aeriole dilatation on GFR is?, with the following options: A: Increases, B: Decreases, C: No change, D: First increase then decrease ### Response:

Increases REF: Ganong's 22" chapter 38 Increase in renal blood flow increases GFR. Afferent aeriole brings blood to the nephron hence its dilation will increase renal blood flow, and efferent aeriole takes blood away from the nephrons, hence its constriction will cause increase filtration, hence increase in GFR.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Effect of efferent aeriole constriction and afferent aeriole dilatation on GFR is?, with the following options: A: Increases, B: Decreases, C: No change, D: First increase then decrease ### Response: Increases REF: Ganong's 22" chapter 38 Increase in renal blood flow increases GFR. Afferent aeriole brings blood to the nephron hence its dilation will increase renal blood flow, and efferent aeriole takes blood away from the nephrons, hence its constriction will cause increase filtration, hence increase in GFR. ### 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 statements about Parvovirus B-19 are true except-, with the following options: A: DNA virus, B: Crosses placenta in only <10% of cases, C: Can cause sever anemia, D: Can cause aplastic crises ### Response:

parvo virus cause aplastic&severe anemia.it is a sdDNA virus REF:ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.554

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 statements about Parvovirus B-19 are true except-, with the following options: A: DNA virus, B: Crosses placenta in only <10% of cases, C: Can cause sever anemia, D: Can cause aplastic crises ### Response: parvo virus cause aplastic&severe anemia.it is a sdDNA virus REF:ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.554 ### 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 ion is exchanged in the stomach for H+ secretion?, with the following options: A: Na+, B: K+, C: Ca+, D: Cl- ### Response:

The unique characteristic of gastric secretion is its high concentration of hydrochloric acid, a product of the parietal cells. As the concentration of H+ rises during secretion, that of Na+ drops in a reciprocal fashion. K+ remains relatively constant at 5-10 meq/L. Chloride concentration remains near 150 meq/L, and gastric juice maintains its isotonicity at varying secretory rates. Acid secretion at the apical membrane is accomplished by a membrane-bound H+/K+-ATPase (the proton pump); H+ is secreted into the lumen in exchange for K+. Ref: Dohey G.M., Way L.W. (2010). Chapter 23. Stomach & Duodenum. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e.

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 ion is exchanged in the stomach for H+ secretion?, with the following options: A: Na+, B: K+, C: Ca+, D: Cl- ### Response: The unique characteristic of gastric secretion is its high concentration of hydrochloric acid, a product of the parietal cells. As the concentration of H+ rises during secretion, that of Na+ drops in a reciprocal fashion. K+ remains relatively constant at 5-10 meq/L. Chloride concentration remains near 150 meq/L, and gastric juice maintains its isotonicity at varying secretory rates. Acid secretion at the apical membrane is accomplished by a membrane-bound H+/K+-ATPase (the proton pump); H+ is secreted into the lumen in exchange for K+. Ref: Dohey G.M., Way L.W. (2010). Chapter 23. Stomach & Duodenum. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Warfarin effect may be enhanced by: March 2005, with the following options: A: Phenobarbitone, B: Ketoconazole, C: Rifampicin, D: Chronic alcoholism ### Response:

Ans. D: Chronic Alcoholism Many commonly-used antibiotics, such as metronidazole or the macrolides, will greatly increase the effect of warfarin by reducing the metabolism of warfarin in the body. Other broad-spectrum antibiotics can reduce the amount of the normal bacterial flora in the bowel, which make significant quantities of vitamin K, thus potentiating the effect of warfarin. In addition, food that contains large quantities of vitamin K will reduce the warfarin effect. Thyroid activity also appears to influence warfarin dosing requirements; hypothyroidism (decreased thyroid function) makes people less responsive to warfarin treatment, while hypehyroidism (overactive thyroid) boosts the anticoagulant effect. Liver diseases, chronic alcoholism may enhance effect as synthesis of clotting factor may be deficient.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Warfarin effect may be enhanced by: March 2005, with the following options: A: Phenobarbitone, B: Ketoconazole, C: Rifampicin, D: Chronic alcoholism ### Response: Ans. D: Chronic Alcoholism Many commonly-used antibiotics, such as metronidazole or the macrolides, will greatly increase the effect of warfarin by reducing the metabolism of warfarin in the body. Other broad-spectrum antibiotics can reduce the amount of the normal bacterial flora in the bowel, which make significant quantities of vitamin K, thus potentiating the effect of warfarin. In addition, food that contains large quantities of vitamin K will reduce the warfarin effect. Thyroid activity also appears to influence warfarin dosing requirements; hypothyroidism (decreased thyroid function) makes people less responsive to warfarin treatment, while hypehyroidism (overactive thyroid) boosts the anticoagulant effect. Liver diseases, chronic alcoholism may enhance effect as synthesis of clotting factor may be deficient. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Oxaloacetate is formed from, with the following options: A: Glutamate, B: Histidine, C: Aspaate, D: Alanine ### Response:

Aminotransferase (transaminase) reactions form pyruvate from alanine, oxaloacetate from aspaate, and a-ketoglutarate from glutamate. Because these reactions are reversible, the cycle also serves as a source of carbon skeletons for the synthesis of these amino acids. Other amino acids contribute to gluconeogenesis because their carbon skeletons give rise to citric acid cycle intermediates. Alanine, cysteine, glycine, hydroxyproline, serine, threonine, and tryptophan yield pyruvate; arginine, histidine, glutamine, and proline yield a-ketoglutarate; isoleucine, methionine, and valine yield succinyl-CoA; tyrosine and phenylalanine yield fumarate. Reference: Harper; 30th edition; Page no: 165

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Oxaloacetate is formed from, with the following options: A: Glutamate, B: Histidine, C: Aspaate, D: Alanine ### Response: Aminotransferase (transaminase) reactions form pyruvate from alanine, oxaloacetate from aspaate, and a-ketoglutarate from glutamate. Because these reactions are reversible, the cycle also serves as a source of carbon skeletons for the synthesis of these amino acids. Other amino acids contribute to gluconeogenesis because their carbon skeletons give rise to citric acid cycle intermediates. Alanine, cysteine, glycine, hydroxyproline, serine, threonine, and tryptophan yield pyruvate; arginine, histidine, glutamine, and proline yield a-ketoglutarate; isoleucine, methionine, and valine yield succinyl-CoA; tyrosine and phenylalanine yield fumarate. Reference: Harper; 30th edition; Page no: 165 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Brown color of contusion is due to -, with the following options: A: Haematodin, B: Reduced hemoglobin, C: Haemosiderin, D: Bilirubin ### Response:

Ans. is 'c' i.e., Haemosiderin Color change and age of bruise (Contusion!o After a bruise has appeared, it tends to get smaller from periphery to center and passes through a series of colour changes. These are due to disintegration of RBCs by hemolysis and breakdown of hemoglobin into the pigments haemosiderin, haematodin and bilirubin changes are: -At first: Red (oxyhemoglobin)Few hours to 3 days : blue (reduced hemoglobin)4th day : Bluish-black to brown (haemosiderin)5-6 days: Greenish (haematodin)7-12 days : Yellow (Bilirubin)2 weeks : Normal (absorption of pigment)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Brown color of contusion is due to -, with the following options: A: Haematodin, B: Reduced hemoglobin, C: Haemosiderin, D: Bilirubin ### Response: Ans. is 'c' i.e., Haemosiderin Color change and age of bruise (Contusion!o After a bruise has appeared, it tends to get smaller from periphery to center and passes through a series of colour changes. These are due to disintegration of RBCs by hemolysis and breakdown of hemoglobin into the pigments haemosiderin, haematodin and bilirubin changes are: -At first: Red (oxyhemoglobin)Few hours to 3 days : blue (reduced hemoglobin)4th day : Bluish-black to brown (haemosiderin)5-6 days: Greenish (haematodin)7-12 days : Yellow (Bilirubin)2 weeks : Normal (absorption of pigment) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A young adult presents with proximal weakness of upper limbs, features of facial palsy and winging of scapula. The most likely diagnosis is-, with the following options: A: Facio-Scapulo-Humeral Dystrophy, B: Limb-Girdle Dystrophy, C: Scapuloproneal Dystrophy, D: Duchene Muscular Dystrophy ### Response:

*Condition typically has an onset in childhood or young adulthood., facial weakness is initial manifestation,weakness of shoulder girdle,loss of scapular stabilizing muscles makes arm elevation difficult,scapular winging becomes apparent with attempts at abduction and forward movement Ref Harrison20th edition pg 2567

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A young adult presents with proximal weakness of upper limbs, features of facial palsy and winging of scapula. The most likely diagnosis is-, with the following options: A: Facio-Scapulo-Humeral Dystrophy, B: Limb-Girdle Dystrophy, C: Scapuloproneal Dystrophy, D: Duchene Muscular Dystrophy ### Response: *Condition typically has an onset in childhood or young adulthood., facial weakness is initial manifestation,weakness of shoulder girdle,loss of scapular stabilizing muscles makes arm elevation difficult,scapular winging becomes apparent with attempts at abduction and forward movement Ref Harrison20th edition pg 2567 ### 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 Pharmacological methods of cervical ripening except?, with the following options: A: Pge2, B: Pge1, C: Mifepristone, D: Transcervical Catheter ### Response:

Pharmacological method Non pharmacological method 1. Dinoprostone gel (pge2) 1. Stripping of membrane 2. Misoprostol (pge1) 2. Mechanical dilators - Transcervical catheter and Osmotic dilators 3. Mifepristone 3.Extra-amniotic saline infusion During cervical ripening,Collagen fibril diameter and proteoglycan and glycosaminoglycan within the matrix is increased.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are Pharmacological methods of cervical ripening except?, with the following options: A: Pge2, B: Pge1, C: Mifepristone, D: Transcervical Catheter ### Response: Pharmacological method Non pharmacological method 1. Dinoprostone gel (pge2) 1. Stripping of membrane 2. Misoprostol (pge1) 2. Mechanical dilators - Transcervical catheter and Osmotic dilators 3. Mifepristone 3.Extra-amniotic saline infusion During cervical ripening,Collagen fibril diameter and proteoglycan and glycosaminoglycan within the matrix is increased. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: About Neuropeptide Y all are true except, with the following options: A: It is mediated through melanocorticotropin hormone, B: Decreases thermogenesis, C: Its level decreases during starvation, D: Contains 36 aminoacid residues ### Response:

Neuropeptide Y has 36 amino acid residues. It stimulates appetite, reduces thermogenesis by decreasing the energy expenditure and also decreases the activity of MSH. During starvation, it is secreted at increased levels.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: About Neuropeptide Y all are true except, with the following options: A: It is mediated through melanocorticotropin hormone, B: Decreases thermogenesis, C: Its level decreases during starvation, D: Contains 36 aminoacid residues ### Response: Neuropeptide Y has 36 amino acid residues. It stimulates appetite, reduces thermogenesis by decreasing the energy expenditure and also decreases the activity of MSH. During starvation, it is secreted at increased levels. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: "Today" sponge contains which of the following:, with the following options: A: Nonoxynol, B: Deflon, C: Femshield, D: Desogestrel ### Response:

Nonoxynol

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: "Today" sponge contains which of the following:, with the following options: A: Nonoxynol, B: Deflon, C: Femshield, D: Desogestrel ### Response: Nonoxynol ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Profuse expectoration of two months durations and clubbing may be seen, with the following options: A: Sarcoidosis, B: Polyaeritis nodosa, C: Pulmonary aery hypeension, D: Allergic bronchopulmonary aspergillosis ### Response:

Allergic bronchopulmonary aspergillosis represents a hypersensitivity reaction to Aspergillus fumigatus.Episodes of bronchial obstruction with mucous plugs leading to coughing 'fits',breathlessness,pulmonary infiltrates.It can result in the development of bronchiectasis.Clubbing can be seen in this case. Reference:Harrison's Medicine-18th edition,page no:1658;Davidson's Medicine-22nd edition,page no:697.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Profuse expectoration of two months durations and clubbing may be seen, with the following options: A: Sarcoidosis, B: Polyaeritis nodosa, C: Pulmonary aery hypeension, D: Allergic bronchopulmonary aspergillosis ### Response: Allergic bronchopulmonary aspergillosis represents a hypersensitivity reaction to Aspergillus fumigatus.Episodes of bronchial obstruction with mucous plugs leading to coughing 'fits',breathlessness,pulmonary infiltrates.It can result in the development of bronchiectasis.Clubbing can be seen in this case. Reference:Harrison's Medicine-18th edition,page no:1658;Davidson's Medicine-22nd edition,page no:697. ### 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 an ocular side-effect of HAART therapy?, with the following options: A: Retinitis, B: Uveitis, C: Optic neuritis, D: Scleritis ### Response:

Ans. b. Uveitis (Ref: Impact of highly active antiretroviral therapy on ophthalmic manifestations in human immunodeficency virus/ acquired immune deficiency syndrome by Kartik K Venkatesh, BA, J Biswas, MD; N, and N Kumarasamy, MBBS, PhD Indian Journal of Ophthalmology Year; 2008 | Volume : 56 | Issue : 5 | Page : 391-393 style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif">articles/PMC2636132/)Impact of highly active antiretroviral therapy on ophthalmic manifestations in human immunodeficiency virus:Before the introduction of HAART, CMV retinitis affected 30-40% of HIV-infected individuals. At that time a study from our center documented CMV retinitis and cotton-wool spots caused by HIV-related microvasculopathy as the most frequently encountered ocular lesions.Additionally, a study conducted at our center in Indian children infected with HIV found a high prevalence of ocular and systemic lesions, most commonly anterior uveitis followed by CMV retinitis.Since the advent of HAART, immune recovery uveitis (IRU) has become an ocular manifestation described in patients with inactive CMV retinitis. The reported incidence of IRU has been shown to vary widely and limited data is available of possible risk factors.Some HIV-infected individuals experience clinical deterioration after initiating antiretroviral therapy that is believed to be a result of the restored immune system to mount an exuberant inflammatory response. Immune reconstitution syndrome can cause posterior segment inflammation in CMV retinitis and can lead to visual morbidity in patients with AIDS.

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 an ocular side-effect of HAART therapy?, with the following options: A: Retinitis, B: Uveitis, C: Optic neuritis, D: Scleritis ### Response: Ans. b. Uveitis (Ref: Impact of highly active antiretroviral therapy on ophthalmic manifestations in human immunodeficency virus/ acquired immune deficiency syndrome by Kartik K Venkatesh, BA, J Biswas, MD; N, and N Kumarasamy, MBBS, PhD Indian Journal of Ophthalmology Year; 2008 | Volume : 56 | Issue : 5 | Page : 391-393 style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif">articles/PMC2636132/)Impact of highly active antiretroviral therapy on ophthalmic manifestations in human immunodeficiency virus:Before the introduction of HAART, CMV retinitis affected 30-40% of HIV-infected individuals. At that time a study from our center documented CMV retinitis and cotton-wool spots caused by HIV-related microvasculopathy as the most frequently encountered ocular lesions.Additionally, a study conducted at our center in Indian children infected with HIV found a high prevalence of ocular and systemic lesions, most commonly anterior uveitis followed by CMV retinitis.Since the advent of HAART, immune recovery uveitis (IRU) has become an ocular manifestation described in patients with inactive CMV retinitis. The reported incidence of IRU has been shown to vary widely and limited data is available of possible risk factors.Some HIV-infected individuals experience clinical deterioration after initiating antiretroviral therapy that is believed to be a result of the restored immune system to mount an exuberant inflammatory response. Immune reconstitution syndrome can cause posterior segment inflammation in CMV retinitis and can lead to visual morbidity in patients with AIDS. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Volatile inhalational anesthetic contributes in all of the following component of general anesthesia except, with the following options: A: Loss of consciousness, B: Loss of reflex, C: Analgesia, D: Muscle relaxation ### Response:

volatile inhalational anesthetic agent contributes in all the component of G.A except - analgesia. they can produce - loss of conciouness loss of reflex response Amnesia Muscle Relaxation

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Volatile inhalational anesthetic contributes in all of the following component of general anesthesia except, with the following options: A: Loss of consciousness, B: Loss of reflex, C: Analgesia, D: Muscle relaxation ### Response: volatile inhalational anesthetic agent contributes in all the component of G.A except - analgesia. they can produce - loss of conciouness loss of reflex response Amnesia Muscle Relaxation ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Gram negative cocci is/are -, with the following options: A: Neisseria gonoorrhoeae, B: Bacillus, C: Staphylococci, D: Streptococci ### Response:

Neisseria gonoorrhoeae- Gram negative cocci Streptococci - Gram Positive cocci Staphylococci- Gram Positive cocci Bacillus - Gram Positive Bacilli

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Gram negative cocci is/are -, with the following options: A: Neisseria gonoorrhoeae, B: Bacillus, C: Staphylococci, D: Streptococci ### Response: Neisseria gonoorrhoeae- Gram negative cocci Streptococci - Gram Positive cocci Staphylococci- Gram Positive cocci Bacillus - Gram Positive Bacilli ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In doing phrenic nerve block, it is best to infiltrate, with the following options: A: Scalenus anterior, B: Scalenus posterior, C: Posterior border of sternomastoid, D: Anterior border of sternomastoid ### Response:

Phrenic nerve is blocked 3 cm above the clavicle at the posterior border of sternomastoid.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In doing phrenic nerve block, it is best to infiltrate, with the following options: A: Scalenus anterior, B: Scalenus posterior, C: Posterior border of sternomastoid, D: Anterior border of sternomastoid ### Response: Phrenic nerve is blocked 3 cm above the clavicle at the posterior border of sternomastoid. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True regarding Kaposi's sarcoma is all except?, with the following options: A: May occur even in the presence of a normal CD4+T cell count, B: HHV-8 has been strongly implicated as a cofactor in the pathogenesis, C: Koebner's Phenomenon may be seen, D: Lymph node involvement suggests worst prognosis ### Response:

Ans. D. Lymph node involvement suggests worst prognosis.a. Kaposi's sarcoma is a multicentric neoplasm consisting of multiple vascular nodules appearing in the skin, mucous membranes, and viscera. The course ranges from indolent, with only minor skin or lymph node involvement, to fulminant, with extensive cutaneous and visceral involvement.b. In the initial period of the AIDS epidemic, KS was a prominent clinical feature of the first cases of AIDS, occurring in 79% of the patients diagnosed in 1981. By 1989 it was seen in only 25% of cases, by 1992 the number had decreased to 9%, and by 1997 the number was <1%. HHV-8 or KSHV has been strongly implicated as a viral cofactor in the pathogenesis of KS.c. Clinically, KS has varied presentations and may be seen at any stage of HIV infection, even in the presence of a normal CD4+ T cell count. The initial lesion may be a small, raised reddish-purple nodule on the skin, a discoloration on the oral mucosa, or a swollen lymph node.d. Lesions often appear in sun-exposed areas, particularly the tip of the nose, and have a propensity to occur in areas of trauma (Koebner phenomenon). Because of the vascular nature of the tumors and the presence of extravasated red blood cells in the lesions, their colors range from reddish to purple to brown and often take the appearance of a bruise, with yellowish discoloration and tattooing.e. Lesions range in size from a few millimeters to several centi- meters in diameter and may be either discrete or confluent. KS lesions most commonly appear as raised macules; however, they can also be papular, particularly in patients with higher CD4+ T cell counts. Con- fluent lesions may give rise to surrounding lymphedema and may be disfiguring when they involve the face and disabling when they involve the lower extremities or the surfaces of joints.f. Apart from skin, lymph nodes, gastrointestinal tract, and lung are the organ systems most commonly affected by KS. Lesions have been reported in virtually every organ, including the heart and the CNS. In contrast to most malignancies, in which lymph node involvement implies metastatic spread and a poor prognosis, lymph node involvement may be seen very early in KS and is of no special clinical significance.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True regarding Kaposi's sarcoma is all except?, with the following options: A: May occur even in the presence of a normal CD4+T cell count, B: HHV-8 has been strongly implicated as a cofactor in the pathogenesis, C: Koebner's Phenomenon may be seen, D: Lymph node involvement suggests worst prognosis ### Response: Ans. D. Lymph node involvement suggests worst prognosis.a. Kaposi's sarcoma is a multicentric neoplasm consisting of multiple vascular nodules appearing in the skin, mucous membranes, and viscera. The course ranges from indolent, with only minor skin or lymph node involvement, to fulminant, with extensive cutaneous and visceral involvement.b. In the initial period of the AIDS epidemic, KS was a prominent clinical feature of the first cases of AIDS, occurring in 79% of the patients diagnosed in 1981. By 1989 it was seen in only 25% of cases, by 1992 the number had decreased to 9%, and by 1997 the number was <1%. HHV-8 or KSHV has been strongly implicated as a viral cofactor in the pathogenesis of KS.c. Clinically, KS has varied presentations and may be seen at any stage of HIV infection, even in the presence of a normal CD4+ T cell count. The initial lesion may be a small, raised reddish-purple nodule on the skin, a discoloration on the oral mucosa, or a swollen lymph node.d. Lesions often appear in sun-exposed areas, particularly the tip of the nose, and have a propensity to occur in areas of trauma (Koebner phenomenon). Because of the vascular nature of the tumors and the presence of extravasated red blood cells in the lesions, their colors range from reddish to purple to brown and often take the appearance of a bruise, with yellowish discoloration and tattooing.e. Lesions range in size from a few millimeters to several centi- meters in diameter and may be either discrete or confluent. KS lesions most commonly appear as raised macules; however, they can also be papular, particularly in patients with higher CD4+ T cell counts. Con- fluent lesions may give rise to surrounding lymphedema and may be disfiguring when they involve the face and disabling when they involve the lower extremities or the surfaces of joints.f. Apart from skin, lymph nodes, gastrointestinal tract, and lung are the organ systems most commonly affected by KS. Lesions have been reported in virtually every organ, including the heart and the CNS. In contrast to most malignancies, in which lymph node involvement implies metastatic spread and a poor prognosis, lymph node involvement may be seen very early in KS and is of no special clinical significance. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Perl's stain or prussion blue test is for:, with the following options: A: Bilirubin, B: Calcium, C: Hemosiderin, D: Glycogen ### Response:

Perls' stain (Prussian-Blue Reaction) is to demonstrate Ferric salts in tissues. These are seen as iron  granules in bone marrow macrophages, erythroblasts (Sideroblasts) and erythrocytes (Siderocytes) in  blood films and haemosiderin in spun urine.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Perl's stain or prussion blue test is for:, with the following options: A: Bilirubin, B: Calcium, C: Hemosiderin, D: Glycogen ### Response: Perls' stain (Prussian-Blue Reaction) is to demonstrate Ferric salts in tissues. These are seen as iron  granules in bone marrow macrophages, erythroblasts (Sideroblasts) and erythrocytes (Siderocytes) in  blood films and haemosiderin in spun urine. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 5 year old male patient complains of multiple decayed teeth and gives a history of frequent snacking and consumption of sugar containing beverages and low socio-economic status. Intraoral examination shows multiple interproximal carious lesions. Which may be recommended by the dentist to this child?, with the following options: A: Aspartame, B: Xylitol, C: Complex carbohydrates, D: Saccharin ### Response:

Xylitol is a sweetener that inhibits the growth of MS. Numerous studies seem to confirm its anticariogenic capability. Clinically effective levels of xylitol show MS strains with reduced adhesion to the teeth and other reduced virulence properties, such as less acid production. Xylitol has been tested as an additive to a variety of foods and to dentifrices. However, the vast majority of published data come from studies in which xylitol was incorporated into chewing  gum. Clinicians may consider recommending xylitol use to moderate- or high-caries-risk  patients.  Those  recommending  xylitol should be familiar with the product labeling and recommend  age-appropriate  products.  They  should  routinely reassess a child for changes in caries-risk status and adjust recommendations accordingly. NOTE- MS- Mutans Streptococci.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 5 year old male patient complains of multiple decayed teeth and gives a history of frequent snacking and consumption of sugar containing beverages and low socio-economic status. Intraoral examination shows multiple interproximal carious lesions. Which may be recommended by the dentist to this child?, with the following options: A: Aspartame, B: Xylitol, C: Complex carbohydrates, D: Saccharin ### Response: Xylitol is a sweetener that inhibits the growth of MS. Numerous studies seem to confirm its anticariogenic capability. Clinically effective levels of xylitol show MS strains with reduced adhesion to the teeth and other reduced virulence properties, such as less acid production. Xylitol has been tested as an additive to a variety of foods and to dentifrices. However, the vast majority of published data come from studies in which xylitol was incorporated into chewing  gum. Clinicians may consider recommending xylitol use to moderate- or high-caries-risk  patients.  Those  recommending  xylitol should be familiar with the product labeling and recommend  age-appropriate  products.  They  should  routinely reassess a child for changes in caries-risk status and adjust recommendations accordingly. NOTE- MS- Mutans Streptococci. ### 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 these are responsible for preferential shunting of well oxygenated blood from fetal right atrium to left hea, EXCEPT?, with the following options: A: Upper interatrial septum, B: Crista dividens, C: Pattern of blood flow in IVC, D: Size difference of left and right atrium ### Response:

More oxygenated blood travels along the medial aspect of IVC and less along lateral aspect, facilitating shunting to opposite sides of hea, that is, more oxygenated travels to left hea through foramen ovale and less oxygenated to right ventricle. This is also facilitated by configuration of interatrial septum called crista dividens. So all are correct except option d.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All of these are responsible for preferential shunting of well oxygenated blood from fetal right atrium to left hea, EXCEPT?, with the following options: A: Upper interatrial septum, B: Crista dividens, C: Pattern of blood flow in IVC, D: Size difference of left and right atrium ### Response: More oxygenated blood travels along the medial aspect of IVC and less along lateral aspect, facilitating shunting to opposite sides of hea, that is, more oxygenated travels to left hea through foramen ovale and less oxygenated to right ventricle. This is also facilitated by configuration of interatrial septum called crista dividens. So all are correct except option d. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Association of choledocholithiasis in cholithiasis, with the following options: A: <5%, B: 15%, C: 20-35%, D: 50% ### Response:

Choledocholithiasis Found in 6-12% of patients with GB stones Retained stones discovered within 2 years of cholecystectomy Recurrent stones detected >2 years of cholecystectomy Ref: Sabiston 20th edition Pgno : 1494

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Association of choledocholithiasis in cholithiasis, with the following options: A: <5%, B: 15%, C: 20-35%, D: 50% ### Response: Choledocholithiasis Found in 6-12% of patients with GB stones Retained stones discovered within 2 years of cholecystectomy Recurrent stones detected >2 years of cholecystectomy Ref: Sabiston 20th edition Pgno : 1494 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: With regard to paranasal sinuses, true is, with the following options: A: The maxillary sinus of the newborn is relatively large compared to that of the adult, B: The mucous membrane of the maxillary sinus and the upper premolar teeth have the same nerve supply, C: The frontal, spheroidal, maxillary and anterior ethmoidal sinuses drain into the middle meatus, D: The spheroidal sinuses are supplied by anterior ethmoidal nerves ### Response:

Paranasal sinuses are rudimentary in newborn. Sphenoid sinus drains into sphenoethmoidal recess and not into middle meatus. Sphenoid sinus is supplied by posterior ethmoidal nerve.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: With regard to paranasal sinuses, true is, with the following options: A: The maxillary sinus of the newborn is relatively large compared to that of the adult, B: The mucous membrane of the maxillary sinus and the upper premolar teeth have the same nerve supply, C: The frontal, spheroidal, maxillary and anterior ethmoidal sinuses drain into the middle meatus, D: The spheroidal sinuses are supplied by anterior ethmoidal nerves ### Response: Paranasal sinuses are rudimentary in newborn. Sphenoid sinus drains into sphenoethmoidal recess and not into middle meatus. Sphenoid sinus is supplied by posterior ethmoidal nerve. ### 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 study of inheritance of the cystic fibrosis gene (CFTR), the genetic mutations in carriers and affected individuals are documented. Based on these findings, investigators determine that there is no simple screening test to detect all carriers of mutations of the CFTR gene. Which of the following is most likely to be the greatest limitation to development of a screening test for CFTR mutations?, with the following options: A: Both copies of the gene must be abnormal for detection, B: Fluorescence in situ hybridization is labor-intensive and expensive, C: Frequency of mutations among ethnic groups limits sensitivity, D: Less than 1 individual in 10,000 is a heterozygote ### Response:

When a genetic disease (e.g., cystic fibrosis) is caused by many different mutations, with different frequencies among populations, there is no simple screening test that can detect all the mutations. Although 70% of patients with cystic fibrosis have a 3-base pair deletion that can be readily detected by PCR (the AF508 mutation), the remaining 30% have disease caused by several hundred allelic forms of CFTR. To detect all would require sequencing of the CFTR genes. This prohibits mass screening. The other listed options do not apply.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In a study of inheritance of the cystic fibrosis gene (CFTR), the genetic mutations in carriers and affected individuals are documented. Based on these findings, investigators determine that there is no simple screening test to detect all carriers of mutations of the CFTR gene. Which of the following is most likely to be the greatest limitation to development of a screening test for CFTR mutations?, with the following options: A: Both copies of the gene must be abnormal for detection, B: Fluorescence in situ hybridization is labor-intensive and expensive, C: Frequency of mutations among ethnic groups limits sensitivity, D: Less than 1 individual in 10,000 is a heterozygote ### Response: When a genetic disease (e.g., cystic fibrosis) is caused by many different mutations, with different frequencies among populations, there is no simple screening test that can detect all the mutations. Although 70% of patients with cystic fibrosis have a 3-base pair deletion that can be readily detected by PCR (the AF508 mutation), the remaining 30% have disease caused by several hundred allelic forms of CFTR. To detect all would require sequencing of the CFTR genes. This prohibits mass screening. The other listed options do not apply. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pethidine should not be given with -, with the following options: A: Reserpine, B: Propranolol, C: Atenolol, D: MAO inhibitors ### Response:

Ans. is `d' i.e., MAO inhibitors o MAO inhibitors inhibit hydrolysis but not detmethylation --> more norpethidine is produced. Hydrolysis Mepridinic acid (major metabolic) Pethidine Dernekiation Norpethidine (minor metabolite) o MAO inhibitors selectively inhibit its hydrolysis without effecting demethylation -4 Accumulation of norpethidine --> Excitement.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pethidine should not be given with -, with the following options: A: Reserpine, B: Propranolol, C: Atenolol, D: MAO inhibitors ### Response: Ans. is `d' i.e., MAO inhibitors o MAO inhibitors inhibit hydrolysis but not detmethylation --> more norpethidine is produced. Hydrolysis Mepridinic acid (major metabolic) Pethidine Dernekiation Norpethidine (minor metabolite) o MAO inhibitors selectively inhibit its hydrolysis without effecting demethylation -4 Accumulation of norpethidine --> Excitement. ### 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 diagnostic barium follow-through features of ileocecal tuberculosis Except –, with the following options: A: Apple – core appearance, B: Pulled up contracted cecum, C: Widening of ileocecal angle, D: Strictures involving terminal ileum ### Response:

Radiological features of ileocecal tuberculosis on barium enema Fleischner or inverted umbrella sign:- wide gaping of the ileocecal valve with narrowing of the terminal ileum. Gooseneck deformity. Conical cecum or Amputed cecum Cecum is shrunken in size and pulled out of the iliac fossa due to fibrosis and contraction of mesocolon. Stierlin sign:- Narrowing of terminal ileum with rapid emptying into a shortened, rigid or obliterated cecum. String sign Widening of ileocecal (IC) angle Purse string (napkin ring) stenosis Discrete and transverse or star-shaped (stellate) ulcers with elevated margins.

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 diagnostic barium follow-through features of ileocecal tuberculosis Except –, with the following options: A: Apple – core appearance, B: Pulled up contracted cecum, C: Widening of ileocecal angle, D: Strictures involving terminal ileum ### Response: Radiological features of ileocecal tuberculosis on barium enema Fleischner or inverted umbrella sign:- wide gaping of the ileocecal valve with narrowing of the terminal ileum. Gooseneck deformity. Conical cecum or Amputed cecum Cecum is shrunken in size and pulled out of the iliac fossa due to fibrosis and contraction of mesocolon. Stierlin sign:- Narrowing of terminal ileum with rapid emptying into a shortened, rigid or obliterated cecum. String sign Widening of ileocecal (IC) angle Purse string (napkin ring) stenosis Discrete and transverse or star-shaped (stellate) ulcers with elevated margins. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Tacrolimus level is increased by all except, with the following options: A: Erythromycin, B: Itraconazole, C: Danazole, D: Rifampicin ### Response:

Ans. (D) Rifampicinwww.medscape.com/druginfo(Ref: KDT 8/e p940, )Erythromycin, itraconazol and danazol inhibit the metabolism of tacrolimus and thus increase the plasma concentration whereas rifampicin is an enzyme inducer and decrease its plasma level.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Tacrolimus level is increased by all except, with the following options: A: Erythromycin, B: Itraconazole, C: Danazole, D: Rifampicin ### Response: Ans. (D) Rifampicinwww.medscape.com/druginfo(Ref: KDT 8/e p940, )Erythromycin, itraconazol and danazol inhibit the metabolism of tacrolimus and thus increase the plasma concentration whereas rifampicin is an enzyme inducer and decrease its plasma level. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Golgi tendon organ helps in detection, with the following options: A: Muscle length, B: Reflex muscle tension, C: Nutrional status, D: Excretory function ### Response:

(Reflex muscle tension): (232-33 Ganong24 edition, 910-A.KJain 5 ; 661-Guyton 12 )Golgi Tendon Organ Helps Control Muscle TensionGTO is an encapsulated sensory receptor through which muscle tendon fibers pass. About 10 to 15 muscle fibers are usually connected to each GTO, and the organ is stimulated when this small bundle of muscle fibers is "tensed" by contracting or stretching the muscle. Thus the major difference in excitation of the Golgi tendon organ versus the muscle spindle is that the spindle detects muscle length and changes in muscle length, whereas the tndon organ detects muscle tension as reflected by the tension in itself* GTO has both dynamic response and static response* GTO provide the nervous system with instantaneous information on the degree of tension in each small segment of each muscle* It acts as a protective reflexGolgi tendon organPathway responsible for the stretch reflex and inverse stretch reflex

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Golgi tendon organ helps in detection, with the following options: A: Muscle length, B: Reflex muscle tension, C: Nutrional status, D: Excretory function ### Response: (Reflex muscle tension): (232-33 Ganong24 edition, 910-A.KJain 5 ; 661-Guyton 12 )Golgi Tendon Organ Helps Control Muscle TensionGTO is an encapsulated sensory receptor through which muscle tendon fibers pass. About 10 to 15 muscle fibers are usually connected to each GTO, and the organ is stimulated when this small bundle of muscle fibers is "tensed" by contracting or stretching the muscle. Thus the major difference in excitation of the Golgi tendon organ versus the muscle spindle is that the spindle detects muscle length and changes in muscle length, whereas the tndon organ detects muscle tension as reflected by the tension in itself* GTO has both dynamic response and static response* GTO provide the nervous system with instantaneous information on the degree of tension in each small segment of each muscle* It acts as a protective reflexGolgi tendon organPathway responsible for the stretch reflex and inverse stretch reflex ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Nasolacrimal duct will not be formed with oblique facial cleft due to n on fusion of which of the following ridges?, with the following options: A: A to B, B: B to C, C: A to C, D: C to D ### Response:

Ans. B. B to Ca. B (failure of fusion of lateral nasal process to maxillary process)1/1000. Clefts may also occur between the lateral nasal process and the maxillary prominence (oblique cleft) exposing the nasolacrimal duct or between the maxillary and mandibular primordial (lateral clefts). Although extremely rare, clefts can also form along the midline of the two mandibular prominences (median mandibular cleft). As the facial prominences fuse, the opposing epithelium disintegrates. Remnants of these epithelial seams may result in cyst formation.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Nasolacrimal duct will not be formed with oblique facial cleft due to n on fusion of which of the following ridges?, with the following options: A: A to B, B: B to C, C: A to C, D: C to D ### Response: Ans. B. B to Ca. B (failure of fusion of lateral nasal process to maxillary process)1/1000. Clefts may also occur between the lateral nasal process and the maxillary prominence (oblique cleft) exposing the nasolacrimal duct or between the maxillary and mandibular primordial (lateral clefts). Although extremely rare, clefts can also form along the midline of the two mandibular prominences (median mandibular cleft). As the facial prominences fuse, the opposing epithelium disintegrates. Remnants of these epithelial seams may result in cyst formation. ### 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 considered as first rank symptoms of Schizophrenia EXCEPT, with the following options: A: Thought broadcast, B: Third person auditory hallucination, C: Somatic passivity, D: Anhedonia ### Response:

(D) Anhedonia # First Rank Symptoms (SFRS) of Schizophrenia:> Hallucinations:> Audible thoughts: Voices speaking out thoughts aloud or 'thought echo'> Voices heard arguing: Two or more hallucinatory voices discussing the subject in third person> Voices commencing on one's action> Thought Alienation Phenomena Thought withdrawal: Thoughts cease and subject experiences them as removed by external force Thought insertion: Subject experiences thoughts imposed by some external force on his passive mind. Thought diffusion or broadcasting: Subject experiences that his thoughts are escaping the confines of his self and are being experienced by others around.> Passivity Phenomena 'Made' feelings or affect 'Made' impulses 'Made' volition or acts. In 'made' effects, impulses and volitions, the subject experiences feelings, impulses or acts, which are imposed by some external force. In 'made' volition, one's own acts are experienced as being under the control of some external force, the subject being like a robot. Somatic passivity: Bodily sensations, especially sensory symptoms imposed on body by some external force> Delusional perception: Normal perception has a private and illogical meaning.> Anhedonia is lack of interest/pleasure and is seen significantly in depression.

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 considered as first rank symptoms of Schizophrenia EXCEPT, with the following options: A: Thought broadcast, B: Third person auditory hallucination, C: Somatic passivity, D: Anhedonia ### Response: (D) Anhedonia # First Rank Symptoms (SFRS) of Schizophrenia:> Hallucinations:> Audible thoughts: Voices speaking out thoughts aloud or 'thought echo'> Voices heard arguing: Two or more hallucinatory voices discussing the subject in third person> Voices commencing on one's action> Thought Alienation Phenomena Thought withdrawal: Thoughts cease and subject experiences them as removed by external force Thought insertion: Subject experiences thoughts imposed by some external force on his passive mind. Thought diffusion or broadcasting: Subject experiences that his thoughts are escaping the confines of his self and are being experienced by others around.> Passivity Phenomena 'Made' feelings or affect 'Made' impulses 'Made' volition or acts. In 'made' effects, impulses and volitions, the subject experiences feelings, impulses or acts, which are imposed by some external force. In 'made' volition, one's own acts are experienced as being under the control of some external force, the subject being like a robot. Somatic passivity: Bodily sensations, especially sensory symptoms imposed on body by some external force> Delusional perception: Normal perception has a private and illogical meaning.> Anhedonia is lack of interest/pleasure and is seen significantly in depression. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Trombiculid mite is the vector of:-, with the following options: A: Epidemic typhus, B: Endemic typhus, C: Scrub typhus, D: Q-fever ### Response:

Disease Agent Vector Reservoir Epidemic typhus Endemic typhus Scrub typhus R. prowazekii R. typhi R. tsutsugamushi Louse Flea Trombiculid mite Humans Rodents Rodents Indian Tick typhus RMSF Rickettsial pox R. conori R. rickettsia R. akari Tick Tick Mite Rodents, dogs Rodents, dogs Mice Q Fever Trench Fever Coxiella burnetiid Baonella Quintana Nil Louse Cattle, sheep, goat Humans

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Trombiculid mite is the vector of:-, with the following options: A: Epidemic typhus, B: Endemic typhus, C: Scrub typhus, D: Q-fever ### Response: Disease Agent Vector Reservoir Epidemic typhus Endemic typhus Scrub typhus R. prowazekii R. typhi R. tsutsugamushi Louse Flea Trombiculid mite Humans Rodents Rodents Indian Tick typhus RMSF Rickettsial pox R. conori R. rickettsia R. akari Tick Tick Mite Rodents, dogs Rodents, dogs Mice Q Fever Trench Fever Coxiella burnetiid Baonella Quintana Nil Louse Cattle, sheep, goat Humans ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Analysis of routine measurement aimed at detecting changes in the environment?, with the following options: A: Surveillance, B: Isolation, C: Monitoring, D: RCT ### Response:

Monitoring is the performance and analysis of routine measurements aimed at detecting changes in the environment or health status of population.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Analysis of routine measurement aimed at detecting changes in the environment?, with the following options: A: Surveillance, B: Isolation, C: Monitoring, D: RCT ### Response: Monitoring is the performance and analysis of routine measurements aimed at detecting changes in the environment or health status of population. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 29–day old child presents with features of congestive cardiac failure and left ventricular hypertrophy. Auscultation shows a short systolic murmur. Most likely diagnosis is –, with the following options: A: Rheumatic fever, B: Tetralogy of Fallot, C: Transposition of great arteries, D: Ventricular septal defect ### Response:

The answer is quite obvious. TOF and TGA are cyanotic heart diseases and Rheumatic fever can be ruled out on basis of age. (Age group of rheumatic fever is 5-15 yrs) Clinical manifestation of VSD The patients become symptomatic around 6 to 10 weeks of age. At this time CHF may develop. Frequent symptoms → Palpitation, dysnea on exertion and chest infections. Signs Hyperkinetic precordium with a thrill at the left sternal border. Pansystolic murmur at left sternal border. S1 & S2 are masked by pan-systolic murmur maximum intensity of murmur is at 3rd, 4th or 5th left interspace. S2 can be make out at the pulmonary area (upper left sternal border) where it is not masked by pan-systolic murmur → S2 is widely split with accentuation of P2 S3 may be audible at the apex. A delayed diastolic murmur in mitral area. Pulmonary systolic ejection murmur in pulmonary area.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 29–day old child presents with features of congestive cardiac failure and left ventricular hypertrophy. Auscultation shows a short systolic murmur. Most likely diagnosis is –, with the following options: A: Rheumatic fever, B: Tetralogy of Fallot, C: Transposition of great arteries, D: Ventricular septal defect ### Response: The answer is quite obvious. TOF and TGA are cyanotic heart diseases and Rheumatic fever can be ruled out on basis of age. (Age group of rheumatic fever is 5-15 yrs) Clinical manifestation of VSD The patients become symptomatic around 6 to 10 weeks of age. At this time CHF may develop. Frequent symptoms → Palpitation, dysnea on exertion and chest infections. Signs Hyperkinetic precordium with a thrill at the left sternal border. Pansystolic murmur at left sternal border. S1 & S2 are masked by pan-systolic murmur maximum intensity of murmur is at 3rd, 4th or 5th left interspace. S2 can be make out at the pulmonary area (upper left sternal border) where it is not masked by pan-systolic murmur → S2 is widely split with accentuation of P2 S3 may be audible at the apex. A delayed diastolic murmur in mitral area. Pulmonary systolic ejection murmur in pulmonary area. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Baroreceptor stimulation produces:, with the following options: A: Decreased hea rate & BP, B: Increased hea rate & BP, C: Increased cardiac contractility, D: All ### Response:

A i.e. Decreased HR & BP Baroreceptors are the stretch receptors in the walls of hea & blood vessels eg carotid sinus & aoic arch receptors, receptors in walls of atria at enterance of SVC, IVC & pulmonary veins and receptors in pulmonary circulation (cardio- pulmonary receptors). These are stimulated by distension of the structure in which they are located 1/t vagal innervation of hea and producing vasodilation, venodilation, a drop in BP, bradycardia & decrease cardiac outputQ.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Baroreceptor stimulation produces:, with the following options: A: Decreased hea rate & BP, B: Increased hea rate & BP, C: Increased cardiac contractility, D: All ### Response: A i.e. Decreased HR & BP Baroreceptors are the stretch receptors in the walls of hea & blood vessels eg carotid sinus & aoic arch receptors, receptors in walls of atria at enterance of SVC, IVC & pulmonary veins and receptors in pulmonary circulation (cardio- pulmonary receptors). These are stimulated by distension of the structure in which they are located 1/t vagal innervation of hea and producing vasodilation, venodilation, a drop in BP, bradycardia & decrease cardiac outputQ. ### 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 used In bronchial asthma, except, with the following options: A: Salbutamol, B: Morphine, C: Aminophylline, D: Steroid ### Response:

Salbutamol is a beta2 agonist which relaxes smooth muscles and relieves bronchospasm.Aminophylline is a phosphodiesterase inhibitor that produces bronchodilator effect along with anti-inflammatory effect.Steroids,both oral and inhalational,are also used in asthma because of their anti-inflammatory propey. WHO proposed step wise approach for management of bronchial asthma. Morphine is used in emergency management of acute myocardial infarction. Reference:Harrison's medicine-18th edition,page no:2110.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are used In bronchial asthma, except, with the following options: A: Salbutamol, B: Morphine, C: Aminophylline, D: Steroid ### Response: Salbutamol is a beta2 agonist which relaxes smooth muscles and relieves bronchospasm.Aminophylline is a phosphodiesterase inhibitor that produces bronchodilator effect along with anti-inflammatory effect.Steroids,both oral and inhalational,are also used in asthma because of their anti-inflammatory propey. WHO proposed step wise approach for management of bronchial asthma. Morphine is used in emergency management of acute myocardial infarction. Reference:Harrison's medicine-18th edition,page no:2110. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which type of mutations usually involves mutation of a gene coding for the following molecule?, with the following options: A: Silent mutation, B: Nonsence mutation, C: Missense mutation, D: Nonsense suppressor mutation ### Response:

A nonsense suppressor mutation is a secondary mutation that reverses the effect of a primary nonsense or chain-termination mutation. Ordinarily, no transfer RNA (tRNA) molecule can recognize a nonsense codon; therefore, protein synthesis terminates when the ribosome reaches such a codon. A nonsense suppressor mutation usually involves the mutation of a tRNA gene, so that the anticodon of the tRNA is altered to a sequence that is complementary to a nonsense codon. The altered tRNA can then bind to the nonsense codon and inse an amino acid at that point in the protein sequence. Thus, protein synthesis is allowed to continue, and the nonsense mutation is suppressed. A silent mutation is one that causes no change in the amino acid sequence of a protein. A missense mutation causes a single amino acid change. A frameshift mutation is the result of an inseion or deletion that alters the reading frame of the ribosome, leading to the production of a garbled amino acid sequence. Ref : Biochemistry by U. Satyanarayana 3rd edition Pgno : 537

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which type of mutations usually involves mutation of a gene coding for the following molecule?, with the following options: A: Silent mutation, B: Nonsence mutation, C: Missense mutation, D: Nonsense suppressor mutation ### Response: A nonsense suppressor mutation is a secondary mutation that reverses the effect of a primary nonsense or chain-termination mutation. Ordinarily, no transfer RNA (tRNA) molecule can recognize a nonsense codon; therefore, protein synthesis terminates when the ribosome reaches such a codon. A nonsense suppressor mutation usually involves the mutation of a tRNA gene, so that the anticodon of the tRNA is altered to a sequence that is complementary to a nonsense codon. The altered tRNA can then bind to the nonsense codon and inse an amino acid at that point in the protein sequence. Thus, protein synthesis is allowed to continue, and the nonsense mutation is suppressed. A silent mutation is one that causes no change in the amino acid sequence of a protein. A missense mutation causes a single amino acid change. A frameshift mutation is the result of an inseion or deletion that alters the reading frame of the ribosome, leading to the production of a garbled amino acid sequence. Ref : Biochemistry by U. Satyanarayana 3rd edition Pgno : 537 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Stratum germinativum is synonymous to, with the following options: A: Stratum Basale, B: Stratum Spinosum, C: Stratum granulosum, D: Stratum corneum ### Response:

Stratum basale: Also called stratum germinativum. Made of single layer of columnar epithelium. Contains keratinocytes and melanocytes.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Stratum germinativum is synonymous to, with the following options: A: Stratum Basale, B: Stratum Spinosum, C: Stratum granulosum, D: Stratum corneum ### Response: Stratum basale: Also called stratum germinativum. Made of single layer of columnar epithelium. Contains keratinocytes and melanocytes. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 34 years old female after thyroidectomy was under observation in post operations ward after shows she developed tense swelling in neck and become breathless. How do you treat this patient?, with the following options: A: Intubate the patient and administer epinephrine, B: Infuse 10% calcium gluconate over 10 min, C: Open the sutures and evacuate the hematoma, D: Turn the patient sideways and give inj.salbutamol subcutaneously ### Response:

Breathlessness within few hans of thyroidectomy and swelling in the neck suggest of tension hematoma, which is treated by removal of stucture & evacuating the hematoma.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 34 years old female after thyroidectomy was under observation in post operations ward after shows she developed tense swelling in neck and become breathless. How do you treat this patient?, with the following options: A: Intubate the patient and administer epinephrine, B: Infuse 10% calcium gluconate over 10 min, C: Open the sutures and evacuate the hematoma, D: Turn the patient sideways and give inj.salbutamol subcutaneously ### Response: Breathlessness within few hans of thyroidectomy and swelling in the neck suggest of tension hematoma, which is treated by removal of stucture & evacuating the hematoma. ### 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 best denotes classical complement pathway activation in immuno inflammatory condition:, with the following options: A: C2, C4 and C3 decreased, B: C2 and C4 normal, C3 is decreased, C: C3 normal and C2, C4 decreased, D: C2, C4, C3 all are elevated ### Response:

Answer is A (C2, C4 and C3 decreased): The final outcome of both the pathways is formation of membrane attack complex , which causes lysis of cells.

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 best denotes classical complement pathway activation in immuno inflammatory condition:, with the following options: A: C2, C4 and C3 decreased, B: C2 and C4 normal, C3 is decreased, C: C3 normal and C2, C4 decreased, D: C2, C4, C3 all are elevated ### Response: Answer is A (C2, C4 and C3 decreased): The final outcome of both the pathways is formation of membrane attack complex , which causes lysis of cells. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 1-month-old infant is brought to the physician by her parents. She has had repeated bouts of bilious vomiting over the past month and cannot be fed adequately She is in the 10th percentile for weight and the 50th percentile for length. An upper GI series discloses marked narrowing of the midportion of the duodenum. What is the most likely cause of this infant's GI obstruction?, with the following options: A: Annular pancreas, B: Duodenal polyp, C: Islet cell adenoma, D: Pancreatic pseudocyst ### Response:

Annular pancreas is a congenital condition in which the head of the pancreas surrounds the second portion of the duodenum. The anomaly may be associated with duodenal atresia. Infants present with feeding disorders and growth retardation. Pyloric stenosis (choice E) involves the gastric outlet. Duodenal polyp (choice B) does not occur in infants.Diagnosis: Annular pancreas

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 1-month-old infant is brought to the physician by her parents. She has had repeated bouts of bilious vomiting over the past month and cannot be fed adequately She is in the 10th percentile for weight and the 50th percentile for length. An upper GI series discloses marked narrowing of the midportion of the duodenum. What is the most likely cause of this infant's GI obstruction?, with the following options: A: Annular pancreas, B: Duodenal polyp, C: Islet cell adenoma, D: Pancreatic pseudocyst ### Response: Annular pancreas is a congenital condition in which the head of the pancreas surrounds the second portion of the duodenum. The anomaly may be associated with duodenal atresia. Infants present with feeding disorders and growth retardation. Pyloric stenosis (choice E) involves the gastric outlet. Duodenal polyp (choice B) does not occur in infants.Diagnosis: Annular pancreas ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Body cavity which is opened first on post moem examination, with the following options: A: Head, B: Neck, C: Thorax, D: abdomen ### Response:

Routinely thorax is the first cavity most commonly opened on PM examination. In aspyxial deaths, dissection of the head is recommended prior to body because a bloodless field . In case of poisoning: After the opening of the skull we may immediately smell the presence of volatile, poisonous substances (e.g., ethanol, cyanide, solvents, etc.) without competing odours from thoracic and abdominal cavity

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Body cavity which is opened first on post moem examination, with the following options: A: Head, B: Neck, C: Thorax, D: abdomen ### Response: Routinely thorax is the first cavity most commonly opened on PM examination. In aspyxial deaths, dissection of the head is recommended prior to body because a bloodless field . In case of poisoning: After the opening of the skull we may immediately smell the presence of volatile, poisonous substances (e.g., ethanol, cyanide, solvents, etc.) without competing odours from thoracic and abdominal cavity ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Urinary D-Xylose test is used for the the study of:, with the following options: A: Proximal small bowel mucosal function, B: Distal small bowel mucosal function, C: Proximal small bowel serosal function, D: Distal small bowel serosal function ### Response:

The urinary D-xylose test: Used for carbohydrate absorption Assesses proximal small-intestinal mucosal function. Ref: Harrison, E-18, P-2467.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Urinary D-Xylose test is used for the the study of:, with the following options: A: Proximal small bowel mucosal function, B: Distal small bowel mucosal function, C: Proximal small bowel serosal function, D: Distal small bowel serosal function ### Response: The urinary D-xylose test: Used for carbohydrate absorption Assesses proximal small-intestinal mucosal function. Ref: Harrison, E-18, P-2467. ### 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 logical sequence?, with the following options: A: Impairment- Disease- Disability- Handicap, B: Disease- Impairment- Disability- Handicap, C: Disease- Impairment- handicap- Disability, D: Disease- Handicap- Impairment- Disability ### Response:

The sequence of events leading to disability and handicap has been stated as follows: Disease- Impairment- Disability- HandicapAccident DiseaseLoss of foot - ImpairmentCannot walk - DisabilityUnemployed - HandicapPark 23e pg: 44

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 logical sequence?, with the following options: A: Impairment- Disease- Disability- Handicap, B: Disease- Impairment- Disability- Handicap, C: Disease- Impairment- handicap- Disability, D: Disease- Handicap- Impairment- Disability ### Response: The sequence of events leading to disability and handicap has been stated as follows: Disease- Impairment- Disability- HandicapAccident DiseaseLoss of foot - ImpairmentCannot walk - DisabilityUnemployed - HandicapPark 23e pg: 44 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 36-year-old woman has become increasingly icteric for 1 month. She has had several bouts of colicky, midabdominal pain for 3 years. On physical examination, she has generalized jaundice with scleral icterus. Her BMI is 32. There is tenderness in the right upper quadrant, and the liver span is normal. A liver biopsy is obtained, and microscopic examination shows bile duct proliferation and intracanalicular bile stasis, but no inflammation or hepatocyte necrosis. The level of which of the following is most likely to be increased in the patient's serum?, with the following options: A: Alkaline phosphatase, B: Ammonia, C: Antimitochondrial antibody, D: Hepatitis C antibody ### Response:

The findings suggest obstructive jaundice from biliary tract disease (e.g., gallstones). Elevation of the serum alkaline phosphatase level is characteristic of cholestasis from biliary obstruction. The alkaline phosphatase comes from the bile duct epithelium and hepatocyte canalicular membrane. The blood ammonia concentration increases with worsening liver failure. When hepatic failure is sufficient to cause hyperammonemia, mental obtundation is seen. In this case, the patient has only jaundice. Primary biliary cirrhosis with an increased antimitochondrial antibody titer is much less common, and PBD eventually leads to bile duct destruction. Most cases of active HCV infection are accompanied by some degree of inflammation with fibrosis. In obstructive biliary tract disease, the direct bilirubin, not the indirect bilirubin, should be elevated.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 36-year-old woman has become increasingly icteric for 1 month. She has had several bouts of colicky, midabdominal pain for 3 years. On physical examination, she has generalized jaundice with scleral icterus. Her BMI is 32. There is tenderness in the right upper quadrant, and the liver span is normal. A liver biopsy is obtained, and microscopic examination shows bile duct proliferation and intracanalicular bile stasis, but no inflammation or hepatocyte necrosis. The level of which of the following is most likely to be increased in the patient's serum?, with the following options: A: Alkaline phosphatase, B: Ammonia, C: Antimitochondrial antibody, D: Hepatitis C antibody ### Response: The findings suggest obstructive jaundice from biliary tract disease (e.g., gallstones). Elevation of the serum alkaline phosphatase level is characteristic of cholestasis from biliary obstruction. The alkaline phosphatase comes from the bile duct epithelium and hepatocyte canalicular membrane. The blood ammonia concentration increases with worsening liver failure. When hepatic failure is sufficient to cause hyperammonemia, mental obtundation is seen. In this case, the patient has only jaundice. Primary biliary cirrhosis with an increased antimitochondrial antibody titer is much less common, and PBD eventually leads to bile duct destruction. Most cases of active HCV infection are accompanied by some degree of inflammation with fibrosis. In obstructive biliary tract disease, the direct bilirubin, not the indirect bilirubin, should be elevated. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Chemoprophylaxis can be done for the following except-, with the following options: A: Meningitis, B: Typhoid, C: Cholera, D: Diphtheria ### Response:

Chemoprophylaxis implies the protection from or prevention of disease. This may be achieved by causal prophylaxis of a disease or by clinical prophylaxis. 1)causal prophylaxis implies the complete prevention of infection by the early elimination of the invading or migrating causal factor 2)clinical prophylaxis implies the prevention of clinical symptoms Indications for chemoprophylaxis: Cholera,bacterial conjunctivitis,diphtheria,influenza,malaria,meningococcal meningitis,plague Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 137

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Chemoprophylaxis can be done for the following except-, with the following options: A: Meningitis, B: Typhoid, C: Cholera, D: Diphtheria ### Response: Chemoprophylaxis implies the protection from or prevention of disease. This may be achieved by causal prophylaxis of a disease or by clinical prophylaxis. 1)causal prophylaxis implies the complete prevention of infection by the early elimination of the invading or migrating causal factor 2)clinical prophylaxis implies the prevention of clinical symptoms Indications for chemoprophylaxis: Cholera,bacterial conjunctivitis,diphtheria,influenza,malaria,meningococcal meningitis,plague Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 137 ### 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 binds only with the aniotic site of cholinesterase?, with the following options: A: Physostigmine, B: Neostigmine, C: Edrophonium, D: Pyridostigmine ### Response:

Ref:KD Tripathi pharmacology 7th edition (page.no: 105) Edrophonium and Tacrine attach only to the anionic site and don't form a covalent bond with the enzyme. so, edrophonium is a very sho-acting drug. While organophosphates attach only to the esteratic site forming a covalent bond. Carbamates (physostigmine, pyridostigmine, neostigmine) carbamylate the esteratic site of the enzyme

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 binds only with the aniotic site of cholinesterase?, with the following options: A: Physostigmine, B: Neostigmine, C: Edrophonium, D: Pyridostigmine ### Response: Ref:KD Tripathi pharmacology 7th edition (page.no: 105) Edrophonium and Tacrine attach only to the anionic site and don't form a covalent bond with the enzyme. so, edrophonium is a very sho-acting drug. While organophosphates attach only to the esteratic site forming a covalent bond. Carbamates (physostigmine, pyridostigmine, neostigmine) carbamylate the esteratic site of the enzyme ### 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 presented with B/L hilar lymphadenopathy with negative Mantoux test. Diagnosis is: (PGI Dec 2007), with the following options: A: Erythema nodosum, B: Sarcoidosis, C: Hepatitis, D: TB ### Response:

Ans.: B (Sarcoidosis) Bilateral hilar fymphadenopathy with negative montaux test is the characteristic of sarcoidosis-Erythema nodosum, Hepatitis; uveitits may be the part of sarcoidosis]A positive gallium scan can support the diagnosis if increased activity is noted in the parotids and lacrimal glands (Panda sign) or in the right par a tracheal and left hilar area (lam bda sign)The Kviem-Siltzbach procedure is a specific diagnostic test for sarcoidosisTable : Frequency of Common Organ Involvement and Lifetime Risk Presentation %Follow-up, %cLungQ9594Skin2443Eye1229Extrathoracic lymph node1516Liver1214Spleen78Neurologic516Cardiac23

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A patient presented with B/L hilar lymphadenopathy with negative Mantoux test. Diagnosis is: (PGI Dec 2007), with the following options: A: Erythema nodosum, B: Sarcoidosis, C: Hepatitis, D: TB ### Response: Ans.: B (Sarcoidosis) Bilateral hilar fymphadenopathy with negative montaux test is the characteristic of sarcoidosis-Erythema nodosum, Hepatitis; uveitits may be the part of sarcoidosis]A positive gallium scan can support the diagnosis if increased activity is noted in the parotids and lacrimal glands (Panda sign) or in the right par a tracheal and left hilar area (lam bda sign)The Kviem-Siltzbach procedure is a specific diagnostic test for sarcoidosisTable : Frequency of Common Organ Involvement and Lifetime Risk Presentation %Follow-up, %cLungQ9594Skin2443Eye1229Extrathoracic lymph node1516Liver1214Spleen78Neurologic516Cardiac23 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Miniature end plate potential (MEPP) is:, with the following options: A: Inhibited by anticholinesterases, B: Recorded in resting muscle, C: Responsible for excitation of the muscle, D: Of 5 to 10 mV amplitude ### Response:

EPP (END PLATE POTENTIAL) -Amplitude is 40 mV =Depolarization reach threshold- AP - contraction -Graded potential, forerunner of Action potential (AP) EPSP (EXCITATORY POSTSYNAPTIC POTENTIAL) -Developed in CNS synapses -Amplitude is 2,3,4 or 5 mV -Multi EPSP will summate to create Action potential MEPP (MINIATURE END PLATE POTENTIAL) -Even in resting conditions, small pockets of Ach released, creating MEPP -Amplitude is 0.5 microvolts

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Miniature end plate potential (MEPP) is:, with the following options: A: Inhibited by anticholinesterases, B: Recorded in resting muscle, C: Responsible for excitation of the muscle, D: Of 5 to 10 mV amplitude ### Response: EPP (END PLATE POTENTIAL) -Amplitude is 40 mV =Depolarization reach threshold- AP - contraction -Graded potential, forerunner of Action potential (AP) EPSP (EXCITATORY POSTSYNAPTIC POTENTIAL) -Developed in CNS synapses -Amplitude is 2,3,4 or 5 mV -Multi EPSP will summate to create Action potential MEPP (MINIATURE END PLATE POTENTIAL) -Even in resting conditions, small pockets of Ach released, creating MEPP -Amplitude is 0.5 microvolts ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Rotavirus infection is diagnosed by the presence of -, with the following options: A: Antigen in stool by ELISA, B: Virus in stool, C: Antigen in blood, D: AB ### Response:

daignisis of rota virus by drminstration if virus instool&antigenic group by ELISA REF:ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.561

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Rotavirus infection is diagnosed by the presence of -, with the following options: A: Antigen in stool by ELISA, B: Virus in stool, C: Antigen in blood, D: AB ### Response: daignisis of rota virus by drminstration if virus instool&antigenic group by ELISA REF:ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.561 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The earliest symptom to occur in corneal ulcer is, with the following options: A: Pain, B: Photophobia, C: Loss of sensation, D: Diminished vision ### Response:

Ans. Pain

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The earliest symptom to occur in corneal ulcer is, with the following options: A: Pain, B: Photophobia, C: Loss of sensation, D: Diminished vision ### Response: Ans. Pain ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The following statements concerning chorda tympani nerve are true except that it, with the following options: A: Carries secretomotor fibers to submandibulgar gland, B: Joins lingual nerve in infratemporal fossa, C: Is a brach of facial nerve, D: Contains postganglionic parasympathetic fibers ### Response:

The chorda tympani is a branch of the facial nerve that originates from the taste buds in the front of the tongue, runs through the middle ear, and carries taste messages to the brain. It joins the facial nerve (cranial nerve VII) inside the facial canal, at the level where the facial nerve exits the skull the petrotympanic fissure ref - BDC 6e vol3 pg279

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The following statements concerning chorda tympani nerve are true except that it, with the following options: A: Carries secretomotor fibers to submandibulgar gland, B: Joins lingual nerve in infratemporal fossa, C: Is a brach of facial nerve, D: Contains postganglionic parasympathetic fibers ### Response: The chorda tympani is a branch of the facial nerve that originates from the taste buds in the front of the tongue, runs through the middle ear, and carries taste messages to the brain. It joins the facial nerve (cranial nerve VII) inside the facial canal, at the level where the facial nerve exits the skull the petrotympanic fissure ref - BDC 6e vol3 pg279 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Foraminal brain herniation leads to?, with the following options: A: Ipsilateral pupillary dilatation, B: Locked in state, C: Respiratory arrest, D: Ipsilateral hemiplegia ### Response:

Foraminal brain herniation leads to compression of the medulla leading to respiratory arrest. Third nerve palsy causing ipsilateral pupillary dilatation and ipsilateral hemiplegia occurs in uncal (midbrain) herniation Locked in state occurs due to a lesion of ventral pons.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Foraminal brain herniation leads to?, with the following options: A: Ipsilateral pupillary dilatation, B: Locked in state, C: Respiratory arrest, D: Ipsilateral hemiplegia ### Response: Foraminal brain herniation leads to compression of the medulla leading to respiratory arrest. Third nerve palsy causing ipsilateral pupillary dilatation and ipsilateral hemiplegia occurs in uncal (midbrain) herniation Locked in state occurs due to a lesion of ventral pons. ### 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 hea disease is most commonly cause of sudden death in young athletes, with the following options: A: Aoic stenosis, B: Mitral regurgitation, C: Aoic regurgitation, D: HOCM ### Response:

Ref Harrison 19 th ed pg 1568 Biopsy is not needed to diagnose hyperophic cardiomyopathy but can be used to exclude infiltrative and metabolic diseases. Rigorous athletic training (athlete's hea) may cause intermediate degrees of physiologic hyperophy difficult to differentiate from mild hyperophic cardiomyopathy. Unlike hyper- trophic cardiomyopathy, hyperophy in the athlete's hea regresses with cessation of training, and is accompanied by supernormal exer- cise capacity (VO2max >50 mL/kg/min), mild ventricular dilation, and normal diastolic function.

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 hea disease is most commonly cause of sudden death in young athletes, with the following options: A: Aoic stenosis, B: Mitral regurgitation, C: Aoic regurgitation, D: HOCM ### Response: Ref Harrison 19 th ed pg 1568 Biopsy is not needed to diagnose hyperophic cardiomyopathy but can be used to exclude infiltrative and metabolic diseases. Rigorous athletic training (athlete's hea) may cause intermediate degrees of physiologic hyperophy difficult to differentiate from mild hyperophic cardiomyopathy. Unlike hyper- trophic cardiomyopathy, hyperophy in the athlete's hea regresses with cessation of training, and is accompanied by supernormal exer- cise capacity (VO2max >50 mL/kg/min), mild ventricular dilation, and normal diastolic function. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Changes in the respiratory system in pregnancy:, with the following options: A: Vital capacity is increased, B: Subcostal angle remains unchanged, C: Tidal volume remains unaltered, D: Residual volume is decreased ### Response:

Changes in respiratory system during pregnancy: With the enlargement of the uterus, specially in the later months, there is elevation of the diaphragm by 4 cm. Total lung capacity is reduced by 5% due to this elevation. Breathing becomes diaphragmatic. Total pulmonary resistance is reduced due to progesterone effect. The subcostal angle increases from 68° to 103°, the transverse diameter of the chest expands by 2 cm and the chest circumference increases by 5–7 cm.  A state of hyperventilation occurs during pregnancy leading to increase in tidal volume and therefore respiratory minute volume by 40%.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Changes in the respiratory system in pregnancy:, with the following options: A: Vital capacity is increased, B: Subcostal angle remains unchanged, C: Tidal volume remains unaltered, D: Residual volume is decreased ### Response: Changes in respiratory system during pregnancy: With the enlargement of the uterus, specially in the later months, there is elevation of the diaphragm by 4 cm. Total lung capacity is reduced by 5% due to this elevation. Breathing becomes diaphragmatic. Total pulmonary resistance is reduced due to progesterone effect. The subcostal angle increases from 68° to 103°, the transverse diameter of the chest expands by 2 cm and the chest circumference increases by 5–7 cm.  A state of hyperventilation occurs during pregnancy leading to increase in tidal volume and therefore respiratory minute volume by 40%. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which substance will elicit the sensation of sour taste?, with the following options: A: Aldehydes, B: Alkaloids, C: Amino acids, D: Hydrogen ions ### Response:

The taste sensation of sour is propoional to the logarithm of the hydrogen ion concentration caused by acids. The taste sensation of sweet is caused by a long list of chemicals, including sugars, alcohols, aldehydes, ketones, and amino acids The taste sensation of bitter is caused by many organic substances that contain nitrogen, as well as by alkaloids.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which substance will elicit the sensation of sour taste?, with the following options: A: Aldehydes, B: Alkaloids, C: Amino acids, D: Hydrogen ions ### Response: The taste sensation of sour is propoional to the logarithm of the hydrogen ion concentration caused by acids. The taste sensation of sweet is caused by a long list of chemicals, including sugars, alcohols, aldehydes, ketones, and amino acids The taste sensation of bitter is caused by many organic substances that contain nitrogen, as well as by alkaloids. ### 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 posterior mediastinal tumor is:, with the following options: A: Neurofibroma, B: Thymoma, C: Germ cell Tumors, D: Aortic aneursym ### Response:

Ans: A (Neruofibroma) Ref: Bobbins Pathologic basis of Disease, 8th ed.Explanation:Mediastinal TumorsAnterior (front) mediastinumGerm cell Tumors - The majority of germ cell neoplasms (60 to 70%) are benign and are found in both males and females.Lymphoma - Malignant tumors that include both Hodgkin's disease and non Hodgkin's lymphoma.Thymoma and thymic cyst - The most common cause of a thymic mass, the majority of thymomas are benign lesions that are contained within a fibrous capsule. However, about 30% of these may be more aggressive and become invasive through the fibrous capsule.Mediastinal Thyroid mass - Usually a benign growth, such as a goiter, these can occasionally be cancerous.Middle mediastinumBronchogenic cyst - A benign growth with respiratory origins.Mediastinal Lymphadenopathy - An enlargement of the lymph nodes.Pericardial cyst - A benign growth that results from an ''out-pouching" of the pericardium (the heart's lining).Mediastinal Thyroid mass - Usually a benign growth, such as a goiter. These types of tumors can occasionally be cancerous.Tracheal tumors - These include tracheal neoplasms and non-euplastic masses, such as tracheobronchopathia osteochondroplastica (benign tumors).Vascular abnormalities including aortic aneurysm and aortic dissection.Posterior (back) mediastinumExtramedullary haematopoiesis - A rare cause of masses that form from bone marrow expansion and are associated with severe anemia.Mediastinal Lymphadenopathy- An enlargement of the lymph nodes.Mediastinal Neuroenteric cyst- A rare growth, which involves both neural and gastrointestinal elements.Mediastinal Neurogenic neoplasm- The most common cause of posterior mediastinal tumors, these are classified as nerve sheath neoplasms, ganglion cell neoplasms, and paraganglionic cell neoplasms. Approximately 70%. of neurogenic neoplasms are benign.Oesophageal abnormalities including achalasia oesophageal, oesophageal neoplasm and hiatal hernia.Paravertebral abnormalities including infectious, malignant and traumatic abnormalities of the thoracic spine.Mediastinal Thyroid mass- Usually a benign growth, such as a goiter, which can occasionally be cancerous. Vascular abnormalities - Includes aortic aneurysms.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common posterior mediastinal tumor is:, with the following options: A: Neurofibroma, B: Thymoma, C: Germ cell Tumors, D: Aortic aneursym ### Response: Ans: A (Neruofibroma) Ref: Bobbins Pathologic basis of Disease, 8th ed.Explanation:Mediastinal TumorsAnterior (front) mediastinumGerm cell Tumors - The majority of germ cell neoplasms (60 to 70%) are benign and are found in both males and females.Lymphoma - Malignant tumors that include both Hodgkin's disease and non Hodgkin's lymphoma.Thymoma and thymic cyst - The most common cause of a thymic mass, the majority of thymomas are benign lesions that are contained within a fibrous capsule. However, about 30% of these may be more aggressive and become invasive through the fibrous capsule.Mediastinal Thyroid mass - Usually a benign growth, such as a goiter, these can occasionally be cancerous.Middle mediastinumBronchogenic cyst - A benign growth with respiratory origins.Mediastinal Lymphadenopathy - An enlargement of the lymph nodes.Pericardial cyst - A benign growth that results from an ''out-pouching" of the pericardium (the heart's lining).Mediastinal Thyroid mass - Usually a benign growth, such as a goiter. These types of tumors can occasionally be cancerous.Tracheal tumors - These include tracheal neoplasms and non-euplastic masses, such as tracheobronchopathia osteochondroplastica (benign tumors).Vascular abnormalities including aortic aneurysm and aortic dissection.Posterior (back) mediastinumExtramedullary haematopoiesis - A rare cause of masses that form from bone marrow expansion and are associated with severe anemia.Mediastinal Lymphadenopathy- An enlargement of the lymph nodes.Mediastinal Neuroenteric cyst- A rare growth, which involves both neural and gastrointestinal elements.Mediastinal Neurogenic neoplasm- The most common cause of posterior mediastinal tumors, these are classified as nerve sheath neoplasms, ganglion cell neoplasms, and paraganglionic cell neoplasms. Approximately 70%. of neurogenic neoplasms are benign.Oesophageal abnormalities including achalasia oesophageal, oesophageal neoplasm and hiatal hernia.Paravertebral abnormalities including infectious, malignant and traumatic abnormalities of the thoracic spine.Mediastinal Thyroid mass- Usually a benign growth, such as a goiter, which can occasionally be cancerous. Vascular abnormalities - Includes aortic aneurysms. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Is the most common type of congenital cataract:, with the following options: A: Lamellar cataract, B: Cataracta centralis pulverulenta, C: Coronary cataract, D: Coralliform cataract ### Response:

Ans. Lamellar cataract

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Is the most common type of congenital cataract:, with the following options: A: Lamellar cataract, B: Cataracta centralis pulverulenta, C: Coronary cataract, D: Coralliform cataract ### Response: Ans. Lamellar cataract ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Vision 2020 "The right to sight" includes all except –, with the following options: A: Trachoma, B: Epidemic conjunctivitis, C: Cataract, D: Onchocerciasis ### Response:

Vision 2020 : The Right to Sight : Global Initiative for Elimination of Avoidable blindness After the realization that unless blindness control efforts are intensified, the prevalence of blindness will double by 2020 AD, the WHO along with an International Partnership committee launched the Vision 2020 Initiative in 1995. Three essential elements of a global plan were set out as follows. Setting up strategies and targets for disease control. Planning human resource needs and development. Addressing infrastructure needs and development. Under the global initiative for the elimination of all avoidable blindness by 2020 AD, all countries are commited to a minimum programme. Countries can include other problems than those identified under the minimum programme based on their local situation and needs. The diseases identified for global elimination include : - Cataract blindness Trachoma blindness and transmission Onchorerciasis Avoidable causes of childhood blindness Refractive errors and low vision Targets have been set up for each of the component diseases for the next 20 years. Above 5 diseases were for global vision 2020. Indian vision 2020 includes following seven diseases. Cataract blindness       Trachoma blindness and transmission           Childhood blindness     Refractive errors and low vision Glaucoma Diabetic retinopathy Corneal blindness

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Vision 2020 "The right to sight" includes all except –, with the following options: A: Trachoma, B: Epidemic conjunctivitis, C: Cataract, D: Onchocerciasis ### Response: Vision 2020 : The Right to Sight : Global Initiative for Elimination of Avoidable blindness After the realization that unless blindness control efforts are intensified, the prevalence of blindness will double by 2020 AD, the WHO along with an International Partnership committee launched the Vision 2020 Initiative in 1995. Three essential elements of a global plan were set out as follows. Setting up strategies and targets for disease control. Planning human resource needs and development. Addressing infrastructure needs and development. Under the global initiative for the elimination of all avoidable blindness by 2020 AD, all countries are commited to a minimum programme. Countries can include other problems than those identified under the minimum programme based on their local situation and needs. The diseases identified for global elimination include : - Cataract blindness Trachoma blindness and transmission Onchorerciasis Avoidable causes of childhood blindness Refractive errors and low vision Targets have been set up for each of the component diseases for the next 20 years. Above 5 diseases were for global vision 2020. Indian vision 2020 includes following seven diseases. Cataract blindness       Trachoma blindness and transmission           Childhood blindness     Refractive errors and low vision Glaucoma Diabetic retinopathy Corneal blindness ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Contraindication to renal biopsy are all EXCEPT, with the following options: A: Bleeding diathesis, B: CRF with normal kidney, C: 60 % damage of kidney texture, D: Uncontrolled hypertension ### Response:

(CRF with normal kidney) (871-CMDT-05) (796-97-CMDT-09)Indication of renal biopsyContraindication1. Unexplained ARF or CRF2. Acute nephritic syndrome3. Unexplained proteinuria and heamaturia4. Previously identified and treated lesions to plan future therapy5. Systemic disease associated with kidney dysfunction such as SLE, Good pasture's syndrome and Wegener's granulomatosis6. Suspected transplant rejection to differentiate it from other causes of ARF7. To guide treatment1. Solitary or ectopic kidney (exception transplant allograft)2. Horseshoe Kidney3. Uncorrected bleeding disorder4. Severe uncontrolled hypertension5. Renal infection, renal neoplasm6. Hydronephrosis, ESRD7. Congenital anomalies, multiple cysts or uncooperative patients* MRI is nearly 100% sensitive and diagnosis of renal artery* 96-98% specific for the stenosis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Contraindication to renal biopsy are all EXCEPT, with the following options: A: Bleeding diathesis, B: CRF with normal kidney, C: 60 % damage of kidney texture, D: Uncontrolled hypertension ### Response: (CRF with normal kidney) (871-CMDT-05) (796-97-CMDT-09)Indication of renal biopsyContraindication1. Unexplained ARF or CRF2. Acute nephritic syndrome3. Unexplained proteinuria and heamaturia4. Previously identified and treated lesions to plan future therapy5. Systemic disease associated with kidney dysfunction such as SLE, Good pasture's syndrome and Wegener's granulomatosis6. Suspected transplant rejection to differentiate it from other causes of ARF7. To guide treatment1. Solitary or ectopic kidney (exception transplant allograft)2. Horseshoe Kidney3. Uncorrected bleeding disorder4. Severe uncontrolled hypertension5. Renal infection, renal neoplasm6. Hydronephrosis, ESRD7. Congenital anomalies, multiple cysts or uncooperative patients* MRI is nearly 100% sensitive and diagnosis of renal artery* 96-98% specific for the stenosis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: End product of purine metabolism is?, with the following options: A: Alanine, B: Uric acid, C: Ammonia, D: Allantoin ### Response:

ANSWER: (B) Uric addREF: Biochemistry 3rd edition by S C Rastogi page 366,In humans and higher primates, uric acid is the final oxidation (breakdown) product of purine metabolism and is excreted in urine.AUantoin is a natural end product of purine metabolism in most mammals other than humans.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: End product of purine metabolism is?, with the following options: A: Alanine, B: Uric acid, C: Ammonia, D: Allantoin ### Response: ANSWER: (B) Uric addREF: Biochemistry 3rd edition by S C Rastogi page 366,In humans and higher primates, uric acid is the final oxidation (breakdown) product of purine metabolism and is excreted in urine.AUantoin is a natural end product of purine metabolism in most mammals other than humans. ### 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 test detects spermine in semen during examination of seminal fluid in a case of sexual assault?, with the following options: A: Barberio test, B: Florence test, C: ELISA, D: Gettler's test ### Response:

Barberio test detects spermine in semen. A saturated aqueous or alcoholic solution of picric acid when added to spermatic fluid produces yellow needle-shaped rhombic crystals of spermine picrate. The reaction depends on the presence of prostatic secretion. Ref: Essentials of Forensic Medicine and Toxicology by KS Narayan Reddy, 27th edition, Page 370.

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 test detects spermine in semen during examination of seminal fluid in a case of sexual assault?, with the following options: A: Barberio test, B: Florence test, C: ELISA, D: Gettler's test ### Response: Barberio test detects spermine in semen. A saturated aqueous or alcoholic solution of picric acid when added to spermatic fluid produces yellow needle-shaped rhombic crystals of spermine picrate. The reaction depends on the presence of prostatic secretion. Ref: Essentials of Forensic Medicine and Toxicology by KS Narayan Reddy, 27th edition, Page 370. ### 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 features of Trachoma stage Ill, except:, with the following options: A: Herbe's pits, B: Pannus, C: Necrosis in scar, D: Scar on tarsal conjunctiva ### Response:

Ans. Pannus

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are features of Trachoma stage Ill, except:, with the following options: A: Herbe's pits, B: Pannus, C: Necrosis in scar, D: Scar on tarsal conjunctiva ### Response: Ans. Pannus ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The complications of shoulder of the following except, with the following options: A: Fetal death, B: Uterine rupture, C: Obstructed labour, D: Shoulder dystocia ### Response:

In true shoulder dystocia,the presentation is cephalic and the head is born ;but the shoulders cannot be delivered by usual methods and there is no other cause for the dystocia (refer pgno:390 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: The complications of shoulder of the following except, with the following options: A: Fetal death, B: Uterine rupture, C: Obstructed labour, D: Shoulder dystocia ### Response: In true shoulder dystocia,the presentation is cephalic and the head is born ;but the shoulders cannot be delivered by usual methods and there is no other cause for the dystocia (refer pgno:390 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: Expectant line of management in placenta praevia is contraindicated in:, with the following options: A: Pre term foetus, B: Live foetus, C: Breech presentation, D: Active labour ### Response:

Active Interference The indication of active treatment in placenta previa are: Bleeding is continuing Baby is dead or known to be congenitally deformed Bleeding occurs at or beyond 38 weeks of pregnancy Patients is in emarginated state on admission Patient is labour.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Expectant line of management in placenta praevia is contraindicated in:, with the following options: A: Pre term foetus, B: Live foetus, C: Breech presentation, D: Active labour ### Response: Active Interference The indication of active treatment in placenta previa are: Bleeding is continuing Baby is dead or known to be congenitally deformed Bleeding occurs at or beyond 38 weeks of pregnancy Patients is in emarginated state on admission Patient is labour. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Source of ammonia in urine -, with the following options: A: Glutaminase, B: Urease, C: Glutamate dehydrogenase, D: Arginase ### Response:

Ans. is 'a' i.e., Glutaminase o In many tissues like liver, kidney and brain, ammonia combines with glutamate to yield glutamine, by the action of glutamine synthase. The brain is a rich source of glutamine synthase and it predominantly detoxifies ammonia by this route.o Glutamine is a nontoxic major transport form of ammonia. The glutamine is transported by blood to liver where deamination (removal of amino group) of glutamine takes place. Glutaminase cleaves glutamine to yield glutamate and free ammonia (ammonium ion). The ammonia is converted by liver to urea.# Formation and secretion ammonia by renal tubular cells maintain acid base balance. Ammonia is formed from glutamine by glutaminase. Excretion of ammonia increases in metabolic acidosis and decreases in metabolic alkalosis.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Source of ammonia in urine -, with the following options: A: Glutaminase, B: Urease, C: Glutamate dehydrogenase, D: Arginase ### Response: Ans. is 'a' i.e., Glutaminase o In many tissues like liver, kidney and brain, ammonia combines with glutamate to yield glutamine, by the action of glutamine synthase. The brain is a rich source of glutamine synthase and it predominantly detoxifies ammonia by this route.o Glutamine is a nontoxic major transport form of ammonia. The glutamine is transported by blood to liver where deamination (removal of amino group) of glutamine takes place. Glutaminase cleaves glutamine to yield glutamate and free ammonia (ammonium ion). The ammonia is converted by liver to urea.# Formation and secretion ammonia by renal tubular cells maintain acid base balance. Ammonia is formed from glutamine by glutaminase. Excretion of ammonia increases in metabolic acidosis and decreases in metabolic alkalosis. ### 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 with pervasive developmental disorder will have all of the following except:, with the following options: A: Stereotype behaviour, B: Reduced social interaction, C: Poor language skills, D: Impaired cognition ### Response:

Ans. d. Impaired cognition (Ref. Kaplan 10th/1191-1197; Niraj Ahuja 7/ep163-165)According to DSM-V, intellectual disability should he ruled out prior to a diagnosis of pervasive developmental defects."The diagnostic category pervasive developmental disorders (PDD), as opposed to specific developmental disorders (SDD) is characterized by delays in the development of multiple basic functions including socialization and communication. "Pervasive Developmental DisordersThe diagnostic category pervasive developmental disorders (PDD), as opposed to specific developmental disorders (SDD) are characterized by delays in the development of multiple basic functions including socialization and communication.Pervasive Developmental Disorders arePervasive developmental disorder not otherwise specified (PDD-NOS), (includes atypical autism): Most commonAutismAsperger syndromeRett syndromeChildhood disintegrative disorder (CDD).The first three of these disorders are commonly called the autism spectrum disorders.Onset of PDD occurs during infancy, but the condition is usually not identified until the child is around three years old.Parents may begin to question the health of their child when developmental milestones are not met including age appropriate motor movement & speech production.DSMV: Diagnostic Criteria Autism Spectrum Disorder 299.00 (F84.0)Persistent deficits in social communication and social interaction across multiple contexts, as manifested by:Deficits in social-emotional reciprocityDeficits in nonverbal communicative behaviors used for social interactionDeficits in developing, maintaining, and understanding relationships.Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following:Stereotyped or repetitive motor movements, use of objects, or speechInsistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal-nonverbal behaviorHighly restricted, fixated interests that are abnormal in intensity or focusHyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environmentSymptoms must be present in the early developmental periodSymptoms cause clinically significant impairment in social, occupational, or other important areas of current functioningThese disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay.Intellectual disability & autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability', social communication should be below that expected for general developmental level.Note: Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger's disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder. Individuals, who have marked deficits in social communication, but whose symptoms do not otherwise meet criteria for autism spectrum disorder, should be evaluated for social (pragmatic) communication disorder.Autistic Disorder (Kartner's Autism)It is characterized by qualitative impairment in reciprocal social interaction, delayed and aberrant communication skills & a restricted repertoire of activities and interestsQ.By definition, the onset is before the age of 3 yearsQ.More common in boysQDevelopmental milestones are normalQ.Temporal lobe is believed to be critical area.Clinical FeaturesAutism (marked impairment in reciprocal social and interpersonal interaction)Marked impairment in language and non-verbal communicationAbnormal behavioral characteristicsMental retardation* Absent social smile* Lack of eye-to-eye- contact* Lack of awareness of others existence or feelings; treats people as furniture* Lack of attachment to parents and absence of separation anxiety.* No or abnormal social play; prefers solitary games.* Marked impairment in making friends* Lack of imitative behavior* Absence of fear in presence of danger* Lack of verbal or facial response to sounds or voices; might be thought as deaf initially.* In infancy, absence of communicative sounds like babbling.* Absent or delayed speech* Abnormal speech patterns and content. Presence of echolalia, perseveration, poor articulation and pronominal reversal is common.* Remote memory is usually good.* Abstract thinking is impaired.* Mannerisms* Stereotyped behaviour such as head-banging, bodyspinning, lining-up objects, rocking, clapping, twirling, etc.* Ritualistic & compulsive behaviour.* Resistance to even the slightest change in the environment.* Attachment may develop to inanimate objects.* Hyperkinesis is commonly associated.* Only about 25% of all children with autism have an IQ >70.* >50% of these children have moderate to profound mental retardation.* There appears to be a correlation between severity of mental retardation, absence of speech & epilepsy- in autism. Treatment of AutismBehaviour TheoryPsychotherapyPharmacotherapy* Development of a regular routine with as few changes as possible.* Structured classroom training, aiming at learning new material & maintenance of acquired learning.* Positive reinforcements to teach self- care skills.* Speech therapy and/or sign language teaching.* Behavioral techniques to encourage interpersonal interactions.* Parental counseling &* supportive psychotherapy can be very useful in allaying parental anxiety and guilt, and helping their active involvement in therapy.* However, overstimulation of child should be avoided during treatment.* Halo peridot decreases dopamine levels in brain, decreases hyperactivity & behavioral symptoms.* Risperidone, for treatment of autism in children aged 5 and above.* Anticonvulsants are used for the treatment of generalized or other seizures

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A child with pervasive developmental disorder will have all of the following except:, with the following options: A: Stereotype behaviour, B: Reduced social interaction, C: Poor language skills, D: Impaired cognition ### Response: Ans. d. Impaired cognition (Ref. Kaplan 10th/1191-1197; Niraj Ahuja 7/ep163-165)According to DSM-V, intellectual disability should he ruled out prior to a diagnosis of pervasive developmental defects."The diagnostic category pervasive developmental disorders (PDD), as opposed to specific developmental disorders (SDD) is characterized by delays in the development of multiple basic functions including socialization and communication. "Pervasive Developmental DisordersThe diagnostic category pervasive developmental disorders (PDD), as opposed to specific developmental disorders (SDD) are characterized by delays in the development of multiple basic functions including socialization and communication.Pervasive Developmental Disorders arePervasive developmental disorder not otherwise specified (PDD-NOS), (includes atypical autism): Most commonAutismAsperger syndromeRett syndromeChildhood disintegrative disorder (CDD).The first three of these disorders are commonly called the autism spectrum disorders.Onset of PDD occurs during infancy, but the condition is usually not identified until the child is around three years old.Parents may begin to question the health of their child when developmental milestones are not met including age appropriate motor movement & speech production.DSMV: Diagnostic Criteria Autism Spectrum Disorder 299.00 (F84.0)Persistent deficits in social communication and social interaction across multiple contexts, as manifested by:Deficits in social-emotional reciprocityDeficits in nonverbal communicative behaviors used for social interactionDeficits in developing, maintaining, and understanding relationships.Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following:Stereotyped or repetitive motor movements, use of objects, or speechInsistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal-nonverbal behaviorHighly restricted, fixated interests that are abnormal in intensity or focusHyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environmentSymptoms must be present in the early developmental periodSymptoms cause clinically significant impairment in social, occupational, or other important areas of current functioningThese disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay.Intellectual disability & autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability', social communication should be below that expected for general developmental level.Note: Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger's disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder. Individuals, who have marked deficits in social communication, but whose symptoms do not otherwise meet criteria for autism spectrum disorder, should be evaluated for social (pragmatic) communication disorder.Autistic Disorder (Kartner's Autism)It is characterized by qualitative impairment in reciprocal social interaction, delayed and aberrant communication skills & a restricted repertoire of activities and interestsQ.By definition, the onset is before the age of 3 yearsQ.More common in boysQDevelopmental milestones are normalQ.Temporal lobe is believed to be critical area.Clinical FeaturesAutism (marked impairment in reciprocal social and interpersonal interaction)Marked impairment in language and non-verbal communicationAbnormal behavioral characteristicsMental retardation* Absent social smile* Lack of eye-to-eye- contact* Lack of awareness of others existence or feelings; treats people as furniture* Lack of attachment to parents and absence of separation anxiety.* No or abnormal social play; prefers solitary games.* Marked impairment in making friends* Lack of imitative behavior* Absence of fear in presence of danger* Lack of verbal or facial response to sounds or voices; might be thought as deaf initially.* In infancy, absence of communicative sounds like babbling.* Absent or delayed speech* Abnormal speech patterns and content. Presence of echolalia, perseveration, poor articulation and pronominal reversal is common.* Remote memory is usually good.* Abstract thinking is impaired.* Mannerisms* Stereotyped behaviour such as head-banging, bodyspinning, lining-up objects, rocking, clapping, twirling, etc.* Ritualistic & compulsive behaviour.* Resistance to even the slightest change in the environment.* Attachment may develop to inanimate objects.* Hyperkinesis is commonly associated.* Only about 25% of all children with autism have an IQ >70.* >50% of these children have moderate to profound mental retardation.* There appears to be a correlation between severity of mental retardation, absence of speech & epilepsy- in autism. Treatment of AutismBehaviour TheoryPsychotherapyPharmacotherapy* Development of a regular routine with as few changes as possible.* Structured classroom training, aiming at learning new material & maintenance of acquired learning.* Positive reinforcements to teach self- care skills.* Speech therapy and/or sign language teaching.* Behavioral techniques to encourage interpersonal interactions.* Parental counseling &* supportive psychotherapy can be very useful in allaying parental anxiety and guilt, and helping their active involvement in therapy.* However, overstimulation of child should be avoided during treatment.* Halo peridot decreases dopamine levels in brain, decreases hyperactivity & behavioral symptoms.* Risperidone, for treatment of autism in children aged 5 and above.* Anticonvulsants are used for the treatment of generalized or other seizures ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pneumatosis intestinalis is diagnostic of, with the following options: A: Ileal perforation, B: Necrotizing enterocolitis, C: Meconium ileus, D: Colonic aganglionosis ### Response:

.Necrotising enterocolitis is an acquired inflammatory disease commonly seen in infants and newborn but occasionally can occur in children and adults. It ismore commonly seen in premature babies. It is more common in formula fed babies than breast bed babies. Reduced gut flora make virulent pathogens to act and cause sepsis. * Common site is terminal ileum, caecum and ascending colon. Often it can involve entire small bowel. * Gas in the bowel wall and often in poal vein is typical. ref:SRB&;s manual of surgery ,ed 3,pg no 810

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pneumatosis intestinalis is diagnostic of, with the following options: A: Ileal perforation, B: Necrotizing enterocolitis, C: Meconium ileus, D: Colonic aganglionosis ### Response: .Necrotising enterocolitis is an acquired inflammatory disease commonly seen in infants and newborn but occasionally can occur in children and adults. It ismore commonly seen in premature babies. It is more common in formula fed babies than breast bed babies. Reduced gut flora make virulent pathogens to act and cause sepsis. * Common site is terminal ileum, caecum and ascending colon. Often it can involve entire small bowel. * Gas in the bowel wall and often in poal vein is typical. ref:SRB&;s manual of surgery ,ed 3,pg no 810 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 25-year-old female complains of a mole on her upper back. The lesion is 6 mm in diameter, darkly pigmented, and asymmetric, with a very irregular border. The next step in management is:, with the following options: A: Tell the patient to avoid sunlight, B: Follow the lesion for any evidence of growth, C: Obtain metastatic workup, D: Obtain full-thickness excisional biopsy ### Response:

Ans. D. Obtain full-thickness excisional biopsya. The lesion has characteristics of melanoma (pigmentation, asymmetry, irregular border), and a full-thickness excisional biopsy is required. Shave biopsy of a suspected melanoma is always contraindicated.b. Diagnosis is urgent; the lesion cannot be observed over time. Once the diagnosis of melanoma is made, the tumor must then be staged to determine prognosis and treatment.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 25-year-old female complains of a mole on her upper back. The lesion is 6 mm in diameter, darkly pigmented, and asymmetric, with a very irregular border. The next step in management is:, with the following options: A: Tell the patient to avoid sunlight, B: Follow the lesion for any evidence of growth, C: Obtain metastatic workup, D: Obtain full-thickness excisional biopsy ### Response: Ans. D. Obtain full-thickness excisional biopsya. The lesion has characteristics of melanoma (pigmentation, asymmetry, irregular border), and a full-thickness excisional biopsy is required. Shave biopsy of a suspected melanoma is always contraindicated.b. Diagnosis is urgent; the lesion cannot be observed over time. Once the diagnosis of melanoma is made, the tumor must then be staged to determine prognosis and treatment. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Corynebacterium diphtheriae can be grown within 6-8 hour on, with the following options: A: Potassiu, tellurite media with iron, B: McConkey's agar, C: Dorset egg medium, D: Loeffler's serum slope ### Response:

The usual media employed for the cultivation of diphtheria bacilli are Loeffler's serum slope and Tellurite blood agar. Loeffler's serum slope: Diphtheria bacilli grow on Loeffler's serum slope very rapidly and colonies can be seen in 6-8 hours, long before other bacteria grow. Colonies are first small, circular white opaque discs but enlarge on continued incubation and may acquire a distinctly yellow tint. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 242

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Corynebacterium diphtheriae can be grown within 6-8 hour on, with the following options: A: Potassiu, tellurite media with iron, B: McConkey's agar, C: Dorset egg medium, D: Loeffler's serum slope ### Response: The usual media employed for the cultivation of diphtheria bacilli are Loeffler's serum slope and Tellurite blood agar. Loeffler's serum slope: Diphtheria bacilli grow on Loeffler's serum slope very rapidly and colonies can be seen in 6-8 hours, long before other bacteria grow. Colonies are first small, circular white opaque discs but enlarge on continued incubation and may acquire a distinctly yellow tint. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 242 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: CD16 and CD56 are markers of, with the following options: A: NK cells, B: B Lymphocytes, C: Helper T lymphocyte, D: Cytotoxic T lymphocyte ### Response:

The function of NK cells is to destroy irreversibly stressed and abnormal cells, such as virus-infected cells and tumor cells. NK cells make up approximately 5% to 10% of peripheral blood lymphocytes. They do not express TCRs or Ig. NK cells are endowed with the ability to kill a variety of virus-infected cells and tumor cells, without prior exposure to or activation by these microbes or tumors. This ability makes NK cells an early line of defense against viral infections and, some tumors. Two cell surface molecules, CD16 and CD56, are commonly used to identify NK cells. CD16 is an Fc receptor for IgG, and it confers on NK cells the ability to lyse IgG-coated target cells. This phenomenon is known as antibody-dependent cell-mediated cytotoxicity (ADCC). The function of CD56 isnot known.Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 6; Diseases of the Immune System; Page no: 192

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: CD16 and CD56 are markers of, with the following options: A: NK cells, B: B Lymphocytes, C: Helper T lymphocyte, D: Cytotoxic T lymphocyte ### Response: The function of NK cells is to destroy irreversibly stressed and abnormal cells, such as virus-infected cells and tumor cells. NK cells make up approximately 5% to 10% of peripheral blood lymphocytes. They do not express TCRs or Ig. NK cells are endowed with the ability to kill a variety of virus-infected cells and tumor cells, without prior exposure to or activation by these microbes or tumors. This ability makes NK cells an early line of defense against viral infections and, some tumors. Two cell surface molecules, CD16 and CD56, are commonly used to identify NK cells. CD16 is an Fc receptor for IgG, and it confers on NK cells the ability to lyse IgG-coated target cells. This phenomenon is known as antibody-dependent cell-mediated cytotoxicity (ADCC). The function of CD56 isnot known.Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 6; Diseases of the Immune System; Page no: 192 ### 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 condition has autosomal dominant inheritance?, with the following options: A: Best disease, B: Gyrate atrophy, C: Laurence Moon Biedl syndrome, D: Bassen-Kornzweig disease ### Response:

Best disease (Juvenile-Onset Vitelliform Dystrophy) is an autosomal dominant disorder. Onset is usually in childhood. The fundoscopic appearance is variable and ranges from a mild pigmentary disturbance within the fovea to the typical vitelliform or "egg yoke" lesion located in the central macula. Visual acuity often remains good. An abnormal electro-oculogram (EOG) is the hallmark of the disease. Gyrate atrophy is an autosomal recessive disorder due to reduced activity of ornithine aminotransferase (OAT). Laurence Moon Biedl syndrome is inherited as autosomal recessive disorder. Bassen-Kornzweig disease is a rare autosomal recessive childhood disorder with the inherited metabolic disorders of the nervous system and commented upon with neuroacanthocytosis. Ref: Fletcher E.C., Chong N, Augsburger J.J., Correa Z.M. (2011). Chapter 10. Retina. In Riordan-Eva P, Cunningham E.T., Jr (Eds), Vaughan & Asbury's General Ophthalmology, 18e

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 condition has autosomal dominant inheritance?, with the following options: A: Best disease, B: Gyrate atrophy, C: Laurence Moon Biedl syndrome, D: Bassen-Kornzweig disease ### Response: Best disease (Juvenile-Onset Vitelliform Dystrophy) is an autosomal dominant disorder. Onset is usually in childhood. The fundoscopic appearance is variable and ranges from a mild pigmentary disturbance within the fovea to the typical vitelliform or "egg yoke" lesion located in the central macula. Visual acuity often remains good. An abnormal electro-oculogram (EOG) is the hallmark of the disease. Gyrate atrophy is an autosomal recessive disorder due to reduced activity of ornithine aminotransferase (OAT). Laurence Moon Biedl syndrome is inherited as autosomal recessive disorder. Bassen-Kornzweig disease is a rare autosomal recessive childhood disorder with the inherited metabolic disorders of the nervous system and commented upon with neuroacanthocytosis. Ref: Fletcher E.C., Chong N, Augsburger J.J., Correa Z.M. (2011). Chapter 10. Retina. In Riordan-Eva P, Cunningham E.T., Jr (Eds), Vaughan & Asbury's General Ophthalmology, 18e ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ion exchange chromatography is based on -, with the following options: A: Size, B: Charge, C: Solubility, D: Polarity ### Response:

Ans. is 'b' i.e.. Charge Property of protein usedMethodProtein solubility'Salting out' or salt extraction (precipitation of protein by ammonium sulfate)Molecular sizeo Gel filtration chromatography (molecular-sieve chromatography or size exclusion chromatography)o Ultracentrifugationo SDS-PAGE (Sodium dodecvl sulphate-polyacry lamide gel electrophoresis)o DialysisMolecular charge (Ionic charge)o Ion exchange chromatographyo High performance liquid chromatography (HPLC)o Electrophoresis (simple on cellulose acetate starch gel)o Isoelectric focusing (a variant of electrophoresis)Molecular charge and molecular w eightPAGE : polyacrylamide gel electrophoresisAffinity bindingAffinity chromatographyHvdnophobidty'Hydrophobic interaction chromatography

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ion exchange chromatography is based on -, with the following options: A: Size, B: Charge, C: Solubility, D: Polarity ### Response: Ans. is 'b' i.e.. Charge Property of protein usedMethodProtein solubility'Salting out' or salt extraction (precipitation of protein by ammonium sulfate)Molecular sizeo Gel filtration chromatography (molecular-sieve chromatography or size exclusion chromatography)o Ultracentrifugationo SDS-PAGE (Sodium dodecvl sulphate-polyacry lamide gel electrophoresis)o DialysisMolecular charge (Ionic charge)o Ion exchange chromatographyo High performance liquid chromatography (HPLC)o Electrophoresis (simple on cellulose acetate starch gel)o Isoelectric focusing (a variant of electrophoresis)Molecular charge and molecular w eightPAGE : polyacrylamide gel electrophoresisAffinity bindingAffinity chromatographyHvdnophobidty'Hydrophobic interaction chromatography ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The differential diagnosis of the lesion, histologically resembling giant cell tumour in the small bones of the hands or feet, includes all of the following except, with the following options: A: Aneurysmal bone cyst, B: Fibrosarcoma, C: Osteosarcoma, D: Hyperparathyroidism ### Response:

The histological differential diagnosis for GCT include all giant cell-containing lesions.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The differential diagnosis of the lesion, histologically resembling giant cell tumour in the small bones of the hands or feet, includes all of the following except, with the following options: A: Aneurysmal bone cyst, B: Fibrosarcoma, C: Osteosarcoma, D: Hyperparathyroidism ### Response: The histological differential diagnosis for GCT include all giant cell-containing lesions. ### 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 is receiving linezolid therapy for 14 days, which of the following should be monitored-, with the following options: A: Renal function tests, B: Liner enzymes, C: Platelet monitoring, D: Monitoring of reflex ### Response:

Ans. is 'c' i.e., Platelet monitoring o The major side effects oflinezolid are thrombocytopenia and neutropenia .Platelet and neutrophil count should be monitored.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A patient is receiving linezolid therapy for 14 days, which of the following should be monitored-, with the following options: A: Renal function tests, B: Liner enzymes, C: Platelet monitoring, D: Monitoring of reflex ### Response: Ans. is 'c' i.e., Platelet monitoring o The major side effects oflinezolid are thrombocytopenia and neutropenia .Platelet and neutrophil count should be monitored. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ahlback Grade2 changes of Osteoarthritis of the knee means:, with the following options: A: Joint space obliterated or almost obliterated, B: Minor bone attrition (<5 mm), C: Moderate bone attrition (5-15 mm), D: Severe bone attrition (>15 mm) ### Response:

Ans. A. Joint space obliterated or almost obliteratedAhlback Radiographic Grading Scale of Osteoarthritis of the Tibiofemoral Joint:Grade of OsteoarthritisDescription0 =No radiographic findings of osteoarthritis1 =Joint space narrowing <3mm2 =Joint space obliterated or almost obliterated3 =Minor bone attrition (<5mm)4 =Moderate bone attrition (5-15mm)5 =Severe bone attrition (>15mm)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ahlback Grade2 changes of Osteoarthritis of the knee means:, with the following options: A: Joint space obliterated or almost obliterated, B: Minor bone attrition (<5 mm), C: Moderate bone attrition (5-15 mm), D: Severe bone attrition (>15 mm) ### Response: Ans. A. Joint space obliterated or almost obliteratedAhlback Radiographic Grading Scale of Osteoarthritis of the Tibiofemoral Joint:Grade of OsteoarthritisDescription0 =No radiographic findings of osteoarthritis1 =Joint space narrowing <3mm2 =Joint space obliterated or almost obliterated3 =Minor bone attrition (<5mm)4 =Moderate bone attrition (5-15mm)5 =Severe bone attrition (>15mm) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In an incised wound, all of the following are true, except: COMEDK 07; NEET 14, 15, with the following options: A: It has clean-cut margins, B: Bleeding is generally less than in lacerations, C: Tailing is often present, D: Length of injury does not correspond with length of blade ### Response:

Ans. Bleeding is generally less than in lacerations

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In an incised wound, all of the following are true, except: COMEDK 07; NEET 14, 15, with the following options: A: It has clean-cut margins, B: Bleeding is generally less than in lacerations, C: Tailing is often present, D: Length of injury does not correspond with length of blade ### Response: Ans. Bleeding is generally less than in lacerations ### 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 mode of inheritance for retinitis pigmentosa is:, with the following options: A: Autosomal recessive, B: Autosomal dominant, C: Sex linked, D: None of the above ### Response:

Ans. Autosomal recessive

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common mode of inheritance for retinitis pigmentosa is:, with the following options: A: Autosomal recessive, B: Autosomal dominant, C: Sex linked, D: None of the above ### Response: Ans. 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: According to Spetzler Martin Grading System for AV malformations, the score of a AV malformation of size 3-6 mm with deep venous drainage and location near internal capsule is, with the following options: A: 2, B: 3, C: 4, D: 5 ### Response:

Ans. (d) 5Ref: Sabiston 20th Edition Page 1904* Spetzler - Martin Grading System is used for AVM grading in Brain.* This grading helps in management also.* Grade varies from 1-5 based on the following points: Size, Location and Deep venous drainage.* Lower score has good outcome.* Grade 1 AVM would be considered as small, superficial, and located in non-eloquent brain, and low risk for surgery.* Grade 4 or 5 AVM are large, deep, and adjacent to eloquent brain.Spetzler - Martin Grading System: for AVM brain Characteristic of lesionNumber of pointsSizeSmall (diameter <3cm)1 Medium (diameter 3-6cm)2 Large (diameter >6cm)3EloquenceNo eloquent siteEloquent site (sensorimoter, language, or thalamus; internal capsule; brain stem; cerebellar peduncles, or cerebellar nuclei)01Pattern of venous drainageSuperficial only0Any deep1

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: According to Spetzler Martin Grading System for AV malformations, the score of a AV malformation of size 3-6 mm with deep venous drainage and location near internal capsule is, with the following options: A: 2, B: 3, C: 4, D: 5 ### Response: Ans. (d) 5Ref: Sabiston 20th Edition Page 1904* Spetzler - Martin Grading System is used for AVM grading in Brain.* This grading helps in management also.* Grade varies from 1-5 based on the following points: Size, Location and Deep venous drainage.* Lower score has good outcome.* Grade 1 AVM would be considered as small, superficial, and located in non-eloquent brain, and low risk for surgery.* Grade 4 or 5 AVM are large, deep, and adjacent to eloquent brain.Spetzler - Martin Grading System: for AVM brain Characteristic of lesionNumber of pointsSizeSmall (diameter <3cm)1 Medium (diameter 3-6cm)2 Large (diameter >6cm)3EloquenceNo eloquent siteEloquent site (sensorimoter, language, or thalamus; internal capsule; brain stem; cerebellar peduncles, or cerebellar nuclei)01Pattern of venous drainageSuperficial only0Any deep1 ### 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 muscle in lid is a ached to upper margin of superior tarsus?, with the following options: A: Superior rectus, B: Muller's muscle, C: Levator palpebrae, D: Superior oblique ### Response:

.

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 muscle in lid is a ached to upper margin of superior tarsus?, with the following options: A: Superior rectus, B: Muller's muscle, C: Levator palpebrae, D: Superior oblique ### Response: . ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Erythematous lesions with Collarets of scales on trunk, with the following options: A: Pityriasis rubra, B: Pityriasis rosea, C: Pityriasis versicolor, D: Pityriasis alba ### Response:

.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Erythematous lesions with Collarets of scales on trunk, with the following options: A: Pityriasis rubra, B: Pityriasis rosea, C: Pityriasis versicolor, D: Pityriasis alba ### Response: . ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Light entering the eye passes through which retinal layer first?, with the following options: A: Inner nuclear layer, B: Outer nuclear layer, C: Outer plexiform layer, D: Retinal ganglion layer ### Response:

The most anterior layer of the retina, through which light passes first, is the retinal ganglion layer. Light then passes through the other cell layers of the retina until it reaches the photoreceptors in the posterior region of the retina. Visual processing/Phototransduction occurs in the opposite direction(Photoreceptors- ganglion cell layer)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Light entering the eye passes through which retinal layer first?, with the following options: A: Inner nuclear layer, B: Outer nuclear layer, C: Outer plexiform layer, D: Retinal ganglion layer ### Response: The most anterior layer of the retina, through which light passes first, is the retinal ganglion layer. Light then passes through the other cell layers of the retina until it reaches the photoreceptors in the posterior region of the retina. Visual processing/Phototransduction occurs in the opposite direction(Photoreceptors- ganglion cell layer) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Sympathetic root of otic ganglion, with the following options: A: Plexus around ICA, B: Plexus around facial aery, C: Plexus around ophthalmic aery, D: Plexus around middle meningeal aery ### Response:

ROOTS OF OTIC GANGLION: Sensory root is by auriculotemporal nerve Sympathetic root is by sympathetic plexus around middle meningeal aery Secretomotor root is by lesser petrosal nerve from tympanic plexus formed by tympanic branch of cranial nerve IX Motor root is by a branch from nerve to medial pterygoid Ref BDC volume 3,sixth edition pg 311

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Sympathetic root of otic ganglion, with the following options: A: Plexus around ICA, B: Plexus around facial aery, C: Plexus around ophthalmic aery, D: Plexus around middle meningeal aery ### Response: ROOTS OF OTIC GANGLION: Sensory root is by auriculotemporal nerve Sympathetic root is by sympathetic plexus around middle meningeal aery Secretomotor root is by lesser petrosal nerve from tympanic plexus formed by tympanic branch of cranial nerve IX Motor root is by a branch from nerve to medial pterygoid Ref BDC volume 3,sixth edition pg 311 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Father of modern psychiatry is ?, with the following options: A: Bleuler, B: Freud, C: Pinel, D: Kraepel in ### Response:

Ans. is 'c' i.e., Pinel Father of psychoanalysis - Sigmund freud Father of modern psychiatry - Phileppel pinel

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Father of modern psychiatry is ?, with the following options: A: Bleuler, B: Freud, C: Pinel, D: Kraepel in ### Response: Ans. is 'c' i.e., Pinel Father of psychoanalysis - Sigmund freud Father of modern psychiatry - Phileppel pinel ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Spermatozoa gets its nutrition from, with the following options: A: Glucose, B: Fructose, C: Galactose, D: Starch ### Response:

Ans: B. Fructose(Ref KS Sanoop 3'd/e p.171)Nutrition to sperms is mainly provided by fructose.Fructose (f .5-6.5 mg/ml).

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Spermatozoa gets its nutrition from, with the following options: A: Glucose, B: Fructose, C: Galactose, D: Starch ### Response: Ans: B. Fructose(Ref KS Sanoop 3'd/e p.171)Nutrition to sperms is mainly provided by fructose.Fructose (f .5-6.5 mg/ml). ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The regimens of Mg So4 for the management of severe preclampsia and eclampsia is known as, with the following options: A: Menon regime, B: Pritchard regime, C: Lean regime, D: Pinard's regime ### Response:

(Pritchard regime) (236-D)* Magnesium sulphate is the drug of choice in preeclampsia and eclampsia, Pritchard and Zuspan or Sibai regime are used* Lvtic cocktail regime (Menon 1961) using chloropromazine, phenergan and pethidine (CPP)* Diazepam therapy (Lean)* Pinard's maneuver - frank breech extraction

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The regimens of Mg So4 for the management of severe preclampsia and eclampsia is known as, with the following options: A: Menon regime, B: Pritchard regime, C: Lean regime, D: Pinard's regime ### Response: (Pritchard regime) (236-D)* Magnesium sulphate is the drug of choice in preeclampsia and eclampsia, Pritchard and Zuspan or Sibai regime are used* Lvtic cocktail regime (Menon 1961) using chloropromazine, phenergan and pethidine (CPP)* Diazepam therapy (Lean)* Pinard's maneuver - frank breech extraction ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The reagent used in Apt test is, with the following options: A: Sodium bicarbonate, B: KCL, C: Sodium hydroxide, D: Sodium chloride ### Response:

Alkali denaturation test (Apt-Downey test / apt test)Used to detect differentiate Fetal or neonatal blood from maternal blood (Qualitative).PrincipleMethodFetal hemoglobin (alpha 2 gamma 2 subunits) is resistant to alkali (basic) denaturation, whereas adult hemoglobin (alpha2 beta 2 subunits) is susceptible to such denaturation.Exposing the blood specimen to sodium hydroxide (NaOH) will denature the adult but NOT the fetal hemoglobin.The fetal hemoglobin will appear as a pinkish color under the microscope while the adult hemoglobin will appear as a yellow-brownish colorThe blood is mixed with sterile water to cause hemolysis of the RBCs, yielding free hemoglobin,The 5 ml pink hemoglobin-containing supernatant is then mixed with 1 mL of 1% NaOH.Fetal hemoglobin will stay pink and adult hemoglobin will turn yellow-brown.Adult hemoglobin changes color because it is less stable and will conve to hematin.Clinical UsesVaginal bleeding in late pregnancy is tested to rule vasa pre.Neonatal bloody vomitus or bloody stool to rule out swallowed maternal blood.To detect the presence of fetal blood in the maternal circulation in cases of suspected fetal-maternal hemorrhage.Positive test indicates that blood is of fetal origin.Negative test indicates that the blood is of maternal origin.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The reagent used in Apt test is, with the following options: A: Sodium bicarbonate, B: KCL, C: Sodium hydroxide, D: Sodium chloride ### Response: Alkali denaturation test (Apt-Downey test / apt test)Used to detect differentiate Fetal or neonatal blood from maternal blood (Qualitative).PrincipleMethodFetal hemoglobin (alpha 2 gamma 2 subunits) is resistant to alkali (basic) denaturation, whereas adult hemoglobin (alpha2 beta 2 subunits) is susceptible to such denaturation.Exposing the blood specimen to sodium hydroxide (NaOH) will denature the adult but NOT the fetal hemoglobin.The fetal hemoglobin will appear as a pinkish color under the microscope while the adult hemoglobin will appear as a yellow-brownish colorThe blood is mixed with sterile water to cause hemolysis of the RBCs, yielding free hemoglobin,The 5 ml pink hemoglobin-containing supernatant is then mixed with 1 mL of 1% NaOH.Fetal hemoglobin will stay pink and adult hemoglobin will turn yellow-brown.Adult hemoglobin changes color because it is less stable and will conve to hematin.Clinical UsesVaginal bleeding in late pregnancy is tested to rule vasa pre.Neonatal bloody vomitus or bloody stool to rule out swallowed maternal blood.To detect the presence of fetal blood in the maternal circulation in cases of suspected fetal-maternal hemorrhage.Positive test indicates that blood is of fetal origin.Negative test indicates that the blood is of maternal origin. ### 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 neuroparasite?, with the following options: A: Acantamoeba, B: Naegleria fowleri, C: Taenia solium, D: Trichinella spiralis ### Response:

Trichinella spiralis is not a neuro parasite, it is seen in striated muscles. It causes trichinosis. Pigs are the most impoant reservoirs of human disease. Humans are infected by eating raw or undercooked meat containing larvae encysted in the muscle. The larvae excyst and mature into adults within the mucosa of the small intestine. Eggs hatch within the adult females, and larvae are released and distributed the bloodstream to many organs; however, they develop only in striated muscle cells. Within the muscle cells they can remain ble for several years but eventually calcify. Ref: Review of Medical Microbiology and Immunology By Warren Levinson, 11th Edition, Chapter 56; Self Assessment and Review Microbiology Immunology Revision at a Glance By Chaurasia, 4th Edition, 2009, Page 407

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 neuroparasite?, with the following options: A: Acantamoeba, B: Naegleria fowleri, C: Taenia solium, D: Trichinella spiralis ### Response: Trichinella spiralis is not a neuro parasite, it is seen in striated muscles. It causes trichinosis. Pigs are the most impoant reservoirs of human disease. Humans are infected by eating raw or undercooked meat containing larvae encysted in the muscle. The larvae excyst and mature into adults within the mucosa of the small intestine. Eggs hatch within the adult females, and larvae are released and distributed the bloodstream to many organs; however, they develop only in striated muscle cells. Within the muscle cells they can remain ble for several years but eventually calcify. Ref: Review of Medical Microbiology and Immunology By Warren Levinson, 11th Edition, Chapter 56; Self Assessment and Review Microbiology Immunology Revision at a Glance By Chaurasia, 4th Edition, 2009, Page 407 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The specific name of the anomaly shown in the following radiograph is:, with the following options: A: Dens in dente, B: Dilated odontome, C: Dens invaginatus, D: Ghost tooth ### Response:

Dens in Dente  (Dens invaginatus, dilated composite odontome) The  ‘dens in dente’  is a  developmental variation which is thought to arise as a result of an invagination in the surface of tooth crown before calcification has occurred. Several causes of this condition have been proposed. These include increased localized external pressure, focal growth retardation, and focal growth stimulation in certain areas of the tooth bud. The permanent maxillary lateral incisors are the teeth most frequently involved,  and in the majority of cases the  ‘dens in dente’ appears to represent simply an accentuation in the development of the lingual pit. Radiological signs Dens in dente represent a tooth-shaped, enamel-covered mass within the crown and/or root of the tooth but which may traverse the length of the tooth. Dilated odontome represents the most extreme form of this anomaly and exhibits a grossly altered morphology that is internally outlined by a dense linear radiopacity. In both cases, the apical region may or may not display an open apex and there may be associated adjacent apical rarefaction.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The specific name of the anomaly shown in the following radiograph is:, with the following options: A: Dens in dente, B: Dilated odontome, C: Dens invaginatus, D: Ghost tooth ### Response: Dens in Dente  (Dens invaginatus, dilated composite odontome) The  ‘dens in dente’  is a  developmental variation which is thought to arise as a result of an invagination in the surface of tooth crown before calcification has occurred. Several causes of this condition have been proposed. These include increased localized external pressure, focal growth retardation, and focal growth stimulation in certain areas of the tooth bud. The permanent maxillary lateral incisors are the teeth most frequently involved,  and in the majority of cases the  ‘dens in dente’ appears to represent simply an accentuation in the development of the lingual pit. Radiological signs Dens in dente represent a tooth-shaped, enamel-covered mass within the crown and/or root of the tooth but which may traverse the length of the tooth. Dilated odontome represents the most extreme form of this anomaly and exhibits a grossly altered morphology that is internally outlined by a dense linear radiopacity. In both cases, the apical region may or may not display an open apex and there may be associated adjacent apical rarefaction. ### 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 put on ventilator shows a reading of ABG analysis as | PaCO2, Normal PaO2 and pH 7.5, what is the likely diagnosis?, with the following options: A: Respiratory acidosis, B: Metabolic alkalosis, C: Metabolic acidosis, D: Respiratory alkalosis ### Response:

The ABG analysis reading in this patient clearly ours for respiratory alkalosis. In respiratory alkalosis: ? |PaCO2 ? | HCO3/PaCO2 ratio ? |pH ? the plasma K is often reduced and Cl increased Respiratory alkalosis is commonly seen in anesthetized or mechanically ventilated patient. Ref: Harrison's Internal Medicine, 18th Edition, Pages 363-372

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A patient put on ventilator shows a reading of ABG analysis as | PaCO2, Normal PaO2 and pH 7.5, what is the likely diagnosis?, with the following options: A: Respiratory acidosis, B: Metabolic alkalosis, C: Metabolic acidosis, D: Respiratory alkalosis ### Response: The ABG analysis reading in this patient clearly ours for respiratory alkalosis. In respiratory alkalosis: ? |PaCO2 ? | HCO3/PaCO2 ratio ? |pH ? the plasma K is often reduced and Cl increased Respiratory alkalosis is commonly seen in anesthetized or mechanically ventilated patient. Ref: Harrison's Internal Medicine, 18th Edition, Pages 363-372 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Spermin is detected in semen by which test -, with the following options: A: Barberio test, B: Florence, C: ELISA, D: Agglutination inhibition ### Response:

Barberio's test → Yellow coloured crystals of spermin picrate. Florence test → 4 Brown crystals of choline periodide.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Spermin is detected in semen by which test -, with the following options: A: Barberio test, B: Florence, C: ELISA, D: Agglutination inhibition ### Response: Barberio's test → Yellow coloured crystals of spermin picrate. Florence test → 4 Brown crystals of choline periodide. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Continuous fixed traction is provided by:, with the following options: A: Thomas splint, B: BB splint, C: Hamilton Russel, D: Gallows ### Response:

Thomas splint is commonly used for the immobilization of hip and thigh injuries. The modified Thomas splint adapted the original Thomas splint to include a traction screw and foot plate and limb suppo built into the splint body.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Continuous fixed traction is provided by:, with the following options: A: Thomas splint, B: BB splint, C: Hamilton Russel, D: Gallows ### Response: Thomas splint is commonly used for the immobilization of hip and thigh injuries. The modified Thomas splint adapted the original Thomas splint to include a traction screw and foot plate and limb suppo built into the splint body. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 50-year-old paddy farmer presented to the ER in shock. Attendants claim that he had sudden onset of fever with difficulty in breathing about 2 days ago and subsequently also developed haemoptysis. Sputum sample was collected, and Wayson staining was done. The organism isolated was indole, MR and VP positive and fermented glucose, mannitol and maltose. It also did not hydrolyse urea. Stalactite growth was seen in the ghee broth. What is the drug of choice of the above condition and which vector transmits the above What is the drug of choice of the above condition and which vector transmits the above disease: - 1. 2. 3. 4., with the following options: A: VECTOR = 1 / DRUG OF CHOICE = Streptomycin, B: VECTOR = 3 / DRUG OF CHOICE = Ampicillin, C: VECTOR = 2 / DRUG OF CHOICE = Gentamycin, D: VECTOR = 3 / DRUG OF CHOICE = Streptomycin ### Response:

This is a case of pneumonic plague caused due to yersinia pestis which is transmitted by (vector 3 in the images shown above) rat flea (Xenopsylla cheopis) and its drug of choice is streptomycin. Sho incubation period, from a few hours to 2-3 days Acute onset of the symptoms Progression from segmental pneumonitis to lobar pneumonia to B/L lung involvement. X-ray chest shows B/L alveolar infiltrates Diffuse interstitial pneumonitis MICROBIOLOGY Yersinia pestis Gram-negative coccobacilli. Bipolar staining Pleomorphic on Wayson/ Wright-Giemsa staining Small, delicate, transparent colonies on nutrient agar Colourless colonies on MacConkey agar. Stalactite growth is seen in ghee broth. Biochemicals: - Indole+, catalase+, VP+, MR+, esculin+

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 50-year-old paddy farmer presented to the ER in shock. Attendants claim that he had sudden onset of fever with difficulty in breathing about 2 days ago and subsequently also developed haemoptysis. Sputum sample was collected, and Wayson staining was done. The organism isolated was indole, MR and VP positive and fermented glucose, mannitol and maltose. It also did not hydrolyse urea. Stalactite growth was seen in the ghee broth. What is the drug of choice of the above condition and which vector transmits the above What is the drug of choice of the above condition and which vector transmits the above disease: - 1. 2. 3. 4., with the following options: A: VECTOR = 1 / DRUG OF CHOICE = Streptomycin, B: VECTOR = 3 / DRUG OF CHOICE = Ampicillin, C: VECTOR = 2 / DRUG OF CHOICE = Gentamycin, D: VECTOR = 3 / DRUG OF CHOICE = Streptomycin ### Response: This is a case of pneumonic plague caused due to yersinia pestis which is transmitted by (vector 3 in the images shown above) rat flea (Xenopsylla cheopis) and its drug of choice is streptomycin. Sho incubation period, from a few hours to 2-3 days Acute onset of the symptoms Progression from segmental pneumonitis to lobar pneumonia to B/L lung involvement. X-ray chest shows B/L alveolar infiltrates Diffuse interstitial pneumonitis MICROBIOLOGY Yersinia pestis Gram-negative coccobacilli. Bipolar staining Pleomorphic on Wayson/ Wright-Giemsa staining Small, delicate, transparent colonies on nutrient agar Colourless colonies on MacConkey agar. Stalactite growth is seen in ghee broth. Biochemicals: - Indole+, catalase+, VP+, MR+, esculin+ ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Open book and bucket handle injuries are seen in :, with the following options: A: Spine, B: Pelvis, C: Femur, D: Knee ### Response:

(A) Bucket handle fracture: A type of pelvis fracture due to side-to-side compression of pelvis where there is fracture of pubic rami anteriorly and sacroiliac joint or ilium posteriorly but on the opposite side. (B)Open book fracture: A pelvic fracture due to anteroposterior compression of pelvis where the pubic symphysis is disrupted and pelvis opens up like a book.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Open book and bucket handle injuries are seen in :, with the following options: A: Spine, B: Pelvis, C: Femur, D: Knee ### Response: (A) Bucket handle fracture: A type of pelvis fracture due to side-to-side compression of pelvis where there is fracture of pubic rami anteriorly and sacroiliac joint or ilium posteriorly but on the opposite side. (B)Open book fracture: A pelvic fracture due to anteroposterior compression of pelvis where the pubic symphysis is disrupted and pelvis opens up like a book. ### 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 fungal orbital cellulitis in diabetes, with the following options: A: Aspergillus, B: Fusarium, C: Mucormycosis, D: Candida ### Response:

Ans. (c) MucormycosisRef: Kanski 7/e, p. 91, Parson's 22/e, p. 242Mucormycosis often affects patients with diabetic ketoacidosis or immunosuppression.

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 fungal orbital cellulitis in diabetes, with the following options: A: Aspergillus, B: Fusarium, C: Mucormycosis, D: Candida ### Response: Ans. (c) MucormycosisRef: Kanski 7/e, p. 91, Parson's 22/e, p. 242Mucormycosis often affects patients with diabetic ketoacidosis or immunosuppression. ### 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 hormone does not act through c-AMP:, with the following options: A: FSH, B: Progesterone, C: Estrogens, D: GH ### Response:

GH

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 hormone does not act through c-AMP:, with the following options: A: FSH, B: Progesterone, C: Estrogens, D: GH ### Response: GH ### 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-year-old woman undergoes an uneventful laparoscopic cholecystectomy for which she receives 1 dose of cephalosporin. One week later, she returns to the emergency room with fever, nausea, and copious diarrhea and is suspected of having pseudomembranous colitis. She is afebrile and has no peritoneal signs on abdominal examination. She has a mild leukocytosis with a left shift. Which of the following is the appropriate initial management strategy?, with the following options: A: Administration of an antidiarrheal agent, B: Exploratory laparotomy with left hemi-colectomy and colostomy, C: Exploratory laparotomy with subtotal abdominal colectomy and ileostomy, D: Administration of oral metronidazole ### Response:

Treatment of C difficile colitis is metronidazole for firstline therapy and oral vancomycin as a second-tier agent. Recurrence appears in up to 20% of patients. Indications for surgical treatment are intractable disease, failure of medical therapy, toxic megacolon, and colonic perforation; surgical therapy consists of subtotal colectomy with end ileostomy. The diagnosis can be made by either detection of the characteristic appearance of pseudomembranes on endoscopy or detection of either toxin A or toxin B in the stool. Anti-diarrheal agents are contraindicated in suspected C difficile colitis as they may prolong the infection.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 45-year-old woman undergoes an uneventful laparoscopic cholecystectomy for which she receives 1 dose of cephalosporin. One week later, she returns to the emergency room with fever, nausea, and copious diarrhea and is suspected of having pseudomembranous colitis. She is afebrile and has no peritoneal signs on abdominal examination. She has a mild leukocytosis with a left shift. Which of the following is the appropriate initial management strategy?, with the following options: A: Administration of an antidiarrheal agent, B: Exploratory laparotomy with left hemi-colectomy and colostomy, C: Exploratory laparotomy with subtotal abdominal colectomy and ileostomy, D: Administration of oral metronidazole ### Response: Treatment of C difficile colitis is metronidazole for firstline therapy and oral vancomycin as a second-tier agent. Recurrence appears in up to 20% of patients. Indications for surgical treatment are intractable disease, failure of medical therapy, toxic megacolon, and colonic perforation; surgical therapy consists of subtotal colectomy with end ileostomy. The diagnosis can be made by either detection of the characteristic appearance of pseudomembranes on endoscopy or detection of either toxin A or toxin B in the stool. Anti-diarrheal agents are contraindicated in suspected C difficile colitis as they may prolong the infection. ### End