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Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Commonest Type of Intracranial Tumour is:, with the following options: A: Astrocytoma, B: Medulloblastoma, C: Meningioma, D: Secondaries ### Response:

Astrocytoma

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Commonest Type of Intracranial Tumour is:, with the following options: A: Astrocytoma, B: Medulloblastoma, C: Meningioma, D: Secondaries ### Response: Astrocytoma ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: DNA enzyme for aging:, with the following options: A: Telosomerase, B: Topoisomerase, C: Telomerase, D: DNA polymerase ### Response:

Ans. (c) TelomeraseRef: Harper's Biochemistry, 30th ed. pg. 374, 732, 26th ed. Pg- 318* The ends of each chromosome contain structures called telomeres.* Telomeres consist of short, repeat TG-rich sequences. Human telomeres have a variable number of repeats of the sequence 5'-TTAGGG-3', which can extend for several kilobases.* Telomerase, is related to viral RNA-dependent DNA polymerases (reverse transcriptases) and is the enzyme responsible for telomere synthesis and thus for maintaining the length of the telomere.* Telomere shortening has been associated with both aging and malignant transformation. Because of this reason, telomerase has become an attractive target for cancer chemotherapy and drug development.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: DNA enzyme for aging:, with the following options: A: Telosomerase, B: Topoisomerase, C: Telomerase, D: DNA polymerase ### Response: Ans. (c) TelomeraseRef: Harper's Biochemistry, 30th ed. pg. 374, 732, 26th ed. Pg- 318* The ends of each chromosome contain structures called telomeres.* Telomeres consist of short, repeat TG-rich sequences. Human telomeres have a variable number of repeats of the sequence 5'-TTAGGG-3', which can extend for several kilobases.* Telomerase, is related to viral RNA-dependent DNA polymerases (reverse transcriptases) and is the enzyme responsible for telomere synthesis and thus for maintaining the length of the telomere.* Telomere shortening has been associated with both aging and malignant transformation. Because of this reason, telomerase has become an attractive target for cancer chemotherapy and drug development. ### 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 subcutaneous muscle?, with the following options: A: Sternocleidomastoid, B: Mylohyoid, C: Palmaris longus, D: Palmaris brevis ### Response:

Palmaris brevisREF: Gray's anatomy 39th edition p. 919Subcutaneous muscles of body are:1. Platysma 2. Palmaris brevis 3. Daos muscle 4. Facial muscles

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is a subcutaneous muscle?, with the following options: A: Sternocleidomastoid, B: Mylohyoid, C: Palmaris longus, D: Palmaris brevis ### Response: Palmaris brevisREF: Gray's anatomy 39th edition p. 919Subcutaneous muscles of body are:1. Platysma 2. Palmaris brevis 3. Daos muscle 4. Facial muscles ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Croup syndrome is usually caused by-, with the following options: A: Rhinoviruses, B: Coxsackie A virus, C: Coxsackie B virus, D: All ### Response:

Ans. is 'a' i.e., Rhinoviruses Croup (Laryngotracheobronchitis) o Croup is a viral infection of upper respiratory tract. o Children between the age of 1-5 years are affected.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Croup syndrome is usually caused by-, with the following options: A: Rhinoviruses, B: Coxsackie A virus, C: Coxsackie B virus, D: All ### Response: Ans. is 'a' i.e., Rhinoviruses Croup (Laryngotracheobronchitis) o Croup is a viral infection of upper respiratory tract. o Children between the age of 1-5 years are affected. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: What is Nitroblue tetrazolium test used for?, with the following options: A: Phagocytosis, B: Complement, C: T cell, D: B cell ### Response:

. Phagocytosis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: What is Nitroblue tetrazolium test used for?, with the following options: A: Phagocytosis, B: Complement, C: T cell, D: B cell ### Response: . Phagocytosis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Blow out fracture of the orbit, most commonly leads to fracture of -, with the following options: A: Posteromedial floor of orbit, B: Medial wall of orbit, C: Lateral wall of orbit, D: Roof of orbit ### Response:

"The most common site for a blowout fracture to occur is the posteromedial aspect of the orbital floor, medial to the infraorbital neurovascular bundle where the maxillary bone is very thin." - The Internet Journal of Otorhinolaryngology.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Blow out fracture of the orbit, most commonly leads to fracture of -, with the following options: A: Posteromedial floor of orbit, B: Medial wall of orbit, C: Lateral wall of orbit, D: Roof of orbit ### Response: "The most common site for a blowout fracture to occur is the posteromedial aspect of the orbital floor, medial to the infraorbital neurovascular bundle where the maxillary bone is very thin." - The Internet Journal of Otorhinolaryngology. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Management of infected pancreatic necrosis includes all of the following except: March 2010, with the following options: A: Percutaneous drainage, B: Pancreatic necrosectomy, C: Manage conservatively with antibiotics alone, D: Nutritional suppo ### Response:

Ans. C: Manage conservatively with antibiotics alone Infection complicating pancreatic necrosis leads to persisting sepsis, multiple organ dysfunction syndrome and accounts for about half the deaths that occur following acute pancreatitis. Severe cases due to gallstones require urgent endoscopic sphincterotomy. Patients with pancreatic necrosis should be followed with serial contrast enhanced computed tomography (CE-CT) and if infection is suspected fine needle aspiration of the necrotic area for bacteriology (FNAB) should be undeaken. If the aspirate is purulent, percutaneous drainage of the infected fluid should be carried out. In the presence of infection and worsening of sepsis despite percutaneous drainage, necrosectomy is indicated. Although traditionally this has been by open surgery, minimally invasive procedures are a promising new alternative. There are many unresolved issues in the management of pancreatic necrosis. These include, the use of antibiotic prophylaxis, the precise indications for and frequency of repeat CE-CT and FNAB and the role of enteral feeding. Nutritional suppo is essential

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Management of infected pancreatic necrosis includes all of the following except: March 2010, with the following options: A: Percutaneous drainage, B: Pancreatic necrosectomy, C: Manage conservatively with antibiotics alone, D: Nutritional suppo ### Response: Ans. C: Manage conservatively with antibiotics alone Infection complicating pancreatic necrosis leads to persisting sepsis, multiple organ dysfunction syndrome and accounts for about half the deaths that occur following acute pancreatitis. Severe cases due to gallstones require urgent endoscopic sphincterotomy. Patients with pancreatic necrosis should be followed with serial contrast enhanced computed tomography (CE-CT) and if infection is suspected fine needle aspiration of the necrotic area for bacteriology (FNAB) should be undeaken. If the aspirate is purulent, percutaneous drainage of the infected fluid should be carried out. In the presence of infection and worsening of sepsis despite percutaneous drainage, necrosectomy is indicated. Although traditionally this has been by open surgery, minimally invasive procedures are a promising new alternative. There are many unresolved issues in the management of pancreatic necrosis. These include, the use of antibiotic prophylaxis, the precise indications for and frequency of repeat CE-CT and FNAB and the role of enteral feeding. Nutritional suppo is essential ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Krabbe's disease is caused by a defect of -, with the following options: A: Ceramidase, B: b galactosidase, C: a galactosidase, D: Galactosyl ceramidase ### Response:

Ans. is 'd' i.e., Galactosyl ceramidaseLipid storage disordersDisorderEnzyme defectGaucher's diseaseb glucosidaseNiemann Pick diseaseSphingomyelinaseFabry's diseasea galactosidaseGM1 gangliosidosisb galactosidaseGM2 gangliosidosisHexosaminidase ASandhoff s diseaseHexosaminidase A and BKrabbe's diseaseGalactosyl ceramidaseMetachromatic leukodystrophyAryl Sulfatase AFarber's diseaseCeramidaseWolman's diseaseAcid lipase

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Krabbe's disease is caused by a defect of -, with the following options: A: Ceramidase, B: b galactosidase, C: a galactosidase, D: Galactosyl ceramidase ### Response: Ans. is 'd' i.e., Galactosyl ceramidaseLipid storage disordersDisorderEnzyme defectGaucher's diseaseb glucosidaseNiemann Pick diseaseSphingomyelinaseFabry's diseasea galactosidaseGM1 gangliosidosisb galactosidaseGM2 gangliosidosisHexosaminidase ASandhoff s diseaseHexosaminidase A and BKrabbe's diseaseGalactosyl ceramidaseMetachromatic leukodystrophyAryl Sulfatase AFarber's diseaseCeramidaseWolman's diseaseAcid lipase ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pulmonary Plethora is seen in -, with the following options: A: TOF, B: TAPVC, C: CoA, D: Tricuspid Atresia ### Response:

Pulmonary plethora It is a term used to describe the appearances of increased pulmonary perfusion on chest radiographs. It may occur in several situations : Total anomalous pulmonary venous return (TAPVC) Left-to-right cardiac shunts (e.g. ASD, VSD, PDA) Truncus Aeriosus Vein of Galen Malformation Transposition of the Great Aeries It may also been seen in pregnancy due to increased cardiac output.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pulmonary Plethora is seen in -, with the following options: A: TOF, B: TAPVC, C: CoA, D: Tricuspid Atresia ### Response: Pulmonary plethora It is a term used to describe the appearances of increased pulmonary perfusion on chest radiographs. It may occur in several situations : Total anomalous pulmonary venous return (TAPVC) Left-to-right cardiac shunts (e.g. ASD, VSD, PDA) Truncus Aeriosus Vein of Galen Malformation Transposition of the Great Aeries It may also been seen in pregnancy due to increased cardiac output. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A primipara is in labor and an episiotomy is about to be cut. Compared with a midline episiotomy, an advantage of mediolateral episiotomy is, with the following options: A: Ease of repair, B: Fewer breakdowns, C: Less blood loss, D: Less extension of the incision. ### Response:

Midline episiotomies are easier to fix and have a smaller incidence of surgical breakdown, less pain, and lower blood loss. The incidence of dyspareunia is somewhat less. However, the incidence of extensions of the incision to include the rectum is considerably higher than with mediolateral episiotomies. Regardless of technique, attention to hemostasis and anatomic restoration is the key element of a technically appropriate repair.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A primipara is in labor and an episiotomy is about to be cut. Compared with a midline episiotomy, an advantage of mediolateral episiotomy is, with the following options: A: Ease of repair, B: Fewer breakdowns, C: Less blood loss, D: Less extension of the incision. ### Response: Midline episiotomies are easier to fix and have a smaller incidence of surgical breakdown, less pain, and lower blood loss. The incidence of dyspareunia is somewhat less. However, the incidence of extensions of the incision to include the rectum is considerably higher than with mediolateral episiotomies. Regardless of technique, attention to hemostasis and anatomic restoration is the key element of a technically appropriate repair. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Oral hairy leukoplakia is associated with?, with the following options: A: Cytomegalovirus, B: Human immunodeficiency virus, C: EBV, D: HPV ### Response:

ANSWER: (C) EBVREF: Jawetzs microbiology 24th edition chapter 33 Herpesviruses & Table 48-8Oral Hairy LeukoplakiaThis lesion is a wart-like growth that develops on the tongue in some HIV-infected persons and transplant patients. It is an epithelial focus of EBV replication.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Oral hairy leukoplakia is associated with?, with the following options: A: Cytomegalovirus, B: Human immunodeficiency virus, C: EBV, D: HPV ### Response: ANSWER: (C) EBVREF: Jawetzs microbiology 24th edition chapter 33 Herpesviruses & Table 48-8Oral Hairy LeukoplakiaThis lesion is a wart-like growth that develops on the tongue in some HIV-infected persons and transplant patients. It is an epithelial focus of EBV replication. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Enzyme deficient in maple syrup urine disease -, with the following options: A: a-ketoacid decarboxylase, B: Transaminase, C: Isomerase, D: Mutase ### Response:

Ans. is 'a' i.e., alpha-ketoacid decarboxylase Maple syrup urine disease (MSUD) or branched chain ketoaciduriao It is an inborn error of metabolism of branched chain amino acids valine, leucine and isoleucineo It is due to deficiency of enzyme that catalyzes the second reaction in these amino acids metabolism i.e. branched chain-a keto acid dehydrogenase which catalyses decarboxylation of branched chain amino acids As a result, the branched chain amino acids, leucine, isoleucine and valine, and their a-keto acids accumulate in blood, urine and CSF.o There is characteristic maple syrup odor to the urine.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Enzyme deficient in maple syrup urine disease -, with the following options: A: a-ketoacid decarboxylase, B: Transaminase, C: Isomerase, D: Mutase ### Response: Ans. is 'a' i.e., alpha-ketoacid decarboxylase Maple syrup urine disease (MSUD) or branched chain ketoaciduriao It is an inborn error of metabolism of branched chain amino acids valine, leucine and isoleucineo It is due to deficiency of enzyme that catalyzes the second reaction in these amino acids metabolism i.e. branched chain-a keto acid dehydrogenase which catalyses decarboxylation of branched chain amino acids As a result, the branched chain amino acids, leucine, isoleucine and valine, and their a-keto acids accumulate in blood, urine and CSF.o There is characteristic maple syrup odor to the 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 32-year-old teacher presents at her physician's office complaining of hearing loss in her right ear. Physical examination reveals cerumen completely obstructing the ear canal. Ear wax removal is recommended using which of the following?, with the following options: A: Jet irrigation (Water Pik), B: 3% hydrogen peroxide ear drops, C: Irrigation of the eardrum if perforated, D: Aqueous irrigation if a bean is present ### Response:

Jet irrigation (e.g., Water Pik) should be avoided to remove cerumen impaction. Detergent ear drops (such as 3% hydrogen peroxide) may be used. Aqueous irrigation should be avoided if organic material is present because further swelling will be induced.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 32-year-old teacher presents at her physician's office complaining of hearing loss in her right ear. Physical examination reveals cerumen completely obstructing the ear canal. Ear wax removal is recommended using which of the following?, with the following options: A: Jet irrigation (Water Pik), B: 3% hydrogen peroxide ear drops, C: Irrigation of the eardrum if perforated, D: Aqueous irrigation if a bean is present ### Response: Jet irrigation (e.g., Water Pik) should be avoided to remove cerumen impaction. Detergent ear drops (such as 3% hydrogen peroxide) may be used. Aqueous irrigation should be avoided if organic material is present because further swelling will be induced. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Dilutional hyponatremia is seen in -, with the following options: A: Addison's disease, B: DI, C: Diuretic therapy, D: None ### Response:

Dilutional hyponatremia, also known as water intoxication, it is a potentially life-threatening condition which occurs when a person consumes too much water without an adequate intake of electrolytes Ref - researchgate.net

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Dilutional hyponatremia is seen in -, with the following options: A: Addison's disease, B: DI, C: Diuretic therapy, D: None ### Response: Dilutional hyponatremia, also known as water intoxication, it is a potentially life-threatening condition which occurs when a person consumes too much water without an adequate intake of electrolytes Ref - researchgate.net ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Small round cell tumors are all EXCEPT:, with the following options: A: Synol carcinoma, B: Neuroblastoma, C: Embryonal rhabdosarcoma, D: PNET ### Response:

Synol carcinoma REF: Khan, Javed, Nature Genetics 27, 64 (2001), http://en.wikipedia.org/wiki/Small-,_round,_ bluecell_tumour, Histopathology: Volume 53, Issue 1, pages 73-80 Small, round, blue-cell tumor: In histopathology, a small, round, blue-cell tumor (abbreted SRBCT), also known as a smallblue-round-cell tumor (SBRCT) or a small-round-cell tumor (SRCT), is a type of malignant neoplasms that has a characteristic appearance under the microscope, i.e. it consists of small round cells that stain with blue on routine H&E stained sections. These have following characteristics: These tumors are more typically seen in children than adults. They typically represent undifferentiated cells. The predominance of blue staining is due the fact that the cells consist predominantly of nucleus They have scant cytoplasm Tumors which have round cells are: Desmoplastic small-round-cell tumor Ewing's Sarcoma PNET (Primitive neuroectoderrnal tumor) Neuroblastoma Medulloblastoma Rhabdomyosarcoma Wilm's tumor Retinoblastoma Small-cell lymphoma Hepatoblastoma

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Small round cell tumors are all EXCEPT:, with the following options: A: Synol carcinoma, B: Neuroblastoma, C: Embryonal rhabdosarcoma, D: PNET ### Response: Synol carcinoma REF: Khan, Javed, Nature Genetics 27, 64 (2001), http://en.wikipedia.org/wiki/Small-,_round,_ bluecell_tumour, Histopathology: Volume 53, Issue 1, pages 73-80 Small, round, blue-cell tumor: In histopathology, a small, round, blue-cell tumor (abbreted SRBCT), also known as a smallblue-round-cell tumor (SBRCT) or a small-round-cell tumor (SRCT), is a type of malignant neoplasms that has a characteristic appearance under the microscope, i.e. it consists of small round cells that stain with blue on routine H&E stained sections. These have following characteristics: These tumors are more typically seen in children than adults. They typically represent undifferentiated cells. The predominance of blue staining is due the fact that the cells consist predominantly of nucleus They have scant cytoplasm Tumors which have round cells are: Desmoplastic small-round-cell tumor Ewing's Sarcoma PNET (Primitive neuroectoderrnal tumor) Neuroblastoma Medulloblastoma Rhabdomyosarcoma Wilm's tumor Retinoblastoma Small-cell lymphoma Hepatoblastoma ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cyanosis is seen in -, with the following options: A: Persistent ductus aeriosus, B: Tricuspid atresia, C: Ostium primumASD, D: All ### Response:

Ans. is 'b' i.e., Tricuspid atresia

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cyanosis is seen in -, with the following options: A: Persistent ductus aeriosus, B: Tricuspid atresia, C: Ostium primumASD, D: All ### Response: Ans. is 'b' i.e., Tricuspid atresia ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 41-year-old woman is diagnosed with CA Cervix. She has right hydronephrosis as evidenced by the intravenous pyelogram (IVP). The biopsy specimen confirms it is squamous cell cancer. Which of the following statements regarding this patient's condition is most accurate?, with the following options: A: The best treatment for her is surgical excision., B: The majority of cervical cancers are of adenomatous cell type., C: Chemoradiation is the preferred treatment, D: Radical hysterectomy is an option in the therapy of this patient. ### Response:

Stage IIIB: Extension of cervical malignancy to pelvic side wall and/or hydronephrosis or non functioning kidney Broadly, the treatment of cervical cancer is surgical upto stage IIA1 (lesion size <4cm without parametrial involvement) after which the treatment involves chemoradiation, therefore here, chemoradiation is treatment of choice Most common histological type of cervical malignancy is squamous cell carcinoma

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 41-year-old woman is diagnosed with CA Cervix. She has right hydronephrosis as evidenced by the intravenous pyelogram (IVP). The biopsy specimen confirms it is squamous cell cancer. Which of the following statements regarding this patient's condition is most accurate?, with the following options: A: The best treatment for her is surgical excision., B: The majority of cervical cancers are of adenomatous cell type., C: Chemoradiation is the preferred treatment, D: Radical hysterectomy is an option in the therapy of this patient. ### Response: Stage IIIB: Extension of cervical malignancy to pelvic side wall and/or hydronephrosis or non functioning kidney Broadly, the treatment of cervical cancer is surgical upto stage IIA1 (lesion size <4cm without parametrial involvement) after which the treatment involves chemoradiation, therefore here, chemoradiation is treatment of choice Most common histological type of cervical malignancy is squamous cell carcinoma ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pemphigus vulgaris, tzank smear shows, with the following options: A: AcanthoIytic CellS, B: Fibroblasts, C: Macrophages, D: Neutrophils ### Response:

tzank smear test: done in vesciculobullous disorders floor of a blister is scraped nd the material is spread on glass slide stained with giemsa stain. result 1.acantholytic cells- rounded cells with relatively large nucleus and peripherally condensed cytoplasm diagnostic of pemphigus vulgaris and foliaceous 2,balooning degeneration and multinucleated gaint cells seen in herpes simplex,herpes zoster and varicella. IADVL textbook of dermatology page 110

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pemphigus vulgaris, tzank smear shows, with the following options: A: AcanthoIytic CellS, B: Fibroblasts, C: Macrophages, D: Neutrophils ### Response: tzank smear test: done in vesciculobullous disorders floor of a blister is scraped nd the material is spread on glass slide stained with giemsa stain. result 1.acantholytic cells- rounded cells with relatively large nucleus and peripherally condensed cytoplasm diagnostic of pemphigus vulgaris and foliaceous 2,balooning degeneration and multinucleated gaint cells seen in herpes simplex,herpes zoster and varicella. IADVL textbook of dermatology page 110 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A male 60 years old wants a denture made. He is on oral hypo-glycaemics. Intraoral examination reveals edentulous arches with firm ridges and good alveolar height. Which of the following can be used in this patient for impression making?, with the following options: A: ZOE paste, B: Impression plaster, C: Impression compound, D: All of the above ### Response:

Inelastic impression materials, such as ZOE paste and plaster, are ideal for making impressions of edentulous jaw structures or soft tissue because, in the proper consistency, they do not compress the tissue during seating of the impression tray. Impression compound is often used to make trays for the construction of full dentures. Reference: Phillips’ science of dental materials / Kenneth J. Anusavice, Chiayi Shen, H. Ralph Rawls.—12th ed.Page no 153

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A male 60 years old wants a denture made. He is on oral hypo-glycaemics. Intraoral examination reveals edentulous arches with firm ridges and good alveolar height. Which of the following can be used in this patient for impression making?, with the following options: A: ZOE paste, B: Impression plaster, C: Impression compound, D: All of the above ### Response: Inelastic impression materials, such as ZOE paste and plaster, are ideal for making impressions of edentulous jaw structures or soft tissue because, in the proper consistency, they do not compress the tissue during seating of the impression tray. Impression compound is often used to make trays for the construction of full dentures. Reference: Phillips’ science of dental materials / Kenneth J. Anusavice, Chiayi Shen, H. Ralph Rawls.—12th ed.Page no 153 ### 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 wrong regarding ophthalmic aery, with the following options: A: Present in dura along with optic nerve, B: Supplies anterior ethmoidal sinus, C: Aery to retina is end aery, D: Leaves orbit through inferior orbital fissure ### Response:

Ans. is 'd' i.e., Leaves orbit through inferior orbital fissure Ophthalmic aery does not leave the orbit. It terminates near the medial angle of eye by dividing into supratrochlear and dorsal nasal branches.It lies along with optic nerve in a common dural sheath.It supplies anterior ethmoidal sinus by its anterior ethmoidal branch.Central aery to retina (branch of ophthalmic aery) is an end aery.

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 wrong regarding ophthalmic aery, with the following options: A: Present in dura along with optic nerve, B: Supplies anterior ethmoidal sinus, C: Aery to retina is end aery, D: Leaves orbit through inferior orbital fissure ### Response: Ans. is 'd' i.e., Leaves orbit through inferior orbital fissure Ophthalmic aery does not leave the orbit. It terminates near the medial angle of eye by dividing into supratrochlear and dorsal nasal branches.It lies along with optic nerve in a common dural sheath.It supplies anterior ethmoidal sinus by its anterior ethmoidal branch.Central aery to retina (branch of ophthalmic aery) is an end aery. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: An old man was brought to OP by his son telling that his father is having habit of washing his hands 'n' number of times and repetition of other daily routines as well. Characteristic of obsession are all, EXCEPT:, with the following options: A: Repetitive behavior, B: Repetitive behavior, C: Ego dystonic, D: Compulsion ### Response:

According to the DSM-IV, obsessive-compulsive disorder (OCD) is characterized by recurrent obsessions or compulsions that are ego-dystonic and time-consuming and that interfere with normal functioning. Compulsions or compulsive behavior may result when patients engage in repetitive behavior in an attempt to reduce anxiety or cope with these obsessive thoughts. Obsessions refer to thoughts, ideas, or images which recur and are distressing or unwanted. Ref: Handbook of Neuropsychology and Aging edited by Paul David Nussbaum, 1997, Page 83.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: An old man was brought to OP by his son telling that his father is having habit of washing his hands 'n' number of times and repetition of other daily routines as well. Characteristic of obsession are all, EXCEPT:, with the following options: A: Repetitive behavior, B: Repetitive behavior, C: Ego dystonic, D: Compulsion ### Response: According to the DSM-IV, obsessive-compulsive disorder (OCD) is characterized by recurrent obsessions or compulsions that are ego-dystonic and time-consuming and that interfere with normal functioning. Compulsions or compulsive behavior may result when patients engage in repetitive behavior in an attempt to reduce anxiety or cope with these obsessive thoughts. Obsessions refer to thoughts, ideas, or images which recur and are distressing or unwanted. Ref: Handbook of Neuropsychology and Aging edited by Paul David Nussbaum, 1997, Page 83. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Not a cause of panuveitis, with the following options: A: Behcet's syndrome, B: Syphillis, C: Sarcoidosis, D: Sympathetic ophthalmitis ### Response:

Syphillis is not a common cause for panuveitis Panuveitis: Inflammation of all the layers of uveal tissue iris, ciliary body and choroid. Diseases causing granulomatous panuveitis. *Tuberculosis *Vogt Kayanaga Harada *Behcet's syndrome *Sarcoidosis *Sympathetic Ophthalmitis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Not a cause of panuveitis, with the following options: A: Behcet's syndrome, B: Syphillis, C: Sarcoidosis, D: Sympathetic ophthalmitis ### Response: Syphillis is not a common cause for panuveitis Panuveitis: Inflammation of all the layers of uveal tissue iris, ciliary body and choroid. Diseases causing granulomatous panuveitis. *Tuberculosis *Vogt Kayanaga Harada *Behcet's syndrome *Sarcoidosis *Sympathetic Ophthalmitis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Adenovirus causes all except -, with the following options: A: Hemorrhagic cystitis, B: Diarrhea, C: Respiratory tract infection, D: IMN ### Response:

Infectious mononucleosis is caused by EBV

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Adenovirus causes all except -, with the following options: A: Hemorrhagic cystitis, B: Diarrhea, C: Respiratory tract infection, D: IMN ### Response: Infectious mononucleosis is caused by EBV ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Brazilian purpuric fever is caused by?, with the following options: A: Haemophilus haemolyticus, B: Haemophilus aphrophilus, C: Haemophilus aegyptius, D: Haemophilus parainfluenzae ### Response:

Brazilian purpuric fever is caused by Haemophilus aegyptius. It is characterised by conjunctivitis which proceeds to fulminant septicemia in infants and children. There is high fatality. It was first recognized in Brazil in 1984. Ref: Ananthanarayan and Paniker's Textbook of Microbiology, 9th edition, p330,331.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Brazilian purpuric fever is caused by?, with the following options: A: Haemophilus haemolyticus, B: Haemophilus aphrophilus, C: Haemophilus aegyptius, D: Haemophilus parainfluenzae ### Response: Brazilian purpuric fever is caused by Haemophilus aegyptius. It is characterised by conjunctivitis which proceeds to fulminant septicemia in infants and children. There is high fatality. It was first recognized in Brazil in 1984. Ref: Ananthanarayan and Paniker's Textbook of Microbiology, 9th edition, p330,331. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following in not a pa of Epithalamus:, with the following options: A: Pineal body, B: Posterior commissure, C: Trigonum Habenulae, D: Geniculate bodies ### Response:

D i.e. Geniculate body

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following in not a pa of Epithalamus:, with the following options: A: Pineal body, B: Posterior commissure, C: Trigonum Habenulae, D: Geniculate bodies ### Response: D i.e. Geniculate body ### 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 side effects of clozapine expect:, with the following options: A: Granulocytopenia, B: Seizures, C: Sedation, D: Extrapyramidal side effects ### Response:

Ref: KDT 8th ed Clozapine is an atypical antipsychotic drug. It does not block D2 receptors, therefore chances of extrapyramidal symptoms are least with this drug.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are side effects of clozapine expect:, with the following options: A: Granulocytopenia, B: Seizures, C: Sedation, D: Extrapyramidal side effects ### Response: Ref: KDT 8th ed Clozapine is an atypical antipsychotic drug. It does not block D2 receptors, therefore chances of extrapyramidal symptoms are least with this drug. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Postitional veigo is, with the following options: A: Lateral, B: Superior, C: Inferior, D: Posterior ### Response:

The disease is caused by the disorder of posterior semicircular canal. Otoconial debris when settles in the cupula of the posterior semicircular canal in a critical head position causes displacement of cupula and veigo. (Ref: Diseases of EAR, NOSE AND THROAT by PL DHINGRA - 6th Edition)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Postitional veigo is, with the following options: A: Lateral, B: Superior, C: Inferior, D: Posterior ### Response: The disease is caused by the disorder of posterior semicircular canal. Otoconial debris when settles in the cupula of the posterior semicircular canal in a critical head position causes displacement of cupula and veigo. (Ref: Diseases of EAR, NOSE AND THROAT by PL DHINGRA - 6th Edition) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Antithyroid drug of choice in pregnancy is, with the following options: A: Propylthiouracil, B: Carbimazole, C: Propranolol, D: Lugol's iodine ### Response:

Propylthiouracil

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Antithyroid drug of choice in pregnancy is, with the following options: A: Propylthiouracil, B: Carbimazole, C: Propranolol, D: Lugol's iodine ### Response: Propylthiouracil ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Approved drug for prostate cancer is, with the following options: A: Bicalutamide, B: Apalutamide, C: Ibalizumab, D: Ivacaftor ### Response:

Apalutamide was approved by FDA in 2018 for the treatment of HIV. It is androgen antagonist. Nilutamide, flutamide, bicalutamide are old drugs used in prostate cancerRef: <a href="

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Approved drug for prostate cancer is, with the following options: A: Bicalutamide, B: Apalutamide, C: Ibalizumab, D: Ivacaftor ### Response: Apalutamide was approved by FDA in 2018 for the treatment of HIV. It is androgen antagonist. Nilutamide, flutamide, bicalutamide are old drugs used in prostate cancerRef: <a href=" ### 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 vasodilators except -, with the following options: A: Procaine, B: Lidocaine, C: Cocaine, D: Chlorprocaine ### Response:

Ans. is 'c' i.e., Cocaine

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are vasodilators except -, with the following options: A: Procaine, B: Lidocaine, C: Cocaine, D: Chlorprocaine ### Response: Ans. is 'c' i.e., Cocaine ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: MIC-2 is a marker of? -, with the following options: A: Ewing sarcoma, B: Chronic lymphocytic leukemia, C: Mantle cell lymphoma, D: All of these ### Response:

Harshmohan textbook of pathology 7th edition In Ewings sarcoma - the cell surface marker by the tumor cells of ES / PNET group is CD99 which is a product of MIC2 gene located on X and Y chromosome. .

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: MIC-2 is a marker of? -, with the following options: A: Ewing sarcoma, B: Chronic lymphocytic leukemia, C: Mantle cell lymphoma, D: All of these ### Response: Harshmohan textbook of pathology 7th edition In Ewings sarcoma - the cell surface marker by the tumor cells of ES / PNET group is CD99 which is a product of MIC2 gene located on X and Y chromosome. . ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which modality is the mainstay in trauma imaging?, with the following options: A: Plain radiograph, B: CT, C: MRI, D: Radionuclide imaging ### Response:

Ans AThough not sensitive for subtle undisplaced or early fractures, plain radiographs even today due to their widespread availability, less radiation (as compared to CT scan), mobility (can be taken in any OPD/IPD/ICU) remain the mainstay of trauma imaging.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which modality is the mainstay in trauma imaging?, with the following options: A: Plain radiograph, B: CT, C: MRI, D: Radionuclide imaging ### Response: Ans AThough not sensitive for subtle undisplaced or early fractures, plain radiographs even today due to their widespread availability, less radiation (as compared to CT scan), mobility (can be taken in any OPD/IPD/ICU) remain the mainstay of trauma imaging. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The dark adaptation time in Vitamin A deficiency is:, with the following options: A: Increased, B: Decreased, C: Unchanged, D: Fluctuating ### Response:

Dark adaptation time is increased in vitamin A deficient individuals. Reference: Satyanarayana- Biochemistry, 3rd edition, pg-121

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The dark adaptation time in Vitamin A deficiency is:, with the following options: A: Increased, B: Decreased, C: Unchanged, D: Fluctuating ### Response: Dark adaptation time is increased in vitamin A deficient individuals. Reference: Satyanarayana- Biochemistry, 3rd edition, pg-121 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Fatty acid with even number of carbon atoms on oxidation produces:, with the following options: A: Acetyl CoA, B: Succinyl CoA, C: Propionyl CoA, D: All of the above ### Response:

Fatty acids with an odd number of carbon atoms are oxidized by the pathway of b-oxidation, producing acetyl-CoA, until a three-carbon (propionyl-CoA) residue remains. This compound is conveed to succinyl-CoA, a constituent of the citric acid cycle. Hence, the propionyl residue from an odd-chain fatty acid is the only pa of a fatty acid that is glucogenic Ref: Harper 28th edition, chapter 22.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Fatty acid with even number of carbon atoms on oxidation produces:, with the following options: A: Acetyl CoA, B: Succinyl CoA, C: Propionyl CoA, D: All of the above ### Response: Fatty acids with an odd number of carbon atoms are oxidized by the pathway of b-oxidation, producing acetyl-CoA, until a three-carbon (propionyl-CoA) residue remains. This compound is conveed to succinyl-CoA, a constituent of the citric acid cycle. Hence, the propionyl residue from an odd-chain fatty acid is the only pa of a fatty acid that is glucogenic Ref: Harper 28th edition, chapter 22. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 27-year-old male presents to the emergency with severe pain behind his right eye for the last 30 minutes. He states that his right eye has also been 'watering excessively' for the last two hours. The man has had similar episodes over the last few weeks, but this time the pain is significantly worse which has prompted him to present to the ER. The vitals are normal and ophthalmic examination demonstrates conjunctival injection and miosis of the right pupil. A CT scan of the brain and ESR are unremarkable. Which is the initial treatment of this patient?, with the following options: A: Sumatriptan, B: Rizatriptan, C: Steroids, D: High flow oxygen ### Response:

Retro orbital pain: Cluster headache (Pain behind the eye) | 1st line of treatment: High flow oxygen at 12-15L/min To prevent future episodes of cluster headache: Verapamil Sumatriptan/Rizatriptan: 1st line treatment for Migraine headache. Steroids: Prevention of fuher attacks.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 27-year-old male presents to the emergency with severe pain behind his right eye for the last 30 minutes. He states that his right eye has also been 'watering excessively' for the last two hours. The man has had similar episodes over the last few weeks, but this time the pain is significantly worse which has prompted him to present to the ER. The vitals are normal and ophthalmic examination demonstrates conjunctival injection and miosis of the right pupil. A CT scan of the brain and ESR are unremarkable. Which is the initial treatment of this patient?, with the following options: A: Sumatriptan, B: Rizatriptan, C: Steroids, D: High flow oxygen ### Response: Retro orbital pain: Cluster headache (Pain behind the eye) | 1st line of treatment: High flow oxygen at 12-15L/min To prevent future episodes of cluster headache: Verapamil Sumatriptan/Rizatriptan: 1st line treatment for Migraine headache. Steroids: Prevention of fuher attacks. ### 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 brought to the casualty in the state of altered sensorium. He was on lithium for affective disorder and has suffered through an attack of epileptic fits. On examination he has tremors increased DTRs and incontinence of urine. He has also undergone an episode of severe gastroenteritis 2 days ago. The serum lithium was found to be 1.95 m moles/L. What is the MOST likely cause of her condition?, with the following options: A: Lithium toxicity, B: Dehydration, C: Manic episode, D: Depressive stupor ### Response:

The clinical manifestations in this patient along with elevated levels of serum lithium more than 1.5mE/l indicates that he is suffering from lithium toxicity.Features of acute lithium intoxication includes vomiting, profuse diarrhea, coarse tremor, ataxia, coma, and convulsions. Nervous system is involved in serious cases of intoxication and its manifestations includes mental confusion, hyperreflexia, gross tremor, dysahria, seizures, and cranial nerve and focal neurological signs, progressing to coma and death.Serum levels of Lithium more than 1.5mE/L is considered to be toxic. Dialysis is the most effective means of removing Lithium in patients exhibiting symptoms of toxicity or patients with serum Li+ concentrations >/= 3 mEq/L in acute overdoses. Ref: Meyer J.M. (2011). Chapter 16. Pharmacotherapy of Psychosis and Mania. In B.C. Knollmann (Ed), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.

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 brought to the casualty in the state of altered sensorium. He was on lithium for affective disorder and has suffered through an attack of epileptic fits. On examination he has tremors increased DTRs and incontinence of urine. He has also undergone an episode of severe gastroenteritis 2 days ago. The serum lithium was found to be 1.95 m moles/L. What is the MOST likely cause of her condition?, with the following options: A: Lithium toxicity, B: Dehydration, C: Manic episode, D: Depressive stupor ### Response: The clinical manifestations in this patient along with elevated levels of serum lithium more than 1.5mE/l indicates that he is suffering from lithium toxicity.Features of acute lithium intoxication includes vomiting, profuse diarrhea, coarse tremor, ataxia, coma, and convulsions. Nervous system is involved in serious cases of intoxication and its manifestations includes mental confusion, hyperreflexia, gross tremor, dysahria, seizures, and cranial nerve and focal neurological signs, progressing to coma and death.Serum levels of Lithium more than 1.5mE/L is considered to be toxic. Dialysis is the most effective means of removing Lithium in patients exhibiting symptoms of toxicity or patients with serum Li+ concentrations >/= 3 mEq/L in acute overdoses. Ref: Meyer J.M. (2011). Chapter 16. Pharmacotherapy of Psychosis and Mania. In B.C. Knollmann (Ed), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: DOC for management of visceral Leishmaniasis:, with the following options: A: Parenteral Sodium stibogluconate, B: Liposomal Amphotericin B, C: Miltefosine, D: Pentamidine ### Response:

Ref: Goodman & Gillman 13th ed. P 996* Drug of choice for visceral leishmaniasis: Liposomal Amphotericin B.# Note: AmpB can be used even during pregnancy# Side effect: Renal toxicity, hypokalemia, hypomagnesemia* Other agents for management of leishmaniasis:# Sodium stibogluconate: Given parenterally 20mg/kg/day for 20 days in cutaneous disease and 28 days in visceral leishmaniasis. Due to increased resistance it has now become obsolete in India. At present oral preparation is available and shows better result.- Side effect: Pancreatitis, Hepatotoxicity, Bone marrow suppression, haemolytic anemia and renal failure# Pentamidine can be used in doses of 2-3mg/kg IV or IM daily or every second day for 4-7 doses to treat cutaneous leishmaniasis.- Side effect: Nephrotoxic, Hypoglycemia# Miltefosine: Oral agent. Can be used in visceral and cutaneous leishmaniasis.- Only oral preparation available. Teratogenic - Not used in pregnancy

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: DOC for management of visceral Leishmaniasis:, with the following options: A: Parenteral Sodium stibogluconate, B: Liposomal Amphotericin B, C: Miltefosine, D: Pentamidine ### Response: Ref: Goodman & Gillman 13th ed. P 996* Drug of choice for visceral leishmaniasis: Liposomal Amphotericin B.# Note: AmpB can be used even during pregnancy# Side effect: Renal toxicity, hypokalemia, hypomagnesemia* Other agents for management of leishmaniasis:# Sodium stibogluconate: Given parenterally 20mg/kg/day for 20 days in cutaneous disease and 28 days in visceral leishmaniasis. Due to increased resistance it has now become obsolete in India. At present oral preparation is available and shows better result.- Side effect: Pancreatitis, Hepatotoxicity, Bone marrow suppression, haemolytic anemia and renal failure# Pentamidine can be used in doses of 2-3mg/kg IV or IM daily or every second day for 4-7 doses to treat cutaneous leishmaniasis.- Side effect: Nephrotoxic, Hypoglycemia# Miltefosine: Oral agent. Can be used in visceral and cutaneous leishmaniasis.- Only oral preparation available. Teratogenic - Not used in pregnancy ### 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 used to measure ECF volume, excepta) Sucroseb) Sodium chloridec) Inulind) Heavy water, with the following options: A: c, B: d, C: ab, D: bd ### Response:

Indicators used for fluid volumes 1.       Total body water (TBW)- Deuterium Oxide D2O, Tritium oxide, Aminopyrine, Antipyrine 2.       ECF- Inulin, Sucrose, Mannitol, Sodium thiosulphate, Na22 3.       Plasma volume- Evan’s blue, radioactive iodine labelled serum albumin (I125)   4.       Blood cell volume- Cr51 labelled RBC

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 used to measure ECF volume, excepta) Sucroseb) Sodium chloridec) Inulind) Heavy water, with the following options: A: c, B: d, C: ab, D: bd ### Response: Indicators used for fluid volumes 1.       Total body water (TBW)- Deuterium Oxide D2O, Tritium oxide, Aminopyrine, Antipyrine 2.       ECF- Inulin, Sucrose, Mannitol, Sodium thiosulphate, Na22 3.       Plasma volume- Evan’s blue, radioactive iodine labelled serum albumin (I125)   4.       Blood cell volume- Cr51 labelled RBC ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most afferent fibers from the lateral geniculate nucleus terminate in the primary visual coex in:, with the following options: A: Layer 1, B: Layer 2 & 3, C: Layer 4, D: Layer 5 & 6 ### Response:

LGB has 6 layers - (i) Layers 1 & 2: They are called magnocellular (contain large cells). The M ganglion cells project to magnocellular poion of LGB, (ii) Layers 3-6: They are called parvocellular (contain small cells). P ganglion cells project to the parvocellular poion of LGB The visual coex has 6 layers. The magnocellular and parvocellular neurons project to layer 4 and 4C of the visual coex. The axons from the interlaminar region end in layers 2 and 3.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most afferent fibers from the lateral geniculate nucleus terminate in the primary visual coex in:, with the following options: A: Layer 1, B: Layer 2 & 3, C: Layer 4, D: Layer 5 & 6 ### Response: LGB has 6 layers - (i) Layers 1 & 2: They are called magnocellular (contain large cells). The M ganglion cells project to magnocellular poion of LGB, (ii) Layers 3-6: They are called parvocellular (contain small cells). P ganglion cells project to the parvocellular poion of LGB The visual coex has 6 layers. The magnocellular and parvocellular neurons project to layer 4 and 4C of the visual coex. The axons from the interlaminar region end in layers 2 and 3. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Iron is predominantly absorbed in -, with the following options: A: Stomach, B: Duodenum, C: Colon, D: Ileum ### Response:

Ans. is 'b' i.e., Duodenum IMPORTANT FACTS ABOUT ABSORPTIONo Absorption pattern of duodenum and jejunum is almost same. Following mentioned nutrients are absorbed both in duodenum and jejunum, however their absorption differs quantitatively : -Mainly absorbed in duodenum : - Calcium. Iron.Mainly absorbed in jejunum : - Amino acids, water soluble vitamins (B1. B2, B3, B5, B6, Biotin and VitaminC), fat soluble vitamins (A, E, D, K), Fats (Triglycerides, Cholesterol), Sugars (monosaccharides, disaccharides), water, NaCl (electrolytes).o Following are absorbed in the Ileum: - Bile & bile salts. Vitamin B12, Na+, water.# Vitamin B12. (cyanocobalamine) is absorbed in the ileum. Intrinsic factor (of castle) is necessary for its absorption IF is secreted by oxyntic cells of stomach. In the lumen of the small intestine, IF forms a complex with vitamin B12. Vitamin B12-IF complex binds with a specific receptor on the surface of the epithelial ceils of the ileum r. Vitamin B12 is transported into the enterocytes leaving behing IF at the brush border.o Following are absorbed in colon : - Water and electrolytes (Na & Cl )Water and electrolyte absorptiono Water and electrolytes need no digestion and are absorbed as such. There is approximately 9 liters of water input: Ingested water: 2.0 litres, Saliva: 1.5 litres, gastric juice: 2.5 litres, bile 0.5 litre, pancreatic juice: 1.5 litres, and small intestine secretions 1.0 litre. Out of these 9 litres, 7.7 litres (85%) is absorbed in small intestine and 1.0 - 1.5 litres (5-10%) is absorbed in large intestine (colon). Total 8.8 litres of water is absorbed and 0.2 litre is excreted in feces. In small intestine, most of the water is reabsorbed in the jejunum.o Na+ and Cl. are also absorbed maximally in jejunum with some absorption in colon.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Iron is predominantly absorbed in -, with the following options: A: Stomach, B: Duodenum, C: Colon, D: Ileum ### Response: Ans. is 'b' i.e., Duodenum IMPORTANT FACTS ABOUT ABSORPTIONo Absorption pattern of duodenum and jejunum is almost same. Following mentioned nutrients are absorbed both in duodenum and jejunum, however their absorption differs quantitatively : -Mainly absorbed in duodenum : - Calcium. Iron.Mainly absorbed in jejunum : - Amino acids, water soluble vitamins (B1. B2, B3, B5, B6, Biotin and VitaminC), fat soluble vitamins (A, E, D, K), Fats (Triglycerides, Cholesterol), Sugars (monosaccharides, disaccharides), water, NaCl (electrolytes).o Following are absorbed in the Ileum: - Bile & bile salts. Vitamin B12, Na+, water.# Vitamin B12. (cyanocobalamine) is absorbed in the ileum. Intrinsic factor (of castle) is necessary for its absorption IF is secreted by oxyntic cells of stomach. In the lumen of the small intestine, IF forms a complex with vitamin B12. Vitamin B12-IF complex binds with a specific receptor on the surface of the epithelial ceils of the ileum r. Vitamin B12 is transported into the enterocytes leaving behing IF at the brush border.o Following are absorbed in colon : - Water and electrolytes (Na & Cl )Water and electrolyte absorptiono Water and electrolytes need no digestion and are absorbed as such. There is approximately 9 liters of water input: Ingested water: 2.0 litres, Saliva: 1.5 litres, gastric juice: 2.5 litres, bile 0.5 litre, pancreatic juice: 1.5 litres, and small intestine secretions 1.0 litre. Out of these 9 litres, 7.7 litres (85%) is absorbed in small intestine and 1.0 - 1.5 litres (5-10%) is absorbed in large intestine (colon). Total 8.8 litres of water is absorbed and 0.2 litre is excreted in feces. In small intestine, most of the water is reabsorbed in the jejunum.o Na+ and Cl. are also absorbed maximally in jejunum with some absorption in colon. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Surgery of choice in patient with congenital ptosis with good levator action is, with the following options: A: LPS resection, B: Muller's Resection, C: Fascia lata sling surgery, D: Fasanella Servat operation ### Response:

SURGICAL CORRECTION * Levator resection : very commonly done in congenital ptosis with moderate and severe grades of ptosis * Fascia lata sling surgery : done in patients having severe ptosis with no levator function. In Marcus Gunn Jaw Winking Ptosis , LPS excision is combined with frontalis sling operation and in Congenital Ptosis with bad elevation we do Sling surgery. * Fasanella Servat operation : - done in patients having mild ptosis with good levator function - it is also done in Horners syndrome *Avoid ptosis surgery in Myasthenia Gravis and Paial third nerve palsy induced ptosis as they usually resolve with medical treatment and with time

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Surgery of choice in patient with congenital ptosis with good levator action is, with the following options: A: LPS resection, B: Muller's Resection, C: Fascia lata sling surgery, D: Fasanella Servat operation ### Response: SURGICAL CORRECTION * Levator resection : very commonly done in congenital ptosis with moderate and severe grades of ptosis * Fascia lata sling surgery : done in patients having severe ptosis with no levator function. In Marcus Gunn Jaw Winking Ptosis , LPS excision is combined with frontalis sling operation and in Congenital Ptosis with bad elevation we do Sling surgery. * Fasanella Servat operation : - done in patients having mild ptosis with good levator function - it is also done in Horners syndrome *Avoid ptosis surgery in Myasthenia Gravis and Paial third nerve palsy induced ptosis as they usually resolve with medical treatment and with time ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ideal time gap between 2 live vaccinations is about, with the following options: A: 2 weeks, B: 4 weeks, C: 8 weeks, D: 12 weeks ### Response:

(B) 4 weeksGUIDELINES FOR SPACING OF LIVE & INACTIVATED ANTIGENSAntigen CombinationRecommended minimum interval between doses>= InactivatedNone; can be administered simultaneously or at any interval between dosesInactivated & LiveNone; can be administered simultaneously or at any interval between doses>=2 live parenteral*4-week minimum interval, if not administered simultaneously * Live oral vaccines (E.g., Ty21a typhoid vaccine, oral polio vaccine) can be administered simultaneously or at any interval before after inactivated or live parenteral vaccines.If live parenteral (injected) vaccines (MMR, MMRV, Varicella zoster, and yellow fever) and live intranasal influenza vaccine (LAIV) are not administered at the same visit, they should be separated by at least 4 weeks.VACCINATION CHART FOR BABIES IN INDIABCGNewborn*. Bacilli Calmette-Guerin (BCG):*. Vaccination is given to combat Tuberculosis & prevent TB Meningitis in child.*. Vaccine contains live culture of the bacterium that causes TB in humans, but in a weakened form, which triggers the immune system of the child, preventing TB to attack the body. It is given at birth.Hep BNew born 1st6th week 2nd6th month 3rd*. Hepatitis B vaccination:*. It is given to prevent liver diseases caused by the Hepatitis B virus, which can cause liver cancer, liver failure and in some cases, death.*. The first dose of vaccination is given at birth.*. RECOMBIVAX HB Hepatitis B vaccine is non- infectious and is created out of a genetic recombination.*. It is made with the help of yeast.OPV6th month 1st9th month 2nd4-6 years 3rd*. Oral Polio Vaccine (OPV):*. It is given to prevent the polio disease. It can be given orally (OPV) or via injection (IPV). OPV is a polio vaccine, It is made up of an inactivated non-wild strain of the virus which helps produce antibodies within the body.IPV6th week 1st10th week 2nd14th week 3rd16th-18th month B1*. Inactivated Polio Vaccine (IPV):*. It is given to prevent polio disease in child. It is a mandatory vaccine for all children.*. It contains a wild strain of inactivated polio virus.*. It is usually given along with the DTP vaccine.DTP6th Week 1st10th week 2nd14th week 3rd16th-18th month B1 4-6 years B2*. Diphtheria, Tetanus, & Pertussis (DTP):*. Commonly known as a whooping cough, this vaccination is mandatory.*. Vaccine is a combination of three antigens-Diphtheria toxoid, Tetanus toxoid, and Pertussis.*. These antigens are inactivated to create the DTP vaccine.*. On receiving the vaccine, antibodies are produced within the body to fight occurrence of the diseases.Rota V6th week 1st 10th week 2nd 14th week 3rd*. This vaccination is essential to protect a child against Rotavirus infection which can cause severe diarrhea in children.*. Rota virus vaccine is composed of 5 strains of inactivated rotaviruses.*. It is developed using DNA technology to build immunity in the infants against rotavirus infection.PCV6th week 1st 10th week 2nd 14th week 3rd 13th-15th month Booster*. Pneumococcal Conjugate Vaccine (PCV):*. It is given to prevent Pneumococcal infections in child.*. Pneumococcal bacteria causes ear infections, pneumonia of the lungs, bacteremia of the blood and brain meningitis.*. PCV vaccine is inactivated & does not contain any live Pneumococcal bacteria.Influenza type B (HiB)6th week 1st10th week 2nd 14th week 3rd 16th-18th month B1*. This vaccination is necessary to protect a child against Haemophilus Influenza type B (HiB) - a bacteria that causes diseases like Meningitis, Pneumonia and Epiglottitis.*. HiB is a conjugate vaccine.*. It consists of inactivated bacterial components which on being introduced to the body helps create immunity against the bacteria.MMR9th month 1st 13th-15th month 2nd 4-6 years 3rd*. Measles, Mumps & Rubella (MMR):*. Vaccination is mandatory to prevent from diseases like Measles, Mumps, and Rubella (MMR).*. Vaccine contains live, attenuated measles, mumps and rubella virus with Moraten & Edmonston- Zagreb strain in Genotype A.Typhoid9th-12th month 24th month*. Typhoid Conjugate Vaccine (TCV):*. It is given to prevent typhoid in child. It is made up of Purified Vi polysaccharide from the TY2 S or Typhi Strain.Hep A12th month 1st 18th month 2nd*. Hepatitis A vaccination is a mandatory one to prevent chronic liver infections, protection from Hepatitis A Virus.*. Hepatitis A is made from sterile suspension of inactivated virus (Strain HM175) propagated in MRC-5.Varicella13rd-15th month 1st 4-6 years 2nd*. Varicella vaccine:*. It is a vaccine that protects against chickenpox.*. One dose of vaccine prevents 95% of moderate disease & 100% of severe disease.*. Two doses of vaccine are more effective than one.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ideal time gap between 2 live vaccinations is about, with the following options: A: 2 weeks, B: 4 weeks, C: 8 weeks, D: 12 weeks ### Response: (B) 4 weeksGUIDELINES FOR SPACING OF LIVE & INACTIVATED ANTIGENSAntigen CombinationRecommended minimum interval between doses>= InactivatedNone; can be administered simultaneously or at any interval between dosesInactivated & LiveNone; can be administered simultaneously or at any interval between doses>=2 live parenteral*4-week minimum interval, if not administered simultaneously * Live oral vaccines (E.g., Ty21a typhoid vaccine, oral polio vaccine) can be administered simultaneously or at any interval before after inactivated or live parenteral vaccines.If live parenteral (injected) vaccines (MMR, MMRV, Varicella zoster, and yellow fever) and live intranasal influenza vaccine (LAIV) are not administered at the same visit, they should be separated by at least 4 weeks.VACCINATION CHART FOR BABIES IN INDIABCGNewborn*. Bacilli Calmette-Guerin (BCG):*. Vaccination is given to combat Tuberculosis & prevent TB Meningitis in child.*. Vaccine contains live culture of the bacterium that causes TB in humans, but in a weakened form, which triggers the immune system of the child, preventing TB to attack the body. It is given at birth.Hep BNew born 1st6th week 2nd6th month 3rd*. Hepatitis B vaccination:*. It is given to prevent liver diseases caused by the Hepatitis B virus, which can cause liver cancer, liver failure and in some cases, death.*. The first dose of vaccination is given at birth.*. RECOMBIVAX HB Hepatitis B vaccine is non- infectious and is created out of a genetic recombination.*. It is made with the help of yeast.OPV6th month 1st9th month 2nd4-6 years 3rd*. Oral Polio Vaccine (OPV):*. It is given to prevent the polio disease. It can be given orally (OPV) or via injection (IPV). OPV is a polio vaccine, It is made up of an inactivated non-wild strain of the virus which helps produce antibodies within the body.IPV6th week 1st10th week 2nd14th week 3rd16th-18th month B1*. Inactivated Polio Vaccine (IPV):*. It is given to prevent polio disease in child. It is a mandatory vaccine for all children.*. It contains a wild strain of inactivated polio virus.*. It is usually given along with the DTP vaccine.DTP6th Week 1st10th week 2nd14th week 3rd16th-18th month B1 4-6 years B2*. Diphtheria, Tetanus, & Pertussis (DTP):*. Commonly known as a whooping cough, this vaccination is mandatory.*. Vaccine is a combination of three antigens-Diphtheria toxoid, Tetanus toxoid, and Pertussis.*. These antigens are inactivated to create the DTP vaccine.*. On receiving the vaccine, antibodies are produced within the body to fight occurrence of the diseases.Rota V6th week 1st 10th week 2nd 14th week 3rd*. This vaccination is essential to protect a child against Rotavirus infection which can cause severe diarrhea in children.*. Rota virus vaccine is composed of 5 strains of inactivated rotaviruses.*. It is developed using DNA technology to build immunity in the infants against rotavirus infection.PCV6th week 1st 10th week 2nd 14th week 3rd 13th-15th month Booster*. Pneumococcal Conjugate Vaccine (PCV):*. It is given to prevent Pneumococcal infections in child.*. Pneumococcal bacteria causes ear infections, pneumonia of the lungs, bacteremia of the blood and brain meningitis.*. PCV vaccine is inactivated & does not contain any live Pneumococcal bacteria.Influenza type B (HiB)6th week 1st10th week 2nd 14th week 3rd 16th-18th month B1*. This vaccination is necessary to protect a child against Haemophilus Influenza type B (HiB) - a bacteria that causes diseases like Meningitis, Pneumonia and Epiglottitis.*. HiB is a conjugate vaccine.*. It consists of inactivated bacterial components which on being introduced to the body helps create immunity against the bacteria.MMR9th month 1st 13th-15th month 2nd 4-6 years 3rd*. Measles, Mumps & Rubella (MMR):*. Vaccination is mandatory to prevent from diseases like Measles, Mumps, and Rubella (MMR).*. Vaccine contains live, attenuated measles, mumps and rubella virus with Moraten & Edmonston- Zagreb strain in Genotype A.Typhoid9th-12th month 24th month*. Typhoid Conjugate Vaccine (TCV):*. It is given to prevent typhoid in child. It is made up of Purified Vi polysaccharide from the TY2 S or Typhi Strain.Hep A12th month 1st 18th month 2nd*. Hepatitis A vaccination is a mandatory one to prevent chronic liver infections, protection from Hepatitis A Virus.*. Hepatitis A is made from sterile suspension of inactivated virus (Strain HM175) propagated in MRC-5.Varicella13rd-15th month 1st 4-6 years 2nd*. Varicella vaccine:*. It is a vaccine that protects against chickenpox.*. One dose of vaccine prevents 95% of moderate disease & 100% of severe disease.*. Two doses of vaccine are more effective than one. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Hasse rule is related to(Kerala 2007repeat), with the following options: A: Age of fetus, B: Weight of fetus, C: Height of fetus, D: Severity of burns ### Response:

Ans) a (Age of fetus) Ref: Reddy 27th ed p68Rule of Hasse-It is used for calculating the age of the foetus. In the first five months of pregnancy the square root of crown rump length gives the approximate age of foetus in months.In the last five months the length in centimeters divided by 5 gives the age in months.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Hasse rule is related to(Kerala 2007repeat), with the following options: A: Age of fetus, B: Weight of fetus, C: Height of fetus, D: Severity of burns ### Response: Ans) a (Age of fetus) Ref: Reddy 27th ed p68Rule of Hasse-It is used for calculating the age of the foetus. In the first five months of pregnancy the square root of crown rump length gives the approximate age of foetus in months.In the last five months the length in centimeters divided by 5 gives the age in months. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Least likely cause of renal papillary necrosis?, with the following options: A: Sickle cell disease, B: Analgesic nephropathy, C: Posterior urethral valves, D: Diabetes with UTI ### Response:

c. Posterior urethral valves(Ref: Nelson's 20/e p 2562-2567Ghai 8/e p 485-486)Sickle cell disease, use of analgesics and Diabetes are important causes of Renal papillary necrosis.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Least likely cause of renal papillary necrosis?, with the following options: A: Sickle cell disease, B: Analgesic nephropathy, C: Posterior urethral valves, D: Diabetes with UTI ### Response: c. Posterior urethral valves(Ref: Nelson's 20/e p 2562-2567Ghai 8/e p 485-486)Sickle cell disease, use of analgesics and Diabetes are important causes of Renal papillary necrosis. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Coracoid process is, with the following options: A: Pressure epiphysis, B: Traction epiphysis, C: Aberrant epiphysis, D: Atavistic epiphysis ### Response:

Coracoid process is directed forwards and slightly laterally. It is bent finger like. It is atavistic type of epiphysis. B D Chaurasia 7th edition Page no : 9

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Coracoid process is, with the following options: A: Pressure epiphysis, B: Traction epiphysis, C: Aberrant epiphysis, D: Atavistic epiphysis ### Response: Coracoid process is directed forwards and slightly laterally. It is bent finger like. It is atavistic type of epiphysis. B D Chaurasia 7th edition Page no : 9 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of following is hypeonic?, with the following options: A: 5%dextrose, B: 0.45% normal saline, C: 0.9%normal saline, D: 3% normal saline ### Response:

3% normal saline REF: Fluids & electrolytes by By Lippincott Williams & Wilkins page 264 Isotonic Hypeonic Hypotonic Dextrose 5% in water 5% dextrose in half normal saline 0.45% normal saline 0.9% normal saline (NaC1) 5% dextrose in normal saline Ringer lactate Dextrose 10% in water

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of following is hypeonic?, with the following options: A: 5%dextrose, B: 0.45% normal saline, C: 0.9%normal saline, D: 3% normal saline ### Response: 3% normal saline REF: Fluids & electrolytes by By Lippincott Williams & Wilkins page 264 Isotonic Hypeonic Hypotonic Dextrose 5% in water 5% dextrose in half normal saline 0.45% normal saline 0.9% normal saline (NaC1) 5% dextrose in normal saline Ringer lactate Dextrose 10% in water ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In recent memory loss, probable lesion is in, with the following options: A: Thalamus, B: Temporal lobe, C: Frontal lobe, D: All of the above ### Response:

The Neuropsychology of Autobiographical Memory The medial temporal lobe memory system includes the hippocampus formation and the adjacent parahippocampal and perirhinal coices. The hippocampus is not the place where the content of memories is stored, but rather appears to contain a set of neural links to the content, which is distributed widely throughout the coex. Memories of an episode in one's life typically contain information from more than one modality: vision, hearing, and even taste, touch, and smell. Each of these components is stored in a unimodal sensory area, for example, the visual components of an episodic memory are stored in the visual coex in the occipital lobe, while the auditory components are stored in the auditory coex in the temporal lobe. These distributed representations are linked to a central index in the hippocampus. When recent episodes are retrieved, the index is reactivated, causing activation to spread to each of the associated unimodal areas. This is more correct of recent episodes, however. Once a representation of an episode has been fully consolidated, activation can spread between the separate features themselves, so that hippocampal activation is no longer needed. We are also beginning to gain an understanding of the brain areas that comprise the frontal components of the medial temporal lobe memory system. Medial temporal and hippocampal regions tend to be more involved in spatial context memory, while the frontocoical region, the diencephalon, and the temporal lobes are involved in temporal context memory. Much has also been learned about the neural bases of sho-term memory systems located in the frontal lobes. Psychologists have had trouble determining whether there is one type of sho-term memory, or several. The time span involved - exactly what 'sho' means - is also not widely agreed upon. In the 1980s, however, neuroscientists began exploring a large area in the dorsolateral poion of the prefrontal lobes. This area seems to be responsible for a so of memory that has been called 'working memory' - a concept that at least overlaps with the psychologist's concept of sho-term memory. Ref Harrison20th edition pg 2235

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In recent memory loss, probable lesion is in, with the following options: A: Thalamus, B: Temporal lobe, C: Frontal lobe, D: All of the above ### Response: The Neuropsychology of Autobiographical Memory The medial temporal lobe memory system includes the hippocampus formation and the adjacent parahippocampal and perirhinal coices. The hippocampus is not the place where the content of memories is stored, but rather appears to contain a set of neural links to the content, which is distributed widely throughout the coex. Memories of an episode in one's life typically contain information from more than one modality: vision, hearing, and even taste, touch, and smell. Each of these components is stored in a unimodal sensory area, for example, the visual components of an episodic memory are stored in the visual coex in the occipital lobe, while the auditory components are stored in the auditory coex in the temporal lobe. These distributed representations are linked to a central index in the hippocampus. When recent episodes are retrieved, the index is reactivated, causing activation to spread to each of the associated unimodal areas. This is more correct of recent episodes, however. Once a representation of an episode has been fully consolidated, activation can spread between the separate features themselves, so that hippocampal activation is no longer needed. We are also beginning to gain an understanding of the brain areas that comprise the frontal components of the medial temporal lobe memory system. Medial temporal and hippocampal regions tend to be more involved in spatial context memory, while the frontocoical region, the diencephalon, and the temporal lobes are involved in temporal context memory. Much has also been learned about the neural bases of sho-term memory systems located in the frontal lobes. Psychologists have had trouble determining whether there is one type of sho-term memory, or several. The time span involved - exactly what 'sho' means - is also not widely agreed upon. In the 1980s, however, neuroscientists began exploring a large area in the dorsolateral poion of the prefrontal lobes. This area seems to be responsible for a so of memory that has been called 'working memory' - a concept that at least overlaps with the psychologist's concept of sho-term memory. Ref Harrison20th edition pg 2235 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about pelvic abscess, with the following options: A: Uncommon cause of intraperitoneal abscess, B: Identified by CT if there is a full bladder, C: Associated with pyothorax, D: May spontaneously drain via rectum ### Response:

Ans. (d) May spontaneously drain via rectumRef: Sabiston I9th edition Page 1312* Pelvic abscess is the mc site of abscess formation in sitting position.* Rutherford Morrison pouch is the mc site of abscess formation in lying position.* Pelvic abscess is drained via rectum.* Pelvic abscess is associated with diverticulitis.* Pelvic abscess is identified after emptying the bladder in USG and CECT abdomen much clearly.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about pelvic abscess, with the following options: A: Uncommon cause of intraperitoneal abscess, B: Identified by CT if there is a full bladder, C: Associated with pyothorax, D: May spontaneously drain via rectum ### Response: Ans. (d) May spontaneously drain via rectumRef: Sabiston I9th edition Page 1312* Pelvic abscess is the mc site of abscess formation in sitting position.* Rutherford Morrison pouch is the mc site of abscess formation in lying position.* Pelvic abscess is drained via rectum.* Pelvic abscess is associated with diverticulitis.* Pelvic abscess is identified after emptying the bladder in USG and CECT abdomen much clearly. ### 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 male presents to the OPD with complaints of fever with chills, headache, abdominal pain, and diarrhoea. He gives history of consuming raw refrigerated vegetables 24 hours back. What is the most likely etiologic organism?, with the following options: A: Staphylococcus aureus, B: Vibrio cholerae, C: Listeria monocytogenes, D: Bacillus cereus ### Response:

The given clinical picture is suggestive of food poisoning caused by Listeria monocytogenes. This organism can grow at low refrigeration temperatures. Listeria moves from cell-to-cell using host cell actin framework. Shows tumbling motility at 25degC. The drug of choice is high dose intravenous ampicillin. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition

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 male presents to the OPD with complaints of fever with chills, headache, abdominal pain, and diarrhoea. He gives history of consuming raw refrigerated vegetables 24 hours back. What is the most likely etiologic organism?, with the following options: A: Staphylococcus aureus, B: Vibrio cholerae, C: Listeria monocytogenes, D: Bacillus cereus ### Response: The given clinical picture is suggestive of food poisoning caused by Listeria monocytogenes. This organism can grow at low refrigeration temperatures. Listeria moves from cell-to-cell using host cell actin framework. Shows tumbling motility at 25degC. The drug of choice is high dose intravenous ampicillin. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Primordial prevention for CAD is: March 2011, with the following options: A: Screening, B: Regular checkups, C: Preserving traditional lifestyle, D: Treatment for raised BP ### Response:

Ans. C: Preserving traditional lifestyle Preserving traditional lifestyles is a primordial level of prevention Levels of Prevention Model This model, advocated by Leaven and Clark in 1975, has influenced both public health practice and ambulatory care delivery worldwide. This model suggests that the natural history of any disease exists on a continuum, with health at one end and advanced disease at the other. The model delineates three levels of the application of preventive measures that can be used to promote health and arrest the disease process at different points along the continuum. The goal is to maintain a healthy state and to prevent disease or injury. It has been defined in terms of four levels: Primordial prevention Prevention of the emergence or development of risk factors in population or countries in which they have not yet appeared. Effos are directed towards discouraging children from adopting harmful lifestyles. Primary prevention An action taken prior to the onset of disease, which removes the possibility that the disease will ever occur. It includes the concept of positive health, that encourages the achievement and maintenance of an "acceptable level of health that will enable every individual to lead a socially and economically productive life. A holistic approach Secondary prevention Action which halts the progress of a disease at its incipient stage and prevents complications. The domain of clinical medicine An imperfect tool in the transmission of disease More expensive and less effective than primary prevention Teiary prevention All measures available to reduce or limit impairment and disabilities, minimize suffering caused by existing depaures from good health and to promote the patient's adjustment to irremediable conditions. Modes of intervention Health promotion Specific protection Early diagnosis and treatment Disability limitation Rehabilitation Health promotion The process of enabling people to in areas to control over and to improve health Health education Environmental modifications Nutritional interventions Lifestyle and behavioral changes Specific protection Immunization Specific nutrients Chemoprophylaxis Protection against occupational hazards Protection from carcinogens Avoidance of allergens Rehabilitation The combined and coordinated use of medical, social, educational and vocational measures for training and retraining the individual to the highest possible level of functional ability. Examples-schools for blind, reconstructive surgery in leprosy, provision of aids for the crippled

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Primordial prevention for CAD is: March 2011, with the following options: A: Screening, B: Regular checkups, C: Preserving traditional lifestyle, D: Treatment for raised BP ### Response: Ans. C: Preserving traditional lifestyle Preserving traditional lifestyles is a primordial level of prevention Levels of Prevention Model This model, advocated by Leaven and Clark in 1975, has influenced both public health practice and ambulatory care delivery worldwide. This model suggests that the natural history of any disease exists on a continuum, with health at one end and advanced disease at the other. The model delineates three levels of the application of preventive measures that can be used to promote health and arrest the disease process at different points along the continuum. The goal is to maintain a healthy state and to prevent disease or injury. It has been defined in terms of four levels: Primordial prevention Prevention of the emergence or development of risk factors in population or countries in which they have not yet appeared. Effos are directed towards discouraging children from adopting harmful lifestyles. Primary prevention An action taken prior to the onset of disease, which removes the possibility that the disease will ever occur. It includes the concept of positive health, that encourages the achievement and maintenance of an "acceptable level of health that will enable every individual to lead a socially and economically productive life. A holistic approach Secondary prevention Action which halts the progress of a disease at its incipient stage and prevents complications. The domain of clinical medicine An imperfect tool in the transmission of disease More expensive and less effective than primary prevention Teiary prevention All measures available to reduce or limit impairment and disabilities, minimize suffering caused by existing depaures from good health and to promote the patient's adjustment to irremediable conditions. Modes of intervention Health promotion Specific protection Early diagnosis and treatment Disability limitation Rehabilitation Health promotion The process of enabling people to in areas to control over and to improve health Health education Environmental modifications Nutritional interventions Lifestyle and behavioral changes Specific protection Immunization Specific nutrients Chemoprophylaxis Protection against occupational hazards Protection from carcinogens Avoidance of allergens Rehabilitation The combined and coordinated use of medical, social, educational and vocational measures for training and retraining the individual to the highest possible level of functional ability. Examples-schools for blind, reconstructive surgery in leprosy, provision of aids for the crippled ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The Labia minora lacks all except, with the following options: A: Eccrine glands, B: Hair follicles, C: Apocrine glands, D: Sebaceous glands ### Response:

Labia minora lacks hair follicles, eccrine glands and apocrine glands. But has many sebaceous glands.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The Labia minora lacks all except, with the following options: A: Eccrine glands, B: Hair follicles, C: Apocrine glands, D: Sebaceous glands ### Response: Labia minora lacks hair follicles, eccrine glands and apocrine glands. But has many sebaceous glands. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which treatment would be least effective for asystole?, with the following options: A: External pacemaker, B: Intravenous epinephrine, 10 ml. of 1:10,000., C: Intravenous calcium gluconate, 10 ml. of 10% solution, D: Intravenous atropine, 0.5 mg. ### Response:

Recommended treatment for asystole is administration of atropine. If atropine is unsuccessful epinephrine is given. Ultimately cardiac pacing is necessary if atropine and epinephrine do not establish an adequate heart rate. Calcium has no clear role in treating asystole.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which treatment would be least effective for asystole?, with the following options: A: External pacemaker, B: Intravenous epinephrine, 10 ml. of 1:10,000., C: Intravenous calcium gluconate, 10 ml. of 10% solution, D: Intravenous atropine, 0.5 mg. ### Response: Recommended treatment for asystole is administration of atropine. If atropine is unsuccessful epinephrine is given. Ultimately cardiac pacing is necessary if atropine and epinephrine do not establish an adequate heart rate. Calcium has no clear role in treating asystole. ### 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 features are true for tetralogy of Fallot, except –, with the following options: A: Ventricular septal defect, B: Right ventricular hypertrophy, C: Atrial septal defect, D: Pulmonary stenosis ### Response:

Tetralogy of Fallot The classical example of cyanotic patients with pulmonic stenosis is tetralogy of fallot. TOF is the commonest congenital heart disease. Constituents of TOF Ventricular septal defect                        Pulmonic stenosis           Overriding or dextroposed aorta     Right ventricular hypertrophy.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The following features are true for tetralogy of Fallot, except –, with the following options: A: Ventricular septal defect, B: Right ventricular hypertrophy, C: Atrial septal defect, D: Pulmonary stenosis ### Response: Tetralogy of Fallot The classical example of cyanotic patients with pulmonic stenosis is tetralogy of fallot. TOF is the commonest congenital heart disease. Constituents of TOF Ventricular septal defect                        Pulmonic stenosis           Overriding or dextroposed aorta     Right ventricular hypertrophy. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: X-ray finding more suggestive of ulcerative colitis than Crohn's disease:, with the following options: A: Rectal sparing, B: Loss of haustrations, C: Tracking of contrast within the bowel wall, D: Discontinuous lesions ### Response:

Ans. (b) Loss of haustrationsRef: Sabiston 20th edition, Page 1342* Lead pipe appearance: Loss of haustrations* Rectal sparing is a feature of Crohn's* Skip lesions are also seen in Crohn's.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: X-ray finding more suggestive of ulcerative colitis than Crohn's disease:, with the following options: A: Rectal sparing, B: Loss of haustrations, C: Tracking of contrast within the bowel wall, D: Discontinuous lesions ### Response: Ans. (b) Loss of haustrationsRef: Sabiston 20th edition, Page 1342* Lead pipe appearance: Loss of haustrations* Rectal sparing is a feature of Crohn's* Skip lesions are also seen in Crohn's. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Based on epidemiological studies, which of the following has been found to be most protective against colon cancer?, with the following options: A: High fiber diet, B: Low fat diet, C: Low selenium diet, D: Low protein diet ### Response:

ENVIRONMENTAL FACTORS & ITS ASSOCIATED RISK TO CAUSE COLON CANCER: INCREASED RISK PROTECTIVE FACTORS High intake of dietary lipids Pelvic irradiation Streptococcus bovis endocarditis Ureterosigmoidostomy High fiber diet NSAIDs Hormone Replacement Therapy

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Based on epidemiological studies, which of the following has been found to be most protective against colon cancer?, with the following options: A: High fiber diet, B: Low fat diet, C: Low selenium diet, D: Low protein diet ### Response: ENVIRONMENTAL FACTORS & ITS ASSOCIATED RISK TO CAUSE COLON CANCER: INCREASED RISK PROTECTIVE FACTORS High intake of dietary lipids Pelvic irradiation Streptococcus bovis endocarditis Ureterosigmoidostomy High fiber diet NSAIDs Hormone Replacement Therapy ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Absence of Corpus callosum leads to-, with the following options: A: Hemiparesis, B: Hemisensory loss, C: Astereognosis, D: No neurological manifestations ### Response:

Ans. is 'd' i.e., No neurological manifestations o Agenesis of corpus callosum is a rare birth defect (congenital disorder) in which there is complete or partial absence of corpus callosum.o Corpus callosum is a band of tissue connecting the two hemispheres of the brain. Fibres of corpus callosum arise from the superficial layers of the cerebral cortex and they project to the homotypic regions of the contralateral cortex by passing through the corpus collosum while crossing the midline.Clinical features of Agenesis of corpus callosum:-o Signs and symptoms of agenesis of corpus callosum vary greatly among individuals.o "Patients usually do not have any neurological manifestations".o However, some features common in agenesis of corpus callosum are# Vision impairment# Low muscle tone (hypotonia)# Poor motor coordination# Delay in motor milestones such as sitting and walking.# Low perception of pain# Delayed toilet training# Chewing and swallowing dijficulties# Early speech and language delays# Social difficultieso Other characteristics sometimes associated with callosal disorders are# Seizures# Spasticity# Early feeding difficulties and or gastric reflux# Hearing impairments# Abnormal head and facial features# Mental retardationInvestigationo CT and MRI reveals "Bat wing" deformity of the ventricles.Treatmento There are currently no specific medical treatments for callosal disorders.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Absence of Corpus callosum leads to-, with the following options: A: Hemiparesis, B: Hemisensory loss, C: Astereognosis, D: No neurological manifestations ### Response: Ans. is 'd' i.e., No neurological manifestations o Agenesis of corpus callosum is a rare birth defect (congenital disorder) in which there is complete or partial absence of corpus callosum.o Corpus callosum is a band of tissue connecting the two hemispheres of the brain. Fibres of corpus callosum arise from the superficial layers of the cerebral cortex and they project to the homotypic regions of the contralateral cortex by passing through the corpus collosum while crossing the midline.Clinical features of Agenesis of corpus callosum:-o Signs and symptoms of agenesis of corpus callosum vary greatly among individuals.o "Patients usually do not have any neurological manifestations".o However, some features common in agenesis of corpus callosum are# Vision impairment# Low muscle tone (hypotonia)# Poor motor coordination# Delay in motor milestones such as sitting and walking.# Low perception of pain# Delayed toilet training# Chewing and swallowing dijficulties# Early speech and language delays# Social difficultieso Other characteristics sometimes associated with callosal disorders are# Seizures# Spasticity# Early feeding difficulties and or gastric reflux# Hearing impairments# Abnormal head and facial features# Mental retardationInvestigationo CT and MRI reveals "Bat wing" deformity of the ventricles.Treatmento There are currently no specific medical treatments for callosal disorders. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which one of the following TCA cycle intermediate may not be added or removed by other metabolic pathways?, with the following options: A: Oxaloacetate, B: Isocitrate, C: Citrate, D: Fumarate ### Response:

Oxaloacetate may be formed from pyruvate during gluconeogenesis. Degradation of tyrosine and phenylalanine may produce fumarate. Citrate is transpoed out of mitochondria to be used as a source of cytoplasmic acetyl CoA. Isocitrate is formed and removed in TCA cycle. Ref: Textbook of Biochemistry for Medical Students by D.M. Vasudevan, 6th Edition, Page: 218

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which one of the following TCA cycle intermediate may not be added or removed by other metabolic pathways?, with the following options: A: Oxaloacetate, B: Isocitrate, C: Citrate, D: Fumarate ### Response: Oxaloacetate may be formed from pyruvate during gluconeogenesis. Degradation of tyrosine and phenylalanine may produce fumarate. Citrate is transpoed out of mitochondria to be used as a source of cytoplasmic acetyl CoA. Isocitrate is formed and removed in TCA cycle. Ref: Textbook of Biochemistry for Medical Students by D.M. Vasudevan, 6th Edition, Page: 218 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 28 years female G2P1 presents to antenatal clinic at 24 weeks for routine check up. USG shows a normal for gestational age fetus at 24 weeks of gestation in frank breech position, with no other abnormalities. What is the most appropriate next step in mgt?, with the following options: A: Glucose challenge test with 50 gm of glucose, B: Culture for Neisseria gonorrhoeae and Chlamydia trachomatis (normally done at initial visit and in certain high-risk GRPs at 32-36 weeks along with GRP B streptococcal screening), C: ECV, D: Immediate LSCS ### Response:

Ans. is a, i.e. Glucose challenge test with 50 gm of glucoseRef. Read belowPoints worthnoting here are:Patient is presenting to antenatal clinic at 24 weeks for routine check up and a coincidental finding on USG is fetus in frank breech position, with no other abnormalities.Now friends at 24 weeks, breech should not worry you as most of the times it spontaneously rotates and becomes cephalic by 32 weeks of pregnancy. Thus options 'c' i.e. ECV and 'd' i.e. immediate LSCS and 'e' i.e. immediate induction and vaginal delivery are ruled out.Culture for Neisseria gonorrhoeae and Chlamydia trachomatis--It is normally done at initial visit and in certain high risk groups at 32-36 weeks along with group B streptococcal screening, so it is also ruled out.24 weeks gestational age is the correct time for screening for gestational diabetes therefore we will do glucose challenge test with 50 gm of glucose.Friends, mentioning about breech presentation was just given to confuse you, actually examiner wants to know whether you know the correct time for different screening tests or not.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 28 years female G2P1 presents to antenatal clinic at 24 weeks for routine check up. USG shows a normal for gestational age fetus at 24 weeks of gestation in frank breech position, with no other abnormalities. What is the most appropriate next step in mgt?, with the following options: A: Glucose challenge test with 50 gm of glucose, B: Culture for Neisseria gonorrhoeae and Chlamydia trachomatis (normally done at initial visit and in certain high-risk GRPs at 32-36 weeks along with GRP B streptococcal screening), C: ECV, D: Immediate LSCS ### Response: Ans. is a, i.e. Glucose challenge test with 50 gm of glucoseRef. Read belowPoints worthnoting here are:Patient is presenting to antenatal clinic at 24 weeks for routine check up and a coincidental finding on USG is fetus in frank breech position, with no other abnormalities.Now friends at 24 weeks, breech should not worry you as most of the times it spontaneously rotates and becomes cephalic by 32 weeks of pregnancy. Thus options 'c' i.e. ECV and 'd' i.e. immediate LSCS and 'e' i.e. immediate induction and vaginal delivery are ruled out.Culture for Neisseria gonorrhoeae and Chlamydia trachomatis--It is normally done at initial visit and in certain high risk groups at 32-36 weeks along with group B streptococcal screening, so it is also ruled out.24 weeks gestational age is the correct time for screening for gestational diabetes therefore we will do glucose challenge test with 50 gm of glucose.Friends, mentioning about breech presentation was just given to confuse you, actually examiner wants to know whether you know the correct time for different screening tests or not. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Krukenberg's spindles are characteristically seen in which of the following condition?, with the following options: A: Chalazion, B: Pigmentary glaucoma, C: Sympathetic opthalmitis, D: Retinitis pigmentosa ### Response:

Krukenberg's spindles refers to deposition of pigment granules on the posterior surface of the cornea. It is seen in pigmentary glaucoma. Pigmentary glaucoma: It is a type of secondary open angle glaucoma wherein clogging up of trabecular meshwork occurs by pigment paicles. Characteristic glaucomatous features are similar to primary open angle glaucoma. It is associated with deposition of pigment granules in the anterior segment structures such as iris, posterior surface of cornea, trabecular meshwork, ciliary zonules and crystalline lens. Gonioscopy shows: Accumulation of pigment along the Schwalbe's line inferiorly (Sampaolesi's line). Iris transillumination shows radial slit like transillumination defects in the mid periphery (Pathognomonic feature).

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Krukenberg's spindles are characteristically seen in which of the following condition?, with the following options: A: Chalazion, B: Pigmentary glaucoma, C: Sympathetic opthalmitis, D: Retinitis pigmentosa ### Response: Krukenberg's spindles refers to deposition of pigment granules on the posterior surface of the cornea. It is seen in pigmentary glaucoma. Pigmentary glaucoma: It is a type of secondary open angle glaucoma wherein clogging up of trabecular meshwork occurs by pigment paicles. Characteristic glaucomatous features are similar to primary open angle glaucoma. It is associated with deposition of pigment granules in the anterior segment structures such as iris, posterior surface of cornea, trabecular meshwork, ciliary zonules and crystalline lens. Gonioscopy shows: Accumulation of pigment along the Schwalbe's line inferiorly (Sampaolesi's line). Iris transillumination shows radial slit like transillumination defects in the mid periphery (Pathognomonic feature). ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The active immunity offered by tetanus toxoid is effective in nearly -, with the following options: A: 25% of the patients, B: 50% of the patients, C: 75 % of the patients, D: 100% of the patients ### Response:

The aim of active immunisation with tetanus toxoid is to vaccinate the entire community and ensure a protective level of antitoxin approximately 0.01 IU/ml serum throughout life Reference; Park&;s Textbook of preventive and social medicine, 24th edition.Pg no. 330

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The active immunity offered by tetanus toxoid is effective in nearly -, with the following options: A: 25% of the patients, B: 50% of the patients, C: 75 % of the patients, D: 100% of the patients ### Response: The aim of active immunisation with tetanus toxoid is to vaccinate the entire community and ensure a protective level of antitoxin approximately 0.01 IU/ml serum throughout life Reference; Park&;s Textbook of preventive and social medicine, 24th edition.Pg no. 330 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 60-year-old male, chronic smoker presented with gross hematuria, pain in the left flank along with significant history of weight loss, fever and shoness of breath for 3 months. O/E, a mass was palpated in the left flank which was firm in consistency and about 5x5 cm in dimensions along with a left sided varicocele was noted. Lab findings revealed anemia along with hypercalcemia. Kidney biopsy was also done. Chest X-ray CECT pelvis All of the following are approved for the above condition except: -, with the following options: A: Sunitinib, B: Pazopanib, C: Temsirolimus, D: Nilotinib ### Response:

Nilotinib is a tyrosine kinase inhibitor given in CML. This is a case of metastatic renal cell carcinoma with cannon ball metastasis in lungs. Chest x-ray shows multiple, bilateral, rounded soft tissue density massessuggestive of cannon ball metastasis in renal cell carcinoma. CT image shows the classical renal cell carcinoma. HPE image is classical of clear cell renal carcinoma. DRUGS APPROVED FOR RENAL CELL CARCINOMA: - Cytokines: - High dose interleukin-2, Interferon-alpha Tyrosine kinase inhibitors: - Sorafenib, Sunitinib, Pazopanib, Axitinib, Carbozantinib, Lenvatinib VEGF ligand antibody: - Bevacizumab mTOR inhibitors: - Temsirolimus, Everolimus PD-1 inhibitor: - Nivolumab

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 60-year-old male, chronic smoker presented with gross hematuria, pain in the left flank along with significant history of weight loss, fever and shoness of breath for 3 months. O/E, a mass was palpated in the left flank which was firm in consistency and about 5x5 cm in dimensions along with a left sided varicocele was noted. Lab findings revealed anemia along with hypercalcemia. Kidney biopsy was also done. Chest X-ray CECT pelvis All of the following are approved for the above condition except: -, with the following options: A: Sunitinib, B: Pazopanib, C: Temsirolimus, D: Nilotinib ### Response: Nilotinib is a tyrosine kinase inhibitor given in CML. This is a case of metastatic renal cell carcinoma with cannon ball metastasis in lungs. Chest x-ray shows multiple, bilateral, rounded soft tissue density massessuggestive of cannon ball metastasis in renal cell carcinoma. CT image shows the classical renal cell carcinoma. HPE image is classical of clear cell renal carcinoma. DRUGS APPROVED FOR RENAL CELL CARCINOMA: - Cytokines: - High dose interleukin-2, Interferon-alpha Tyrosine kinase inhibitors: - Sorafenib, Sunitinib, Pazopanib, Axitinib, Carbozantinib, Lenvatinib VEGF ligand antibody: - Bevacizumab mTOR inhibitors: - Temsirolimus, Everolimus PD-1 inhibitor: - Nivolumab ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Bradycardia in athletes is due to, with the following options: A: Increased vagal tone, B: Increased sympathetic tone, C: Decreased cardiac output, D: Low venous return ### Response:

(A) (increased vagal tone)Persons undergoing long term training develop bradycardia at rest. The resting pulse rates in some top class sportsmen/ atheletes (for example. Zatopek. Borg) are quite low. This bradycardia is believed to be due to excessive tone of the vagi. On the other hand, exercise of some intensity will cause less rise of pulse rate after trainingAthletic pseudonephritis ; prolonged, heavy exercise, increases proteins, cells and other abnormal substance in urine due to1. Decrease in renal blood flow (RBE) produces glomerular capillary hypoxia, and increases permeability to large molecules2. Increase in plasma proteins during exercise3. Decreased rate of RBF, thus larger time is required to filter these moleculerCauses of BradycardiaPhysiologicalPathologicalDrugs* Sleep* Athletes* Hypothermia* Hypothyroidism* Heart attack* CHD* Degenerative process of aging* Obstructive jaundice* Increased intracranial pressure* Beta blockers* Channel blocker* Digitalis and antiarrhythmic drugs.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Bradycardia in athletes is due to, with the following options: A: Increased vagal tone, B: Increased sympathetic tone, C: Decreased cardiac output, D: Low venous return ### Response: (A) (increased vagal tone)Persons undergoing long term training develop bradycardia at rest. The resting pulse rates in some top class sportsmen/ atheletes (for example. Zatopek. Borg) are quite low. This bradycardia is believed to be due to excessive tone of the vagi. On the other hand, exercise of some intensity will cause less rise of pulse rate after trainingAthletic pseudonephritis ; prolonged, heavy exercise, increases proteins, cells and other abnormal substance in urine due to1. Decrease in renal blood flow (RBE) produces glomerular capillary hypoxia, and increases permeability to large molecules2. Increase in plasma proteins during exercise3. Decreased rate of RBF, thus larger time is required to filter these moleculerCauses of BradycardiaPhysiologicalPathologicalDrugs* Sleep* Athletes* Hypothermia* Hypothyroidism* Heart attack* CHD* Degenerative process of aging* Obstructive jaundice* Increased intracranial pressure* Beta blockers* Channel blocker* Digitalis and antiarrhythmic drugs. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 69-yrs-old man with a 60 pack-year history for smoking presents with dizziness and visual disturbances. Physical examination reveals a purplish discoloration of his face, arms, and neck; retinal vein engorgement; and visible distention of his neck veins. His complete blood count reveals a normocytic anemia. The pathophysiology of this patient's clinical presentation most likely involves, with the following options: A: Right hea failure secondary to left hea failure, B: Obstruction of the superior vena cava by a primary tumor arising in the lungs, C: Metastatic disease to the cervical lymph nodes with compression of the jugular veins, D: Polycythemia rubra vera ### Response:

The patient has the superior vena caval syndrome (SVCS). Malignancy accounts for 80% to 90% of cases of SVCS. Most cases are caused by a primary lung cancer extending into the neck and obstructing the superior vena cava. Clinically, patients have a puffy face with a blue to purple discoloration of the face, arms, and shoulders. Retinal vein engorgement results from increased venous pressure. Central nervous system findings include dizziness, convulsions, and visual disturbances. Increased venous pressure is noted in the upper extremities. The diagnosis is confirmed by venography, and the prognosis is poor.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 69-yrs-old man with a 60 pack-year history for smoking presents with dizziness and visual disturbances. Physical examination reveals a purplish discoloration of his face, arms, and neck; retinal vein engorgement; and visible distention of his neck veins. His complete blood count reveals a normocytic anemia. The pathophysiology of this patient's clinical presentation most likely involves, with the following options: A: Right hea failure secondary to left hea failure, B: Obstruction of the superior vena cava by a primary tumor arising in the lungs, C: Metastatic disease to the cervical lymph nodes with compression of the jugular veins, D: Polycythemia rubra vera ### Response: The patient has the superior vena caval syndrome (SVCS). Malignancy accounts for 80% to 90% of cases of SVCS. Most cases are caused by a primary lung cancer extending into the neck and obstructing the superior vena cava. Clinically, patients have a puffy face with a blue to purple discoloration of the face, arms, and shoulders. Retinal vein engorgement results from increased venous pressure. Central nervous system findings include dizziness, convulsions, and visual disturbances. Increased venous pressure is noted in the upper extremities. The diagnosis is confirmed by venography, and the prognosis is poor. ### 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 statements about Fluconazole is most accurate, with the following options: A: It is it effective in the treatment of Aspergillosis, B: It does not penetrate the blood brain barrier, C: It's oral bioavailability is less than that of ketoconazole, D: It inhibits demethylation of lanosterol ### Response:

Ref-KDT 6/e p761 Azoles act by inhibiting the enzyme lanosterol-14-alpha-demethvlase.resulting in reduced ergosterol synthesis. It has very good CNS penetration and oral bioavailability. It is not very effective against aspergillosis (voriconazole is thedrug of choice).

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 statements about Fluconazole is most accurate, with the following options: A: It is it effective in the treatment of Aspergillosis, B: It does not penetrate the blood brain barrier, C: It's oral bioavailability is less than that of ketoconazole, D: It inhibits demethylation of lanosterol ### Response: Ref-KDT 6/e p761 Azoles act by inhibiting the enzyme lanosterol-14-alpha-demethvlase.resulting in reduced ergosterol synthesis. It has very good CNS penetration and oral bioavailability. It is not very effective against aspergillosis (voriconazole is thedrug of choice). ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Baby presents with froth in mouth after 3 days of birth, coughing on feeding:, with the following options: A: TE fistula, B: Choanal atresia, C: Cleft palate, D: Diaphragmatic hernia ### Response:

Ans. A. TE fistula Ref: Nelson Textbook of Pediatrics 20th/ed pl783ExplanationConditionPresentationTE fistulaMaternal polyhydramnois and single umbilical artery Excessive drooling soon after birth with frothing. Choking and cyanosis on feedingChoanal atresiaCyanosis which improves on cryingCleft palateMorphological defect presentDiaphragmatic herniaScaphoid abdomen, respiratory distress

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Baby presents with froth in mouth after 3 days of birth, coughing on feeding:, with the following options: A: TE fistula, B: Choanal atresia, C: Cleft palate, D: Diaphragmatic hernia ### Response: Ans. A. TE fistula Ref: Nelson Textbook of Pediatrics 20th/ed pl783ExplanationConditionPresentationTE fistulaMaternal polyhydramnois and single umbilical artery Excessive drooling soon after birth with frothing. Choking and cyanosis on feedingChoanal atresiaCyanosis which improves on cryingCleft palateMorphological defect presentDiaphragmatic herniaScaphoid abdomen, respiratory distress ### 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 hepatitis E virus is:, with the following options: A: Seen in Post transfusion cases, B: Associated with increased moality in pregnant female, C: Associated with hepatitis B virus, D: All ### Response:

Answer is B (Associated with increased moality in pregnant women) Hepatitis E is associated with increased moality in pregnant women and is acquired by fecooral route. Hepatitis E is not associated with transfusion with Hepatitis B virus infection. Most common virus associated with transfusion associated hepatitis is HCV Hepatitis E is associated with increased moality in pregnant females A unique feature of Hepatitis E virus is the clinical severity and high case fatality rate of 20-40% in pregnant women, especially in the last trimester of pregnancy. Hepatitis D is associated with Hepatitis B infection and not Hepatitis E

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True regarding hepatitis E virus is:, with the following options: A: Seen in Post transfusion cases, B: Associated with increased moality in pregnant female, C: Associated with hepatitis B virus, D: All ### Response: Answer is B (Associated with increased moality in pregnant women) Hepatitis E is associated with increased moality in pregnant women and is acquired by fecooral route. Hepatitis E is not associated with transfusion with Hepatitis B virus infection. Most common virus associated with transfusion associated hepatitis is HCV Hepatitis E is associated with increased moality in pregnant females A unique feature of Hepatitis E virus is the clinical severity and high case fatality rate of 20-40% in pregnant women, especially in the last trimester of pregnancy. Hepatitis D is associated with Hepatitis B infection and not Hepatitis E ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about oculocardiac reflex -, with the following options: A: Increase heart rate with eye movement, B: Decrease heart rate with eye movement, C: Increase heart rate by traction on medial rectus, D: Decrease heart rate by traction on medial rectus ### Response:

Ans. is 'd' i.e., Decrease heart rate by traction on medial rectus Oculocardiac reflexo Traction on the extraocular muscles or pressure on globe (eye ball) causes bradycardia, AV block, ventricular ectopy or asystole. It is especially seen with traction on the medial rectus, but can occur with stimulation of any of the orbital contents, including the periosteumo The reflex is trigeminovagal, i.e., afferent is via trigeminal and efferent is via vagal pathwayo The oculocardiac reflex is most common in pediatric patients undergoing strabismus surgery. Nonetheless, it can be evoked in all age groups and during a variety of ocular procedures including cataract extraction, enucleation, and retinal detachment repair.o Anticholinergic drugs (atropine, glycopyrrolate) is often helpful in preventing oculocardiac reflex.o Management of oculocardiac reflex includes cessation of surgical stimulus; adequate ventilation, oxygenation & anesthesia; intravenous atropine; infiltration of rectus muscles with local anesthetic.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about oculocardiac reflex -, with the following options: A: Increase heart rate with eye movement, B: Decrease heart rate with eye movement, C: Increase heart rate by traction on medial rectus, D: Decrease heart rate by traction on medial rectus ### Response: Ans. is 'd' i.e., Decrease heart rate by traction on medial rectus Oculocardiac reflexo Traction on the extraocular muscles or pressure on globe (eye ball) causes bradycardia, AV block, ventricular ectopy or asystole. It is especially seen with traction on the medial rectus, but can occur with stimulation of any of the orbital contents, including the periosteumo The reflex is trigeminovagal, i.e., afferent is via trigeminal and efferent is via vagal pathwayo The oculocardiac reflex is most common in pediatric patients undergoing strabismus surgery. Nonetheless, it can be evoked in all age groups and during a variety of ocular procedures including cataract extraction, enucleation, and retinal detachment repair.o Anticholinergic drugs (atropine, glycopyrrolate) is often helpful in preventing oculocardiac reflex.o Management of oculocardiac reflex includes cessation of surgical stimulus; adequate ventilation, oxygenation & anesthesia; intravenous atropine; infiltration of rectus muscles with local anesthetic. ### 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 bacteria contains mycolic acid in the cell wall, with the following options: A: Escherichia, B: Mycoplasma, C: Mycobacteria, D: Staphylococcus ### Response:

Mycobacterium are slender rods that sometimes show branching, filamentous forms resembling fungal mycelium. In liquid cultures, they form a mould like a pellicle. they do not stain readily, but once stained, resist decolourisation with dilute mineral acids, due to the presence of mycolic acid in their cell wall. They are called acid-fast bacilli. Mycobacterium are slow-growing, aerobic, non-motile, non-capsulated and non-sporing. Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th edition; Pg;351

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 bacteria contains mycolic acid in the cell wall, with the following options: A: Escherichia, B: Mycoplasma, C: Mycobacteria, D: Staphylococcus ### Response: Mycobacterium are slender rods that sometimes show branching, filamentous forms resembling fungal mycelium. In liquid cultures, they form a mould like a pellicle. they do not stain readily, but once stained, resist decolourisation with dilute mineral acids, due to the presence of mycolic acid in their cell wall. They are called acid-fast bacilli. Mycobacterium are slow-growing, aerobic, non-motile, non-capsulated and non-sporing. Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th edition; Pg;351 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Neuroblastomas - good prognositc factor is, with the following options: A: N-myc amplification, B: RAS oncogene, C: Hyperdiploidy, D: Translocations ### Response:

Ref : Sabiston 20th edition Pgno : 1887-1888 Neuroblastoma prognostic factors Favorable prognosis Unourable Prognosis Age <1 year Thoracic primary lesion Shimada index showing well differentiated stromal rich tumor Increased ratio of VMA/HVA Normal serum ferritin Hyperdiploid or near triploid High level of expression of Trk-A gene N-myc amplification (>10) Deletion of 1p(most characteristic cytogenetics abnormality) and gain of 17q Expression of multidrug resistance protein Over expression of telomerase Increased serum ferritin Diploid Older patients of stages III and IV

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Neuroblastomas - good prognositc factor is, with the following options: A: N-myc amplification, B: RAS oncogene, C: Hyperdiploidy, D: Translocations ### Response: Ref : Sabiston 20th edition Pgno : 1887-1888 Neuroblastoma prognostic factors Favorable prognosis Unourable Prognosis Age <1 year Thoracic primary lesion Shimada index showing well differentiated stromal rich tumor Increased ratio of VMA/HVA Normal serum ferritin Hyperdiploid or near triploid High level of expression of Trk-A gene N-myc amplification (>10) Deletion of 1p(most characteristic cytogenetics abnormality) and gain of 17q Expression of multidrug resistance protein Over expression of telomerase Increased serum ferritin Diploid Older patients of stages III and IV ### 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 presents with fever, uicaria, itching and swelling followed by injection of Penicillin. It is due to, with the following options: A: IgG Hypersensitivity, B: IgE Hypersensitivity, C: Delayed Hypersensitivity, D: Immune complex Hypersensitivity ### Response:

There are two clinical pictures that can result from penicillin allergy, namely acute (Type I) and sub-acute reactions (Type II) mediated by IgE and IgG antibodies respectively. The acute allergic reaction arises immediately or rapidly within minutes to an hour or two and includes sudden anaphylaxis with hypotension, bronchospasm, angioedema and uicaria. Acute reactions result from reaction with preformed IgE to penicillin as a result of previous exposure. A less dramatic picture may occur 7 to 10 days after penicillin treatment stas or 1-2 days after repeat therapy. In this setting, the picture is sub-acute and can include uicaria, fever and ahralgias or ahritis. The sub-acute reaction is caused by preformed IgG to penicillin as a result of previous penicillin treatment. The IgG antibody results in the activation of the complement reactions producing inflammation resulting in the symptoms. Ref : Ananthanarayana textbook of Microbiology 9th edition Pgno : 166,167

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A patient presents with fever, uicaria, itching and swelling followed by injection of Penicillin. It is due to, with the following options: A: IgG Hypersensitivity, B: IgE Hypersensitivity, C: Delayed Hypersensitivity, D: Immune complex Hypersensitivity ### Response: There are two clinical pictures that can result from penicillin allergy, namely acute (Type I) and sub-acute reactions (Type II) mediated by IgE and IgG antibodies respectively. The acute allergic reaction arises immediately or rapidly within minutes to an hour or two and includes sudden anaphylaxis with hypotension, bronchospasm, angioedema and uicaria. Acute reactions result from reaction with preformed IgE to penicillin as a result of previous exposure. A less dramatic picture may occur 7 to 10 days after penicillin treatment stas or 1-2 days after repeat therapy. In this setting, the picture is sub-acute and can include uicaria, fever and ahralgias or ahritis. The sub-acute reaction is caused by preformed IgG to penicillin as a result of previous penicillin treatment. The IgG antibody results in the activation of the complement reactions producing inflammation resulting in the symptoms. Ref : Ananthanarayana textbook of Microbiology 9th edition Pgno : 166,167 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which is not a feature of Kallman syndrome?, with the following options: A: Micropenis, B: Primary amenorrhea, C: Mirror movements of hands, D: Mental retardation ### Response:

Kallman Syndrome occurs due to defective synthesis of GnRH (Gonadotropin releasing hormone). KAL gene is X linked. During fetal life, the GnRH neurons originate in Olfactory Placode and then migrate along fetal olfactory neuron. They eventually wend their way to the hypothalamus. Presenting features Associated with Males: delayed pubey and micro-penis. Females: Primary amenorrhea and failure of development of secondary sexual characteristics Anosmia Colour blindness, optic atrophy SN deafness Mirror movements of hands (synkinesia) Cleft palate Renal abnormalities Mirror movements

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which is not a feature of Kallman syndrome?, with the following options: A: Micropenis, B: Primary amenorrhea, C: Mirror movements of hands, D: Mental retardation ### Response: Kallman Syndrome occurs due to defective synthesis of GnRH (Gonadotropin releasing hormone). KAL gene is X linked. During fetal life, the GnRH neurons originate in Olfactory Placode and then migrate along fetal olfactory neuron. They eventually wend their way to the hypothalamus. Presenting features Associated with Males: delayed pubey and micro-penis. Females: Primary amenorrhea and failure of development of secondary sexual characteristics Anosmia Colour blindness, optic atrophy SN deafness Mirror movements of hands (synkinesia) Cleft palate Renal abnormalities Mirror movements ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Consider the following health hazards. Which of the associated with enviromental lead exposure?, with the following options: A: Lowering of IQ in children \/ Lowering of systolic blood pressure \/ Reduced RBC survival and reduced heme biosynthesis & Higher rates of miscarriages, stillbihs and preterm deliveries, B: Lowering of IQ in children & Lowering of systolic blood pressure, C: Lowering of IQ in children \/ Reduced RBC survival and reduced heme biosynthesis & Higher rates of miscarriages, stillbihs and preterm deliveries, D: Lowering of IQ in children \/ Lowering of systolic blood pressure & Reduced RBC survival and reduced heme biosynthesis ### Response:

parks textbook of preventive and social medicine 23rd edition. *lead poisons many systems in the body and it is paicularly damage to children devoloping brain and nervous system elevated lead levels in children is associated with impaired neuropsychologic devolopment as measued by loss of IQ,poor scholl preformance and behavioural difficulties.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Consider the following health hazards. Which of the associated with enviromental lead exposure?, with the following options: A: Lowering of IQ in children \/ Lowering of systolic blood pressure \/ Reduced RBC survival and reduced heme biosynthesis & Higher rates of miscarriages, stillbihs and preterm deliveries, B: Lowering of IQ in children & Lowering of systolic blood pressure, C: Lowering of IQ in children \/ Reduced RBC survival and reduced heme biosynthesis & Higher rates of miscarriages, stillbihs and preterm deliveries, D: Lowering of IQ in children \/ Lowering of systolic blood pressure & Reduced RBC survival and reduced heme biosynthesis ### Response: parks textbook of preventive and social medicine 23rd edition. *lead poisons many systems in the body and it is paicularly damage to children devoloping brain and nervous system elevated lead levels in children is associated with impaired neuropsychologic devolopment as measued by loss of IQ,poor scholl preformance and behavioural difficulties. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Hysteria is characterised by, with the following options: A: Indifference to suffering, B: Flight of ideas, C: Pressure of speech, D: Autistic thinking ### Response:

(A) Indifference to suffering # The characteristics of HYSTERIA are :> Impulsive, uncontrolled behavior (impulse dyscontrol).> Manipulative, exhibitionistic, emotional, dramatic, and/or seductive behavior (histrionic personality traits).> Absence of objective signs of organic illness.> Presence of multiple vague somatic symptoms, especially in a female patient (masked depression, somatization disorder or Briquet's hysteria).> Hypochondriasis; Any mental illness.> Presence of certain symptoms which are not explainable in the context of present organic illness (functional overlay, conversion symptoms).> Difficult patient; poor doctor-patient communication.> 'Sick' role or 'abnormal illness behavior'.; Psychosomatic disorders.; Malingering. ; Psychosexual dysfunctions.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Hysteria is characterised by, with the following options: A: Indifference to suffering, B: Flight of ideas, C: Pressure of speech, D: Autistic thinking ### Response: (A) Indifference to suffering # The characteristics of HYSTERIA are :> Impulsive, uncontrolled behavior (impulse dyscontrol).> Manipulative, exhibitionistic, emotional, dramatic, and/or seductive behavior (histrionic personality traits).> Absence of objective signs of organic illness.> Presence of multiple vague somatic symptoms, especially in a female patient (masked depression, somatization disorder or Briquet's hysteria).> Hypochondriasis; Any mental illness.> Presence of certain symptoms which are not explainable in the context of present organic illness (functional overlay, conversion symptoms).> Difficult patient; poor doctor-patient communication.> 'Sick' role or 'abnormal illness behavior'.; Psychosomatic disorders.; Malingering. ; Psychosexual dysfunctions. ### 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 true Fanconi's anaemia except, with the following options: A: Defect in DNA repair, B: Bone marrow hyperplasia, C: Congenital anomaly present, D: Increased chances of cancer ### Response:

Ref Robbins 8/e p1090; 9/e p630 Fanconi anemia (FA) is an autosomal recessive disease characterized by congenital anomalies, bone marrow failure, and leukemia susceptibility. FA cells show chromosome instability and hypersensitivity to DNA cross-linking agents such as mitomycin C. Recent studies indicate that there are at least 8 genetically distinct FA groups (A, B, C, D1, D2, E, F, G). To date, 6 genes (for A, C, D2, E, F, and G) have been cloned. In this review, we describe the structures and functions of FA proteins. Increasing evidence indicates that the multiple FA proteins cooperate in a biochemical pathway and/or a multimer complex. FANCD2, a downstream component of the FA pathway, has recently been shown to be ubiquitinated in response to DNA damage and to translocate to nuclear foci containing BRCA1, a breast cancer susceptibility gene product, suggesting a role for this protein in DNA repair functions. We also describe 2 emerging issues: genotype-phenotype relationships and mosaicism. The FA pathway is likely to play a critical role as a caretaker of genomic integrity in hematopoietic stem cells. Clarifying the molecular basis of this disease may provide new insights into the pathogenesis of bone marrow failure syndromes and myeloid malignancies.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are true Fanconi's anaemia except, with the following options: A: Defect in DNA repair, B: Bone marrow hyperplasia, C: Congenital anomaly present, D: Increased chances of cancer ### Response: Ref Robbins 8/e p1090; 9/e p630 Fanconi anemia (FA) is an autosomal recessive disease characterized by congenital anomalies, bone marrow failure, and leukemia susceptibility. FA cells show chromosome instability and hypersensitivity to DNA cross-linking agents such as mitomycin C. Recent studies indicate that there are at least 8 genetically distinct FA groups (A, B, C, D1, D2, E, F, G). To date, 6 genes (for A, C, D2, E, F, and G) have been cloned. In this review, we describe the structures and functions of FA proteins. Increasing evidence indicates that the multiple FA proteins cooperate in a biochemical pathway and/or a multimer complex. FANCD2, a downstream component of the FA pathway, has recently been shown to be ubiquitinated in response to DNA damage and to translocate to nuclear foci containing BRCA1, a breast cancer susceptibility gene product, suggesting a role for this protein in DNA repair functions. We also describe 2 emerging issues: genotype-phenotype relationships and mosaicism. The FA pathway is likely to play a critical role as a caretaker of genomic integrity in hematopoietic stem cells. Clarifying the molecular basis of this disease may provide new insights into the pathogenesis of bone marrow failure syndromes and myeloid malignancies. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Theophylline therapeutic blood ranges, with the following options: A: 0-5, B: 10-May, C: 15-May, D: 20-May ### Response:

(5-20) (221-KDT6th)* Therapeutic ranges 5-20 as shown in above figure* Theophylline has a narrow margin of safety. Dose dependent toxicity starts from upper part of therapeutic concentration

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Theophylline therapeutic blood ranges, with the following options: A: 0-5, B: 10-May, C: 15-May, D: 20-May ### Response: (5-20) (221-KDT6th)* Therapeutic ranges 5-20 as shown in above figure* Theophylline has a narrow margin of safety. Dose dependent toxicity starts from upper part of therapeutic concentration ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Common cause of acute osteomyelitis is DLETE, with the following options: A: Trauma, B: Surgery, C: Fungal infection, D: Hematogenous spread ### Response:

Hematogenous osteomyelitis is the commonest form of osteomyelitis and most common source if bone and joint infection is Hematogenous Refer Maheshwari 6th/e 168

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Common cause of acute osteomyelitis is DLETE, with the following options: A: Trauma, B: Surgery, C: Fungal infection, D: Hematogenous spread ### Response: Hematogenous osteomyelitis is the commonest form of osteomyelitis and most common source if bone and joint infection is Hematogenous Refer Maheshwari 6th/e 168 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The patient with the following show the maximum deposits of lipofuscin in -, with the following options: A: Gaucher's disease, B: Tay sach's disease, C: Acute Enteric fever, D: Severe malnutrition ### Response:

Ans. is 'd' i.e., Severe malnutrition

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The patient with the following show the maximum deposits of lipofuscin in -, with the following options: A: Gaucher's disease, B: Tay sach's disease, C: Acute Enteric fever, D: Severe malnutrition ### Response: Ans. is 'd' i.e., Severe malnutrition ### 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 true about 1st pa of duodenum, except ?, with the following options: A: 5 cm long, B: Is superior pa, C: Develops from foregut, D: Supplied by superior mesenteric aery ### Response:

Ans. is 'd' i.e., Supplied by superior mesenteric aeryDuodenum Duodenum is 'C' shaped, shoest, widest and most fixed pa of small intestine. It is 25 cm long. It is devoid of mesentery. Most of the duodenum is retroperitoneal and fixed, except at its two ends where it is suspended by folds of peritoneum, and is therefore mobile. Duodenum lies opposite Ll, L2 and L3 veebrae.Duodenum is C-shaped curve which encloses the head of pancreas and is subdivided into four pas :1. First pa (Superior pa) : It is 5 cm (2 inches) long. It begins at the pylorus and meet the second pa at superior duodenal flexure. This pa appears as duodenal cap on barium studies.2. Second pa (Descending pa) : It is about 7.5 cm (3 inches) long. It is veical pa which begins at superior duodenal flexure and meet the third pa at inferior duodenal flexure. The interior of second pa of duodenum shows following features :i) Major duodenal papilla : It is present 8-10 cm distal to the pylorus. The hepatopancreatic ampulla or ampulla of Vater (joint pa of bile duct and pancreatic duct) opens here.ii) Minor duodenal papilla : It is present 6-8 cm distal to the pylorus. Accessory pancreatic duct opens here.3. Third pa (Horizonal pa) : It is 10 cm (4 inches) long. It begins at inferior duodenal flexure and passes towards the left in front of IVC behind superior mesenteric vessels and root of mesentery to meet 4th pa of duodenum.Fouh pa : It is 2-5 cm (1 inches) long and runs upward immediately to the left of aoa. It ends at duodenojejunal flexure by joining the jejunum.Aerial supplyThe pa of duodenum before the opening of bile duct (major duodenal papilla) develops from foregut and therefore is supplied by coeliac trunk through superior pancreaticoduodenal aery, a branch of gastroduodenal aery, which in trun is a branch of common hepatic aery. Pa of duodenum distal to opening of bile duct is developed from midgut and therefore is supplied by superior mesenteric aery through inferior pancreaticoduodenal aery. First pa of duodenum receives additional supply from right gastric aery, supraduodenal aery (a branch of common hapatic aery), retroduodenal branch of gastrodudenal aery and right gastropiploic aery.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are true about 1st pa of duodenum, except ?, with the following options: A: 5 cm long, B: Is superior pa, C: Develops from foregut, D: Supplied by superior mesenteric aery ### Response: Ans. is 'd' i.e., Supplied by superior mesenteric aeryDuodenum Duodenum is 'C' shaped, shoest, widest and most fixed pa of small intestine. It is 25 cm long. It is devoid of mesentery. Most of the duodenum is retroperitoneal and fixed, except at its two ends where it is suspended by folds of peritoneum, and is therefore mobile. Duodenum lies opposite Ll, L2 and L3 veebrae.Duodenum is C-shaped curve which encloses the head of pancreas and is subdivided into four pas :1. First pa (Superior pa) : It is 5 cm (2 inches) long. It begins at the pylorus and meet the second pa at superior duodenal flexure. This pa appears as duodenal cap on barium studies.2. Second pa (Descending pa) : It is about 7.5 cm (3 inches) long. It is veical pa which begins at superior duodenal flexure and meet the third pa at inferior duodenal flexure. The interior of second pa of duodenum shows following features :i) Major duodenal papilla : It is present 8-10 cm distal to the pylorus. The hepatopancreatic ampulla or ampulla of Vater (joint pa of bile duct and pancreatic duct) opens here.ii) Minor duodenal papilla : It is present 6-8 cm distal to the pylorus. Accessory pancreatic duct opens here.3. Third pa (Horizonal pa) : It is 10 cm (4 inches) long. It begins at inferior duodenal flexure and passes towards the left in front of IVC behind superior mesenteric vessels and root of mesentery to meet 4th pa of duodenum.Fouh pa : It is 2-5 cm (1 inches) long and runs upward immediately to the left of aoa. It ends at duodenojejunal flexure by joining the jejunum.Aerial supplyThe pa of duodenum before the opening of bile duct (major duodenal papilla) develops from foregut and therefore is supplied by coeliac trunk through superior pancreaticoduodenal aery, a branch of gastroduodenal aery, which in trun is a branch of common hepatic aery. Pa of duodenum distal to opening of bile duct is developed from midgut and therefore is supplied by superior mesenteric aery through inferior pancreaticoduodenal aery. First pa of duodenum receives additional supply from right gastric aery, supraduodenal aery (a branch of common hapatic aery), retroduodenal branch of gastrodudenal aery and right gastropiploic aery. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Unsegmented eggs are seen in which of the following, with the following options: A: Trichuris trichura, B: Necator americanus, C: Ankylostoma, D: Dracunculus ### Response:

Manner of egg layingOrganismsOviparous Unsegmented eggsAscaris lumbricoides , Trichuris trichiuraSegmented eggsAncylostoma duodenale, Necator americanusEgg containing larvaEnterobius vermicularisViviparous Dracunculus medinensis, Trichinella spiralis , Brugia spp, Wuchereria bancrofti , OvoviviparousStrongyloides stercoralis(Ref: K.D Chatterjee 13th edition, p205-206)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Unsegmented eggs are seen in which of the following, with the following options: A: Trichuris trichura, B: Necator americanus, C: Ankylostoma, D: Dracunculus ### Response: Manner of egg layingOrganismsOviparous Unsegmented eggsAscaris lumbricoides , Trichuris trichiuraSegmented eggsAncylostoma duodenale, Necator americanusEgg containing larvaEnterobius vermicularisViviparous Dracunculus medinensis, Trichinella spiralis , Brugia spp, Wuchereria bancrofti , OvoviviparousStrongyloides stercoralis(Ref: K.D Chatterjee 13th edition, p205-206) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Actinomycetoma is caused by-, with the following options: A: Actinomyces, B: Nocardias, C: Streptomyces, D: All ### Response:

Ans. is 'a' i.e., Actinomyces; 'b' i.e., Nocardia; 'c' i.e., Streptomyces

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Actinomycetoma is caused by-, with the following options: A: Actinomyces, B: Nocardias, C: Streptomyces, D: All ### Response: Ans. is 'a' i.e., Actinomyces; 'b' i.e., Nocardia; 'c' i.e., Streptomyces ### 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 primarily restrictive operations for morbid obesity, except:, with the following options: A: Veical band gastroplasty, B: Duodenal switch operation, C: Roux-en-Y gastric bypass, D: Laparoscopic adjustable gastric banding ### Response:

Types of Bariatric Surgeries: Bariatric operation Mechanism of action Veical banded gastroplasty Laparoscopic adjustable gastric banding (Safest & reversible) Restrictive Roux-en-Y gastric bypass (RYGB): MC performed procedure now-a-days Largely Biliopancreatic diversion- Duodenal switch Largely Malabsorptive/Mildly Restrictive

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 primarily restrictive operations for morbid obesity, except:, with the following options: A: Veical band gastroplasty, B: Duodenal switch operation, C: Roux-en-Y gastric bypass, D: Laparoscopic adjustable gastric banding ### Response: Types of Bariatric Surgeries: Bariatric operation Mechanism of action Veical banded gastroplasty Laparoscopic adjustable gastric banding (Safest & reversible) Restrictive Roux-en-Y gastric bypass (RYGB): MC performed procedure now-a-days Largely Biliopancreatic diversion- Duodenal switch Largely Malabsorptive/Mildly Restrictive ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Tripod fracture is -, with the following options: A: Displaced fracture of calcaneum, B: Zygomatiomaxillary fracture, C: Sphenoid Wing Fracture, D: Coronal Shear pilon Fracture ### Response:

Ans. is 'b' i.e., Zygomatiomaxillary fracture o Zygomaticomaxillary complex (ZMC) fractures, also known as a tripod, tetrapod, quadripod, malar or trimalar fractures, are seen in the setting of traumatic injury to the face. They comprise fractures of the:# Zygomatic arch# Inferior orbital rim, and anterior and posterior maxillary sinus walls# Lateral orbital rim

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Tripod fracture is -, with the following options: A: Displaced fracture of calcaneum, B: Zygomatiomaxillary fracture, C: Sphenoid Wing Fracture, D: Coronal Shear pilon Fracture ### Response: Ans. is 'b' i.e., Zygomatiomaxillary fracture o Zygomaticomaxillary complex (ZMC) fractures, also known as a tripod, tetrapod, quadripod, malar or trimalar fractures, are seen in the setting of traumatic injury to the face. They comprise fractures of the:# Zygomatic arch# Inferior orbital rim, and anterior and posterior maxillary sinus walls# Lateral orbital rim ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Quinsy is -, with the following options: A: Peritonsillar abscess, B: Retropharyngeal abscess, C: Parapharyngeal abscess, D: None ### Response:

Ans. is 'a' i.e., Peritonsillar abscess Peritonsillar abscess (Quinsy)o Quinsy consists of suppuration outside the capsule in the area around the capsule. There is collection of pus between the capsule of tonsil and the superior constrictor muscle, i.e. in the peritonsillar area. Peritonsillar abscess is a complication of tonsillitis and is most commonly caused by group A beta - hemolytic streptococcus.Clinical features of Quinsyo Clinical features are divided intoGeneral: They are due to septicaemia and resemble any acute infection. They include fever (up to 104degF), chills and rigors, general malaise, body aches, headache, nausea and constipation.Local:Severe pain in throat. Usually unilateral.Odynophagia. It is so marked that the patient cannot even swallow his own saliva which dribbles from the angle of his mouth. Patient is usually dehydrated.Muffled and thick speech, often called "Hot potato voice".Foul breath due to sepsis in the oral cavity and poor hygiene.Ipsilateral earache. This is referred pain via CN IX which supplies both the tonsil and the ear.Trismus due to spasm of pterygoid muscles which are in close proximity to the superior constrictor.Examination findingsThe tonsil, pillars and soft palate on the involved side are congested and swollen. Tonsil itself may not appear enlarged as it gets buried in the oedematous pillars.Uvula is swollen and oedematous and pushed to the opposite side.Bulging of the soft palate and anterior pillar above the tonsil.Mucopus may be seen covering the tonsillar region.Cervical lymphadenopathy is commonly seen. This involves jugulodigastric lymph nodes.Torticollis : Patient keeps the neck tilted to the side of abscess.Treatment of peritonsillar abscesso IV fluidso Antibiotics : High dose penicllin. (iv benzipenicillin) is the DOC. In patients allergic to penicillin erythromycin is the DOC.o Incision and drainage per orally, if the abscess does not resolve depite high dose of iv antibioticso Tonsillectomy is done 6 weeks following an attack of quinsy (interval tonsillectomy)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Quinsy is -, with the following options: A: Peritonsillar abscess, B: Retropharyngeal abscess, C: Parapharyngeal abscess, D: None ### Response: Ans. is 'a' i.e., Peritonsillar abscess Peritonsillar abscess (Quinsy)o Quinsy consists of suppuration outside the capsule in the area around the capsule. There is collection of pus between the capsule of tonsil and the superior constrictor muscle, i.e. in the peritonsillar area. Peritonsillar abscess is a complication of tonsillitis and is most commonly caused by group A beta - hemolytic streptococcus.Clinical features of Quinsyo Clinical features are divided intoGeneral: They are due to septicaemia and resemble any acute infection. They include fever (up to 104degF), chills and rigors, general malaise, body aches, headache, nausea and constipation.Local:Severe pain in throat. Usually unilateral.Odynophagia. It is so marked that the patient cannot even swallow his own saliva which dribbles from the angle of his mouth. Patient is usually dehydrated.Muffled and thick speech, often called "Hot potato voice".Foul breath due to sepsis in the oral cavity and poor hygiene.Ipsilateral earache. This is referred pain via CN IX which supplies both the tonsil and the ear.Trismus due to spasm of pterygoid muscles which are in close proximity to the superior constrictor.Examination findingsThe tonsil, pillars and soft palate on the involved side are congested and swollen. Tonsil itself may not appear enlarged as it gets buried in the oedematous pillars.Uvula is swollen and oedematous and pushed to the opposite side.Bulging of the soft palate and anterior pillar above the tonsil.Mucopus may be seen covering the tonsillar region.Cervical lymphadenopathy is commonly seen. This involves jugulodigastric lymph nodes.Torticollis : Patient keeps the neck tilted to the side of abscess.Treatment of peritonsillar abscesso IV fluidso Antibiotics : High dose penicllin. (iv benzipenicillin) is the DOC. In patients allergic to penicillin erythromycin is the DOC.o Incision and drainage per orally, if the abscess does not resolve depite high dose of iv antibioticso Tonsillectomy is done 6 weeks following an attack of quinsy (interval tonsillectomy) ### 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 prominence is unpaired:, with the following options: A: Frontonasal, B: Maxillary, C: Mandibular, D: None of the above ### Response:

The frontonasal prominence is a single unpaired structure; the other prominences are paired. Ref: Langman's embryology 11th edition Chapter 16.

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 prominence is unpaired:, with the following options: A: Frontonasal, B: Maxillary, C: Mandibular, D: None of the above ### Response: The frontonasal prominence is a single unpaired structure; the other prominences are paired. Ref: Langman's embryology 11th edition Chapter 16. ### 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 enzymes are involved in oxidation-reduction reactions, except:, with the following options: A: Dehydrogenases, B: Hydrolases, C: Oxygenases, D: Peroxidases ### Response:

Hydrolases does not belong to oxidoreductase family. Oxidoreductases are enzymes which catalyse the transfer of electrons from one molecule (reductant) to another molecule (oxidant). It plays a major role in biodegradation pathways. Enzymes present in oxidoreductase family are oxygenase, reductase, dehydrogenase and peroxidase. Ref: Microorganisms in Environmental Management: Microbes and Environment By T. Satyanarayana, Bhavdish Narain Johri, Anil Prakash, Page 233; Biochemical Engineering By Gummadi, Page 89

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 enzymes are involved in oxidation-reduction reactions, except:, with the following options: A: Dehydrogenases, B: Hydrolases, C: Oxygenases, D: Peroxidases ### Response: Hydrolases does not belong to oxidoreductase family. Oxidoreductases are enzymes which catalyse the transfer of electrons from one molecule (reductant) to another molecule (oxidant). It plays a major role in biodegradation pathways. Enzymes present in oxidoreductase family are oxygenase, reductase, dehydrogenase and peroxidase. Ref: Microorganisms in Environmental Management: Microbes and Environment By T. Satyanarayana, Bhavdish Narain Johri, Anil Prakash, Page 233; Biochemical Engineering By Gummadi, Page 89 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Technique used for Aspiration of sperm directly from Testes for In-vitro feilization is:, with the following options: A: IVF, B: ICSI, C: TESA, D: GIFT ### Response:

Testicular sperm aspiration (TESA) is a procedure sample of sperm cells are removed from the testicle through a small needle attached to a syringe. Other methods used are PESA: Percutaneous Epididymal Sperm Aspiration both TESA and PESA can be done under LA. MESA: Microsurgical Epididymal Sperm Aspiration TESE: Testicular Sperm Extraction MESA is the best technique for getting useable sperms since the epididymal sperms are the 'Ready'sperms which are ejaculated with the sexual act MESA allows for diagnosis and possible reconstruction of ductal pathology and because it usually yields very large numbers of sperm, sperm cryopreservation and avoidance of repeat surgery may be possible ICSI: Intracytoplasmic sperm injection GIFT: Gamete intra fallopian tube transfer IVF: In vitro feilisation

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Technique used for Aspiration of sperm directly from Testes for In-vitro feilization is:, with the following options: A: IVF, B: ICSI, C: TESA, D: GIFT ### Response: Testicular sperm aspiration (TESA) is a procedure sample of sperm cells are removed from the testicle through a small needle attached to a syringe. Other methods used are PESA: Percutaneous Epididymal Sperm Aspiration both TESA and PESA can be done under LA. MESA: Microsurgical Epididymal Sperm Aspiration TESE: Testicular Sperm Extraction MESA is the best technique for getting useable sperms since the epididymal sperms are the 'Ready'sperms which are ejaculated with the sexual act MESA allows for diagnosis and possible reconstruction of ductal pathology and because it usually yields very large numbers of sperm, sperm cryopreservation and avoidance of repeat surgery may be possible ICSI: Intracytoplasmic sperm injection GIFT: Gamete intra fallopian tube transfer IVF: In vitro feilisation ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Patients should be cautioned not to consume alcohol when given a prescription for any of the following EXCEPT:, with the following options: A: Cefixime, B: Cefoperazone, C: Chlorpropamide, D: Metronidazole ### Response:

Drugs showing disulfiram like reaction with alcohol are: Cefamandole, Cefoperazone, Cefotetan Moxalactam Chlorpropamide Metronidazole Griseofulvin Procarbazine

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Patients should be cautioned not to consume alcohol when given a prescription for any of the following EXCEPT:, with the following options: A: Cefixime, B: Cefoperazone, C: Chlorpropamide, D: Metronidazole ### Response: Drugs showing disulfiram like reaction with alcohol are: Cefamandole, Cefoperazone, Cefotetan Moxalactam Chlorpropamide Metronidazole Griseofulvin Procarbazine ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Child's criteria is used in Cirrhosis, with the following options: A: Pancreatitis, B: Cirrhosis, C: Multiple myeloma, D: AIDS ### Response:

Variables of CTP score Serum albumin Serum bilirubin Prothrombin time Ascites Encephalopathy Ref: Sabiston 20th edition Pgno : 1436

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Child's criteria is used in Cirrhosis, with the following options: A: Pancreatitis, B: Cirrhosis, C: Multiple myeloma, D: AIDS ### Response: Variables of CTP score Serum albumin Serum bilirubin Prothrombin time Ascites Encephalopathy Ref: Sabiston 20th edition Pgno : 1436 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Spike and Dome pattern is seen in: March 2007, with the following options: A: Petitmal seizures, B: Grandmal seizures, C: Clonic seizures, D: Myoclonic seizures ### Response:

Ans. A: Petitmal seizures This classification is based on observation (clinical and EEG) rather than the underlying pathophysiology or anatomy. Paial seizures (Older term: focal seizures) Simple paial seizures - consciousness is not impaired (With motor, sensory, autonomic or psychic symptoms) Complex paial seizures - consciousness is impaired (Older terms: temporal lobe or psychomotor seizures) Paial seizures evolving to secondarily generalized seizures Generalized seizures -- Absence seizures (Older term: petit mal) - Myoclonic seizures - Tonic seizures - Tonic-clonic seizures (Older term: grand mal) - Atonic seizures Unclassified epileptic seizures Absence seizures: This condition however usually affects children(aged 4-8 year) as opposed to adults, and no warning are given e.g Aura, although the patient may act strangely including a blank stare. It can be defined as 5 - 30 sec of unconsciousness, during which muscles undergoe twitchlike contractions, normally the head region e.g blinking of the eyes. The contractions are usually followed by consciousness and resumation of previous activities. The brain wave pattern is typified by a spike and dome reading. Where the spike region of the recording is almost identical to the spikes that occur in Grand Mal epilepsy, but the dome region's are distinctly different.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Spike and Dome pattern is seen in: March 2007, with the following options: A: Petitmal seizures, B: Grandmal seizures, C: Clonic seizures, D: Myoclonic seizures ### Response: Ans. A: Petitmal seizures This classification is based on observation (clinical and EEG) rather than the underlying pathophysiology or anatomy. Paial seizures (Older term: focal seizures) Simple paial seizures - consciousness is not impaired (With motor, sensory, autonomic or psychic symptoms) Complex paial seizures - consciousness is impaired (Older terms: temporal lobe or psychomotor seizures) Paial seizures evolving to secondarily generalized seizures Generalized seizures -- Absence seizures (Older term: petit mal) - Myoclonic seizures - Tonic seizures - Tonic-clonic seizures (Older term: grand mal) - Atonic seizures Unclassified epileptic seizures Absence seizures: This condition however usually affects children(aged 4-8 year) as opposed to adults, and no warning are given e.g Aura, although the patient may act strangely including a blank stare. It can be defined as 5 - 30 sec of unconsciousness, during which muscles undergoe twitchlike contractions, normally the head region e.g blinking of the eyes. The contractions are usually followed by consciousness and resumation of previous activities. The brain wave pattern is typified by a spike and dome reading. Where the spike region of the recording is almost identical to the spikes that occur in Grand Mal epilepsy, but the dome region's are distinctly different. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 40-year-old man presented with painless haematuria. Bimanual examination revealed a ballottable mass over the right flank. Subsequently right nephrectomy was done and the mass was seen to be composed of cells with clear cytoplasm. Areas of hemorrhage and necrosis were frequent cytogenetic analysis of this mass is likely to reveal the abnormality of-, with the following options: A: Chromosome 1, B: Chromosome 3, C: Chromosome 11, D: Chromosome 17 ### Response:

Clear cell type RCC (70%): This is the most common pattern. The clear cytoplasm of tumour cells is due to the removal of glycogen and lipid from the cytoplasm during the processing of tissues Sporadic and familial (Homozygous loss of VHL gene located on chromosome 3) Ref: Textbook of pathology Harsh Mohan 6th edition page 695

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 40-year-old man presented with painless haematuria. Bimanual examination revealed a ballottable mass over the right flank. Subsequently right nephrectomy was done and the mass was seen to be composed of cells with clear cytoplasm. Areas of hemorrhage and necrosis were frequent cytogenetic analysis of this mass is likely to reveal the abnormality of-, with the following options: A: Chromosome 1, B: Chromosome 3, C: Chromosome 11, D: Chromosome 17 ### Response: Clear cell type RCC (70%): This is the most common pattern. The clear cytoplasm of tumour cells is due to the removal of glycogen and lipid from the cytoplasm during the processing of tissues Sporadic and familial (Homozygous loss of VHL gene located on chromosome 3) Ref: Textbook of pathology Harsh Mohan 6th edition page 695 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Phase 3 is, with the following options: A: High Stationary Stage, B: Late expanding stage, C: Low Stationary stage, D: Early expanding stage ### Response:

Demographic cycle based on CBR & CDR Demographic cycle CBR CDR 1st stage High stationary High High 2nd stage Early expanding High Sta decreasing 3rd stage Late expanding Sta decreasing Already decreasing 4th stage Low stationary Low Low 5th stage Decline CDR > CBR

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Phase 3 is, with the following options: A: High Stationary Stage, B: Late expanding stage, C: Low Stationary stage, D: Early expanding stage ### Response: Demographic cycle based on CBR & CDR Demographic cycle CBR CDR 1st stage High stationary High High 2nd stage Early expanding High Sta decreasing 3rd stage Late expanding Sta decreasing Already decreasing 4th stage Low stationary Low Low 5th stage Decline CDR > CBR ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: As per WHO classification 'X2' stage of xerophthalmia refers to:, with the following options: A: Conjunctival xerosis, B: Bitot's spots, C: Corneal xerosis, D: Corneal ulceration ### Response:

Ans. Corneal xerosis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: As per WHO classification 'X2' stage of xerophthalmia refers to:, with the following options: A: Conjunctival xerosis, B: Bitot's spots, C: Corneal xerosis, D: Corneal ulceration ### Response: Ans. Corneal xerosis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Direct action on Nm Cholinoreceptors is shown by-, with the following options: A: Physostigmine, B: Neostigmine, C: Both the above, D: None of the above ### Response:

Ans. is 'b' i.e.'b' Neostigmine Comparative features of physosdgmine and neostigmine PhysostigmineNeostigmine1. SourceNatural alkaloid form Physosiigma venenosum (Calabar bean)Synthetic2. ChemistryTertiaryr amine derivativeQuaternary' ammonium compound3. Oral absorptionGoodPoor4. CNS actionsPresentAbsent5. Applied to eyePenetrates corneaPoor penetration6. Direct action on Xm cholinoceptorsAbsentPresent7. Prominent effect onAutonomic effectorsSkeletal muscles& Important useMiotic (glaucoma)Myasthenia gravis9. Dose0-5-1 mg oral/parenteral0-I-T0%eye drops0-5-2-5mgi.m./s.c.15-30 mg orally10. Duration of actionSystemic 4-6 hrsIn eye 6 to 24 hrs3-4 hrs.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Direct action on Nm Cholinoreceptors is shown by-, with the following options: A: Physostigmine, B: Neostigmine, C: Both the above, D: None of the above ### Response: Ans. is 'b' i.e.'b' Neostigmine Comparative features of physosdgmine and neostigmine PhysostigmineNeostigmine1. SourceNatural alkaloid form Physosiigma venenosum (Calabar bean)Synthetic2. ChemistryTertiaryr amine derivativeQuaternary' ammonium compound3. Oral absorptionGoodPoor4. CNS actionsPresentAbsent5. Applied to eyePenetrates corneaPoor penetration6. Direct action on Xm cholinoceptorsAbsentPresent7. Prominent effect onAutonomic effectorsSkeletal muscles& Important useMiotic (glaucoma)Myasthenia gravis9. Dose0-5-1 mg oral/parenteral0-I-T0%eye drops0-5-2-5mgi.m./s.c.15-30 mg orally10. Duration of actionSystemic 4-6 hrsIn eye 6 to 24 hrs3-4 hrs. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Antimalarial of choice in a pregnant woman (I timester) who is chloroquine resistant is?, with the following options: A: Quinine, B: Proguanil, C: Dapsone & pyrimethamine, D: Mefloquine ### Response:

Ans. is 'a' i.e., Quinine "Quinine is the only widely available drug that is acceptable as suitable for treating chloroquine - resistant infections during pregnancy".

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Antimalarial of choice in a pregnant woman (I timester) who is chloroquine resistant is?, with the following options: A: Quinine, B: Proguanil, C: Dapsone & pyrimethamine, D: Mefloquine ### Response: Ans. is 'a' i.e., Quinine "Quinine is the only widely available drug that is acceptable as suitable for treating chloroquine - resistant infections during pregnancy". ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Contrast agent which are not used for CT scan:, with the following options: A: Water, B: CO2, C: Barium compounds, D: Iodinated high-osmolality contrast media ### Response:

Ans. B. CO2Ref Sumer Sethi 6th/20; Radiology 6 Imaging by Thayalan159; Dahne Radiology Manual 7th/1147-48Radiocontrast agents are a type of medical contrast medium used to improve the visibility of internal bodily structures in X-ray-based imaging techniques such as computed tomography (CT), radiography & fluoroscopy.Radiocontrast agents are typically iodine or barium compounds.When an agent improves visibility of an area, it is called "contrast enhancingGadolinium is a key component of the contrast material most often used in magnetic resonance (MR) exams.Saline (salt water) and air are also used as contrast materials in imaging exams.Barium sulfate contrast media continue to be the preferred agents for opacification of the gastrointestinal tract for conventional fluoroscopic examinationsThe current use of iodinated water-soluble contrast media is primarily limited to select situationsTwo commercid water-soluble iodinated high-osmolality contrast media (HOCMs) specifically designed for enteric opacification are in common use. Gastrografin and, Gastroview

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Contrast agent which are not used for CT scan:, with the following options: A: Water, B: CO2, C: Barium compounds, D: Iodinated high-osmolality contrast media ### Response: Ans. B. CO2Ref Sumer Sethi 6th/20; Radiology 6 Imaging by Thayalan159; Dahne Radiology Manual 7th/1147-48Radiocontrast agents are a type of medical contrast medium used to improve the visibility of internal bodily structures in X-ray-based imaging techniques such as computed tomography (CT), radiography & fluoroscopy.Radiocontrast agents are typically iodine or barium compounds.When an agent improves visibility of an area, it is called "contrast enhancingGadolinium is a key component of the contrast material most often used in magnetic resonance (MR) exams.Saline (salt water) and air are also used as contrast materials in imaging exams.Barium sulfate contrast media continue to be the preferred agents for opacification of the gastrointestinal tract for conventional fluoroscopic examinationsThe current use of iodinated water-soluble contrast media is primarily limited to select situationsTwo commercid water-soluble iodinated high-osmolality contrast media (HOCMs) specifically designed for enteric opacification are in common use. Gastrografin and, Gastroview ### 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 statements about Cefepime is true, with the following options: A: It is a 4th generation cephalosporin, B: Once a day dosing is given, C: It is not active against pseudomonas, D: It is a prodrug ### Response:

Refer Goodman Gilman 12th/1498 Cefepime is 4th generation cephalosporin with good activity against pseudomonas. It is given 8-12 hourly

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 statements about Cefepime is true, with the following options: A: It is a 4th generation cephalosporin, B: Once a day dosing is given, C: It is not active against pseudomonas, D: It is a prodrug ### Response: Refer Goodman Gilman 12th/1498 Cefepime is 4th generation cephalosporin with good activity against pseudomonas. It is given 8-12 hourly ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Predisposing factors for skin cancer are, with the following options: A: Smoking, B: Uv light, C: Chronic ulcer, D: Infrared light ### Response:

Ref Robbins 9/e p1155; Harrison 16/e p497 Uvrays and chronic ulcer are also the answers proliferation. Dysplasia is encountered principally in epi- thelial lesions. It is a loss in the uniformity of individual cells and in their architectural orientation. Dysplastic cells exhibit considerable pleomorphism and often possess hyperchro- matic nuclei that are abnormally large for the size of the cell. Mitotic figures are more abundant than usual and frequently appear in abnormal locations within the epithe- lium. In dysplastic stratified squamous epithelium, mitoses are not confined to the basal layers, where they normally occur, but may be seen at all levels and even in surface cells. There is considerable architectural anarchy. For example, the usual progressive maturation of tall cells in the basal layer to flattened squames on the surface may be lost and replaced by a disordered scrambling of dark basal- appearing cells (Fig. 5-6). When dysplastic changes are marked and involve the entire thickness of the epithelium, the lesion is referred to as carcinoma in situ, a preinvasive stage of cancer (Chapter 18). Although dysplastic changes often are found adjacent to foci of malignant transforma- tion, and long-term studies of cigarette smokers show that epithelial dysplasia almost invariably antedates the appear- ance of cancer, the term dysplasia is not synonymous with cancer; mild to moderate dysplasias that do not involve the entire thickness of the epithelium sometimes regress completely, par- ticularly if inciting causes are removed. Clinical Features Although most of these lesions arise in the skin, they also may involve the oral and anogenital mucosal surfaces, the esophagus, the meninges, and the eye. The following com- ments apply to cutaneous melanomas. Melanoma of the skin usually is asymptomatic, although pruritus may be an early manifestation. The most impoant clinical sign is a change in the color or size of a pigmented lesion. The main clinical warning signs are 1. Rapid enlargement of a preexisting nevus 2. Itching or pain in a lesion 3. Development of a new pigmented lesion during adult life 4. Irregularity of the borders of a pigmented lesion 5. Variegation of color within a pigmented lesion These principles are expressed in the so-called ABCs of melanoma: asymmetry, border, color, diameter, and evolu- tion (change of an existing nevus). It is vitally impoant to recognize melanomas and intervene as rapidly as pos- sible. The vast majority of superficial lesions are curable surgically, while metastatic melanoma has a very poor prognosis. The probability of metastasis is predicted by measuring the depth of invasion in millimeters of the veical growth phase nodule from the top of the granular cell layer of the overlying epidermis (Breslow thickness). Metastasis risk also is increased in tumors with a high mitotic rate and in those that fail to induce a local immune response. When metastases occur, they involve not only regional lymph nodes but also liver, lungs, brain, and viually any other site that can be seeded hematogenously. Sentinel lymph node biopsy (of the first draining node of a primary melanoma) at the time of surgery provides additional information on biologic aggressiveness. In some cases, metastases may appear for the first time many years after complete surgical excision of the primary tumor, suggesting a long phase of dormancy, during which time the tumor may be held in check by the host immune response. Recognition of the likely role of the host immune response has led to therapeutic trials of immunomodula- tors. Some impressive responses in patients with advanced

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Predisposing factors for skin cancer are, with the following options: A: Smoking, B: Uv light, C: Chronic ulcer, D: Infrared light ### Response: Ref Robbins 9/e p1155; Harrison 16/e p497 Uvrays and chronic ulcer are also the answers proliferation. Dysplasia is encountered principally in epi- thelial lesions. It is a loss in the uniformity of individual cells and in their architectural orientation. Dysplastic cells exhibit considerable pleomorphism and often possess hyperchro- matic nuclei that are abnormally large for the size of the cell. Mitotic figures are more abundant than usual and frequently appear in abnormal locations within the epithe- lium. In dysplastic stratified squamous epithelium, mitoses are not confined to the basal layers, where they normally occur, but may be seen at all levels and even in surface cells. There is considerable architectural anarchy. For example, the usual progressive maturation of tall cells in the basal layer to flattened squames on the surface may be lost and replaced by a disordered scrambling of dark basal- appearing cells (Fig. 5-6). When dysplastic changes are marked and involve the entire thickness of the epithelium, the lesion is referred to as carcinoma in situ, a preinvasive stage of cancer (Chapter 18). Although dysplastic changes often are found adjacent to foci of malignant transforma- tion, and long-term studies of cigarette smokers show that epithelial dysplasia almost invariably antedates the appear- ance of cancer, the term dysplasia is not synonymous with cancer; mild to moderate dysplasias that do not involve the entire thickness of the epithelium sometimes regress completely, par- ticularly if inciting causes are removed. Clinical Features Although most of these lesions arise in the skin, they also may involve the oral and anogenital mucosal surfaces, the esophagus, the meninges, and the eye. The following com- ments apply to cutaneous melanomas. Melanoma of the skin usually is asymptomatic, although pruritus may be an early manifestation. The most impoant clinical sign is a change in the color or size of a pigmented lesion. The main clinical warning signs are 1. Rapid enlargement of a preexisting nevus 2. Itching or pain in a lesion 3. Development of a new pigmented lesion during adult life 4. Irregularity of the borders of a pigmented lesion 5. Variegation of color within a pigmented lesion These principles are expressed in the so-called ABCs of melanoma: asymmetry, border, color, diameter, and evolu- tion (change of an existing nevus). It is vitally impoant to recognize melanomas and intervene as rapidly as pos- sible. The vast majority of superficial lesions are curable surgically, while metastatic melanoma has a very poor prognosis. The probability of metastasis is predicted by measuring the depth of invasion in millimeters of the veical growth phase nodule from the top of the granular cell layer of the overlying epidermis (Breslow thickness). Metastasis risk also is increased in tumors with a high mitotic rate and in those that fail to induce a local immune response. When metastases occur, they involve not only regional lymph nodes but also liver, lungs, brain, and viually any other site that can be seeded hematogenously. Sentinel lymph node biopsy (of the first draining node of a primary melanoma) at the time of surgery provides additional information on biologic aggressiveness. In some cases, metastases may appear for the first time many years after complete surgical excision of the primary tumor, suggesting a long phase of dormancy, during which time the tumor may be held in check by the host immune response. Recognition of the likely role of the host immune response has led to therapeutic trials of immunomodula- tors. Some impressive responses in patients with advanced ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Single best moality indicator-, with the following options: A: CDR, B: PMR, C: ASDR, D: CFR ### Response:

Ans. is 'c' i.e., ASDR o Age standardized death rate (ASDR) is best moality indicator.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Single best moality indicator-, with the following options: A: CDR, B: PMR, C: ASDR, D: CFR ### Response: Ans. is 'c' i.e., ASDR o Age standardized death rate (ASDR) is best moality indicator. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Waxy flexibility, stereotype verbal, behavioural signs and negative symptoms are feature of?, with the following options: A: Paranoid schizophrenia, B: Hebephrenic schizophrenia, C: Catatonic schizophrenia, D: Simple schizophrenia ### Response:

Ans. C. Catatonic schizophrenia. (Ref Neeraj Ahuja 5th /pg. 68; Kaplan & Sadock's synopsis of psychiatry:10th/Tab 13-5)Schizophrenia (Catatonic Type )A form of schizophrenia that is characterized by marked psychomotor activity, a variety of catatonic symptoms.Features Of Catatonic Schizophrenia# Bizarre posturing# Rigidity# Echolalia, echopraxia# Mutism# Waxy flexibility# Ambitendancy (no goal directed actions)# Stupor# Negativism (motiveless resistance to all commands and doing opposite)# Other signs (mannerisms, stereotype verbal and behavioural automatic obedience, verbigeration)SchizophreniaParanoidHebephrenic (Disorganized)CatatonicSimpleOccur in later life(3rd or 4th decade).Occurs in early 2nd decade.Occurs in late 2nd or 3rd decade.Occurs in early life (2nd decade).Onset is insidious and course is progressive.Onset is insidious and course is progressive.Onset is usually acute course is episodic.Onset is insidious and course is progressiveProminent preoccupation with a specific delusional system and who otherwise do not qualify as having disorganized-type disease.Disorganized speech and behavior are accompanied by a superficial or silly affect.Clinical presentation is dominated by profound changes in motor activity, negativism, and echolalia or echopraxia. Has best prognosis compared to other subtypes. Completely recovery does not occur.Worst prognosisRecovery from episode is usually complete.Prognosis is usually poor.Schizophrenias||||||| Commonest TypeAmphetamine causesEarly onset & Bad prognosisLate onset & best prognosisVery late (3rd,4th Deacde)Worst pronosis & most difficult to diagnose|||||| ParanoidParanoidhebephrenicCatatonicParanoidSimple Paranoid- Delusions of persecution or grandeur- Often accompanied by hallucinations( voices)Catatonic- Complete stupor or pronounced decrease in spontaneous movements- Alternatively, can be excited and evidence extreme motor agitationDisorganized- Incoherent, primitive, uninhibited- Unorganized behaviors and speech- Active, butr aimless- Pronounced thought disorderUndifferentiated- Psychotic symptoms but does not fit paranoid, catatonic, or disorgazized diagnosesResidual- Previous episode, but not prominent psychotic symptoms at evaluation- Some lingering negatilve symptoms Negative symptomsPositive sympytom- Loss of function- Loose associations- Anhedonia- Hallucinations and delusions- Decreased emotional expression- Bizarre behavior, and- Impaired concentration, and- Increased speech- Diminished social engagement)SCHNEIDER'S FIRST-RANK SYMPTOMS OF SCHIZOPHRENIA INCLUDE:# Withdrawal or broadcasting;# Auditory hallucinations;# Impulses or actions;# Somatic passivity (Mnemonic: WAIST MD)# Thought insertion,# Made feelings,# Delusional perception.EUGEN BLEULER'S FUNDAMENTAL SYMPTOMS OF SCHIZOPHRENIA (4 A'S)# Ambivalence (marked inability to decide for or against)# Autism (withdrawal into self)# Affect blunting (disturbance of affect)# Association disturbances (loosening of association, thought disorder)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Waxy flexibility, stereotype verbal, behavioural signs and negative symptoms are feature of?, with the following options: A: Paranoid schizophrenia, B: Hebephrenic schizophrenia, C: Catatonic schizophrenia, D: Simple schizophrenia ### Response: Ans. C. Catatonic schizophrenia. (Ref Neeraj Ahuja 5th /pg. 68; Kaplan & Sadock's synopsis of psychiatry:10th/Tab 13-5)Schizophrenia (Catatonic Type )A form of schizophrenia that is characterized by marked psychomotor activity, a variety of catatonic symptoms.Features Of Catatonic Schizophrenia# Bizarre posturing# Rigidity# Echolalia, echopraxia# Mutism# Waxy flexibility# Ambitendancy (no goal directed actions)# Stupor# Negativism (motiveless resistance to all commands and doing opposite)# Other signs (mannerisms, stereotype verbal and behavioural automatic obedience, verbigeration)SchizophreniaParanoidHebephrenic (Disorganized)CatatonicSimpleOccur in later life(3rd or 4th decade).Occurs in early 2nd decade.Occurs in late 2nd or 3rd decade.Occurs in early life (2nd decade).Onset is insidious and course is progressive.Onset is insidious and course is progressive.Onset is usually acute course is episodic.Onset is insidious and course is progressiveProminent preoccupation with a specific delusional system and who otherwise do not qualify as having disorganized-type disease.Disorganized speech and behavior are accompanied by a superficial or silly affect.Clinical presentation is dominated by profound changes in motor activity, negativism, and echolalia or echopraxia. Has best prognosis compared to other subtypes. Completely recovery does not occur.Worst prognosisRecovery from episode is usually complete.Prognosis is usually poor.Schizophrenias||||||| Commonest TypeAmphetamine causesEarly onset & Bad prognosisLate onset & best prognosisVery late (3rd,4th Deacde)Worst pronosis & most difficult to diagnose|||||| ParanoidParanoidhebephrenicCatatonicParanoidSimple Paranoid- Delusions of persecution or grandeur- Often accompanied by hallucinations( voices)Catatonic- Complete stupor or pronounced decrease in spontaneous movements- Alternatively, can be excited and evidence extreme motor agitationDisorganized- Incoherent, primitive, uninhibited- Unorganized behaviors and speech- Active, butr aimless- Pronounced thought disorderUndifferentiated- Psychotic symptoms but does not fit paranoid, catatonic, or disorgazized diagnosesResidual- Previous episode, but not prominent psychotic symptoms at evaluation- Some lingering negatilve symptoms Negative symptomsPositive sympytom- Loss of function- Loose associations- Anhedonia- Hallucinations and delusions- Decreased emotional expression- Bizarre behavior, and- Impaired concentration, and- Increased speech- Diminished social engagement)SCHNEIDER'S FIRST-RANK SYMPTOMS OF SCHIZOPHRENIA INCLUDE:# Withdrawal or broadcasting;# Auditory hallucinations;# Impulses or actions;# Somatic passivity (Mnemonic: WAIST MD)# Thought insertion,# Made feelings,# Delusional perception.EUGEN BLEULER'S FUNDAMENTAL SYMPTOMS OF SCHIZOPHRENIA (4 A'S)# Ambivalence (marked inability to decide for or against)# Autism (withdrawal into self)# Affect blunting (disturbance of affect)# Association disturbances (loosening of association, thought disorder) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Internal pudendal aery supplies all except, with the following options: A: Perineum, B: Penis, C: Anal canal, D: Anterior abdominal wall ### Response:

It arises from the anterior division of internal iliac aery. It runs on the lateral pelvic wall.It exits the pelvic cavity through the greater sciatic foramen, inferior to the piriformis foramen, to enter the gluteal region.It then curves around the sacrospinous ligament to enter the perineum through the lesser sciatic formen.It travels through the pudental canal with the internal pudental vein and the pudental nerve. ref - BDC 6e vol2 pg364

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Internal pudendal aery supplies all except, with the following options: A: Perineum, B: Penis, C: Anal canal, D: Anterior abdominal wall ### Response: It arises from the anterior division of internal iliac aery. It runs on the lateral pelvic wall.It exits the pelvic cavity through the greater sciatic foramen, inferior to the piriformis foramen, to enter the gluteal region.It then curves around the sacrospinous ligament to enter the perineum through the lesser sciatic formen.It travels through the pudental canal with the internal pudental vein and the pudental nerve. ref - BDC 6e vol2 pg364 ### End