Datasets:

jesse-tong

/

medqa

like 0

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A young girl has consumed barium carbonate with suicidal intent. She complains of generalized muscle weakness. The most likely electrolyte is:, with the following options: A: Hyponatremia, B: Hypocalcemia, C: Hypokalemia, D: Hypomagnesemia ### Response:

Barium may shift extracellular potassium intracellularly, resulting in extracellular hypokalemia, which is believed to mediate barium-induced paralysis and muscle weakness. So hypokalemia is thesingle best answer of choice Ref: Medical Toxicology-Richard C. Da, Pages 1403-04; The Essentials of Forensic Medicine and Toxicology By Dr.K.S. Narayan R.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A young girl has consumed barium carbonate with suicidal intent. She complains of generalized muscle weakness. The most likely electrolyte is:, with the following options: A: Hyponatremia, B: Hypocalcemia, C: Hypokalemia, D: Hypomagnesemia ### Response: Barium may shift extracellular potassium intracellularly, resulting in extracellular hypokalemia, which is believed to mediate barium-induced paralysis and muscle weakness. So hypokalemia is thesingle best answer of choice Ref: Medical Toxicology-Richard C. Da, Pages 1403-04; The Essentials of Forensic Medicine and Toxicology By Dr.K.S. Narayan R. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Thickening of axon leads to -, with the following options: A: Increased speed of conduction, B: Decreased speed of conduction, C: Increased absolute refractory period, D: Unmyelination ### Response:

Ans. is 'a' i.e., Increased speed of conduction o Thickness of nerve fiber (Axon) has linear relation with velocity (speed) of conduction.Factors affecting nerve conduction (Propagation of APIo There are many factors that affect the nerve conduction. Propagation of action potential (nerve conduction) is favoured byQ:-Low axoplasmic resistance (Ri)QLow external longitudinal resistance (Ro)High membrane resistance (Rm)QLow membrane capacitance (Cm) QHigh space constantHigh time constantThick (large) nerve - Linear relation with conduction QMyelination of nerv e Q

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Thickening of axon leads to -, with the following options: A: Increased speed of conduction, B: Decreased speed of conduction, C: Increased absolute refractory period, D: Unmyelination ### Response: Ans. is 'a' i.e., Increased speed of conduction o Thickness of nerve fiber (Axon) has linear relation with velocity (speed) of conduction.Factors affecting nerve conduction (Propagation of APIo There are many factors that affect the nerve conduction. Propagation of action potential (nerve conduction) is favoured byQ:-Low axoplasmic resistance (Ri)QLow external longitudinal resistance (Ro)High membrane resistance (Rm)QLow membrane capacitance (Cm) QHigh space constantHigh time constantThick (large) nerve - Linear relation with conduction QMyelination of nerv e Q ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Epithelium of "Trigone of bladder" is derived from, with the following options: A: Vesicourethral Canal, B: Mesoderm, C: Splanchnopleuric Mesoderm, D: Urachus ### Response:

The urinary bladder is derived from the cranial pa of the vesicourethral canal (endoderm).The epithelium of the trigone is derived from absorbed mesonephric ducts (mesoderm)Reference: Inderbir Singh Embryology; 10th edition; Page no: 292

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Epithelium of "Trigone of bladder" is derived from, with the following options: A: Vesicourethral Canal, B: Mesoderm, C: Splanchnopleuric Mesoderm, D: Urachus ### Response: The urinary bladder is derived from the cranial pa of the vesicourethral canal (endoderm).The epithelium of the trigone is derived from absorbed mesonephric ducts (mesoderm)Reference: Inderbir Singh Embryology; 10th edition; Page no: 292 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is not a feature of Wernicke's,encephalopathy:, with the following options: A: Global confusion, B: Opthalmoplegia, C: Ataxia, D: Aphasia ### Response:

Ans.(d) AphasiaRef: Harrison 19th ed. / 2724The classic triad of symptoms found in Wernicke's encepha- lopathy is:* Global Confusion* Ophthalmo-plegia (Most commonly affecting the lateral rectus muscle).* AtaxiaFor diagnosis: Thiamine can be measured using an erythrocyte transketolase activity assay or by activation by measurement of in vitro thiamine diphosphate levels.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is not a feature of Wernicke's,encephalopathy:, with the following options: A: Global confusion, B: Opthalmoplegia, C: Ataxia, D: Aphasia ### Response: Ans.(d) AphasiaRef: Harrison 19th ed. / 2724The classic triad of symptoms found in Wernicke's encepha- lopathy is:* Global Confusion* Ophthalmo-plegia (Most commonly affecting the lateral rectus muscle).* AtaxiaFor diagnosis: Thiamine can be measured using an erythrocyte transketolase activity assay or by activation by measurement of in vitro thiamine diphosphate levels. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In tubercular meningitis what is not seen?, with the following options: A: Low sugar, B: Lymphocytic pleocytosis, C: High protein, D: Opening pressure is low ### Response:

ANSWER: (D) Opening pressure is lowREF: Chandrasoma Taylor 3rd ed p. 915CSF changes in meningitisCSF parametersBacterial meningitisTB meningitisViral meningitisOpening pressureRaisedRaisedRaisedGross appearanceTurbidClear (may clot)ClearProtein (normal - 20-50 mg/dl)HighVery highSlightly highGlucose (40-70mg/dl)Very lowLowLowChloride (116-122 micro gram/dl)LowVery lowNormalCells > 5/microliterNeutrophilsPleocytosisLymphocytosis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In tubercular meningitis what is not seen?, with the following options: A: Low sugar, B: Lymphocytic pleocytosis, C: High protein, D: Opening pressure is low ### Response: ANSWER: (D) Opening pressure is lowREF: Chandrasoma Taylor 3rd ed p. 915CSF changes in meningitisCSF parametersBacterial meningitisTB meningitisViral meningitisOpening pressureRaisedRaisedRaisedGross appearanceTurbidClear (may clot)ClearProtein (normal - 20-50 mg/dl)HighVery highSlightly highGlucose (40-70mg/dl)Very lowLowLowChloride (116-122 micro gram/dl)LowVery lowNormalCells > 5/microliterNeutrophilsPleocytosisLymphocytosis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Perioperative respiratory failure is, with the following options: A: Type I respiratory failure, B: Type II respiratory failure, C: Type III respiratory failure, D: Type IV respiratory failure ### Response:

TYPE III RESPIRATORY FAILUREThis form of respiratory failure results from lung atelectasis. Because atelectasis occurs so commonly in the perioperative period, this form is also called perioperative respiratory failure. After general anaesthesia, decreases in functional residual capacity lead to the collapse of dependent lung units. Such atelectasis can be treated by frequent changes in position, chest physiotherapy, upright positioning, and control of incisional and/or abdominal pain.Noninvasive positive-pressure ventilation may also be used to reverse regional atelectasis.Harrison 19e pg:1732

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Perioperative respiratory failure is, with the following options: A: Type I respiratory failure, B: Type II respiratory failure, C: Type III respiratory failure, D: Type IV respiratory failure ### Response: TYPE III RESPIRATORY FAILUREThis form of respiratory failure results from lung atelectasis. Because atelectasis occurs so commonly in the perioperative period, this form is also called perioperative respiratory failure. After general anaesthesia, decreases in functional residual capacity lead to the collapse of dependent lung units. Such atelectasis can be treated by frequent changes in position, chest physiotherapy, upright positioning, and control of incisional and/or abdominal pain.Noninvasive positive-pressure ventilation may also be used to reverse regional atelectasis.Harrison 19e pg:1732 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: On MRI, the differential diagnosis of spinal cord edema is:, with the following options: A: Myelodysplasia, B: Myelomalacia, C: Myeloschisis, D: Cord tumors ### Response:

Myelomalacia is a increased T2w signal in the spinal cord where the spinal cord is atrophic with gliosis producing small and bright appearence of spinal cord

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: On MRI, the differential diagnosis of spinal cord edema is:, with the following options: A: Myelodysplasia, B: Myelomalacia, C: Myeloschisis, D: Cord tumors ### Response: Myelomalacia is a increased T2w signal in the spinal cord where the spinal cord is atrophic with gliosis producing small and bright appearence of spinal cord ### 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 assess the mid-upper arm circumference except?, with the following options: A: Bangle test, B: Shakir tape method, C: Quac stick, D: Harpenden calliper ### Response:

Harpenden calliper is used to measure skinfold thickness which is an indication of subcutaneous fat. The other three are used to measure the mid-upper arm circumference. The Shakir tape is used to measure mid-upper arm circumference. It has three coloured zones corresponding to various levels of wasting * In bangle test, a bangle with an internal diameter of 4 cm is passed above the elbow. In severe malnutrition, it can be passed above the elbow, in normal children it cannot. * QUACK stick - Quaker arm circumference measuringstick. It is a measure of expected Mid-arm circumference that would be expected for a given height

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 assess the mid-upper arm circumference except?, with the following options: A: Bangle test, B: Shakir tape method, C: Quac stick, D: Harpenden calliper ### Response: Harpenden calliper is used to measure skinfold thickness which is an indication of subcutaneous fat. The other three are used to measure the mid-upper arm circumference. The Shakir tape is used to measure mid-upper arm circumference. It has three coloured zones corresponding to various levels of wasting * In bangle test, a bangle with an internal diameter of 4 cm is passed above the elbow. In severe malnutrition, it can be passed above the elbow, in normal children it cannot. * QUACK stick - Quaker arm circumference measuringstick. It is a measure of expected Mid-arm circumference that would be expected for a given height ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Normal Axis of the hea is best described as being between:, with the following options: A: -30 to + 110, B: +30 to - 110, C: -30 to - 110, D: +90 to + 110 ### Response:

Cardiac Axis Normal Cardiac Axis Normal cardiac axis flow down and towards the left lower aspect of the hea between - 30 and +110 Left Axis Detion Cardiac axis flow is upward and toward the left upper half of the hea between -30 and -90 Right Axis Detion Cardiac axis flow is downward and toward the right pa of the hea between +90 and +/-180 Extreme Right Axis Detion When flow of cardiac axis is upward and to the right between +/-180 and -90

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Normal Axis of the hea is best described as being between:, with the following options: A: -30 to + 110, B: +30 to - 110, C: -30 to - 110, D: +90 to + 110 ### Response: Cardiac Axis Normal Cardiac Axis Normal cardiac axis flow down and towards the left lower aspect of the hea between - 30 and +110 Left Axis Detion Cardiac axis flow is upward and toward the left upper half of the hea between -30 and -90 Right Axis Detion Cardiac axis flow is downward and toward the right pa of the hea between +90 and +/-180 Extreme Right Axis Detion When flow of cardiac axis is upward and to the right between +/-180 and -90 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are features of hypernatremia except, with the following options: A: Convulsions, B: Elevated intracranial tension, C: Periodic paralysis, D: Doughy skin ### Response:

Ans. is 'c' i.e., Periodic paralysis Periodic paralysis, is seen in hyponatermia Clinical features of Hypernatremia :? Most patients with hypernatremia are dehydrated and have the typical signs and symptoms of dehydration. Hypernatremia even without dehydration causes central nervous system symptoms that tend to parallel the degree of sodium elevation and the acuity of the increase. Patients are irritable, restless weak and lethargic Some have high pitched cry and hyperpnea. Ale patient are very thirsty. Hypernatremia causes fever although many patients have underlying process that contributes to the fever Except for dehydration, there is no clear direct effect of hypernatremia on other organs or tissues except the brain. Complication of hypernatremia :? Brain hemorrhage is the most devastating consequence of hypernatremia. As the extracellular osmolarity increases water moves out of brain cells, resulting in decrease in brain volume. This can result in tearing of intra cerebral veins and bridging vessels as the brain moves away from the skull and the meninges. Patient may have subarachnoid, subdural and parenchymal hemorrhage. Seizure and coma are possible sequale of the hemorrhage even though seizures are more common during t/t. Thrombotic complications are common in severe hypernatremic dehydration and include stroke, dural sinus thrombosis, peripheral thrombosis and renal vein thrombosis. The intracranial tension can be increased due to hemorrhage

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are features of hypernatremia except, with the following options: A: Convulsions, B: Elevated intracranial tension, C: Periodic paralysis, D: Doughy skin ### Response: Ans. is 'c' i.e., Periodic paralysis Periodic paralysis, is seen in hyponatermia Clinical features of Hypernatremia :? Most patients with hypernatremia are dehydrated and have the typical signs and symptoms of dehydration. Hypernatremia even without dehydration causes central nervous system symptoms that tend to parallel the degree of sodium elevation and the acuity of the increase. Patients are irritable, restless weak and lethargic Some have high pitched cry and hyperpnea. Ale patient are very thirsty. Hypernatremia causes fever although many patients have underlying process that contributes to the fever Except for dehydration, there is no clear direct effect of hypernatremia on other organs or tissues except the brain. Complication of hypernatremia :? Brain hemorrhage is the most devastating consequence of hypernatremia. As the extracellular osmolarity increases water moves out of brain cells, resulting in decrease in brain volume. This can result in tearing of intra cerebral veins and bridging vessels as the brain moves away from the skull and the meninges. Patient may have subarachnoid, subdural and parenchymal hemorrhage. Seizure and coma are possible sequale of the hemorrhage even though seizures are more common during t/t. Thrombotic complications are common in severe hypernatremic dehydration and include stroke, dural sinus thrombosis, peripheral thrombosis and renal vein thrombosis. The intracranial tension can be increased due to hemorrhage ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Atherosclerosis is due to, with the following options: A: HDL receptor defect, B: Apo protein E deficiency, C: Decreased LDL activity, D: Decreased lipoprotein lipase ### Response:

Atherosclerosis is a slowly progressive disease of large to medium-sized muscular aeries and large elastic aeries characterised by elevated focal intimal fibrofattyPlaques. Principal larger vessels affected are the abdominal aoa, descending thoracic aoa, internal carotid aeries and medium to smaller sized vessels affected are popliteal aeries, coronary aeries, and circle of Willis in brain. The atheroma may be preceded by fatty streaks that are intimal collection of lipid-laden macrophages and smooth muscle cells, occurring in persons as young as one year of age.The disease typically manifests in later life as the vessel lumen is compromised, predisposing to thrombosis and the underlying media is thinned, predisposing to aneurysm formation. It is the number one killer disease, 50 per cent of all deaths in the USA are attributed to atherosclerosis and half of theseare due to acute myocardial infarctions. The remainder include cerebrovascular accidents ("stroke"), aneurysm rupture, mesenteric occlusion and gangrene of theextremities. Etiological Factors Major risk factors in CHD have been discussed earlier. Risk of developing atherosclerosis increases with age, a positive family history, cigarette smoking, diabetes mellitus, hypeension, and hypercholesterolemia. The risk is correlated with elevated LDL and inversely related to the HDL level. Hereditary defects, e.g. familial hypercholesterolemia involving the LDL receptor or the LDL apoproteins cause elevated LDL, hypercholesterolemia andaccelerated atherosclerosis. Lesser influences on the risk of atherosclerosis include sedentary, or high-stress lifestyle, obesity and oral contraceptives.Ref: M.N. Chatterjee - Textbook of Biochemistry, 8th edition, page no: 454 - 456

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Atherosclerosis is due to, with the following options: A: HDL receptor defect, B: Apo protein E deficiency, C: Decreased LDL activity, D: Decreased lipoprotein lipase ### Response: Atherosclerosis is a slowly progressive disease of large to medium-sized muscular aeries and large elastic aeries characterised by elevated focal intimal fibrofattyPlaques. Principal larger vessels affected are the abdominal aoa, descending thoracic aoa, internal carotid aeries and medium to smaller sized vessels affected are popliteal aeries, coronary aeries, and circle of Willis in brain. The atheroma may be preceded by fatty streaks that are intimal collection of lipid-laden macrophages and smooth muscle cells, occurring in persons as young as one year of age.The disease typically manifests in later life as the vessel lumen is compromised, predisposing to thrombosis and the underlying media is thinned, predisposing to aneurysm formation. It is the number one killer disease, 50 per cent of all deaths in the USA are attributed to atherosclerosis and half of theseare due to acute myocardial infarctions. The remainder include cerebrovascular accidents ("stroke"), aneurysm rupture, mesenteric occlusion and gangrene of theextremities. Etiological Factors Major risk factors in CHD have been discussed earlier. Risk of developing atherosclerosis increases with age, a positive family history, cigarette smoking, diabetes mellitus, hypeension, and hypercholesterolemia. The risk is correlated with elevated LDL and inversely related to the HDL level. Hereditary defects, e.g. familial hypercholesterolemia involving the LDL receptor or the LDL apoproteins cause elevated LDL, hypercholesterolemia andaccelerated atherosclerosis. Lesser influences on the risk of atherosclerosis include sedentary, or high-stress lifestyle, obesity and oral contraceptives.Ref: M.N. Chatterjee - Textbook of Biochemistry, 8th edition, page no: 454 - 456 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A multigravida at 35 weeks' gestation had the following finding on ultrasound. The following can be the causes except:, with the following options: A: Diabetes, B: Posterior urethral valve, C: Rh alloimmunization, D: Anencephaly ### Response:

Ans. B. Posterior urethral valvePolyhydramnios is diagnosed when the AFI >24cm or the single deepest pocket measures >8cm.Causes of polyhydramnios:a. MC cause of mild polyhydramnios = idiopathicb. Multifetal pregnancyc. Maternal diabetesd. Cleft lip/palate (GIT anomalies >NTD)e. Esophageal atresia/duodenal atresiaf. Anencephalyg. Chorangioma of placentah. Hydrops fetalis (Rh alloimmunization)i. TORCHj. Trisomyk. sacrococcygeal teratoma

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A multigravida at 35 weeks' gestation had the following finding on ultrasound. The following can be the causes except:, with the following options: A: Diabetes, B: Posterior urethral valve, C: Rh alloimmunization, D: Anencephaly ### Response: Ans. B. Posterior urethral valvePolyhydramnios is diagnosed when the AFI >24cm or the single deepest pocket measures >8cm.Causes of polyhydramnios:a. MC cause of mild polyhydramnios = idiopathicb. Multifetal pregnancyc. Maternal diabetesd. Cleft lip/palate (GIT anomalies >NTD)e. Esophageal atresia/duodenal atresiaf. Anencephalyg. Chorangioma of placentah. Hydrops fetalis (Rh alloimmunization)i. TORCHj. Trisomyk. sacrococcygeal teratoma ### 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 male is brought by his wife. He thinks that he had committed sins all through his life. He is very much depressed and has considered committing suicide but has not thought about going for it. He had also attached sessions with a spiritual guru. He is not convinced by his wife that he has lead a pious life. He does not want to hear anything on the contrary. How will you treat him ?, with the following options: A: Antipsychotic + Antidepressant, B: Antidepressant with cognitive behavioural therapy, C: Guidance & recounselling with guru + Antidepressant, D: Anti depressant alone ### Response:

The patient in question is presenting with features of depression and delusional guilt suggesting a diagnosis of depressive disorder with psychotic features. Such patients should be managed with a combination of Antipsychotics and antidepressants.

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 male is brought by his wife. He thinks that he had committed sins all through his life. He is very much depressed and has considered committing suicide but has not thought about going for it. He had also attached sessions with a spiritual guru. He is not convinced by his wife that he has lead a pious life. He does not want to hear anything on the contrary. How will you treat him ?, with the following options: A: Antipsychotic + Antidepressant, B: Antidepressant with cognitive behavioural therapy, C: Guidance & recounselling with guru + Antidepressant, D: Anti depressant alone ### Response: The patient in question is presenting with features of depression and delusional guilt suggesting a diagnosis of depressive disorder with psychotic features. Such patients should be managed with a combination of Antipsychotics and antidepressants. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In spinal anaesthesia the needle pierced upto, with the following options: A: Subdural space, B: Extradural space, C: Epidural space, D: Subrachnoid space ### Response:

Ans. d (Subarachnoid space). (Ref. Harrisons, Medicine, 18th/735)SPINAL ANESTHESIA# The term "spinal anesthesia" was coined in 1885 by Leonard Corning.Technique of spinal anesthesia:# In spinal anaesthesia the spinal needle is pierced upto subarachnoid space where the anaesthetic agent is injected to produce the anaesthesia.# The selected level should be below LI in an adult and L3 in a child to avoid needle trauma to the spinal cord. As an anatomic landmark, the L3-L4 interspace is located at the line intersecting the top of the iliac crests. Either a midline or paramedian approach can be used.# The anatomic layers passed through include skin, subcutaneous structures, supraspinous ligament, interspinous ligament, ligamentum flavum, dura mater, and arachnoid membrane.# Once the needle tip is believed to be in the subarachnoid space, the stylet is removed to see if CSF appears at the needle hub. With small diameter needles (26 to 29 gauge) this generally requires 5 to 10 seconds, but may require >1 minute in some patients. Gentle aspiration may speed the appearance of CSF. If CSF does not appear, the needle orifice may be obstructed by a nerve root and rotating the needle 90 degrees may result in CSF flow. Alternatively, the needle orifice may not be completely in the subarachnoid space and advancing an additional 1 to 2 mm may result in brisk CSF flow. This is particularly true of pencil-point needles, which have their orifice on the side of the needle shaft proximal to the needle tip.# Finally, failure to obtain CSF suggests that the needle orifice is not in the subarachnoid space and the needle should be reinserted.# Common complications include hypotension, bradycardia, increased sensitivity to sedative medications, nausea and vomiting (possibly secondary to hypotension), postdural puncture headache, nerve injury, total spinal, and hematoma/abscess formation at the site of puncture.# Total spinal anesthesia results from local anesthetic depression of the cervical spinal cord and brain stem. Signs and symptoms include dysphonia, dyspnea, upper extremity weakness, loss of consciousness, pupillary dilation, hypotension, bradycardia, and cardiopulmonary arrest. Eaily recognition is the key to management. Treatment includes securing the airway, mechanical ventilation, volume infusion, and pressor support.# Absolute contraindications include local infection at the puncture site, bacteremia, severe hypovolemia, coagulopathy, severe stenotic valvular disease, infection at the site of the procedure, and intracranial hypertension. Relative contraindications include progressive degenerative (demyelinating) neurologic disease (multiple sclerosis), low back pain, and sepsis.# Intrathecal opioids:- Opioids produce intense visceral analgesia and may prolong sensory blockade without affecting motor or sympathetic function.- Fentanyl and sufentanil have a rapid onset of action and an effective duration greater than 6 hours.- Morphine lasts 6-24 hours.- Side effects include respiratory depression (which may occur late with hydrophilic agents), nausea, vomiting, pruritus, and urinary retention.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In spinal anaesthesia the needle pierced upto, with the following options: A: Subdural space, B: Extradural space, C: Epidural space, D: Subrachnoid space ### Response: Ans. d (Subarachnoid space). (Ref. Harrisons, Medicine, 18th/735)SPINAL ANESTHESIA# The term "spinal anesthesia" was coined in 1885 by Leonard Corning.Technique of spinal anesthesia:# In spinal anaesthesia the spinal needle is pierced upto subarachnoid space where the anaesthetic agent is injected to produce the anaesthesia.# The selected level should be below LI in an adult and L3 in a child to avoid needle trauma to the spinal cord. As an anatomic landmark, the L3-L4 interspace is located at the line intersecting the top of the iliac crests. Either a midline or paramedian approach can be used.# The anatomic layers passed through include skin, subcutaneous structures, supraspinous ligament, interspinous ligament, ligamentum flavum, dura mater, and arachnoid membrane.# Once the needle tip is believed to be in the subarachnoid space, the stylet is removed to see if CSF appears at the needle hub. With small diameter needles (26 to 29 gauge) this generally requires 5 to 10 seconds, but may require >1 minute in some patients. Gentle aspiration may speed the appearance of CSF. If CSF does not appear, the needle orifice may be obstructed by a nerve root and rotating the needle 90 degrees may result in CSF flow. Alternatively, the needle orifice may not be completely in the subarachnoid space and advancing an additional 1 to 2 mm may result in brisk CSF flow. This is particularly true of pencil-point needles, which have their orifice on the side of the needle shaft proximal to the needle tip.# Finally, failure to obtain CSF suggests that the needle orifice is not in the subarachnoid space and the needle should be reinserted.# Common complications include hypotension, bradycardia, increased sensitivity to sedative medications, nausea and vomiting (possibly secondary to hypotension), postdural puncture headache, nerve injury, total spinal, and hematoma/abscess formation at the site of puncture.# Total spinal anesthesia results from local anesthetic depression of the cervical spinal cord and brain stem. Signs and symptoms include dysphonia, dyspnea, upper extremity weakness, loss of consciousness, pupillary dilation, hypotension, bradycardia, and cardiopulmonary arrest. Eaily recognition is the key to management. Treatment includes securing the airway, mechanical ventilation, volume infusion, and pressor support.# Absolute contraindications include local infection at the puncture site, bacteremia, severe hypovolemia, coagulopathy, severe stenotic valvular disease, infection at the site of the procedure, and intracranial hypertension. Relative contraindications include progressive degenerative (demyelinating) neurologic disease (multiple sclerosis), low back pain, and sepsis.# Intrathecal opioids:- Opioids produce intense visceral analgesia and may prolong sensory blockade without affecting motor or sympathetic function.- Fentanyl and sufentanil have a rapid onset of action and an effective duration greater than 6 hours.- Morphine lasts 6-24 hours.- Side effects include respiratory depression (which may occur late with hydrophilic agents), nausea, vomiting, pruritus, and urinary retention. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Apex of the heart is formed by -, with the following options: A: Left atrium, B: Left atrium + left ventricle, C: Left ventricle, D: Right ventricle + left ventricle ### Response:

Ans. is 'c' i.e., Left ventricle o The heart has following borders and surfacesA) Bordersi) Right border:- Formed by right atrium.ii) Left border (obtuse margin):- Formed mainly by left ventricle and partly by left auricle (in its upper most part).iii) Inferior border (acute margin):- Formed mainly by right ventricle and partly by left ventricle near apex.iv) Upper border:- Mainly by left atrium and partly by right atrium where SVC enters.v) Apex:- Formed by left ventricle.B) Surfacesi) Anterior (sternocostal) surface:- Formed mostly by right ventricle (major) and right auricle and partly by left ventricle and left auricle.ii) Inferior (diaphragmatic) surface:- It is formed by left ventricle (left 2/3) and right ventricle (right 1/3). It is traversed by posterior interventricular groove (PIV) containing PIV branch of RCA.iii) Base (posterior surface) :- Formed mainly by left atrium and partly by right atrium. It is separated from T5 to T8 vertebrae by pericardium, oblique pericardial sinus, esophagus and descending thoracic aorta.iv) Right surface:- Mainly by right atrium.v) Left surface :- Mainly by left ventricle and partly by left auricle.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Apex of the heart is formed by -, with the following options: A: Left atrium, B: Left atrium + left ventricle, C: Left ventricle, D: Right ventricle + left ventricle ### Response: Ans. is 'c' i.e., Left ventricle o The heart has following borders and surfacesA) Bordersi) Right border:- Formed by right atrium.ii) Left border (obtuse margin):- Formed mainly by left ventricle and partly by left auricle (in its upper most part).iii) Inferior border (acute margin):- Formed mainly by right ventricle and partly by left ventricle near apex.iv) Upper border:- Mainly by left atrium and partly by right atrium where SVC enters.v) Apex:- Formed by left ventricle.B) Surfacesi) Anterior (sternocostal) surface:- Formed mostly by right ventricle (major) and right auricle and partly by left ventricle and left auricle.ii) Inferior (diaphragmatic) surface:- It is formed by left ventricle (left 2/3) and right ventricle (right 1/3). It is traversed by posterior interventricular groove (PIV) containing PIV branch of RCA.iii) Base (posterior surface) :- Formed mainly by left atrium and partly by right atrium. It is separated from T5 to T8 vertebrae by pericardium, oblique pericardial sinus, esophagus and descending thoracic aorta.iv) Right surface:- Mainly by right atrium.v) Left surface :- Mainly by left ventricle and partly by left auricle. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: "Cock-up" splint is used in treatment of, with the following options: A: Ulnar nerve palsy, B: Radial nerve palsy, C: Median nerve palsy, D: Sciatic nerve palsy ### Response:

Ans. b (Radial nerve palsy) (Ref. Maheshwari orthopedics 3rd ed., p 59; Table 10.6.)RADIAL NERVE PALSY# This is a common injury after a humerus and if there is no prospect of return of function, then transfers of flexor tendons to the extensor side will stabilise the wrist and allow extension of the fingers.# The classic transfer is the Robert Jones.# Pronator teres is inserted into extensor radialis iongus to restore wrist extension.# Flexor carpi ulnaris is inserted into extensor digitorum to restore finger extension.# Palmaris iongus when present is inserted into extensor potlicis Iongus to restore thumb extension.# Splintage: cock-up splintSome important splints used in orthopedic practiseSplints and castsClinical useCock-up splintShoulder abduction splintKnuckle-bender splintFoot-drop splintRadial nerve palsy (Extensors of the wrist and MP joints paralysed)Axillary nerve (Deltoid paralysis)Ulnar nerve palsy (Lumbricals paralysis)Sciatic nerve or common peroneal nerve palsy Cylinder/tubular castFracture patellaHanging castFracture humerusPatellar tendon bearing castFracture tibiaMinerva castCervical spine fractureTrunk Buckle castScoliosisRisser's castScoliosisAluminium splintImmobilization of fingerThomas splintFracture femurBohler Braun splintFracture femurToe rising splintFoot dropKnuckle bender splintUlnar nerve palsyDennis Brown splintCTEVSome important splits and casts used in orthopedic practiseDunlop tractionFracture elbowGallow's tractionFracture femur - shaft (below 2 years)Bryant's tractionFracture femur - shaft (below 2 years)Russell's tractionTrochanteric fracturePerkin's tractionFracture shaft femur in adults

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: "Cock-up" splint is used in treatment of, with the following options: A: Ulnar nerve palsy, B: Radial nerve palsy, C: Median nerve palsy, D: Sciatic nerve palsy ### Response: Ans. b (Radial nerve palsy) (Ref. Maheshwari orthopedics 3rd ed., p 59; Table 10.6.)RADIAL NERVE PALSY# This is a common injury after a humerus and if there is no prospect of return of function, then transfers of flexor tendons to the extensor side will stabilise the wrist and allow extension of the fingers.# The classic transfer is the Robert Jones.# Pronator teres is inserted into extensor radialis iongus to restore wrist extension.# Flexor carpi ulnaris is inserted into extensor digitorum to restore finger extension.# Palmaris iongus when present is inserted into extensor potlicis Iongus to restore thumb extension.# Splintage: cock-up splintSome important splints used in orthopedic practiseSplints and castsClinical useCock-up splintShoulder abduction splintKnuckle-bender splintFoot-drop splintRadial nerve palsy (Extensors of the wrist and MP joints paralysed)Axillary nerve (Deltoid paralysis)Ulnar nerve palsy (Lumbricals paralysis)Sciatic nerve or common peroneal nerve palsy Cylinder/tubular castFracture patellaHanging castFracture humerusPatellar tendon bearing castFracture tibiaMinerva castCervical spine fractureTrunk Buckle castScoliosisRisser's castScoliosisAluminium splintImmobilization of fingerThomas splintFracture femurBohler Braun splintFracture femurToe rising splintFoot dropKnuckle bender splintUlnar nerve palsyDennis Brown splintCTEVSome important splits and casts used in orthopedic practiseDunlop tractionFracture elbowGallow's tractionFracture femur - shaft (below 2 years)Bryant's tractionFracture femur - shaft (below 2 years)Russell's tractionTrochanteric fracturePerkin's tractionFracture shaft femur in adults ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common cause of breech presentation is, with the following options: A: Prematurity, B: Contracted pelvis, C: Oligohydramnios, D: Placenta pre ### Response:

Causes of breech presentation : Prematurity - Most common cause Undue mobility of the fetus Fetal abnormality Favorable adaptation Ref: Dutta Obs 9e pg 352.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common cause of breech presentation is, with the following options: A: Prematurity, B: Contracted pelvis, C: Oligohydramnios, D: Placenta pre ### Response: Causes of breech presentation : Prematurity - Most common cause Undue mobility of the fetus Fetal abnormality Favorable adaptation Ref: Dutta Obs 9e pg 352. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: ACE inhibitor when used for long time in hypeension patient cause, with the following options: A: Rightward shift in Renal pressure natriuresis curve, B: Reduction in filtration fraction, C: Significant increase in hea rate, D: No change in the compliance of large aeries ### Response:

Refer Goodman and Gilman 10e p804 Angiotensin 2 shifts the renal pressure natriuresis curve to the right side and helps to adjust the sodium levels in the body according to dietary intake of the sodium( more excretion from more intake and less excretion from less excretion from less intake ACE inhibitors block the action of angiotensin 11 and cause leftward shift of renal pressure natriuresis curve show that if the sodium intake is decreased much more natriuresis occur ACE inhibitors can increase the renal blood flow without increasing GFR and thus result in reduction of filtration fraction

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: ACE inhibitor when used for long time in hypeension patient cause, with the following options: A: Rightward shift in Renal pressure natriuresis curve, B: Reduction in filtration fraction, C: Significant increase in hea rate, D: No change in the compliance of large aeries ### Response: Refer Goodman and Gilman 10e p804 Angiotensin 2 shifts the renal pressure natriuresis curve to the right side and helps to adjust the sodium levels in the body according to dietary intake of the sodium( more excretion from more intake and less excretion from less excretion from less intake ACE inhibitors block the action of angiotensin 11 and cause leftward shift of renal pressure natriuresis curve show that if the sodium intake is decreased much more natriuresis occur ACE inhibitors can increase the renal blood flow without increasing GFR and thus result in reduction of filtration fraction ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The ideal treatment of bilateral idiopathic clubfoot in a newborn is -, with the following options: A: Manipulation by mother, B: Manipulation and Dennis Brown splint, C: Manipulation and casts, D: Surgical release ### Response:

Bilateral idiopathic clubfoot is managed by manipulation & applying cast I.e the surgeon manipulates the foot after sedating the child .The foot is then held in corrected position with plaster casts. There are two philosophies of treatment of clubfoot - * Kite&;s & * ponsetti&;s * kite&;s philosophy- begin at age of 1 month .deformities are corrected sequentially .Adduction deformity is corrected first followed by inversion deformity then equinus deformity . Then a below - knee plaster cast us usually sufficient . the cast is changed every 2 weeks , & continued until it is possible to overcorrect all deformities .once this happens foot is kept in corrected position by maintenance device. *ponsetti philosophy - the calcaneo- cuboid - navicular complex is internally rotated under plantarflexed talus , hence the deformity can be corrected back under talus by gradually stretching the tight structures . This is done by putting thumb pressure under talus .By doing so the calcaneo- cuboid- navicular complex is externally rotated under the talar head .treatment is staed within 1st week of life .cavus aspect of deformity is corrected first ,followed by adduction ,then varus & lastly equinus .after each correction above knee pop is applied , which is changed every 5-7 days .Possible to correct all components within 6weeks.Equinus deformity is often under corrected , can be treated by percutaneous tenotomy of tendoachilles . REF:Essential ohopedics, Maheshwari ,9th edition, pg.no.214

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The ideal treatment of bilateral idiopathic clubfoot in a newborn is -, with the following options: A: Manipulation by mother, B: Manipulation and Dennis Brown splint, C: Manipulation and casts, D: Surgical release ### Response: Bilateral idiopathic clubfoot is managed by manipulation & applying cast I.e the surgeon manipulates the foot after sedating the child .The foot is then held in corrected position with plaster casts. There are two philosophies of treatment of clubfoot - * Kite&;s & * ponsetti&;s * kite&;s philosophy- begin at age of 1 month .deformities are corrected sequentially .Adduction deformity is corrected first followed by inversion deformity then equinus deformity . Then a below - knee plaster cast us usually sufficient . the cast is changed every 2 weeks , & continued until it is possible to overcorrect all deformities .once this happens foot is kept in corrected position by maintenance device. *ponsetti philosophy - the calcaneo- cuboid - navicular complex is internally rotated under plantarflexed talus , hence the deformity can be corrected back under talus by gradually stretching the tight structures . This is done by putting thumb pressure under talus .By doing so the calcaneo- cuboid- navicular complex is externally rotated under the talar head .treatment is staed within 1st week of life .cavus aspect of deformity is corrected first ,followed by adduction ,then varus & lastly equinus .after each correction above knee pop is applied , which is changed every 5-7 days .Possible to correct all components within 6weeks.Equinus deformity is often under corrected , can be treated by percutaneous tenotomy of tendoachilles . REF:Essential ohopedics, Maheshwari ,9th edition, pg.no.214 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: HTLV-1 causes which of the following?, with the following options: A: Tropical spastic paraparesis, B: Familial medeterranian fever, C: Cutaneous T cell lymphoma, D: burkitts lymphoma ### Response:

HTLV1 causes tropical spastic paraparesis&adult T cell leukemia REF:MICROBIOLOGY ANANTHA NARAYANAN NINTH EDITION PAGE.567

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: HTLV-1 causes which of the following?, with the following options: A: Tropical spastic paraparesis, B: Familial medeterranian fever, C: Cutaneous T cell lymphoma, D: burkitts lymphoma ### Response: HTLV1 causes tropical spastic paraparesis&adult T cell leukemia REF:MICROBIOLOGY ANANTHA NARAYANAN NINTH EDITION PAGE.567 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Patient's relative gives a history of tattoo, however it was not found during autopsy. What should be dissected to find it:, with the following options: A: Lymph node, B: Skin, C: Spleen, D: Kidney ### Response:

Tattoo Marks Faint or disappeared tattoo marks can be made out on histological study of the regional lymph nodesQ. In Decomposed bodies,they are made visible by treating the area with 3 %hydrogen peroxideQ.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Patient's relative gives a history of tattoo, however it was not found during autopsy. What should be dissected to find it:, with the following options: A: Lymph node, B: Skin, C: Spleen, D: Kidney ### Response: Tattoo Marks Faint or disappeared tattoo marks can be made out on histological study of the regional lymph nodesQ. In Decomposed bodies,they are made visible by treating the area with 3 %hydrogen peroxideQ. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 55-year-old woman is diagnosed with invasive cervical carcinoma by cone biopsy. Pelvic examination and rectal examination reveal the parametrium is free of disease but upper part of vagina is involved with tumor .IVP and sigmoidoscopy are negative but CT S can of abdomen and pelvis shows grossly enlarged pelvic and para aortic nodes. Thus patient is classified as stage., with the following options: A: IIa, B: IIb, C: IIIa, D: IIIb ### Response:

Now here — in this patient On examination — Parametrium is not involved and upper part of vagina is involved so stage will be IIa — clinically. Remember cervical cancer is still staged clinically by using investigations recommended by FIGO. CT scan results, while clinically useful are not useful to stage the disease. No matter whatever finding are reported on CT scan it does not after the staging so Answer remains is Stage 11a.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 55-year-old woman is diagnosed with invasive cervical carcinoma by cone biopsy. Pelvic examination and rectal examination reveal the parametrium is free of disease but upper part of vagina is involved with tumor .IVP and sigmoidoscopy are negative but CT S can of abdomen and pelvis shows grossly enlarged pelvic and para aortic nodes. Thus patient is classified as stage., with the following options: A: IIa, B: IIb, C: IIIa, D: IIIb ### Response: Now here — in this patient On examination — Parametrium is not involved and upper part of vagina is involved so stage will be IIa — clinically. Remember cervical cancer is still staged clinically by using investigations recommended by FIGO. CT scan results, while clinically useful are not useful to stage the disease. No matter whatever finding are reported on CT scan it does not after the staging so Answer remains is Stage 11a. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: What is the dosage of retinol palmitate for early stages of xerophthalmia: September 2011, with the following options: A: 90 mg orally on two successive days, B: 100 mg orally on two successive days, C: 110 mg orally on two successive days, D: 120 mg orally on two successive days ### Response:

Ans. C: 110 mg orally on two successive days Nearly all of the early stages of xerophthalmia can be reversed by administration of a massive dose (2,00,000 IU or 110 mg of retinol palmitate) orally on 2 successive days Xerophthalmia/ Dry eyes Condition in which the eye fails to produce tears. Xerophthalmia caused by a severe vitamin A deficiency is described by pathologic dryness of the conjunctiva and * cornea. The conjunctiva becomes dry, thick and wrinkled. If untreated, it can lead to corneal ulceration and ultimately to blindness as a result of corneal damage. Xerophthalmia is a term that usually implies a destructive dryness of the conjunctival epithelium due to dietary vitamin A deficiency -- a rare condition in developed countries, but still causing much damage in developing countries. Other forms of dry eye are associated with aging, poor lid closure, scarring from previous injury, or autoimmune diseases such as rheumatoid ahritis and SjOgren's syndrome, and these can all cause chronic conjunctivitis. Radioiodine therapy can also induce xerophthalmia, often transiently Xerophthalmia from hypovitaminosis A is specifically due to lack of the hormone-like vitamin A metabolite retinoic acid Treatment can occur in two ways: treating symptoms and treating the deficiency. Treatment of symptoms usually includes use of aificial tears in the form of eye drops, increasing the humidity of the environment with humidifiers, and wearing wrap around glasses when outdoors. Treatment of the deficiency can be accomplished with a Vitamin A or multivitamin supplement or by eating foods rich in Vitamin A. Treatment with supplements and/or diet can be successful until the disease progresses as far as corneal ulceration, at which point only an extreme surgery can offer a chance of returning sight.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: What is the dosage of retinol palmitate for early stages of xerophthalmia: September 2011, with the following options: A: 90 mg orally on two successive days, B: 100 mg orally on two successive days, C: 110 mg orally on two successive days, D: 120 mg orally on two successive days ### Response: Ans. C: 110 mg orally on two successive days Nearly all of the early stages of xerophthalmia can be reversed by administration of a massive dose (2,00,000 IU or 110 mg of retinol palmitate) orally on 2 successive days Xerophthalmia/ Dry eyes Condition in which the eye fails to produce tears. Xerophthalmia caused by a severe vitamin A deficiency is described by pathologic dryness of the conjunctiva and * cornea. The conjunctiva becomes dry, thick and wrinkled. If untreated, it can lead to corneal ulceration and ultimately to blindness as a result of corneal damage. Xerophthalmia is a term that usually implies a destructive dryness of the conjunctival epithelium due to dietary vitamin A deficiency -- a rare condition in developed countries, but still causing much damage in developing countries. Other forms of dry eye are associated with aging, poor lid closure, scarring from previous injury, or autoimmune diseases such as rheumatoid ahritis and SjOgren's syndrome, and these can all cause chronic conjunctivitis. Radioiodine therapy can also induce xerophthalmia, often transiently Xerophthalmia from hypovitaminosis A is specifically due to lack of the hormone-like vitamin A metabolite retinoic acid Treatment can occur in two ways: treating symptoms and treating the deficiency. Treatment of symptoms usually includes use of aificial tears in the form of eye drops, increasing the humidity of the environment with humidifiers, and wearing wrap around glasses when outdoors. Treatment of the deficiency can be accomplished with a Vitamin A or multivitamin supplement or by eating foods rich in Vitamin A. Treatment with supplements and/or diet can be successful until the disease progresses as far as corneal ulceration, at which point only an extreme surgery can offer a chance of returning sight. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is an example of Trinucleotide repeat mutation?, with the following options: A: Huntington's chorea, B: Fragile-X-syndrome, C: Friedreich ataxia, D: All of the above ### Response:

Polyglutamine Disorders Huntington Disease (HD) Spinobulbar Muscular Atrophy (SBMA) Spinocerebellar Ataxias (SCA types 1, 2, 3, 6, 7, and 17) Dentatorubro-Pallidoluysian Atrophy (DRPLA) Non-polyglutamine Disorders Fragile X Syndrome (FRAXA) Fragile XE Mental Retardation (FRAXE) Friedreich Ataxia (FRDA) Myotonic Dystrophy (DM, not MD) Spinocerebellar Ataxias (SCA types 8, and 12) Ref-D.M.Vasudevan 7/e p509

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is an example of Trinucleotide repeat mutation?, with the following options: A: Huntington's chorea, B: Fragile-X-syndrome, C: Friedreich ataxia, D: All of the above ### Response: Polyglutamine Disorders Huntington Disease (HD) Spinobulbar Muscular Atrophy (SBMA) Spinocerebellar Ataxias (SCA types 1, 2, 3, 6, 7, and 17) Dentatorubro-Pallidoluysian Atrophy (DRPLA) Non-polyglutamine Disorders Fragile X Syndrome (FRAXA) Fragile XE Mental Retardation (FRAXE) Friedreich Ataxia (FRDA) Myotonic Dystrophy (DM, not MD) Spinocerebellar Ataxias (SCA types 8, and 12) Ref-D.M.Vasudevan 7/e p509 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Streptococcus is classified based on, with the following options: A: M protein, B: Cultural characteristics, C: Bile solubility, D: Cell wall carbohydrate ### Response:

Hemolytic streptococci were classified by Lancefield serologically into groups based on the nature of a carbohydrate (C) antigen on the cell wall. These are known as Lancefield groups, twenty of which have been identified so far and named A-V (without I and J). Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 211

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Streptococcus is classified based on, with the following options: A: M protein, B: Cultural characteristics, C: Bile solubility, D: Cell wall carbohydrate ### Response: Hemolytic streptococci were classified by Lancefield serologically into groups based on the nature of a carbohydrate (C) antigen on the cell wall. These are known as Lancefield groups, twenty of which have been identified so far and named A-V (without I and J). Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 211 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: When fetus is in attitude of flexion, presentation is :, with the following options: A: Veex, B: Brow, C: Cephalic, D: Face ### Response:

The pa of the fetus which occupies the lower pole of the uterus is called the presentation of the fetus In an attitude of flexion the presention is Cephalic Ref: Dutta Obs 9e pg 69.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: When fetus is in attitude of flexion, presentation is :, with the following options: A: Veex, B: Brow, C: Cephalic, D: Face ### Response: The pa of the fetus which occupies the lower pole of the uterus is called the presentation of the fetus In an attitude of flexion the presention is Cephalic Ref: Dutta Obs 9e pg 69. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Broad casts seen in cases of -, with the following options: A: Advanced renal failure, B: Hypotention, C: Severe hydronephrosis, D: Renal pappilary necrosis ### Response:

Ans. is 'a' i.e., Advanced renal failure Casts* Urinary casts are formed only in the distal convoluted tubuleQ (DCT) or the collecting ductR (distal nephron).* The proximal convoluted tubule and loop of henle are not the locations for cast formation.* Casts are formed through the solidification of materials in the tubules of nephrons.* Later the material is flushed out of the kidney upon the production of more urine leaving a small solidified microscopic cylinder that can also contain what ever other materials that might be within the tubules of the kidneys at the time of cast formation.* The microscopic detection of various types of casts can often be helpful diagnostic tool in the study of various types of renal diseases.Urinary casts and their characteristic featuresHvaline casts* These are the most common type of casts and they can be found in normal urine samples.* They consists almost entirely of Tamm Horsfall protein.* Zero-to Two hyaline casts per low power field is considered normal.* Increased numbers of Hyaline casts can occur with exercise, heat exposure, dehydration, fever, congestive heart failure and diuretic.Renal tubular epithelial cell casts* These casts results when the epithelial cells of the renal tubules are being excreted along with the casts.* These are rarer casts, can in theory indicate a serious situation involving the possible breaking down of the lining of the renal tubules themselves.* Renal tubular epithelial casts are most suggestive of tubular injury as in acute tubular necrosis.* They are also found in other disorders including eclampsia, heavy metal poisoning, ethyleneglycol intoxication (most of these cases lead to acute tubular necrosis).Granular casts* These casts are fairly common and occur in both pathological and non pathological condition.* Granular casts can result either from the breakdown of cellular casts to a point where the cells that once were within them are no longer distinguishable or they can result from the inclusion of aggregates of plasma proteins, fibrinogen or immune complexes within the cast upon formation.* They can be further divided into coarse granular casts and fine granular casts.* Fine granular casts can appear in non pathological conditions such as vigorous exercise, but the presence of coarse granular cast is abnormal and presents in wide variety of clinical diseases.* They are common in renal parenchymal disease.Broad casts* These casts originate from dilated chronically damaged tubules or the collecting ducts therefore thev are called renal failure casts.* These are formed in collecting duct as a result of urinary stasis.* Broad casts are two to six times the size of other types of casts.* Broad casts or renal failure casts are usually seen in patients with advanced renal failure.Waxv casts* Waxy casts are cylinders of smooth highly refractive material.* Waxy aists are seen in final stages of degeneration of fine granular casts. Since the granules need time to degrade, this implies nephron obstruction.* Waxy casts are seen in chronic renal diseases associated with renal failure seen in diabetic nephropathy, malignant hypertension, glomerulonephritis.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Broad casts seen in cases of -, with the following options: A: Advanced renal failure, B: Hypotention, C: Severe hydronephrosis, D: Renal pappilary necrosis ### Response: Ans. is 'a' i.e., Advanced renal failure Casts* Urinary casts are formed only in the distal convoluted tubuleQ (DCT) or the collecting ductR (distal nephron).* The proximal convoluted tubule and loop of henle are not the locations for cast formation.* Casts are formed through the solidification of materials in the tubules of nephrons.* Later the material is flushed out of the kidney upon the production of more urine leaving a small solidified microscopic cylinder that can also contain what ever other materials that might be within the tubules of the kidneys at the time of cast formation.* The microscopic detection of various types of casts can often be helpful diagnostic tool in the study of various types of renal diseases.Urinary casts and their characteristic featuresHvaline casts* These are the most common type of casts and they can be found in normal urine samples.* They consists almost entirely of Tamm Horsfall protein.* Zero-to Two hyaline casts per low power field is considered normal.* Increased numbers of Hyaline casts can occur with exercise, heat exposure, dehydration, fever, congestive heart failure and diuretic.Renal tubular epithelial cell casts* These casts results when the epithelial cells of the renal tubules are being excreted along with the casts.* These are rarer casts, can in theory indicate a serious situation involving the possible breaking down of the lining of the renal tubules themselves.* Renal tubular epithelial casts are most suggestive of tubular injury as in acute tubular necrosis.* They are also found in other disorders including eclampsia, heavy metal poisoning, ethyleneglycol intoxication (most of these cases lead to acute tubular necrosis).Granular casts* These casts are fairly common and occur in both pathological and non pathological condition.* Granular casts can result either from the breakdown of cellular casts to a point where the cells that once were within them are no longer distinguishable or they can result from the inclusion of aggregates of plasma proteins, fibrinogen or immune complexes within the cast upon formation.* They can be further divided into coarse granular casts and fine granular casts.* Fine granular casts can appear in non pathological conditions such as vigorous exercise, but the presence of coarse granular cast is abnormal and presents in wide variety of clinical diseases.* They are common in renal parenchymal disease.Broad casts* These casts originate from dilated chronically damaged tubules or the collecting ducts therefore thev are called renal failure casts.* These are formed in collecting duct as a result of urinary stasis.* Broad casts are two to six times the size of other types of casts.* Broad casts or renal failure casts are usually seen in patients with advanced renal failure.Waxv casts* Waxy casts are cylinders of smooth highly refractive material.* Waxy aists are seen in final stages of degeneration of fine granular casts. Since the granules need time to degrade, this implies nephron obstruction.* Waxy casts are seen in chronic renal diseases associated with renal failure seen in diabetic nephropathy, malignant hypertension, glomerulonephritis. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Contraceptive method of choice in lactating mothers is, with the following options: A: Barrier method, B: Progesterone only pills, C: Oral contraceptive pills, D: Lactational amenorrhea ### Response:

Progesterone only pills or mini pill Pills that contain very low doses of progestin, do not contain estrogen, and so can be used throughout the period of breastfeeding.These pills work primarily by thickening cervical mucus, disrupting the menstrual cycle, and preventing the ovulation.Reference: Mudaliar and Menon&;s clicks obstetrics,12th edition, page no:452

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Contraceptive method of choice in lactating mothers is, with the following options: A: Barrier method, B: Progesterone only pills, C: Oral contraceptive pills, D: Lactational amenorrhea ### Response: Progesterone only pills or mini pill Pills that contain very low doses of progestin, do not contain estrogen, and so can be used throughout the period of breastfeeding.These pills work primarily by thickening cervical mucus, disrupting the menstrual cycle, and preventing the ovulation.Reference: Mudaliar and Menon&;s clicks obstetrics,12th edition, page no:452 ### 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 mediators of acute inflammation except -, with the following options: A: Angiotensin, B: Prostaglandin E2, C: Kallikrein, D: C 3a ### Response:

. Angiotensin

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 mediators of acute inflammation except -, with the following options: A: Angiotensin, B: Prostaglandin E2, C: Kallikrein, D: C 3a ### Response: . Angiotensin ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Regarding Anti-mullerian hormone true is all except, with the following options: A: It causes regression of ipsilateral paramesonephric duct., B: Controls rapid gubernacular growth necessary for transabdominal descent of testis., C: AMH levels in women reflect ovarian follicle reserve., D: AMH is secreted by Leydig cells. ### Response:

AMH is secreted by sertoli cells.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Regarding Anti-mullerian hormone true is all except, with the following options: A: It causes regression of ipsilateral paramesonephric duct., B: Controls rapid gubernacular growth necessary for transabdominal descent of testis., C: AMH levels in women reflect ovarian follicle reserve., D: AMH is secreted by Leydig cells. ### Response: AMH is secreted by sertoli cells. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Frequency for trans vaginal USG for obstetric purpose, with the following options: A: 3 - 5 MHz, B: 5 -7.5 MHz, C: 7.5 - 20 MHz, D: > 20 MHz ### Response:

Transabdominal USG - 3 - 5 MHz. Trans vaginal USG - 5 - 7.5 MHz.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Frequency for trans vaginal USG for obstetric purpose, with the following options: A: 3 - 5 MHz, B: 5 -7.5 MHz, C: 7.5 - 20 MHz, D: > 20 MHz ### Response: Transabdominal USG - 3 - 5 MHz. Trans vaginal USG - 5 - 7.5 MHz. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Energy is required in which transport process, across cell membrane -, with the following options: A: Osmosis, B: Facilitated diffusion, C: Active transport, D: Simple diffusion ### Response:

Ans. is kc' i.e.. Active transport Types of transport across cell membrane Carrier protein involvedEnergy requiredConcentration gradientSimple diffusionNoNoAlong (Down hill)Osmosis (Diffusion of H30)NoNoAlong (Down hill)Facilitated diffusionYesNoAlong (Down hill)Active transportYesYesAgainst (Uphill)ExocytosisNoYesN/A (not applicable)Endocytosis# Pinocytosis & PhagocytosisNoYesN/A# Receptor mediated endocytosisYesYesN/A

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Energy is required in which transport process, across cell membrane -, with the following options: A: Osmosis, B: Facilitated diffusion, C: Active transport, D: Simple diffusion ### Response: Ans. is kc' i.e.. Active transport Types of transport across cell membrane Carrier protein involvedEnergy requiredConcentration gradientSimple diffusionNoNoAlong (Down hill)Osmosis (Diffusion of H30)NoNoAlong (Down hill)Facilitated diffusionYesNoAlong (Down hill)Active transportYesYesAgainst (Uphill)ExocytosisNoYesN/A (not applicable)Endocytosis# Pinocytosis & PhagocytosisNoYesN/A# Receptor mediated endocytosisYesYesN/A ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Maintenance level of Mixed Venous Oxygen Saturation in shock must be, with the following options: A: < 40%, B: 40-50%, C: 50-70%, D: >70%. ### Response:

Mixed Venous Oxygen Saturation: - * This is a measure of oxygen returning to hea from body after delivery and extraction by tissues. * Normal Value- 50-70% * In cardiogenic shock and Hypovolemic shock, the tissues takes up more oxygen and hence value is low < 50% * In Septic and Distributive shock , the tissues takes up less oxygen and hence more oxygenated blood returns to hea and hence value is high > 70% Ref:- Surgery Sixer 3rd Edition; Pg num:- 8

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Maintenance level of Mixed Venous Oxygen Saturation in shock must be, with the following options: A: < 40%, B: 40-50%, C: 50-70%, D: >70%. ### Response: Mixed Venous Oxygen Saturation: - * This is a measure of oxygen returning to hea from body after delivery and extraction by tissues. * Normal Value- 50-70% * In cardiogenic shock and Hypovolemic shock, the tissues takes up more oxygen and hence value is low < 50% * In Septic and Distributive shock , the tissues takes up less oxygen and hence more oxygenated blood returns to hea and hence value is high > 70% Ref:- Surgery Sixer 3rd Edition; Pg num:- 8 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A baby with flat face, low set ears, micrognathia has limb deformities . and bilateral renal agenesis . There is antenatal history of oligohydromnios . The baby died of pulmonary hypoplasia what is the most probable diagnosis?, with the following options: A: Polycystic Kidney disease, B: Prune belly syndrome, C: Potter syndrome, D: Multicystic dysplastic kidney ### Response:

Potter syndrome : potter facies : Flat face, flat nose, low set ears, receding chin. Bilateral renal agenesis. Most common cause of death in pulmonary hypoplasia.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A baby with flat face, low set ears, micrognathia has limb deformities . and bilateral renal agenesis . There is antenatal history of oligohydromnios . The baby died of pulmonary hypoplasia what is the most probable diagnosis?, with the following options: A: Polycystic Kidney disease, B: Prune belly syndrome, C: Potter syndrome, D: Multicystic dysplastic kidney ### Response: Potter syndrome : potter facies : Flat face, flat nose, low set ears, receding chin. Bilateral renal agenesis. Most common cause of death in pulmonary hypoplasia. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Iceberg phenomonon is shown by -, with the following options: A: Rabies, B: Measles, C: Tetanus, D: Influenza ### Response:

Ans. is 'd' i.e., Influenza Icebarg of diseaseo Disease in a community may be compared with an iceberg. The floating tip of the iceberg represents what the physian sees in the community, i.e. clinical cases (Diagnosed case, symptomatic case or clinically apparent case).o The vast submerged portion of the iceberg represents the hidden mass of disease, i.e. latent, inapparent, presymptomatic and undiagnosed cases and carriers in the communityo The "waterline" represents the demarcation between apparent and inapparent disease.o Epidemiologist is concerned with Hidden portion of iceberg whereas clinician is concerned with tip of icebergo Screening is done for Hidden portion of iceberg whereas diagnosis is done for tip of icebergo Iceberg phenomenon of disease is not shown by rabies, tetanus and measles.o The clinician concerned only with the tip of iceberg, i.e symptomatic cases that are seen in clinical treatment, this can result in inaccurate view of the nature and causes of a disease results because the minority of the cases are studied (hidden cases submerged portion of ice berg is not studied) - Clinician's Fallacy.o Important diseases with a great deal of subclinical cases (and thus showing iceberg phenomenon) are : Rubella. Polio. Mumps, Japanese encephalitis. Influenza, diphtheria, Hepatitis A, and Hepatitis B.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Iceberg phenomonon is shown by -, with the following options: A: Rabies, B: Measles, C: Tetanus, D: Influenza ### Response: Ans. is 'd' i.e., Influenza Icebarg of diseaseo Disease in a community may be compared with an iceberg. The floating tip of the iceberg represents what the physian sees in the community, i.e. clinical cases (Diagnosed case, symptomatic case or clinically apparent case).o The vast submerged portion of the iceberg represents the hidden mass of disease, i.e. latent, inapparent, presymptomatic and undiagnosed cases and carriers in the communityo The "waterline" represents the demarcation between apparent and inapparent disease.o Epidemiologist is concerned with Hidden portion of iceberg whereas clinician is concerned with tip of icebergo Screening is done for Hidden portion of iceberg whereas diagnosis is done for tip of icebergo Iceberg phenomenon of disease is not shown by rabies, tetanus and measles.o The clinician concerned only with the tip of iceberg, i.e symptomatic cases that are seen in clinical treatment, this can result in inaccurate view of the nature and causes of a disease results because the minority of the cases are studied (hidden cases submerged portion of ice berg is not studied) - Clinician's Fallacy.o Important diseases with a great deal of subclinical cases (and thus showing iceberg phenomenon) are : Rubella. Polio. Mumps, Japanese encephalitis. Influenza, diphtheria, Hepatitis A, and Hepatitis B. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Least common cause of clubbing is:, with the following options: A: Adenocarcinoma, B: Squamous cell cancer, C: Small cell cancer, D: Mesothelioma ### Response:

Lung cancer is the most common cause of clubbing . Most common with adenocarcinoma and is least common with small cell lung cancer.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Least common cause of clubbing is:, with the following options: A: Adenocarcinoma, B: Squamous cell cancer, C: Small cell cancer, D: Mesothelioma ### Response: Lung cancer is the most common cause of clubbing . Most common with adenocarcinoma and is least common with small cell lung cancer. ### 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 changes does not occur in malignant hypeension :, with the following options: A: Peticheal Haemorrhages on coical surface, B: Fibrinoid necrosis of aerioles, C: Intimal concentric thickening, D: Hyaline aeriosclerosis ### Response:

Answer is D (Hyaline Aeriosclerosis) : Hyaline aeriosclerosis is a feature of Benign Nephrosclerosis associated with benign phase of Hypeension. It is not a ,feature of Malignant Hypeension.

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 changes does not occur in malignant hypeension :, with the following options: A: Peticheal Haemorrhages on coical surface, B: Fibrinoid necrosis of aerioles, C: Intimal concentric thickening, D: Hyaline aeriosclerosis ### Response: Answer is D (Hyaline Aeriosclerosis) : Hyaline aeriosclerosis is a feature of Benign Nephrosclerosis associated with benign phase of Hypeension. It is not a ,feature of Malignant Hypeension. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Fixative agent for PAP smear is which of the following?, with the following options: A: Normal saline, B: 95% ethanol, C: Formalin, D: Air drying ### Response:

PAP smear is an impoant screening test which is used to diagnose cervical dysplasia or cervical carcinoma in females. We use Ether and 95% ethyl alcohol solution in the ratio 1:1 as fixative for the purpose of PAP smear. Best screening test to pick up cervical cancer in the early stage - (Visual Inspection of Cervix with Acetic acid)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Fixative agent for PAP smear is which of the following?, with the following options: A: Normal saline, B: 95% ethanol, C: Formalin, D: Air drying ### Response: PAP smear is an impoant screening test which is used to diagnose cervical dysplasia or cervical carcinoma in females. We use Ether and 95% ethyl alcohol solution in the ratio 1:1 as fixative for the purpose of PAP smear. Best screening test to pick up cervical cancer in the early stage - (Visual Inspection of Cervix with Acetic acid) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Amino acid derived hormone are all except:, with the following options: A: Adrenal medullary hormone., B: Thyroid hormone., C: FSH., D: None. ### Response:

Steroid hormones (derivatives of cholesterol) - Eg: Corticosteroids and sex hormones Derivatives of amino acid tyrosine - Eg: Thyroid & adrenal medullary hormones Protein hormones – i) Glycoproteins - Eg: TSH, LH, FSH ii) Polypeptides - Eg: Growth hormone, ACTH, Insulin, Prolactin

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Amino acid derived hormone are all except:, with the following options: A: Adrenal medullary hormone., B: Thyroid hormone., C: FSH., D: None. ### Response: Steroid hormones (derivatives of cholesterol) - Eg: Corticosteroids and sex hormones Derivatives of amino acid tyrosine - Eg: Thyroid & adrenal medullary hormones Protein hormones – i) Glycoproteins - Eg: TSH, LH, FSH ii) Polypeptides - Eg: Growth hormone, ACTH, Insulin, Prolactin ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Highest cholesterol content is seen in -, with the following options: A: LDL, B: VLDL, C: Chylomicrons, D: IDL ### Response:

Ans. is 'a' i.e., LDL o Maximum triglyceride contento Maximum exogenous triglyceride o Maximum endogenous triglycerideo Maximum cholesterol content----ChylomicronsChylomicronsVLDLLDL

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Highest cholesterol content is seen in -, with the following options: A: LDL, B: VLDL, C: Chylomicrons, D: IDL ### Response: Ans. is 'a' i.e., LDL o Maximum triglyceride contento Maximum exogenous triglyceride o Maximum endogenous triglycerideo Maximum cholesterol content----ChylomicronsChylomicronsVLDLLDL ### 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 examples of microvascular causes of acute kidney injury, EXCEPT:, with the following options: A: Antiphospholipid antibody syndrome, B: Radiation nephritis, C: Thrombotic thrombocytopenic purpura, D: Renal vein thrombosis ### Response:

Microvascular causes of AKI are Thrombotic microangiopathies Antiphospholipid antibody syndrome Radiation nephritis Malignant nephrosclerosis Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP-HUS) Scleroderma Atheroembolic disease Large vessel diseases associated with AKI include Renal aery dissection Thromboembolism Thrombosis Renal vein compression or thrombosis Ref: Harrison, E-18, P-2296.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are examples of microvascular causes of acute kidney injury, EXCEPT:, with the following options: A: Antiphospholipid antibody syndrome, B: Radiation nephritis, C: Thrombotic thrombocytopenic purpura, D: Renal vein thrombosis ### Response: Microvascular causes of AKI are Thrombotic microangiopathies Antiphospholipid antibody syndrome Radiation nephritis Malignant nephrosclerosis Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP-HUS) Scleroderma Atheroembolic disease Large vessel diseases associated with AKI include Renal aery dissection Thromboembolism Thrombosis Renal vein compression or thrombosis Ref: Harrison, E-18, P-2296. ### 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 contents of occipital triangle except, with the following options: A: Greta auricular nerve, B: Suprascapular nerve, C: Lesser occipital nerve, D: Occipital aery ### Response:

Ref BDC volume3,6th edition pg 87 CONTENTS OF OCCIPITAL TRIANGLE NERVES: Spinal accessory nerve Four cutaneous branches of cervical plexus; lesser occipital, great auricular,anterior cutaneous nerve of neck,suprascapular Muscular branches; two small branches to the levator scapulae, two small branches to the trapezius,nerve to rhomboids C5, C6 roots of brachial plexus VESSELS: Transverse cervical aery and vein Occipital aery LYMPH NODES: Supraclavicular nodes Occipital nodes NOTES: Suprascapular nerve is present in subclan triangle.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are contents of occipital triangle except, with the following options: A: Greta auricular nerve, B: Suprascapular nerve, C: Lesser occipital nerve, D: Occipital aery ### Response: Ref BDC volume3,6th edition pg 87 CONTENTS OF OCCIPITAL TRIANGLE NERVES: Spinal accessory nerve Four cutaneous branches of cervical plexus; lesser occipital, great auricular,anterior cutaneous nerve of neck,suprascapular Muscular branches; two small branches to the levator scapulae, two small branches to the trapezius,nerve to rhomboids C5, C6 roots of brachial plexus VESSELS: Transverse cervical aery and vein Occipital aery LYMPH NODES: Supraclavicular nodes Occipital nodes NOTES: Suprascapular nerve is present in subclan triangle. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Patient presenting with joint pain and mild fever. NSAIDs prescribed by the doctor. Developed pigmentation after 1 week on the tip of the nose. What may be the condition?, with the following options: A: Melasma, B: Dengue, C: Chikungunya, D: Fixed drug eruption ### Response:

Ans. (c) ChikungunyaRef: Illustrated Synopsis of Dermatology and SexuallyTransmitted Diseases by Neena Khanna 4th Ed; Page No- 284* Melasma is most commonly occurs in female with peak incidence 30-50 years. In Melasma brown macular lesions with scalloped margins are seen on the cheeks and nose. So it is ruled out.. Melasma1. sites of predilection of melasma2 (1) Melasma; (2) Sites of predilection of Melasma* As the patient has previous history of taking drugs so fixed drug eruption may the answer but In fixed drug eruption; lesions recur at the same site, each time the drug is taken,usually 8-16 h after the intake of drug and the lesions are seen in genitalis and lips. So it is ruled out.* In this case the rash presents in tipoff the nose with chicks and chick signs are marked. So it is case of Chikungunya.Chikungunya Virus* Chikungunya is mosquito-borne viral disease first described during an outbreak in southern Tanzania.* It is a RNA virus that belongs to the Alphavirus genus of the family Togoviridae.* Vector is Aedes aegypti.* No animal reservoir.* Clinical Features:# Typical biphasic fever# Crippling joint pain with maculopapular rash# Conjunctivitis# Lymphadenopathy.* Investigation:# IgM antibody levels are highest 3 to 5 weeks after the onset of illness and persist for about 2 months.# IgM/IgG ELISA in paired sea# RTPCR* Treatment:# No vaccine is available# No specific antiviral drugs# Supportive measures like antipyretics, analgesics and fluids.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Patient presenting with joint pain and mild fever. NSAIDs prescribed by the doctor. Developed pigmentation after 1 week on the tip of the nose. What may be the condition?, with the following options: A: Melasma, B: Dengue, C: Chikungunya, D: Fixed drug eruption ### Response: Ans. (c) ChikungunyaRef: Illustrated Synopsis of Dermatology and SexuallyTransmitted Diseases by Neena Khanna 4th Ed; Page No- 284* Melasma is most commonly occurs in female with peak incidence 30-50 years. In Melasma brown macular lesions with scalloped margins are seen on the cheeks and nose. So it is ruled out.. Melasma1. sites of predilection of melasma2 (1) Melasma; (2) Sites of predilection of Melasma* As the patient has previous history of taking drugs so fixed drug eruption may the answer but In fixed drug eruption; lesions recur at the same site, each time the drug is taken,usually 8-16 h after the intake of drug and the lesions are seen in genitalis and lips. So it is ruled out.* In this case the rash presents in tipoff the nose with chicks and chick signs are marked. So it is case of Chikungunya.Chikungunya Virus* Chikungunya is mosquito-borne viral disease first described during an outbreak in southern Tanzania.* It is a RNA virus that belongs to the Alphavirus genus of the family Togoviridae.* Vector is Aedes aegypti.* No animal reservoir.* Clinical Features:# Typical biphasic fever# Crippling joint pain with maculopapular rash# Conjunctivitis# Lymphadenopathy.* Investigation:# IgM antibody levels are highest 3 to 5 weeks after the onset of illness and persist for about 2 months.# IgM/IgG ELISA in paired sea# RTPCR* Treatment:# No vaccine is available# No specific antiviral drugs# Supportive measures like antipyretics, analgesics and fluids. ### 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 yrs old male comes to casualty with acute retention of urine since 12 hrs. On examination there was distended bladder. His wife gives a history of taking some drug by the patient since 2 days as he is suffering from depression. The most likely drug is:, with the following options: A: CPZ, B: Amitriptyline, C: Haloperidol, D: Pimozide ### Response:

Anticholinergic effects of tricyclic antidepressants (TCAs) are most common. These effects result in dry mouth, constipation, urinary retention, blurred vision, and confusion. They are more common with teiary amine TCAs such as amitriptyline and imipramine than with the secondary amine TCAs desipramine and noriptyline. The potent alpha blocking propey of TCAs often results in ohostatic hypotension. H1 antagonism by the TCAs is associated with weight gain and sedation. The TCAs are class 1A antiarrhythmic agents and are arrhythmogenic at higher doses. Sexual effects are common, paicularly with highly serotonergic TCAs such as clomipramine. The TCAs have a prominent discontinuation syndrome characterized by cholinergic rebound and flulike symptoms. Ref: DeBattista C. (2012). Chapter 30. Antidepressant Agents. In B.G. Katzung, S.B. Masters, A.J. Trevor (Eds), Basic & Clinical Pharmacology, 12e.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 60 yrs old male comes to casualty with acute retention of urine since 12 hrs. On examination there was distended bladder. His wife gives a history of taking some drug by the patient since 2 days as he is suffering from depression. The most likely drug is:, with the following options: A: CPZ, B: Amitriptyline, C: Haloperidol, D: Pimozide ### Response: Anticholinergic effects of tricyclic antidepressants (TCAs) are most common. These effects result in dry mouth, constipation, urinary retention, blurred vision, and confusion. They are more common with teiary amine TCAs such as amitriptyline and imipramine than with the secondary amine TCAs desipramine and noriptyline. The potent alpha blocking propey of TCAs often results in ohostatic hypotension. H1 antagonism by the TCAs is associated with weight gain and sedation. The TCAs are class 1A antiarrhythmic agents and are arrhythmogenic at higher doses. Sexual effects are common, paicularly with highly serotonergic TCAs such as clomipramine. The TCAs have a prominent discontinuation syndrome characterized by cholinergic rebound and flulike symptoms. Ref: DeBattista C. (2012). Chapter 30. Antidepressant Agents. In B.G. Katzung, S.B. Masters, A.J. Trevor (Eds), Basic & Clinical Pharmacology, 12e. ### 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 psychedelic drugs except?, with the following options: A: Lysergic acid diethylamide, B: Phencyclidine, C: Cocaine, D: Mescaline ### Response:

Hallucinogens (Psychotomimetics, psychedelics, psychotogens) are drugs which alter mood, behaviour, thought and perception in a manner similar to that seen in psychosis. These are as: Lysergic acid diethylamide (LSD) Psilocybin Harmine Bufotenin Mescaline (Phenyl alkyl amines) Phencyclidine Lysergic acid amide

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 psychedelic drugs except?, with the following options: A: Lysergic acid diethylamide, B: Phencyclidine, C: Cocaine, D: Mescaline ### Response: Hallucinogens (Psychotomimetics, psychedelics, psychotogens) are drugs which alter mood, behaviour, thought and perception in a manner similar to that seen in psychosis. These are as: Lysergic acid diethylamide (LSD) Psilocybin Harmine Bufotenin Mescaline (Phenyl alkyl amines) Phencyclidine Lysergic acid amide ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Evan's syndome refers to presence of which of the following hematologic changes?, with the following options: A: Autoimmune thrombocytopenia in autoimmune hemolytic anemia, B: DIC in autoimmune hemolytic anemia, C: Thrombocytopenia in hairy cell leukemia, D: Thrombocytosis in autoimmune hemolytic anemia ### Response:

Some cases of autoimmune hemolytic anemia can be associated with autoimmune thrombocytopenia, known as Evan's syndrome. Ref: Harrison's principles of internal medicine, 18th edition, Page 881.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Evan's syndome refers to presence of which of the following hematologic changes?, with the following options: A: Autoimmune thrombocytopenia in autoimmune hemolytic anemia, B: DIC in autoimmune hemolytic anemia, C: Thrombocytopenia in hairy cell leukemia, D: Thrombocytosis in autoimmune hemolytic anemia ### Response: Some cases of autoimmune hemolytic anemia can be associated with autoimmune thrombocytopenia, known as Evan's syndrome. Ref: Harrison's principles of internal medicine, 18th edition, Page 881. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Dimpling in carcinoma is due to:, with the following options: A: Edema, B: Contraction of Cooper's ligaments, C: Subdermal lymphangitis, D: Scarring ### Response:

Dimpling: Small depression over skin of breast due to infiltration of ligament of Cooper by carcinoma Puckering: Small fold or wrinkle of skin over the breast due to infiltration of ligament of Cooper by carcinoma Cancer en-cuirasse: Infiltration of breast skin & chest wall with multiple nodules & ulceration by the carcinoma

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Dimpling in carcinoma is due to:, with the following options: A: Edema, B: Contraction of Cooper's ligaments, C: Subdermal lymphangitis, D: Scarring ### Response: Dimpling: Small depression over skin of breast due to infiltration of ligament of Cooper by carcinoma Puckering: Small fold or wrinkle of skin over the breast due to infiltration of ligament of Cooper by carcinoma Cancer en-cuirasse: Infiltration of breast skin & chest wall with multiple nodules & ulceration by the carcinoma ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 30 year old female with a 15 year history of asthma presents to the emergency room with left elbow pain. Physical examination reveals tenderness and swelling over the olecranon process. An x-ray of the left arm reveals a fracture. Her medications include oral prednisone and albuterol aerosol. By which of the following mechanisms might coicosteroids have contributed to her fracture?, with the following options: A: Decreased osteoblastic bone formation only, B: Decreased osteoblastic bone formation and osteoclastic bone resorption, C: Increased osteoclastic bone resorption only, D: Increased osteoclastic bone resorption and decreased osteoblastic bone formation ### Response:

Coicosteroids inhibit the proliferation and function of osteoblasts, which are modified mesenchymal cells. These agents stimulate osteoclasts to differentiate from bone marrow macrophages and also stimulate their activity.The net effect is maximal bone loss with increased resorption and decreased formation. Ref: Funder J.W. (2011). Chapter 42. ACTH, Adrenal Steroids, and Pharmacology of the Adrenal Coex. 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 30 year old female with a 15 year history of asthma presents to the emergency room with left elbow pain. Physical examination reveals tenderness and swelling over the olecranon process. An x-ray of the left arm reveals a fracture. Her medications include oral prednisone and albuterol aerosol. By which of the following mechanisms might coicosteroids have contributed to her fracture?, with the following options: A: Decreased osteoblastic bone formation only, B: Decreased osteoblastic bone formation and osteoclastic bone resorption, C: Increased osteoclastic bone resorption only, D: Increased osteoclastic bone resorption and decreased osteoblastic bone formation ### Response: Coicosteroids inhibit the proliferation and function of osteoblasts, which are modified mesenchymal cells. These agents stimulate osteoclasts to differentiate from bone marrow macrophages and also stimulate their activity.The net effect is maximal bone loss with increased resorption and decreased formation. Ref: Funder J.W. (2011). Chapter 42. ACTH, Adrenal Steroids, and Pharmacology of the Adrenal Coex. 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: Recurrent dislocation is least common in, with the following options: A: Shoulder, B: Knee, C: Patella, D: None ### Response:

B i.e. Knee * Recurrent dislocation is most common in shoulder jointQ, accounting for nearly 50% of all dislocations.* Anterior shoulder dislocation of subcoracoid typeQ (> anterior subclavicular type) is most common type of shoulder dislocation.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Recurrent dislocation is least common in, with the following options: A: Shoulder, B: Knee, C: Patella, D: None ### Response: B i.e. Knee * Recurrent dislocation is most common in shoulder jointQ, accounting for nearly 50% of all dislocations.* Anterior shoulder dislocation of subcoracoid typeQ (> anterior subclavicular type) is most common type of shoulder dislocation. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 25-year-old male athlete is admitted to the emergency department after a bad landing in the pole vault. Radiographic examination of his hand reveals a fractured carpal bone in the floor of the anatomic snuffbox. Which bone has most likely been fractured?, with the following options: A: Triquetral, B: Scaphoid, C: Capitate, D: Hamate ### Response:

(b) Source: GAS 752-754; GA 392, 394, 422 The anatomic snuffbox is formed by the tendons of the extensor pollicis brevis, the abductor pollicis longus, and the extensor pollicis longus. The floor is formed by the scaphoid bone, and it is here that one can palpate for a possible fractured scaphoid.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 25-year-old male athlete is admitted to the emergency department after a bad landing in the pole vault. Radiographic examination of his hand reveals a fractured carpal bone in the floor of the anatomic snuffbox. Which bone has most likely been fractured?, with the following options: A: Triquetral, B: Scaphoid, C: Capitate, D: Hamate ### Response: (b) Source: GAS 752-754; GA 392, 394, 422 The anatomic snuffbox is formed by the tendons of the extensor pollicis brevis, the abductor pollicis longus, and the extensor pollicis longus. The floor is formed by the scaphoid bone, and it is here that one can palpate for a possible fractured scaphoid. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Putrefaction process is delayed by :, with the following options: A: Peritonitis, B: Ansarca, C: Carbolic acid, D: Sepsis ### Response:

Carbolic acid delays the process of putrefaction. Peritonitis, ansarca, sepsis enhances the process of putrefaction.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Putrefaction process is delayed by :, with the following options: A: Peritonitis, B: Ansarca, C: Carbolic acid, D: Sepsis ### Response: Carbolic acid delays the process of putrefaction. Peritonitis, ansarca, sepsis enhances the process of putrefaction. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Autophagic vacuoles fuse with -, with the following options: A: Golgi complex, B: ER, C: Lysosome, D: Mitocondria ### Response:

Ans. is 'c' i.e., Lysosome o Autophagy is the process by which cells sequester and degrade their own cytoplasmic organelles,o During the process, autophagic vacuole is formed, which is a bilayer vacule containing unnecessary or dysfunctional organelle.o Autophagic vacule fuses with lysosome to form autophagosome (autophagolysosome).o Then, hydrolytic enzymes of lysosome degrade the organelle of autophagic vacuole.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Autophagic vacuoles fuse with -, with the following options: A: Golgi complex, B: ER, C: Lysosome, D: Mitocondria ### Response: Ans. is 'c' i.e., Lysosome o Autophagy is the process by which cells sequester and degrade their own cytoplasmic organelles,o During the process, autophagic vacuole is formed, which is a bilayer vacule containing unnecessary or dysfunctional organelle.o Autophagic vacule fuses with lysosome to form autophagosome (autophagolysosome).o Then, hydrolytic enzymes of lysosome degrade the organelle of autophagic vacuole. ### 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 ovoviviparous?, with the following options: A: Strongyloides, B: Trichinella, C: Enterobius, D: Ascaris ### Response:

Nematodes that lay eggs from which larvae immediately hatch out. So bih of larvae instead of eggs are called viviparous. Strongyloides stercoralis is ovoviviparous.

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 ovoviviparous?, with the following options: A: Strongyloides, B: Trichinella, C: Enterobius, D: Ascaris ### Response: Nematodes that lay eggs from which larvae immediately hatch out. So bih of larvae instead of eggs are called viviparous. Strongyloides stercoralis is ovoviviparous. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The first neuromuscular blocker-, with the following options: A: Succinylcholine, B: d-tubocurare, C: Atracurium, D: Doxacurium ### Response:

The first agent to be used was d-tubocurare the purified and standardized product of plant chondrodendron tomentosum.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The first neuromuscular blocker-, with the following options: A: Succinylcholine, B: d-tubocurare, C: Atracurium, D: Doxacurium ### Response: The first agent to be used was d-tubocurare the purified and standardized product of plant chondrodendron tomentosum. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Condylomata latae are seen in, with the following options: A: Congential syphilis, B: Primary syphilis, C: Secondary syphilis, D: Teiary syphilis ### Response:

C i.e. Secondary Syphilis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Condylomata latae are seen in, with the following options: A: Congential syphilis, B: Primary syphilis, C: Secondary syphilis, D: Teiary syphilis ### Response: C i.e. Secondary Syphilis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Abortion stick used in criminal abortion causes abortion by the mechanism of -, with the following options: A: Uterine contraction, B: Stimulation of uterine nerves, C: Uterine infection & necrosis, D: Placental separation ### Response:

Abortion stick used in criminal abortion causes abortion by uterine contraction.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Abortion stick used in criminal abortion causes abortion by the mechanism of -, with the following options: A: Uterine contraction, B: Stimulation of uterine nerves, C: Uterine infection & necrosis, D: Placental separation ### Response: Abortion stick used in criminal abortion causes abortion by uterine contraction. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 55yr old male patient with his HTN on ACE inhibitors and has CABG four years back is scheduled for hernia surgery He has good effo tolerance which of the following pre-op investigations are ordered, with the following options: A: Routine preop evaluation + Routine preop evaluation, B: Routine preop +clinical+stress testing, C: Routine preop + clinical +angiography to look for potency, D: Routine preop + clinical exam +V/Q scan ### Response:

ref : willey 10th ed

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 55yr old male patient with his HTN on ACE inhibitors and has CABG four years back is scheduled for hernia surgery He has good effo tolerance which of the following pre-op investigations are ordered, with the following options: A: Routine preop evaluation + Routine preop evaluation, B: Routine preop +clinical+stress testing, C: Routine preop + clinical +angiography to look for potency, D: Routine preop + clinical exam +V/Q scan ### Response: ref : willey 10th ed ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Bell clapper testis predisposes to:, with the following options: A: Torsion testis, B: Varicocele, C: Cancer of testis, D: Hydrocele ### Response:

Testicular torsion is a condition in which testicle twists in such a way that the blood supply is compromised. Abnormalities which lead to torsion of the testis: 1. High investment of tunica vaginalis causing the testis to hang within the tunica like a clapper in the bell bilaterally. 2. Inversion of the testis. 3. Separation of the epididymis from the pedicle that connects the testis.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Bell clapper testis predisposes to:, with the following options: A: Torsion testis, B: Varicocele, C: Cancer of testis, D: Hydrocele ### Response: Testicular torsion is a condition in which testicle twists in such a way that the blood supply is compromised. Abnormalities which lead to torsion of the testis: 1. High investment of tunica vaginalis causing the testis to hang within the tunica like a clapper in the bell bilaterally. 2. Inversion of the testis. 3. Separation of the epididymis from the pedicle that connects the testis. ### 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 branch of posterior cord of Brachial plexus-, with the following options: A: Thoracodorsal, B: Radial, C: Ulnar, D: Axillary ### Response:

Ans. C. UlnarBranches of brachial plexus-a. Musculocutaneous nerve branchThe musculocutaneous nerve is a mixed nerve containing sensory and motor axons. The musculocutaneous nerve is derived from the lateral cord. The musculocutaneous nerve leaves the brachial plexus sheath high in the axilla at the level of the lower border of the teres major muscle and passes into the coracobrachialis muscle. It innervates the muscles in the flexor compartment of the arm and carries sensation from the lateral (radial) side of the forearm.b. Ulnar nerve branchThe ulnar nerve is derived from the medial cord. Motor innervation is mainly to intrinsic muscles of the hand. Sensory innervation is to the medial (ulnar) 1.5 digits (little finger, half of the ring finger).c. Median nerve branchThe median nerve is derived from the lateral and medial cords. Motor innervation is to most flexor muscles in the forearm and intrinsic muscles of the thumb (thenar muscles). Sensory innervation is to the lateral (radial) 3.5 digits (thumb, index and middle fingers, half of the ring finger).d. Axillary nerve branchThe axillary nerve is derived from the posterior cord. The axillary nerve leaves the brachial plexus at the lower border of the subscapularis muscle and continues along the inferior and posterior surface of the axillary artery as the radial nerve. The axillary nerve serves as motor innervation to the deltoid and teres minor muscles. These act at the glenohumeral joint. Sensory innervation is from the skin just below the point of the shoulder. The axillary nerve continues as the superior lateral brachial cutaneous nerve of the arm.e. Radial nerve branchThe radial nerve is also derived from the posterior cord. The radial nerve continues along the posterior and inferior surface of the axillary artery and innervates the extensor muscles of the elbow, wrist, and fingers. Sensory innervation is from the skin on the dorsum of the hand on the radial side.f. Additional branchesIn addition to the 5 terminal branches described above, numerous preterminal or collateral branches leave the plexus at various points along its length.g. Dorsal scapular nerveThe dorsal scapular nerve is derived from the C5 root just after its exit from the intervertebral foramen. It serves as the motor nerve to the rhomboids major and minor musclesh. Long thoracic nerveThe long thoracic nerve is derived from C5 ,C6 , and C7 roots immediately after their emergence from the intervertebral foramina. The long thoracic nerve crosses the first rib and then descends through the axilla behind the major branches of the plexus. It innervates the serratus anterior muscle.i. Phrenic nerveThe phrenic nerve arises from C3 ,C4 , and C5 root levels, although chiefly from the C4 nerve root. It crosses the anterior scalene from lateral to medial and extends into the thorax between the subclavian vein and artery.j. Subclavius muscle nerveThe nerve to the subclavius muscle is a small filament that arises from the upper trunk. It descends to the subclavius muscle in front of the subclavian artery and the lower trunk of the plexus.k. Suprascapular nerveThe suprascapular nerve arises from the upper trunk formed by the union of the fifth and sixth cervical nerves. It innervates the supraspinatus muscles and infraspinatus muscles. It runs laterally beneath the trapezius and the omohyoideus and enters the supraspinatus fossa through the suprascapular notch, below the superior transverse scapular ligament; it then passes beneath the supraspinatus and curves around the lateral border of the spine of the scapula to the infraspinatus fossa.l. Lateral pectoral nerveThe lateral pectoral nerve arises from the lateral cord of the brachial plexus, from the fifth, sixth, and seventh cervical nerves. It passes across the axillary artery and vein, pierces the coracoclavicular fascia, and is distributed to the deep surface of the pectoralis major. It sends a filament to join the medial anterior thoracic and forms with it a loop in front of the first part of the axillary artery. This nerve innervates the clavicular head of the pectoralis major muscle.m. Medial pectoral nerveThe medial pectoral nerve arises from the medial cord from the eighth cervical and first thoracic nerve. It passes behind the first part of the axillary artery, curves forward between the axillary artery and vein, and unites in front of the artery with a filament from the lateral nerve. It then enters the deep surface of the pectoralis minor, where it divides into a number of branches, which supply the muscle. Several branches of the medial pectoral nerve pierce the muscle and end in the pectoralis major, which supply the muscle.The medial and lateral pectoral nerve often join together to act as a single nerve innervating the pectoralis major and minor muscles.n. Thoracodorsal nerveThe thoracodorsal nerve arises from the posterior cord (C6 to 8) between the subscapular nerves. It accompanies the subscapular artery along the posterior axillary wall and supplies latissimus dorsi, reaching its distal border.o. Medial brachial cutaneous nerveThe medial brachial cutaneous nerve is the smallest branch of the brachial plexus; arising from the medial cord, it receives its fibers from the eighth cervical and first thoracic nerves. It passes through the axilla, at first lying behind and then medial to the axillary vein, and communicates with the intercostobrachial nerve.The medial brachial cutaneous nerve descends along the medial side of the brachial artery to the middle of the arm, where it pierces the deep fascia, and is distributed to the skin of the back of the lower third of the arm, extending as far as the elbow, where some filaments are lost in the skin in front of the medial epicondyle, and others over the olecranon. It communicates with the ulnar branch of the medial antebrachial cutaneous nerve. The medial brachial cutaneous nerve carries sensation from the lower medial portion of the arm.p. Medial antebrachial cutaneous nerveThe medial antebrachial cutaneous arises from the medial cord of the brachial plexus. It derives its fibers from the eighth cervical and first thoracic nerves and at its commencement is medial to the axillary artery. It gives off near the axilla a filament that pierces the fascia and supplies the integument covering the biceps brachii, nearly as far as the elbow. The nerve then runs down the ulnar side of the arm medial to the brachial artery, pierces the deep fascia with the basilic vein, about the middle of the arm, and divides into a volar and an ulnar branch.

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 branch of posterior cord of Brachial plexus-, with the following options: A: Thoracodorsal, B: Radial, C: Ulnar, D: Axillary ### Response: Ans. C. UlnarBranches of brachial plexus-a. Musculocutaneous nerve branchThe musculocutaneous nerve is a mixed nerve containing sensory and motor axons. The musculocutaneous nerve is derived from the lateral cord. The musculocutaneous nerve leaves the brachial plexus sheath high in the axilla at the level of the lower border of the teres major muscle and passes into the coracobrachialis muscle. It innervates the muscles in the flexor compartment of the arm and carries sensation from the lateral (radial) side of the forearm.b. Ulnar nerve branchThe ulnar nerve is derived from the medial cord. Motor innervation is mainly to intrinsic muscles of the hand. Sensory innervation is to the medial (ulnar) 1.5 digits (little finger, half of the ring finger).c. Median nerve branchThe median nerve is derived from the lateral and medial cords. Motor innervation is to most flexor muscles in the forearm and intrinsic muscles of the thumb (thenar muscles). Sensory innervation is to the lateral (radial) 3.5 digits (thumb, index and middle fingers, half of the ring finger).d. Axillary nerve branchThe axillary nerve is derived from the posterior cord. The axillary nerve leaves the brachial plexus at the lower border of the subscapularis muscle and continues along the inferior and posterior surface of the axillary artery as the radial nerve. The axillary nerve serves as motor innervation to the deltoid and teres minor muscles. These act at the glenohumeral joint. Sensory innervation is from the skin just below the point of the shoulder. The axillary nerve continues as the superior lateral brachial cutaneous nerve of the arm.e. Radial nerve branchThe radial nerve is also derived from the posterior cord. The radial nerve continues along the posterior and inferior surface of the axillary artery and innervates the extensor muscles of the elbow, wrist, and fingers. Sensory innervation is from the skin on the dorsum of the hand on the radial side.f. Additional branchesIn addition to the 5 terminal branches described above, numerous preterminal or collateral branches leave the plexus at various points along its length.g. Dorsal scapular nerveThe dorsal scapular nerve is derived from the C5 root just after its exit from the intervertebral foramen. It serves as the motor nerve to the rhomboids major and minor musclesh. Long thoracic nerveThe long thoracic nerve is derived from C5 ,C6 , and C7 roots immediately after their emergence from the intervertebral foramina. The long thoracic nerve crosses the first rib and then descends through the axilla behind the major branches of the plexus. It innervates the serratus anterior muscle.i. Phrenic nerveThe phrenic nerve arises from C3 ,C4 , and C5 root levels, although chiefly from the C4 nerve root. It crosses the anterior scalene from lateral to medial and extends into the thorax between the subclavian vein and artery.j. Subclavius muscle nerveThe nerve to the subclavius muscle is a small filament that arises from the upper trunk. It descends to the subclavius muscle in front of the subclavian artery and the lower trunk of the plexus.k. Suprascapular nerveThe suprascapular nerve arises from the upper trunk formed by the union of the fifth and sixth cervical nerves. It innervates the supraspinatus muscles and infraspinatus muscles. It runs laterally beneath the trapezius and the omohyoideus and enters the supraspinatus fossa through the suprascapular notch, below the superior transverse scapular ligament; it then passes beneath the supraspinatus and curves around the lateral border of the spine of the scapula to the infraspinatus fossa.l. Lateral pectoral nerveThe lateral pectoral nerve arises from the lateral cord of the brachial plexus, from the fifth, sixth, and seventh cervical nerves. It passes across the axillary artery and vein, pierces the coracoclavicular fascia, and is distributed to the deep surface of the pectoralis major. It sends a filament to join the medial anterior thoracic and forms with it a loop in front of the first part of the axillary artery. This nerve innervates the clavicular head of the pectoralis major muscle.m. Medial pectoral nerveThe medial pectoral nerve arises from the medial cord from the eighth cervical and first thoracic nerve. It passes behind the first part of the axillary artery, curves forward between the axillary artery and vein, and unites in front of the artery with a filament from the lateral nerve. It then enters the deep surface of the pectoralis minor, where it divides into a number of branches, which supply the muscle. Several branches of the medial pectoral nerve pierce the muscle and end in the pectoralis major, which supply the muscle.The medial and lateral pectoral nerve often join together to act as a single nerve innervating the pectoralis major and minor muscles.n. Thoracodorsal nerveThe thoracodorsal nerve arises from the posterior cord (C6 to 8) between the subscapular nerves. It accompanies the subscapular artery along the posterior axillary wall and supplies latissimus dorsi, reaching its distal border.o. Medial brachial cutaneous nerveThe medial brachial cutaneous nerve is the smallest branch of the brachial plexus; arising from the medial cord, it receives its fibers from the eighth cervical and first thoracic nerves. It passes through the axilla, at first lying behind and then medial to the axillary vein, and communicates with the intercostobrachial nerve.The medial brachial cutaneous nerve descends along the medial side of the brachial artery to the middle of the arm, where it pierces the deep fascia, and is distributed to the skin of the back of the lower third of the arm, extending as far as the elbow, where some filaments are lost in the skin in front of the medial epicondyle, and others over the olecranon. It communicates with the ulnar branch of the medial antebrachial cutaneous nerve. The medial brachial cutaneous nerve carries sensation from the lower medial portion of the arm.p. Medial antebrachial cutaneous nerveThe medial antebrachial cutaneous arises from the medial cord of the brachial plexus. It derives its fibers from the eighth cervical and first thoracic nerves and at its commencement is medial to the axillary artery. It gives off near the axilla a filament that pierces the fascia and supplies the integument covering the biceps brachii, nearly as far as the elbow. The nerve then runs down the ulnar side of the arm medial to the brachial artery, pierces the deep fascia with the basilic vein, about the middle of the arm, and divides into a volar and an ulnar branch. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: BRCA1 gene is located on which chromosome?, with the following options: A: Chromosome 13, B: Chromosome 19, C: Chromosome 21, D: Chromosome 17 ### Response:

The BRCA2 gene is located on chromosome 13 and encodes over 3000 amino acids. It appears that BRCA2 plays an important role in male breast cancer. • The human BRCA1 gene is located on the long (q) arm of chromosome 17

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: BRCA1 gene is located on which chromosome?, with the following options: A: Chromosome 13, B: Chromosome 19, C: Chromosome 21, D: Chromosome 17 ### Response: The BRCA2 gene is located on chromosome 13 and encodes over 3000 amino acids. It appears that BRCA2 plays an important role in male breast cancer. • The human BRCA1 gene is located on the long (q) arm of chromosome 17 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In retinal sealing/retinopexy, what is used?, with the following options: A: Sulphur hexafluoride, B: Carbon monooxide, C: Nitrous oxide, D: S02 ### Response:

The gases commonly employed for tamponading the retina are sulphur hexafluoride (SF6) or perfluoropropane (C3F8). These are injected after sealing the breaks with cryopaxy. The gas bubble remains in contact with the tear for 5-7 days and are absorbed later. Ref: Parson's 22 nd edition page no. 335

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In retinal sealing/retinopexy, what is used?, with the following options: A: Sulphur hexafluoride, B: Carbon monooxide, C: Nitrous oxide, D: S02 ### Response: The gases commonly employed for tamponading the retina are sulphur hexafluoride (SF6) or perfluoropropane (C3F8). These are injected after sealing the breaks with cryopaxy. The gas bubble remains in contact with the tear for 5-7 days and are absorbed later. Ref: Parson's 22 nd edition page no. 335 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Red flag sign in child development if not attained ?, with the following options: A: Vocalization at 2 months, B: Walking at 12 months, C: Single word at 12 months, D: Standing alone at 16 month ### Response:

Ans. is 'd' i.e., Standing alone at l6 month Red flag sign of child developmentMilestoneAgeNo visual fixation or following by2 monthsNo vocalisation6 monthsNot siting without suppo9-10 monthsNot standing alone16 monthsNot walking alone18 monthsNot single word18 monthsLack of imaginative play3 years

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Red flag sign in child development if not attained ?, with the following options: A: Vocalization at 2 months, B: Walking at 12 months, C: Single word at 12 months, D: Standing alone at 16 month ### Response: Ans. is 'd' i.e., Standing alone at l6 month Red flag sign of child developmentMilestoneAgeNo visual fixation or following by2 monthsNo vocalisation6 monthsNot siting without suppo9-10 monthsNot standing alone16 monthsNot walking alone18 monthsNot single word18 monthsLack of imaginative play3 years ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The energy for muscle contraction is supplied by the enzymatic hydrolysis of ATP by ATPase present in:, with the following options: A: Heavy meromyosin, B: Light meromyosin, C: Tropomyosin, D: Troponin ### Response:

The energy for muscle contraction is supplied by the enzymatic hydrolysis of ATP by ATPase present in heavy meromyosin. Two strands of heavy meromyosin are found in each myosin head - one of which is folded over as a protein mass. Light meromyosin is also found in myosin but is not involved in splitting ATP. Troponin and tropomyosin are located on the actin filament. Ref: Murray R.K. (2011). Chapter 49. Muscle & the Cytoskeleton. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The energy for muscle contraction is supplied by the enzymatic hydrolysis of ATP by ATPase present in:, with the following options: A: Heavy meromyosin, B: Light meromyosin, C: Tropomyosin, D: Troponin ### Response: The energy for muscle contraction is supplied by the enzymatic hydrolysis of ATP by ATPase present in heavy meromyosin. Two strands of heavy meromyosin are found in each myosin head - one of which is folded over as a protein mass. Light meromyosin is also found in myosin but is not involved in splitting ATP. Troponin and tropomyosin are located on the actin filament. Ref: Murray R.K. (2011). Chapter 49. Muscle & the Cytoskeleton. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Coffee bean nuclei are seen in all of the following Except, with the following options: A: Granulosa cell tumor, B: Follicular carcinoma thyroid, C: Brenner tumor, D: Langerhan's cell histiocytosis ### Response:

A nucleus with longitudinal groove gives it a coffee bean nuclei appearance and is seen characteristically inPapillary carcinoma thyroidBrenner tumorGranulosa cell tumorLangerhan's cell histiocytosis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Coffee bean nuclei are seen in all of the following Except, with the following options: A: Granulosa cell tumor, B: Follicular carcinoma thyroid, C: Brenner tumor, D: Langerhan's cell histiocytosis ### Response: A nucleus with longitudinal groove gives it a coffee bean nuclei appearance and is seen characteristically inPapillary carcinoma thyroidBrenner tumorGranulosa cell tumorLangerhan's cell histiocytosis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Bone marrow in Amyloid Lightchain Amyloidosis shows which of the following features?, with the following options: A: Bone marrow plasmacytosis, B: Granulomatous reaction, C: Fibrosis, D: Giant cell formation ### Response:

Amyloid light chain (AL) protein is derived from plasma cells. All patients with AL amyloidosis have increased plasma cells in their bone marrow presumably accounting for the production of precursors of AL protein. Ref: Pathologic Basis of Disease, Robbins, 6th Edition, Page 253; 7th Edition, Page 261

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Bone marrow in Amyloid Lightchain Amyloidosis shows which of the following features?, with the following options: A: Bone marrow plasmacytosis, B: Granulomatous reaction, C: Fibrosis, D: Giant cell formation ### Response: Amyloid light chain (AL) protein is derived from plasma cells. All patients with AL amyloidosis have increased plasma cells in their bone marrow presumably accounting for the production of precursors of AL protein. Ref: Pathologic Basis of Disease, Robbins, 6th Edition, Page 253; 7th Edition, Page 261 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Dawn phenomenon refers to-, with the following options: A: Early morning hyperglycemia, B: Early morning hypolgycemia, C: Hypoglycemia followed by hyperglycemia, D: High insulin levels ### Response:

Question repeated The dawn phenomenon, sometimes called the dawn effect, is an early-morning (usually between 2 a.m. and 8 a.m.) increase in blood sugar (glucose) relevant to people with diabetes. It is different from chronic Somogyi rebound in that dawn phenomenon is not associated with nocturnal hypoglycemia. The dawn phenomenon can be managed in many patients by avoiding carbohydrate intake at bedtime, adjusting the dosage of medication or insulin, switching to a different medication, or by using an insulin pump to administer extra insulin during early-morning hours. In most of the cases, there is no need to change insulin dosing of patients who encounter the dawn phenomenon.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Dawn phenomenon refers to-, with the following options: A: Early morning hyperglycemia, B: Early morning hypolgycemia, C: Hypoglycemia followed by hyperglycemia, D: High insulin levels ### Response: Question repeated The dawn phenomenon, sometimes called the dawn effect, is an early-morning (usually between 2 a.m. and 8 a.m.) increase in blood sugar (glucose) relevant to people with diabetes. It is different from chronic Somogyi rebound in that dawn phenomenon is not associated with nocturnal hypoglycemia. The dawn phenomenon can be managed in many patients by avoiding carbohydrate intake at bedtime, adjusting the dosage of medication or insulin, switching to a different medication, or by using an insulin pump to administer extra insulin during early-morning hours. In most of the cases, there is no need to change insulin dosing of patients who encounter the dawn phenomenon. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Indication for surgery in a case of adrenal incidentaloma -, with the following options: A: Size > 5 cm, B: Bilateral adrenal metastasis, C: Functional tumor, D: All of the above ### Response:

According to CSDT nonfunctioning adrenal tumors larger than 5 cm in diameter should be removed because of the high risk of malignancy.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Indication for surgery in a case of adrenal incidentaloma -, with the following options: A: Size > 5 cm, B: Bilateral adrenal metastasis, C: Functional tumor, D: All of the above ### Response: According to CSDT nonfunctioning adrenal tumors larger than 5 cm in diameter should be removed because of the high risk of malignancy. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Restriction fragment length polymorphism uses the technique of: UP 10; NIMHANS 11, with the following options: A: Southern blotting, B: Nohern blotting, C: Western blotting, D: Eastern blotting ### Response:

Ans. Southern blotting

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Restriction fragment length polymorphism uses the technique of: UP 10; NIMHANS 11, with the following options: A: Southern blotting, B: Nohern blotting, C: Western blotting, D: Eastern blotting ### Response: Ans. Southern blotting ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which drug is not acetylated?, with the following options: A: INH, B: Dapsone, C: Hydralazine, D: Metoclopropamide ### Response:

Ans. is 'd' i.e. Metoclopramide Acetylation is a phase II metabolic reactionPhase II reactions serves to attach a conjugate to the drug molecule. After the phase II reactions all drugs becomes water soluble, so that they can be readily eliminated from the body.Phase II reactions includesGlucuronidationAcetylationMethylationSulfationGlycine conjugation AcetylationDrugs having amino or hydrazine resides are conjugated with the help of acetyl coenzyme A. Examples are :S - Sulfonamides (Dapsone)H- Hydralazine I - Isoniazid P-PASAcetylation is a genetically mediated condition.Multiple genes control the acetyl transferases and the rate of acetylation shows genetic polymorphism

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which drug is not acetylated?, with the following options: A: INH, B: Dapsone, C: Hydralazine, D: Metoclopropamide ### Response: Ans. is 'd' i.e. Metoclopramide Acetylation is a phase II metabolic reactionPhase II reactions serves to attach a conjugate to the drug molecule. After the phase II reactions all drugs becomes water soluble, so that they can be readily eliminated from the body.Phase II reactions includesGlucuronidationAcetylationMethylationSulfationGlycine conjugation AcetylationDrugs having amino or hydrazine resides are conjugated with the help of acetyl coenzyme A. Examples are :S - Sulfonamides (Dapsone)H- Hydralazine I - Isoniazid P-PASAcetylation is a genetically mediated condition.Multiple genes control the acetyl transferases and the rate of acetylation shows genetic polymorphism ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Drugs of choice for MRSA in skin-soft tissue infections and serious infections are:, with the following options: A: Vancomycin, Teicoplanin, B: Clindamycin, Vancomycin, C: Vancomycin, Linezolid, D: Dicloxacillin, Vancomycin ### Response:

Ans. B. Clindamycin, VancomycinMRSA mild infection - Clindamycin, MRSA serious infection - Vancomycin, empirical therapy - Vancomycin

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Drugs of choice for MRSA in skin-soft tissue infections and serious infections are:, with the following options: A: Vancomycin, Teicoplanin, B: Clindamycin, Vancomycin, C: Vancomycin, Linezolid, D: Dicloxacillin, Vancomycin ### Response: Ans. B. Clindamycin, VancomycinMRSA mild infection - Clindamycin, MRSA serious infection - Vancomycin, empirical therapy - Vancomycin ### End

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

Ans. is 'a' i.e., Scrub typhus

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Mite transmits -, with the following options: A: Scrub typhus, B: Trench fever, C: Endemic typhus, D: Epidemic typhus ### Response: Ans. is 'a' i.e., Scrub typhus ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pauci immune glomerulonephritis is seen in ?, with the following options: A: After transplant in Alpos, B: Microscopic polyangitis, C: Henoch-schonlein nephritis, D: Lupus ### Response:

Ans. is 'b' i.e., Microscopic polyangitis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pauci immune glomerulonephritis is seen in ?, with the following options: A: After transplant in Alpos, B: Microscopic polyangitis, C: Henoch-schonlein nephritis, D: Lupus ### Response: Ans. is 'b' i.e., Microscopic polyangitis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Bone not present at bih-, with the following options: A: Malleus, B: Incus, C: Stapes, D: Petrous temporal ### Response:

D i.e. Petrous temporal

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Bone not present at bih-, with the following options: A: Malleus, B: Incus, C: Stapes, D: Petrous temporal ### Response: D i.e. Petrous temporal ### 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 is not a cause for "Restrictive cardiomyopathy" -, with the following options: A: Alcohol, B: Hemochromatosis, C: Amyloidosis, D: Sarcoidosis ### Response:

Ref: Harrison&;s 19th E: pg: 1566. Most common cause of restrictive cardiomyopathy is amylodosis. The least common of the physiologic triad of cardiomyopathies is restrictive cardiomyopathy, which is dominated by abnormal diastolic function, often with mildly decreased contractility and ejection fraction (usually >30-50%). Other causes : hemochromatosis, hyper and hypothyroidism, pheochromocytoma, nutritional deficiencies., sarcoidosis.

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 is not a cause for "Restrictive cardiomyopathy" -, with the following options: A: Alcohol, B: Hemochromatosis, C: Amyloidosis, D: Sarcoidosis ### Response: Ref: Harrison&;s 19th E: pg: 1566. Most common cause of restrictive cardiomyopathy is amylodosis. The least common of the physiologic triad of cardiomyopathies is restrictive cardiomyopathy, which is dominated by abnormal diastolic function, often with mildly decreased contractility and ejection fraction (usually >30-50%). Other causes : hemochromatosis, hyper and hypothyroidism, pheochromocytoma, nutritional deficiencies., sarcoidosis. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In fracture surgical neck of humerus, the following nerve injury is common:, with the following options: A: Axillary, B: Radial, C: Ulnar, D: Median ### Response:

A i.e. Axillary

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In fracture surgical neck of humerus, the following nerve injury is common:, with the following options: A: Axillary, B: Radial, C: Ulnar, D: Median ### Response: A i.e. Axillary ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A destitute woman is admitted to the hospital with altered sensorium and dehydration; urine analysis shows mild proteinuria and no sugar; what other test would be desirable, with the following options: A: Fouchet, B: Rothera, C: Hays, D: Benedicts ### Response:

Rothera The women are presenting with altered sensorium and dehydration, which may be the presenting features of ketoacidosis. She has already been tested for urine sugar (rules out diabetic ketoacidosis) and protein. The important investigation missed out in this patient is ketone bodies in urine, which is important to reach the diagnosis of starvation ketosis. Ketone bodies are tested by Rothera's test. About other options

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A destitute woman is admitted to the hospital with altered sensorium and dehydration; urine analysis shows mild proteinuria and no sugar; what other test would be desirable, with the following options: A: Fouchet, B: Rothera, C: Hays, D: Benedicts ### Response: Rothera The women are presenting with altered sensorium and dehydration, which may be the presenting features of ketoacidosis. She has already been tested for urine sugar (rules out diabetic ketoacidosis) and protein. The important investigation missed out in this patient is ketone bodies in urine, which is important to reach the diagnosis of starvation ketosis. Ketone bodies are tested by Rothera's test. About other options ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ash leaf macules are characteristic of, with the following options: A: Von Recklinghausen disease, B: Bournviller disease, C: Von Hipple -Lindau disease, D: Sturge - Weber syndrome ### Response:

Ash leaf macules are hypopigmental off - white coloured macules 1 - 3 cm in zise.It is seen is tuberous sclerosis (also known as Bournville's disease).

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ash leaf macules are characteristic of, with the following options: A: Von Recklinghausen disease, B: Bournviller disease, C: Von Hipple -Lindau disease, D: Sturge - Weber syndrome ### Response: Ash leaf macules are hypopigmental off - white coloured macules 1 - 3 cm in zise.It is seen is tuberous sclerosis (also known as Bournville's disease). ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Phenylketonuria is due to the deficiency of:, with the following options: A: Phenylalanine, B: Phenylalanine hydroxylase (PAH), C: Phenylene, D: All of these ### Response:

(B) Phenylalanine hydroxylase (PAH)[?]PHENYLKETONURIAoClassical is HyperPhenylaminemia. Other can be due to defective biopterin cofactoroBiosynthesis-GTP cyclohydrolase I-6-pyruvoyl-tetrahydropterin synthase - Dihydropterin reductase.[?]Biology of PhenylketonuriaoPhenylketonuria or PKU is the inability of the body to Metabolize pheynlamine.oPhenylaline builds to toxic levels in the tissues, particularly damaging the nervous systemoPKU is a chronic disease, but it is possible to greatly reduce the probability of further damage by following a strict low-protein dietoPKU is autosomal recessive and carried on chromosome 1 2[?]Symptoms: Often have lighter skin, hair, and eyes than brothers or sisters without the disease.oOther symptoms include:-Eczema-Recurrent vomiting-Jerking movements in arms and legs-Tremors & Mood disorders, MicrocephalyoA birth defect that causes an amino acid called phenylalanine to build up in the body.oPKU is an autosomal recessive metabolic genetic disorder.oPKU is characterized by homozygous or compound heterozygousmutations in the gene for the hepatic enzyme phenylalanine hydroxylase (PAH), rendering it nonfunctional.oThis enzyme is necessary to metabolize the amino acid phenylalanine (Phe) to the amino acid tyrosine (Tyr). When PAH activity is reduced, phenylalanine accumulates and is converted into phenylpyruvate (phenyl ketone), which can be detected in the urine.oPAH gene is located on chromosome 12 in the bands 12q22-q24.1.oMore than 400 disease-causing mutations have been found in the PAH gene.INBORN ERRORS OF AMINO ACID METABOLISMS DISORDERSDisorderEnzyme Deficiency*. PhenylketonuriaPhenylalanine hydroxylase*. AlkptonuriaHomogentistate 1, 2- Dioxygenase complex*. Homocystenuria Type IDefect in cofactor binding site of cystathionine synthase*. Homocysteinuria Type IIMethylene THF Reductase Decrease*. Cysteinuria Type ICystathionine synthase*. CystathioninuriaCystathionase*. Tyrosinemia Type ICystathionine synthase*. Tyrosinemia Type IITyrosine Aminotransferase*. Tyrosinemia Type IIIPara-hydroxyphenylpyruvate dioxygenase*. AlbinismTyrosinase

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Phenylketonuria is due to the deficiency of:, with the following options: A: Phenylalanine, B: Phenylalanine hydroxylase (PAH), C: Phenylene, D: All of these ### Response: (B) Phenylalanine hydroxylase (PAH)[?]PHENYLKETONURIAoClassical is HyperPhenylaminemia. Other can be due to defective biopterin cofactoroBiosynthesis-GTP cyclohydrolase I-6-pyruvoyl-tetrahydropterin synthase - Dihydropterin reductase.[?]Biology of PhenylketonuriaoPhenylketonuria or PKU is the inability of the body to Metabolize pheynlamine.oPhenylaline builds to toxic levels in the tissues, particularly damaging the nervous systemoPKU is a chronic disease, but it is possible to greatly reduce the probability of further damage by following a strict low-protein dietoPKU is autosomal recessive and carried on chromosome 1 2[?]Symptoms: Often have lighter skin, hair, and eyes than brothers or sisters without the disease.oOther symptoms include:-Eczema-Recurrent vomiting-Jerking movements in arms and legs-Tremors & Mood disorders, MicrocephalyoA birth defect that causes an amino acid called phenylalanine to build up in the body.oPKU is an autosomal recessive metabolic genetic disorder.oPKU is characterized by homozygous or compound heterozygousmutations in the gene for the hepatic enzyme phenylalanine hydroxylase (PAH), rendering it nonfunctional.oThis enzyme is necessary to metabolize the amino acid phenylalanine (Phe) to the amino acid tyrosine (Tyr). When PAH activity is reduced, phenylalanine accumulates and is converted into phenylpyruvate (phenyl ketone), which can be detected in the urine.oPAH gene is located on chromosome 12 in the bands 12q22-q24.1.oMore than 400 disease-causing mutations have been found in the PAH gene.INBORN ERRORS OF AMINO ACID METABOLISMS DISORDERSDisorderEnzyme Deficiency*. PhenylketonuriaPhenylalanine hydroxylase*. AlkptonuriaHomogentistate 1, 2- Dioxygenase complex*. Homocystenuria Type IDefect in cofactor binding site of cystathionine synthase*. Homocysteinuria Type IIMethylene THF Reductase Decrease*. Cysteinuria Type ICystathionine synthase*. CystathioninuriaCystathionase*. Tyrosinemia Type ICystathionine synthase*. Tyrosinemia Type IITyrosine Aminotransferase*. Tyrosinemia Type IIIPara-hydroxyphenylpyruvate dioxygenase*. AlbinismTyrosinase ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Following operations are done in case of otosclerosis:, with the following options: A: Stapedectomy, B: Fenestration, C: Stapedotomy, D: All ### Response:

Role of surgery in a case of otosclerosisSurgeryformsthe mainstay of management in a case of otosclerosis(Surgery of choice)|Stapedectoy / stapedotmy(surgery oh choice) Lempes fenestration procedure|Fenestration of the lateral semicircular canal is done. It is reserved for cases where footplate cannot be mobilized during stapedectomy(Outdated nowadays) Stapes mobilization|It is done in those cases only in wbichthere is paial ankylosis of footplate of stapes althoughreankylosis tends to develop a although reankylosis tends to develop

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Following operations are done in case of otosclerosis:, with the following options: A: Stapedectomy, B: Fenestration, C: Stapedotomy, D: All ### Response: Role of surgery in a case of otosclerosisSurgeryformsthe mainstay of management in a case of otosclerosis(Surgery of choice)|Stapedectoy / stapedotmy(surgery oh choice) Lempes fenestration procedure|Fenestration of the lateral semicircular canal is done. It is reserved for cases where footplate cannot be mobilized during stapedectomy(Outdated nowadays) Stapes mobilization|It is done in those cases only in wbichthere is paial ankylosis of footplate of stapes althoughreankylosis tends to develop a although reankylosis tends to develop ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Honey comb lung appearance is seen in, with the following options: A: Consolidation, B: Alveolar cell carcinoma, C: Scleroderma, D: Pulmonary edema ### Response:

Honey comb lung Histiocytosis-x, scleroderma, Rheumatoid arthritis, ILD, TB.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Honey comb lung appearance is seen in, with the following options: A: Consolidation, B: Alveolar cell carcinoma, C: Scleroderma, D: Pulmonary edema ### Response: Honey comb lung Histiocytosis-x, scleroderma, Rheumatoid arthritis, ILD, TB. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Frame shift mutation causes -, with the following options: A: Transversion, B: Transition, C: Termination of protein synthesis, D: Alteration of whole reading sequence ### Response:

Ans. is 'd' i.e., Alteration of whole reading sequenceMutationso A mutation is apermanant change in the DMA.o Mutations that affect germ cells (sperm or ovum) are transmitted to progeny and may give rise to inherited disease.o Mutations that affect somatic cells are not transmitted to progeny but are important in the genesis of cancers and congenital malformations,o Mutations may be classified into three categories -l.Gene mutationsThe vast majority of mutations associated with hereditary disease are gene mutationsThese may of different types depending whether it involves complete gene or single base -(a) Point mutationo A single nucleotide base is substituted by a different base.o When a pyrimidine base is substituted by other pyrimidine base or a purine base is substituted by other purine - Transition.o When a purine is substituded by a pyrimidine or vice-versa - Transversion,o This may alter the code in a triplet of bases, i.e. in codon and leads to replacement of one aminoacid by another in the gene product.o Because these mutations alter the meaning of the genetic code, they are often termed missense mutation.o Example is sickle mutation in which CTC codon in b-chain of hemoglobin that codes for glutamic acid is changed to CAC codon that codes for valine,o Another type of point mutation is nonsense mutation in which a point mutation may change an amino acid codon to a stop codon.o Example is b-thalassemia in which CAG codon in b-chain of hemoglobin that code for glutamin is changed to stop codon UAG after point mutation.(b) Deletion and insertionso Deletion or insertion of one or two base lead to alterations in the reading frame of the DNA strand - frame shift mutation.o If the number of base pairs invoved is three or a multiple of three framshift does not occur (because codon is triplet), instead an abnormal protein missing one or more amino acids is synthesized.(c) Trinucleotide repeat mutationo Normally a codon is triplet ie trinucleotide.o In this type of mutation a codon, ie trinucleotide sequence undergoes amplification and the same codon is repeated continuously so many times in the chain,o For example in fragile X-syndrome. CGG codon is repeated 250-4000 times, ie. there are 250-4000 tandem repeates of CGG.Chnomosome mutationo Result from rearrangement of genetic material that give rise to visible structural changes in the chromosome.Genome mutationo Involves loss or gain of whole chromosome, e.g. monosomy - Turner syndrome, trisomy - Down syndrome.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Frame shift mutation causes -, with the following options: A: Transversion, B: Transition, C: Termination of protein synthesis, D: Alteration of whole reading sequence ### Response: Ans. is 'd' i.e., Alteration of whole reading sequenceMutationso A mutation is apermanant change in the DMA.o Mutations that affect germ cells (sperm or ovum) are transmitted to progeny and may give rise to inherited disease.o Mutations that affect somatic cells are not transmitted to progeny but are important in the genesis of cancers and congenital malformations,o Mutations may be classified into three categories -l.Gene mutationsThe vast majority of mutations associated with hereditary disease are gene mutationsThese may of different types depending whether it involves complete gene or single base -(a) Point mutationo A single nucleotide base is substituted by a different base.o When a pyrimidine base is substituted by other pyrimidine base or a purine base is substituted by other purine - Transition.o When a purine is substituded by a pyrimidine or vice-versa - Transversion,o This may alter the code in a triplet of bases, i.e. in codon and leads to replacement of one aminoacid by another in the gene product.o Because these mutations alter the meaning of the genetic code, they are often termed missense mutation.o Example is sickle mutation in which CTC codon in b-chain of hemoglobin that codes for glutamic acid is changed to CAC codon that codes for valine,o Another type of point mutation is nonsense mutation in which a point mutation may change an amino acid codon to a stop codon.o Example is b-thalassemia in which CAG codon in b-chain of hemoglobin that code for glutamin is changed to stop codon UAG after point mutation.(b) Deletion and insertionso Deletion or insertion of one or two base lead to alterations in the reading frame of the DNA strand - frame shift mutation.o If the number of base pairs invoved is three or a multiple of three framshift does not occur (because codon is triplet), instead an abnormal protein missing one or more amino acids is synthesized.(c) Trinucleotide repeat mutationo Normally a codon is triplet ie trinucleotide.o In this type of mutation a codon, ie trinucleotide sequence undergoes amplification and the same codon is repeated continuously so many times in the chain,o For example in fragile X-syndrome. CGG codon is repeated 250-4000 times, ie. there are 250-4000 tandem repeates of CGG.Chnomosome mutationo Result from rearrangement of genetic material that give rise to visible structural changes in the chromosome.Genome mutationo Involves loss or gain of whole chromosome, e.g. monosomy - Turner syndrome, trisomy - Down syndrome. ### 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 Cluster B personality disorder?, with the following options: A: Schiziod personality disorder, B: Narcissistic personality disorder, C: Dependant personality disorder, D: Anantastic personality disorder ### Response:

Narcissistic personality disorder is a cluster B personality disorder. Schiziod personality disorder is a cluster A personality disorder. Dependant & Anankastic personality disorders are cluster C personality disorder.

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 Cluster B personality disorder?, with the following options: A: Schiziod personality disorder, B: Narcissistic personality disorder, C: Dependant personality disorder, D: Anantastic personality disorder ### Response: Narcissistic personality disorder is a cluster B personality disorder. Schiziod personality disorder is a cluster A personality disorder. Dependant & Anankastic personality disorders are cluster C personality disorder. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 2 year old child without fever develops bone pain, vomiting and features of increased intracranial pressure following excessive medication. The drug most likely to be responsible for this is –, with the following options: A: Vitamin A, B: Phenothiazine, C: Phenytoin, D: Vitamin D ### Response:

It is a case of pseudotumor cerebri.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 2 year old child without fever develops bone pain, vomiting and features of increased intracranial pressure following excessive medication. The drug most likely to be responsible for this is –, with the following options: A: Vitamin A, B: Phenothiazine, C: Phenytoin, D: Vitamin D ### Response: It is a case of pseudotumor cerebri. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: NARY is a -, with the following options: A: Lipid storage disorder, B: Glycogen storage disorder, C: Mitochondrial disorder, D: Lysosomal storage disorder ### Response:

Ans is 'c' i.e., Mitochondria! disorder Clinical Syndromes of Mitochondrial Diseases Primary Features Chronic progressive external o External ophthalmoplegia ophthalmoplegia (CPEO) o Bilateral ptosis o PEO onset before age 20 years o Pigmentary retinopathy o One of the following CSF protein greater than I g/L, cerebellar ataxia, hea block o Sideroblastic anemia of childhood o Panytopenia o Exocrine pancreatic failure o Hypotonia in the first year of life o Feeding and respiratory difficulties o Subacute relapsing encephalopathy o Cerebellar and brain-stem signs o Infantile onset o Late-childhood or adult-onset peripheral neuropathy o Ataxia o Pigmentary retinopathy o Stroke-like episodes before age 40 years o Seizures and/or dementia o Ragged-red fibers and/or lactic acidosis o Myoclonus o Seizures o Cerebellar ataxia o Myopathy o Subacute painless bilateral visual failure o Males: females-- 4:1 o Median age of onset 24 years Bilateral deafness Myopathy Dysphagia Diabetes mellitus Hypoparathyroidism Dementia Renal tubular defects Fatal form may be associated with a cardiomyopathy and/or the Toni-Fanconi-Debre syndrome Basal ganglia lucencies Maternal history of neurologic disease of Leigh syndroms Basal ganglia lucencies Abnormal electroretinogram Sensorimotor neuropathy 0 Diabetes mellitus 0 Cardiomyopathy (initially hyperophic; later dilated) 0 Bilateral deafness 0 Pigmentary retinopathy 0 Cerebellar ataxia Dementia Optic atrophy Bilateral deafness Peripheral neuropathy Spasticity Multiple lipomata Dystonia Cardiac pre-excitation syndromes

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: NARY is a -, with the following options: A: Lipid storage disorder, B: Glycogen storage disorder, C: Mitochondrial disorder, D: Lysosomal storage disorder ### Response: Ans is 'c' i.e., Mitochondria! disorder Clinical Syndromes of Mitochondrial Diseases Primary Features Chronic progressive external o External ophthalmoplegia ophthalmoplegia (CPEO) o Bilateral ptosis o PEO onset before age 20 years o Pigmentary retinopathy o One of the following CSF protein greater than I g/L, cerebellar ataxia, hea block o Sideroblastic anemia of childhood o Panytopenia o Exocrine pancreatic failure o Hypotonia in the first year of life o Feeding and respiratory difficulties o Subacute relapsing encephalopathy o Cerebellar and brain-stem signs o Infantile onset o Late-childhood or adult-onset peripheral neuropathy o Ataxia o Pigmentary retinopathy o Stroke-like episodes before age 40 years o Seizures and/or dementia o Ragged-red fibers and/or lactic acidosis o Myoclonus o Seizures o Cerebellar ataxia o Myopathy o Subacute painless bilateral visual failure o Males: females-- 4:1 o Median age of onset 24 years Bilateral deafness Myopathy Dysphagia Diabetes mellitus Hypoparathyroidism Dementia Renal tubular defects Fatal form may be associated with a cardiomyopathy and/or the Toni-Fanconi-Debre syndrome Basal ganglia lucencies Maternal history of neurologic disease of Leigh syndroms Basal ganglia lucencies Abnormal electroretinogram Sensorimotor neuropathy 0 Diabetes mellitus 0 Cardiomyopathy (initially hyperophic; later dilated) 0 Bilateral deafness 0 Pigmentary retinopathy 0 Cerebellar ataxia Dementia Optic atrophy Bilateral deafness Peripheral neuropathy Spasticity Multiple lipomata Dystonia Cardiac pre-excitation syndromes ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The basic pathology of Barrett's esophagus is -, with the following options: A: Metaplasia of columnar cells to squamous cells, B: Metaplasia of squamous cells to columnar cells, C: Dysplasia of esophageal epithelium, D: Cardiac sphincter pressure disturbances ### Response:

Ans. is 'b' i.e., Metaplasia of squamous cells to columnar cells Barrett's esophaguso Is metaplastic change of distal esophageal mucosa from normal squamous epithelium to columnar epithelium, in response to chronic gastro-esophageal reflux.o The junction between squamous esophageal mucosa and gastric mucosa moves proximally.o Three types of columnar epithelium have been described in Barrett's esophagus:i) Intestinal type - the most common typeii) The junctional type andiii) The gastric fundic typeo Barrett's esophagus is a premalignant condition for adenocarcinoma esophaguso "The definition of Barrett's esophagus (BE) has evolved considerably over the past decade. Traditionally, BE was identified by the presence of columnar mucosa extending at least 3 cm into the esophagus. It is now recognized that the specialized intestinal type epithelium found in the Barrett's mucosa is the only tissue predisposed to malignant degeneration. Consequently, the diagnosis of BE is presently made given any length of endoscopically indentifiable columnar mucosa that proves on biopsy to show intestinal metaplasia." - Schwartz 9/e p831 (8/e, p868)Also remembero The hallmark of intestinal metaplasia is the presence of intestinal goblet cells.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The basic pathology of Barrett's esophagus is -, with the following options: A: Metaplasia of columnar cells to squamous cells, B: Metaplasia of squamous cells to columnar cells, C: Dysplasia of esophageal epithelium, D: Cardiac sphincter pressure disturbances ### Response: Ans. is 'b' i.e., Metaplasia of squamous cells to columnar cells Barrett's esophaguso Is metaplastic change of distal esophageal mucosa from normal squamous epithelium to columnar epithelium, in response to chronic gastro-esophageal reflux.o The junction between squamous esophageal mucosa and gastric mucosa moves proximally.o Three types of columnar epithelium have been described in Barrett's esophagus:i) Intestinal type - the most common typeii) The junctional type andiii) The gastric fundic typeo Barrett's esophagus is a premalignant condition for adenocarcinoma esophaguso "The definition of Barrett's esophagus (BE) has evolved considerably over the past decade. Traditionally, BE was identified by the presence of columnar mucosa extending at least 3 cm into the esophagus. It is now recognized that the specialized intestinal type epithelium found in the Barrett's mucosa is the only tissue predisposed to malignant degeneration. Consequently, the diagnosis of BE is presently made given any length of endoscopically indentifiable columnar mucosa that proves on biopsy to show intestinal metaplasia." - Schwartz 9/e p831 (8/e, p868)Also remembero The hallmark of intestinal metaplasia is the presence of intestinal goblet cells. ### 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 is not true regarding pseudocyst of pancreas -, with the following options: A: Epigastric mass, B: Increase level of amylase, C: Cystogastrostomy is the ideal T/t, D: Percutaneus aspiration is the T/t ### Response:

Ans is 'd' ie Percutaneous aspiration is the t/t Percutaneous aspiration is preferred only in cases of infected cyst and abcesses, other wise internal drainage is the t/t of choice. Epigastric mass is the main symptom of pseudocyst. Increased level of amylase is usually elevated with pancreatic pseudocysts.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which one is not true regarding pseudocyst of pancreas -, with the following options: A: Epigastric mass, B: Increase level of amylase, C: Cystogastrostomy is the ideal T/t, D: Percutaneus aspiration is the T/t ### Response: Ans is 'd' ie Percutaneous aspiration is the t/t Percutaneous aspiration is preferred only in cases of infected cyst and abcesses, other wise internal drainage is the t/t of choice. Epigastric mass is the main symptom of pseudocyst. Increased level of amylase is usually elevated with pancreatic pseudocysts. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: National Family Health Survey has successfully completed -, with the following options: A: One round, B: Two rounds, C: Three rounds, D: Four rounds ### Response:

The National Family Health Survey (NFHS) is a large-scale, multi-round survey conducted in a representative sample of households throughout India. Three rounds of the survey have been conducted since the first survey in 1992-93. The survey provides state and national information for India on feility, infant and child moality, the practice of family planning, maternal and child health, reproductive health, nutrition, anaemia, utilization and quality of health and family planning services. Each successive round of the NFHS has had two specific goals: a) to provide essential data on health and family welfare needed by the Ministry of Health and Family Welfare and other agencies for policy and programme purposes, and b) to provide information on impoant emerging health and family welfare issues. The Ministry of Health and Family Welfare (MOHFW), Government of India, designated the International Institute for Population Sciences(IIPS) Mumbai, as the nodal agency, responsible for providing coordination and technical guidance for the survey. IIPS collaborated with a number of Field Organizations (FO) for survey implementation. Each FO was responsible for conducting survey activities in one or more states covered by the NFHS. Technical assistance for the NFHS was provided mainly by ORC Macro (USA) and other organizations on specific issues. The funding for different rounds of NFHS has been provided by USAID, DFID, the Bill and Melinda Gates Foundation, UNICEF, UNFPA, and MOHFW, GOI Ref: GOI

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: National Family Health Survey has successfully completed -, with the following options: A: One round, B: Two rounds, C: Three rounds, D: Four rounds ### Response: The National Family Health Survey (NFHS) is a large-scale, multi-round survey conducted in a representative sample of households throughout India. Three rounds of the survey have been conducted since the first survey in 1992-93. The survey provides state and national information for India on feility, infant and child moality, the practice of family planning, maternal and child health, reproductive health, nutrition, anaemia, utilization and quality of health and family planning services. Each successive round of the NFHS has had two specific goals: a) to provide essential data on health and family welfare needed by the Ministry of Health and Family Welfare and other agencies for policy and programme purposes, and b) to provide information on impoant emerging health and family welfare issues. The Ministry of Health and Family Welfare (MOHFW), Government of India, designated the International Institute for Population Sciences(IIPS) Mumbai, as the nodal agency, responsible for providing coordination and technical guidance for the survey. IIPS collaborated with a number of Field Organizations (FO) for survey implementation. Each FO was responsible for conducting survey activities in one or more states covered by the NFHS. Technical assistance for the NFHS was provided mainly by ORC Macro (USA) and other organizations on specific issues. The funding for different rounds of NFHS has been provided by USAID, DFID, the Bill and Melinda Gates Foundation, UNICEF, UNFPA, and MOHFW, GOI Ref: GOI ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Essential criteria for TOF includes all, EXCEPT:, with the following options: A: Valvular stenosis, B: Infundibular stenosis, C: Over riding of aoa, D: RVH ### Response:

ToF is the most common cyanotic congenital hea malformation and one of the first complex lesions to be successfully repaired. ToF occurs in 7% to 10% of children with CHD. The four characteristic findings in ToF are (1) a malaligned VSD, (2) RV outflow or pulmonary valve or aery stenosis or atresia, (3) a dextroposed overriding aoa, and (4) RV hyperophy. Valvular stenosis is not a essential criteria for TOF. Ref: Aboulhosn J.A., Child J.S. (2011). Chapter 84. Congenital Hea Disease in Adults. In V. Fuster, R.A. Walsh, R.A. Harrington (Eds), Hurst's The Hea, 13e.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Essential criteria for TOF includes all, EXCEPT:, with the following options: A: Valvular stenosis, B: Infundibular stenosis, C: Over riding of aoa, D: RVH ### Response: ToF is the most common cyanotic congenital hea malformation and one of the first complex lesions to be successfully repaired. ToF occurs in 7% to 10% of children with CHD. The four characteristic findings in ToF are (1) a malaligned VSD, (2) RV outflow or pulmonary valve or aery stenosis or atresia, (3) a dextroposed overriding aoa, and (4) RV hyperophy. Valvular stenosis is not a essential criteria for TOF. Ref: Aboulhosn J.A., Child J.S. (2011). Chapter 84. Congenital Hea Disease in Adults. In V. Fuster, R.A. Walsh, R.A. Harrington (Eds), Hurst's The Hea, 13e. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common extra articular manifestation of Ankylosing spondylitis is, with the following options: A: Anterior uveitis, B: Inflammatory bowel disease, C: Gallstones, D: Heart block ### Response:

(A) Anterior uveitis # Most common extra articular manifestation is ACUTE ANTERIOR UVEITIS, which occurs in 40% of patients and can antedate the spondylitis. Attacks are typically unilateral, causing pain, photophobia, & increased lacrimation. These tend to recur, often in opposite eye. Up to 60% of patients have inflammation in the colon or ileum. This is usually asymptomatic, but in 5 to 10% of patients with AS, frank IBD will develop. Aortic insufficiency, sometimes producing symptoms of congestive heart failure, occurs in a few percent of patients, occasionally early in the course of the spinal disease but usually after prolonged disease. Third-degree heart block may occur alone or together with aortic insufficiency. Gall stones are not a prominent feature. Mortality attributable to AS is largely the result of spinal trauma, aortic insufficiency, respiratory failure, amyloid nephropathy, or complications of therapy such as upper gastrointestinal hemorrhage.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common extra articular manifestation of Ankylosing spondylitis is, with the following options: A: Anterior uveitis, B: Inflammatory bowel disease, C: Gallstones, D: Heart block ### Response: (A) Anterior uveitis # Most common extra articular manifestation is ACUTE ANTERIOR UVEITIS, which occurs in 40% of patients and can antedate the spondylitis. Attacks are typically unilateral, causing pain, photophobia, & increased lacrimation. These tend to recur, often in opposite eye. Up to 60% of patients have inflammation in the colon or ileum. This is usually asymptomatic, but in 5 to 10% of patients with AS, frank IBD will develop. Aortic insufficiency, sometimes producing symptoms of congestive heart failure, occurs in a few percent of patients, occasionally early in the course of the spinal disease but usually after prolonged disease. Third-degree heart block may occur alone or together with aortic insufficiency. Gall stones are not a prominent feature. Mortality attributable to AS is largely the result of spinal trauma, aortic insufficiency, respiratory failure, amyloid nephropathy, or complications of therapy such as upper gastrointestinal hemorrhage. ### 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 umbilical aery Doppler is, with the following options: A: Changes in the flow velocity waveforms of umbilical aery may be impoant in the management of high-risk pregnancies, B: Absence of end-diastolic flow is normal at term, C: Maternal smoking decreases SID ratio, D: Increased diastolic flow indicates worse prognosis ### Response:

Ans. Absence of end-diastolic flow is normal at term

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about umbilical aery Doppler is, with the following options: A: Changes in the flow velocity waveforms of umbilical aery may be impoant in the management of high-risk pregnancies, B: Absence of end-diastolic flow is normal at term, C: Maternal smoking decreases SID ratio, D: Increased diastolic flow indicates worse prognosis ### Response: Ans. Absence of end-diastolic flow is normal at term ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which drug is not metabolised by acetylation?, with the following options: A: INH, B: Dapsone, C: Hydralazine, D: Metoclopramide ### Response:

Acetylation is a phase II metabolic reaction. Drugs metabolized by acetylation are Sulfonamides, Hydralazine, Isoniazid, Procainamide. Individuals who are slow acetylators are predisposed to drug-induced autoimmune disorders. Ref: K.D.T 6th Ed Page 25

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which drug is not metabolised by acetylation?, with the following options: A: INH, B: Dapsone, C: Hydralazine, D: Metoclopramide ### Response: Acetylation is a phase II metabolic reaction. Drugs metabolized by acetylation are Sulfonamides, Hydralazine, Isoniazid, Procainamide. Individuals who are slow acetylators are predisposed to drug-induced autoimmune disorders. Ref: K.D.T 6th Ed Page 25 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In marasmus, which of the following is not seen?, with the following options: A: Edema, B: Voracious appetite, C: Hepatomegaly not seen, D: Child is active ### Response:

Edema is a feature of Kwashiorkor, not seen in marasmus. Kwashiorkor Marasmus Edema Present absent appetite poor Voracious appetite CNS involvement apathy Active child Hepatomegaly seen Not seen Skin and hair changes More common Less common

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In marasmus, which of the following is not seen?, with the following options: A: Edema, B: Voracious appetite, C: Hepatomegaly not seen, D: Child is active ### Response: Edema is a feature of Kwashiorkor, not seen in marasmus. Kwashiorkor Marasmus Edema Present absent appetite poor Voracious appetite CNS involvement apathy Active child Hepatomegaly seen Not seen Skin and hair changes More common Less common ### 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 posterior mediastinal tumor :, with the following options: A: Neurofibroma, B: Lymphoma, C: Thymoma, D: Gastroenteric cyst ### Response:

Ans is 'c' ie Thymoma Mediastinum- is situated b/w the lungs in the center of the thorax.It is divided into 3 compartmentsAnterior or Anterosuperior it lies in front of the anterior pericardium & tracheaMiddle mediastinum or Visceral compartment it lies within the pericardial cavity including the tracheaPosterior mediastinum or paravertebral sulci it lies posterior to the post pericardium & tracheaLocations of the common Mediastinal MassesAnterior mediastinumMiddle MediastinumPost. MediastinumThymoma (most common in Ant med.)LymphomaGerm cell tumorsMesenchymal tumorsThyroid & parathyroid massesThymic cystCysts (MC in Mid. Med.)pleuropericardialbronchogenicenterogenousneuroentericVascular masses (aneurysm)Lymph node enlargement (including lymphoma)Mesenchymal tumorsPheochromocytomaMC tumor in middle Mediastinum- LymphomaNeurogenic tumors (MC overall)MeningoceleGastroenteric cystMesenchymal tumorsPheochromocytomaLymphoma

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Not a posterior mediastinal tumor :, with the following options: A: Neurofibroma, B: Lymphoma, C: Thymoma, D: Gastroenteric cyst ### Response: Ans is 'c' ie Thymoma Mediastinum- is situated b/w the lungs in the center of the thorax.It is divided into 3 compartmentsAnterior or Anterosuperior it lies in front of the anterior pericardium & tracheaMiddle mediastinum or Visceral compartment it lies within the pericardial cavity including the tracheaPosterior mediastinum or paravertebral sulci it lies posterior to the post pericardium & tracheaLocations of the common Mediastinal MassesAnterior mediastinumMiddle MediastinumPost. MediastinumThymoma (most common in Ant med.)LymphomaGerm cell tumorsMesenchymal tumorsThyroid & parathyroid massesThymic cystCysts (MC in Mid. Med.)pleuropericardialbronchogenicenterogenousneuroentericVascular masses (aneurysm)Lymph node enlargement (including lymphoma)Mesenchymal tumorsPheochromocytomaMC tumor in middle Mediastinum- LymphomaNeurogenic tumors (MC overall)MeningoceleGastroenteric cystMesenchymal tumorsPheochromocytomaLymphoma ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 26-year-oldman, Raju met with an accident & is brought to emergency. The person accompanying him informed that a truck run over the patient. CXR reveals an air fluid level in left lung &nasogastric tube got coiled upward into left chest. Which of the following is the next best step in management of this patient?, with the following options: A: Placement of a chest tube on left side, B: Thoracotomy, C: Diagnostic peritoneal lavage, D: Laparotomy ### Response:

This is likely a case of acute diaphragmatic rupture and should be treated with immediate laparotomy. Etiology of diaphragmatic rupture: 1. Penetrating trauma 2. Blunt trauma - Comprehensive force applied to pelvis or abdomen Clinical features: Most injuries are Silent Patients presents with S/S of injury of associated organs Late complication of diaphragmatic injury -Herniation Most common organ herniated - Stomach > colon > Small intestine Investigations VATS (Video assisted Thoracoscopy) Laparoscopy & evaluate the other abdominal organs Treatment: Operative repair in all cases BergquistTraid: Rib fracture Spine or Pelvic fracture Traumatic rupture of diaphragm

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 26-year-oldman, Raju met with an accident & is brought to emergency. The person accompanying him informed that a truck run over the patient. CXR reveals an air fluid level in left lung &nasogastric tube got coiled upward into left chest. Which of the following is the next best step in management of this patient?, with the following options: A: Placement of a chest tube on left side, B: Thoracotomy, C: Diagnostic peritoneal lavage, D: Laparotomy ### Response: This is likely a case of acute diaphragmatic rupture and should be treated with immediate laparotomy. Etiology of diaphragmatic rupture: 1. Penetrating trauma 2. Blunt trauma - Comprehensive force applied to pelvis or abdomen Clinical features: Most injuries are Silent Patients presents with S/S of injury of associated organs Late complication of diaphragmatic injury -Herniation Most common organ herniated - Stomach > colon > Small intestine Investigations VATS (Video assisted Thoracoscopy) Laparoscopy & evaluate the other abdominal organs Treatment: Operative repair in all cases BergquistTraid: Rib fracture Spine or Pelvic fracture Traumatic rupture of diaphragm ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Area 4 of the coex corresponds to:, with the following options: A: Primary motor area, B: Primary sensory area, C: Visual coex, D: None of the above ### Response:

The primary motor coex (MI) corresponds to the precentral gyrus (area 4). It is the area of coex with the lowest threshold for eliciting contralateral muscle contraction by electrical stimulation. Ref: Gray's anatomy 40th edition, Chapter 21.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Area 4 of the coex corresponds to:, with the following options: A: Primary motor area, B: Primary sensory area, C: Visual coex, D: None of the above ### Response: The primary motor coex (MI) corresponds to the precentral gyrus (area 4). It is the area of coex with the lowest threshold for eliciting contralateral muscle contraction by electrical stimulation. Ref: Gray's anatomy 40th edition, Chapter 21. ### 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 sulfonylureas is -, with the following options: A: Chlorpropamide is 2nd generation agent, B: Most common side effect is hypoglycemia, C: Effective even after pancreactomy, D: Safe in pregnancy ### Response:

Ans. is 'b' i.e., Most common side effect is hypoglycemiao Sulfonylureas are -1. First generation Tolbutamide, chlorpropamide.2. Second generation Glibenclamide (Glyburide), glipizide, gliclazide, glimpride.Sulfonylureas act byo Sulfonylurease provoke a brisk release of insulin from pancreas. They act on the so called "Sulfonylurea receptors" (SUR1) on pancreatic b-cell membrane - cause depolarization by reducing conductance of ATP sensitive K+ channels. This enhances influx of Ca+2 - degranulation. They do not cause hypoglycemia in pancreatectomized animals and type 1 diabetes (Presence of at least 30% of functional b-cells in essential for their action). A minor action reducing glucagon secretion by increasing insulin and somatostatin release has been demonstratedo Extrahepatic action# On chronic administration they sensitize the target cells (especially the liver) to the action of insulin.# On chronic administration their action on pancrease (to release insuline) declines due to down regulation of sulfonylurea receptors.# But glycemic control is maintained due to extrahepatic action.# Glimepiride exerts beneficial effects with regard to ischemic preconditioning.Sulfonyloreas cause following adverse effectso Hypoglycemia# This is commonest side effect.# More common in elderly, liver and kidney disease.# Chlorpropamide is a frequent culprit due to its long action due to its long action.# Tolbutamide carries lowest risk due to its low potency and short duration of action.# Lower incidence is also reported with glipizide, glibenclamide, glimepiride.o Hypersensitivity# Rashes, photosensitivity, purpura, transient leukopenia, rarely agranulocytosiso Adverse effects specific to particular drug# Cholorpropamide causes cholestasis, dilutional hyponatremia, intolerance to alcohol (disulfiram like reaction). Chlorpropamide causes dilutional hyponatremia by sensitising the kidney to ADH action.# Tolbutamide reduces iodine uptake by thyroid.o Sulfonylureas are not safe during pregnancy - change over to insulin. Sulfonylureas are secreted in milk - should not be given to nursing mothers. Gliclazide has an antiplatelet effect.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about sulfonylureas is -, with the following options: A: Chlorpropamide is 2nd generation agent, B: Most common side effect is hypoglycemia, C: Effective even after pancreactomy, D: Safe in pregnancy ### Response: Ans. is 'b' i.e., Most common side effect is hypoglycemiao Sulfonylureas are -1. First generation Tolbutamide, chlorpropamide.2. Second generation Glibenclamide (Glyburide), glipizide, gliclazide, glimpride.Sulfonylureas act byo Sulfonylurease provoke a brisk release of insulin from pancreas. They act on the so called "Sulfonylurea receptors" (SUR1) on pancreatic b-cell membrane - cause depolarization by reducing conductance of ATP sensitive K+ channels. This enhances influx of Ca+2 - degranulation. They do not cause hypoglycemia in pancreatectomized animals and type 1 diabetes (Presence of at least 30% of functional b-cells in essential for their action). A minor action reducing glucagon secretion by increasing insulin and somatostatin release has been demonstratedo Extrahepatic action# On chronic administration they sensitize the target cells (especially the liver) to the action of insulin.# On chronic administration their action on pancrease (to release insuline) declines due to down regulation of sulfonylurea receptors.# But glycemic control is maintained due to extrahepatic action.# Glimepiride exerts beneficial effects with regard to ischemic preconditioning.Sulfonyloreas cause following adverse effectso Hypoglycemia# This is commonest side effect.# More common in elderly, liver and kidney disease.# Chlorpropamide is a frequent culprit due to its long action due to its long action.# Tolbutamide carries lowest risk due to its low potency and short duration of action.# Lower incidence is also reported with glipizide, glibenclamide, glimepiride.o Hypersensitivity# Rashes, photosensitivity, purpura, transient leukopenia, rarely agranulocytosiso Adverse effects specific to particular drug# Cholorpropamide causes cholestasis, dilutional hyponatremia, intolerance to alcohol (disulfiram like reaction). Chlorpropamide causes dilutional hyponatremia by sensitising the kidney to ADH action.# Tolbutamide reduces iodine uptake by thyroid.o Sulfonylureas are not safe during pregnancy - change over to insulin. Sulfonylureas are secreted in milk - should not be given to nursing mothers. Gliclazide has an antiplatelet effect. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The most common cause of pulmonary embolism is, with the following options: A: Amniotic fluid embolism, B: Calf vein thrombi, C: Pelvic vein thrombosis, D: Cardio thoracic surgery ### Response:

About half of the patient with pelvic vein thrombosis or proximal leg deep vein thrombosis have pulmonary thromboembolism. Isolated calf vein thrombosis pose a lower risk of pulmonary embolism. The majority of pulmonary emboli arise from the propagation of lower limb deep vein thrombosis (p. 186). Rare causes include septic emboli (from endocarditis affecting the tricuspid or pulmonary valves), tumour (especially choriocarcinoma), fat following fracture of long bones such as the femur, air, and amniotic fluid, which may enter the mother's circulation following delivery. Ref Davidson edition23rd pg 620

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The most common cause of pulmonary embolism is, with the following options: A: Amniotic fluid embolism, B: Calf vein thrombi, C: Pelvic vein thrombosis, D: Cardio thoracic surgery ### Response: About half of the patient with pelvic vein thrombosis or proximal leg deep vein thrombosis have pulmonary thromboembolism. Isolated calf vein thrombosis pose a lower risk of pulmonary embolism. The majority of pulmonary emboli arise from the propagation of lower limb deep vein thrombosis (p. 186). Rare causes include septic emboli (from endocarditis affecting the tricuspid or pulmonary valves), tumour (especially choriocarcinoma), fat following fracture of long bones such as the femur, air, and amniotic fluid, which may enter the mother's circulation following delivery. Ref Davidson edition23rd pg 620 ### 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 hemobilia, with the following options: A: Triad of jaundice, pain, Melena, B: MC cause : rupture of poal vein into biliary system, C: MR angiography is the IOC, D: None of the above ### Response:

Clinical features of Hemobilia Characterised by Quinck's triad (Sandblom's triad) : GI hemorrhage +biliary colic +jaundice Presentation: Melena (90 %), hemetemesis (60%), biliary colic (70%), and jaundice (60%). Tendency for delayed presentation (upto weeks) and recurrent brisk but limited bleeding over months and even years Ref : Sabiston 20th edition Pgno :1472-1474

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True regarding hemobilia, with the following options: A: Triad of jaundice, pain, Melena, B: MC cause : rupture of poal vein into biliary system, C: MR angiography is the IOC, D: None of the above ### Response: Clinical features of Hemobilia Characterised by Quinck's triad (Sandblom's triad) : GI hemorrhage +biliary colic +jaundice Presentation: Melena (90 %), hemetemesis (60%), biliary colic (70%), and jaundice (60%). Tendency for delayed presentation (upto weeks) and recurrent brisk but limited bleeding over months and even years Ref : Sabiston 20th edition Pgno :1472-1474 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Schizophrenia is characterized by -, with the following options: A: Formed through disorder, B: Hallucination, C: Delusion, D: All ### Response:

This one is different from both the previous one. Here the examiner has not asked about the characteristic feature of schizophrenia. Schizophrenia is characterized by all symptoms which have been explained earlier. So, Schizophrenia is a disorder of → thought, perception, mood & volition. Hallmark of schizophrenia→ Thought disorders. Characteristic features of schizophrenia → Delusions, hallucinations, disorganized speech and behavior, negative symptoms. Schizophrenia is characterized by → All previously explained symptoms.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Schizophrenia is characterized by -, with the following options: A: Formed through disorder, B: Hallucination, C: Delusion, D: All ### Response: This one is different from both the previous one. Here the examiner has not asked about the characteristic feature of schizophrenia. Schizophrenia is characterized by all symptoms which have been explained earlier. So, Schizophrenia is a disorder of → thought, perception, mood & volition. Hallmark of schizophrenia→ Thought disorders. Characteristic features of schizophrenia → Delusions, hallucinations, disorganized speech and behavior, negative symptoms. Schizophrenia is characterized by → All previously explained symptoms. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Infection of CNS spreads in inner ear through, with the following options: A: Cochlear aqueduct, B: Endolymphatic sac, C: Vestibular aqueduct, D: Hyle fissure ### Response:

Ans. A Cochlear aqueductAs we know that cochlear aqueduct (Aqueduct of Cochlea) is a connection between scala tympani (containing perilymph) and the subarachnoid space (containing CSF). On occassions, paicularly in young children, the Cochlear aqueduct is large and open.Infection can spread to the inner ear from the infected CSF or vice versa, the cochlear aqueduct resulting in severe profound hearing loss (meningitic labyrinthitis).

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Infection of CNS spreads in inner ear through, with the following options: A: Cochlear aqueduct, B: Endolymphatic sac, C: Vestibular aqueduct, D: Hyle fissure ### Response: Ans. A Cochlear aqueductAs we know that cochlear aqueduct (Aqueduct of Cochlea) is a connection between scala tympani (containing perilymph) and the subarachnoid space (containing CSF). On occassions, paicularly in young children, the Cochlear aqueduct is large and open.Infection can spread to the inner ear from the infected CSF or vice versa, the cochlear aqueduct resulting in severe profound hearing loss (meningitic labyrinthitis). ### End