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Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 40 years males presented with painful vesicular lesion in the forehead extending to the eyelids. Diagnosis is, with the following options: A: Herpes simplex, B: Herpes-Zoster, C: Coxschiae infection, D: Molluscum contagiosum ### Response:

(Herpes- Zoster) (52-Roxburg's 17th) (1182- CMDT-08)* Herpes simplex - manifest as acute gingivo-stomalitis, herpes labialis**, balanitis, vulvo-vaginitis, proctitis or kerato conjunctivitis* Intraepidermal vesicles around the mouth and lip (Type I) on the genitalia (Type II)* Herpes Zoster (Shingles) - Involvement of the branches of trigeminal ganglion, with lesions in the distribution of the maxillary, mandibular or ophthalmic sensory nerves as is involvement of dermatomes of the cervical and thoracic regions* H. Zoster affecting the opthalmic branch of the trigeminal nerve involving the right side of the forehead and eye and corneal ulcerations (.Hutchinson's sign)* The eruption consists of grouped tense vesicles or even bullae surrounded by a zone of erythema characteristically limited to a singe neural segment and is strictly unilateralMolluscum Contagiosum - transmitted by skin to skin contact* Typical lesion is a pink - coloured or skin coloured umbilicatedpapule** containing a greyish central plug, face and genital regions are commonly involved* A live attenuated VZV vaccine helps prevent herpes Zoster in persons 60 years and older

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 40 years males presented with painful vesicular lesion in the forehead extending to the eyelids. Diagnosis is, with the following options: A: Herpes simplex, B: Herpes-Zoster, C: Coxschiae infection, D: Molluscum contagiosum ### Response: (Herpes- Zoster) (52-Roxburg's 17th) (1182- CMDT-08)* Herpes simplex - manifest as acute gingivo-stomalitis, herpes labialis**, balanitis, vulvo-vaginitis, proctitis or kerato conjunctivitis* Intraepidermal vesicles around the mouth and lip (Type I) on the genitalia (Type II)* Herpes Zoster (Shingles) - Involvement of the branches of trigeminal ganglion, with lesions in the distribution of the maxillary, mandibular or ophthalmic sensory nerves as is involvement of dermatomes of the cervical and thoracic regions* H. Zoster affecting the opthalmic branch of the trigeminal nerve involving the right side of the forehead and eye and corneal ulcerations (.Hutchinson's sign)* The eruption consists of grouped tense vesicles or even bullae surrounded by a zone of erythema characteristically limited to a singe neural segment and is strictly unilateralMolluscum Contagiosum - transmitted by skin to skin contact* Typical lesion is a pink - coloured or skin coloured umbilicatedpapule** containing a greyish central plug, face and genital regions are commonly involved* A live attenuated VZV vaccine helps prevent herpes Zoster in persons 60 years and older ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Rough endoplasmic reticulum is site of synthesis for, with the following options: A: Protein, B: Cholesterol, C: Carbohydrate, D: Fat ### Response:

Ans. is 'a' i.e. Protein Rough endoplasmic reticulum is concerned withProtein synthesis*Initial folding of the polypeptide chains with the formation of disulfide bondsSmooth endoplasmic reticulum is concerned withSteroid synthesis*Detoxification processesAs sarcoplasmic reticulum plays important role in skeletal and cardiac muscle contraction *

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Rough endoplasmic reticulum is site of synthesis for, with the following options: A: Protein, B: Cholesterol, C: Carbohydrate, D: Fat ### Response: Ans. is 'a' i.e. Protein Rough endoplasmic reticulum is concerned withProtein synthesis*Initial folding of the polypeptide chains with the formation of disulfide bondsSmooth endoplasmic reticulum is concerned withSteroid synthesis*Detoxification processesAs sarcoplasmic reticulum plays important role in skeletal and cardiac muscle contraction * ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: DNA restriction fragments are separated by, with the following options: A: Paper chromatography, B: Agarose gel electrophoresis, C: Thin-layer chromatography, D: Ultracentrifugation ### Response:

Typically, a DNA molecule is digested with restriction enzymes, and the agarose gel electrophoresis is used as a diagnostic tool to visualize the fragments. An electric current is used to move the DNA molecules across an agarose gel, which is a polysaccharide matrix that functions as a so of sieve. Ref-D.M.Vasudevan 7/e p479

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: DNA restriction fragments are separated by, with the following options: A: Paper chromatography, B: Agarose gel electrophoresis, C: Thin-layer chromatography, D: Ultracentrifugation ### Response: Typically, a DNA molecule is digested with restriction enzymes, and the agarose gel electrophoresis is used as a diagnostic tool to visualize the fragments. An electric current is used to move the DNA molecules across an agarose gel, which is a polysaccharide matrix that functions as a so of sieve. Ref-D.M.Vasudevan 7/e p479 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: "Intranuclear inclusions" in oligodendrocytes are seen in, with the following options: A: Creutzfeldt Jacob disease, B: Polio, C: Japanese encephalitis, D: Progressive multiple encephalopathy ### Response:

progressive multifocal leukoencephalopathy, JC virus-infected oligodendroglia display 2 distinct patterns of intranuclear viral inclusions: full inclusions in which progeny virions are present throughout enlarged nuclei and dot-shaped inclusions in which virions are clustered in subnuclear domains termed "promyelocytic leukemia nuclear bodies" (PML-NBs) Surrounding the demyelinated areas, the oligodendrocytes are enlarged and contain intranuclear inclusionbodies filled with papovavirus paicles, often forming pseudocrystalline arrays Ref ganong's review of medical physiology 25e

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: "Intranuclear inclusions" in oligodendrocytes are seen in, with the following options: A: Creutzfeldt Jacob disease, B: Polio, C: Japanese encephalitis, D: Progressive multiple encephalopathy ### Response: progressive multifocal leukoencephalopathy, JC virus-infected oligodendroglia display 2 distinct patterns of intranuclear viral inclusions: full inclusions in which progeny virions are present throughout enlarged nuclei and dot-shaped inclusions in which virions are clustered in subnuclear domains termed "promyelocytic leukemia nuclear bodies" (PML-NBs) Surrounding the demyelinated areas, the oligodendrocytes are enlarged and contain intranuclear inclusionbodies filled with papovavirus paicles, often forming pseudocrystalline arrays Ref ganong's review of medical physiology 25e ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Artery not supplying Kisselbacks plexus is-, with the following options: A: Anterior ethmoidal artery, B: Greater Palatine artery, C: Sphenopalatine artery, D: Ascending pharyngeal artery ### Response:

Ans. is 'd' i.e., Ascending pharyngeal artery * Kiesselbach's plexus, which lies in KiesselbaclTs area or Little's area, is a region in the anteroinferior part of the nasal septum where four arteries anastomose to form a vascular plexus. The arteries arei) Anterior ethmoidal artery (branch of the ophthalmic artery)ii) Sphenopalatine artery (terminal branch of the maxillary artery)iii) Greater palatine artery (from the maxillary artery)iv) Septal branch of the superior labial artery (from the facial artery)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Artery not supplying Kisselbacks plexus is-, with the following options: A: Anterior ethmoidal artery, B: Greater Palatine artery, C: Sphenopalatine artery, D: Ascending pharyngeal artery ### Response: Ans. is 'd' i.e., Ascending pharyngeal artery * Kiesselbach's plexus, which lies in KiesselbaclTs area or Little's area, is a region in the anteroinferior part of the nasal septum where four arteries anastomose to form a vascular plexus. The arteries arei) Anterior ethmoidal artery (branch of the ophthalmic artery)ii) Sphenopalatine artery (terminal branch of the maxillary artery)iii) Greater palatine artery (from the maxillary artery)iv) Septal branch of the superior labial artery (from the facial artery) ### 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 new markers for Acute Kidney Injury (AKI) except:, with the following options: A: Plasma IL 18, B: Urinary IL 18, C: Plasma NGAL, D: Urinary NGAL ### Response:

Marker of AKI: Urinary 1) KIM- 1 - Kidney injury molecule-1 Plasma & Urinary 2) NGAL - Neutrophil gratinate associated lipocalin Urinary 3) IL - 18 | Tissue protected effected in proximal tubule

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are new markers for Acute Kidney Injury (AKI) except:, with the following options: A: Plasma IL 18, B: Urinary IL 18, C: Plasma NGAL, D: Urinary NGAL ### Response: Marker of AKI: Urinary 1) KIM- 1 - Kidney injury molecule-1 Plasma & Urinary 2) NGAL - Neutrophil gratinate associated lipocalin Urinary 3) IL - 18 | Tissue protected effected in proximal tubule ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Bonds in cellulose that make it resistant to digestion is:, with the following options: A: b1-4, B: a1-6, C: b1-6, D: a1-6 ### Response:

Cellulose is the chief constituent of plant cell walls. It is insoluble and consists of b-D -glucopyranose units linked by b,1-4 bonds to form long, straight chains strengthened by cross-linking hydrogen bonds. Mammals lack any enzyme that hydrolyzes the b1 -4 bonds, and so cannot digest cellulose. Ref: Harper 28th edition, chapter 14.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Bonds in cellulose that make it resistant to digestion is:, with the following options: A: b1-4, B: a1-6, C: b1-6, D: a1-6 ### Response: Cellulose is the chief constituent of plant cell walls. It is insoluble and consists of b-D -glucopyranose units linked by b,1-4 bonds to form long, straight chains strengthened by cross-linking hydrogen bonds. Mammals lack any enzyme that hydrolyzes the b1 -4 bonds, and so cannot digest cellulose. Ref: Harper 28th edition, chapter 14. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Coenzyme, in an enzymatic reaction usually functions to :, with the following options: A: Activate the substrate, B: Increase the active sites of apoenzyme, C: Enhance the specificity of aponzyme, D: Accept one of the cleavage products ### Response:

Coenzymes act either a donar or an acceptor of group. They serve as recyclable shuttles - or group transfer agents - that transpo many substrates from their point of generation to their point of utilization.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Coenzyme, in an enzymatic reaction usually functions to :, with the following options: A: Activate the substrate, B: Increase the active sites of apoenzyme, C: Enhance the specificity of aponzyme, D: Accept one of the cleavage products ### Response: Coenzymes act either a donar or an acceptor of group. They serve as recyclable shuttles - or group transfer agents - that transpo many substrates from their point of generation to their point of utilization. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Non caseating granuloma is characteristically seen in, with the following options: A: Syphilis, B: Sarcoidosis, C: TB, D: Histoplasmosis ### Response:

ref Robbins 8/e p701 ,9/e p98 NONCASEATING GRANULOMA Sarcoidosis is characterized bynoncaseating granulomas. These are different than the caseating granulomasproduced by other diseases, especially tuberculosis. Caseous necrosis is destruction of cells which are conveed to amorphous greyish debris located centrally ingranulomas.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Non caseating granuloma is characteristically seen in, with the following options: A: Syphilis, B: Sarcoidosis, C: TB, D: Histoplasmosis ### Response: ref Robbins 8/e p701 ,9/e p98 NONCASEATING GRANULOMA Sarcoidosis is characterized bynoncaseating granulomas. These are different than the caseating granulomasproduced by other diseases, especially tuberculosis. Caseous necrosis is destruction of cells which are conveed to amorphous greyish debris located centrally ingranulomas. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of these is not a sign of increased ICT:, with the following options: A: Erosion of dorsum sella, B: Sutural diastases, C: Ballooning of sella, D: copper-beaten appearance ### Response:

Ballooning of sella Ballooning of sella is seen in intrasellar neoplasm or empty sella syndrome The radiological signs of raised ICT on plain x-ray depend on the age of the patient and the duration of the elevated ICT. The radiological sign of raised ICT on plain x-rays are: a. Suture diastasis: - Seen only in infants and children - Suture diastasis is the first and most prominent sign of raised ICT in infants and children. b.Increased convolutional markings (Copper beaten appearance) - seen in children - Copper beaten appearance was attributed to raised ICT in past, but recent books say, it has little diagnostic impoance. It may also be seen in normal children. c. Erosion of dorsum sellae - Erosion of the dorsum sellae is the cardinal sign of raised ICT in adults - Frank erosion of sella may also be seen in local tumors. d.J-shaped sella - Direct pressure on the sella by tile an'erior end of an enlarged third ventricle in chronic hydrocephalus may give rise to a J-shaped sella. e. Pineal displacement - Pineal displacement is an impoant sign in adults, but not in infants and children as pineal gland is rarely calcified in infants and children. - In standard PA view of skull, the pineal gland lies within 3 mm of the midline. - Any lateral displacement of pineal gland more than 3 mm strongly suggests presence of intracranial tumor.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of these is not a sign of increased ICT:, with the following options: A: Erosion of dorsum sella, B: Sutural diastases, C: Ballooning of sella, D: copper-beaten appearance ### Response: Ballooning of sella Ballooning of sella is seen in intrasellar neoplasm or empty sella syndrome The radiological signs of raised ICT on plain x-ray depend on the age of the patient and the duration of the elevated ICT. The radiological sign of raised ICT on plain x-rays are: a. Suture diastasis: - Seen only in infants and children - Suture diastasis is the first and most prominent sign of raised ICT in infants and children. b.Increased convolutional markings (Copper beaten appearance) - seen in children - Copper beaten appearance was attributed to raised ICT in past, but recent books say, it has little diagnostic impoance. It may also be seen in normal children. c. Erosion of dorsum sellae - Erosion of the dorsum sellae is the cardinal sign of raised ICT in adults - Frank erosion of sella may also be seen in local tumors. d.J-shaped sella - Direct pressure on the sella by tile an'erior end of an enlarged third ventricle in chronic hydrocephalus may give rise to a J-shaped sella. e. Pineal displacement - Pineal displacement is an impoant sign in adults, but not in infants and children as pineal gland is rarely calcified in infants and children. - In standard PA view of skull, the pineal gland lies within 3 mm of the midline. - Any lateral displacement of pineal gland more than 3 mm strongly suggests presence of intracranial tumor. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: During shock which organ is spared from vasoconstriction?, with the following options: A: Skin, B: Hea, C: Kidney, D: Liver ### Response:

During shock vasoconstriction is generalized, sparing only the vessels of the brain and hea.A widespread reflex venoconstriction also helps maintain the filling pressure of the heaIn the kidneys, both afferent and efferent aerioles are constrictedRef: Ganong's Review of Medical Physiology Twenty-Third Edition Page No:516

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: During shock which organ is spared from vasoconstriction?, with the following options: A: Skin, B: Hea, C: Kidney, D: Liver ### Response: During shock vasoconstriction is generalized, sparing only the vessels of the brain and hea.A widespread reflex venoconstriction also helps maintain the filling pressure of the heaIn the kidneys, both afferent and efferent aerioles are constrictedRef: Ganong's Review of Medical Physiology Twenty-Third Edition Page No:516 ### 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 Nicotine withdrawal?, with the following options: A: Depression, B: Headache, C: Tachycardia, D: Anxiety ### Response:

In nicotine withdrawal there is bradycardia not tachycardia. The most common symptoms of nicotine withdrawal are impaired concentration, irritability, tension, disturbed sleep or drowsiness, intense longing for a cigarette/nicotine, headaches, and an increased appetite leading to weight gain.

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 Nicotine withdrawal?, with the following options: A: Depression, B: Headache, C: Tachycardia, D: Anxiety ### Response: In nicotine withdrawal there is bradycardia not tachycardia. The most common symptoms of nicotine withdrawal are impaired concentration, irritability, tension, disturbed sleep or drowsiness, intense longing for a cigarette/nicotine, headaches, and an increased appetite leading to weight gain. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Drug used for post-operative shivering -, with the following options: A: Atropine, B: Pethidine, C: Thiopenone, D: Suxamethonium ### Response:

Ans. is 'b' i.e., Pethidine Post-anaesthesia shivering (PAS)o Post anaesthesia (post operative) shivering occurs in 40% of patients recovering from general anaesthesia,o Some time it is preceded by central hypothermia and peripheral vasoconstriction, indicating that it is a thermoregulatory mechanism.o Pethidine is most effective drug for treatment of PAS.o Other drugs used are -clonidine, doxapram, ketanserin, alfentonil, butorphanol, chlorpromazine.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Drug used for post-operative shivering -, with the following options: A: Atropine, B: Pethidine, C: Thiopenone, D: Suxamethonium ### Response: Ans. is 'b' i.e., Pethidine Post-anaesthesia shivering (PAS)o Post anaesthesia (post operative) shivering occurs in 40% of patients recovering from general anaesthesia,o Some time it is preceded by central hypothermia and peripheral vasoconstriction, indicating that it is a thermoregulatory mechanism.o Pethidine is most effective drug for treatment of PAS.o Other drugs used are -clonidine, doxapram, ketanserin, alfentonil, butorphanol, chlorpromazine. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: |A 65-year-old male complains of severe back pain and inability to move his left lower limb. Radiographic studies demonstrate the compression of nerve elements at the intervertebral foramen between vertebrae L5 and S1. Which structure is most likely responsible for this space-occupying lesion?, with the following options: A: Anulus fibrosus, B: Nucleus pulposus, C: Posterior longitudinal ligament, D: Anterior longitudinal ligament ### Response:

Compression of nerves at the intervertebral foramen indicates a disk herniation. A disk herniation is characterized by protrusion of the nucleus pulposus from the anulus fibrosus posterolaterally into the spinal canal or intervertebral foramen. The ligaments may be affected by the herniation but are not responsible for the compression of the spinal nerve roots.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: |A 65-year-old male complains of severe back pain and inability to move his left lower limb. Radiographic studies demonstrate the compression of nerve elements at the intervertebral foramen between vertebrae L5 and S1. Which structure is most likely responsible for this space-occupying lesion?, with the following options: A: Anulus fibrosus, B: Nucleus pulposus, C: Posterior longitudinal ligament, D: Anterior longitudinal ligament ### Response: Compression of nerves at the intervertebral foramen indicates a disk herniation. A disk herniation is characterized by protrusion of the nucleus pulposus from the anulus fibrosus posterolaterally into the spinal canal or intervertebral foramen. The ligaments may be affected by the herniation but are not responsible for the compression of the spinal nerve roots. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Jones fracture is fracture of -, with the following options: A: Metatarsal, B: Metacarpal, C: Proximal phalynx, D: Distal phalynx ### Response:

Ans. is 'a' i.e., Metatarsal Fracture of the base of 5th metatarsal (Jones* fracture)* This is a fracture at the base of the 5th metatarsal, caused by the pull exerted by the tendon of the peroneus brevis muscle inserted on it.* Clinically, there is pain, swelling and tenderness at the outer border of the foot, most marked at the base of the 5th metatarsal.* Diagnosis is easily confirmed on X-ray.* Treatment is by a below-knee walking plaster cast for 3 weeks.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Jones fracture is fracture of -, with the following options: A: Metatarsal, B: Metacarpal, C: Proximal phalynx, D: Distal phalynx ### Response: Ans. is 'a' i.e., Metatarsal Fracture of the base of 5th metatarsal (Jones* fracture)* This is a fracture at the base of the 5th metatarsal, caused by the pull exerted by the tendon of the peroneus brevis muscle inserted on it.* Clinically, there is pain, swelling and tenderness at the outer border of the foot, most marked at the base of the 5th metatarsal.* Diagnosis is easily confirmed on X-ray.* Treatment is by a below-knee walking plaster cast for 3 weeks. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which screening test is not done in pregnant women?, with the following options: A: VDRL, B: Hep A, C: Hep B, D: Hep D ### Response:

Ans: b (Hep A) Ref: Dutta, 6th ed, p. 99Routine investigations done during antenatal checkup1. Blood grouping. VDRL, RBS( only in selected cases)2. Urine routine-- protein, sugar and pus cells.3. Cervical cytology in selected cases.Special investigations in pregnancy1. Serological tests for rubella. Hep B and HIV (with consent).2. MSAFP or triple test for mothers at risk.3. USG - first trimester scan and anomaly scan at 20 wks.Though Hep D is also not mentioned, it can be taken as a part of Hep B virus because Hep D does not occur alone. It is always associated with Hep B. So the best answer here is Hep A- which is not transmitted by blood.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which screening test is not done in pregnant women?, with the following options: A: VDRL, B: Hep A, C: Hep B, D: Hep D ### Response: Ans: b (Hep A) Ref: Dutta, 6th ed, p. 99Routine investigations done during antenatal checkup1. Blood grouping. VDRL, RBS( only in selected cases)2. Urine routine-- protein, sugar and pus cells.3. Cervical cytology in selected cases.Special investigations in pregnancy1. Serological tests for rubella. Hep B and HIV (with consent).2. MSAFP or triple test for mothers at risk.3. USG - first trimester scan and anomaly scan at 20 wks.Though Hep D is also not mentioned, it can be taken as a part of Hep B virus because Hep D does not occur alone. It is always associated with Hep B. So the best answer here is Hep A- which is not transmitted by blood. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: 45 years male, blood sample gives purple-brown colour in Ehrich&;s solution, the substance is, with the following options: A: Urobilinogen, B: Conjugated bilirubin, C: Unconjugated biliburin, D: Haemosedrin ### Response:

Bilinogens(UBG and SBG) react with Ehrlich solution to form red/brown color. Ehrlich&;s aldehyde reagent(para dimethylamino benzaldehyde) don&;t react with any other forms of bilirubin or hemosiderinRef: Textbook of biochemistry for medical students, seventh edition, page no: 279

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: 45 years male, blood sample gives purple-brown colour in Ehrich&;s solution, the substance is, with the following options: A: Urobilinogen, B: Conjugated bilirubin, C: Unconjugated biliburin, D: Haemosedrin ### Response: Bilinogens(UBG and SBG) react with Ehrlich solution to form red/brown color. Ehrlich&;s aldehyde reagent(para dimethylamino benzaldehyde) don&;t react with any other forms of bilirubin or hemosiderinRef: Textbook of biochemistry for medical students, seventh edition, page no: 279 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 3 year old girl is brought to the casualty by her mother. She has multiple bruises on her body. On X-ray 3 fractures at different stage of healing are seen. Excessive callus formation is also noted. The father is repoed to be an alcoholic. Mother claims that the baby had fallen off the stairs. What is the likely diagnosis?, with the following options: A: Scurvy, B: Rickets, C: Osteopetrosis, D: Child abuse ### Response:

The above given is a classical description of battered baby syndrome or child abuse. Here the child as sustained injuries as a result of physical abuse from an adult parent or caregiver. The presence of injuries at various stages of healing proves the long term nature of the problem and that it is a non-accidental injury.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 3 year old girl is brought to the casualty by her mother. She has multiple bruises on her body. On X-ray 3 fractures at different stage of healing are seen. Excessive callus formation is also noted. The father is repoed to be an alcoholic. Mother claims that the baby had fallen off the stairs. What is the likely diagnosis?, with the following options: A: Scurvy, B: Rickets, C: Osteopetrosis, D: Child abuse ### Response: The above given is a classical description of battered baby syndrome or child abuse. Here the child as sustained injuries as a result of physical abuse from an adult parent or caregiver. The presence of injuries at various stages of healing proves the long term nature of the problem and that it is a non-accidental injury. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 35 year old lady complains dysphagia, Raynaud's phenomenon, sclerodactyly. Investigations show antinuclear antibody. The likely diagnosis is ?, with the following options: A: Systemic lupus erythematosis, B: Systemic sclerosis, C: Mixed connective tissue disorder, D: Rheumatoid ahritis ### Response:

Ans. is 'b' i.e., Systemic sclerosiso Dysphagia, Raynaud's phenomenon, sclerodactyly in 35 years old lady suggest the diagnosis of systemic sclerosis (see above explanations).I think option 'b' needs some explanation here.Mixed connective tissue diseaseo Patients having the co-existence of features suggestive of SLE, polymyositis, Rheumatoid ahritis and systemic sclerosis.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 35 year old lady complains dysphagia, Raynaud's phenomenon, sclerodactyly. Investigations show antinuclear antibody. The likely diagnosis is ?, with the following options: A: Systemic lupus erythematosis, B: Systemic sclerosis, C: Mixed connective tissue disorder, D: Rheumatoid ahritis ### Response: Ans. is 'b' i.e., Systemic sclerosiso Dysphagia, Raynaud's phenomenon, sclerodactyly in 35 years old lady suggest the diagnosis of systemic sclerosis (see above explanations).I think option 'b' needs some explanation here.Mixed connective tissue diseaseo Patients having the co-existence of features suggestive of SLE, polymyositis, Rheumatoid ahritis and systemic sclerosis. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 17-year-old boy is admitted to the hospital after a road traffic accident. Per abdomen examination is normal. After adequate resuscitation, his pulse rate is 80/min and BP is 110/70 mm Hg. Abdominal CT reveals 1 cm deep laceration in the left lobe of the liver extending from the done more than half way through the parenchyma. Appropriate management at this time would be:, with the following options: A: Conservative treatment, B: Abdominal exploration and packing of hepatic wounds, C: Abdominal exploration and ligation of left hepatic aery, D: Left hepatectomy ### Response:

Classification of liver injury (Moore) Grade Types Operative or CT Scan findings I Hematoma Laceration Subcapsular, <10% of surface area Capsular tear, < 1 cm in parenchymal death II Hematoma laceration Subcapsular, 10-50% of surface area Intraparenchymal, <10 cm in diameter 1-3 cm in parenchymal depth, <10 cm in length III Hematoma laceration Subcapsular, >50% of surface area or expanding; rupture subcapsular or parenchymal hematoma Intraparenchymal, hematoma > 10 cm or expanding > 3 cm in parenchymal depth IV Laceration Parenchymal disruption involving 25-75% of the hepatic lobe or 1-3 couinauds segments in a single lobe V Laceration vascular Parenchymal disruption involving >75% of the hepatic lobe or > 3 Coulnauds segments in a single lobe Juxta hepatic venous injuries, i.e retro hepatic vena cava / central major hepatic veins VI Vascular Hepatic avulsion

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 17-year-old boy is admitted to the hospital after a road traffic accident. Per abdomen examination is normal. After adequate resuscitation, his pulse rate is 80/min and BP is 110/70 mm Hg. Abdominal CT reveals 1 cm deep laceration in the left lobe of the liver extending from the done more than half way through the parenchyma. Appropriate management at this time would be:, with the following options: A: Conservative treatment, B: Abdominal exploration and packing of hepatic wounds, C: Abdominal exploration and ligation of left hepatic aery, D: Left hepatectomy ### Response: Classification of liver injury (Moore) Grade Types Operative or CT Scan findings I Hematoma Laceration Subcapsular, <10% of surface area Capsular tear, < 1 cm in parenchymal death II Hematoma laceration Subcapsular, 10-50% of surface area Intraparenchymal, <10 cm in diameter 1-3 cm in parenchymal depth, <10 cm in length III Hematoma laceration Subcapsular, >50% of surface area or expanding; rupture subcapsular or parenchymal hematoma Intraparenchymal, hematoma > 10 cm or expanding > 3 cm in parenchymal depth IV Laceration Parenchymal disruption involving 25-75% of the hepatic lobe or 1-3 couinauds segments in a single lobe V Laceration vascular Parenchymal disruption involving >75% of the hepatic lobe or > 3 Coulnauds segments in a single lobe Juxta hepatic venous injuries, i.e retro hepatic vena cava / central major hepatic veins VI Vascular Hepatic avulsion ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Adenoma carcinoma sequence was prototypically observed in which carcinoma, with the following options: A: Colon, B: Gastric, C: Salivary gland, D: Lacrimalgland ### Response:

Adenoma of colon has high malignant potential. Potentiality increases with size. If size of adenoma is >2cm there is 30-50% chance of developing carcinoma. If it is 1-2cm then there is 10% chance of developing carcinoma, and if it is less than 1cm then there is 1-5% chance of carcinoma. Reference : SRB's Manual of Surgery, 6th Edition, page no = 890.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Adenoma carcinoma sequence was prototypically observed in which carcinoma, with the following options: A: Colon, B: Gastric, C: Salivary gland, D: Lacrimalgland ### Response: Adenoma of colon has high malignant potential. Potentiality increases with size. If size of adenoma is >2cm there is 30-50% chance of developing carcinoma. If it is 1-2cm then there is 10% chance of developing carcinoma, and if it is less than 1cm then there is 1-5% chance of carcinoma. Reference : SRB's Manual of Surgery, 6th Edition, page no = 890. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: When doctor is charged with serious professional misconduct, the action will be taken by, with the following options: A: MCI, B: State medical council, C: Cou, D: CBI ### Response:

State Medical Council sends a warning notice to a doctor if he or she is found guilty of any of the following these conditions Adultery Aboion Association with unqualified persons in professional matters Adveising Addiction Alcohol Ref: K.S. Narayan Reddy's Synopsis of Forensic Medicine & Toxicology, 29th edition,Page 15 & 17.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: When doctor is charged with serious professional misconduct, the action will be taken by, with the following options: A: MCI, B: State medical council, C: Cou, D: CBI ### Response: State Medical Council sends a warning notice to a doctor if he or she is found guilty of any of the following these conditions Adultery Aboion Association with unqualified persons in professional matters Adveising Addiction Alcohol Ref: K.S. Narayan Reddy's Synopsis of Forensic Medicine & Toxicology, 29th edition,Page 15 & 17. ### 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 or propey of a virus?, with the following options: A: Heat labile, B: Antibiotic resistant, C: May contain both DNA and RNA, D: Forms extra cellular infectious paicle ### Response:

Virus contains either RNA or DNA, not both, it is surrounded by a capsid composed of small protein units called capsomeres. Other specific propeies of viruses are : inability to replicate on their own, inability to divide by binarry fission, mitosis or meiosis, lack of genes and enzymes needed for energy production, depend on ribosomes, enzymes and metabolites of host cell for protein and nucleic acid production.

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 or propey of a virus?, with the following options: A: Heat labile, B: Antibiotic resistant, C: May contain both DNA and RNA, D: Forms extra cellular infectious paicle ### Response: Virus contains either RNA or DNA, not both, it is surrounded by a capsid composed of small protein units called capsomeres. Other specific propeies of viruses are : inability to replicate on their own, inability to divide by binarry fission, mitosis or meiosis, lack of genes and enzymes needed for energy production, depend on ribosomes, enzymes and metabolites of host cell for protein and nucleic acid production. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: An infant of a mother with type I. Diabetes has a PCV of 68%. On day 3 of life, he suddenly manifests gross hematuria and a flank mass on the left. Most likely diagnosis is:, with the following options: A: Meconium plug, B: Neuroblastoma, C: Renal venous thrombosis, D: Ureteropelvic junction obstruction ### Response:

Renal venous thrombosis in the newborn period commonly presents with gross hematoria and a flank mass. Infants of diabetic mothers by viue of polycythemia are at slightly increased risk for this condition. A meconium plug may cause abdominal distention, but probably would not cause a discrete flank mass and would not lead to gross hematuria. A neuroblastoma would not produce hematuria nor grow so fast as to suddenly produce a flank mass. A ureteropelvic junction obstruction is usually not associated with hematuria and should have been palpable at the time of bih. An adrenal hemorrhage may present as a sizeable mass but would not be associated with gross hematuria.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: An infant of a mother with type I. Diabetes has a PCV of 68%. On day 3 of life, he suddenly manifests gross hematuria and a flank mass on the left. Most likely diagnosis is:, with the following options: A: Meconium plug, B: Neuroblastoma, C: Renal venous thrombosis, D: Ureteropelvic junction obstruction ### Response: Renal venous thrombosis in the newborn period commonly presents with gross hematoria and a flank mass. Infants of diabetic mothers by viue of polycythemia are at slightly increased risk for this condition. A meconium plug may cause abdominal distention, but probably would not cause a discrete flank mass and would not lead to gross hematuria. A neuroblastoma would not produce hematuria nor grow so fast as to suddenly produce a flank mass. A ureteropelvic junction obstruction is usually not associated with hematuria and should have been palpable at the time of bih. An adrenal hemorrhage may present as a sizeable mass but would not be associated with gross hematuria. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Epidural analgesia is suitable for, with the following options: A: Rib fracture, B: Lower abdominal Surgery, C: Thoracotomy, D: All of the above ### Response:

Epidural is very suitable as independent anaesthesia technique and as accompanying technique with general anaesthesia. thoracic epidural for Thoracic surgery , rib fracture Lumbar Epidural for upper and lower abdominal surgeries.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Epidural analgesia is suitable for, with the following options: A: Rib fracture, B: Lower abdominal Surgery, C: Thoracotomy, D: All of the above ### Response: Epidural is very suitable as independent anaesthesia technique and as accompanying technique with general anaesthesia. thoracic epidural for Thoracic surgery , rib fracture Lumbar Epidural for upper and lower abdominal surgeries. ### 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 nor a feature of irritable bowel syndrome?, with the following options: A: Abdominal pain, B: Constipation, C: Rectal bleeding, D: Bloating ### Response:

Answer is C (Rectal Bleeding) Irritable Bowel syndrome is characteristically not associated with rectal bleeding. Evidence of blood in stool should raise an alarm that a process other than IBS is operating and should prompt fuher investigations. Abdominal pain, abnormal stool formation (hard/constipation or loose/ watery stool), and Bloating or feeling abdominal distension are characteristic features of Irritable Bowel Syndrome. Symptoms that cumulatively suppo the diagnosis of Irritable Bowel Syndrome: Abnormal stool frequencyQ (fbr research Imposes., "abnormal- defined as > 3 bowel movements/week) Abnormal stool formations (lumpy/hard or loose/watery stool) Abnormal stool habitsQ (straining, urgency, or feeling of incomplete evacuation) Passage al mucusQ Bloating or feeling of abdominal distention The diagnosis of a functional bowel disorder always presumes the absence of a structural or biochemical explanation for the symptoms. Dagnostic criteria for Irritable Bowel Syndrome 1. Recurrent abdominal pain or discomfo at least 3 days per month in the last 3 months associated with two or more of the follow ing I. Improvement with defecation 2. Onset associated with a change in frequency of sioole 3. Onset associated with a change in form (appearance) of stoolQ. Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis. Discomfo means an uncomfoable sensation not described as pain. In pathophvsiologv research and clinical trails, a pain/discomfo frequency of at least 2 days a week during screening evaluation is required for subject eligibility.

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 nor a feature of irritable bowel syndrome?, with the following options: A: Abdominal pain, B: Constipation, C: Rectal bleeding, D: Bloating ### Response: Answer is C (Rectal Bleeding) Irritable Bowel syndrome is characteristically not associated with rectal bleeding. Evidence of blood in stool should raise an alarm that a process other than IBS is operating and should prompt fuher investigations. Abdominal pain, abnormal stool formation (hard/constipation or loose/ watery stool), and Bloating or feeling abdominal distension are characteristic features of Irritable Bowel Syndrome. Symptoms that cumulatively suppo the diagnosis of Irritable Bowel Syndrome: Abnormal stool frequencyQ (fbr research Imposes., "abnormal- defined as > 3 bowel movements/week) Abnormal stool formations (lumpy/hard or loose/watery stool) Abnormal stool habitsQ (straining, urgency, or feeling of incomplete evacuation) Passage al mucusQ Bloating or feeling of abdominal distention The diagnosis of a functional bowel disorder always presumes the absence of a structural or biochemical explanation for the symptoms. Dagnostic criteria for Irritable Bowel Syndrome 1. Recurrent abdominal pain or discomfo at least 3 days per month in the last 3 months associated with two or more of the follow ing I. Improvement with defecation 2. Onset associated with a change in frequency of sioole 3. Onset associated with a change in form (appearance) of stoolQ. Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis. Discomfo means an uncomfoable sensation not described as pain. In pathophvsiologv research and clinical trails, a pain/discomfo frequency of at least 2 days a week during screening evaluation is required for subject eligibility. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 52 year female pt. presents with symptoms of pheochromocytoma. She also has a thyroid carcinoma. Her thyroid Ca is of which type -, with the following options: A: Anaplastic, B: Medullary, C: Follicular, D: Papillary ### Response:

Pt. is having MEN syndrome type II. MEN syndrome is associated with medullary Ca of thyroid. MTC with MEN syndrome present at a younger age and are multicentric and bilateral. These patients with familial MTC can be recognized early by identifying RET proto-oncogene mutation and death can be prevented from thyroid carcinoma by performing prophylactic thyroidectomy. Schwartz writes - "Total thyroidectomy is indicated in RET mutation carriers once the mutation is confirmed. The procedure should be performed before age 6 years in MEN 2A patients. Central neck dissection can be avoided in children who are RET positive and calcitonin negative with a normal ultrasound examination. When the calcitonin is increased or the ultrasound suggests a thyroid cancer, a prophylactic central neck dissection is indicated."

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 52 year female pt. presents with symptoms of pheochromocytoma. She also has a thyroid carcinoma. Her thyroid Ca is of which type -, with the following options: A: Anaplastic, B: Medullary, C: Follicular, D: Papillary ### Response: Pt. is having MEN syndrome type II. MEN syndrome is associated with medullary Ca of thyroid. MTC with MEN syndrome present at a younger age and are multicentric and bilateral. These patients with familial MTC can be recognized early by identifying RET proto-oncogene mutation and death can be prevented from thyroid carcinoma by performing prophylactic thyroidectomy. Schwartz writes - "Total thyroidectomy is indicated in RET mutation carriers once the mutation is confirmed. The procedure should be performed before age 6 years in MEN 2A patients. Central neck dissection can be avoided in children who are RET positive and calcitonin negative with a normal ultrasound examination. When the calcitonin is increased or the ultrasound suggests a thyroid cancer, a prophylactic central neck dissection is indicated." ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Salivary gland tumor is most common in which Salivary Gland?, with the following options: A: Sublingual gland, B: Submandibular gland, C: Minor salivary gland, D: Parotid gland ### Response:

Ans. (d) Parotid GlandRef: Bailey and Love 27th edition Page 783Incidence of Salivary Gland Tumors:TypeLocationIncidenceMalignancy Percentage of the tumors seenMajorParotidCommon10-20%SubmandibularUncommon50%SublingualVery rare85%MinorUpper aerodigestive tractRare90%

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Salivary gland tumor is most common in which Salivary Gland?, with the following options: A: Sublingual gland, B: Submandibular gland, C: Minor salivary gland, D: Parotid gland ### Response: Ans. (d) Parotid GlandRef: Bailey and Love 27th edition Page 783Incidence of Salivary Gland Tumors:TypeLocationIncidenceMalignancy Percentage of the tumors seenMajorParotidCommon10-20%SubmandibularUncommon50%SublingualVery rare85%MinorUpper aerodigestive tractRare90% ### 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 used as emergency contraceptive?, with the following options: A: Danazol, B: Levonorgestrel, C: Mifepristone, D: IUCD ### Response:

Isoxazole derivative of 17 - alpha ethinyl testosterone propeies Causes atrophy of endometrium It is strictly antigonadotropin but acts as an androgen agonist Mode of action Acting on the hypothalamo - pituitary - gonadal axis - depression of frequency of GnRh pulses - suppression of pituitary FSH and LH surge. There is however no change in the basal gonadotropin level Indication of danazol Endometriosis DUB Symptomatic fibroid Precocious pubey

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 used as emergency contraceptive?, with the following options: A: Danazol, B: Levonorgestrel, C: Mifepristone, D: IUCD ### Response: Isoxazole derivative of 17 - alpha ethinyl testosterone propeies Causes atrophy of endometrium It is strictly antigonadotropin but acts as an androgen agonist Mode of action Acting on the hypothalamo - pituitary - gonadal axis - depression of frequency of GnRh pulses - suppression of pituitary FSH and LH surge. There is however no change in the basal gonadotropin level Indication of danazol Endometriosis DUB Symptomatic fibroid Precocious pubey ### 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 malignant bone tumor is:, with the following options: A: Ewing's sarcoma, B: Osteosarcoma, C: Metastasis, D: Chondrosarcoma ### Response:

Ans: c (Metastasis) Ref: Maheswari, 3rd ed, p. 224Metastatic tumors are the most common malignant tumors of the bone followed by primary bone tumors.Most common sites from which mets arise are:Lungs--in malesBreast-- in femalesProstateThyroidFrequently asked questions regarding bone tumorsMost common malignancy of bone-SecondariesMost common primary malignant bone tumour-Multiple myelomaMost common primary malignant tumour of long bones-OsteosarcomaMost common true benign tumour of bone-Osteoid osteomaCommonest benign tumour of bone-OsteochondromaHormone dependent bone tumour-fibrous dysplasiaMost common symptom of secondaries-pain

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common malignant bone tumor is:, with the following options: A: Ewing's sarcoma, B: Osteosarcoma, C: Metastasis, D: Chondrosarcoma ### Response: Ans: c (Metastasis) Ref: Maheswari, 3rd ed, p. 224Metastatic tumors are the most common malignant tumors of the bone followed by primary bone tumors.Most common sites from which mets arise are:Lungs--in malesBreast-- in femalesProstateThyroidFrequently asked questions regarding bone tumorsMost common malignancy of bone-SecondariesMost common primary malignant bone tumour-Multiple myelomaMost common primary malignant tumour of long bones-OsteosarcomaMost common true benign tumour of bone-Osteoid osteomaCommonest benign tumour of bone-OsteochondromaHormone dependent bone tumour-fibrous dysplasiaMost common symptom of secondaries-pain ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In a small child diagnosed with H. influenza meningitis, what investigation must be done before discharging him from the hospital?, with the following options: A: BERA, B: MBI, C: CT scan, D: X ray skull ### Response:

Ans. (a) BERARef: OP Ghai 8th ed./619; OskisPediatrics: Principles & Practice by Julia A. McMillan

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In a small child diagnosed with H. influenza meningitis, what investigation must be done before discharging him from the hospital?, with the following options: A: BERA, B: MBI, C: CT scan, D: X ray skull ### Response: Ans. (a) BERARef: OP Ghai 8th ed./619; OskisPediatrics: Principles & Practice by Julia A. McMillan ### 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 nephrotic syndrome in paediatric age group is, with the following options: A: Minimal change disease, B: Membranous glomerulonephritis, C: Malarial infection, D: Mesangioproliferative glomerulonephritis ### Response:

Ans. a (Minimal change disease). Refer to Q. No.49 of Pathology section of same paper.Minimal-Change Disease (Lipoid Nephrosis)# This relatively benign disorder is the most frequent cause of the nephrotic syndrome in children.# It is characterized by glomeruli that have a normal appearance by light microscopy but show diffuse effacement of podocyte foot processes when viewed with the electron microscope.# Although it may develop at any age, this condition is most common between ages 1 and 7 years.# When the changes in the podocytes reverse (e.g., in response to corticosteroids), the proteinuria remits.

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 nephrotic syndrome in paediatric age group is, with the following options: A: Minimal change disease, B: Membranous glomerulonephritis, C: Malarial infection, D: Mesangioproliferative glomerulonephritis ### Response: Ans. a (Minimal change disease). Refer to Q. No.49 of Pathology section of same paper.Minimal-Change Disease (Lipoid Nephrosis)# This relatively benign disorder is the most frequent cause of the nephrotic syndrome in children.# It is characterized by glomeruli that have a normal appearance by light microscopy but show diffuse effacement of podocyte foot processes when viewed with the electron microscope.# Although it may develop at any age, this condition is most common between ages 1 and 7 years.# When the changes in the podocytes reverse (e.g., in response to corticosteroids), the proteinuria remits. ### 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 forms the Passavant&;s ridge?, with the following options: A: Palatoglossus, B: Salpingopharyngeus, C: Palatopharyngeus, D: Hyoglossus ### Response:

Some of the upper fibres of the palatopharyngeus pass circularly deep to the mucous membrane of the pharynx,and form a sphincter internal to the superior constrictor.These fibres constitute passavant's muscle which on contraction raises a ridge called the Passavant's Ridge. REF.BDC VOL.3,FIFTH EDITION

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 forms the Passavant&;s ridge?, with the following options: A: Palatoglossus, B: Salpingopharyngeus, C: Palatopharyngeus, D: Hyoglossus ### Response: Some of the upper fibres of the palatopharyngeus pass circularly deep to the mucous membrane of the pharynx,and form a sphincter internal to the superior constrictor.These fibres constitute passavant's muscle which on contraction raises a ridge called the Passavant's Ridge. REF.BDC VOL.3,FIFTH EDITION ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Insulin storage in the body requires which ion?, with the following options: A: Cu, B: Zn, C: Mo, D: Se ### Response:

Zinc is involved in the insulin packaging, secretion, and signaling Zinc in pancreatic beta cells binds to several insulin molecules, six to be exact, forming an insulin hexamer for storage.Ref: DM Vasudevan, 7th edition, page no: 319

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Insulin storage in the body requires which ion?, with the following options: A: Cu, B: Zn, C: Mo, D: Se ### Response: Zinc is involved in the insulin packaging, secretion, and signaling Zinc in pancreatic beta cells binds to several insulin molecules, six to be exact, forming an insulin hexamer for storage.Ref: DM Vasudevan, 7th edition, page no: 319 ### 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 seen in ARDS, except :, with the following options: A: Pulmonary edema, B: Decreased tidal volume, C: Hypercapnia, D: Decreased compliance ### Response:

Answer is C (Hypercapnia): ARDS results in Type I Respiratory failure and is characterized by normal or low PaCO2 (Hypocapnia) and not Hypercapnia (see previous explanation on types of respiratory failure). ARDS (Acute Respiratory distress syndrome) ARDS is an acute form of lung injury characterized by: Increased permeability of alveolar capillary membrane. Diffuse alveolar damage. Accumulation of proteinaceous pulmonary edema (non cardiogenic pulmonary edema Q)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are seen in ARDS, except :, with the following options: A: Pulmonary edema, B: Decreased tidal volume, C: Hypercapnia, D: Decreased compliance ### Response: Answer is C (Hypercapnia): ARDS results in Type I Respiratory failure and is characterized by normal or low PaCO2 (Hypocapnia) and not Hypercapnia (see previous explanation on types of respiratory failure). ARDS (Acute Respiratory distress syndrome) ARDS is an acute form of lung injury characterized by: Increased permeability of alveolar capillary membrane. Diffuse alveolar damage. Accumulation of proteinaceous pulmonary edema (non cardiogenic pulmonary edema Q) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The power to summon persons by a police officer comes under which section of CRPC, with the following options: A: 39, B: 175, C: 357, D: 416 ### Response:

Section Deals with 39 Duty to give information 53 examination of accused by a medical at the request of medical professor 53A examination of person accused of rape by medical practitioner 54 examination of arrested person by medical practitioner by request of arrested person 61-69 summons 161 the police has the power to examine witness 162 oral statements made to the police and recorded by police should not be signed 175 power to summons by a police officer Reference :the essentials of Forensic Medicine and toxicology page number 55

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The power to summon persons by a police officer comes under which section of CRPC, with the following options: A: 39, B: 175, C: 357, D: 416 ### Response: Section Deals with 39 Duty to give information 53 examination of accused by a medical at the request of medical professor 53A examination of person accused of rape by medical practitioner 54 examination of arrested person by medical practitioner by request of arrested person 61-69 summons 161 the police has the power to examine witness 162 oral statements made to the police and recorded by police should not be signed 175 power to summons by a police officer Reference :the essentials of Forensic Medicine and toxicology page number 55 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Renal vein thrombosis is most commonly found in :, with the following options: A: Focal glomenilosclerosis, B: Membranous GN, C: Minimal change GN, D: Acute pyelonephritis ### Response:

Nephrotic syndrome accompanying membranous glomerulopathy and certain carcinomas are the most common cause of RVT. Remember : Most common cause of RVT in adult —› Nephrotic syndrome due to membranous glomerulonephritis. Most common cause of RVT in children —› K nephrotic syndrome due to minimal change disease. Most common cause of RVT in newborns and infants ---> Asphyxia, dehydration, shock and sepsis.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Renal vein thrombosis is most commonly found in :, with the following options: A: Focal glomenilosclerosis, B: Membranous GN, C: Minimal change GN, D: Acute pyelonephritis ### Response: Nephrotic syndrome accompanying membranous glomerulopathy and certain carcinomas are the most common cause of RVT. Remember : Most common cause of RVT in adult —› Nephrotic syndrome due to membranous glomerulonephritis. Most common cause of RVT in children —› K nephrotic syndrome due to minimal change disease. Most common cause of RVT in newborns and infants ---> Asphyxia, dehydration, shock and sepsis. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Aaron's sign is seen in:, with the following options: A: Chronic appendicitis, B: Hiatus hernia, C: Mediastinum emphysema, D: Acute appendicitis ### Response:

Abdominal Examination Signs Sign Description Diagnosis Aaron Sign Pain or pressure in epigastrium or anterior chest with persistent firm pressure applied to McBurney's point. Acute appendicitis Bassler Sign Sharp pain created by compressing appendix between abdominal wall and iliacus Chronic appendicitis Blumberg's Sign Transient abdominal wall rebound tenderness Peritoneal inflammation Carnett's Sign Loss of abdominal tenderness when abdominal wall muscles are contracted Intra-abdominal source of abdominal pain Claybrook Sign Accentuation of breath and cardiac sounds through abdominal wall Ruptured abdominal viscus Mannkopf's Sign Increased pulse when painful abdomen palpated Absent if malingering Ten Horn Sign Pain caused by gentle traction of right testicle Acute appendicitis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Aaron's sign is seen in:, with the following options: A: Chronic appendicitis, B: Hiatus hernia, C: Mediastinum emphysema, D: Acute appendicitis ### Response: Abdominal Examination Signs Sign Description Diagnosis Aaron Sign Pain or pressure in epigastrium or anterior chest with persistent firm pressure applied to McBurney's point. Acute appendicitis Bassler Sign Sharp pain created by compressing appendix between abdominal wall and iliacus Chronic appendicitis Blumberg's Sign Transient abdominal wall rebound tenderness Peritoneal inflammation Carnett's Sign Loss of abdominal tenderness when abdominal wall muscles are contracted Intra-abdominal source of abdominal pain Claybrook Sign Accentuation of breath and cardiac sounds through abdominal wall Ruptured abdominal viscus Mannkopf's Sign Increased pulse when painful abdomen palpated Absent if malingering Ten Horn Sign Pain caused by gentle traction of right testicle Acute appendicitis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A highway truck driver has profuse rhinorrhea and sneezing. Which of the following drugs would you prescribe him?, with the following options: A: Cetrizine, B: Pheniramine, C: Promethazine, D: Dimenhydrinate ### Response:

As the patient in the question is a truck driver, antihistamine which is best suitable for him is cetrizine. Cetirizine is a second generation antihistamine with least sedation. Promethazine and Dimenhydrinate are highly sedative and Pheniramine is moderately sedative preparations of H1 antihistamine which is not preferred for a truck driver as it causes sedation while driving. Ref: Essentials of Medical Pharmacology By K D Tripathi, 5th Edition, Pages 141-2

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A highway truck driver has profuse rhinorrhea and sneezing. Which of the following drugs would you prescribe him?, with the following options: A: Cetrizine, B: Pheniramine, C: Promethazine, D: Dimenhydrinate ### Response: As the patient in the question is a truck driver, antihistamine which is best suitable for him is cetrizine. Cetirizine is a second generation antihistamine with least sedation. Promethazine and Dimenhydrinate are highly sedative and Pheniramine is moderately sedative preparations of H1 antihistamine which is not preferred for a truck driver as it causes sedation while driving. Ref: Essentials of Medical Pharmacology By K D Tripathi, 5th Edition, Pages 141-2 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Highly selective proteinuria is seen in, with the following options: A: Minimal change, B: Mesangial proliferative nephritis, C: Membranous glomerulonephritis, D: Focal glomerulosclerosis ### Response:

Loss of glomerular basement membrane (GBM) polyanion has been proposed as a cause of the selective proteinuria in minimal change nephrotic syndrome (MCNS).The exact role of charge selectivity in the pathogenesis of nephrotic proteinuria remains controversial Proteinuria that is more than 85% albumin is selective proteinuria. Nonselective proteinuria, being a glomerular leakage of all plasma proteins, would not involve changes in glomerular net charge but rather a generalized defect in permeability Ref Harrison20th edition pg 287

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Highly selective proteinuria is seen in, with the following options: A: Minimal change, B: Mesangial proliferative nephritis, C: Membranous glomerulonephritis, D: Focal glomerulosclerosis ### Response: Loss of glomerular basement membrane (GBM) polyanion has been proposed as a cause of the selective proteinuria in minimal change nephrotic syndrome (MCNS).The exact role of charge selectivity in the pathogenesis of nephrotic proteinuria remains controversial Proteinuria that is more than 85% albumin is selective proteinuria. Nonselective proteinuria, being a glomerular leakage of all plasma proteins, would not involve changes in glomerular net charge but rather a generalized defect in permeability Ref Harrison20th edition pg 287 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In a child, non – functioning kidney is best diagnosed by :, with the following options: A: Ultras onography, B: IVU, C: DTPA renogram, D: Creatinine clearance ### Response:

The most convenient method of estimation of renal function is by isotope renography. Two types of isotope renography is there : 1) Renogram, DTPA scan or MAG3 : DTPA and MAG3 are rapidly excreted by the kidney and are therefore used as radiopharmaceutical agents for dynamic scan. This scan is preferred for the information : i) About the blood flow of kidney. ii) How well each kidney is functioning. iii) It there is any obstruction to urine output. 2) DMSA scan : DMSA is concentrated in the renal parenchyma for a time and is therefore used as static scan. This scan is preferred to lood at structure of kidney, i.e. size, shape and position.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In a child, non – functioning kidney is best diagnosed by :, with the following options: A: Ultras onography, B: IVU, C: DTPA renogram, D: Creatinine clearance ### Response: The most convenient method of estimation of renal function is by isotope renography. Two types of isotope renography is there : 1) Renogram, DTPA scan or MAG3 : DTPA and MAG3 are rapidly excreted by the kidney and are therefore used as radiopharmaceutical agents for dynamic scan. This scan is preferred for the information : i) About the blood flow of kidney. ii) How well each kidney is functioning. iii) It there is any obstruction to urine output. 2) DMSA scan : DMSA is concentrated in the renal parenchyma for a time and is therefore used as static scan. This scan is preferred to lood at structure of kidney, i.e. size, shape and position. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Management of retinoblastoma:, with the following options: A: Enucleation, B: Chemotherapy, C: Radiotherapy, D: All ### Response:

A i.e. Enucleation; B i.e. Chemotherapy; C i.e. Radiotherapy

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Management of retinoblastoma:, with the following options: A: Enucleation, B: Chemotherapy, C: Radiotherapy, D: All ### Response: A i.e. Enucleation; B i.e. Chemotherapy; C i.e. Radiotherapy ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Hormones decreased in PCOD, with the following options: A: Androgens, B: Progesterone, C: Estrone, D: Insulin ### Response:

In PCOD, Progesterone is decreased due to anovulation.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Hormones decreased in PCOD, with the following options: A: Androgens, B: Progesterone, C: Estrone, D: Insulin ### Response: In PCOD, Progesterone is decreased due to anovulation. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A patient has a congenital deficiency in factor XIII (fibrin-stabilizing factor). What would analysis of his blood reveal?, with the following options: A: Prolonged prothrombin time, B: Prolonged whole blood clotting time, C: Prolonged paial thromboplastin time, D: Easily breakable clot ### Response:

Fibrin monomers polymerize to form a clot. Creation of a strong clot requires the presence of fibrin stabilizing factor that is released from platelets within the clot. The other clotting tests determine the activation of extrinsic and intrinsic pathways or number of platelets.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A patient has a congenital deficiency in factor XIII (fibrin-stabilizing factor). What would analysis of his blood reveal?, with the following options: A: Prolonged prothrombin time, B: Prolonged whole blood clotting time, C: Prolonged paial thromboplastin time, D: Easily breakable clot ### Response: Fibrin monomers polymerize to form a clot. Creation of a strong clot requires the presence of fibrin stabilizing factor that is released from platelets within the clot. The other clotting tests determine the activation of extrinsic and intrinsic pathways or number of platelets. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Lateral medullary syndrome (Wallenberg syndrome) is characterized by all, Except :, with the following options: A: Giddiness, B: Dysphagia, C: Crossed hemianaesthesia, D: Homer's syndrome is rare ### Response:

Answer is D (Horner's syndrome is rare): Horner's syndrome forms pa of the constellation of manifestations seen in lateral medullary syndrome or Wallenberg syndrome. It is produced as a result of infUrction of the descending sympathetic tract. Ipsilateral Homer's syndrome

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Lateral medullary syndrome (Wallenberg syndrome) is characterized by all, Except :, with the following options: A: Giddiness, B: Dysphagia, C: Crossed hemianaesthesia, D: Homer's syndrome is rare ### Response: Answer is D (Horner's syndrome is rare): Horner's syndrome forms pa of the constellation of manifestations seen in lateral medullary syndrome or Wallenberg syndrome. It is produced as a result of infUrction of the descending sympathetic tract. Ipsilateral Homer's syndrome ### 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 extranodal site for non-hodkin&;s lymphoma is -, with the following options: A: Stomach, B: Brain, C: Intestines, D: Tonsils ### Response:

Extranodal marginal zone B cell lymphoma of MALT type also called as MALTOMA comprises about 8% of NHLs.In this most frequent is gastric lymphoma of MALT type. Reference : Harsh Mohan textbook of pathology, 7th edition.Pg no.357

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common extranodal site for non-hodkin&;s lymphoma is -, with the following options: A: Stomach, B: Brain, C: Intestines, D: Tonsils ### Response: Extranodal marginal zone B cell lymphoma of MALT type also called as MALTOMA comprises about 8% of NHLs.In this most frequent is gastric lymphoma of MALT type. Reference : Harsh Mohan textbook of pathology, 7th edition.Pg no.357 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Regarding Fanconi anemia, the wrong statement is:, with the following options: A: Autosomal dominant, B: Bone marrow show pancytopenia, C: Usually aplastic anemia, D: It is due to defective DNA repair ### Response:

Fanconi's anemia is an autosomal recessive disease Characterized:- Progressive pancytopenia Increased risk of malignancy (solid tumors and AML) Congenital developmental anomalies like sho stature, cafe au lait spots, abnormalities affecting thumb, radius and genitourinary tract. Fanconi's anemia is associated with BRCA gene.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Regarding Fanconi anemia, the wrong statement is:, with the following options: A: Autosomal dominant, B: Bone marrow show pancytopenia, C: Usually aplastic anemia, D: It is due to defective DNA repair ### Response: Fanconi's anemia is an autosomal recessive disease Characterized:- Progressive pancytopenia Increased risk of malignancy (solid tumors and AML) Congenital developmental anomalies like sho stature, cafe au lait spots, abnormalities affecting thumb, radius and genitourinary tract. Fanconi's anemia is associated with BRCA gene. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ethambutol should be used very cautiously in child-hood tuberculosis due to which of its side effect?, with the following options: A: Ocular toxicity, B: Renal damage, C: Hepatotoxicity, D: Neurotoxicity ### Response:

Ethambutol (E) Ethambutol is selectively tuberculostatic and clinically as active as S. Fast multiplying bacilli are more susceptible as are many atypical mycobacteria. Added to the triple drug regimen ofRHZ it has been found to hasten the rate of sputum conversion and to prevent development of resistance Patient acceptability of E is very good and side effects are few. Loss of visual acuity I colour vision. field defects due to optic neuritis is the most impoant dose and duration of therapy dependent toxicity. Because young children ma,be unable to repo early visual impairment, it should not be used below 6 years of age. With early recognition and stoppage of therapy, visual toxicity is largely reversible. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:742,743

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ethambutol should be used very cautiously in child-hood tuberculosis due to which of its side effect?, with the following options: A: Ocular toxicity, B: Renal damage, C: Hepatotoxicity, D: Neurotoxicity ### Response: Ethambutol (E) Ethambutol is selectively tuberculostatic and clinically as active as S. Fast multiplying bacilli are more susceptible as are many atypical mycobacteria. Added to the triple drug regimen ofRHZ it has been found to hasten the rate of sputum conversion and to prevent development of resistance Patient acceptability of E is very good and side effects are few. Loss of visual acuity I colour vision. field defects due to optic neuritis is the most impoant dose and duration of therapy dependent toxicity. Because young children ma,be unable to repo early visual impairment, it should not be used below 6 years of age. With early recognition and stoppage of therapy, visual toxicity is largely reversible. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:742,743 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Bacillus anthracis is unique to other bacteria. It is the only bacteria to possess which of the following, with the following options: A: A polypeptide capsule, B: A polysaccharide capsule, C: An exotoxin, D: An endotoxin ### Response:

Virulent forms of B. anthracis, the causative agent of anthrax, are more likely to be surrounded by a capsule. This capsule is a polypeptide, composed of a polymer of glutamic acid, and is a unique feature of B. anthracis. Lipopolysaccharides (LPS/endotoxin) are unique to gram-negative bacteria (B. anthracis is a gram-positive rod). In addition, whereas B. anthracis is associated with both teichoic acid (cell wall) and a potent exotoxin, these are not unique features of this bacterium. Other gram-positives (i.e., staphylococci) release exotoxins and have teichoic acid in their cell walls.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Bacillus anthracis is unique to other bacteria. It is the only bacteria to possess which of the following, with the following options: A: A polypeptide capsule, B: A polysaccharide capsule, C: An exotoxin, D: An endotoxin ### Response: Virulent forms of B. anthracis, the causative agent of anthrax, are more likely to be surrounded by a capsule. This capsule is a polypeptide, composed of a polymer of glutamic acid, and is a unique feature of B. anthracis. Lipopolysaccharides (LPS/endotoxin) are unique to gram-negative bacteria (B. anthracis is a gram-positive rod). In addition, whereas B. anthracis is associated with both teichoic acid (cell wall) and a potent exotoxin, these are not unique features of this bacterium. Other gram-positives (i.e., staphylococci) release exotoxins and have teichoic acid in their cell walls. ### 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 peptic ulcer disease:, with the following options: A: Posteriorly perforated ulcers are always managed conservatively, B: Anterior ulcers bleed more commonly Increased acid production is prerequisite for gastric ulcer, C: Anti-H. pylori drugs must be included in the treatment regimen, D: H. pylori is known to increase the incidence of gastric malignancy ### Response:

Ans is 'd' (H. pylori is known to increase the incidence of gastric malignancy) Surgery is almost always indicated for perforated ulcers, although occasionally nonsurgical treatment can be used in stable patients without peritonitis, and in whom radiologic studies document a sealed perforation. Though increased acid production is associated with duodenal ulcers, its not so with gastric ulcers. Gastric ulcers type I and type IV are associated with decreased acid secretion. (Gastric type II and type III are associated with acid hypersecretion) Anti-H.pylori drugs are included in those pts. of peptic ulcer ds. who test positive for H. pylori.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True regarding peptic ulcer disease:, with the following options: A: Posteriorly perforated ulcers are always managed conservatively, B: Anterior ulcers bleed more commonly Increased acid production is prerequisite for gastric ulcer, C: Anti-H. pylori drugs must be included in the treatment regimen, D: H. pylori is known to increase the incidence of gastric malignancy ### Response: Ans is 'd' (H. pylori is known to increase the incidence of gastric malignancy) Surgery is almost always indicated for perforated ulcers, although occasionally nonsurgical treatment can be used in stable patients without peritonitis, and in whom radiologic studies document a sealed perforation. Though increased acid production is associated with duodenal ulcers, its not so with gastric ulcers. Gastric ulcers type I and type IV are associated with decreased acid secretion. (Gastric type II and type III are associated with acid hypersecretion) Anti-H.pylori drugs are included in those pts. of peptic ulcer ds. who test positive for H. pylori. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Non-invasive prenatal screening (NIPS) is paicularly useful in the modern era of diagnosis in clinical genetics. Which of the following statements is not true regarding this test?, with the following options: A: Useful in screening for aneuploidies, B: Evaluates maternal blood for abnormalities, C: HIgh positive predictive value, D: Positive test need confirmation by invasive testing ### Response:

Non-invasive prenatal screening (NIPS) has a high negative predictive value. NIPS: Useful in screening high-risk pregnancies for aneuploidies Done after 10 weeks of gestation Evaluates maternal blood for screening Positive tests need confirmation by invasive testing (like amniocentesis, Chorionic villous sampling) Ref: Ghai essential pediatrics 9th edition Pgno: 643

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Non-invasive prenatal screening (NIPS) is paicularly useful in the modern era of diagnosis in clinical genetics. Which of the following statements is not true regarding this test?, with the following options: A: Useful in screening for aneuploidies, B: Evaluates maternal blood for abnormalities, C: HIgh positive predictive value, D: Positive test need confirmation by invasive testing ### Response: Non-invasive prenatal screening (NIPS) has a high negative predictive value. NIPS: Useful in screening high-risk pregnancies for aneuploidies Done after 10 weeks of gestation Evaluates maternal blood for screening Positive tests need confirmation by invasive testing (like amniocentesis, Chorionic villous sampling) Ref: Ghai essential pediatrics 9th edition Pgno: 643 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: 1 mm change in Length of the eyeball, leads to the change in dioptor power of eye by, with the following options: A: 1 D, B: 2.5 D, C: 5D, D: 6D ### Response:

(3D): (3-Khurana 5th edition; 1-Nema 6th/ed)The axial length (AL) is the distance between the anterior surface of the cornea and the fovea and usually measured by A-scan ultrasonography or optical coherence biometry. The AL is the most important factor in IOL calculation: A 1-mm error in AL measurement results in a refractive error of approximately 2.35 D in an average eye.Axial length of the eyeThe distance between the anterior and posterior poles of the eye. In vivo, it is measured either by ultrasonography or by partial coherence interferometry (PCI). These measurements represent the distance between the anterior pole and Bruch's membrane. (In young eyes in which there is a refractive index difference at the retina-vitreous interface ultrasonography measures the distance between the anterior pole and the anterior surface of the retina.) The axial length of the eye at birth is approximately 17 mm and reaches approximately 24 mm in adulthood. It is typically longer than 24 mm in myopes and shorter than 24 mm in hyperopes. Each mm of change in axial length of the eye corresponds to approximately 2.5 D* At birth, the eyeball measures antero posteriorly about 17.5 mm and reaches 24 mm in adults. The horizontal and vertical diameter of the eye ball are 23.5 and 23 mm respectively* The optic nerve leaves the eyeball 3 mm medial to the posterior pole and passes along the axis of the orbit, therefore, the axes of the eye ball and the orbit do not coincide but make an angle between them

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: 1 mm change in Length of the eyeball, leads to the change in dioptor power of eye by, with the following options: A: 1 D, B: 2.5 D, C: 5D, D: 6D ### Response: (3D): (3-Khurana 5th edition; 1-Nema 6th/ed)The axial length (AL) is the distance between the anterior surface of the cornea and the fovea and usually measured by A-scan ultrasonography or optical coherence biometry. The AL is the most important factor in IOL calculation: A 1-mm error in AL measurement results in a refractive error of approximately 2.35 D in an average eye.Axial length of the eyeThe distance between the anterior and posterior poles of the eye. In vivo, it is measured either by ultrasonography or by partial coherence interferometry (PCI). These measurements represent the distance between the anterior pole and Bruch's membrane. (In young eyes in which there is a refractive index difference at the retina-vitreous interface ultrasonography measures the distance between the anterior pole and the anterior surface of the retina.) The axial length of the eye at birth is approximately 17 mm and reaches approximately 24 mm in adulthood. It is typically longer than 24 mm in myopes and shorter than 24 mm in hyperopes. Each mm of change in axial length of the eye corresponds to approximately 2.5 D* At birth, the eyeball measures antero posteriorly about 17.5 mm and reaches 24 mm in adults. The horizontal and vertical diameter of the eye ball are 23.5 and 23 mm respectively* The optic nerve leaves the eyeball 3 mm medial to the posterior pole and passes along the axis of the orbit, therefore, the axes of the eye ball and the orbit do not coincide but make an angle between them ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are true statement about spinal cord except, with the following options: A: Coccygeal ligament is investing layer of dura over filum terminale, B: Dural sac ends at S2 veebra, C: Cords ends at lower border of L1, D: Filum terminate extends up to coccyx ### Response:

Final terminal is the pia connecting conus medullaris to coccyx. Below the end of Dural sac at S2, dura encloses this filum and attaches to coccyx as coccygeal ligament.(Ref: Vishram Singh textbook of clinical neuroanatomy second edition pg 53)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are true statement about spinal cord except, with the following options: A: Coccygeal ligament is investing layer of dura over filum terminale, B: Dural sac ends at S2 veebra, C: Cords ends at lower border of L1, D: Filum terminate extends up to coccyx ### Response: Final terminal is the pia connecting conus medullaris to coccyx. Below the end of Dural sac at S2, dura encloses this filum and attaches to coccyx as coccygeal ligament.(Ref: Vishram Singh textbook of clinical neuroanatomy second edition pg 53) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Virchow's triad includes all of the following except, with the following options: A: Venous stasis, B: Endothelial injury to veins, C: Blood Hypercoagulability, D: Venous thrombosis ### Response:

(D) Venous thrombosis # Virchow's triad refers to three primary influences that predispose to thrombus formation.> This triad should be the cornerstone for the assessment of risk factors for deep venous thrombosis. This includes Endothelial injury Stasis or turbulence of blood flow Blood hypercoagulability> These factors may act independently or they may combine to cause thrombus formation.> Note that endothelial integrity is the single most important factor. Injury to endotlielial cells can affect local blood flow or coagula bility# Some important Points on DVT: Homan's sign - Caif tenderness on forced ankle dorsiflexion. Phlegmasia alba do lens - Painful white leg Phlegmasia cerulea dolens - Painful blue leg Moses Sign - Calf tenderness on direct pressure on the calf. Pratt's Sign - Calf tenderness on squeezing the calf from the sides.> Duplex ultasound is the diagnostic modality of choice in deep vein thrombosis.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Virchow's triad includes all of the following except, with the following options: A: Venous stasis, B: Endothelial injury to veins, C: Blood Hypercoagulability, D: Venous thrombosis ### Response: (D) Venous thrombosis # Virchow's triad refers to three primary influences that predispose to thrombus formation.> This triad should be the cornerstone for the assessment of risk factors for deep venous thrombosis. This includes Endothelial injury Stasis or turbulence of blood flow Blood hypercoagulability> These factors may act independently or they may combine to cause thrombus formation.> Note that endothelial integrity is the single most important factor. Injury to endotlielial cells can affect local blood flow or coagula bility# Some important Points on DVT: Homan's sign - Caif tenderness on forced ankle dorsiflexion. Phlegmasia alba do lens - Painful white leg Phlegmasia cerulea dolens - Painful blue leg Moses Sign - Calf tenderness on direct pressure on the calf. Pratt's Sign - Calf tenderness on squeezing the calf from the sides.> Duplex ultasound is the diagnostic modality of choice in deep vein thrombosis. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Phantom limb phenomenon is explained by, with the following options: A: Law of projection, B: Webers law, C: Fechner's law of degeneration, D: Pascals law ### Response:

The sensory fibres are experimentally stimulated anywhere in their course to the coex, the conscious sensation produced is referred to the loaction of the receptor. This principle is called the law of projection. Due to this, after amputation of a limb, sometimes patient complains of intense pain in the absent limb (phantom limb). These sensations are produced due to irritation of the damaged nociceptive and proprioceptive afferents at the stump of amputated limb. The sensations are evoked are projected to the area where receptors are used to be located. Ref: guyton and hall textbook of medical physiology 12 edition page number: 671,672,673

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Phantom limb phenomenon is explained by, with the following options: A: Law of projection, B: Webers law, C: Fechner's law of degeneration, D: Pascals law ### Response: The sensory fibres are experimentally stimulated anywhere in their course to the coex, the conscious sensation produced is referred to the loaction of the receptor. This principle is called the law of projection. Due to this, after amputation of a limb, sometimes patient complains of intense pain in the absent limb (phantom limb). These sensations are produced due to irritation of the damaged nociceptive and proprioceptive afferents at the stump of amputated limb. The sensations are evoked are projected to the area where receptors are used to be located. Ref: guyton and hall textbook of medical physiology 12 edition page number: 671,672,673 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A coin is struck at 25 cm from incisor in the esophagus, this place coincides with-, with the following options: A: Cricopharyngeal junction, B: Bronchial bifurcation, C: Aortic arch, D: Oesophago-gastric junction ### Response:

Esophagus shows three normal constriction which are narrower portions of esophagus and foreign body can be held there. These constrictions are : - At pharyngo-esophageal junction (C6) - 15 cm from the upper incisors. At crossing of arch of aorta and left main bronchus (T4) - 25 cm from upper incisors. Where it pierces the diaphragm (T10) - 40 cm from upper incisors.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A coin is struck at 25 cm from incisor in the esophagus, this place coincides with-, with the following options: A: Cricopharyngeal junction, B: Bronchial bifurcation, C: Aortic arch, D: Oesophago-gastric junction ### Response: Esophagus shows three normal constriction which are narrower portions of esophagus and foreign body can be held there. These constrictions are : - At pharyngo-esophageal junction (C6) - 15 cm from the upper incisors. At crossing of arch of aorta and left main bronchus (T4) - 25 cm from upper incisors. Where it pierces the diaphragm (T10) - 40 cm from upper incisors. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: SAFE strategy is recommended for-, with the following options: A: Glaucoma, B: Cataract, C: Trachoma, D: Diabetic retinopathy ### Response:

Ans. is 'c' i.e., Trachoma o SAFE strategy developed by the WHO is the key to the treatment of trachoma. This consists of Surgery (S) on the lids. Antibiotics to treat the community pool of infection (A), Facial cleanliness (F) ; and Environmental changes (E). Blindness From Trachoma Can Be Stopped At FourDifferent points: SAFES - Surgical correction for trichiasis. It is a simple operation that can turn out lashes which are scratching the cornea, patients can be operated on in a local dispensary or health center, or other community space if properly prepared.The surgical procedure can be performed by those who have had surgical training : eye doctors, eye nurses or eye care assistants.A - Antibiotic treatment of people with active trachoma infection.Regular detection and treatment of people with active trachoma is important. The recommended treatment is as follows:o Wash the face and clean the eyeso Apply tetracycline 1% ointment to both eyes two times daily for six weekso The ointment is sticky and may blur the vision for a few moments. This will only last a few moments. If possible, treat all the children in the family.F - Clean FacesFamilies and individuals can do something to protect themselves from infection by increasing the number of times a child washes his/her face. Regular face washing removes discharge so that flies are not attracted to faces. It does not require great quantities of water : one liter of water can wash up to 30 faces.E - Environmental Improvemento This question is a repeat from NEET 2012-13, All India & AIIMS.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: SAFE strategy is recommended for-, with the following options: A: Glaucoma, B: Cataract, C: Trachoma, D: Diabetic retinopathy ### Response: Ans. is 'c' i.e., Trachoma o SAFE strategy developed by the WHO is the key to the treatment of trachoma. This consists of Surgery (S) on the lids. Antibiotics to treat the community pool of infection (A), Facial cleanliness (F) ; and Environmental changes (E). Blindness From Trachoma Can Be Stopped At FourDifferent points: SAFES - Surgical correction for trichiasis. It is a simple operation that can turn out lashes which are scratching the cornea, patients can be operated on in a local dispensary or health center, or other community space if properly prepared.The surgical procedure can be performed by those who have had surgical training : eye doctors, eye nurses or eye care assistants.A - Antibiotic treatment of people with active trachoma infection.Regular detection and treatment of people with active trachoma is important. The recommended treatment is as follows:o Wash the face and clean the eyeso Apply tetracycline 1% ointment to both eyes two times daily for six weekso The ointment is sticky and may blur the vision for a few moments. This will only last a few moments. If possible, treat all the children in the family.F - Clean FacesFamilies and individuals can do something to protect themselves from infection by increasing the number of times a child washes his/her face. Regular face washing removes discharge so that flies are not attracted to faces. It does not require great quantities of water : one liter of water can wash up to 30 faces.E - Environmental Improvemento This question is a repeat from NEET 2012-13, All India & AIIMS. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ulnar nerve injury at wrist involves following except :, with the following options: A: Palmar interossei, B: Opponems pollicis, C: Dorsal interossei, D: Adductor pollicis ### Response:

B. i.e. Oppenens polices Ulnar nerve in hand supply-3rd & 4"1 lumbricals, interossei (pabnar & dorsal), adductor pollicis & hypothenar musclesQ.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ulnar nerve injury at wrist involves following except :, with the following options: A: Palmar interossei, B: Opponems pollicis, C: Dorsal interossei, D: Adductor pollicis ### Response: B. i.e. Oppenens polices Ulnar nerve in hand supply-3rd & 4"1 lumbricals, interossei (pabnar & dorsal), adductor pollicis & hypothenar musclesQ. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Atracurium is excreted by -, with the following options: A: Renal excretion, B: Hepatic elimination, C: Nonenzymatic degradation, D: All of the above ### Response:

Ans. is 'c' i.e., Nonenzymatic degradation o The unique feature of atracurium is inactivation in plasma by spontaneous nonenzymatic degradation (Hofmann elimination) in addition to that by alkaline ester hydrolysis.o Consequently, its duration of action is not altered in patients with hepatic/renal insufficiency or hyperdynamic circulation - Preferred muscle relaxant for such patients as well as for neonates and the elderly.o Atracurium is metabolized to laudanosine that is responsible for seizures,o It can cause histamine release Hypotension & bronchoconstriction.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Atracurium is excreted by -, with the following options: A: Renal excretion, B: Hepatic elimination, C: Nonenzymatic degradation, D: All of the above ### Response: Ans. is 'c' i.e., Nonenzymatic degradation o The unique feature of atracurium is inactivation in plasma by spontaneous nonenzymatic degradation (Hofmann elimination) in addition to that by alkaline ester hydrolysis.o Consequently, its duration of action is not altered in patients with hepatic/renal insufficiency or hyperdynamic circulation - Preferred muscle relaxant for such patients as well as for neonates and the elderly.o Atracurium is metabolized to laudanosine that is responsible for seizures,o It can cause histamine release Hypotension & bronchoconstriction. ### 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 chronic pancreatitis is:-, with the following options: A: Alcohol, B: Gall stones, C: Trauma, D: Smoking ### Response:

Most common cause of chronic pancreatitis is alcohol

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 chronic pancreatitis is:-, with the following options: A: Alcohol, B: Gall stones, C: Trauma, D: Smoking ### Response: Most common cause of chronic pancreatitis is alcohol ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The greater petrosal nerve is formed from -, with the following options: A: Geniculate ganglion, B: Plexus around ICA, C: Plexus around middle meningeal artery, D: None of the above ### Response:

Ans-A

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The greater petrosal nerve is formed from -, with the following options: A: Geniculate ganglion, B: Plexus around ICA, C: Plexus around middle meningeal artery, D: None of the above ### Response: Ans-A ### 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 fetal response to acute hypoxia is?, with the following options: A: Tachycardia, B: Tachypnea, C: Bradycardia, D: Arrhythmia ### Response:

Ans. is 'c' i.e., Bradycardia The initial response of the normal fetus to acute hypoxia or asphyxia is bradycardia results from chemoreceptor stimulation of vagal nerve.

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 fetal response to acute hypoxia is?, with the following options: A: Tachycardia, B: Tachypnea, C: Bradycardia, D: Arrhythmia ### Response: Ans. is 'c' i.e., Bradycardia The initial response of the normal fetus to acute hypoxia or asphyxia is bradycardia results from chemoreceptor stimulation of vagal nerve. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Hormonal abnormalities in men and post menopausal women suffering from rheumatoid ahritis include the following except, with the following options: A: Decreased testosterone, B: Decreased luteinizing hormone, C: Decreased dehydroepiandrosterone, D: Decreased thyroid autoantibodies ### Response:

Answer- D. Decreased thyroid autoantibodiesMen and postmenopausal women with RA have lower mean serum testosterone, luteinizing hormone (LH) and dehydroepiandrosterone (DHEA) levels than control populations.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Hormonal abnormalities in men and post menopausal women suffering from rheumatoid ahritis include the following except, with the following options: A: Decreased testosterone, B: Decreased luteinizing hormone, C: Decreased dehydroepiandrosterone, D: Decreased thyroid autoantibodies ### Response: Answer- D. Decreased thyroid autoantibodiesMen and postmenopausal women with RA have lower mean serum testosterone, luteinizing hormone (LH) and dehydroepiandrosterone (DHEA) levels than control populations. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Brain damage in phenylketonuria is due to accumulation of-, with the following options: A: Tyrosine, B: Phenylalanine, C: Tryptophan, D: None ### Response:

Ans. is 'b' i.e., Phenylalanine "The primary symptom of untreated phenylketonuria (i.e. mental retardation) is the result of consuming foods that contain phenylalanine, which is toxic to brain tissue "Phenviaketonuriao It is an autosomal recessive disorder due to deficiency of phenylalanine hydroxylase.o As a result phenylalanine is not metabolized by hydroxylase, and metabolism is shifted to alternative pathvway and there is increased concentration of phenylalanine, phenylpyruvate, phenylacetate and phenyl-lactate.o Because phenylalanine is not converted into tyrosine, tyrosine becomes art essential amino acid.o Classical phenylketonuria is due to deficiency ofphenylalanine hydroxylase. Milder form may be caused by deficiency of dihydrobiopterin reductase that produces tetrahydrobiopterin, a cofactor for phenylalanine hydroxylase.Clinical presentationo The babies are normal at birth but may present with vomiting. Gradually mental retrardation and growth retardation develop. Baby has light complexion with blue iris. Other features are microcephaly, rash, hypertonia, seizures, exaggerated tendon reflex, wide spaced teeth, enamel hypoplasia and hyperactivity.o There is musty or mousy odour of urine and other body secretions due to presence of phenylketones.o Pregnant females with increased pheynlalanine (maternal phenylketonuria) may cause mental retardation, microcephaly, growth retardation and CHDs in babies.Diagnosiso Elevated phenylalanine levelso Elevated blood tyrosine levelo Presence of urinary metabolites of phenylalanineo Guthrie's Test - It detects the presence of phenylalanine in serumo FeCl3 - It detects the presence of phenylalanine in urine. FeCl3 is added to patients urine. If it contains phenylalanine, it will turn green.o 2-4 Dinitrophenol hydrazine - gives yellow precipitate with old urine.Treatmento Administration of low phenylalanine is the mainstay of treatment (but phenylalanine should not be completely restricted as it is necessary for growth). Tetrahydrobiopterin can be used in milder form.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Brain damage in phenylketonuria is due to accumulation of-, with the following options: A: Tyrosine, B: Phenylalanine, C: Tryptophan, D: None ### Response: Ans. is 'b' i.e., Phenylalanine "The primary symptom of untreated phenylketonuria (i.e. mental retardation) is the result of consuming foods that contain phenylalanine, which is toxic to brain tissue "Phenviaketonuriao It is an autosomal recessive disorder due to deficiency of phenylalanine hydroxylase.o As a result phenylalanine is not metabolized by hydroxylase, and metabolism is shifted to alternative pathvway and there is increased concentration of phenylalanine, phenylpyruvate, phenylacetate and phenyl-lactate.o Because phenylalanine is not converted into tyrosine, tyrosine becomes art essential amino acid.o Classical phenylketonuria is due to deficiency ofphenylalanine hydroxylase. Milder form may be caused by deficiency of dihydrobiopterin reductase that produces tetrahydrobiopterin, a cofactor for phenylalanine hydroxylase.Clinical presentationo The babies are normal at birth but may present with vomiting. Gradually mental retrardation and growth retardation develop. Baby has light complexion with blue iris. Other features are microcephaly, rash, hypertonia, seizures, exaggerated tendon reflex, wide spaced teeth, enamel hypoplasia and hyperactivity.o There is musty or mousy odour of urine and other body secretions due to presence of phenylketones.o Pregnant females with increased pheynlalanine (maternal phenylketonuria) may cause mental retardation, microcephaly, growth retardation and CHDs in babies.Diagnosiso Elevated phenylalanine levelso Elevated blood tyrosine levelo Presence of urinary metabolites of phenylalanineo Guthrie's Test - It detects the presence of phenylalanine in serumo FeCl3 - It detects the presence of phenylalanine in urine. FeCl3 is added to patients urine. If it contains phenylalanine, it will turn green.o 2-4 Dinitrophenol hydrazine - gives yellow precipitate with old urine.Treatmento Administration of low phenylalanine is the mainstay of treatment (but phenylalanine should not be completely restricted as it is necessary for growth). Tetrahydrobiopterin can be used in milder form. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A female presents with ductal ca in situ of breast with diffuse microcalcifications on mammography. She also gives family history of breast ca. What is best possible management, with the following options: A: Breast conservative surgery, B: Simple mastectomy, C: Modified radical mastectomy, D: Radiotherapy ### Response:

.* Total (simple) mastectomy: Along with the tumour, entire breast, areola, nipple, skin over the breast, including axillary tail are removed. There is no axillary dissection. Often the patient is subjected to radiotherapy later (External) to axilla. * Conservative breast surgeries: Tumour is removed with a rim of 1 cm of normal tissue. It may be a. Wide excision. b. Quadrantectomy as pa of therapy -- QUA (VERONESI): Entire segment of the involved breast is removed along with axillary dissection (done through a separate incision in the axilla, level I and II removal) and radiotherapy. There is a higher rate of local recurrence after conservative QUA therapy especially in younger patient and in high grade tumours. ref:SRB&;s manual of surgery,ed 3,pg no 484

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A female presents with ductal ca in situ of breast with diffuse microcalcifications on mammography. She also gives family history of breast ca. What is best possible management, with the following options: A: Breast conservative surgery, B: Simple mastectomy, C: Modified radical mastectomy, D: Radiotherapy ### Response: .* Total (simple) mastectomy: Along with the tumour, entire breast, areola, nipple, skin over the breast, including axillary tail are removed. There is no axillary dissection. Often the patient is subjected to radiotherapy later (External) to axilla. * Conservative breast surgeries: Tumour is removed with a rim of 1 cm of normal tissue. It may be a. Wide excision. b. Quadrantectomy as pa of therapy -- QUA (VERONESI): Entire segment of the involved breast is removed along with axillary dissection (done through a separate incision in the axilla, level I and II removal) and radiotherapy. There is a higher rate of local recurrence after conservative QUA therapy especially in younger patient and in high grade tumours. ref:SRB&;s manual of surgery,ed 3,pg no 484 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Esophageal atresia may occur as a part of VACTER group of anomalies. What does 'TE' stand for?, with the following options: A: Tetralogy of Fallot, B: Thoracic empyema, C: Tracheo-esophageal fistula, D: Talipes equinovarus ### Response:

c. Tracheo-esophageal fistula(Ref: Nelson's 20/e p 1783, Ghai 8/e p 173)VACTERL association (also called VATER association) refers to the non-random co-occurrence of birth defects including Vertebral anomalies, Anal atresia, Cardiac defects, Tracheoesophageal fistula and/or Esophageal atresia, Renal and Radial anomalies and Limb defects.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Esophageal atresia may occur as a part of VACTER group of anomalies. What does 'TE' stand for?, with the following options: A: Tetralogy of Fallot, B: Thoracic empyema, C: Tracheo-esophageal fistula, D: Talipes equinovarus ### Response: c. Tracheo-esophageal fistula(Ref: Nelson's 20/e p 1783, Ghai 8/e p 173)VACTERL association (also called VATER association) refers to the non-random co-occurrence of birth defects including Vertebral anomalies, Anal atresia, Cardiac defects, Tracheoesophageal fistula and/or Esophageal atresia, Renal and Radial anomalies and Limb defects. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 56 year old chronic smoker, mass in bronchus resected. What is the possible marker-, with the following options: A: Cytokeratin, B: Vimentin, C: Epithelial membrane Cadherin, D: Leukocyte ### Response:

Ref:Harrison&;s principle of internal medicine ,18 th edition, page no. 739 The diagnosis of lung cancer most often rests on the morphologic or cytologic features correlated with clinical and radiologic findings. Immunohistochemistry may be used to verify neuroendocrine differentiation within a tumour, with markers such as neuron specific enolase (NSE),CD56 or neural cell adhesion molecule (NCAM), synaptophysin, chromograin, and Leu7.Cytokeratin 7 and 20 used in combination can help narrow the differential diagnosis; Non-Small Cell Lung Cancer , Small Cell Lung <a href=" and mesothelioma may stain positive &nbsp;CK7and negative for CK20, while squamous cell lung cancer will be both CK7 and CK20 negative. mesotelioma can be easily identified ultrastructurally, but it has historically been difficult to differentiate from &nbsp;adenocarcinoma through morphology and immunohistochemical staining. several markers in the past few years have proven to be more helpful, including CK5/6,calretin, and wilms&; tumour gene 1(WT-1), all of which show positivity in mesothelioma.</p>

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 56 year old chronic smoker, mass in bronchus resected. What is the possible marker-, with the following options: A: Cytokeratin, B: Vimentin, C: Epithelial membrane Cadherin, D: Leukocyte ### Response: Ref:Harrison&;s principle of internal medicine ,18 th edition, page no. 739 The diagnosis of lung cancer most often rests on the morphologic or cytologic features correlated with clinical and radiologic findings. Immunohistochemistry may be used to verify neuroendocrine differentiation within a tumour, with markers such as neuron specific enolase (NSE),CD56 or neural cell adhesion molecule (NCAM), synaptophysin, chromograin, and Leu7.Cytokeratin 7 and 20 used in combination can help narrow the differential diagnosis; Non-Small Cell Lung Cancer , Small Cell Lung <a href=" and mesothelioma may stain positive &nbsp;CK7and negative for CK20, while squamous cell lung cancer will be both CK7 and CK20 negative. mesotelioma can be easily identified ultrastructurally, but it has historically been difficult to differentiate from &nbsp;adenocarcinoma through morphology and immunohistochemical staining. several markers in the past few years have proven to be more helpful, including CK5/6,calretin, and wilms&; tumour gene 1(WT-1), all of which show positivity in mesothelioma.</p> ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: False rejection of a true null hypothesis is due to?, with the following options: A: Type II error, B: Type I error, C: Beta error, D: Error of second kind ### Response:

Ans. is 'b' i.e., Type I error Statistical errors Statistical errors are used to describe possible errors made in statistical decision. Before reading about the types of error you must know null hypothesis because these tests are related to null hypothesis. Null hypothesis says - Any kind of difference or significance you see in a set of data is due to chance and not significant that means there is no variation (difference) exists between variables. Null hypothesis testing (e.g., in Chisquare test) is used to make a decision about whether : - i) The data contradict the null hypothesis - That means there is true difference (which is significant) between variables and it is not due to chance. Or ii) The data approve the null hypothesis There is no difference between variables and the difference you see is due to chance. Now see types of error :? There are two basic type of statistical errors : ? Type I error Type II error Type I error It is also known as an error of first kind or a-error or false positive. This type of error rejects null hypothesis when it is true - False rejection of null hypothesis. That means in real there is no difference (as null hypothesis says) but we observe a difference (by rejecting the null hypotesis due to error). In very simple words "we observe a difference when it is not true" - false positive. One of the simplest example of this would be if a test shows that a women is pregnant when in reality she is not, i.e., she is false positive for pregnancy. Probability of type-I error is given by 'P-value' (probability of declaring a significant difference when actually it is not present). Significance (a) level is the maximum tolerable probability of type I error. Significance (a) level is fixed in advance and calculation of P value (probability of type I error) can be less than, equal to or greater than the significance (a) level. If the probability of type I error (P -value) is less than significance (a) level, the results are declared statistically significant. Therefore, to declare the results statistical significant, type I error (a-level) should be kept to minimum . Type I error is more serious that type II error. Type II error It is also known as an error or second kind or A-error or false negative. This type of error accept/fail to reject the null hypothesis when it is false False acceptance of null hypothesis. That means we fail to observe a difference when in truth there is one - False negative. An example of this would be if a test shows that a woman is not pregnant when in reality she is i.e., she is false negative.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: False rejection of a true null hypothesis is due to?, with the following options: A: Type II error, B: Type I error, C: Beta error, D: Error of second kind ### Response: Ans. is 'b' i.e., Type I error Statistical errors Statistical errors are used to describe possible errors made in statistical decision. Before reading about the types of error you must know null hypothesis because these tests are related to null hypothesis. Null hypothesis says - Any kind of difference or significance you see in a set of data is due to chance and not significant that means there is no variation (difference) exists between variables. Null hypothesis testing (e.g., in Chisquare test) is used to make a decision about whether : - i) The data contradict the null hypothesis - That means there is true difference (which is significant) between variables and it is not due to chance. Or ii) The data approve the null hypothesis There is no difference between variables and the difference you see is due to chance. Now see types of error :? There are two basic type of statistical errors : ? Type I error Type II error Type I error It is also known as an error of first kind or a-error or false positive. This type of error rejects null hypothesis when it is true - False rejection of null hypothesis. That means in real there is no difference (as null hypothesis says) but we observe a difference (by rejecting the null hypotesis due to error). In very simple words "we observe a difference when it is not true" - false positive. One of the simplest example of this would be if a test shows that a women is pregnant when in reality she is not, i.e., she is false positive for pregnancy. Probability of type-I error is given by 'P-value' (probability of declaring a significant difference when actually it is not present). Significance (a) level is the maximum tolerable probability of type I error. Significance (a) level is fixed in advance and calculation of P value (probability of type I error) can be less than, equal to or greater than the significance (a) level. If the probability of type I error (P -value) is less than significance (a) level, the results are declared statistically significant. Therefore, to declare the results statistical significant, type I error (a-level) should be kept to minimum . Type I error is more serious that type II error. Type II error It is also known as an error or second kind or A-error or false negative. This type of error accept/fail to reject the null hypothesis when it is false False acceptance of null hypothesis. That means we fail to observe a difference when in truth there is one - False negative. An example of this would be if a test shows that a woman is not pregnant when in reality she is i.e., she is false negative. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Sign of antemortal hanging is?, with the following options: A: Dribbling of saliva, B: Ligature mark, C: Fracture of hyoid bone, D: Seminal emission ### Response:

ANSWER: (A) Dribbling of salivaREF: Parikh 6th edition page 3.44 Antemortem hangingPostmortem hangingMotiveUsually suicidal (Homicidal only in Lynching)HomicidalLigature markWell developed with parchment like base and is yellow or brownNot well developedSalivaDribbling of saliva presentAbsentInjuriesNo other injuries seenOther injuries causing death seenSigns of asphyxiaPresentAbsentCircumstantialevidenceClosed room No signs of struggleSigns of struggle presentDrag marks on bodyMaybe seenNot seenSuicide noteMay or may not be presentNever presentRope fibresMay be seen in the handsNot seen

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Sign of antemortal hanging is?, with the following options: A: Dribbling of saliva, B: Ligature mark, C: Fracture of hyoid bone, D: Seminal emission ### Response: ANSWER: (A) Dribbling of salivaREF: Parikh 6th edition page 3.44 Antemortem hangingPostmortem hangingMotiveUsually suicidal (Homicidal only in Lynching)HomicidalLigature markWell developed with parchment like base and is yellow or brownNot well developedSalivaDribbling of saliva presentAbsentInjuriesNo other injuries seenOther injuries causing death seenSigns of asphyxiaPresentAbsentCircumstantialevidenceClosed room No signs of struggleSigns of struggle presentDrag marks on bodyMaybe seenNot seenSuicide noteMay or may not be presentNever presentRope fibresMay be seen in the handsNot seen ### 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 statement about Bradykinin is true?, with the following options: A: Causes pain, B: Causes bronchodilation, C: Causes vasoconstriction, D: Decreases vascular permeability ### Response:

Bradykinin increases vascular permeability, causes contraction of smooth muscles (bronchoconstriction), dilatation of blood vessels and pain. Ref: Urinary Tract By Karl-Erik Andersson, Page 413; Peptidergic G Protein-coupled Receptors: From Basic Research to Clinical Applications By Pierangelo Geppetti, Page 100; The New Angiotherapy By Tai-Ping D. Fan, Elise C. Kohn, Page 94; Robbin's Illustrated Pathology, 7th Edition, Pages 65, 74, 75

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 statement about Bradykinin is true?, with the following options: A: Causes pain, B: Causes bronchodilation, C: Causes vasoconstriction, D: Decreases vascular permeability ### Response: Bradykinin increases vascular permeability, causes contraction of smooth muscles (bronchoconstriction), dilatation of blood vessels and pain. Ref: Urinary Tract By Karl-Erik Andersson, Page 413; Peptidergic G Protein-coupled Receptors: From Basic Research to Clinical Applications By Pierangelo Geppetti, Page 100; The New Angiotherapy By Tai-Ping D. Fan, Elise C. Kohn, Page 94; Robbin's Illustrated Pathology, 7th Edition, Pages 65, 74, 75 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: False regarding delirium tremens ?, with the following options: A: Tremors, B: Opthalmoplegia, C: Visual hallucination, D: Clouding of consciousness ### Response:

Ans. is 'b' i.e., Ophthalmoplegia Delirium tremens Delirium tremens is the most severe alcohol withdrawal syndrome. It occurs usually within 2-4 days of complete or significant alcohol abstinence. This is an acute organic brain syndrome (delirium) with characteristic features of delirium. Clouding of consciousness with disorientation in time and place. Poor attention span and distractability. Visual (and also auditory) hallucination, and illusion. Tactile hallucination of insect crawling under the skin (formication) may also occur. Marked autonomic disturbances with tachycardia, sweating, hypeension, mydriasis, coarse tremers. Insomnia, psychomotor agitation, ataxia, anxiety. Benzodiazepines are the drugs of choice for delirium tremens. Chlordiazepoxide is the agent of choice with diazepam as an alternative.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: False regarding delirium tremens ?, with the following options: A: Tremors, B: Opthalmoplegia, C: Visual hallucination, D: Clouding of consciousness ### Response: Ans. is 'b' i.e., Ophthalmoplegia Delirium tremens Delirium tremens is the most severe alcohol withdrawal syndrome. It occurs usually within 2-4 days of complete or significant alcohol abstinence. This is an acute organic brain syndrome (delirium) with characteristic features of delirium. Clouding of consciousness with disorientation in time and place. Poor attention span and distractability. Visual (and also auditory) hallucination, and illusion. Tactile hallucination of insect crawling under the skin (formication) may also occur. Marked autonomic disturbances with tachycardia, sweating, hypeension, mydriasis, coarse tremers. Insomnia, psychomotor agitation, ataxia, anxiety. Benzodiazepines are the drugs of choice for delirium tremens. Chlordiazepoxide is the agent of choice with diazepam as an alternative. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: DOC in allergic bronchopulmonary aspergillosis ABPA:, with the following options: A: Prednisolone, B: IV Amphotercin B, C: IV Phenramine maleate, D: Fluconazole ### Response:

Ans: a (Prednisolone) Ref: Harrison, 16th ed, p. 1189; 17th ed, p. 1260, Table (197-2)Drug of choice for ABPA is prednisolone. (According to new recommendadation 17th ed, Harrison,Table 197-2 drug of choice is ITRACONAZOLE)Treatment of aspergillus infectionFungus ball of the lung - Surgical resectionABPA- short course of Glucocorticoids (prednisolone)Invasive Aspergillosis-voriconazole, liposomal or conventional amphotercin BMajor diagnostic criteria for ABPA:Secondary diagnostic criteria1. Clinical history of asthma1. History of brownish plugs in sputum2. Pulmonary infiltrates (transient or fixed)2. Culture of A. fumigatus from sputum3. Peripheral eosinophilia (> 1000/uL)3. Late skin reactivity to aspergillus antigen4. Immediate skin reactivity to aspergillus antigen.4. Elevated IgE (and IgG) class antibodies specific for A. fumigatus.5. Serum precipitates to A. fumigatus6. Elevated serum IgE levels.7. Central / proximal bronchiectasis(In recent papers lot of questions are asked regarding the antimicrobial of choice. Therefore we have listed some of the important ones.)Gonococcal infection- CeftriaxoneClostridium- Penicillin (IV) + ClindamycinDiphtheria- ErythromycinListeria- IV Ampicillin or PenicillinKlebsiella- CarbepenemCampylobacter- ErythromycinYersenia pestis- StreptomycinPertussis- ErythromycinBrucella- StreptomycinChlamydia- AzithromycinMycoplasma- Erythromycin

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: DOC in allergic bronchopulmonary aspergillosis ABPA:, with the following options: A: Prednisolone, B: IV Amphotercin B, C: IV Phenramine maleate, D: Fluconazole ### Response: Ans: a (Prednisolone) Ref: Harrison, 16th ed, p. 1189; 17th ed, p. 1260, Table (197-2)Drug of choice for ABPA is prednisolone. (According to new recommendadation 17th ed, Harrison,Table 197-2 drug of choice is ITRACONAZOLE)Treatment of aspergillus infectionFungus ball of the lung - Surgical resectionABPA- short course of Glucocorticoids (prednisolone)Invasive Aspergillosis-voriconazole, liposomal or conventional amphotercin BMajor diagnostic criteria for ABPA:Secondary diagnostic criteria1. Clinical history of asthma1. History of brownish plugs in sputum2. Pulmonary infiltrates (transient or fixed)2. Culture of A. fumigatus from sputum3. Peripheral eosinophilia (> 1000/uL)3. Late skin reactivity to aspergillus antigen4. Immediate skin reactivity to aspergillus antigen.4. Elevated IgE (and IgG) class antibodies specific for A. fumigatus.5. Serum precipitates to A. fumigatus6. Elevated serum IgE levels.7. Central / proximal bronchiectasis(In recent papers lot of questions are asked regarding the antimicrobial of choice. Therefore we have listed some of the important ones.)Gonococcal infection- CeftriaxoneClostridium- Penicillin (IV) + ClindamycinDiphtheria- ErythromycinListeria- IV Ampicillin or PenicillinKlebsiella- CarbepenemCampylobacter- ErythromycinYersenia pestis- StreptomycinPertussis- ErythromycinBrucella- StreptomycinChlamydia- AzithromycinMycoplasma- Erythromycin ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Reflux Nephropathy with protenuria in the nephrotic range may be seen in patients with :, with the following options: A: Membranous glomerulonephritis, B: Focal segmental Glomerulosclerosis, C: Nodular glomerulosclerosis, D: Crescenteric glomerulonephritis ### Response:

Answer is B (Focal segmental Glomerulosclerosis): Focal segmental glomerulosclerosis may develop following acquired loss of nephrons from reflux nephropathy. Proteinuria is nonselective in most cases and may be in subnephrotic range (nephritic range < 3.0 g/24h) or nephrotic range. - Harrison Association of Reflux Nephropathy and protein aria suggests an irreversible glomerular lesion most commonly focal segmental glomerulosclerosis : Medline

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Reflux Nephropathy with protenuria in the nephrotic range may be seen in patients with :, with the following options: A: Membranous glomerulonephritis, B: Focal segmental Glomerulosclerosis, C: Nodular glomerulosclerosis, D: Crescenteric glomerulonephritis ### Response: Answer is B (Focal segmental Glomerulosclerosis): Focal segmental glomerulosclerosis may develop following acquired loss of nephrons from reflux nephropathy. Proteinuria is nonselective in most cases and may be in subnephrotic range (nephritic range < 3.0 g/24h) or nephrotic range. - Harrison Association of Reflux Nephropathy and protein aria suggests an irreversible glomerular lesion most commonly focal segmental glomerulosclerosis : Medline ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In ACLS which drug can be given following ventricular fibrillation after cardiac arrest other than epinephrine?, with the following options: A: Amiodarone, B: Dopamine, C: Adenosine, D: Atropine ### Response:

V-Fib or VF is the most common rhythm that occurs immediately after cardiac arrest. In this rhythm, the hea beats with rapid, erratic electrical impulses. Treatment: * Shock / Defibrillation: every 2 minutes in a single one shock, successive, shockable increments * 200 joules - Followed by immediate CPR for 2 minutes / give and circulate a drug(s) * 300 joules - Followed by immediate CPR for 2 minutes / give and circulate a drug(s) * 360 joules - Followed by immediate CPR for 2 minutes / give and circulate a drug(s) * Drugs : * Give Epinephrine 1mg of a 1:10,000 solu,on every 3 to 5 minutes * Give either: * Amiodarone : 300mg first dose / 150mg second dose at 3 to 5 minutes increments. Lidocaine: First dose: 1mg/kg or 1.5 mg/kg. Can repeat it at half the original dose up to a total of 3 mg/kg REF : BAILEY AND LOVE 27TH ED

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In ACLS which drug can be given following ventricular fibrillation after cardiac arrest other than epinephrine?, with the following options: A: Amiodarone, B: Dopamine, C: Adenosine, D: Atropine ### Response: V-Fib or VF is the most common rhythm that occurs immediately after cardiac arrest. In this rhythm, the hea beats with rapid, erratic electrical impulses. Treatment: * Shock / Defibrillation: every 2 minutes in a single one shock, successive, shockable increments * 200 joules - Followed by immediate CPR for 2 minutes / give and circulate a drug(s) * 300 joules - Followed by immediate CPR for 2 minutes / give and circulate a drug(s) * 360 joules - Followed by immediate CPR for 2 minutes / give and circulate a drug(s) * Drugs : * Give Epinephrine 1mg of a 1:10,000 solu,on every 3 to 5 minutes * Give either: * Amiodarone : 300mg first dose / 150mg second dose at 3 to 5 minutes increments. Lidocaine: First dose: 1mg/kg or 1.5 mg/kg. Can repeat it at half the original dose up to a total of 3 mg/kg REF : BAILEY AND LOVE 27TH ED ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Taste sensation from anterior 2/3rd of tongue are carried by, with the following options: A: Glossopharyngeal, B: Chordatympani, C: Trigeminal, D: Greater auricular ### Response:

TASTE SENSATION FROM ANTERIOR TWO-THIRDS OF TONGUE IS CARRIED BY CHORDA TYMPANI. CHORDA TYMPANI IS THE NERVE OF TASTE EXCEPT VALLAA PAPILLAE. REFER BDC 6 TH EDITION VOLUME 3 PAGE NO: 268 REFER FIG 17.8

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Taste sensation from anterior 2/3rd of tongue are carried by, with the following options: A: Glossopharyngeal, B: Chordatympani, C: Trigeminal, D: Greater auricular ### Response: TASTE SENSATION FROM ANTERIOR TWO-THIRDS OF TONGUE IS CARRIED BY CHORDA TYMPANI. CHORDA TYMPANI IS THE NERVE OF TASTE EXCEPT VALLAA PAPILLAE. REFER BDC 6 TH EDITION VOLUME 3 PAGE NO: 268 REFER FIG 17.8 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Concentration of H+ ion is 10-9. What is the pH of the solution?, with the following options: A: 9, B: 13, C: 4, D: 7 ### Response:

Ref: Vasudevan DM, Sreekumari S. Text book of BIOCHEMISTRY, 6th Edn. Page No: 339,Explanation:pH is defined as the negative logarithm of hydrogen ion concentration (moles/L)pH = -Log10 In this problem, H+ Concentration is 1X109 Moles/LpH = -log 10pH = 9Similarly pka = -logl0 Where Ka is dissociation constant. M/L M/LpHpOHInference1 X10 -131 X 10 1113Strong acid1 X 10 -10c1 X 10 -4410Acid1 X 10 -71 X 10 -777Neutral1 X 10 -41 X 10 -10104Alkali1 X 10 -11 X 10 -13131Strong alkali

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Concentration of H+ ion is 10-9. What is the pH of the solution?, with the following options: A: 9, B: 13, C: 4, D: 7 ### Response: Ref: Vasudevan DM, Sreekumari S. Text book of BIOCHEMISTRY, 6th Edn. Page No: 339,Explanation:pH is defined as the negative logarithm of hydrogen ion concentration (moles/L)pH = -Log10 In this problem, H+ Concentration is 1X109 Moles/LpH = -log 10pH = 9Similarly pka = -logl0 Where Ka is dissociation constant. M/L M/LpHpOHInference1 X10 -131 X 10 1113Strong acid1 X 10 -10c1 X 10 -4410Acid1 X 10 -71 X 10 -777Neutral1 X 10 -41 X 10 -10104Alkali1 X 10 -11 X 10 -13131Strong alkali ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which pox wont grow in egg, animal cells:, with the following options: A: Cow pox, B: Vaccinia, C: Variola, D: Molluscum ### Response:

Ans. d. Molluscum

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which pox wont grow in egg, animal cells:, with the following options: A: Cow pox, B: Vaccinia, C: Variola, D: Molluscum ### Response: Ans. d. Molluscum ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are true of water shed infarcts except, with the following options: A: Seen at junction of major cerebral aeries, B: Seen at sub ganglionic White matter, C: Cerebral vasospasm may cause it, D: Associated With hypoxic ischemic encephatopathy ### Response:

Harrison's principles of internal medicine. *Occur at distal territories between the major cerebral aeries and can cause cognitive deficits,visual agnosia and weakness that is greater in proximal than in distal muscle groups. watershed stroke is defined as a brain ischemia that is localized to the vulnerable border zones between the tissues supplied by the anterior, posterior and middle cerebral aeries. The actual blood stream blockage/restriction site can be located far away from the infarcts. Watershed locations are those border-zone regions in the brain supplied by the major cerebral aeries where blood supply is decreased. Watershed strokes are a concern because they comprise approximately 10% of all ischemic stroke casesThe watershed zones themselves are paicularly susceptible to infarction from global ischemia as the distal nature of the vasculature predisposes these areas to be most sensitive to profound hypoperfusion Ref Harrison20th edition pg 2234

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are true of water shed infarcts except, with the following options: A: Seen at junction of major cerebral aeries, B: Seen at sub ganglionic White matter, C: Cerebral vasospasm may cause it, D: Associated With hypoxic ischemic encephatopathy ### Response: Harrison's principles of internal medicine. *Occur at distal territories between the major cerebral aeries and can cause cognitive deficits,visual agnosia and weakness that is greater in proximal than in distal muscle groups. watershed stroke is defined as a brain ischemia that is localized to the vulnerable border zones between the tissues supplied by the anterior, posterior and middle cerebral aeries. The actual blood stream blockage/restriction site can be located far away from the infarcts. Watershed locations are those border-zone regions in the brain supplied by the major cerebral aeries where blood supply is decreased. Watershed strokes are a concern because they comprise approximately 10% of all ischemic stroke casesThe watershed zones themselves are paicularly susceptible to infarction from global ischemia as the distal nature of the vasculature predisposes these areas to be most sensitive to profound hypoperfusion Ref Harrison20th edition pg 2234 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The primary role of chaperones is to help in, with the following options: A: Protein synthesis, B: Protein degradation, C: Protein denaturation, D: Protein folding ### Response:

Proteins must fold to achieve their functional form. Folding can be spontaneous or facilitated by chaperones. Proteins that are defective (for example misfolded) or destined for rapid turnover are marked for destruction by the attachment of chains of a small, highly conserved protein called ubiquitin. Ubiquitinated proteins are rapidly degraded by a cytosolic complex known as the proteasome. Reference: Lippincotts illustrated reviews of Biochemistry Sixth edition: page no; 807

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The primary role of chaperones is to help in, with the following options: A: Protein synthesis, B: Protein degradation, C: Protein denaturation, D: Protein folding ### Response: Proteins must fold to achieve their functional form. Folding can be spontaneous or facilitated by chaperones. Proteins that are defective (for example misfolded) or destined for rapid turnover are marked for destruction by the attachment of chains of a small, highly conserved protein called ubiquitin. Ubiquitinated proteins are rapidly degraded by a cytosolic complex known as the proteasome. Reference: Lippincotts illustrated reviews of Biochemistry Sixth edition: page no; 807 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A lady with 36-week pregnancy with previous C section comes with low BP, tachycardia and on USG fluid present in peritoneum. What is diagnosis and next management, with the following options: A: Uterine scar rupture with Laparotomy, B: Impending dehiscence and Laparoscopy, C: Ectopic pregnancy and aboion, D: Abruptio and C-section ### Response:

Above history points towards diagnosis of Uterine scar rupture Signs and symptom of rupture: Maternal Tachycardia Maternal hypotension Dead baby or severe fetal distress Uterine contour is lost Sudden stoppage of uterine contraction Hemoperitoneum P/V: loss of station Mx: Emergency laparotomy

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A lady with 36-week pregnancy with previous C section comes with low BP, tachycardia and on USG fluid present in peritoneum. What is diagnosis and next management, with the following options: A: Uterine scar rupture with Laparotomy, B: Impending dehiscence and Laparoscopy, C: Ectopic pregnancy and aboion, D: Abruptio and C-section ### Response: Above history points towards diagnosis of Uterine scar rupture Signs and symptom of rupture: Maternal Tachycardia Maternal hypotension Dead baby or severe fetal distress Uterine contour is lost Sudden stoppage of uterine contraction Hemoperitoneum P/V: loss of station Mx: Emergency laparotomy ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: It is true regarding the normal microbial flora present on the skin and mucous membranes that ?, with the following options: A: It cannot be eradicated by antimicrobial agents, B: It is absent in the stomach due to the acidic pH, C: It establishes in the body only after the neonatal period, D: The flora in the small bronchi is similar to that of the trachea ### Response:

Ans is 'a' i.e., It cannot be eradicated by antimicrobial agents . The normal microbial flora are more or less constant for each species and are broadly divided into residents and transients. The former constitute a constant population which cannot be completely removed permanently. - Ananthanarayan 7'''/e 599 . Because of low pH of stomach, it is viually sterile except soon after eating - Ananthanarayan 71/4 601 . With in 4-24 hours of bih an intestinal flora is established - Ananthanarayan r/e 600 . In the pharynx and trachea, flora is similar to that of mouth, while smaller bronchi and alveoli are normally sterile - Ananthanarayan 7th/e 600

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: It is true regarding the normal microbial flora present on the skin and mucous membranes that ?, with the following options: A: It cannot be eradicated by antimicrobial agents, B: It is absent in the stomach due to the acidic pH, C: It establishes in the body only after the neonatal period, D: The flora in the small bronchi is similar to that of the trachea ### Response: Ans is 'a' i.e., It cannot be eradicated by antimicrobial agents . The normal microbial flora are more or less constant for each species and are broadly divided into residents and transients. The former constitute a constant population which cannot be completely removed permanently. - Ananthanarayan 7'''/e 599 . Because of low pH of stomach, it is viually sterile except soon after eating - Ananthanarayan 71/4 601 . With in 4-24 hours of bih an intestinal flora is established - Ananthanarayan r/e 600 . In the pharynx and trachea, flora is similar to that of mouth, while smaller bronchi and alveoli are normally sterile - Ananthanarayan 7th/e 600 ### 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 organs involved in the wagners granulomatosis are, with the following options: A: Skin and nose, B: Lung and kidney, C: Hea and kidney, D: Kidney and nervous system ### Response:

Refer robbins 9/e p511 Granulomatosis with polyangiitis (formerly called Wegener's) is a rare disease of unceain cause that can affect people of all ages. It is characterized by inflammation in various tissues, including blood vessels (vasculitis), but primarily pas of the respiratory tract and the kidneys. The areas most commonly affected by GPA include the sinuses, lungs, and kidneys, but any site can be affected

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common organs involved in the wagners granulomatosis are, with the following options: A: Skin and nose, B: Lung and kidney, C: Hea and kidney, D: Kidney and nervous system ### Response: Refer robbins 9/e p511 Granulomatosis with polyangiitis (formerly called Wegener's) is a rare disease of unceain cause that can affect people of all ages. It is characterized by inflammation in various tissues, including blood vessels (vasculitis), but primarily pas of the respiratory tract and the kidneys. The areas most commonly affected by GPA include the sinuses, lungs, and kidneys, but any site can be affected ### 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 fibromuscular dysplasia are all except -, with the following options: A: Medium size vessels, B: OCPs predispose, C: Aneurysm may occur, D: Irregular hyperplasia ### Response:

Ans. is 'b' i.e., OCPs predispose Fibromuscular dysplasia It is focal irregular thickening of the walls of medium and large muscular aeries, including renal, carotid, splanchnic, and veebral vessels. Segments of vessel wall are focally thickened by a combination of irregular medial and intimal hyperplasia and fibrosis, causing luminal stenosis. In renal vessels, it may cause renovascular hypeension. Aneurysm may develop in the vessel segment with attenuated media, and can rupture in some cases. There is no association with use of oral contraceptives or sex hormone abnormalities.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True regarding fibromuscular dysplasia are all except -, with the following options: A: Medium size vessels, B: OCPs predispose, C: Aneurysm may occur, D: Irregular hyperplasia ### Response: Ans. is 'b' i.e., OCPs predispose Fibromuscular dysplasia It is focal irregular thickening of the walls of medium and large muscular aeries, including renal, carotid, splanchnic, and veebral vessels. Segments of vessel wall are focally thickened by a combination of irregular medial and intimal hyperplasia and fibrosis, causing luminal stenosis. In renal vessels, it may cause renovascular hypeension. Aneurysm may develop in the vessel segment with attenuated media, and can rupture in some cases. There is no association with use of oral contraceptives or sex hormone abnormalities. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 20 year old male come to casuality with head injury. Examination reveals normal counsciousness, clinically normal and blood in the tympanic membrane, most likely cause is, with the following options: A: Extradural haemorrhage, B: Subdural haemorrhage, C: Intraventricular haemorrhage, D: Complete basilar fracture ### Response:

(Complete basilar fracture) (595 - 99- B & L 24th) (302-Baily & Love 25th)Extradural haemorrhage - Common in younger age group* Usually from haemorrhage of middle meningeal artery* **Lucid interval is characteristic* Surgery without delay is essentialSubdural haematoma - most common intracranial mass lesions resulting from head trauma* *Develop from tom bridging veins or cortical lacerations* More severe poorer out come* **CT - concave hyperdense collectionsBase of skull fractures|||Anterior Cranial Fossa FractureMiddle Cranial Fossa Fracture* Sub conjunctival haematoma* CSF rhinorrhoea* Carotico-cavemous fistula* Periorbital haematoma or "raccoon eyes"* CSF otorrhoea or rhinorrhoea* Haemotympanum ** Ossicular disruption* "Battle sign" (brushing behind the ear)* VII and VIII cranial nerve palsies

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 20 year old male come to casuality with head injury. Examination reveals normal counsciousness, clinically normal and blood in the tympanic membrane, most likely cause is, with the following options: A: Extradural haemorrhage, B: Subdural haemorrhage, C: Intraventricular haemorrhage, D: Complete basilar fracture ### Response: (Complete basilar fracture) (595 - 99- B & L 24th) (302-Baily & Love 25th)Extradural haemorrhage - Common in younger age group* Usually from haemorrhage of middle meningeal artery* **Lucid interval is characteristic* Surgery without delay is essentialSubdural haematoma - most common intracranial mass lesions resulting from head trauma* *Develop from tom bridging veins or cortical lacerations* More severe poorer out come* **CT - concave hyperdense collectionsBase of skull fractures|||Anterior Cranial Fossa FractureMiddle Cranial Fossa Fracture* Sub conjunctival haematoma* CSF rhinorrhoea* Carotico-cavemous fistula* Periorbital haematoma or "raccoon eyes"* CSF otorrhoea or rhinorrhoea* Haemotympanum ** Ossicular disruption* "Battle sign" (brushing behind the ear)* VII and VIII cranial nerve palsies ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The receptor through which M-tropic HIV strains bind -, with the following options: A: CCR5, B: CXCR4, C: CXCR5, D: Any of the above ### Response:

HIV-1 most commonly uses the chemokine receptors CCR5 and/or CXCR4 as co-receptors to enter target immunological cells. Option 1: Macrophage (M-tropic) strains of HIV-1, or non-syncitia-inducing strains (NSI) use the beta-chemokine receptor CCR5 for entry and are thus able to replicate in macrophages and CD4+ T-cells. These strains are now called R5 viruses. Option 2: T-cell line (T-tropic) isolates or syncytium-inducing (SI) strains replicate in primary CD4+ T-cells as well as in macrophages and use the alpha-chemokine receptor, CXCR4, for entry. Option 3: CXCR5 in B-cell and tumor cell responses: expressed in Burkitt Lymphoma and Intraocular Lymphoma.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The receptor through which M-tropic HIV strains bind -, with the following options: A: CCR5, B: CXCR4, C: CXCR5, D: Any of the above ### Response: HIV-1 most commonly uses the chemokine receptors CCR5 and/or CXCR4 as co-receptors to enter target immunological cells. Option 1: Macrophage (M-tropic) strains of HIV-1, or non-syncitia-inducing strains (NSI) use the beta-chemokine receptor CCR5 for entry and are thus able to replicate in macrophages and CD4+ T-cells. These strains are now called R5 viruses. Option 2: T-cell line (T-tropic) isolates or syncytium-inducing (SI) strains replicate in primary CD4+ T-cells as well as in macrophages and use the alpha-chemokine receptor, CXCR4, for entry. Option 3: CXCR5 in B-cell and tumor cell responses: expressed in Burkitt Lymphoma and Intraocular Lymphoma. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cilastatin is given along with, with the following options: A: Imipenem, B: Amoxycillin, C: Erythromycin, D: Ampicillin ### Response:

.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cilastatin is given along with, with the following options: A: Imipenem, B: Amoxycillin, C: Erythromycin, D: Ampicillin ### Response: . ### 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 statement is not true regarding NK cells, with the following options: A: NK cells have CD markers 16, 56, B: They mediate antibody dependent cell mediated cytotoxicity, C: They are MHC I restricted, D: Reduced expression of MHC Class I moleules favours cytotoxicity of NK cells. ### Response:

NK cells are not MHC restricted.

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 statement is not true regarding NK cells, with the following options: A: NK cells have CD markers 16, 56, B: They mediate antibody dependent cell mediated cytotoxicity, C: They are MHC I restricted, D: Reduced expression of MHC Class I moleules favours cytotoxicity of NK cells. ### Response: NK cells are not MHC restricted. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All of the following are the posterior relations of kidney except:, with the following options: A: Psoas Major, B: Quadratus Lumborum, C: Sympathetic chain, D: Ilioinguinal Nerve ### Response:

Ans. C. Sympathetic chainThe posterior relations of two kidneys are:a. Four muscles: Diaphragm, quadratus lumborum, psoas major, and transversus abdominis.b. Three nerves: Subcostal (T12 , iliohypogastric (L1 ), and ilioinguinal (L1 ). The subcostal nerve is accompanied by the subcostal vessels.c. One or two ribs: The right kidney is related to the 12th rib whereas the left kidney is related to the 11th and 12th ribs.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All of the following are the posterior relations of kidney except:, with the following options: A: Psoas Major, B: Quadratus Lumborum, C: Sympathetic chain, D: Ilioinguinal Nerve ### Response: Ans. C. Sympathetic chainThe posterior relations of two kidneys are:a. Four muscles: Diaphragm, quadratus lumborum, psoas major, and transversus abdominis.b. Three nerves: Subcostal (T12 , iliohypogastric (L1 ), and ilioinguinal (L1 ). The subcostal nerve is accompanied by the subcostal vessels.c. One or two ribs: The right kidney is related to the 12th rib whereas the left kidney is related to the 11th and 12th ribs. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In a small child diagnosed with H.influenza meningitis, what investigation must be done before discharging him from the hospital ?, with the following options: A: BERA, B: MBI, C: CT scan, D: X-ray skull ### Response:

Clinical description : Bacterial meningitis is characterized by acute onset of fever (usually > 38.5 degC rectal or 38.0 degC axillary), headache and one of the following signs: neck stiffness, altered consciousness or other meningeal signs. Hib, meningococcal meningitis and pneumococcal meningitis cannot be differentiated on clinical grounds alone Laboratory criteria for diagnosis Bacterial meningitis can be confirmed by three methods. (1) Culture method: isolation of a bacterial pathogen from a normally sterile clinical specimen such as CSF or blood. (2) Antigen detection methods: identification of a bacterial antigen in normally sterile fluids (i.e. CSF or blood) by such methods as latex agglutination or counterimmunoelectrophoresis (CIE). (3) Gram stain results Case classification Suspected: Any person with sudden onset of fever (> 38.5 degC rectal or 38.0 degC axillary) and one of the following signs: neck stiffness, altered consciousness or other meningeal sign Probable: A suspected case with CSF examination showing at least one of the following: - turbid appearance; - leukocytosis (> 100 cells/mm3); - leukocytosis (10-100 cells/ mm3) AND either an elevated protein (> 100 mg/dl) or decreased glucose (< 40) Confirmed: A case that is laboratory-confirmed by growing (i.e. culturing) or identifying (i.e. by Gram stain or antigen detection methods) a bacterial pathogen (Hib, pneumococcus or meningococcus) in the CSF or from the blood in a child with a clinical syndrome consistent with bacterial meningitis. Acute bacterial meningitis (ABM) constitutes 1.5% of all admissions in the pediatric ward with a mean case fatality of 16%. Sensorineural hearing loss (SNHL) is the most common neuropsychological sequel of ABM. It occurs in as many as 30% of patients with pneumococcal meningitis, 10% with meningococcal meningitis and 5-20% with Haemophilus influenzae type &;b&; meningitis.The effect of SNHL on language is well-recognized and therefore early detection is mandatory. However, hearing assessment is difficult in infants and young children. Brainstem evoked response audiometry (BERA) can help to assess hearing in this population. BERA is a helpful tool for screening of SNHL, especially in the young children and infants in whom other conventional methods may not be of much use. There is significantly increased risk of developing SNHL if the CSF has increased cells, paicularly polymorphs and proteins. Reference: GHAI Essential pediatrics, 8th edition

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In a small child diagnosed with H.influenza meningitis, what investigation must be done before discharging him from the hospital ?, with the following options: A: BERA, B: MBI, C: CT scan, D: X-ray skull ### Response: Clinical description : Bacterial meningitis is characterized by acute onset of fever (usually > 38.5 degC rectal or 38.0 degC axillary), headache and one of the following signs: neck stiffness, altered consciousness or other meningeal signs. Hib, meningococcal meningitis and pneumococcal meningitis cannot be differentiated on clinical grounds alone Laboratory criteria for diagnosis Bacterial meningitis can be confirmed by three methods. (1) Culture method: isolation of a bacterial pathogen from a normally sterile clinical specimen such as CSF or blood. (2) Antigen detection methods: identification of a bacterial antigen in normally sterile fluids (i.e. CSF or blood) by such methods as latex agglutination or counterimmunoelectrophoresis (CIE). (3) Gram stain results Case classification Suspected: Any person with sudden onset of fever (> 38.5 degC rectal or 38.0 degC axillary) and one of the following signs: neck stiffness, altered consciousness or other meningeal sign Probable: A suspected case with CSF examination showing at least one of the following: - turbid appearance; - leukocytosis (> 100 cells/mm3); - leukocytosis (10-100 cells/ mm3) AND either an elevated protein (> 100 mg/dl) or decreased glucose (< 40) Confirmed: A case that is laboratory-confirmed by growing (i.e. culturing) or identifying (i.e. by Gram stain or antigen detection methods) a bacterial pathogen (Hib, pneumococcus or meningococcus) in the CSF or from the blood in a child with a clinical syndrome consistent with bacterial meningitis. Acute bacterial meningitis (ABM) constitutes 1.5% of all admissions in the pediatric ward with a mean case fatality of 16%. Sensorineural hearing loss (SNHL) is the most common neuropsychological sequel of ABM. It occurs in as many as 30% of patients with pneumococcal meningitis, 10% with meningococcal meningitis and 5-20% with Haemophilus influenzae type &;b&; meningitis.The effect of SNHL on language is well-recognized and therefore early detection is mandatory. However, hearing assessment is difficult in infants and young children. Brainstem evoked response audiometry (BERA) can help to assess hearing in this population. BERA is a helpful tool for screening of SNHL, especially in the young children and infants in whom other conventional methods may not be of much use. There is significantly increased risk of developing SNHL if the CSF has increased cells, paicularly polymorphs and proteins. Reference: GHAI Essential pediatrics, 8th edition ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following cervical joint helps a person to look towards the right or left?, with the following options: A: Atlanto-occipital joint, B: Atlanto-axial joint, C: C2-C3 joint, D: C3-C4 joint ### Response:

The atlantoaxial joint allows the greatest degree of motion among all the joints of the neck. It allows the head to flex and extend about 10 degrees, and also allows more than 60 degree of rotation in the horizontal plane. Thereby permitting a person to look to the right or left. Ref: Atlas of Interventional Pain Management By Steven D. Waldman, 3rd edition, Page 7 ; Understanding Joints: A Practical Guide to Their Structure and Function By Bernard Kingston, Page 36 ; Clinical Anatomy by Region's by Richard's Snell, Page 862, 858

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 cervical joint helps a person to look towards the right or left?, with the following options: A: Atlanto-occipital joint, B: Atlanto-axial joint, C: C2-C3 joint, D: C3-C4 joint ### Response: The atlantoaxial joint allows the greatest degree of motion among all the joints of the neck. It allows the head to flex and extend about 10 degrees, and also allows more than 60 degree of rotation in the horizontal plane. Thereby permitting a person to look to the right or left. Ref: Atlas of Interventional Pain Management By Steven D. Waldman, 3rd edition, Page 7 ; Understanding Joints: A Practical Guide to Their Structure and Function By Bernard Kingston, Page 36 ; Clinical Anatomy by Region's by Richard's Snell, Page 862, 858 ### 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 example of hyaline cailage?, with the following options: A: Epiglottis, B: Tip of nose, C: Apex of arytenoid cailage, D: Pinna ### Response:

Hyaline cailage is seen at tip of nose ; lateral wall of nose and nasal septum Inderbir Singh&;s textbook of human Histology Seventh edition Pg no 82

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 example of hyaline cailage?, with the following options: A: Epiglottis, B: Tip of nose, C: Apex of arytenoid cailage, D: Pinna ### Response: Hyaline cailage is seen at tip of nose ; lateral wall of nose and nasal septum Inderbir Singh&;s textbook of human Histology Seventh edition Pg no 82 ### 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 true about anatomy of the cerebellum?, with the following options: A: Globose cells are present in the roof, B: Vermis is present in the midline, C: Flocculonodular lobe is concerned with smoothening and co-ordination of movements, D: Dentate nucleus is the medial most nucleus ### Response:

Ans. is 'b' i.e., Vermis is present in the midline.(Ref: Ganong 23d/e p. 255)'The vermis is a midline structure that connects the two cerebellar hemispheres.'Dentate nucleus is the lateral most nucleus.''Spinocerebellum and not flocculonodular lobe is concerned with smoothing and coordination of movements''Globose cells are a pa of deep cerebellar nuclei and are present deep inside the substance of cerebellum.

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 true about anatomy of the cerebellum?, with the following options: A: Globose cells are present in the roof, B: Vermis is present in the midline, C: Flocculonodular lobe is concerned with smoothening and co-ordination of movements, D: Dentate nucleus is the medial most nucleus ### Response: Ans. is 'b' i.e., Vermis is present in the midline.(Ref: Ganong 23d/e p. 255)'The vermis is a midline structure that connects the two cerebellar hemispheres.'Dentate nucleus is the lateral most nucleus.''Spinocerebellum and not flocculonodular lobe is concerned with smoothing and coordination of movements''Globose cells are a pa of deep cerebellar nuclei and are present deep inside the substance of cerebellum. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Not transmitted by fish -, with the following options: A: Paragonimus westermanii, B: Clonorchis sinensis, C: Diphyllobothrium latum, D: Schistosoma japonicum ### Response:

definitive host-man and domestic animals Intermediate snail host-Oncomelania sp. (refer pgno:117 baveja 3 rd edition)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Not transmitted by fish -, with the following options: A: Paragonimus westermanii, B: Clonorchis sinensis, C: Diphyllobothrium latum, D: Schistosoma japonicum ### Response: definitive host-man and domestic animals Intermediate snail host-Oncomelania sp. (refer pgno:117 baveja 3 rd edition) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which is safest to be used in asthmatic patients –, with the following options: A: Nitrazepam, B: Phenobarbitone, C: Chloral hydrate, D: All hypnotics are safe ### Response:

Safe in asthma → Propofol, etomidate, ketamine, vecuronium, rocuronium, Pancuronium, Halothane, Sevoflurane, Desflurane, Isoflurane, Pethidine, Fentanyl, Alfentanil, Benzodiazepines (Nitrazepam).

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which is safest to be used in asthmatic patients –, with the following options: A: Nitrazepam, B: Phenobarbitone, C: Chloral hydrate, D: All hypnotics are safe ### Response: Safe in asthma → Propofol, etomidate, ketamine, vecuronium, rocuronium, Pancuronium, Halothane, Sevoflurane, Desflurane, Isoflurane, Pethidine, Fentanyl, Alfentanil, Benzodiazepines (Nitrazepam). ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: "Break bone fever" is:, with the following options: A: Rheumatic fever, B: Dengue fever, C: Rat-bite fever, D: Relapsing fever ### Response:

(Dengue fever): Ref: 111, 1164-H (1230-H17th)DENGUE FEVER: - Caused by (4 - serotype) Aedes - aegpti (flavi virus)* Headache, musculoskeletal pain ("break bone fever"): leukopenia occasionally biphasic ( "saddleback") fever* Macular rash on the first day, as well as adenopathy, palatal vesicles and scleral injection* Epistaxis and scattered petectiae are often noted in uncomplicated dengue, and preexisting GI lesion may bleed during the acute illness* Leucopenia, thrombocytopenia and increased aminotransferase

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: "Break bone fever" is:, with the following options: A: Rheumatic fever, B: Dengue fever, C: Rat-bite fever, D: Relapsing fever ### Response: (Dengue fever): Ref: 111, 1164-H (1230-H17th)DENGUE FEVER: - Caused by (4 - serotype) Aedes - aegpti (flavi virus)* Headache, musculoskeletal pain ("break bone fever"): leukopenia occasionally biphasic ( "saddleback") fever* Macular rash on the first day, as well as adenopathy, palatal vesicles and scleral injection* Epistaxis and scattered petectiae are often noted in uncomplicated dengue, and preexisting GI lesion may bleed during the acute illness* Leucopenia, thrombocytopenia and increased aminotransferase ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 14 year old boy presents with chronic diarrhea. Duodenal biopsy shows villous atrophy. Anti endomysial antibodies and IgA TTG antibodies are positive. What is the treatment of choice?, with the following options: A: Gluten free diet, B: Antibiotics, C: Loperamide, D: 5-ASA ### Response:

Chronic diarrhea, villous atrophy of duodenal biopsy, anti-endomysial antibodies and IgA TTG antibodies are features of coeliac sprue. Management of coeliac sprue includes life long gluten free diet and correcting deficiencies of iron, folate and calcium. Ref: Davidson's principles and practice of Medicine, 20th Edition, Chapter 22, Page 894-896; Harrison's Principles of Internal Medicine, 16th Edition, Page 1772

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 14 year old boy presents with chronic diarrhea. Duodenal biopsy shows villous atrophy. Anti endomysial antibodies and IgA TTG antibodies are positive. What is the treatment of choice?, with the following options: A: Gluten free diet, B: Antibiotics, C: Loperamide, D: 5-ASA ### Response: Chronic diarrhea, villous atrophy of duodenal biopsy, anti-endomysial antibodies and IgA TTG antibodies are features of coeliac sprue. Management of coeliac sprue includes life long gluten free diet and correcting deficiencies of iron, folate and calcium. Ref: Davidson's principles and practice of Medicine, 20th Edition, Chapter 22, Page 894-896; Harrison's Principles of Internal Medicine, 16th Edition, Page 1772 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which gas is most commonly used in laparoscopy:, with the following options: A: O2, B: CO2, C: N2O, D: N2 ### Response:

Ans. is 'b' CO2

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which gas is most commonly used in laparoscopy:, with the following options: A: O2, B: CO2, C: N2O, D: N2 ### Response: Ans. is 'b' CO2 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The procedure shown below is used in all of the following illnesses except:, with the following options: A: Catatonic SZ, B: Treatment-resistant major depressive disorder, C: Severe Mania, D: Dissociative Disorder ### Response:

Ans:D.) Dissociative Disorder.Electroconvulsive therapy is shown in the image.ECT It is used with informed consent in treatment-resistant major depressive disorder, treatment-resistant catatonia, or prolonged or severe mania, and in conditions where "there is a need for rapid, definitive response because of the severity of a psychiatric or medical condition (e.g., when illness is characterized by stupor, marked psycho-motor retardation, depressive delusions or hallucinations, or life-threatening physical exhaustion associated with mania)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The procedure shown below is used in all of the following illnesses except:, with the following options: A: Catatonic SZ, B: Treatment-resistant major depressive disorder, C: Severe Mania, D: Dissociative Disorder ### Response: Ans:D.) Dissociative Disorder.Electroconvulsive therapy is shown in the image.ECT It is used with informed consent in treatment-resistant major depressive disorder, treatment-resistant catatonia, or prolonged or severe mania, and in conditions where "there is a need for rapid, definitive response because of the severity of a psychiatric or medical condition (e.g., when illness is characterized by stupor, marked psycho-motor retardation, depressive delusions or hallucinations, or life-threatening physical exhaustion associated with mania) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Calcium in human milk is (mg/100gm) -, with the following options: A: 200, B: 100, C: 70, D: 28 ### Response:

Ans. is 'd' i.e., 28 Cow's milkHuman milkLactose (g)4.47.4Proteins (g)3.21.1Fat (g)4.13.4Calcium (mg)12028Iron (mg)0.21.0Water (g)8788Energy (Kcal)6765

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Calcium in human milk is (mg/100gm) -, with the following options: A: 200, B: 100, C: 70, D: 28 ### Response: Ans. is 'd' i.e., 28 Cow's milkHuman milkLactose (g)4.47.4Proteins (g)3.21.1Fat (g)4.13.4Calcium (mg)12028Iron (mg)0.21.0Water (g)8788Energy (Kcal)6765 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: One of the following in high doses can cause convulsions ?, with the following options: A: Penicillin, B: Aminoglycosides, C: Erythromycin, D: All ### Response:

Ans. is 'a' i.e., Penicillin Drugs causing seizures o Lactam antibiotics o Local anaesthetics o Quinolones o Cyclosporine o Acyclovir & Ganciclovir o OKT3 o Isoniazid o Tacrolimus o Meperidine o Interferons o Tramadol o Antidepressants o Antipsychotics o Lithium o Theophylline o Alcohol withdrawl o Barbiturate withdrawl o Benzodiazepine withdrawl

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: One of the following in high doses can cause convulsions ?, with the following options: A: Penicillin, B: Aminoglycosides, C: Erythromycin, D: All ### Response: Ans. is 'a' i.e., Penicillin Drugs causing seizures o Lactam antibiotics o Local anaesthetics o Quinolones o Cyclosporine o Acyclovir & Ganciclovir o OKT3 o Isoniazid o Tacrolimus o Meperidine o Interferons o Tramadol o Antidepressants o Antipsychotics o Lithium o Theophylline o Alcohol withdrawl o Barbiturate withdrawl o Benzodiazepine withdrawl ### End