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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: During fetal life development of testis takes place in relation with:, with the following options: A: Intraperitoneal near ventral wall, B: Anterior abdominal wall, C: Retroperitoneal near dorsal wall, D: All ### Response:

C i.e. Retroperitoneal Near dorsal wall

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: During fetal life development of testis takes place in relation with:, with the following options: A: Intraperitoneal near ventral wall, B: Anterior abdominal wall, C: Retroperitoneal near dorsal wall, D: All ### Response: C i.e. Retroperitoneal Near dorsal wall ### 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 exclusively involve neurons:, with the following options: A: Spinocerebellar ataxia, B: Supranuclear palsy, C: Corticobasilar degeneration, D: Multiple system atrophy ### Response:

Ans. is 'a' i.e. Spinocerebellar ataxia

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 exclusively involve neurons:, with the following options: A: Spinocerebellar ataxia, B: Supranuclear palsy, C: Corticobasilar degeneration, D: Multiple system atrophy ### Response: Ans. is 'a' i.e. Spinocerebellar ataxia ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Component of PQLI -, with the following options: A: Neonatal moality rate, B: Infant moality rate, C: Perinatal moality rate, D: None of the above ### Response:

PQLI- Physical Quality of Life Index is one index to measure quality of life.It consolidates 3 indicators -infant moality rate -life expectancy at age one -literacy For each component score 0 to 100 given.The composite index is calculated by averaging three indicators,giving equal weight to each.Resulting PQLI is also scaled 0 to 100. Parks textbook of preventive and social medicine.K Park. Edition 23.Pg no: 17

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Component of PQLI -, with the following options: A: Neonatal moality rate, B: Infant moality rate, C: Perinatal moality rate, D: None of the above ### Response: PQLI- Physical Quality of Life Index is one index to measure quality of life.It consolidates 3 indicators -infant moality rate -life expectancy at age one -literacy For each component score 0 to 100 given.The composite index is calculated by averaging three indicators,giving equal weight to each.Resulting PQLI is also scaled 0 to 100. Parks textbook of preventive and social medicine.K Park. Edition 23.Pg no: 17 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A key gluconeogenic amino acid is:, with the following options: A: Alanine, B: Serine, C: Valine, D: Tyrosine ### Response:

Alanine is a key gluconeogenic amino acid. The rate of hepatic gluconeogenesis from alanine is far higher than from all other amino acids. The capacity of the liver for gluconeogenesis from alanine does not reach saturation until the alanine concentration reaches 20 to 30 times its normal physiologic level. Ref: Harper’s illustrated biochemistry. 30th edition page no: 289

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A key gluconeogenic amino acid is:, with the following options: A: Alanine, B: Serine, C: Valine, D: Tyrosine ### Response: Alanine is a key gluconeogenic amino acid. The rate of hepatic gluconeogenesis from alanine is far higher than from all other amino acids. The capacity of the liver for gluconeogenesis from alanine does not reach saturation until the alanine concentration reaches 20 to 30 times its normal physiologic level. Ref: Harper’s illustrated biochemistry. 30th edition page no: 289 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Effective dose in radiation at 1 m is 4 Gy; at 4 m it will be:, with the following options: A: 0.25, B: 0.5, C: 2, D: 4 ### Response:

Intensity of an X-ray beam is inversely proportional to the square of the distance between the source and the point of measure. When the distance from the focal spot is doubled, the intensity of the beam decreases to one quarter.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Effective dose in radiation at 1 m is 4 Gy; at 4 m it will be:, with the following options: A: 0.25, B: 0.5, C: 2, D: 4 ### Response: Intensity of an X-ray beam is inversely proportional to the square of the distance between the source and the point of measure. When the distance from the focal spot is doubled, the intensity of the beam decreases to one quarter. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Not a cause of consecutive optic atrophy:, with the following options: A: Retinitis pigmentosa(RP), B: CRAO, C: Pathological Myopia, D: Retrobulbar neuritis ### Response:

Retrobulbar neuritis is considered as Primary optic atrophy.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Not a cause of consecutive optic atrophy:, with the following options: A: Retinitis pigmentosa(RP), B: CRAO, C: Pathological Myopia, D: Retrobulbar neuritis ### Response: Retrobulbar neuritis is considered as Primary optic atrophy. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Dissociative fugue is: Maharashtra 08, with the following options: A: Person has sudden onset of paralysis, B: Person is fearful of a specified object, C: Person has multiple identities, D: Person flees from an immediate life situation ### Response:

Ans. Person flees from an immediate life situation

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Dissociative fugue is: Maharashtra 08, with the following options: A: Person has sudden onset of paralysis, B: Person is fearful of a specified object, C: Person has multiple identities, D: Person flees from an immediate life situation ### Response: Ans. Person flees from an immediate life situation ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Continuous cell culture of bacteria, with the following options: A: U tube, B: Craige tube, C: Chemostat device, D: Agar dilution method ### Response:

Ans. is 'c' i.e., Chemostat device Bacterial cultures can be maintained in a state of exponentional growth over long periods of time using a system of continuous culture. Continuous culture, in a device called chemostat, can be used to maintain a bacterial population at a constant density, a situation that is, in many ways, more similar to bacterial growth in natural environments. In a chemostat microbial cells are grown at a steady state where cell biomass production, substrates and products concentrations remains constant, and growth occurs at a constant rate. These features make a chemostat unique and powerful tool for biological and physiological research.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Continuous cell culture of bacteria, with the following options: A: U tube, B: Craige tube, C: Chemostat device, D: Agar dilution method ### Response: Ans. is 'c' i.e., Chemostat device Bacterial cultures can be maintained in a state of exponentional growth over long periods of time using a system of continuous culture. Continuous culture, in a device called chemostat, can be used to maintain a bacterial population at a constant density, a situation that is, in many ways, more similar to bacterial growth in natural environments. In a chemostat microbial cells are grown at a steady state where cell biomass production, substrates and products concentrations remains constant, and growth occurs at a constant rate. These features make a chemostat unique and powerful tool for biological and physiological research. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Second injury in an explosion is due to -, with the following options: A: Due to flying debris, B: Due to blast wind, C: Due to shock wave, D: Due to complication ### Response:

Ans. is 'a' i.e., Due to flying debriso Primary injuryo Secondary injuryo Tertiary injuryo Quaternary injury- due to shock wrave.- due to flying debris.- due to blast wind.- due to complicating factors (complications).

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Second injury in an explosion is due to -, with the following options: A: Due to flying debris, B: Due to blast wind, C: Due to shock wave, D: Due to complication ### Response: Ans. is 'a' i.e., Due to flying debriso Primary injuryo Secondary injuryo Tertiary injuryo Quaternary injury- due to shock wrave.- due to flying debris.- due to blast wind.- due to complicating factors (complications). ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Monoprotic acid are -, with the following options: A: Formic acid, B: Acetic acid, C: Nitric acid, D: All of these ### Response:

Monapratic acids (HA) can donate 1 proton (H+) per molecule. Examples are hydrochloric acid (HCl), nitric acid (HNO3), formic acid, acetic acid, lactic acid and benzoic acid. Polyprotic acids can donate more than one protons (H+) per molecules. These can be divided into :- (i) Diprotic acid (H2A) :- These can donate upto 2 protons (RE) per molecule. Examples are carbonic acid, sulphuric acid, succinic acid and glutaric acid. (iii) Triprotic acid (H3A) :- These can donate upto 3 protons (H+) per molecule. Examples are phosphoric acid and citric acid.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Monoprotic acid are -, with the following options: A: Formic acid, B: Acetic acid, C: Nitric acid, D: All of these ### Response: Monapratic acids (HA) can donate 1 proton (H+) per molecule. Examples are hydrochloric acid (HCl), nitric acid (HNO3), formic acid, acetic acid, lactic acid and benzoic acid. Polyprotic acids can donate more than one protons (H+) per molecules. These can be divided into :- (i) Diprotic acid (H2A) :- These can donate upto 2 protons (RE) per molecule. Examples are carbonic acid, sulphuric acid, succinic acid and glutaric acid. (iii) Triprotic acid (H3A) :- These can donate upto 3 protons (H+) per molecule. Examples are phosphoric acid and citric acid. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Triad of exophthalmos, bone lesions, and diabetes insipidus is a feature of, with the following options: A: Hand-schuller christian disease, B: Craniofacial dysostosis, C: Mickulicz syndrome, D: Letterer - sieve disease ### Response:

HSCD is associated with multifocal langerhans cell histiocytosis. Triad: Exophthalmos Lytic bone lesions Diabetes insipidus.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Triad of exophthalmos, bone lesions, and diabetes insipidus is a feature of, with the following options: A: Hand-schuller christian disease, B: Craniofacial dysostosis, C: Mickulicz syndrome, D: Letterer - sieve disease ### Response: HSCD is associated with multifocal langerhans cell histiocytosis. Triad: Exophthalmos Lytic bone lesions Diabetes insipidus. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Sternocleidomastoid is supplied by all of the following aeries, EXCEPT:, with the following options: A: Occipital, B: Posterior auricular, C: Thyrocervical trunk, D: Superior thyroid ### Response:

The sternocleidomastoid muscle derives its blood supply from three separate sources: Superior-occipital aeryCentral-superior thyroid aeryInferior- thyrocervical trunkRef: Gray's anatomy: the anatomical basis of clinical practice by Henry Gray, Susan Standring, Harold Ellis, 2005, Page 536.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Sternocleidomastoid is supplied by all of the following aeries, EXCEPT:, with the following options: A: Occipital, B: Posterior auricular, C: Thyrocervical trunk, D: Superior thyroid ### Response: The sternocleidomastoid muscle derives its blood supply from three separate sources: Superior-occipital aeryCentral-superior thyroid aeryInferior- thyrocervical trunkRef: Gray's anatomy: the anatomical basis of clinical practice by Henry Gray, Susan Standring, Harold Ellis, 2005, Page 536. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: AFP surveillance registry indicator is ?, with the following options: A: Number of AFP cases repoed, B: Number of wild polio-virus positive cases, C: Number of non-polio AFP < 5 years, D: Number of non-polio AFP < 15 years ### Response:

Ans. is 'a' i.e., Number of AFP cases repoed The number of AFP cases repoed each year is used as an indicator of a country's ability to detect polio, even in countries where the disease no longer occurs. Polio surveillance It is the most impoant pa of whole polio eradication intiative. It has two components:? Acute flaccid paralysis (AFP) surveillance Acute flaccid paralysis is defined as acute onset (< 4 weeks) of flaccid paralysis (reduced tone) without other obvious cause in children WHO recommends the immediate repoing and investigation of every case of AFP in children less than 15 years.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: AFP surveillance registry indicator is ?, with the following options: A: Number of AFP cases repoed, B: Number of wild polio-virus positive cases, C: Number of non-polio AFP < 5 years, D: Number of non-polio AFP < 15 years ### Response: Ans. is 'a' i.e., Number of AFP cases repoed The number of AFP cases repoed each year is used as an indicator of a country's ability to detect polio, even in countries where the disease no longer occurs. Polio surveillance It is the most impoant pa of whole polio eradication intiative. It has two components:? Acute flaccid paralysis (AFP) surveillance Acute flaccid paralysis is defined as acute onset (< 4 weeks) of flaccid paralysis (reduced tone) without other obvious cause in children WHO recommends the immediate repoing and investigation of every case of AFP in children less than 15 years. ### 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 anterior shoulder dislocation -, with the following options: A: It is most common type of shoulder dislocation, B: It is most commonly subclavicular, C: Patient keeps his arm in saluting position, D: Injury to brachial plexus may occur ### Response:

Answer- A. It is most common type of shoulder dislocationMost common type of shoulder dislocation is anterior dislocation (subcoracoid being most common).Patient keeps his arm by the side ofthebodyin apositionofabduction anileernalrotation

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 anterior shoulder dislocation -, with the following options: A: It is most common type of shoulder dislocation, B: It is most commonly subclavicular, C: Patient keeps his arm in saluting position, D: Injury to brachial plexus may occur ### Response: Answer- A. It is most common type of shoulder dislocationMost common type of shoulder dislocation is anterior dislocation (subcoracoid being most common).Patient keeps his arm by the side ofthebodyin apositionofabduction anileernalrotation ### 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 presentation of organ damage in Diabetes mellitus is, with the following options: A: Retinal changes, B: Microalbuminuria, C: Autonomic neuropathy, D: Coronary artery disease ### Response:

(A) Retinal changes # CHRONIC SYMPTOMS OF DIABETES are due to vascular damage from persistent hyperglycemia.> Vascular damage leads to end-organ damage.> Other conditions associated with diabetes, such as hypertension, dyslipidemia (as well as smoking) accelerate the development of vascular damage and the chronic complications of diabetes, which are the following:# Microvascular complications are a significant cause of morbidity. Persistent hyperglycemia is the major cause for the microvascular complications which are highly specific for diabetes. Retinopathy with potential loss of vision Nephropathy leading to kidney failure Peripheral neuropathy leading to pain, foot ulcers, and limb amputation Autonomic neuropathy causing gastrointestinal, genitourinary, cardiovascular symptoms and sexual dysfunction# Macrovascular complications are the main cause of mortality.> Although persistent hyperglycemia may contribute to macrovascular complications, it is the associated conditions (hypertension, dyslipidemia, smoking) that account for most of the burden of the macrovascular complications. Coronary heart disease which is the major cause of death for patients with diabetes Peripheral vascular disease Cerebrovascular disease> Diabetic retinopathy may be the most common microvascular complication of diabetes. The risk of developing diabetic retinopathy or other microvascular complications of diabetes depends on both the duration and the severity of hyperglycemia. Development of diabetic retinopathy in patients with type 2 diabetes was found to be related to both severity of hyperglycemia and presence of hypertension.> Diabetic nephropathy is the leading cause of renal failure. It is defined by proteinuria > 500 mg in 24 hours in the setting of diabetes, but this is preceded by lower degrees of proteinuria, or "microalbuminuria." Microalbuminuria is albumin excretion of 30-299 mg/24 hours. Without intervention, diabetic patients with microalbuminuria typically progress to proteinuria and overt diabetic nephropathy. This progression occurs in both type 1 and type 2 diabetes.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common presentation of organ damage in Diabetes mellitus is, with the following options: A: Retinal changes, B: Microalbuminuria, C: Autonomic neuropathy, D: Coronary artery disease ### Response: (A) Retinal changes # CHRONIC SYMPTOMS OF DIABETES are due to vascular damage from persistent hyperglycemia.> Vascular damage leads to end-organ damage.> Other conditions associated with diabetes, such as hypertension, dyslipidemia (as well as smoking) accelerate the development of vascular damage and the chronic complications of diabetes, which are the following:# Microvascular complications are a significant cause of morbidity. Persistent hyperglycemia is the major cause for the microvascular complications which are highly specific for diabetes. Retinopathy with potential loss of vision Nephropathy leading to kidney failure Peripheral neuropathy leading to pain, foot ulcers, and limb amputation Autonomic neuropathy causing gastrointestinal, genitourinary, cardiovascular symptoms and sexual dysfunction# Macrovascular complications are the main cause of mortality.> Although persistent hyperglycemia may contribute to macrovascular complications, it is the associated conditions (hypertension, dyslipidemia, smoking) that account for most of the burden of the macrovascular complications. Coronary heart disease which is the major cause of death for patients with diabetes Peripheral vascular disease Cerebrovascular disease> Diabetic retinopathy may be the most common microvascular complication of diabetes. The risk of developing diabetic retinopathy or other microvascular complications of diabetes depends on both the duration and the severity of hyperglycemia. Development of diabetic retinopathy in patients with type 2 diabetes was found to be related to both severity of hyperglycemia and presence of hypertension.> Diabetic nephropathy is the leading cause of renal failure. It is defined by proteinuria > 500 mg in 24 hours in the setting of diabetes, but this is preceded by lower degrees of proteinuria, or "microalbuminuria." Microalbuminuria is albumin excretion of 30-299 mg/24 hours. Without intervention, diabetic patients with microalbuminuria typically progress to proteinuria and overt diabetic nephropathy. This progression occurs in both type 1 and type 2 diabetes. ### 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 of Lymphoma in HIV is?, with the following options: A: CNS, B: GIT, C: Retroperitoneum, D: Mediastinum ### Response:

Ans. (a) CNS(Ref: Harrison 18th/pg Chapter 189)Lymphoma in HIV90% of lymphomas in HIV are B cell in phenotype; more than half contain EBV DNA.Immunoblastic lymphomas account for 60% of the cases of lymphoma in patients with AIDS.Primary CNS lymphoma accounts for 20% of the cases of lymphoma in patients with HIV infection.Most common extranodal site involved in Lymphoma in HIV is the CNS, which is involved in one-third of all patients with lymphoma.

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 of Lymphoma in HIV is?, with the following options: A: CNS, B: GIT, C: Retroperitoneum, D: Mediastinum ### Response: Ans. (a) CNS(Ref: Harrison 18th/pg Chapter 189)Lymphoma in HIV90% of lymphomas in HIV are B cell in phenotype; more than half contain EBV DNA.Immunoblastic lymphomas account for 60% of the cases of lymphoma in patients with AIDS.Primary CNS lymphoma accounts for 20% of the cases of lymphoma in patients with HIV infection.Most common extranodal site involved in Lymphoma in HIV is the CNS, which is involved in one-third of all patients with lymphoma. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about cushing's syndrome is -, with the following options: A: Adrenomedullary hyperplasia in association wift MEN syndrome is common cause, B: Bronchial &Mediastinal carcinoid causes wishing syndrome, C: It is diagnosed by hypokalemia in association wifo increased adrenal secretion, D: It is often fatal due to its coronary and cerebrovascular accidents ### Response:

most of the cases are associated with oat cell type of bronchogenic carcinoma or with carcinoid tumor of thymus, pancreas, ovary, medullary carcinoma of thyroid, bronchial adenoma( Harrison 17 pg 2255)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about cushing's syndrome is -, with the following options: A: Adrenomedullary hyperplasia in association wift MEN syndrome is common cause, B: Bronchial &Mediastinal carcinoid causes wishing syndrome, C: It is diagnosed by hypokalemia in association wifo increased adrenal secretion, D: It is often fatal due to its coronary and cerebrovascular accidents ### Response: most of the cases are associated with oat cell type of bronchogenic carcinoma or with carcinoid tumor of thymus, pancreas, ovary, medullary carcinoma of thyroid, bronchial adenoma( Harrison 17 pg 2255) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cerebellar hemangioblastoma and retinal tumors are seen in:, with the following options: A: Von Hippel Lindau syndrome, B: Neurofibromatosis type 1, C: Tuberous sclerosis, D: Neurofibromatosis type 2 ### Response:

Ref: Chapter 28. CNS. page - 1343: Robbins and Cot ran Pathologic Basis of Disease: 8th editionExplanation:The Von Hippel Lindau gene (VHL) is tumor suppressor gene located on Chromosome 3p25-p26 and down-regulates expression of vascular endothelial growth factor; hence its dysregulation is associated with hemangioblastomas and retinal tumors.The neurofibromatosis type 1 (Chr. 17) is associated with:Optic nerve gliomasLisch nodules (pigmented nodules of the iris)Cafe au lait spots (cutaneous hyperpig- mented macules)Neurofibromatosis type 2 (Chr. 22) is associated with:8th nerve schwannomasMultiple meningiomasGliomasEpendymoma of spinal cordTuberous sclerosis complex: It is associated with:Cortical tubersSubependymal nodulesSubependymal giant cell astrocytomasRenal angiomyolipomasRetinal glial hamartomasPulmonary lymphangioleiomyomatosisCardiac rhabdomyomasShagreen patches (cutaneous leathery thickenings)Ash-leaf patches (hypopigmented areas)Subungual fibromas

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cerebellar hemangioblastoma and retinal tumors are seen in:, with the following options: A: Von Hippel Lindau syndrome, B: Neurofibromatosis type 1, C: Tuberous sclerosis, D: Neurofibromatosis type 2 ### Response: Ref: Chapter 28. CNS. page - 1343: Robbins and Cot ran Pathologic Basis of Disease: 8th editionExplanation:The Von Hippel Lindau gene (VHL) is tumor suppressor gene located on Chromosome 3p25-p26 and down-regulates expression of vascular endothelial growth factor; hence its dysregulation is associated with hemangioblastomas and retinal tumors.The neurofibromatosis type 1 (Chr. 17) is associated with:Optic nerve gliomasLisch nodules (pigmented nodules of the iris)Cafe au lait spots (cutaneous hyperpig- mented macules)Neurofibromatosis type 2 (Chr. 22) is associated with:8th nerve schwannomasMultiple meningiomasGliomasEpendymoma of spinal cordTuberous sclerosis complex: It is associated with:Cortical tubersSubependymal nodulesSubependymal giant cell astrocytomasRenal angiomyolipomasRetinal glial hamartomasPulmonary lymphangioleiomyomatosisCardiac rhabdomyomasShagreen patches (cutaneous leathery thickenings)Ash-leaf patches (hypopigmented areas)Subungual fibromas ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The role of plasmids in conjugation was first described by Lederberg and Tatum (1946) in which bacteria?, with the following options: A: H. influenza, B: Pseudomonas, C: Escherichia coli, D: M. Tuberculosis ### Response:

Bacterial conjugation was first described by Lederberg and Tatum (1946) in a strain of E.coli called K12 (carried a conjugative plasmid F) The F factor: The F plasmid, also called F factor, is a transfer factor that contains the genetic information, essential for controlling mating process of the bacteria during conjugation. The F plasmid of Escherichia coli is the prototype for feility plasmids in Gram-negative bacteria. Strains of E. coli with F+ plasmid are called as donors, whereas plasmid are F- behave as recipients.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The role of plasmids in conjugation was first described by Lederberg and Tatum (1946) in which bacteria?, with the following options: A: H. influenza, B: Pseudomonas, C: Escherichia coli, D: M. Tuberculosis ### Response: Bacterial conjugation was first described by Lederberg and Tatum (1946) in a strain of E.coli called K12 (carried a conjugative plasmid F) The F factor: The F plasmid, also called F factor, is a transfer factor that contains the genetic information, essential for controlling mating process of the bacteria during conjugation. The F plasmid of Escherichia coli is the prototype for feility plasmids in Gram-negative bacteria. Strains of E. coli with F+ plasmid are called as donors, whereas plasmid are F- behave as recipients. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A rickshaw ran over the thighs of a child. The tyre marks of the vehicle can be seen on the child's thighs. These marks are an example of:, with the following options: A: Imprint bruise, B: Patterned bruise, C: Imprint abrasion, D: Ectopic bruise ### Response:

A patterned contusion is one in which the size and shape mirror a poion of the object which caused it. In this case a tryre mark is seen on the child's thigh so it is a case of patterned bruise. Ref: K.S.N.Reddy 29th Ed Page 166

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A rickshaw ran over the thighs of a child. The tyre marks of the vehicle can be seen on the child's thighs. These marks are an example of:, with the following options: A: Imprint bruise, B: Patterned bruise, C: Imprint abrasion, D: Ectopic bruise ### Response: A patterned contusion is one in which the size and shape mirror a poion of the object which caused it. In this case a tryre mark is seen on the child's thigh so it is a case of patterned bruise. Ref: K.S.N.Reddy 29th Ed Page 166 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A male, 55 years old is brought to the clinic in unconscious condition. The patient is a Type 2 diabetic since 15 years. General examination reveals RBS levels 268 mg/dl. Blood and Urine samples confirm the presence of ketone bodies. Which of the following substances found raised in this patient blood is volatilized by lungs?, with the following options: A: β-hydroxybutyrate, B: Acetoacetate, C: Acetone, D: Glycerol 3- phosphate ### Response:

In most cases, ketonemia is due to increased production of ketone bodies by the liver rather than to a deficiency in their utilization by extrahepatic tissues. While acetoacetate and d(−)-3-hydroxybutyrate are readily oxidized by extrahepatic tissues, acetone is difficult to oxidize in vivo and to a large extent is volatilized in the lungs. A clear understanding of the biochemical basis and pathophysiology of DKA is essential for its efficient treatment. The cardinal biochemical features are: Hyperketonaemia (≥  3.0 mmol/L) or ketonuria (more than 2+ on standard urine sticks) Hyperglycaemia (blood glucose  ≥ 11 mmol/L, (approximately 200 mg/dL)) Metabolic acidosis (venous bicarbonate < 15 mmol/L and/or venous pH < 7.3 (H+ > 50 nmol/L)). Reference: HARPERS ILLUSTRATED BIOCHEMISTRY30th ed Page no 231; Davidson, page no 735

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A male, 55 years old is brought to the clinic in unconscious condition. The patient is a Type 2 diabetic since 15 years. General examination reveals RBS levels 268 mg/dl. Blood and Urine samples confirm the presence of ketone bodies. Which of the following substances found raised in this patient blood is volatilized by lungs?, with the following options: A: β-hydroxybutyrate, B: Acetoacetate, C: Acetone, D: Glycerol 3- phosphate ### Response: In most cases, ketonemia is due to increased production of ketone bodies by the liver rather than to a deficiency in their utilization by extrahepatic tissues. While acetoacetate and d(−)-3-hydroxybutyrate are readily oxidized by extrahepatic tissues, acetone is difficult to oxidize in vivo and to a large extent is volatilized in the lungs. A clear understanding of the biochemical basis and pathophysiology of DKA is essential for its efficient treatment. The cardinal biochemical features are: Hyperketonaemia (≥  3.0 mmol/L) or ketonuria (more than 2+ on standard urine sticks) Hyperglycaemia (blood glucose  ≥ 11 mmol/L, (approximately 200 mg/dL)) Metabolic acidosis (venous bicarbonate < 15 mmol/L and/or venous pH < 7.3 (H+ > 50 nmol/L)). Reference: HARPERS ILLUSTRATED BIOCHEMISTRY30th ed Page no 231; Davidson, page no 735 ### 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 meningococcal epidemic?, with the following options: A: A, B: C, C: Y, D: W-135 ### Response:

Ans. is 'a' i.e., A Meningococcal meningitis (cerebrospinal fever) It is an acute communicable disease caused by N. meningitidis. Out of 13 serogroups, group A, B and C are most impoant. Group A is associated with epidemics and group C mostly with localized outbreaks, while group B causes both epidemics and outbreaks. Group 29-E, W-135 and Y also frequently cause meningitis. Reservoir - Human nasopharynx is the only reservoir Source of infection - carriers are the most impoant source of infection, not the clinical cases. Age group - Children between 3 months to 5 years. Outbreaks of meningococcal meningitis occur more frequently in the dry and cold months of the year. Period of communicability - until meningococci are no longer present in discharges from nose and throat. Cases rapidly lose their infectiousness within 24 hours of specific treatment. Meningococcal meningitis is a very fatal disease. In untreated cases moality is 80%. The disease is fatal in 5-10% of cases even with prompt antimicrobial treatment in good health care facility.

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 meningococcal epidemic?, with the following options: A: A, B: C, C: Y, D: W-135 ### Response: Ans. is 'a' i.e., A Meningococcal meningitis (cerebrospinal fever) It is an acute communicable disease caused by N. meningitidis. Out of 13 serogroups, group A, B and C are most impoant. Group A is associated with epidemics and group C mostly with localized outbreaks, while group B causes both epidemics and outbreaks. Group 29-E, W-135 and Y also frequently cause meningitis. Reservoir - Human nasopharynx is the only reservoir Source of infection - carriers are the most impoant source of infection, not the clinical cases. Age group - Children between 3 months to 5 years. Outbreaks of meningococcal meningitis occur more frequently in the dry and cold months of the year. Period of communicability - until meningococci are no longer present in discharges from nose and throat. Cases rapidly lose their infectiousness within 24 hours of specific treatment. Meningococcal meningitis is a very fatal disease. In untreated cases moality is 80%. The disease is fatal in 5-10% of cases even with prompt antimicrobial treatment in good health care facility. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are used for the treatment of Pulmonary hypeension except, with the following options: A: Endothelin receptor antagonist, B: Phosphodiesterase inhibitors, C: Calcium channel blockers, D: Beta blockers ### Response:

Refer kDT 6/e p 297 Vasodilators are used for the treatment of Pulmonary hypeension. Treatments include: endothelin receptor antagonists - such as bosentan, ambrisentan and macitentan phosphodiesterase 5 inhibitors - sildenafil and tadalafil prostaglandins - epoprostenol, iloprost and treprostinil soluble guanylate cyclase stimulators - such as riociguat calcium channel blockers - nifedipine, diltiazem, nicardipine and amlodipine

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are used for the treatment of Pulmonary hypeension except, with the following options: A: Endothelin receptor antagonist, B: Phosphodiesterase inhibitors, C: Calcium channel blockers, D: Beta blockers ### Response: Refer kDT 6/e p 297 Vasodilators are used for the treatment of Pulmonary hypeension. Treatments include: endothelin receptor antagonists - such as bosentan, ambrisentan and macitentan phosphodiesterase 5 inhibitors - sildenafil and tadalafil prostaglandins - epoprostenol, iloprost and treprostinil soluble guanylate cyclase stimulators - such as riociguat calcium channel blockers - nifedipine, diltiazem, nicardipine and amlodipine ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All of the following statements about unfractionated heparin are true except:-, with the following options: A: It is a powerful anticoagulant only in vivo, B: Protamine sulfate is the antidote, C: It should not be given by intramuscular route, D: It acts by inhibiting factor IIa and Xa ### Response:

Heparin Warfarin 1. Route of administration parenteral (IV, SC) Oral 2. Onset of action Rapid Delayed (1-3 days) 3. Activity In vitro and in vivo In vivo only 4. MOA Activates Antihrombin III | Activation of II, VII, IX, X 5 Monitoring by aPTT PT 6. Antagonist Protamine sulphate Vit. K1 (Phytonadione) 7. Placental barrier Does not cross placenta Fetal warfarin syndrome 8. Use To initiate therapy For maintenance

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All of the following statements about unfractionated heparin are true except:-, with the following options: A: It is a powerful anticoagulant only in vivo, B: Protamine sulfate is the antidote, C: It should not be given by intramuscular route, D: It acts by inhibiting factor IIa and Xa ### Response: Heparin Warfarin 1. Route of administration parenteral (IV, SC) Oral 2. Onset of action Rapid Delayed (1-3 days) 3. Activity In vitro and in vivo In vivo only 4. MOA Activates Antihrombin III | Activation of II, VII, IX, X 5 Monitoring by aPTT PT 6. Antagonist Protamine sulphate Vit. K1 (Phytonadione) 7. Placental barrier Does not cross placenta Fetal warfarin syndrome 8. Use To initiate therapy For maintenance ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 36-year-old woman with a history of obstructive sleep apnea is admitted with acute shoness of breath, cough with greenish sputum, and fever. On physical examination, she is febrile and has decreased breath sounds generally and diffuse bilateral rhonchi. ABGs: pH 7.32; PCO2 47 mm Hg; PO2 65 mm Hg with O2 saturation 87%.The patient improves initially but has a respiratory arrest as she is being moved to the ICU, requiring emergency endotracheal intubation. While a CXR is ordered, it is noted that she has absent breath sounds on the left side. CXR shows, with the following options: A: Left pneumothorax, B: Pneumomediastinum with esophageal rupture, C: Left pleural effusion, D: Atelectasis ### Response:

The chest radiograph shows a homogeneous opacity occupying the left hemithorax with no air bronchograms. The left hea border and left diaphragm are not seen, consistent with left lung atelectasis. The right upper zone parahilar area is also paially opacified, suggesting paial right upper lobe atelectasis. An endotracheal tube is seen extending down to the right intermediate bronchus. This patient was admitted with symptoms of pneumonia with hypoxemia and respiratory acidosis. Initial treatment should include controlled oxygen therapy, antibiotics, and aerosolized bronchodilator therapy. IV theophylline is not considered standard practice and is not a first-line drug for bronchospasm. During CPR and resuscitation, traumatic pneumothorax and pneumomediastinum can occur. The CXR shows left-sided atelectasis with the endotracheal tube placed distally in the right intermediate bronchus. Correct positioning of the tube above the carina should be the first step in this case.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 36-year-old woman with a history of obstructive sleep apnea is admitted with acute shoness of breath, cough with greenish sputum, and fever. On physical examination, she is febrile and has decreased breath sounds generally and diffuse bilateral rhonchi. ABGs: pH 7.32; PCO2 47 mm Hg; PO2 65 mm Hg with O2 saturation 87%.The patient improves initially but has a respiratory arrest as she is being moved to the ICU, requiring emergency endotracheal intubation. While a CXR is ordered, it is noted that she has absent breath sounds on the left side. CXR shows, with the following options: A: Left pneumothorax, B: Pneumomediastinum with esophageal rupture, C: Left pleural effusion, D: Atelectasis ### Response: The chest radiograph shows a homogeneous opacity occupying the left hemithorax with no air bronchograms. The left hea border and left diaphragm are not seen, consistent with left lung atelectasis. The right upper zone parahilar area is also paially opacified, suggesting paial right upper lobe atelectasis. An endotracheal tube is seen extending down to the right intermediate bronchus. This patient was admitted with symptoms of pneumonia with hypoxemia and respiratory acidosis. Initial treatment should include controlled oxygen therapy, antibiotics, and aerosolized bronchodilator therapy. IV theophylline is not considered standard practice and is not a first-line drug for bronchospasm. During CPR and resuscitation, traumatic pneumothorax and pneumomediastinum can occur. The CXR shows left-sided atelectasis with the endotracheal tube placed distally in the right intermediate bronchus. Correct positioning of the tube above the carina should be the first step in this case. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The pattern for the metallic framework of a removable partial denture is fabricated from:, with the following options: A: Inlay wax type-II, B: Boxing wax, C: Modeling wax, D: Casting wax ### Response:

Dental waxes can also be classified in one of three types, pattern wax (inlay, casting, and baseplate types), processing wax (boxing, utility, and sticky types), and impression wax (bite registration and correction types).  Casting wax is used for partial denture frameworks and other metal frameworks. Ref: Phillip’s 12th edition page 195.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The pattern for the metallic framework of a removable partial denture is fabricated from:, with the following options: A: Inlay wax type-II, B: Boxing wax, C: Modeling wax, D: Casting wax ### Response: Dental waxes can also be classified in one of three types, pattern wax (inlay, casting, and baseplate types), processing wax (boxing, utility, and sticky types), and impression wax (bite registration and correction types).  Casting wax is used for partial denture frameworks and other metal frameworks. Ref: Phillip’s 12th edition page 195. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The following are true of Mendelson's syndrome –, with the following options: A: Critical volume of aspirate is 50 mls, B: Critical pH of gastric aspirate is 1.5, C: Onset of symptoms generally occurs within 30 minutes, D: Steroids have been shown to improve outcome ### Response:

Symptoms of Mendelson's syndrome generally occurs within 30 minutes of aspiration. Critical pH is 2.5 and critical volume is 25 ml. Use of corticosteroid is generally not recommended.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The following are true of Mendelson's syndrome –, with the following options: A: Critical volume of aspirate is 50 mls, B: Critical pH of gastric aspirate is 1.5, C: Onset of symptoms generally occurs within 30 minutes, D: Steroids have been shown to improve outcome ### Response: Symptoms of Mendelson's syndrome generally occurs within 30 minutes of aspiration. Critical pH is 2.5 and critical volume is 25 ml. Use of corticosteroid is generally not recommended. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Centre of air pollution control by WHO ?, with the following options: A: Hyderabad, B: Bombay, C: Nagpur, D: Kanpur ### Response:

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

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Centre of air pollution control by WHO ?, with the following options: A: Hyderabad, B: Bombay, C: Nagpur, D: Kanpur ### Response: Ans. is 'c' i.e., Nagpur ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Knowledge of the segmental cutaneous innervation of the skin of the lower extremity is important in determining the level of intervertebral disc disease. Thus, S1 nerve root irritation will result in pain located along the -, with the following options: A: Anterior aspect of the thigh, B: Medial aspect of the thigh, C: Anteromedial aspect of the leg, D: Lateral side of the foot ### Response:

S1 nerve root impairment results in Weak plantar flexion Weak eversion of the foot Depressed ankle jerk Sensory loss along lateral border of foot

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Knowledge of the segmental cutaneous innervation of the skin of the lower extremity is important in determining the level of intervertebral disc disease. Thus, S1 nerve root irritation will result in pain located along the -, with the following options: A: Anterior aspect of the thigh, B: Medial aspect of the thigh, C: Anteromedial aspect of the leg, D: Lateral side of the foot ### Response: S1 nerve root impairment results in Weak plantar flexion Weak eversion of the foot Depressed ankle jerk Sensory loss along lateral border of foot ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Discoloration of the skin, mucosa and nails is sideeffect of, with the following options: A: Zidovudine, B: Lamivudine, C: Stavudine, D: Enfuviide ### Response:

.When nail discoloration is due to zidovudine, patients are usually able to repo if the discoloration preceded or coincided with the initiation of therapy. Another unusual side effect of zidovudine noted by some is a grayish-black discoloration of the tongue. Azidothymidine-induced nail pigmentation Ref Robbins 9/e pg 789

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Discoloration of the skin, mucosa and nails is sideeffect of, with the following options: A: Zidovudine, B: Lamivudine, C: Stavudine, D: Enfuviide ### Response: .When nail discoloration is due to zidovudine, patients are usually able to repo if the discoloration preceded or coincided with the initiation of therapy. Another unusual side effect of zidovudine noted by some is a grayish-black discoloration of the tongue. Azidothymidine-induced nail pigmentation Ref Robbins 9/e pg 789 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A patient presents with following findings. what will be the media used to diagnose this condition?, with the following options: A: Loffler's serum slope, B: Lowenstein Johnson, C: Karry Blair, D: Chocolate agar ### Response:

The image shows grey membrane on the tonsil extending to anterior pillar that is suggestive ofdiphtherial infection. Loeffler's serum slope: Enriched medium frequently used for the growth ofC. diphtheriae. Bacteria produce a luxuriant growth in 6-8 hours at 37degC. Does not suppo the growth of streptococci pneumococci.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A patient presents with following findings. what will be the media used to diagnose this condition?, with the following options: A: Loffler's serum slope, B: Lowenstein Johnson, C: Karry Blair, D: Chocolate agar ### Response: The image shows grey membrane on the tonsil extending to anterior pillar that is suggestive ofdiphtherial infection. Loeffler's serum slope: Enriched medium frequently used for the growth ofC. diphtheriae. Bacteria produce a luxuriant growth in 6-8 hours at 37degC. Does not suppo the growth of streptococci pneumococci. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pseudoexotropia is associated with:, with the following options: A: Prominent epicanthal fold, B: Positive angle kappa, C: Negative angle kappa, D: None of the above ### Response:

Ans. Positive angle kappa

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pseudoexotropia is associated with:, with the following options: A: Prominent epicanthal fold, B: Positive angle kappa, C: Negative angle kappa, D: None of the above ### Response: Ans. Positive angle kappa ### 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 strategies are effective in preventing mother to child transmission of IV, except -, with the following options: A: Zidovudine to mother & baby, B: Vaginal cleansing before delivery, C: Stopping breast feeding, D: Elective caesarean section ### Response:

Methods to prevent vertical transmission a) Antiretroviral prophylaxis- Vertical transmission can be prevented substantially by giving antiretroviral therapy to mother and early prophylaxis to newborn. b) Caesarean delivery - Elective caesarean section reduces the risk of transmission by 50% in women with or without ZDV treatment. c) Breast feeding - Because breast milk can carry the virus, breastfeeding by HIV infected mothers is contraindicated. However, Dutta/obs writes - "In the developing world, where alternative forms of infant nutrition are not safe, the minor risk associated with breastfeeding may be accepted. Mother is counselled as regards the risk and benefits. She is helped to make an informed choice."

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 strategies are effective in preventing mother to child transmission of IV, except -, with the following options: A: Zidovudine to mother & baby, B: Vaginal cleansing before delivery, C: Stopping breast feeding, D: Elective caesarean section ### Response: Methods to prevent vertical transmission a) Antiretroviral prophylaxis- Vertical transmission can be prevented substantially by giving antiretroviral therapy to mother and early prophylaxis to newborn. b) Caesarean delivery - Elective caesarean section reduces the risk of transmission by 50% in women with or without ZDV treatment. c) Breast feeding - Because breast milk can carry the virus, breastfeeding by HIV infected mothers is contraindicated. However, Dutta/obs writes - "In the developing world, where alternative forms of infant nutrition are not safe, the minor risk associated with breastfeeding may be accepted. Mother is counselled as regards the risk and benefits. She is helped to make an informed choice." ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Percentage of Blasts in AML, with the following options: A: 8%, B: 15%, C: 20%, D: 25% ### Response:

Ans.(c) 20%Ref: Nelson 18th ed. ch. 495* The characteristic feature of AML is that >20% of bone marrow cells on bone marrow aspiration or biopsy touch preparations constitute a fairly homogeneous population of blast cells, with features similar to those that characterize early differentiation states of the myeloid-monocyte-megakaryocyte series of blood cells. The most common classification of the subtypes of AML is the FAB system.French-American-British (FAB) Classification of Acute Myelogenous LeukemiaSUBTYPECOMMON NAMEMlAcute myeloblastic leukemia without maturationM2Acute myeloblastic leukemia with maturationM3Acute promyeloblastic leukemiaM4Acute myelomonocytic leukemiaM5Acute monocytic leukemiaM6ErythroleukemiaM7Acute megakaryocytic leukemia

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Percentage of Blasts in AML, with the following options: A: 8%, B: 15%, C: 20%, D: 25% ### Response: Ans.(c) 20%Ref: Nelson 18th ed. ch. 495* The characteristic feature of AML is that >20% of bone marrow cells on bone marrow aspiration or biopsy touch preparations constitute a fairly homogeneous population of blast cells, with features similar to those that characterize early differentiation states of the myeloid-monocyte-megakaryocyte series of blood cells. The most common classification of the subtypes of AML is the FAB system.French-American-British (FAB) Classification of Acute Myelogenous LeukemiaSUBTYPECOMMON NAMEMlAcute myeloblastic leukemia without maturationM2Acute myeloblastic leukemia with maturationM3Acute promyeloblastic leukemiaM4Acute myelomonocytic leukemiaM5Acute monocytic leukemiaM6ErythroleukemiaM7Acute megakaryocytic leukemia ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: ADAMTS deficiency is seen in -, with the following options: A: Essential thrombocythemia, B: ITP, C: Thrombotic thrombocytopenic purpura, D: CLL ### Response:

Answer- C. Thrombotic thrombocytopenic purpuraPatients with TTP are deficient in an enzyme called ADAMTS (This enzyme is ako known as vWF metalloprotease).

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: ADAMTS deficiency is seen in -, with the following options: A: Essential thrombocythemia, B: ITP, C: Thrombotic thrombocytopenic purpura, D: CLL ### Response: Answer- C. Thrombotic thrombocytopenic purpuraPatients with TTP are deficient in an enzyme called ADAMTS (This enzyme is ako known as vWF metalloprotease). ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Poal vein is formed by union of which of the following veins?, with the following options: A: Superior mesenteric vein & Splenic vein, B: Superior mesenteric vein & inferior mesenteric vein, C: Inferior mesenteric vein & Splenic vein, D: inferior mesenteric vein & Hepatic vein ### Response:

Poal vein is formed by the union of Superior mesenteric vein (SMV) and splenic vein posterior to the neck of pancreas. The inferior mesenteric vein drains into the splenic vein. The hepatic poal vein pass posterior to the first pa of duodenum, in the free edge of lesser omentum. At the poa hepatis, it divides into right and left branches supplying the right and left lobes of the liver. Within the sinusoids of the liver, hepatic poal blood and oxygenated blood from the hepatic aery mix together and come into contact with the hepatocytes, where metabolites such as products of digestion are exchanged. Blood from the sinusoids empties into hepatic veins draining the liver and in turn drain into IVC, and blood is returned to hea.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Poal vein is formed by union of which of the following veins?, with the following options: A: Superior mesenteric vein & Splenic vein, B: Superior mesenteric vein & inferior mesenteric vein, C: Inferior mesenteric vein & Splenic vein, D: inferior mesenteric vein & Hepatic vein ### Response: Poal vein is formed by the union of Superior mesenteric vein (SMV) and splenic vein posterior to the neck of pancreas. The inferior mesenteric vein drains into the splenic vein. The hepatic poal vein pass posterior to the first pa of duodenum, in the free edge of lesser omentum. At the poa hepatis, it divides into right and left branches supplying the right and left lobes of the liver. Within the sinusoids of the liver, hepatic poal blood and oxygenated blood from the hepatic aery mix together and come into contact with the hepatocytes, where metabolites such as products of digestion are exchanged. Blood from the sinusoids empties into hepatic veins draining the liver and in turn drain into IVC, and blood is returned to hea. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The extrinsic pathway of clotting is activated by, with the following options: A: Release of tissue thromboplastin, B: Conversion of fibrinogen into fibrin, C: Formation of prothrombin, D: Release of calcium ### Response:

The extrinsic system is triggered by the release of tissue thromboplastin, a protein–phospholipid mixture that activates factor VII.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The extrinsic pathway of clotting is activated by, with the following options: A: Release of tissue thromboplastin, B: Conversion of fibrinogen into fibrin, C: Formation of prothrombin, D: Release of calcium ### Response: The extrinsic system is triggered by the release of tissue thromboplastin, a protein–phospholipid mixture that activates factor VII. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Nerve related to anatomical snuff box ?, with the following options: A: Ulnar, B: Median, C: Superficial branch of radial, D: Axillary ### Response:

ANATOMICAL SNUFF BOX is a triangular depression on the lateral side of the wrist. BOUNDARIES: ANTERIOR-Tendons of abductor pollicis longus and extensor pollicis brevis. POSTERIOR: Tendon of extensor pollicis longus Limited above by Styloid process of the radius. FLOOR: Scaphoid and Trapezium. CONTENTS: Superficial branch of radial nerve radial aery cephalic vein Ref - BD Chaurasia 7th edition Page no: 136

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Nerve related to anatomical snuff box ?, with the following options: A: Ulnar, B: Median, C: Superficial branch of radial, D: Axillary ### Response: ANATOMICAL SNUFF BOX is a triangular depression on the lateral side of the wrist. BOUNDARIES: ANTERIOR-Tendons of abductor pollicis longus and extensor pollicis brevis. POSTERIOR: Tendon of extensor pollicis longus Limited above by Styloid process of the radius. FLOOR: Scaphoid and Trapezium. CONTENTS: Superficial branch of radial nerve radial aery cephalic vein Ref - BD Chaurasia 7th edition Page no: 136 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 50year old with history of jaundice in the past has presented with RUQ abdominal pain. Examination and investigations reveals chronic calculous cholecystitis. The liver function tests are within normal limits and on ultrasound examination, the common bile ducts is not dilated. Which of the following will be the procedure of choice in her, with the following options: A: Laparoscopic cholecystectomy, B: Open choledocholithotomy with CBD exploration, C: ERCP + choledocholithotomy followed by laparoscopic cholecystectomy, D: Laparoscopic Cholecystectomy followed by ERCP +choledocholithotomy ### Response:

In the given question, there was an episode of jaundice, but at present, LFT is normal and CBD is not dilated. The best option is laparoscopic cholecystectomy only Management of CBD stones associated with GB stones Pre-operatively detected stones Experienced laparoscopic surgeon - Cholecystectomy and choledochotony in same suiting Inexperienced laparoscopic surgeon - pre-op ERCP with stone removal and laparoscopic cholecystectomy later Unsuspected stones found at the time of cholecystectomy Experienced Laparoscopic surgeon - Laparoscopic CBD exploration and stone retrieval through the cystic duct. Laparoscopic choledochotomy and stone extraction Inexperienced laparoscopic surgeon - Conve to open procedure and remove CBD stones. Complete the cholecystectomy and refer the patient for ERCP. Conversion to an open procedure is preferred over ERCP because the success rate of ERCP is not 100% Ref: Sabiston 20th edition Pgno :1496

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 50year old with history of jaundice in the past has presented with RUQ abdominal pain. Examination and investigations reveals chronic calculous cholecystitis. The liver function tests are within normal limits and on ultrasound examination, the common bile ducts is not dilated. Which of the following will be the procedure of choice in her, with the following options: A: Laparoscopic cholecystectomy, B: Open choledocholithotomy with CBD exploration, C: ERCP + choledocholithotomy followed by laparoscopic cholecystectomy, D: Laparoscopic Cholecystectomy followed by ERCP +choledocholithotomy ### Response: In the given question, there was an episode of jaundice, but at present, LFT is normal and CBD is not dilated. The best option is laparoscopic cholecystectomy only Management of CBD stones associated with GB stones Pre-operatively detected stones Experienced laparoscopic surgeon - Cholecystectomy and choledochotony in same suiting Inexperienced laparoscopic surgeon - pre-op ERCP with stone removal and laparoscopic cholecystectomy later Unsuspected stones found at the time of cholecystectomy Experienced Laparoscopic surgeon - Laparoscopic CBD exploration and stone retrieval through the cystic duct. Laparoscopic choledochotomy and stone extraction Inexperienced laparoscopic surgeon - Conve to open procedure and remove CBD stones. Complete the cholecystectomy and refer the patient for ERCP. Conversion to an open procedure is preferred over ERCP because the success rate of ERCP is not 100% Ref: Sabiston 20th edition Pgno :1496 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Renal biopsy is indicated in all the following conditions except:, with the following options: A: CRF with normal size kidney, B: Size<60%, C: Glomerular disease in adults, D: Asymptomatic proteinuria ### Response:

(B) Size<60%# Renal biopsy is used to establish the nature and extent of renal disease in order to judge the prognosis and need for treatment.# Indications:> Acute renal failure that is not adequately explained> CRF with normal-sized kidneys> Nephrotic Syndrome or glomerular proteinuria in adults.> Nephrotic Syndrome in children that has atypical features or is not responding to treatment> Isolated haematuria with "renal" characteristics or associated abnormalities.> Asymptomatic proteinuria (> 1 gm/day)# Contraindications:> Coagulation disordered or thrombocytopenia> Uncontrolled hypertension Kidneys < 60% predicted size Solitary kidney (except transplants)> Infections - perinephritic abscess, pyonephrosis etc.> Cystic disease - Hydronephrosis, polycystic disease of kidneys or large solitary cyst.> Hypernephroma

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Renal biopsy is indicated in all the following conditions except:, with the following options: A: CRF with normal size kidney, B: Size<60%, C: Glomerular disease in adults, D: Asymptomatic proteinuria ### Response: (B) Size<60%# Renal biopsy is used to establish the nature and extent of renal disease in order to judge the prognosis and need for treatment.# Indications:> Acute renal failure that is not adequately explained> CRF with normal-sized kidneys> Nephrotic Syndrome or glomerular proteinuria in adults.> Nephrotic Syndrome in children that has atypical features or is not responding to treatment> Isolated haematuria with "renal" characteristics or associated abnormalities.> Asymptomatic proteinuria (> 1 gm/day)# Contraindications:> Coagulation disordered or thrombocytopenia> Uncontrolled hypertension Kidneys < 60% predicted size Solitary kidney (except transplants)> Infections - perinephritic abscess, pyonephrosis etc.> Cystic disease - Hydronephrosis, polycystic disease of kidneys or large solitary cyst.> Hypernephroma ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Modified radical mastoidectomy is indicated in all except -, with the following options: A: Safe CSOM, B: Unsafe CSOM with attticoantra! disease, C: Coalescent mastoiditis, D: Limited mastoid pathology ### Response:

Ans- A in safe tympanoplasty is done

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Modified radical mastoidectomy is indicated in all except -, with the following options: A: Safe CSOM, B: Unsafe CSOM with attticoantra! disease, C: Coalescent mastoiditis, D: Limited mastoid pathology ### Response: Ans- A in safe tympanoplasty is done ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A girl has primary amenorrhea with normal ovaries, absent internal genitalia but normal external genitalia. Most probable diagnosis?, with the following options: A: Mayer-Rokitansky-Kuster-Hausers- syndrome, B: Turner's syndrome, C: Noonan's, D: Androgen insensitivity syndrome ### Response:

Mayer Rokitansky Kuster Hauser's syndrome : karyotype is 46,XX Normal secondary sexual charecteristics Functional ovaries Normal hormonal profile Associated with skeletal and renal anomalies Management involves creation of a functional vagina for coital purposes and can become biological mother by surrogacy. SHAW'S TEXTBOOK OF GYNAECOLOGY,Pg no:286,15th edition

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A girl has primary amenorrhea with normal ovaries, absent internal genitalia but normal external genitalia. Most probable diagnosis?, with the following options: A: Mayer-Rokitansky-Kuster-Hausers- syndrome, B: Turner's syndrome, C: Noonan's, D: Androgen insensitivity syndrome ### Response: Mayer Rokitansky Kuster Hauser's syndrome : karyotype is 46,XX Normal secondary sexual charecteristics Functional ovaries Normal hormonal profile Associated with skeletal and renal anomalies Management involves creation of a functional vagina for coital purposes and can become biological mother by surrogacy. SHAW'S TEXTBOOK OF GYNAECOLOGY,Pg no:286,15th edition ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Changes occuring in vessels in Raynauds disease are all except -, with the following options: A: Asphyxia, B: Recovery, C: Hyperfusion, D: Syncope ### Response:

Ans. is 'c' i.e., Hyperperfusion Three stages are observed with exposure to cold or emotional disturbances. These are -Stages of local syncope - On cold exposure - digital arterioles go in spasm and blood flow decreases, pallor or blanching is observed (Stage of blanching).Stage of local asphyxia - With gradual warming there is slow relaxation of arterioleso Slowly flowing blood becomes easily deoxygenated - the part becomes dusky or cyanosed (Stages of dusky anoxia).C) Stage of recovery -o Attack passes off - arterioles are fully relaxed - oxygenated blood returns into dilated capillaries - fingers becomes red and swollen (Stage of red engorgement).

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Changes occuring in vessels in Raynauds disease are all except -, with the following options: A: Asphyxia, B: Recovery, C: Hyperfusion, D: Syncope ### Response: Ans. is 'c' i.e., Hyperperfusion Three stages are observed with exposure to cold or emotional disturbances. These are -Stages of local syncope - On cold exposure - digital arterioles go in spasm and blood flow decreases, pallor or blanching is observed (Stage of blanching).Stage of local asphyxia - With gradual warming there is slow relaxation of arterioleso Slowly flowing blood becomes easily deoxygenated - the part becomes dusky or cyanosed (Stages of dusky anoxia).C) Stage of recovery -o Attack passes off - arterioles are fully relaxed - oxygenated blood returns into dilated capillaries - fingers becomes red and swollen (Stage of red engorgement). ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Acute coronary syndrome includes all except-, with the following options: A: STEMI, B: NSTEMI, C: Stable angina, D: Unstable angina ### Response:

Ref: R. Alagappan Manual for Medicine 4th Edition pg no:179 This syndrome includes unstable angina, and non-ST elevation myocardial infarction (NSTEMI). ACS is a spectrum of disease characterised by either one of the following: 1. New-onset angina 2. Angina at rest 3. Progression of angina of increasing frequency or severity 4. Angina in response to lower levels of exeion. ACS most often represents acute atherosclerotic plaque rupture with exposure of thrombogenic sub-endothelial matrix. Thrombus formation, which may be episodic in nature and it is the mechanism by which it interferes with coronary blood flow

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Acute coronary syndrome includes all except-, with the following options: A: STEMI, B: NSTEMI, C: Stable angina, D: Unstable angina ### Response: Ref: R. Alagappan Manual for Medicine 4th Edition pg no:179 This syndrome includes unstable angina, and non-ST elevation myocardial infarction (NSTEMI). ACS is a spectrum of disease characterised by either one of the following: 1. New-onset angina 2. Angina at rest 3. Progression of angina of increasing frequency or severity 4. Angina in response to lower levels of exeion. ACS most often represents acute atherosclerotic plaque rupture with exposure of thrombogenic sub-endothelial matrix. Thrombus formation, which may be episodic in nature and it is the mechanism by which it interferes with coronary blood flow ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Edrophonium test is diagnostic of, with the following options: A: Myasthenia gravis, B: Lambert Eaton syndrome, C: Ammyotropic lateral sclerosis, D: All ### Response:

Ans. a (Myasthenia gravis). (Ref. Harrison, Internal Medicine, 16th ed., 2519)Test for diagnosis of MGCommentsAcetyl Choline Esterase/Tensilon/EdrophoniumTest# Most commonly used rapid test.# Highly probable diagnosis if unequivocally positive.# False positive in ammyotropic lateral sclerosis and placebo reactorsAnti-Ach receptor ab assay# 85% positivity in generalized myasthenia gravis.# 50% positivity in ocular myasthenia gravis.# Definitive diagnosis if positive.Repetitive nerve stimulation test# Highly probable.Single fiber EMG# Confirmatory but non-specific

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Edrophonium test is diagnostic of, with the following options: A: Myasthenia gravis, B: Lambert Eaton syndrome, C: Ammyotropic lateral sclerosis, D: All ### Response: Ans. a (Myasthenia gravis). (Ref. Harrison, Internal Medicine, 16th ed., 2519)Test for diagnosis of MGCommentsAcetyl Choline Esterase/Tensilon/EdrophoniumTest# Most commonly used rapid test.# Highly probable diagnosis if unequivocally positive.# False positive in ammyotropic lateral sclerosis and placebo reactorsAnti-Ach receptor ab assay# 85% positivity in generalized myasthenia gravis.# 50% positivity in ocular myasthenia gravis.# Definitive diagnosis if positive.Repetitive nerve stimulation test# Highly probable.Single fiber EMG# Confirmatory but non-specific ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Increased oxygen delivery during prematurity causes all the following EXCEPT:, with the following options: A: Vasoconstriction, B: Vasodilation, C: Vaso obliteration, D: Neovascularisation ### Response:

Ans. (b) VasodilationRef.:: Nelson's 18th edCh: 97.2 style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif">. gov/pubmed/12030843Supplemental oxygen in premature infants leads to the development of bronchopulmonary dysplasia.The Pathogenesis Involves* Vasoconstriction in the retina is an early response to oxygen that can lead to Vaso-obliteration.* Neovascularization* FibrosisOxygen causes tissue injury through the formation of reactive oxygen intermediates and peroxidation of membrane lipids.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Increased oxygen delivery during prematurity causes all the following EXCEPT:, with the following options: A: Vasoconstriction, B: Vasodilation, C: Vaso obliteration, D: Neovascularisation ### Response: Ans. (b) VasodilationRef.:: Nelson's 18th edCh: 97.2 style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif">. gov/pubmed/12030843Supplemental oxygen in premature infants leads to the development of bronchopulmonary dysplasia.The Pathogenesis Involves* Vasoconstriction in the retina is an early response to oxygen that can lead to Vaso-obliteration.* Neovascularization* FibrosisOxygen causes tissue injury through the formation of reactive oxygen intermediates and peroxidation of membrane lipids. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A middle aged man presented with pain in back, lack of interest in recreational activities, low mood, lethargy, decreased sleep and appetite for two months. There was no history suggestive of delusions or hallucinations. He did not suffer from any chronic medical illness. There was no family history of psychiatric illness. Routine investigations including haemogram, renal function tests, liver function tests electrocadiogram did not reveal any abnormality. This patient should be treated with -, with the following options: A: Haloperidol, B: Sertraline, C: Alprazolam, D: Olanzapine ### Response:

This patient has (for 2 months) i) Lack of interest                   ii) Low mood   iii) Loss of energy / fatigue (lethargy)      iv) Decreased sleep  v) Decreased appetite           Diagnosis is major depression → Antidepressant should be given. Amongst the given options only sertaline is antidepressant.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A middle aged man presented with pain in back, lack of interest in recreational activities, low mood, lethargy, decreased sleep and appetite for two months. There was no history suggestive of delusions or hallucinations. He did not suffer from any chronic medical illness. There was no family history of psychiatric illness. Routine investigations including haemogram, renal function tests, liver function tests electrocadiogram did not reveal any abnormality. This patient should be treated with -, with the following options: A: Haloperidol, B: Sertraline, C: Alprazolam, D: Olanzapine ### Response: This patient has (for 2 months) i) Lack of interest                   ii) Low mood   iii) Loss of energy / fatigue (lethargy)      iv) Decreased sleep  v) Decreased appetite           Diagnosis is major depression → Antidepressant should be given. Amongst the given options only sertaline is antidepressant. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Point prevalence studies tend to over estimate the occurence of which of the following diseases?, with the following options: A: Diseases with a high incidence, B: Disease with a long duration, C: Disease with a high moality, D: Diseases with a sho duration ### Response:

.point prevalence of a disease is defined as the number of all current cases old and new of a disease at one point of time.point prevalence can be made specific for age,sex,and other relevant factors or attributes. prevalence studies are mainly employed in the study of those diseases which have a longer duration of action. ref:park&;s textbook,ed 22,pg no 59

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Point prevalence studies tend to over estimate the occurence of which of the following diseases?, with the following options: A: Diseases with a high incidence, B: Disease with a long duration, C: Disease with a high moality, D: Diseases with a sho duration ### Response: .point prevalence of a disease is defined as the number of all current cases old and new of a disease at one point of time.point prevalence can be made specific for age,sex,and other relevant factors or attributes. prevalence studies are mainly employed in the study of those diseases which have a longer duration of action. ref:park&;s textbook,ed 22,pg no 59 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Least amount of co2 is in, with the following options: A: Anatomical dead space-end inspiration phase, B: Anatomical dead space-end expiration phase, C: Alveoli-end inspiration phase, D: Alveoli-end expiration phase ### Response:

Ans. (a) Anatomical dead space-end inspiration phase(Ref: Ganong, 25th ed/p.630)Anatomical dead space containing atmospheric air at the end of inspiration will have the least amount of CO2 - because atmospheric air has negligible CO2 Anatomical dead space-end expiration phase: Here alveolar gas rich in CO2 occupies the Anatomical dead space dead space areaAlveolar air contains a mixture of O2 from the inspired air and CO2 which is continuously added to it to exhale out

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Least amount of co2 is in, with the following options: A: Anatomical dead space-end inspiration phase, B: Anatomical dead space-end expiration phase, C: Alveoli-end inspiration phase, D: Alveoli-end expiration phase ### Response: Ans. (a) Anatomical dead space-end inspiration phase(Ref: Ganong, 25th ed/p.630)Anatomical dead space containing atmospheric air at the end of inspiration will have the least amount of CO2 - because atmospheric air has negligible CO2 Anatomical dead space-end expiration phase: Here alveolar gas rich in CO2 occupies the Anatomical dead space dead space areaAlveolar air contains a mixture of O2 from the inspired air and CO2 which is continuously added to it to exhale out ### 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 fulminant diabetes is?, with the following options: A: Viruses, B: Diabetic Ketoacidosis, C: Non-ketotic hyperosmolar coma, D: Autoimmunity ### Response:

Bcz of virus - coxackie B, Mumps, Rubella Type IDM - insulinopenia Leading causes - 1) Autoimmunity 2) Fulminant DM | 3) Bronze DM - Hemochromatosis

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 fulminant diabetes is?, with the following options: A: Viruses, B: Diabetic Ketoacidosis, C: Non-ketotic hyperosmolar coma, D: Autoimmunity ### Response: Bcz of virus - coxackie B, Mumps, Rubella Type IDM - insulinopenia Leading causes - 1) Autoimmunity 2) Fulminant DM | 3) Bronze DM - Hemochromatosis ### 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 sign of pulmonary hydatidosis, with the following options: A: Waterlily sign, B: Rising sun sign, C: Meniscus sign, D: Drooping lilly sign ### Response:

Drooping lilly sign is seen in neuroblastoma and duplication of ureter Duplication of ureter: Drooping lilly sign on IVP(Nonvisualized upper pole of a duplex system displaces the lower pole down, looking like a drooped down lilly flower on IVP Chracteristic signs of pulmonary hydatidosis Meniscus sign Double arc sign Moon sign Waterlily sign Crescent sign Ref: Wolfgang 2nd edition Pg no : 309

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 sign of pulmonary hydatidosis, with the following options: A: Waterlily sign, B: Rising sun sign, C: Meniscus sign, D: Drooping lilly sign ### Response: Drooping lilly sign is seen in neuroblastoma and duplication of ureter Duplication of ureter: Drooping lilly sign on IVP(Nonvisualized upper pole of a duplex system displaces the lower pole down, looking like a drooped down lilly flower on IVP Chracteristic signs of pulmonary hydatidosis Meniscus sign Double arc sign Moon sign Waterlily sign Crescent sign Ref: Wolfgang 2nd edition Pg no : 309 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about multipotential connective tissue cells is:, with the following options: A: These are most radiosensitive, B: These are most radioresistant, C: They have intermediate sensitivity, D: None of the above ### Response:

Multipotent connective tissue cells: These cells have intermediate sensitivity. These cells divide when there is a demand for more cells. Eg: Endothelial cells, fibroblasts, mesenchymal cells.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about multipotential connective tissue cells is:, with the following options: A: These are most radiosensitive, B: These are most radioresistant, C: They have intermediate sensitivity, D: None of the above ### Response: Multipotent connective tissue cells: These cells have intermediate sensitivity. These cells divide when there is a demand for more cells. Eg: Endothelial cells, fibroblasts, mesenchymal cells. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Maximum refractive power is due to the, with the following options: A: Anterior surface of lens, B: Posterior surface of lens, C: Anterior surface of cornea, D: Posterior surface of cornea ### Response:

Ans. Anterior surface of cornea

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Maximum refractive power is due to the, with the following options: A: Anterior surface of lens, B: Posterior surface of lens, C: Anterior surface of cornea, D: Posterior surface of cornea ### Response: Ans. Anterior surface of cornea ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A new born is noted to have a large head and sho limbs. On fuher examination, sho broad fingers, a small face, and low-normal length are noted. The trunk appears long and narrow. to confirm the diagnosis you should -, with the following options: A: Order an ophthalmologic examination, B: Obtain skeletal radiographs, C: Order chromosome analysis, D: Examine the parents ### Response:

Ans. is 'b' i.e., Obtain skeletal radiographs o In case of dispropoionate limbs and trunk, arrange for skeletal X-rays.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A new born is noted to have a large head and sho limbs. On fuher examination, sho broad fingers, a small face, and low-normal length are noted. The trunk appears long and narrow. to confirm the diagnosis you should -, with the following options: A: Order an ophthalmologic examination, B: Obtain skeletal radiographs, C: Order chromosome analysis, D: Examine the parents ### Response: Ans. is 'b' i.e., Obtain skeletal radiographs o In case of dispropoionate limbs and trunk, arrange for skeletal X-rays. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Expressed emotionally is related to which of the following illnesses?, with the following options: A: Depression, B: Schizophrenia, C: Mania, D: Somatoform disorder ### Response:

"Expressed emotions" is a term which is used to describe ceain attitudes of family members of patients with Schizophrenia, which have an impact on the illness itself. Family inveions are done in psychosocial treatment of schizophrenia. These attitudes includes over involvement (excessive and pathological involvement with the patient), hostility (hostile attitude towards the patient), passing critical comments (making negative comments about the patient), etc.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Expressed emotionally is related to which of the following illnesses?, with the following options: A: Depression, B: Schizophrenia, C: Mania, D: Somatoform disorder ### Response: "Expressed emotions" is a term which is used to describe ceain attitudes of family members of patients with Schizophrenia, which have an impact on the illness itself. Family inveions are done in psychosocial treatment of schizophrenia. These attitudes includes over involvement (excessive and pathological involvement with the patient), hostility (hostile attitude towards the patient), passing critical comments (making negative comments about the patient), etc. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Drug of choice in type I lepra reaction with severe neuritis is:, with the following options: A: Systemic steroid, B: Clofazimine, C: Thalidomide, D: Chloroquine ### Response:

Therapy for Reactions Type 1 lepra reactions are best treated with glucocoicoids (e.g., prednisone, initially at doses of 40-60 mg/d). As the inflammation subsides, the glucocoicoid dose can be tapered, but steroid therapy must be continued for at least 6 months Type 2 Lepra reaction: If ENL is mild (i.e., without fever or other organ involvement), it may be treated with antipyretics alone. In cases with many skin lesions, fever, malaise, and other tissue involvement, brief courses (1-2 weeks) of glucocoicoids are effective. If, despite two courses of glucocoicoid therapy ENL appears to be recurring and persisting, treatment with thalidomide should be initiated

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Drug of choice in type I lepra reaction with severe neuritis is:, with the following options: A: Systemic steroid, B: Clofazimine, C: Thalidomide, D: Chloroquine ### Response: Therapy for Reactions Type 1 lepra reactions are best treated with glucocoicoids (e.g., prednisone, initially at doses of 40-60 mg/d). As the inflammation subsides, the glucocoicoid dose can be tapered, but steroid therapy must be continued for at least 6 months Type 2 Lepra reaction: If ENL is mild (i.e., without fever or other organ involvement), it may be treated with antipyretics alone. In cases with many skin lesions, fever, malaise, and other tissue involvement, brief courses (1-2 weeks) of glucocoicoids are effective. If, despite two courses of glucocoicoid therapy ENL appears to be recurring and persisting, treatment with thalidomide should be initiated ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Tip of tongue drains into -, with the following options: A: Occipital lymph node, B: Submental lymph node, C: Deep cervical lymph nodes, D: Tonsillar lymph nodes ### Response:

Tip of the tongue drains into submental nodes, anterior 2/3 drains into submandibular nodes, and posterior 1/3 into jugulodigastric nodes. Finally, all lymphatics drain into juguloomohyoid nodes, also known as lymph nodes of the tongue.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Tip of tongue drains into -, with the following options: A: Occipital lymph node, B: Submental lymph node, C: Deep cervical lymph nodes, D: Tonsillar lymph nodes ### Response: Tip of the tongue drains into submental nodes, anterior 2/3 drains into submandibular nodes, and posterior 1/3 into jugulodigastric nodes. Finally, all lymphatics drain into juguloomohyoid nodes, also known as lymph nodes of the tongue. ### 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 central controllers of appetite does not decrease the appetite?, with the following options: A: CART, B: GRP-1, C: Melanin concentrating hormone (MCH), D: MSH-alpha ### Response:

Answer: c) Melanin concentrating hormone (MCH)Decrease Feeding (Anorexigenic)Increase Feeding (Orexigenic)a-Melanocyte-stimulating hormone (a-MSH)Neuropeptide Y (NPY)LeptinAgouti-related protein (AGRP)SerotoninMelanin-concentrating hormone (MCH)NorepinephrineOrexins A and B (Hypocretins)Corticotropin-releasing hormoneEndorphinsInsulinGalanin (GAL)Cholecystokinin (CCK)Amino acids (GABA)Glucagon-like peptide (GLP)CortisolCocaine- and amphetamine-regulated transcript (CART)GhrelinPeptide YY (PYY)Endocannabinoids

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 central controllers of appetite does not decrease the appetite?, with the following options: A: CART, B: GRP-1, C: Melanin concentrating hormone (MCH), D: MSH-alpha ### Response: Answer: c) Melanin concentrating hormone (MCH)Decrease Feeding (Anorexigenic)Increase Feeding (Orexigenic)a-Melanocyte-stimulating hormone (a-MSH)Neuropeptide Y (NPY)LeptinAgouti-related protein (AGRP)SerotoninMelanin-concentrating hormone (MCH)NorepinephrineOrexins A and B (Hypocretins)Corticotropin-releasing hormoneEndorphinsInsulinGalanin (GAL)Cholecystokinin (CCK)Amino acids (GABA)Glucagon-like peptide (GLP)CortisolCocaine- and amphetamine-regulated transcript (CART)GhrelinPeptide YY (PYY)Endocannabinoids ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Regarding alcoholic gaze nystagmus, which one of the following is false, with the following options: A: It appears at blood alcohol levels of 50 - 100 mg %, B: Horizontal gaze nystagmus is pathognomic of alcohol intoxication, C: Positional alcohol nystagmus I occurs 30 minutes after ingestion, D: Positional alcohol nystagmus II occurs 5 - 6 hours after ingestion ### Response:

Alcoholic gaze nystagmus - It appears at blood alcohol levels of 50 - 100 mg % - Positional alcohol nystagmus I occurs 30 minutes after ingestion - Positional alcohol nystagmus II occurs 5 - 6 hours after ingestion - Horizontal gaze nystagmus is not pathognomic of alcohol intoxication, can occur in pathological conditions, ingestion of sedatives and transquillizers

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Regarding alcoholic gaze nystagmus, which one of the following is false, with the following options: A: It appears at blood alcohol levels of 50 - 100 mg %, B: Horizontal gaze nystagmus is pathognomic of alcohol intoxication, C: Positional alcohol nystagmus I occurs 30 minutes after ingestion, D: Positional alcohol nystagmus II occurs 5 - 6 hours after ingestion ### Response: Alcoholic gaze nystagmus - It appears at blood alcohol levels of 50 - 100 mg % - Positional alcohol nystagmus I occurs 30 minutes after ingestion - Positional alcohol nystagmus II occurs 5 - 6 hours after ingestion - Horizontal gaze nystagmus is not pathognomic of alcohol intoxication, can occur in pathological conditions, ingestion of sedatives and transquillizers ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: While seeing a colour chart a colour blind male has decreased vision for red light colour which appear very light than that of other colours. Which of the following is the likely anomaly in him?, with the following options: A: Protanomaly, B: Dutanomaly, C: Tritanomaly, D: Butanomaly ### Response:

(A) Protanomaly > Prefixes "Prot = red, Deuter = green & Tri = blue refer to defects cone system, respectively Suffixes anomaly = colour weakness; anopia = colour blindness> Individuals with normal colour vision and those with Protanomaly (red colour weakness), deuteranomaly (green colour weakness), and tritanomaly (blue colour weakness) are called Trichomates --i.e. they have all three cones, system but one is weak.> Dichromates: only two cone system present, E.g. Protanopia = red cone absent; Deuteranopia = green cone absent Tritanopia = Blue cone absent.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: While seeing a colour chart a colour blind male has decreased vision for red light colour which appear very light than that of other colours. Which of the following is the likely anomaly in him?, with the following options: A: Protanomaly, B: Dutanomaly, C: Tritanomaly, D: Butanomaly ### Response: (A) Protanomaly > Prefixes "Prot = red, Deuter = green & Tri = blue refer to defects cone system, respectively Suffixes anomaly = colour weakness; anopia = colour blindness> Individuals with normal colour vision and those with Protanomaly (red colour weakness), deuteranomaly (green colour weakness), and tritanomaly (blue colour weakness) are called Trichomates --i.e. they have all three cones, system but one is weak.> Dichromates: only two cone system present, E.g. Protanopia = red cone absent; Deuteranopia = green cone absent Tritanopia = Blue cone absent. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most sensitive test for acute fetal distress :, with the following options: A: Fresh meconium on induction of labour, B: Loss of beat to beat variation of hea beat, C: Increased fetal movements, D: Type 1 dips in second stage ### Response:

Loss of beat to beat variation of hea beat

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most sensitive test for acute fetal distress :, with the following options: A: Fresh meconium on induction of labour, B: Loss of beat to beat variation of hea beat, C: Increased fetal movements, D: Type 1 dips in second stage ### Response: Loss of beat to beat variation of hea beat ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following condition respond well with Clonidine?, with the following options: A: Opiate withdrawal, B: Attention-deficit/hyperactivity disorder, C: Tourette's disorder, D: All of the above ### Response:

Ans. D. All of the aboveClinically, clonidine has been useful and effective in a series of medical and psychiatric conditions. Among them are Tourette's disorder, other tic disorders, opiate withdrawal, nicotine withdrawal, autism spectrum disorders, posttraumatic stress disorder (PTSD), and other anxiety disorders. Clonidine was synthesized in the early 1960s and was found to produce vasoconstriction mediated by -receptors. Clonidine is well absorbed after oral administration, and its bioavailability is nearly 100 percent.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following condition respond well with Clonidine?, with the following options: A: Opiate withdrawal, B: Attention-deficit/hyperactivity disorder, C: Tourette's disorder, D: All of the above ### Response: Ans. D. All of the aboveClinically, clonidine has been useful and effective in a series of medical and psychiatric conditions. Among them are Tourette's disorder, other tic disorders, opiate withdrawal, nicotine withdrawal, autism spectrum disorders, posttraumatic stress disorder (PTSD), and other anxiety disorders. Clonidine was synthesized in the early 1960s and was found to produce vasoconstriction mediated by -receptors. Clonidine is well absorbed after oral administration, and its bioavailability is nearly 100 percent. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ototoxicity and nephrotoxicity may be the side effect of: March 2012, with the following options: A: Vancomycin, B: Azithromycin, C: Clindamycin, D: Penicillin ### Response:

Ans: A i.e. Vancomycin Drugs and side-effects Vancomycin can cause plasma concentration dependent nerve deafness which may be permanent. Kidney damage is also dose related. Side-effects of azithromycin are mild gastric upset, abdominal pain (less than erythromycin), headache and dizziness Side effects of clindamycin are rashes, uicaria, abdominal pain, but the major problem is diarrhoea and pseudomembranous colitis due to Cl. Difficile superinfection which is potentially fatal. Adverse effects of penicillin include local irritancy and direct toxicity, hypersensitivity, superinfections and JarischHerxheimer reaction (in syphilitic patient)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ototoxicity and nephrotoxicity may be the side effect of: March 2012, with the following options: A: Vancomycin, B: Azithromycin, C: Clindamycin, D: Penicillin ### Response: Ans: A i.e. Vancomycin Drugs and side-effects Vancomycin can cause plasma concentration dependent nerve deafness which may be permanent. Kidney damage is also dose related. Side-effects of azithromycin are mild gastric upset, abdominal pain (less than erythromycin), headache and dizziness Side effects of clindamycin are rashes, uicaria, abdominal pain, but the major problem is diarrhoea and pseudomembranous colitis due to Cl. Difficile superinfection which is potentially fatal. Adverse effects of penicillin include local irritancy and direct toxicity, hypersensitivity, superinfections and JarischHerxheimer reaction (in syphilitic patient) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Respiratory rate in a 2 month old, to label it tachypnea is –, with the following options: A: 40, B: 50, C: 60, D: 70 ### Response:

Tach nea < 2 months --->             60 or more RR/min 2-12 months —>          50 or more RR/min 12-60 months -3      40 or more RR/min

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Respiratory rate in a 2 month old, to label it tachypnea is –, with the following options: A: 40, B: 50, C: 60, D: 70 ### Response: Tach nea < 2 months --->             60 or more RR/min 2-12 months —>          50 or more RR/min 12-60 months -3      40 or more RR/min ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: An 8 year old boy presents with boggy swelling and easily pluckable hair, Diagnosis is –, with the following options: A: Tinea capitis, B: Alopecia areata, C: Tuberculorid leprosy, D: Pityriasis alba ### Response:

Boggy swelling with easily pluckable hair suggests the diagnosis of keroin type of Tinea capitis.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: An 8 year old boy presents with boggy swelling and easily pluckable hair, Diagnosis is –, with the following options: A: Tinea capitis, B: Alopecia areata, C: Tuberculorid leprosy, D: Pityriasis alba ### Response: Boggy swelling with easily pluckable hair suggests the diagnosis of keroin type of Tinea capitis. ### 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 vehicle accident, the musculocutaneous nerve was completely severed, but still the person was able to weekly flex the elbow joint. All of the following muscles are responsible for this flexion, EXCEPT?, with the following options: A: Brachioradialis, B: Flexor carpi radialis, C: Ulnar head of Pronator teres, D: Flexor carpi ulnaris ### Response:

Muscles involved in elbow flexion are biceps brachii/biceps, brachialis, brachioradialis, extensor carpi radialis longus/ long radial extensor, pronator teres, palmaris longus, flexor carpi radialis and flexor carpi ulnaris.Pronator teres has two heads a humeral and an ulnar head. The ulnar head arises from the medial border of coronoid process of ulna. And both the heads get united and the combined muscle passes obliquely across the proximal forearm for inseion into lateral surface of radius. This muscle is primarily involved in the rapid pronation movements of the forearm.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In a vehicle accident, the musculocutaneous nerve was completely severed, but still the person was able to weekly flex the elbow joint. All of the following muscles are responsible for this flexion, EXCEPT?, with the following options: A: Brachioradialis, B: Flexor carpi radialis, C: Ulnar head of Pronator teres, D: Flexor carpi ulnaris ### Response: Muscles involved in elbow flexion are biceps brachii/biceps, brachialis, brachioradialis, extensor carpi radialis longus/ long radial extensor, pronator teres, palmaris longus, flexor carpi radialis and flexor carpi ulnaris.Pronator teres has two heads a humeral and an ulnar head. The ulnar head arises from the medial border of coronoid process of ulna. And both the heads get united and the combined muscle passes obliquely across the proximal forearm for inseion into lateral surface of radius. This muscle is primarily involved in the rapid pronation movements of the forearm. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Peau d' orange is due to -, with the following options: A: Secondary infection, B: Blockage of subdermal lymphatics, C: Invasion of skin with malignant cells, D: Aerial obstruction ### Response:

Peaud's orange is produced due to obstruction of superficial lymph vessels by cancer cells. This causes edema of the skin giving rise to an appearance like that of the skin of an orange (Peau'd orange appearance) Ref - Srb's manual of surgery 5e p534

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Peau d' orange is due to -, with the following options: A: Secondary infection, B: Blockage of subdermal lymphatics, C: Invasion of skin with malignant cells, D: Aerial obstruction ### Response: Peaud's orange is produced due to obstruction of superficial lymph vessels by cancer cells. This causes edema of the skin giving rise to an appearance like that of the skin of an orange (Peau'd orange appearance) Ref - Srb's manual of surgery 5e p534 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Fetal blood is separated from syncytiotrophoblast with all the following except :, with the following options: A: Fetal blood capillary membrane, B: Mesenchyme of intervillous blood space, C: Cytotrophoblast, D: Decidua parietalis ### Response:

The decidua over the anembryonic pole is the decidua capsularis.As the chorionic cavity becomes larger, the decidua capsularis is streched and degenerates .The chorion leave now comes into close contact with the uterine wall on the opposite side,resulting in the formation of the decidua parietalis. For more information refer page no 59,60 and also fig.5,18 ,of textbook of obsteics,sheila balakrishnan,2 nd edition. layers of placental barrier from maternal to fetal side includes: maternal blood<syncytiotrophoblast<cytotrophoblast<connective tisssue stroma of villus<fetal blood vessel Reference: D C Dutta Text book of Obstetrics 7th edition page 34

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Fetal blood is separated from syncytiotrophoblast with all the following except :, with the following options: A: Fetal blood capillary membrane, B: Mesenchyme of intervillous blood space, C: Cytotrophoblast, D: Decidua parietalis ### Response: The decidua over the anembryonic pole is the decidua capsularis.As the chorionic cavity becomes larger, the decidua capsularis is streched and degenerates .The chorion leave now comes into close contact with the uterine wall on the opposite side,resulting in the formation of the decidua parietalis. For more information refer page no 59,60 and also fig.5,18 ,of textbook of obsteics,sheila balakrishnan,2 nd edition. layers of placental barrier from maternal to fetal side includes: maternal blood<syncytiotrophoblast<cytotrophoblast<connective tisssue stroma of villus<fetal blood vessel Reference: D C Dutta Text book of Obstetrics 7th edition page 34 ### 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 anxiety is all except: (Repeat), with the following options: A: Adaptive response, B: Alert signal, C: Autonomic hyperactivity, D: Always pathological ### Response:

Ans: D (Always pathological) Ref.: Synopsis of Psychiatry, Kaplan & Sadock, 10th editionExplanation:Anxiety is a state of mind characterized by alertness, in response to any threatening stimulus and it is an adaptive response.It has cognitive symptoms (inattention - forgetfulness)Emotional symptoms (feeling on the edge)Autonomic symptoms (hyper-sympathetic state)Physical symptoms (muscle tension).While anxiety is due to an internal, vague, distant stimuli, fear is a response to a stimulus which is external, well-defined and immediate.- Also Refer Psychiatry question explanation in 2011 paper.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True regarding anxiety is all except: (Repeat), with the following options: A: Adaptive response, B: Alert signal, C: Autonomic hyperactivity, D: Always pathological ### Response: Ans: D (Always pathological) Ref.: Synopsis of Psychiatry, Kaplan & Sadock, 10th editionExplanation:Anxiety is a state of mind characterized by alertness, in response to any threatening stimulus and it is an adaptive response.It has cognitive symptoms (inattention - forgetfulness)Emotional symptoms (feeling on the edge)Autonomic symptoms (hyper-sympathetic state)Physical symptoms (muscle tension).While anxiety is due to an internal, vague, distant stimuli, fear is a response to a stimulus which is external, well-defined and immediate.- Also Refer Psychiatry question explanation in 2011 paper. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about decoicate rigidity?, with the following options: A: Removal of cerebral coex and basal ganglia, B: Flexion of lower limbs & extension of upperlimbs, C: Rigidity is less pronounced than decerebrate rigidity, D: None of the above ### Response:

Decoicate Rigidity Made by removing whole cerebral coex but leaving basal ganglia intact. Characterised by flexion of upper extremities at elbow & extension of lower extremities. Flexion due to rubrospinal tract excitation of flexors in upper extremities & hyperextension of lower extremity. Decoicate animal doesnot have intense hypeonia as decerebrate animal.Due to intact basal ganglia in decoicate animal. Ref: Guyton and Hall Textbook of Medical Physiology 13th edition Pgno: 682

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about decoicate rigidity?, with the following options: A: Removal of cerebral coex and basal ganglia, B: Flexion of lower limbs & extension of upperlimbs, C: Rigidity is less pronounced than decerebrate rigidity, D: None of the above ### Response: Decoicate Rigidity Made by removing whole cerebral coex but leaving basal ganglia intact. Characterised by flexion of upper extremities at elbow & extension of lower extremities. Flexion due to rubrospinal tract excitation of flexors in upper extremities & hyperextension of lower extremity. Decoicate animal doesnot have intense hypeonia as decerebrate animal.Due to intact basal ganglia in decoicate animal. Ref: Guyton and Hall Textbook of Medical Physiology 13th edition Pgno: 682 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Thymidylated RNA present in:, with the following options: A: mRNA, B: rRNA, C: tRNA, D: 16-s-RNA ### Response:

C i.e. t RNAThe TN/ C arm of tRNA has sequence of thymidineQ, Pseudouridine, and cytosine.The Tyr C arm of tRNA is involved in binding of amino acyl - tRNA to the ribosomal surface at the site of protein synthesis.hn RNA is heterogenous nuclear RNA, they are processed to generate the mRNA, which then enter the cytoplasm to serve as template for protein synthesis.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Thymidylated RNA present in:, with the following options: A: mRNA, B: rRNA, C: tRNA, D: 16-s-RNA ### Response: C i.e. t RNAThe TN/ C arm of tRNA has sequence of thymidineQ, Pseudouridine, and cytosine.The Tyr C arm of tRNA is involved in binding of amino acyl - tRNA to the ribosomal surface at the site of protein synthesis.hn RNA is heterogenous nuclear RNA, they are processed to generate the mRNA, which then enter the cytoplasm to serve as template for protein synthesis. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: What is the approximate Total fetal cardiac output?, with the following options: A: 300 ml/kg/min, B: 450 ml/kg/min, C: 600 ml/kg/min, D: 150 ml/kg/min ### Response:

b. 450ml/kg/min(Ref: Nelson's 20/e p 2161)Total fetal cardiac output, i.e. combined output of both left and right ventricles--is 450mL/kg/min.65% of descending aortic blood flow returns to the placenta and remaining 35% perfuses the fetal organs and tissues.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: What is the approximate Total fetal cardiac output?, with the following options: A: 300 ml/kg/min, B: 450 ml/kg/min, C: 600 ml/kg/min, D: 150 ml/kg/min ### Response: b. 450ml/kg/min(Ref: Nelson's 20/e p 2161)Total fetal cardiac output, i.e. combined output of both left and right ventricles--is 450mL/kg/min.65% of descending aortic blood flow returns to the placenta and remaining 35% perfuses the fetal organs and tissues. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 32 years old Bengali women had fever since 48 hours with history of irrelevant talk and 2 episodes of tonic clonic seizures on succession on the way to hospital. She was previously alright. Which of the following drug can be given while rest of the investigations were being carried out?, with the following options: A: IV mannitol, B: IV amphotericin B, C: IV penicillin, D: IV acyclovir ### Response:

Ans. d. IV acyclovir (Ref: Harrison 19/e p893. 18/e)A 32 years old Bengali women had fever since 48 hours with history of irrelevant talk and 2 episodes of tonic clonic seizures on succession on the way to hospital. She was previously alright. This patient is most probably suffering from viral encephalitis. Acyclovir is of benefit in the treatment of HSV and should be started empirically in patients with suspected viral encephalitis, especially if focal features are present, while awaiting viral diagnostic studies.Acyclovir is of benefit in the treatment of HSV and should be started empirically in patients with suspected viral encephalitis, especially if focal features are present, while awaiting viral diagnostic studies. Harrison 18/eViral EncephalitisIn encephalitis the brain parenchyma is involved.Many patients with encephalitis also have evidence of associated meningitis (meningoencephalitis) and, in some cases, involvement of the spinal cord or nerve roots (encephalomyelitis, encephalomyeloradiculitis).Clinical Features:In addition to the acute febrile illness with evidence of meningeal involvement, an altered level of consciousnessQ (confusion, behavioral abnormalities), or a depressed level of consciousness ranging from mild lethargy to coma, and evidence of either focal or diffuse neurologic signs and symptomsQ.Focal or generalized seizuresQ occur in many patients with encephalitis.MC encountered focal findings are aphasia, ataxia, upper or lower motor neuron patterns of weakness, involuntary movements (e.g., myoclonic jerks, tremor), and cranial nerve deficitsQ (e.g., ocular palsies, facial weakness).Diagnosis:CSF PCR has become the primary diagnostic test for CIVS infections caused by CMV, EBV. HHV-6. and enterovirusesQThe sensitivity (~ 96%) and specificity (~ 99%) of HSV CSF PCR is equivalent to or exceeds that of brain biopsyQ.Patients with suspected encephalitis almost invariably undergo neuroimaging studies and often EEGQ.Focal findings in a patient with encephalitis should always raise the possibility of HSV encephalitisQ.Treatment:Specific antiviral therapy should be initiated when appropriateQ.Basic management and supportive therapy should include careful monitoring of ICP, fluid restriction, avoidance of hypotonic intravenous solutions, and suppression of fever.Seizures should be treated with standard anticonvulsant regimensQ, and prophylactic therapy should be considered in view of the high frequency of seizures in severe cases of encephalitis.Acyclovir is of benefit in the treatment of HSV and should be started empirically in patients with suspected viral encephalitis, especially if focal features are present, while awaiting viral diagnostic studies.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 32 years old Bengali women had fever since 48 hours with history of irrelevant talk and 2 episodes of tonic clonic seizures on succession on the way to hospital. She was previously alright. Which of the following drug can be given while rest of the investigations were being carried out?, with the following options: A: IV mannitol, B: IV amphotericin B, C: IV penicillin, D: IV acyclovir ### Response: Ans. d. IV acyclovir (Ref: Harrison 19/e p893. 18/e)A 32 years old Bengali women had fever since 48 hours with history of irrelevant talk and 2 episodes of tonic clonic seizures on succession on the way to hospital. She was previously alright. This patient is most probably suffering from viral encephalitis. Acyclovir is of benefit in the treatment of HSV and should be started empirically in patients with suspected viral encephalitis, especially if focal features are present, while awaiting viral diagnostic studies.Acyclovir is of benefit in the treatment of HSV and should be started empirically in patients with suspected viral encephalitis, especially if focal features are present, while awaiting viral diagnostic studies. Harrison 18/eViral EncephalitisIn encephalitis the brain parenchyma is involved.Many patients with encephalitis also have evidence of associated meningitis (meningoencephalitis) and, in some cases, involvement of the spinal cord or nerve roots (encephalomyelitis, encephalomyeloradiculitis).Clinical Features:In addition to the acute febrile illness with evidence of meningeal involvement, an altered level of consciousnessQ (confusion, behavioral abnormalities), or a depressed level of consciousness ranging from mild lethargy to coma, and evidence of either focal or diffuse neurologic signs and symptomsQ.Focal or generalized seizuresQ occur in many patients with encephalitis.MC encountered focal findings are aphasia, ataxia, upper or lower motor neuron patterns of weakness, involuntary movements (e.g., myoclonic jerks, tremor), and cranial nerve deficitsQ (e.g., ocular palsies, facial weakness).Diagnosis:CSF PCR has become the primary diagnostic test for CIVS infections caused by CMV, EBV. HHV-6. and enterovirusesQThe sensitivity (~ 96%) and specificity (~ 99%) of HSV CSF PCR is equivalent to or exceeds that of brain biopsyQ.Patients with suspected encephalitis almost invariably undergo neuroimaging studies and often EEGQ.Focal findings in a patient with encephalitis should always raise the possibility of HSV encephalitisQ.Treatment:Specific antiviral therapy should be initiated when appropriateQ.Basic management and supportive therapy should include careful monitoring of ICP, fluid restriction, avoidance of hypotonic intravenous solutions, and suppression of fever.Seizures should be treated with standard anticonvulsant regimensQ, and prophylactic therapy should be considered in view of the high frequency of seizures in severe cases of encephalitis.Acyclovir is of benefit in the treatment of HSV and should be started empirically in patients with suspected viral encephalitis, especially if focal features are present, while awaiting viral diagnostic studies. ### 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 comes with froathy, green vaginal discharge of 5 days duration. There was "strawberry cervix" on examination. Drug of choice for the infection is:, with the following options: A: Metronidazole, B: Tetracycline, C: Fluconazole, D: Ciprofloxacin ### Response:

Above symptoms are suggestive of infection by Trichomonas.vaginalis, which is treated by  T.Metronidazole 2g stat (or T.Secnidazole 2g stat)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A female comes with froathy, green vaginal discharge of 5 days duration. There was "strawberry cervix" on examination. Drug of choice for the infection is:, with the following options: A: Metronidazole, B: Tetracycline, C: Fluconazole, D: Ciprofloxacin ### Response: Above symptoms are suggestive of infection by Trichomonas.vaginalis, which is treated by  T.Metronidazole 2g stat (or T.Secnidazole 2g stat) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Now-a-days, the selective serotonin re-uptake inhibitors are the preferred drugs for which of the following psychiatric disorder apa from their role in the treatment of depression:, with the following options: A: Phobias, B: Obsessive compulsive disorder, C: Post-traumatic stress disorder, D: All of the above ### Response:

Clinical application of SSRI's: 1. Major depressive Disorder (MDD) 2. Anxiety disorder 3. Panic Disorder 4. Obsessive compulsive disorder 5. Post traumatic stress disorder 6. Peri-menopausal vasomotor symptoms 7.Eating disorders (Bulimia) SSRI are the first line agent in treatment of both MDD and anxiety disorders

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Now-a-days, the selective serotonin re-uptake inhibitors are the preferred drugs for which of the following psychiatric disorder apa from their role in the treatment of depression:, with the following options: A: Phobias, B: Obsessive compulsive disorder, C: Post-traumatic stress disorder, D: All of the above ### Response: Clinical application of SSRI's: 1. Major depressive Disorder (MDD) 2. Anxiety disorder 3. Panic Disorder 4. Obsessive compulsive disorder 5. Post traumatic stress disorder 6. Peri-menopausal vasomotor symptoms 7.Eating disorders (Bulimia) SSRI are the first line agent in treatment of both MDD and anxiety disorders ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: During embryonic development, prolapsed gut returns to the abdominal cavity by:, with the following options: A: 12th week, B: 15th week, C: 18th week, D: 20th week ### Response:

During the sixth week of fetal development, the midgut grows too rapidly to be accommodated in the abdominal cavity and therefore prolapses into the umbilical cord. Between the tenth and twelfth weeks, the midgut returns to the abdominal cavity, undergoing a 270-degree counterclockwise rotation around the superior mesenteric aery. Because the duodenum also rotates caudal to the aery, it acquires a C loop that traces this path. Ref: Schwaz's principle of surgery 9th edition, chapter 39.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: During embryonic development, prolapsed gut returns to the abdominal cavity by:, with the following options: A: 12th week, B: 15th week, C: 18th week, D: 20th week ### Response: During the sixth week of fetal development, the midgut grows too rapidly to be accommodated in the abdominal cavity and therefore prolapses into the umbilical cord. Between the tenth and twelfth weeks, the midgut returns to the abdominal cavity, undergoing a 270-degree counterclockwise rotation around the superior mesenteric aery. Because the duodenum also rotates caudal to the aery, it acquires a C loop that traces this path. Ref: Schwaz's principle of surgery 9th edition, chapter 39. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pheochromocytoma is a neoplasm derived from, with the following options: A: Chromaffin cells, B: Paraganglia in neck, C: An adrenal gland tumor due to nephrogenic rest, D: Primitive totipotential cells ### Response:

Pheochromocytomas are neoplasms composed of chromaffin cells, which synthesize and release catecholamines and in some instances peptide hormones. Pheochromocytomas that develop in extra-adrenal paraganglia are designated paragangliomas Robbins 9e pg: 1134 Ref img

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pheochromocytoma is a neoplasm derived from, with the following options: A: Chromaffin cells, B: Paraganglia in neck, C: An adrenal gland tumor due to nephrogenic rest, D: Primitive totipotential cells ### Response: Pheochromocytomas are neoplasms composed of chromaffin cells, which synthesize and release catecholamines and in some instances peptide hormones. Pheochromocytomas that develop in extra-adrenal paraganglia are designated paragangliomas Robbins 9e pg: 1134 Ref img ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Choose the TRUE statement/s about mucormycosis:, with the following options: A: Nose is a common site, B: Diabetics is a predisposing factor, C: Common in India, D: All of the above ### Response:

Mucormycosis Caused by - rhizopus, rhizomucor, cunninghamella. The higher prevalence of mucormycosis in India turned out to be statistically significant (p < ? 0001. in comparison with all other countries Predisposing factors: Organ transplant recipients Long term desferroxamine therapy Immunosuppression due to steroids or cytotoxic drugs Hematological malignancy Diabetis Mellitus Chronic renal failure Five forms of mucormycosis are: Rhinocerebral (most common site) Pulmonary mucormycosis (2nd most common) Cutaneous Gastrointestinal Disseminated Miscellaneous Diagnosis: Biopsy with histopathologic examination is the most sensitive and specific modality for definitive diagnosis. Biopsy shows wide, thick walled, ribbon like, aseptate hyphal elements that branch at acute angles.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Choose the TRUE statement/s about mucormycosis:, with the following options: A: Nose is a common site, B: Diabetics is a predisposing factor, C: Common in India, D: All of the above ### Response: Mucormycosis Caused by - rhizopus, rhizomucor, cunninghamella. The higher prevalence of mucormycosis in India turned out to be statistically significant (p < ? 0001. in comparison with all other countries Predisposing factors: Organ transplant recipients Long term desferroxamine therapy Immunosuppression due to steroids or cytotoxic drugs Hematological malignancy Diabetis Mellitus Chronic renal failure Five forms of mucormycosis are: Rhinocerebral (most common site) Pulmonary mucormycosis (2nd most common) Cutaneous Gastrointestinal Disseminated Miscellaneous Diagnosis: Biopsy with histopathologic examination is the most sensitive and specific modality for definitive diagnosis. Biopsy shows wide, thick walled, ribbon like, aseptate hyphal elements that branch at acute angles. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Defect in Snurps causes -, with the following options: A: Defect in 5' - capping, B: Defect in addition of poly-A tail, C: Defect in Splicing, D: Defect in terminal addition of nucleotide ### Response:

Ans. is 'c' i.e., Defect in splicingm-RNA processingo Prokaryotic mRNA is functional immediately upon synthesis, i.e. prokaryotic primary transcript of mRNA is functional. Thus it does not require post-transcriptional modification. In Eukaryotes the primary transcript of mRNA is the hn RNA (hetrogeneous nuclear RNA). After transcription hnRNA is extensively modified to form functional mRNA. These modifications are as follows.The 51-cappingThis is the first processing reaction. 5l-end of mRNA is capped with 7-methylguansosine. This cap helps in initiation of translation (protein synthesis) and stabilizes the structure of mRNA by protecting from 5'-exonuclease.Addition of poly 'A' tail As the name suggests, multiple4A' (adenylate) residues are added at 31 end.This poly-A tail is not transcribed from DNA. but rather added after transcription. These tails helps to stabilize the mRNA (by protecting from 31-exonuclease), facilitate exit from the nucleus, and aid in translation. After mRNA enters the cytosol, the poly-A tail is gradually shortened. Some mRNAs do not have poly-A tail, e.g. mRNAs of histones and some interferons.Removal of introns (splicing) Eukaryotic genes contain some coding sequences which code for protein and some intervening non-coding sequences which do not code for protein. The coding sequences are called 'exons'and intervening non-coding sequences are called 'introns'. The process by which introns are excised and exons are linked to form functional mRNA is called splicing. Thus mature mRNA does not contain introns.# Spitcesome :- Splicesome is an assembly made up of small nuclear RNA (snRNA), some proteins and hnRNA. snRNA combines with proteins to form small nuclear ribnonucleoprotein particles (snRNPs or snurps) that mediate splicing. It is snRNA component of snurps that catalyzes splicing. Snurps are U1, U2, U3, U4, U5 and U6-o Only about 1[?]5% of human DNA has coding sequence (exons). Remaining is non-coding (introns).Alternate splicing :- The hn-RNA molecules from some genes can be spliced in alternative way in different tissues. Thus two or more different mRNA (and therefore 2 or more proteins) can be synthesized from same hnRNA. For example, difference isoforms of tropomyosin in different tissues in due to alternate splicing.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Defect in Snurps causes -, with the following options: A: Defect in 5' - capping, B: Defect in addition of poly-A tail, C: Defect in Splicing, D: Defect in terminal addition of nucleotide ### Response: Ans. is 'c' i.e., Defect in splicingm-RNA processingo Prokaryotic mRNA is functional immediately upon synthesis, i.e. prokaryotic primary transcript of mRNA is functional. Thus it does not require post-transcriptional modification. In Eukaryotes the primary transcript of mRNA is the hn RNA (hetrogeneous nuclear RNA). After transcription hnRNA is extensively modified to form functional mRNA. These modifications are as follows.The 51-cappingThis is the first processing reaction. 5l-end of mRNA is capped with 7-methylguansosine. This cap helps in initiation of translation (protein synthesis) and stabilizes the structure of mRNA by protecting from 5'-exonuclease.Addition of poly 'A' tail As the name suggests, multiple4A' (adenylate) residues are added at 31 end.This poly-A tail is not transcribed from DNA. but rather added after transcription. These tails helps to stabilize the mRNA (by protecting from 31-exonuclease), facilitate exit from the nucleus, and aid in translation. After mRNA enters the cytosol, the poly-A tail is gradually shortened. Some mRNAs do not have poly-A tail, e.g. mRNAs of histones and some interferons.Removal of introns (splicing) Eukaryotic genes contain some coding sequences which code for protein and some intervening non-coding sequences which do not code for protein. The coding sequences are called 'exons'and intervening non-coding sequences are called 'introns'. The process by which introns are excised and exons are linked to form functional mRNA is called splicing. Thus mature mRNA does not contain introns.# Spitcesome :- Splicesome is an assembly made up of small nuclear RNA (snRNA), some proteins and hnRNA. snRNA combines with proteins to form small nuclear ribnonucleoprotein particles (snRNPs or snurps) that mediate splicing. It is snRNA component of snurps that catalyzes splicing. Snurps are U1, U2, U3, U4, U5 and U6-o Only about 1[?]5% of human DNA has coding sequence (exons). Remaining is non-coding (introns).Alternate splicing :- The hn-RNA molecules from some genes can be spliced in alternative way in different tissues. Thus two or more different mRNA (and therefore 2 or more proteins) can be synthesized from same hnRNA. For example, difference isoforms of tropomyosin in different tissues in due to alternate splicing. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 36-year-old man presents to his primary care physician complaining of painless enlargement of the testis. Fuher laboratory studies reveal an increase in serum hCG. Of the following, which is the most likely diagnosis?, with the following options: A: Dysgerminoma, B: Embryonal carcinoma, C: Seminoma, D: Yolk sac tumor ### Response:

Seminoma is the most common germ cell tumor of the testis. Serum hCG levels, elaborated by syncytiotrophoblasts, are elevated in about 15% of cases, but these elevations are not as high as those seen in choriocarcinoma. The tumor is highly radiosensitive and often curable, even when metastatic. The peak incidence is in 3rd decade of life Histology : uniform cells with clear cytoplasm and central nucleus, with a prominent nucleolus giving it a fried-egg appearance, with delicate fibrous septa containing a lymphocytic infiltrate. Dysgerminoma represents the ovarian counterpa of seminoma. Embryonal carcinoma is highly pleomorphic and is much less responsive to therapy than seminoma. Yolk sac tumor is the most common tumor of the testis during infancy and early childhood and is usually accompanied by an increase in serum a-fetoprotein.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 36-year-old man presents to his primary care physician complaining of painless enlargement of the testis. Fuher laboratory studies reveal an increase in serum hCG. Of the following, which is the most likely diagnosis?, with the following options: A: Dysgerminoma, B: Embryonal carcinoma, C: Seminoma, D: Yolk sac tumor ### Response: Seminoma is the most common germ cell tumor of the testis. Serum hCG levels, elaborated by syncytiotrophoblasts, are elevated in about 15% of cases, but these elevations are not as high as those seen in choriocarcinoma. The tumor is highly radiosensitive and often curable, even when metastatic. The peak incidence is in 3rd decade of life Histology : uniform cells with clear cytoplasm and central nucleus, with a prominent nucleolus giving it a fried-egg appearance, with delicate fibrous septa containing a lymphocytic infiltrate. Dysgerminoma represents the ovarian counterpa of seminoma. Embryonal carcinoma is highly pleomorphic and is much less responsive to therapy than seminoma. Yolk sac tumor is the most common tumor of the testis during infancy and early childhood and is usually accompanied by an increase in serum a-fetoprotein. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about hydrocution are all except: September 2006, with the following options: A: Electrocution in water, B: Death results from cardiac arrest, C: Results from falling in the water with feet first, D: Emotionally tense individuals are prone for this ### Response:

Ans. A: Electrocution in water Any poorly-diagnosed, sudden death that takes place in water, but is not due to drowning is known as hydrocution Immersion syndrome/ hydrocution/ submersion inhibition: Death results from cardiac arrest due to vagal stimulation as a result of? Cold water Water striking the epigastrium Cold water penetrating ear drums, nasal passages and the pharynx Alcohol increases such effect.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about hydrocution are all except: September 2006, with the following options: A: Electrocution in water, B: Death results from cardiac arrest, C: Results from falling in the water with feet first, D: Emotionally tense individuals are prone for this ### Response: Ans. A: Electrocution in water Any poorly-diagnosed, sudden death that takes place in water, but is not due to drowning is known as hydrocution Immersion syndrome/ hydrocution/ submersion inhibition: Death results from cardiac arrest due to vagal stimulation as a result of? Cold water Water striking the epigastrium Cold water penetrating ear drums, nasal passages and the pharynx Alcohol increases such effect. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: which of the following is a side effect of vagal nerve stimulation, with the following options: A: paradoxical suicide, B: voice alteration, C: aaythmia, D: epilepsy ### Response:

Vagus nerve stimulation * Electrical stimulation of left vagus nerve * Stimulation of raphe nucleus and locus cereleus * Release of norepinephrine and serotonin * Side effects * Voice alteration Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 1065

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: which of the following is a side effect of vagal nerve stimulation, with the following options: A: paradoxical suicide, B: voice alteration, C: aaythmia, D: epilepsy ### Response: Vagus nerve stimulation * Electrical stimulation of left vagus nerve * Stimulation of raphe nucleus and locus cereleus * Release of norepinephrine and serotonin * Side effects * Voice alteration Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 1065 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Recommended transpo medium for stool specimen suspected to contain enteric pathogens is ?, with the following options: A: Arnie's medium, B: Buffered glycerol saline medium, C: MacConkey medium, D: All ### Response:

Ans. is 'b' i.e., Buffered glyceral saline medium . Following transpo medium are used for stool specimen :- Cary Blair medium, buffered glycerol saline or Stua medium.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Recommended transpo medium for stool specimen suspected to contain enteric pathogens is ?, with the following options: A: Arnie's medium, B: Buffered glycerol saline medium, C: MacConkey medium, D: All ### Response: Ans. is 'b' i.e., Buffered glyceral saline medium . Following transpo medium are used for stool specimen :- Cary Blair medium, buffered glycerol saline or Stua medium. ### 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 structure is intact in closed head injury?, with the following options: A: Scalp, B: Skull, C: Dura mater, D: Arachnoid mater ### Response:

Closed head injury (non-penetrating): Damage to the brain without any fracture of the skull and/or penetration of dura; most often results from blunt trauma. Ref - Krishan Vij textbook of forensic medicine and toxicology 5e pg : 281,284

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 structure is intact in closed head injury?, with the following options: A: Scalp, B: Skull, C: Dura mater, D: Arachnoid mater ### Response: Closed head injury (non-penetrating): Damage to the brain without any fracture of the skull and/or penetration of dura; most often results from blunt trauma. Ref - Krishan Vij textbook of forensic medicine and toxicology 5e pg : 281,284 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Three hosts in life cycle are required in-, with the following options: A: Taenia solium, B: Entamoeba histolytica, C: Trichuris trichiura, D: Diphyllobothrium latum ### Response:

Ans. D. Diphyllobothrium latuma. In D. latum-There are three hosts-one definitive and two intermediateb. Definitive host: man, dog, cat, pigc. First intermediate host: cyclopsd. Second intermediate host: fresh water fishe. Entamoeba histolytica and Trichuris trichiura need only one host (man) in the life cycle.f. Taenia solium requires two hosts in life cycle-man and pig

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Three hosts in life cycle are required in-, with the following options: A: Taenia solium, B: Entamoeba histolytica, C: Trichuris trichiura, D: Diphyllobothrium latum ### Response: Ans. D. Diphyllobothrium latuma. In D. latum-There are three hosts-one definitive and two intermediateb. Definitive host: man, dog, cat, pigc. First intermediate host: cyclopsd. Second intermediate host: fresh water fishe. Entamoeba histolytica and Trichuris trichiura need only one host (man) in the life cycle.f. Taenia solium requires two hosts in life cycle-man and pig ### 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 cerebellar tumor in children?, with the following options: A: Astrocytoma, B: Medulloblastoma, C: Ependymoma, D: PNET ### Response:

Ans. (a) Astrocytoma(Ref: Robbins 9th/pg 1306: See Ans 69)*Most common pediatric brain tumor-Pilocytic astrocytoma*Most aggressive pediatric brain tumor-Medulloblastoma

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common cerebellar tumor in children?, with the following options: A: Astrocytoma, B: Medulloblastoma, C: Ependymoma, D: PNET ### Response: Ans. (a) Astrocytoma(Ref: Robbins 9th/pg 1306: See Ans 69)*Most common pediatric brain tumor-Pilocytic astrocytoma*Most aggressive pediatric brain tumor-Medulloblastoma ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following can be given in hepatic as well as in renal failure -, with the following options: A: Atracurium, B: Vecuronium, C: Pancuronium, D: Miyacurium ### 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: Which of the following can be given in hepatic as well as in renal failure -, with the following options: A: Atracurium, B: Vecuronium, C: Pancuronium, D: Miyacurium ### 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: Which of the following represents site of reversal of polarity of myosin molecules in thick muscle filaments?, with the following options: A: M line, B: Z line, C: I line, D: H line ### Response:

The M line is the site of the reversal of polarity of the myosin molecules in each of the thick filaments. At these points, there are slender cross-connections that hold the thick filaments in proper array.

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 represents site of reversal of polarity of myosin molecules in thick muscle filaments?, with the following options: A: M line, B: Z line, C: I line, D: H line ### Response: The M line is the site of the reversal of polarity of the myosin molecules in each of the thick filaments. At these points, there are slender cross-connections that hold the thick filaments in proper array. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 5-day-old female infant was born with a laryngeal defect. The greater cornuae and the inferior pa of the hyoid bone were absent at bih. Failure of development of which of the following embryonic structures has most likely led to these defects?, with the following options: A: First Pharyngeal Arch, B: Second pharyngeal arch, C: Third pharyngeal arch, D: Fouh pharyngeal arch ### Response:

The third pharyngeal arch gives rise to the greater cornuae and lower pa of the hyoid bone, in addition to the stylopharyngeus muscle. The maxillary prominence of 1st Arch is impoant in the development of the cheeks and upper lip. The mandibular prominence of 1st Arch is impoant in development of the mandible. The second pharyngeal arch gives rise to the lesser cornu and upper pa of the hyoid bone. The fouh pharyngeal arches, while extensively involved in development of the cailage and muscles of the larynx, play no pa in the development of the hyoid bone.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 5-day-old female infant was born with a laryngeal defect. The greater cornuae and the inferior pa of the hyoid bone were absent at bih. Failure of development of which of the following embryonic structures has most likely led to these defects?, with the following options: A: First Pharyngeal Arch, B: Second pharyngeal arch, C: Third pharyngeal arch, D: Fouh pharyngeal arch ### Response: The third pharyngeal arch gives rise to the greater cornuae and lower pa of the hyoid bone, in addition to the stylopharyngeus muscle. The maxillary prominence of 1st Arch is impoant in the development of the cheeks and upper lip. The mandibular prominence of 1st Arch is impoant in development of the mandible. The second pharyngeal arch gives rise to the lesser cornu and upper pa of the hyoid bone. The fouh pharyngeal arches, while extensively involved in development of the cailage and muscles of the larynx, play no pa in the development of the hyoid bone. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The aoic component of the second hea sound is best heard at what location?, with the following options: A: Infraclavicular region, B: Ludwig's angle to the right, C: Apex, D: 2nd intercostal space to the left ### Response:

Aoic area lies in the right second intercostal space near to sternum (Ludwig's angle)Ref: Medical Physiology Indu Khurana 2015 edition page No:212

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The aoic component of the second hea sound is best heard at what location?, with the following options: A: Infraclavicular region, B: Ludwig's angle to the right, C: Apex, D: 2nd intercostal space to the left ### Response: Aoic area lies in the right second intercostal space near to sternum (Ludwig's angle)Ref: Medical Physiology Indu Khurana 2015 edition page No:212 ### 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 markers are seen in Primary effusion lymphoma?, with the following options: A: CD30, CD138, B: CD20, CD28, C: CD19, CD20, D: CD29, CD30 ### Response:

C030, CD138 Primary effusion lymphoma is a.k.a. Body cavity-based lymphoma It is caused by EBV+ Kaposi sarcoma virus (HHV-8). Mostly, seen in HIV-AIDS patients. Markers: The lymphoma cells usually express CD45 but lack pan-B-cell markers such as CD19, CD20, and CD79a. Activation and plasma cell-related markers and a variety of non-lineage associated antigens such as HLA-DR, CD30, CD38, VS38c, CD138, and EMA are often demonstrable.

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 markers are seen in Primary effusion lymphoma?, with the following options: A: CD30, CD138, B: CD20, CD28, C: CD19, CD20, D: CD29, CD30 ### Response: C030, CD138 Primary effusion lymphoma is a.k.a. Body cavity-based lymphoma It is caused by EBV+ Kaposi sarcoma virus (HHV-8). Mostly, seen in HIV-AIDS patients. Markers: The lymphoma cells usually express CD45 but lack pan-B-cell markers such as CD19, CD20, and CD79a. Activation and plasma cell-related markers and a variety of non-lineage associated antigens such as HLA-DR, CD30, CD38, VS38c, CD138, and EMA are often demonstrable. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Acute physiology and Chronic Health Evaluation (APACHE) scoring system is used as a scoring system to, with the following options: A: To predict postoperative cardiac risk, B: To predict postoperative pulmonary complications, C: To evaluate prognosis in the critical care settings, D: To evaluate prognosis after acute myocardial infarction ### Response:

Currently, the most commonly utilized scoring systems are the APACHE (acute physiology and chronic health evaluation) system and the SAPS (simplified acute physiology score) system. These systems were designed to predict outcomes in critical illness and use common variables that include age; vital signs; assessments of respiratory, renal, and neurologic function; and an evaluation of chronic medical illnesses. The APACHE II system is the most commonly used SOI scoring system in Noh America. Age, type of ICU admission (after elective surgery vs. nonsurgical or after emergency surgery), a chronic health problem score, and 12 physiologic variables (the most severely abnormal of each in the first 24 h of ICU admission) are used to derive a score. The predicted hospital moality is derived from a formula that takes into account the APACHE II score, the need for emergency surgery, and a weighted, disease-specific diagnostic category. ref:harrison&;s principles of internal medicine,ed 18,pg no 2196

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Acute physiology and Chronic Health Evaluation (APACHE) scoring system is used as a scoring system to, with the following options: A: To predict postoperative cardiac risk, B: To predict postoperative pulmonary complications, C: To evaluate prognosis in the critical care settings, D: To evaluate prognosis after acute myocardial infarction ### Response: Currently, the most commonly utilized scoring systems are the APACHE (acute physiology and chronic health evaluation) system and the SAPS (simplified acute physiology score) system. These systems were designed to predict outcomes in critical illness and use common variables that include age; vital signs; assessments of respiratory, renal, and neurologic function; and an evaluation of chronic medical illnesses. The APACHE II system is the most commonly used SOI scoring system in Noh America. Age, type of ICU admission (after elective surgery vs. nonsurgical or after emergency surgery), a chronic health problem score, and 12 physiologic variables (the most severely abnormal of each in the first 24 h of ICU admission) are used to derive a score. The predicted hospital moality is derived from a formula that takes into account the APACHE II score, the need for emergency surgery, and a weighted, disease-specific diagnostic category. ref:harrison&;s principles of internal medicine,ed 18,pg no 2196 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Drug X which inhibit the binding of RANKL to its receptor (RANK) in osteoporosis:, with the following options: A: Teriparatide, B: Alendronate, C: Denosumab, D: Estrogen ### Response:

Ans. C. DenosumabOsteoclasts express RANK receptor which on stimulation causes resorption of bone. Denosumab is monoclonal antibody which inhibit the binding of ligand to the receptor and thus play a role in osteoporosis.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Drug X which inhibit the binding of RANKL to its receptor (RANK) in osteoporosis:, with the following options: A: Teriparatide, B: Alendronate, C: Denosumab, D: Estrogen ### Response: Ans. C. DenosumabOsteoclasts express RANK receptor which on stimulation causes resorption of bone. Denosumab is monoclonal antibody which inhibit the binding of ligand to the receptor and thus play a role in osteoporosis. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Acrodermatitis entero pathica is d/t deficiency of:, with the following options: A: Zn, B: Se, C: Cu, D: Cr ### Response:

A. i.e. Zn Autosomal recessiveQ disorder acrodermatitis enteropathica d/t deficiency of zinc0 is characterized by diarrhea, depression, eczematous dermatitis, alopecia and lethargy. (Mn- DEAL). Zn supplementation rapidly improves conditionQ.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Acrodermatitis entero pathica is d/t deficiency of:, with the following options: A: Zn, B: Se, C: Cu, D: Cr ### Response: A. i.e. Zn Autosomal recessiveQ disorder acrodermatitis enteropathica d/t deficiency of zinc0 is characterized by diarrhea, depression, eczematous dermatitis, alopecia and lethargy. (Mn- DEAL). Zn supplementation rapidly improves conditionQ. ### 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 useful fluid for resuscitation in cardiac Arrest Patient:-, with the following options: A: Normal Saline, B: Ringers Lactate, C: 5% Dextrose, D: Whole Blood ### Response:

5% Dextrose is not a fluid to be ued for resusitation as dextrose is metabolised and it rest becomes free water.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is not a useful fluid for resuscitation in cardiac Arrest Patient:-, with the following options: A: Normal Saline, B: Ringers Lactate, C: 5% Dextrose, D: Whole Blood ### Response: 5% Dextrose is not a fluid to be ued for resusitation as dextrose is metabolised and it rest becomes free water. ### 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 the 1st sign of strangulation of ingunial hernia -, with the following options: A: Tense, B: Tender, C: Irreducible, D: Redness ### Response:

Ans. is 'b' i.e. Tender

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which is the 1st sign of strangulation of ingunial hernia -, with the following options: A: Tense, B: Tender, C: Irreducible, D: Redness ### Response: Ans. is 'b' i.e. Tender ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Death due to which poison causes postmoem staining of cherry-red -color:, with the following options: A: Carbon monoxide, B: Aniline, C: Phosphorus, D: Nitrites ### Response:

A i.e. Carbon monoxide

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Death due to which poison causes postmoem staining of cherry-red -color:, with the following options: A: Carbon monoxide, B: Aniline, C: Phosphorus, D: Nitrites ### Response: A i.e. Carbon monoxide ### 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 diseases can lead to the following position of the body?, with the following options: A: Tetany, B: Kernicterus, C: Measles, D: Pertussis ### Response:

Ans. (b) Kernicterus.The neonate shown in the image is showing opisthotonus due to marked contraction of paravertebral muscles and is seen in tetanus and kernicterus. Image. Source. style="font-size: 1.04761904761905em; color: rgba(0, 0, 0, 1); font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0">

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 diseases can lead to the following position of the body?, with the following options: A: Tetany, B: Kernicterus, C: Measles, D: Pertussis ### Response: Ans. (b) Kernicterus.The neonate shown in the image is showing opisthotonus due to marked contraction of paravertebral muscles and is seen in tetanus and kernicterus. Image. Source. style="font-size: 1.04761904761905em; color: rgba(0, 0, 0, 1); font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0"> ### 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 the most common site for hymen tear following intercourse, with the following options: A: Posterolaterally, B: Anteromedially, C: Posteromedially, D: Anterolaterally ### Response:

Tears usually occur at 4 or 8 clock position. (at posterolateral location).

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which is the most common site for hymen tear following intercourse, with the following options: A: Posterolaterally, B: Anteromedially, C: Posteromedially, D: Anterolaterally ### Response: Tears usually occur at 4 or 8 clock position. (at posterolateral location). ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Following statements are true with respect to glycogen except, with the following options: A: Principle storage of carbohydrate in the human body is glycogen, B: Liver and muscle are the main sites of glycogen storage, C: Produced by glycogenesis, D: Insulin stimulates glycogenolysis ### Response:

Insulin inhibits glycogenolysis by oring the inactivation of glycogen phosphorylase and inhibiting glucose-6-phosphatase. The net effect of all these three mechanisms, blood glucose level is lowered.Ref: DM Vasudevan, 7th edition, page no: 321

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Following statements are true with respect to glycogen except, with the following options: A: Principle storage of carbohydrate in the human body is glycogen, B: Liver and muscle are the main sites of glycogen storage, C: Produced by glycogenesis, D: Insulin stimulates glycogenolysis ### Response: Insulin inhibits glycogenolysis by oring the inactivation of glycogen phosphorylase and inhibiting glucose-6-phosphatase. The net effect of all these three mechanisms, blood glucose level is lowered.Ref: DM Vasudevan, 7th edition, page no: 321 ### End