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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: Clotting factor common to extrinsic and intrinsic pathway is:, with the following options: A: Factor II, B: Factor III, C: Factor V, D: Factor VII ### Response:

Tissue factor initiates the extrinsic pathway, whereas contact of Factor XII and platelets with collagen in the vascular wall initiates the intrinsic pathway. An especially important difference between the extrinsic  and  intrinsic  pathways is that the extrinsic  pathway can be explosive; once initiated, its speed of completion to the final clot is limited only by the amount of tissue factor released from the traumatized tissues and by the quantities of Factors X, VII,  and V in the blood. With severe tissue trauma, clotting can occur in as little as 15 seconds. The intrinsic pathway is much slower to proceed, usually requiring 1 to 6 minutes to cause clotting.  Clotting factor common to extrinsic and intrinsic pathway is Factor V.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Clotting factor common to extrinsic and intrinsic pathway is:, with the following options: A: Factor II, B: Factor III, C: Factor V, D: Factor VII ### Response: Tissue factor initiates the extrinsic pathway, whereas contact of Factor XII and platelets with collagen in the vascular wall initiates the intrinsic pathway. An especially important difference between the extrinsic  and  intrinsic  pathways is that the extrinsic  pathway can be explosive; once initiated, its speed of completion to the final clot is limited only by the amount of tissue factor released from the traumatized tissues and by the quantities of Factors X, VII,  and V in the blood. With severe tissue trauma, clotting can occur in as little as 15 seconds. The intrinsic pathway is much slower to proceed, usually requiring 1 to 6 minutes to cause clotting.  Clotting factor common to extrinsic and intrinsic pathway is Factor V. ### 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 debranching enzyme:, with the following options: A: Glycogen synthetase, B: Glucose-6-phosphatase, C: Amylo alpha-1,6-glucosidase, D: Amylo (1,4)-(1,6) trans glycosylase ### Response:

Debranching enzyme is a Bifunctional enzyme with two activities Glucan transferase Amylo a-1,6-glucosidase breaks the alpha (1-6) glycosidic bond present at the branch point of glycogen in glycogen breakdown. Other Options: Glycogen synthetase transfer glucose from UDP-glucose to glycogenin. Glycogen branching enzyme (also known as amylo-a(1,4)-a(1,6) trans glycosylase) make glycogen branches by transferring the end of the chain onto an earlier pa a-1,6 glycosidic bond. Glucose-6-phosphatase dephosphorylates glucose-6-phosphate to free glucose.

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 debranching enzyme:, with the following options: A: Glycogen synthetase, B: Glucose-6-phosphatase, C: Amylo alpha-1,6-glucosidase, D: Amylo (1,4)-(1,6) trans glycosylase ### Response: Debranching enzyme is a Bifunctional enzyme with two activities Glucan transferase Amylo a-1,6-glucosidase breaks the alpha (1-6) glycosidic bond present at the branch point of glycogen in glycogen breakdown. Other Options: Glycogen synthetase transfer glucose from UDP-glucose to glycogenin. Glycogen branching enzyme (also known as amylo-a(1,4)-a(1,6) trans glycosylase) make glycogen branches by transferring the end of the chain onto an earlier pa a-1,6 glycosidic bond. Glucose-6-phosphatase dephosphorylates glucose-6-phosphate to free glucose. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The primary form of coisol in the plasma is, with the following options: A: Bound to albumin, B: Bound to transthyretin, C: Free in solution, D: Bound to coicosteroid-binding globulin (CBG) ### Response:

The majority of coisol is bound to a specific carrier protein, coicosteroid binding globulin (CBG), while smaller amounts are bound nonspecifically to albumin. Few, if any, coisol receptors would be expected in the plasma and transthyretin binds primarily thyroxine.Ref: Guyton; 13th edition

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The primary form of coisol in the plasma is, with the following options: A: Bound to albumin, B: Bound to transthyretin, C: Free in solution, D: Bound to coicosteroid-binding globulin (CBG) ### Response: The majority of coisol is bound to a specific carrier protein, coicosteroid binding globulin (CBG), while smaller amounts are bound nonspecifically to albumin. Few, if any, coisol receptors would be expected in the plasma and transthyretin binds primarily thyroxine.Ref: Guyton; 13th edition ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: MRI finding of Schizophrenia FALSE is, with the following options: A: Increased ventricular volume, B: Cortical thickening, C: Reduced volume of temporal lobe, D: Reduced volume of hippocampal lobe ### Response:

(B) Cortical thickening# MRI studies utilizing modern cortical surface reconstruction techniques have shown widespread reduction in cerebral cortical thickness (i.e., "cortical thinning") in frontal and temporal regions.> Whole brain and hippocampal volume are reduced and that ventricular volume is increased in patients with a first psychotic episoderelative to healthy controls.> Most schizophrenia studies have found average reduced volume of the left medial temporal lobe and left superior temporal gyrus, and half of studies have revealed deficits in certain areas of the frontal gyrus, parahippocampal gyrus and temporal gyrus.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: MRI finding of Schizophrenia FALSE is, with the following options: A: Increased ventricular volume, B: Cortical thickening, C: Reduced volume of temporal lobe, D: Reduced volume of hippocampal lobe ### Response: (B) Cortical thickening# MRI studies utilizing modern cortical surface reconstruction techniques have shown widespread reduction in cerebral cortical thickness (i.e., "cortical thinning") in frontal and temporal regions.> Whole brain and hippocampal volume are reduced and that ventricular volume is increased in patients with a first psychotic episoderelative to healthy controls.> Most schizophrenia studies have found average reduced volume of the left medial temporal lobe and left superior temporal gyrus, and half of studies have revealed deficits in certain areas of the frontal gyrus, parahippocampal gyrus and temporal gyrus. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most commonly lesioned nerve in intracranial aneurysms is, with the following options: A: Optic, B: Oculomotor, C: Trochlear, D: Abducent ### Response:

Intracranial aneurysm may involve oculomotor, abducent and optic nerve in descending order Trochlear nerve is involvement is higher in head trauma. Ref: Gray's 39e/p-227

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most commonly lesioned nerve in intracranial aneurysms is, with the following options: A: Optic, B: Oculomotor, C: Trochlear, D: Abducent ### Response: Intracranial aneurysm may involve oculomotor, abducent and optic nerve in descending order Trochlear nerve is involvement is higher in head trauma. Ref: Gray's 39e/p-227 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Features of right side carcinoma colon are I. Obstruction II. Altered bowel habit III. Anemia IV. Melena, with the following options: A: 1 only, B: 1 and 2, C: 3 and 4, D: 2, 3 and 4 ### Response:

Right sided Ca. Bleeds ( melena) causing anemia.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Features of right side carcinoma colon are I. Obstruction II. Altered bowel habit III. Anemia IV. Melena, with the following options: A: 1 only, B: 1 and 2, C: 3 and 4, D: 2, 3 and 4 ### Response: Right sided Ca. Bleeds ( melena) causing anemia. ### 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 activated for nuclear fragmentation in apoptosis -, with the following options: A: Caspases, B: Apaf - 1, C: Oxygen free radicals, D: All ### Response:

Caspases and endonuclease cause chromatin fragmentation in apoptosis. They are inactive, so first they should be activated. Cytochrome &;c&; binds with Apaf-1 and this complex activates caspases. Caspases cause fragmentation of chromatin and also activate endonuclease. About option &;b&; Though Apaf-1 helps in activation of caspases, it has no role in chromatin framentation and It does not have two seprate forms active or inactive. It just forms complex with cytochrome &;C&; to activate caspases. REF: ROBBINS pathology 10th edition

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which is activated for nuclear fragmentation in apoptosis -, with the following options: A: Caspases, B: Apaf - 1, C: Oxygen free radicals, D: All ### Response: Caspases and endonuclease cause chromatin fragmentation in apoptosis. They are inactive, so first they should be activated. Cytochrome &;c&; binds with Apaf-1 and this complex activates caspases. Caspases cause fragmentation of chromatin and also activate endonuclease. About option &;b&; Though Apaf-1 helps in activation of caspases, it has no role in chromatin framentation and It does not have two seprate forms active or inactive. It just forms complex with cytochrome &;C&; to activate caspases. REF: ROBBINS pathology 10th edition ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Radical neck dissection involves all except, with the following options: A: Sternocleidomastoid muscle, B: Internal jugular vein, C: Vagus nerve, D: Spinal accessory nerve ### Response:

Vagus nerve is not removed in Radical Neck Dissection. Structures removed in Radical Neck Dissection: Level I-V Lymph nodes, Sternocleidomastoid, Internal Jugular Vein, Spinal Accessory Nerve, Submandibular salivary gland, Tail of parotid and Omohyoid muscle. Ref: Textbook of ENT, Dhingra; 6th edition; Pg no: 388 ref img

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Radical neck dissection involves all except, with the following options: A: Sternocleidomastoid muscle, B: Internal jugular vein, C: Vagus nerve, D: Spinal accessory nerve ### Response: Vagus nerve is not removed in Radical Neck Dissection. Structures removed in Radical Neck Dissection: Level I-V Lymph nodes, Sternocleidomastoid, Internal Jugular Vein, Spinal Accessory Nerve, Submandibular salivary gland, Tail of parotid and Omohyoid muscle. Ref: Textbook of ENT, Dhingra; 6th edition; Pg no: 388 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: Laparoscopic sterilization is not recommended during the period of:, with the following options: A: Immediate post-paum, B: Interval, C: Post menstrual, D: Post first trimester M.T.P ### Response:

- Laparoscopy is not advisable for postpaum patients for 6 weeks following delivery- Hence, option-1 is answer - However, it can be done as a concurrent procedure to MTP. - Haemoglobin should not be less than 8. - It is recommended that the patient be kept in hospital for a minimum of 48 hours after the operation.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Laparoscopic sterilization is not recommended during the period of:, with the following options: A: Immediate post-paum, B: Interval, C: Post menstrual, D: Post first trimester M.T.P ### Response: - Laparoscopy is not advisable for postpaum patients for 6 weeks following delivery- Hence, option-1 is answer - However, it can be done as a concurrent procedure to MTP. - Haemoglobin should not be less than 8. - It is recommended that the patient be kept in hospital for a minimum of 48 hours after the operation. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In case of Blockade of 2nd pa of axillary aery blood supply to upper limb is maintained by which anastomosis -, with the following options: A: Dorsal scapular anastomosis, B: Ventral scapular anastomosis, C: Circle of Willis, D: Anastomosis around internal thoracic aery ### Response:

Ans. is'a'i.e., Dorsal scapular anastomosis(Ref: Clinical anatomy 3d/e p. 756)Dorsal Scapular Anastomosis:This anastomosis occurs connects the 1st pa of subclan aery to the third pa of axillary aery providing an alternate route of flow of blood in case of occlusion anywhere within the subclan and axillary aery.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In case of Blockade of 2nd pa of axillary aery blood supply to upper limb is maintained by which anastomosis -, with the following options: A: Dorsal scapular anastomosis, B: Ventral scapular anastomosis, C: Circle of Willis, D: Anastomosis around internal thoracic aery ### Response: Ans. is'a'i.e., Dorsal scapular anastomosis(Ref: Clinical anatomy 3d/e p. 756)Dorsal Scapular Anastomosis:This anastomosis occurs connects the 1st pa of subclan aery to the third pa of axillary aery providing an alternate route of flow of blood in case of occlusion anywhere within the subclan and axillary aery. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Mammography was performed in 45 year old female for screening of breast cancer. The finding is suggestive of, with the following options: A: Benign lesion, B: Malignant lesion, C: Indeterminate, D: No opinion can be given ### Response:

Mammography Soft tissue radiographs are taken by placing the breast in direct contact with ultrasensitive film and exposing it to low-voltage, high-amperage x-rays. The dose of radiation is approximately 0.1 cGy and, therefore, mammography is a very safe investigation. The sensitivity of this investigation increases with age as the breast becomes less dense. In total, 5% of breast cancers are missed by population-based mammographic screening programmes; even in retrospect, such carcinomas are not apparent. Thus, a normal mammogram does not exclude the presence of carcinoma. Digital mammography is being introduced, which allows manipulation of the images and computer-aided diagnosis. Tomo-mammography is also being assessed as a more sensitive diagnostic modality. Ultrasound Ref: Sabiston 20th edition Pgno : 861

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Mammography was performed in 45 year old female for screening of breast cancer. The finding is suggestive of, with the following options: A: Benign lesion, B: Malignant lesion, C: Indeterminate, D: No opinion can be given ### Response: Mammography Soft tissue radiographs are taken by placing the breast in direct contact with ultrasensitive film and exposing it to low-voltage, high-amperage x-rays. The dose of radiation is approximately 0.1 cGy and, therefore, mammography is a very safe investigation. The sensitivity of this investigation increases with age as the breast becomes less dense. In total, 5% of breast cancers are missed by population-based mammographic screening programmes; even in retrospect, such carcinomas are not apparent. Thus, a normal mammogram does not exclude the presence of carcinoma. Digital mammography is being introduced, which allows manipulation of the images and computer-aided diagnosis. Tomo-mammography is also being assessed as a more sensitive diagnostic modality. Ultrasound Ref: Sabiston 20th edition Pgno : 861 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 45-years-old multipara presents with dysmenorrhea and menorrhagia. Uterus is symmetrically enlarged upto 14 weeks. What is the probable diagnosis?, with the following options: A: Intramural fibroid, B: Adenomyosis, C: Endometrial hyperplasia, D: Pelvic inflammatory disease ### Response:

AdenomyosisCommon in women above 40 years.Often co-exists with fibroid, endometriosis and endometrial cancer.Uterus is symmetrically enlarged to not more than 14 weeks size.Histology - Islands of endometrial glands surrounded by stroma seen in the myometrial tissue beyond the endomyometrial junction.The distance between basal endometrium and the endometrial gland should be > 2.5 mm.Common complaint--Menorrhagia and progressive dysmenorrhoea.Clinical examination reveals symmetrical enlargement of uterus and tender uterus.Treatment is localized excision, hysterectomy.Medical treatment includes danazol, GnRH, Mirena IUCD.(Refer: Shaw&;s Textbook of Gynaecology, 15th edition, pg no: 407, 475)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 45-years-old multipara presents with dysmenorrhea and menorrhagia. Uterus is symmetrically enlarged upto 14 weeks. What is the probable diagnosis?, with the following options: A: Intramural fibroid, B: Adenomyosis, C: Endometrial hyperplasia, D: Pelvic inflammatory disease ### Response: AdenomyosisCommon in women above 40 years.Often co-exists with fibroid, endometriosis and endometrial cancer.Uterus is symmetrically enlarged to not more than 14 weeks size.Histology - Islands of endometrial glands surrounded by stroma seen in the myometrial tissue beyond the endomyometrial junction.The distance between basal endometrium and the endometrial gland should be > 2.5 mm.Common complaint--Menorrhagia and progressive dysmenorrhoea.Clinical examination reveals symmetrical enlargement of uterus and tender uterus.Treatment is localized excision, hysterectomy.Medical treatment includes danazol, GnRH, Mirena IUCD.(Refer: Shaw&;s Textbook of Gynaecology, 15th edition, pg no: 407, 475) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Maastrichat classification category 3 stands for DCD donor of:, with the following options: A: Brought dead patient, B: Cardiac arrest during brain dead, C: Awaiting cardiac death after withdrawal of supports, D: Cardiac arrest and unsuccessful resuscitation in hospital ### Response:

Ref. Sabiston Textbook of Surgery. Pg. 877   MAASTRICHAAT CLASSIFICATION OF NHBD Category 1 : Dead on arrival at hospital Category 2 : Death with unsuccessful resuscitation . Category 3 : Awaiting cardiac death . Category 4 : Cardiac arrest while brain dead .

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Maastrichat classification category 3 stands for DCD donor of:, with the following options: A: Brought dead patient, B: Cardiac arrest during brain dead, C: Awaiting cardiac death after withdrawal of supports, D: Cardiac arrest and unsuccessful resuscitation in hospital ### Response: Ref. Sabiston Textbook of Surgery. Pg. 877   MAASTRICHAAT CLASSIFICATION OF NHBD Category 1 : Dead on arrival at hospital Category 2 : Death with unsuccessful resuscitation . Category 3 : Awaiting cardiac death . Category 4 : Cardiac arrest while brain dead . ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Aflatoxin is produced by -, with the following options: A: Aspergillus flavus, B: Aspergillus famigatus, C: Calviceps purpura, D: Argemone mexicana ### Response:

Ans. is 'a' i.e., Aspergillus flavus

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Aflatoxin is produced by -, with the following options: A: Aspergillus flavus, B: Aspergillus famigatus, C: Calviceps purpura, D: Argemone mexicana ### Response: Ans. is 'a' i.e., Aspergillus flavus ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is the most common cause of “reversible” dementia in geriatric population?, with the following options: A: Depression, B: Normal Pressure Hydrocephalus, C: Hypothyroidism, D: Vit B12 deficiency ### Response:

Depression (ref : pg 189 Clinical Practice guidelines JK Trivedi)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is the most common cause of “reversible” dementia in geriatric population?, with the following options: A: Depression, B: Normal Pressure Hydrocephalus, C: Hypothyroidism, D: Vit B12 deficiency ### Response: Depression (ref : pg 189 Clinical Practice guidelines JK Trivedi) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Allopurinol is used in treatment of:, with the following options: A: Rheumatoid arthritis, B: Psoriatic arthritis, C: Gouty arthritis, D: Poly sero arthritis ### Response:

Ans. is 'c' i.e., Gouty arthritis* Allopurinol is a hypoxanthine analogue which was synthesized as a purine anti metabolite.* Allopurinol is xanthine oxidase inhibitor.* Uses:# Allopurinol is the first choice drug for chronic gout. It can be used for both over producers as well as under excretors of uric acid.# With long term allopurinol therapy, tophi gradually disappear and nephropathy is halted and even reversed.* Allopurinol is contraindicated in acute gout because a sudden decrease in urate levels may precipitate re - crystallization in the joints.* Other uses# Allopurinol may be used in some cases of kala azar or leishmaniasis but efficacy is doubtful.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Allopurinol is used in treatment of:, with the following options: A: Rheumatoid arthritis, B: Psoriatic arthritis, C: Gouty arthritis, D: Poly sero arthritis ### Response: Ans. is 'c' i.e., Gouty arthritis* Allopurinol is a hypoxanthine analogue which was synthesized as a purine anti metabolite.* Allopurinol is xanthine oxidase inhibitor.* Uses:# Allopurinol is the first choice drug for chronic gout. It can be used for both over producers as well as under excretors of uric acid.# With long term allopurinol therapy, tophi gradually disappear and nephropathy is halted and even reversed.* Allopurinol is contraindicated in acute gout because a sudden decrease in urate levels may precipitate re - crystallization in the joints.* Other uses# Allopurinol may be used in some cases of kala azar or leishmaniasis but efficacy is doubtful. ### 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 approaches you with multiple infected bite wounds to the shoulder. There are also a few scratch marks on his back. He confess you that he has raped a woman a few weeks ago but has asked you to keep it a secret. He warns you that he would sue you for breach of professional secrecy if you inform anyone. What is the appropriate response in this scenario?, with the following options: A: Treat the patient and keep the information a secret, B: Refused to treat the patient and inform the police, C: Treat the patient and inform the police immediately, D: Treat the patient and inform the police after his wounds have healed ### Response:

As per section 3a, CrPC and section 176 IPC the doctor is duty bound to repo such matters (crimes) to the nearest magistrate or police. Failing to do so intentionally is punishable by imprisonment as per section 202 of IPC. Since an infected bite wound can sepsis and death. Its essential to treat the wounds in this case. Ref: Textbook of Forensic Medicine and Toxicology by Narayan Reddy, Edition 21, Page - 28,29

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A patient approaches you with multiple infected bite wounds to the shoulder. There are also a few scratch marks on his back. He confess you that he has raped a woman a few weeks ago but has asked you to keep it a secret. He warns you that he would sue you for breach of professional secrecy if you inform anyone. What is the appropriate response in this scenario?, with the following options: A: Treat the patient and keep the information a secret, B: Refused to treat the patient and inform the police, C: Treat the patient and inform the police immediately, D: Treat the patient and inform the police after his wounds have healed ### Response: As per section 3a, CrPC and section 176 IPC the doctor is duty bound to repo such matters (crimes) to the nearest magistrate or police. Failing to do so intentionally is punishable by imprisonment as per section 202 of IPC. Since an infected bite wound can sepsis and death. Its essential to treat the wounds in this case. Ref: Textbook of Forensic Medicine and Toxicology by Narayan Reddy, Edition 21, Page - 28,29 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following statement is false: March 2007, with the following options: A: Granulomatous inflammation is found in Crohn's disease., B: Perianal lesions are common in Crohn's disease, C: Stricture involving the colon is found in ulcerative colitis, D: Fistula formation is common in Crohn's disease. ### Response:

Ans. C: Stricture involving the colon is found in ulcerative colitisCrohn's disease/regional enteritis) is an autoimmune disease, which can affect any pa of the gastrointestinal tract from mouth to anus (terminal ileum is the area most commonly affected).Anal lesions are also commonThe disease is characterized by areas of inflammation with areas of normal lining between in a symptom known as skip lesions.Microscopy of Crohn's disease show focal areas of chronic inflammation involving all layers of the intestinal walls.There are non-caseating granulomas, but these are found in only 60% of patients.The main gastrointestinal symptoms are:Abdominal pain may be the initial symptom of Crohn's disease. It is often accompanied by diarrhea, especially in those who have had surgery. The diarrhea may or may not be bloody.The nature of the diarrhea in Crohn's disease depends on the pa of the small intestine or colon that is involved. Ileitis typically results in large-volume watery feces. Colitis may result in a smaller volume of feces of higher frequency.Visible bleeding in the feces is less common in Crohn's disease than in ulcerative colitis, but may be seen in the setting of Crohn's colitis.Although the association is greater in the context of ulcerative colitis, Crohn's disease may also be associated with primary sclerosing cholangitisPerianal discomfo may also be prominent in Crohn's disease. Itchiness or pain around the anus may be suggestive of inflammation, fistulization or abscess around the anal area or anal fissure.Crohn's disease is associated with a type of rheumatologic disease known as seronegative spondyloahropathy. This group of diseases is characterized by inflammation of one or more joints (ahritis) or muscle inseions (enthesitis). Common complications of inflammation include scarring that can produce intestinal blockage (obstruction) and deep ulcers penetrating through the bowel wall that can create pus-filled pockets of infection (abscesses) or abnormal connecting channels between the intestine and other organs (fistulas).When the large intestine is affected extensively by Crohn's disease, rectal bleeding commonly occurs.After many years, the risk of colon cancer (cancer of the large intestine) is greatly increased.About one third of people who develop Crohn's disease have problems around the anus, especially fistulas and cracks (fissures) in the lining of the mucus membrane of the anus.Crohn's disease may lead to complications in other pas of the body. These complications include gallstones, inadequate absorption of nutrients, urinary tract infections, kidney stones, and deposits of the protein amyloid in several organs (amyloidosis).A colonoscopy is the best test for making the diagnosis of Crohn's disease as it allows direct visualization of the colon and the terminal ileum, identifying the pattern of disease involvement. Finding a patchy distribution of disease, with involvement of the colon or ileum but not the rectum, is suggestive of Crohn's disease, as are other endoscopic stigmata. The most common disease that mimics the symptoms of Crohn's disease is ulcerative colitis, as both are inflammatory bowel diseases that can affect the colon with similar symptoms.It is impoant to differentiate these diseases, since the course of the diseases and treatments may be different.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following statement is false: March 2007, with the following options: A: Granulomatous inflammation is found in Crohn's disease., B: Perianal lesions are common in Crohn's disease, C: Stricture involving the colon is found in ulcerative colitis, D: Fistula formation is common in Crohn's disease. ### Response: Ans. C: Stricture involving the colon is found in ulcerative colitisCrohn's disease/regional enteritis) is an autoimmune disease, which can affect any pa of the gastrointestinal tract from mouth to anus (terminal ileum is the area most commonly affected).Anal lesions are also commonThe disease is characterized by areas of inflammation with areas of normal lining between in a symptom known as skip lesions.Microscopy of Crohn's disease show focal areas of chronic inflammation involving all layers of the intestinal walls.There are non-caseating granulomas, but these are found in only 60% of patients.The main gastrointestinal symptoms are:Abdominal pain may be the initial symptom of Crohn's disease. It is often accompanied by diarrhea, especially in those who have had surgery. The diarrhea may or may not be bloody.The nature of the diarrhea in Crohn's disease depends on the pa of the small intestine or colon that is involved. Ileitis typically results in large-volume watery feces. Colitis may result in a smaller volume of feces of higher frequency.Visible bleeding in the feces is less common in Crohn's disease than in ulcerative colitis, but may be seen in the setting of Crohn's colitis.Although the association is greater in the context of ulcerative colitis, Crohn's disease may also be associated with primary sclerosing cholangitisPerianal discomfo may also be prominent in Crohn's disease. Itchiness or pain around the anus may be suggestive of inflammation, fistulization or abscess around the anal area or anal fissure.Crohn's disease is associated with a type of rheumatologic disease known as seronegative spondyloahropathy. This group of diseases is characterized by inflammation of one or more joints (ahritis) or muscle inseions (enthesitis). Common complications of inflammation include scarring that can produce intestinal blockage (obstruction) and deep ulcers penetrating through the bowel wall that can create pus-filled pockets of infection (abscesses) or abnormal connecting channels between the intestine and other organs (fistulas).When the large intestine is affected extensively by Crohn's disease, rectal bleeding commonly occurs.After many years, the risk of colon cancer (cancer of the large intestine) is greatly increased.About one third of people who develop Crohn's disease have problems around the anus, especially fistulas and cracks (fissures) in the lining of the mucus membrane of the anus.Crohn's disease may lead to complications in other pas of the body. These complications include gallstones, inadequate absorption of nutrients, urinary tract infections, kidney stones, and deposits of the protein amyloid in several organs (amyloidosis).A colonoscopy is the best test for making the diagnosis of Crohn's disease as it allows direct visualization of the colon and the terminal ileum, identifying the pattern of disease involvement. Finding a patchy distribution of disease, with involvement of the colon or ileum but not the rectum, is suggestive of Crohn's disease, as are other endoscopic stigmata. The most common disease that mimics the symptoms of Crohn's disease is ulcerative colitis, as both are inflammatory bowel diseases that can affect the colon with similar symptoms.It is impoant to differentiate these diseases, since the course of the diseases and treatments may be different. ### 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 is the most common cause of delayed urinary tract obstructive symptoms after TURP, with the following options: A: Stricture of the Navicular fossa, B: Stricture of the membranous urethra, C: Stricture of the bulb of urethra, D: Bladder neck stenosis ### Response:

Complications of TURP Bleeding, urethral stricture or bladder neck contracture, perforation of the prostate capsule with extravasation, and if severe, TUR syndrome Late complications Bladder neck stenosis (4%) > Urethral stricture (3.6%) Bladder neck stenosis is seen more often with small (<30 gm) fibrotic prostate Bladder neck contracture Occasionally, a dense fibrotic stenosis of the bladder neck occurs following overaggressive resection of a small prostate. It may be due to the overuse of coagulating diathermy. Trans- urethral incision of the scar tissue is necessary using laser or diathermy. Ref: Bailey and love 27th edition Pgno :1467

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 is the most common cause of delayed urinary tract obstructive symptoms after TURP, with the following options: A: Stricture of the Navicular fossa, B: Stricture of the membranous urethra, C: Stricture of the bulb of urethra, D: Bladder neck stenosis ### Response: Complications of TURP Bleeding, urethral stricture or bladder neck contracture, perforation of the prostate capsule with extravasation, and if severe, TUR syndrome Late complications Bladder neck stenosis (4%) > Urethral stricture (3.6%) Bladder neck stenosis is seen more often with small (<30 gm) fibrotic prostate Bladder neck contracture Occasionally, a dense fibrotic stenosis of the bladder neck occurs following overaggressive resection of a small prostate. It may be due to the overuse of coagulating diathermy. Trans- urethral incision of the scar tissue is necessary using laser or diathermy. Ref: Bailey and love 27th edition Pgno :1467 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All of the following are malignancies caused by Epstein Barr (EB) virus, EXCEPT:, with the following options: A: Hodgkin's disease, B: Non-Hodgkin's lymphoma, C: Nasopharyngeal carcinoma, D: Multiple myeloma ### Response:

EBV can cause both malignant and nonmalignant diseases. Multiple myeloma is not associated with EBV infection. Non malignant diseases caused by EBV virus are Infectious mononucleosis, oral hairy leukoplakia, and X linked lymphoproliferative syndrome. Malignancies caused by EBV includes Burkitt's lymphoma, Hodgkins disease, Post transplant lymphoma, Tcell lymphoma, Nasopharyngeal carcinoma, Gastric carcinoma and Leiomyosarcoma. Ref: Sequelae and Long-Term Consequences of Infectious Diseases By Pina M. Fratamico, Page 352-3 ; Oral Microbiology At a Glance By Richard J. Lamon, Page 69

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All of the following are malignancies caused by Epstein Barr (EB) virus, EXCEPT:, with the following options: A: Hodgkin's disease, B: Non-Hodgkin's lymphoma, C: Nasopharyngeal carcinoma, D: Multiple myeloma ### Response: EBV can cause both malignant and nonmalignant diseases. Multiple myeloma is not associated with EBV infection. Non malignant diseases caused by EBV virus are Infectious mononucleosis, oral hairy leukoplakia, and X linked lymphoproliferative syndrome. Malignancies caused by EBV includes Burkitt's lymphoma, Hodgkins disease, Post transplant lymphoma, Tcell lymphoma, Nasopharyngeal carcinoma, Gastric carcinoma and Leiomyosarcoma. Ref: Sequelae and Long-Term Consequences of Infectious Diseases By Pina M. Fratamico, Page 352-3 ; Oral Microbiology At a Glance By Richard J. Lamon, Page 69 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Zero order kinetics is shown by which drug -, with the following options: A: Digoxin, B: Theophylline, C: Phenobarbitane, D: Etomidate ### Response:

Ans. is 'b' i.e., Theophylline 1 o Drugs showing zero/pseudo-zero order kinetics :# Phenytoin# Tolbutamide# Theophylline# Warfarin# Alcohol# Salicylates (Aspirin)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Zero order kinetics is shown by which drug -, with the following options: A: Digoxin, B: Theophylline, C: Phenobarbitane, D: Etomidate ### Response: Ans. is 'b' i.e., Theophylline 1 o Drugs showing zero/pseudo-zero order kinetics :# Phenytoin# Tolbutamide# Theophylline# Warfarin# Alcohol# Salicylates (Aspirin) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Greenstick fracture is -, with the following options: A: Incomplete transverse fracture pattern in children, B: Complete transverse fracture pattern in children, C: Incomplete spiral fracture pattern in children, D: Complete spiral fracture pattern in children ### Response:

Ans. is 'a' i.e., Incomplete transverse fracture pattern in children * A greenstick fracture is an incomplete transverse fracture pattern seen in children.* Greenstick fractures occur when an injuring force applied to a bone exceeds the limits of elasticity of the bone.* This results in the bone's bending to the point of bony disruption and fracture on the side opposite to the applied force.* However, a green-stick fracture is an incomplete fracture, in which the compressed cortex and periosteum remain intact.* Greenstick fractures of radius-ulna are common fractures in children and often result from a fall on a outstretched hands.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Greenstick fracture is -, with the following options: A: Incomplete transverse fracture pattern in children, B: Complete transverse fracture pattern in children, C: Incomplete spiral fracture pattern in children, D: Complete spiral fracture pattern in children ### Response: Ans. is 'a' i.e., Incomplete transverse fracture pattern in children * A greenstick fracture is an incomplete transverse fracture pattern seen in children.* Greenstick fractures occur when an injuring force applied to a bone exceeds the limits of elasticity of the bone.* This results in the bone's bending to the point of bony disruption and fracture on the side opposite to the applied force.* However, a green-stick fracture is an incomplete fracture, in which the compressed cortex and periosteum remain intact.* Greenstick fractures of radius-ulna are common fractures in children and often result from a fall on a outstretched hands. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: DNA replication and transcription occurs in which direction -, with the following options: A: 51-31, B: 5l-51, C: 31 -51, D: 31 -31 ### Response:

Ans. is 'a' i.e., 51 - 31 Elongation in DNA synthesiso Once the RNA primer has been synthesized at each of the replicating forks, a DNA polymerase III initiates the synthesis of new DNA strand by adding deoxyribonucleotides to the 31 end of RNA primer. Thus, both new strands are synthesized always in 51- 31 direction. Both the DNA strands are synthesized simultaneously, but in opposite direction.o During synthesis of RNA primer and synthesis of DNA strands, the nucleotides are added according to the sequence of base in the template strand, i.e. 'base pairing rule'. For example, an adenine nucleotide would enter at a thymine nucleotide.Elongation in transcriptiono The process of elongation proceeds after the formation of the first phosphodiester bond. After formation of approximately 10 phosphadiester bonds of new RNA, sigma (a) factor dissociates from the core enzyme. RNA polymerase utilize ribnucleotide triphosphate (ATP, GTP, CTP and UTP) for the formation of RNA.o RNA synthesis occurs in 51-3' direction (similar to DNA synthesis), i.e. genetic information is read in 31-51direction on template DNA and complementary base sequence is synthesized in 51-31 direction for RNA strand.o The selection of nucleotide is according to base-pairing rule, (e.g. U opposite to A and G opposite to C)o The process of elongation continues until a termiantion point is reached.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: DNA replication and transcription occurs in which direction -, with the following options: A: 51-31, B: 5l-51, C: 31 -51, D: 31 -31 ### Response: Ans. is 'a' i.e., 51 - 31 Elongation in DNA synthesiso Once the RNA primer has been synthesized at each of the replicating forks, a DNA polymerase III initiates the synthesis of new DNA strand by adding deoxyribonucleotides to the 31 end of RNA primer. Thus, both new strands are synthesized always in 51- 31 direction. Both the DNA strands are synthesized simultaneously, but in opposite direction.o During synthesis of RNA primer and synthesis of DNA strands, the nucleotides are added according to the sequence of base in the template strand, i.e. 'base pairing rule'. For example, an adenine nucleotide would enter at a thymine nucleotide.Elongation in transcriptiono The process of elongation proceeds after the formation of the first phosphodiester bond. After formation of approximately 10 phosphadiester bonds of new RNA, sigma (a) factor dissociates from the core enzyme. RNA polymerase utilize ribnucleotide triphosphate (ATP, GTP, CTP and UTP) for the formation of RNA.o RNA synthesis occurs in 51-3' direction (similar to DNA synthesis), i.e. genetic information is read in 31-51direction on template DNA and complementary base sequence is synthesized in 51-31 direction for RNA strand.o The selection of nucleotide is according to base-pairing rule, (e.g. U opposite to A and G opposite to C)o The process of elongation continues until a termiantion point is reached. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Good prognosis factors of ALL are all except, with the following options: A: Hyperdipoidy, B: WBC count < 50000, C: Age > 10 years, D: T (12:21) translocation ### Response:

Hyperdiploidy with chromosome number more than 50 is associated with good prognosis for ALL.Ceain chromosomal abnormalities like t(12;21) are also associated with good prognosis.Age > 10 years is a bad prognostic factor,the age group of 2-10 years have ourable outcome. WBC count less than 50,000/mm3 is also associated with good prognosis. Reference:Essential pediatrics-Ghai,8th edition,page no:600,601.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Good prognosis factors of ALL are all except, with the following options: A: Hyperdipoidy, B: WBC count < 50000, C: Age > 10 years, D: T (12:21) translocation ### Response: Hyperdiploidy with chromosome number more than 50 is associated with good prognosis for ALL.Ceain chromosomal abnormalities like t(12;21) are also associated with good prognosis.Age > 10 years is a bad prognostic factor,the age group of 2-10 years have ourable outcome. WBC count less than 50,000/mm3 is also associated with good prognosis. Reference:Essential pediatrics-Ghai,8th edition,page no:600,601. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Mechanism of action of oxybutynin is:-, with the following options: A: Cholinergic muscarinic receptor agonist, B: Cholinergic muscarinic receptor antagonist, C: Cholinergic nicotinic receptor antagonist, D: Cholinergic nicotinic receptor agonist ### Response:

Oxybutynin is an anticholinergic drug used in overactive bladder. It acts by blocking M3 muscarinic receptors. It has maximum risk of causing dry mouth and other anti-cholinergic adverse effects.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Mechanism of action of oxybutynin is:-, with the following options: A: Cholinergic muscarinic receptor agonist, B: Cholinergic muscarinic receptor antagonist, C: Cholinergic nicotinic receptor antagonist, D: Cholinergic nicotinic receptor agonist ### Response: Oxybutynin is an anticholinergic drug used in overactive bladder. It acts by blocking M3 muscarinic receptors. It has maximum risk of causing dry mouth and other anti-cholinergic adverse effects. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Aschoffs nodules are seen in:, with the following options: A: Subacute bacterial endocarditis, B: Libman sacks endocarditis, C: Rheumatic carditis, D: Non bacterial thrombotic endocarditis ### Response:

Aschoffs bodies are characteristic focal inflammatory lesion of acute rheumatic fever found in any of the three layers of the hea. (ref Robbins 7th/593,9/e558)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Aschoffs nodules are seen in:, with the following options: A: Subacute bacterial endocarditis, B: Libman sacks endocarditis, C: Rheumatic carditis, D: Non bacterial thrombotic endocarditis ### Response: Aschoffs bodies are characteristic focal inflammatory lesion of acute rheumatic fever found in any of the three layers of the hea. (ref Robbins 7th/593,9/e558) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True statement regarding base excision repair is ?, with the following options: A: Used only for the bases which are deaminated, B: Uses enzyme called as DNA glycosylase which generate abasic suger site, C: Removes about 10 – 15 nucleotide, D: Recognizes a bulk lesion ### Response:

- This is the first step of base excision repair. Bases modified by deamination, methylation, or by other chemical modification are removed by this kind of repair system.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True statement regarding base excision repair is ?, with the following options: A: Used only for the bases which are deaminated, B: Uses enzyme called as DNA glycosylase which generate abasic suger site, C: Removes about 10 – 15 nucleotide, D: Recognizes a bulk lesion ### Response: - This is the first step of base excision repair. Bases modified by deamination, methylation, or by other chemical modification are removed by this kind of repair system. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Memory T cell can be identified using the following marker, with the following options: A: CD45RA, B: CD45RB, C: CD45RC, D: CD45RO ### Response:

.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Memory T cell can be identified using the following marker, with the following options: A: CD45RA, B: CD45RB, C: CD45RC, D: CD45RO ### Response: . ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In ICDS the requirement in pregnant females is ?, with the following options: A: 300 cal, 15 gm protein, B: 300 cal , 25 gm protein, C: 500 cal, 15 gm protein, D: None ### Response:

Ans. is 'None' o According to 21st/e of Park, answer of this question is none as 600 calories and 18-20 grams of protein are recommended for pregnant and nursing women. Kishori Shakti Yojna (KSY) o KSY is rename of 'Adolescent Girl's scheme' under ICDS. Its aims are - To improve the nutritional and health status of adolescent girls To promote self development, awareness of health, hyiegene nutrition and family life and child care. o KSY covers 6118 ICDS projects.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In ICDS the requirement in pregnant females is ?, with the following options: A: 300 cal, 15 gm protein, B: 300 cal , 25 gm protein, C: 500 cal, 15 gm protein, D: None ### Response: Ans. is 'None' o According to 21st/e of Park, answer of this question is none as 600 calories and 18-20 grams of protein are recommended for pregnant and nursing women. Kishori Shakti Yojna (KSY) o KSY is rename of 'Adolescent Girl's scheme' under ICDS. Its aims are - To improve the nutritional and health status of adolescent girls To promote self development, awareness of health, hyiegene nutrition and family life and child care. o KSY covers 6118 ICDS projects. ### 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 an indication ofcotrimoxazole aEUR', with the following options: A: >Lower UTI, B: >Prostatitis, C: >Chancroid, D: >Typhoid ### Response:

Chancroid Corimoxazole in Typhoid Initially cotrimoxazole was an effective alternative to chloramphenicol. However, in many areas resistant S. typhi have appeared and now it is seldom used. Cotrimoxazole in chancroid Corimoxazole for 7 days is a 3rd choice inexpensive alternative to ceftriaxone, erythromycin or iprofloxacin. Cotrimoxazole It is a combination of sulfonamide (sulfamethoxazole) and trime- thoprim in the ratio of 1 :5. Cotrimoxazole was claimed to be more effective than either of its components individually in treating bacterial infections. Because of its associated greater incidence of adverse effects including allergic responses its widespread use has been restricted in many countries to very specific circumstances where its improved efficacy is demonstracted. Uses of Cotrimoxazole Upper and lower respiratory tract infections - Exacerbations of chronic bronchitis - For otitis media and sinusitis. - It should never be used for streptococcal pharyngitis. Urinary tract infections -Uncomplicated cystitis in non pregnant women. Especially valuable for chronic and recurrent cases. - Prostatitis (cotrimoxazole is concentrated in goodamounts in prostate) Pneumocystic carinii pneumonia -Drug of choice next to pentamidine for the treatment and prophylaxis of pneumonias caused by Pneumocystic Jirovecci (commonly seen in imtnunocompromised patients including those suffering from HIV/AIDS). Other conditions where cotrimoxazole finds its use. -Listeria monocytogens infections - Meliodosis - Shigellosis - Traveller's diarrhoeas (E. coli, Campylobacter, Shigella, Y. enterocolitica) - Prophylaxis of cerebral toxoplasmosis - Whipple's disease - Salmonella (typhoid) initially it was responsive but now resistant strains have emerged. - Chancroid According to K.D.T. - Cotrimoxaxole can be used in both chancroid and typhoid. According to Harrison (18/e) Cotrimoxazole is used in Typhoid but it is not used in chancroid. Antiobiotic therapy in typhoid Empirical Ceftriaxone Azithromycin Fully susceptible Ciprofloxacin Amoxicillin Chloramphenicol Cotritnoxazole Multidrug resistant Ciprofloxacin Ceftriaxonl Azithromycin Nalidixic acid resistant Ceftriaxone Azithromycin High dose ciprofloxacin Treatment of chancroid Ciprofloxacin Ceftriaxone Azithromycin

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 an indication ofcotrimoxazole aEUR', with the following options: A: >Lower UTI, B: >Prostatitis, C: >Chancroid, D: >Typhoid ### Response: Chancroid Corimoxazole in Typhoid Initially cotrimoxazole was an effective alternative to chloramphenicol. However, in many areas resistant S. typhi have appeared and now it is seldom used. Cotrimoxazole in chancroid Corimoxazole for 7 days is a 3rd choice inexpensive alternative to ceftriaxone, erythromycin or iprofloxacin. Cotrimoxazole It is a combination of sulfonamide (sulfamethoxazole) and trime- thoprim in the ratio of 1 :5. Cotrimoxazole was claimed to be more effective than either of its components individually in treating bacterial infections. Because of its associated greater incidence of adverse effects including allergic responses its widespread use has been restricted in many countries to very specific circumstances where its improved efficacy is demonstracted. Uses of Cotrimoxazole Upper and lower respiratory tract infections - Exacerbations of chronic bronchitis - For otitis media and sinusitis. - It should never be used for streptococcal pharyngitis. Urinary tract infections -Uncomplicated cystitis in non pregnant women. Especially valuable for chronic and recurrent cases. - Prostatitis (cotrimoxazole is concentrated in goodamounts in prostate) Pneumocystic carinii pneumonia -Drug of choice next to pentamidine for the treatment and prophylaxis of pneumonias caused by Pneumocystic Jirovecci (commonly seen in imtnunocompromised patients including those suffering from HIV/AIDS). Other conditions where cotrimoxazole finds its use. -Listeria monocytogens infections - Meliodosis - Shigellosis - Traveller's diarrhoeas (E. coli, Campylobacter, Shigella, Y. enterocolitica) - Prophylaxis of cerebral toxoplasmosis - Whipple's disease - Salmonella (typhoid) initially it was responsive but now resistant strains have emerged. - Chancroid According to K.D.T. - Cotrimoxaxole can be used in both chancroid and typhoid. According to Harrison (18/e) Cotrimoxazole is used in Typhoid but it is not used in chancroid. Antiobiotic therapy in typhoid Empirical Ceftriaxone Azithromycin Fully susceptible Ciprofloxacin Amoxicillin Chloramphenicol Cotritnoxazole Multidrug resistant Ciprofloxacin Ceftriaxonl Azithromycin Nalidixic acid resistant Ceftriaxone Azithromycin High dose ciprofloxacin Treatment of chancroid Ciprofloxacin Ceftriaxone Azithromycin ### 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 recommended dose of steroids for attaining fetal lung maturity?, with the following options: A: Inj Betamethasone 12 mg for 2 doses 12 hours apart, B: Inj Betamethasone 12 mg for 2 doses 24 hours apart, C: Inj Dexamethasone 6 mg for 4 doses 24 hours apart, D: Inj Dexamethasone 12 mg for 2 doses 12 hours apart ### Response:

b. Inj Betamethasone 12mg for 2 doses 24 hours apart(Ref: Nelson's 20/e p 852)Inj Betamethasone 12mg IM 2 doses, 24 hrs apart or Inj Dexamethasone 6mg IM every 12 hrs for 4 doses can be used

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 recommended dose of steroids for attaining fetal lung maturity?, with the following options: A: Inj Betamethasone 12 mg for 2 doses 12 hours apart, B: Inj Betamethasone 12 mg for 2 doses 24 hours apart, C: Inj Dexamethasone 6 mg for 4 doses 24 hours apart, D: Inj Dexamethasone 12 mg for 2 doses 12 hours apart ### Response: b. Inj Betamethasone 12mg for 2 doses 24 hours apart(Ref: Nelson's 20/e p 852)Inj Betamethasone 12mg IM 2 doses, 24 hrs apart or Inj Dexamethasone 6mg IM every 12 hrs for 4 doses can be used ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cicatrising alopecia with perifollicular blue-gray patches is most commonly associated with:, with the following options: A: Pitting of nails, B: Whitish lesions in the buccal mucosa, C: Ahritis, D: Discoid plaques in the face ### Response:

Cicatrising alopecia with perifollicular blue-gray patches is likely to be associated with whitish lesions in buccal mucosa which is characteristic of Lichen planus. Ref: Cicatricial Alopecia: An approach to diagnosis and management, By Vera Price, Paradi Mirmirani, Page 1-5.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cicatrising alopecia with perifollicular blue-gray patches is most commonly associated with:, with the following options: A: Pitting of nails, B: Whitish lesions in the buccal mucosa, C: Ahritis, D: Discoid plaques in the face ### Response: Cicatrising alopecia with perifollicular blue-gray patches is likely to be associated with whitish lesions in buccal mucosa which is characteristic of Lichen planus. Ref: Cicatricial Alopecia: An approach to diagnosis and management, By Vera Price, Paradi Mirmirani, Page 1-5. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: To test the association between risk factor and disease, which of the following is the wakest study design -, with the following options: A: Case-control study, B: Ecological study, C: Coho study, D: Cross-sectional study ### Response:

Ans. is 'b' i.e., Ecological study To test the association between risk factor and diseaseo Most reliable, overall --> systematic review and meta-analysis of RCTso Most reliable individual study --> Randomized controlled trial.o Most reliable observational analytic study Coho studyo Least reliable study and least reliable observational analytic study --> Ecological study.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: To test the association between risk factor and disease, which of the following is the wakest study design -, with the following options: A: Case-control study, B: Ecological study, C: Coho study, D: Cross-sectional study ### Response: Ans. is 'b' i.e., Ecological study To test the association between risk factor and diseaseo Most reliable, overall --> systematic review and meta-analysis of RCTso Most reliable individual study --> Randomized controlled trial.o Most reliable observational analytic study Coho studyo Least reliable study and least reliable observational analytic study --> Ecological study. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is the first sign of pubey in girls?, with the following options: A: Pubarche, B: Thelarche, C: Menarche, D: Growth spu ### Response:

Adolescence: Stage of transmission from childhood to adulthood. During this stage, there will be an appearance of sexual characters with changes in cognition and psychology. Adolescence refers to this entire process, pubey refers to the physical aspect. Age 10-19 year is considered as a period of adolescence and pubey marks the early half of adolescence. Pubey in girls stas with breast development( thelarche) anytime between 8-13 years. This is followed by an appearance of pubic hair ( pubarche) and subsequently menstruation ( menarche), occurring at an average of 12.6 years. Menarche occurs after 2-21/2 years of thelarche. In boys, the earliest change is an increase in testicular size( testicular volume reaching 4 ml) and this occurs between 9-14 years. This is followed by an appearance of pubic hair and lengthening of the penis. Spermarche( sperm production) stas during mid-adolescence. Laryngeal growth, manifesting as cracking of voice, begins in boys in mid-pubey, deepening of voice is complete by end of pubey. During pubey, boys gain 20-30 cm and girls 16-28 cm of height. Peak growth velocity in girls occurs before attainment of menarche. Boys have their peak growth in later stages of pubey. Reference: GHAI Essential pediatrics, 8th edition

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is the first sign of pubey in girls?, with the following options: A: Pubarche, B: Thelarche, C: Menarche, D: Growth spu ### Response: Adolescence: Stage of transmission from childhood to adulthood. During this stage, there will be an appearance of sexual characters with changes in cognition and psychology. Adolescence refers to this entire process, pubey refers to the physical aspect. Age 10-19 year is considered as a period of adolescence and pubey marks the early half of adolescence. Pubey in girls stas with breast development( thelarche) anytime between 8-13 years. This is followed by an appearance of pubic hair ( pubarche) and subsequently menstruation ( menarche), occurring at an average of 12.6 years. Menarche occurs after 2-21/2 years of thelarche. In boys, the earliest change is an increase in testicular size( testicular volume reaching 4 ml) and this occurs between 9-14 years. This is followed by an appearance of pubic hair and lengthening of the penis. Spermarche( sperm production) stas during mid-adolescence. Laryngeal growth, manifesting as cracking of voice, begins in boys in mid-pubey, deepening of voice is complete by end of pubey. During pubey, boys gain 20-30 cm and girls 16-28 cm of height. Peak growth velocity in girls occurs before attainment of menarche. Boys have their peak growth in later stages of pubey. Reference: GHAI Essential pediatrics, 8th edition ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: NOT a content of Jugular Foramen, with the following options: A: Hypoglossal nerve, B: Glossopharyngeal nerve, C: Occipital arteries, D: Sigmoidal sinus ### Response:

(A) Hypoglossal nerve# JUGULAR FORAMEN may be subdivided into three compartments, each with their own contents.> Anterior compartment transmits the inferior petrosal sinus.> Intermediate transmits the glossopharyngeal, vagus, and accessory nerves ( cranial nerves number IX, X, and XI respectively).> Posterior transmits the sigmoid sinus (becoming the internal jugular vein) and some meningeal branches from the occipital and ascending pharyngeal arteries.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: NOT a content of Jugular Foramen, with the following options: A: Hypoglossal nerve, B: Glossopharyngeal nerve, C: Occipital arteries, D: Sigmoidal sinus ### Response: (A) Hypoglossal nerve# JUGULAR FORAMEN may be subdivided into three compartments, each with their own contents.> Anterior compartment transmits the inferior petrosal sinus.> Intermediate transmits the glossopharyngeal, vagus, and accessory nerves ( cranial nerves number IX, X, and XI respectively).> Posterior transmits the sigmoid sinus (becoming the internal jugular vein) and some meningeal branches from the occipital and ascending pharyngeal arteries. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Nail pitting is caused by all except -, with the following options: A: Lichen planus, B: Psoriasis, C: Alopecia areata, D: Pityriasis Rosacea ### Response:

Nail involvement is common in alopecia areata, paicularly in severe forms. Pitting is the most common finding, but other abnormalities such as trachyonychia have been repoed. Nail plate pitting tends to be more shallow and regularly spaced than in psori-atic nail pitting Nail pitting is often a sign of another condition that can include: psoriasis, which causes skin inflammation. reactive ahritis or inflammation caused by an infection elsewhere. alopecia areata, which causes temporary bald patches on the scalp. Ref Harrison20th edition pg 1278

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Nail pitting is caused by all except -, with the following options: A: Lichen planus, B: Psoriasis, C: Alopecia areata, D: Pityriasis Rosacea ### Response: Nail involvement is common in alopecia areata, paicularly in severe forms. Pitting is the most common finding, but other abnormalities such as trachyonychia have been repoed. Nail plate pitting tends to be more shallow and regularly spaced than in psori-atic nail pitting Nail pitting is often a sign of another condition that can include: psoriasis, which causes skin inflammation. reactive ahritis or inflammation caused by an infection elsewhere. alopecia areata, which causes temporary bald patches on the scalp. Ref Harrison20th edition pg 1278 ### 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 most probable cause of this condition?, with the following options: A: Chronic lymphedema, B: Chronic aerial blockage, C: Chronic venous blockage, D: Chronic venous insufficiency ### Response:

In the given image :- Buffalo hump, squaring of toes :- chronic lymphedema Unlike other types of oedema,lymphedema characteristically involves the foot.The contour of the ankle is lost through infilling of the submalleolar depressions,a "buffalo hump" forms on the dorsum of the foot,the toes appear"square" because of confinement of footwear and the skin on the dorsum of the toes cannot be pinched because of subcutaneous fibrosis(Stemmer's sign)

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 most probable cause of this condition?, with the following options: A: Chronic lymphedema, B: Chronic aerial blockage, C: Chronic venous blockage, D: Chronic venous insufficiency ### Response: In the given image :- Buffalo hump, squaring of toes :- chronic lymphedema Unlike other types of oedema,lymphedema characteristically involves the foot.The contour of the ankle is lost through infilling of the submalleolar depressions,a "buffalo hump" forms on the dorsum of the foot,the toes appear"square" because of confinement of footwear and the skin on the dorsum of the toes cannot be pinched because of subcutaneous fibrosis(Stemmer's sign) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Floating water-lily sign is feature of:, with the following options: A: Lung Hydatid, B: Bronchial adenoma, C: Lung abscess, D: Aspergilloma ### Response:

C i.e. Pulmonary Hamaoma Calcification type Condition associated Pop corn calcification Pulmonary hamaomaQ, mediastinal lymph nodes of acute histoplasmosis. Egg shell (peripheral) calcification SilicosisQ, SarcoidosisQ Rice grain calcification CysticercosisQ Tram track (Rail road) calcification Struge Weber syndromeQ Basal ganglion calcification Hyper parathyroidism Cardiac calcification Carcinoid syndrome Pericardial calcification Constructive pericarditis Not calcify Hydatid cyst in lungQ

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Floating water-lily sign is feature of:, with the following options: A: Lung Hydatid, B: Bronchial adenoma, C: Lung abscess, D: Aspergilloma ### Response: C i.e. Pulmonary Hamaoma Calcification type Condition associated Pop corn calcification Pulmonary hamaomaQ, mediastinal lymph nodes of acute histoplasmosis. Egg shell (peripheral) calcification SilicosisQ, SarcoidosisQ Rice grain calcification CysticercosisQ Tram track (Rail road) calcification Struge Weber syndromeQ Basal ganglion calcification Hyper parathyroidism Cardiac calcification Carcinoid syndrome Pericardial calcification Constructive pericarditis Not calcify Hydatid cyst in lungQ ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A normal MCV would be expected in a patient with which one of the following conditions?, with the following options: A: Resection of the terminal ileum, B: b-thalassemia minor, C: 2 days post-acute bleed, D: Chronic bleeding duodenal ulcer ### Response:

A patient who is 2 days post-acute bleed will have a normal MCV because the bone marrow has not had enough time to release reticulocytes into the peripheral blood. Reticulocytes are larger than a mature RBC and could potentially increase the MCV. The other choices in the question are conditions associated with either an increase or decrease in the MCV. A pregnant woman not taking vitamin supplements will very likely develop folate deficiency because she has only a 3-4 month supply of the vitamin in her liver. A patient with resection of the terminal ileum will develop vitamin B deficiency, since the terminal ileum has receptors for the vitamin B factor complex for reabsorption. The patient with b- thalassemia minor as well as the patient with a chronic bleeding peptic ulcer will have a microcytic anemia, the former from a decrease in globin-chain synthesis, and the latter secondary to iron deficiency.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A normal MCV would be expected in a patient with which one of the following conditions?, with the following options: A: Resection of the terminal ileum, B: b-thalassemia minor, C: 2 days post-acute bleed, D: Chronic bleeding duodenal ulcer ### Response: A patient who is 2 days post-acute bleed will have a normal MCV because the bone marrow has not had enough time to release reticulocytes into the peripheral blood. Reticulocytes are larger than a mature RBC and could potentially increase the MCV. The other choices in the question are conditions associated with either an increase or decrease in the MCV. A pregnant woman not taking vitamin supplements will very likely develop folate deficiency because she has only a 3-4 month supply of the vitamin in her liver. A patient with resection of the terminal ileum will develop vitamin B deficiency, since the terminal ileum has receptors for the vitamin B factor complex for reabsorption. The patient with b- thalassemia minor as well as the patient with a chronic bleeding peptic ulcer will have a microcytic anemia, the former from a decrease in globin-chain synthesis, and the latter secondary to iron deficiency. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Neurofibromomatosis I is, with the following options: A: AD, B: AR, C: X linked recessive, D: X linked dominant ### Response:

Autosomal Dominant Inheritance Familial hypercholesterolemia Marfan syndrome Ehlers-Danlos syndrome Hereditary spherocytosis Neurofibromatosis, type 1 Adult polycystic kidney disease Autosomal Recessive Inheritance Cystic fibrosis Phenylketonuria Tay-Sachs disease Severe combined immunodeficiency a- and b-Thalassemias Sickle cell anemia X-linked Recessive Inheritance Hemophilia A Duchenne/Becker muscular dystrophy Fragile X syndrome (Robbins Basic Pathology,9th edition,pg no. 219)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Neurofibromomatosis I is, with the following options: A: AD, B: AR, C: X linked recessive, D: X linked dominant ### Response: Autosomal Dominant Inheritance Familial hypercholesterolemia Marfan syndrome Ehlers-Danlos syndrome Hereditary spherocytosis Neurofibromatosis, type 1 Adult polycystic kidney disease Autosomal Recessive Inheritance Cystic fibrosis Phenylketonuria Tay-Sachs disease Severe combined immunodeficiency a- and b-Thalassemias Sickle cell anemia X-linked Recessive Inheritance Hemophilia A Duchenne/Becker muscular dystrophy Fragile X syndrome (Robbins Basic Pathology,9th edition,pg no. 219) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Appendix of testis is remnant of ?, with the following options: A: Mesonephric duct, B: Mesonephric tubules, C: Wolffian duct, D: Mullerian duct ### Response:

Mullerian duct

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Appendix of testis is remnant of ?, with the following options: A: Mesonephric duct, B: Mesonephric tubules, C: Wolffian duct, D: Mullerian duct ### Response: Mullerian duct ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Lower esophageal sphincter lies at what distance from the incisor teeth?, with the following options: A: 15cm, B: 25cm, C: 40cm, D: 50cm ### Response:

Ans. is 'c' i.e., 40cm * 2nd constriction is at T4 level where arch of aorta crosses esophagus.Esophageal constrictionsNumberDistance from incisorBony levelAnatomical landmark1st15 cm (6 inches)C6At its beginning (pharyngo-esophageal junction)2nd22.5 cm (9 inches)T4Crossing of aortic arch3rd27.5 cm (11 inches)T6Crossing of left main bronchus4th37.5 - 40 cm (15-16 inches)T10Piercing diaphragm (at lower esophageal sphmotor)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Lower esophageal sphincter lies at what distance from the incisor teeth?, with the following options: A: 15cm, B: 25cm, C: 40cm, D: 50cm ### Response: Ans. is 'c' i.e., 40cm * 2nd constriction is at T4 level where arch of aorta crosses esophagus.Esophageal constrictionsNumberDistance from incisorBony levelAnatomical landmark1st15 cm (6 inches)C6At its beginning (pharyngo-esophageal junction)2nd22.5 cm (9 inches)T4Crossing of aortic arch3rd27.5 cm (11 inches)T6Crossing of left main bronchus4th37.5 - 40 cm (15-16 inches)T10Piercing diaphragm (at lower esophageal sphmotor) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Obstruction of IVC leads to, with the following options: A: Dilatation of thoracoepigastric veins, B: Caput medusae, C: Hemorrhoids, D: Esophageal varices ### Response:

.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Obstruction of IVC leads to, with the following options: A: Dilatation of thoracoepigastric veins, B: Caput medusae, C: Hemorrhoids, D: Esophageal varices ### Response: . ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Duplication of GIT most commonly involves?, with the following options: A: Esophagus, B: Stomach, C: Duodenum, D: Ileum ### Response:

Answer is 'd' i.e. Ileum "The term duplication actually is a misnomer, since approximately 75% are enteric cysts & not true duplication. The remainder are true tubular duplications that are intimately attached to the adjacent poion of the G.I.T, possesses a gastrointestinal type of mucosal lining & may or may not communicate with the visceral lumen. Duplications occur on the mesenteric side of the intestine between the leaves of the mesentery & are most often found in the Ileum. Cystic lesions may present with symptoms of obstruction from extrinsic compression. Communicating tubular duplication often are lined by gastric mucosa, which may ulcerate and present with gastrointestinal hemorrhage or perforation. In addition, cancers have been repoed to arise in the mucosal lining of these duplications. Treatment is surgical resection. Small tubular duplications and all cysts are excised along with overlying normal intestine; intestinal continuity is restored by end-to-end anastomosis" - Schwaz

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Duplication of GIT most commonly involves?, with the following options: A: Esophagus, B: Stomach, C: Duodenum, D: Ileum ### Response: Answer is 'd' i.e. Ileum "The term duplication actually is a misnomer, since approximately 75% are enteric cysts & not true duplication. The remainder are true tubular duplications that are intimately attached to the adjacent poion of the G.I.T, possesses a gastrointestinal type of mucosal lining & may or may not communicate with the visceral lumen. Duplications occur on the mesenteric side of the intestine between the leaves of the mesentery & are most often found in the Ileum. Cystic lesions may present with symptoms of obstruction from extrinsic compression. Communicating tubular duplication often are lined by gastric mucosa, which may ulcerate and present with gastrointestinal hemorrhage or perforation. In addition, cancers have been repoed to arise in the mucosal lining of these duplications. Treatment is surgical resection. Small tubular duplications and all cysts are excised along with overlying normal intestine; intestinal continuity is restored by end-to-end anastomosis" - Schwaz ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A women at 8 months of pregnancy complains of abdominal pain and slight vaginal bleed. On examination the uterus is tender with size more than expected for dates with absent fetal hea sounds. The diagnosis, with the following options: A: Hydramnios, B: Concealed haemorrhage, C: Active labour, D: Uterine rupture ### Response:

This is a case of abruption with concealed retroplacental bleed which makes the uterus tender and also increase the uterine height. Please note that there may be some amount of vaginal bleeding in concealed hemorrhage as well. The uterine tenderness is also because of bruising of the uterine surface. With abruption the fetal hea sounds are often not heard due to the taut abdominal wall and hypeonic uterus, even when the fetus is alive. If the fetal hea rate is normal, the best management here is to induce labour,

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A women at 8 months of pregnancy complains of abdominal pain and slight vaginal bleed. On examination the uterus is tender with size more than expected for dates with absent fetal hea sounds. The diagnosis, with the following options: A: Hydramnios, B: Concealed haemorrhage, C: Active labour, D: Uterine rupture ### Response: This is a case of abruption with concealed retroplacental bleed which makes the uterus tender and also increase the uterine height. Please note that there may be some amount of vaginal bleeding in concealed hemorrhage as well. The uterine tenderness is also because of bruising of the uterine surface. With abruption the fetal hea sounds are often not heard due to the taut abdominal wall and hypeonic uterus, even when the fetus is alive. If the fetal hea rate is normal, the best management here is to induce labour, ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Crystalline Lens is derived from (JIPMER May 2019), with the following options: A: Surface ectoderm, B: Neuroectoderm, C: Mesoderm, D: Endoderm ### Response:

- Eye ball have contribution from several structures - Neural plate ectoderm forms Neural tube form - CNS which have diencephalon pa of brain aExtension of diencephalon (optic sulcus) into eyeball form retina (optic cup) & optic nerve (optic stalk) - Neural plate ectoderm also forms - epithelium of ciliary body & iris muscle - Muscles of Iris - Sphincter pupillae, dilator pupillae - Eye ball have some contribution from surface ectoderm as well which gives Surface epithelium of cornea (1st layer) Eye lens - Most of derivatives in eyeball come from neural crest cells which gives Secondary mesoderm of eyeball - Forms sclera, choroid, ciliary body & Iris (not epithelium) - All other layers of cornea except 1st layer develops from N.C.C

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Crystalline Lens is derived from (JIPMER May 2019), with the following options: A: Surface ectoderm, B: Neuroectoderm, C: Mesoderm, D: Endoderm ### Response: - Eye ball have contribution from several structures - Neural plate ectoderm forms Neural tube form - CNS which have diencephalon pa of brain aExtension of diencephalon (optic sulcus) into eyeball form retina (optic cup) & optic nerve (optic stalk) - Neural plate ectoderm also forms - epithelium of ciliary body & iris muscle - Muscles of Iris - Sphincter pupillae, dilator pupillae - Eye ball have some contribution from surface ectoderm as well which gives Surface epithelium of cornea (1st layer) Eye lens - Most of derivatives in eyeball come from neural crest cells which gives Secondary mesoderm of eyeball - Forms sclera, choroid, ciliary body & Iris (not epithelium) - All other layers of cornea except 1st layer develops from N.C.C ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In acute inflammation, excessive fluid seepage occurs due to increased permeability of?, with the following options: A: Venules, B: Capillaries, C: Arterioles, D: Arterioles and capillaries ### Response:

Postcapillary venules are an important point of interchange between the Lumen of the vessels and the surrounding tissue. Moreover, both vascular leakage and Leukocyte exudation occur preferentially in venules in many types of inflammation. Increased vascular permeability is the hallmark of acute inflammation.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In acute inflammation, excessive fluid seepage occurs due to increased permeability of?, with the following options: A: Venules, B: Capillaries, C: Arterioles, D: Arterioles and capillaries ### Response: Postcapillary venules are an important point of interchange between the Lumen of the vessels and the surrounding tissue. Moreover, both vascular leakage and Leukocyte exudation occur preferentially in venules in many types of inflammation. Increased vascular permeability is the hallmark of acute inflammation. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: 5 yr old male had fever and cervical lymphadenopathy. Histopathologic examination of cervical lymph nodes shows:, with the following options: A: Caseating granuloma, B: Non caseating granuloma, C: Stellate granuloma, D: Fat necrosis ### Response:

Ans. (a) Caseating granulomaCaseating granuloma typical granuloma resulting from infection with Mycobacterium tuberculosis showing central area of caseous necrosis, activated epithelioid macrophages, giant cells, and a peripheral accumulation of lymphocytes.. We can also see langhans giant cell at 3, 0 clock position in image

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: 5 yr old male had fever and cervical lymphadenopathy. Histopathologic examination of cervical lymph nodes shows:, with the following options: A: Caseating granuloma, B: Non caseating granuloma, C: Stellate granuloma, D: Fat necrosis ### Response: Ans. (a) Caseating granulomaCaseating granuloma typical granuloma resulting from infection with Mycobacterium tuberculosis showing central area of caseous necrosis, activated epithelioid macrophages, giant cells, and a peripheral accumulation of lymphocytes.. We can also see langhans giant cell at 3, 0 clock position in image ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 57-year- old lady came with chief complaints of fatigue. On fuher questioning, she reveals that she has gained 5 kg weight in one month. She has been taking L-thyroxine for hypothyroidism since 10 years and fairly controlled. Recently she was staed on an anti-arrhythmic drug for treatment of his cardiac condition. The symptoms staed after sta of this drug. Most likely anti-arrhythmic drug she was prescribed is?, with the following options: A: Lignocaine, B: Amiodarone, C: Procainamide, D: Verapamil ### Response:

The patient is already a case of hypothyroidism stabilized on thyroxine. Amiodarone is an antiarrhythmic drug with side effects on the thyroid gland and thyroid hormones. It inhibits peripheral conversion of T4 to T3. It contains iodine and can inhibit the formation of thyroid hormones. Most likely Amiodarone would have resulted in loss of control over the hypothyroidism. Procainamide, lidocaine and verapamil are also anti-arrhythmics but have no role on thyroid.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 57-year- old lady came with chief complaints of fatigue. On fuher questioning, she reveals that she has gained 5 kg weight in one month. She has been taking L-thyroxine for hypothyroidism since 10 years and fairly controlled. Recently she was staed on an anti-arrhythmic drug for treatment of his cardiac condition. The symptoms staed after sta of this drug. Most likely anti-arrhythmic drug she was prescribed is?, with the following options: A: Lignocaine, B: Amiodarone, C: Procainamide, D: Verapamil ### Response: The patient is already a case of hypothyroidism stabilized on thyroxine. Amiodarone is an antiarrhythmic drug with side effects on the thyroid gland and thyroid hormones. It inhibits peripheral conversion of T4 to T3. It contains iodine and can inhibit the formation of thyroid hormones. Most likely Amiodarone would have resulted in loss of control over the hypothyroidism. Procainamide, lidocaine and verapamil are also anti-arrhythmics but have no role on thyroid. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Neurological complications of meningitis include all of the following, except:, with the following options: A: Seizures., B: Increased intra-cranial pressure., C: Cerebral hamartoma., D: Subdural effusions. ### Response:

Ans. is 'c' i.e. Cerebral hamartoma Cerebral hamartoma is a benign, neoplastic condition and is not associated with meningitis.Complications of MeningitisHydrocephalusCranial nerve involvementSeizuresSubdural effusionsSubdural empyemaCerebral herniation d/t increased ICT.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Neurological complications of meningitis include all of the following, except:, with the following options: A: Seizures., B: Increased intra-cranial pressure., C: Cerebral hamartoma., D: Subdural effusions. ### Response: Ans. is 'c' i.e. Cerebral hamartoma Cerebral hamartoma is a benign, neoplastic condition and is not associated with meningitis.Complications of MeningitisHydrocephalusCranial nerve involvementSeizuresSubdural effusionsSubdural empyemaCerebral herniation d/t increased ICT. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: HLA Complex in human is located on chromosome?, with the following options: A: Chromosome 5, B: Chromosome 6, C: Chromosome 7, D: Chromosome 8 ### Response:

Harshmohan textbook of pathology 7th edition. *HLA or MHC are located on sho arm of chromosome 6.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: HLA Complex in human is located on chromosome?, with the following options: A: Chromosome 5, B: Chromosome 6, C: Chromosome 7, D: Chromosome 8 ### Response: Harshmohan textbook of pathology 7th edition. *HLA or MHC are located on sho arm of chromosome 6. ### 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 false regarding point source single exposure epidemic?, with the following options: A: Often explosive, B: Is caused by infectious agents only, C: Cases develop within incubation period only, D: Rapid rise and fall of epidemic curve occurs ### Response:

Point source single epidemic is commonly caused by infectious agent but not always. The example of non infectious agents being involved include Bhopal gas tragedy, Chernobyl tragedy etc. Ref: Park, 21st Edition, Pages 60, 61.

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 false regarding point source single exposure epidemic?, with the following options: A: Often explosive, B: Is caused by infectious agents only, C: Cases develop within incubation period only, D: Rapid rise and fall of epidemic curve occurs ### Response: Point source single epidemic is commonly caused by infectious agent but not always. The example of non infectious agents being involved include Bhopal gas tragedy, Chernobyl tragedy etc. Ref: Park, 21st Edition, Pages 60, 61. ### 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 of the following is not a content of inguinal canal?, with the following options: A: Spermatic cord, B: Round ligament, C: Ilioinguinal nerve, D: Pudendal nerve ### Response:

Contents of inguinal canal: Spermatic cord- in males Round ligament- in females Ilioinguinal nerve Genital branch of genitofemoral nerve

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which is of the following is not a content of inguinal canal?, with the following options: A: Spermatic cord, B: Round ligament, C: Ilioinguinal nerve, D: Pudendal nerve ### Response: Contents of inguinal canal: Spermatic cord- in males Round ligament- in females Ilioinguinal nerve Genital branch of genitofemoral nerve ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Probenecid interacts with ?, with the following options: A: Streptomycin, B: Ampicillin, C: Vancomycin, D: Erythromycin ### Response:

Ans. is 'b' i.e., Ampicillin Interactions of probenecid Probenecid inhibits urinary excretion of penicillins, cephalosporins, methotrexate, sulfonamides and indomethacin. It inhibits biliary excretion of rifampicin. Salicylates block uricosuric action of probenecid. Probenecid inhibits tubular secretion of nitrofurantoin. Pyrazinamide and ethambutol may interfere with uricosuric action of probenecid. Note : Ampicillin is a penicillin.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Probenecid interacts with ?, with the following options: A: Streptomycin, B: Ampicillin, C: Vancomycin, D: Erythromycin ### Response: Ans. is 'b' i.e., Ampicillin Interactions of probenecid Probenecid inhibits urinary excretion of penicillins, cephalosporins, methotrexate, sulfonamides and indomethacin. It inhibits biliary excretion of rifampicin. Salicylates block uricosuric action of probenecid. Probenecid inhibits tubular secretion of nitrofurantoin. Pyrazinamide and ethambutol may interfere with uricosuric action of probenecid. Note : Ampicillin is a penicillin. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cause of neonatal hyperbilirubinemia ?, with the following options: A: Inefficient ervthropoiesis, B: RBC hemoglobin, C: Immature liver enzyme, D: All of above ### Response:

Ans. is 'd' i.e., All of aboveAvery -textbook of neonatology (P.1536/ed 6th)o 75% of daily billirubin production in Neonats came from normal destruction of circulating RBC.o 25% comes from other factor like.Ineffective erythropoiesisDestruction of immature RBCo Immature UDPGT activity in foetal liver especially preterm baby.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cause of neonatal hyperbilirubinemia ?, with the following options: A: Inefficient ervthropoiesis, B: RBC hemoglobin, C: Immature liver enzyme, D: All of above ### Response: Ans. is 'd' i.e., All of aboveAvery -textbook of neonatology (P.1536/ed 6th)o 75% of daily billirubin production in Neonats came from normal destruction of circulating RBC.o 25% comes from other factor like.Ineffective erythropoiesisDestruction of immature RBCo Immature UDPGT activity in foetal liver especially preterm baby. ### 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 oxytocin are all except -, with the following options: A: Synthesized by paraventricular nucleus of hypothalamus, B: Secreted by posterior pituitary, C: Causes uterine contraction of body, D: Causes contraction of lower segment ### Response:

Ans. is 'd' i.e., Causes contraction of lower segmentOxytocino Oxytocin is a nonapeptide, synthesized predominantly in the paraventricular nucleus of the hypothalamus along with its binding protein neurophysin II. Oxytocin has following physiological actions : -Uterus : - It increases the force and frequency of uterine contraction. Estrogens sensitize the uterus to oxytocin, while progestins decrease the sensitivity. The increased contractility is restricted to the fundus and body, lower segment is not contracted, may even be relaxed at term.Breast: - Oxytocin contracts myoepithelium of mammary alveoli and forces milk into bigger sinusuids - Milk ejection or milk letdown reflex.o Oxytocin secretion is inhibited by sympathetic discharge and circulating catecholamines, by pain and enkephalins, by emotional stress, especially fear, and by alcohol.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about oxytocin are all except -, with the following options: A: Synthesized by paraventricular nucleus of hypothalamus, B: Secreted by posterior pituitary, C: Causes uterine contraction of body, D: Causes contraction of lower segment ### Response: Ans. is 'd' i.e., Causes contraction of lower segmentOxytocino Oxytocin is a nonapeptide, synthesized predominantly in the paraventricular nucleus of the hypothalamus along with its binding protein neurophysin II. Oxytocin has following physiological actions : -Uterus : - It increases the force and frequency of uterine contraction. Estrogens sensitize the uterus to oxytocin, while progestins decrease the sensitivity. The increased contractility is restricted to the fundus and body, lower segment is not contracted, may even be relaxed at term.Breast: - Oxytocin contracts myoepithelium of mammary alveoli and forces milk into bigger sinusuids - Milk ejection or milk letdown reflex.o Oxytocin secretion is inhibited by sympathetic discharge and circulating catecholamines, by pain and enkephalins, by emotional stress, especially fear, and by alcohol. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A patient presented with scarring alopecia, thinned nails, hyperpigmented macular lesions over the trunk and oral mucosa. Diagnosis is:, with the following options: A: Psoriasis, B: Leprosy, C: Lichen planus, D: Pemphigus ### Response:

Scarring alopecia is found in LP and Leprosy both. But oral mucosal involvement and thinning of nails or the diagnosis of LP.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A patient presented with scarring alopecia, thinned nails, hyperpigmented macular lesions over the trunk and oral mucosa. Diagnosis is:, with the following options: A: Psoriasis, B: Leprosy, C: Lichen planus, D: Pemphigus ### Response: Scarring alopecia is found in LP and Leprosy both. But oral mucosal involvement and thinning of nails or the diagnosis of LP. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Migraine prophylaxis includes:, with the following options: A: Verapamil, B: Valproate, C: Amitryptiline, D: All of the above ### Response:

Trick: Very Volatile Pharma Agent For Migraine Prophylaxis V  →  Verapamil V  →  Valproate P  →  Pizotifen A  →  Amitryptiline F  →  Flunarizine M  →  Methylsergide P  →  Propranolol

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Migraine prophylaxis includes:, with the following options: A: Verapamil, B: Valproate, C: Amitryptiline, D: All of the above ### Response: Trick: Very Volatile Pharma Agent For Migraine Prophylaxis V  →  Verapamil V  →  Valproate P  →  Pizotifen A  →  Amitryptiline F  →  Flunarizine M  →  Methylsergide P  →  Propranolol ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Best treatment of refractory peri-anal fistula in crohn's disease:-, with the following options: A: Fistulectomy, B: Infliximab, C: Olasalizine, D: Mesalamine ### Response:

Infliximab is effective in CD patients with refractory perianal and enterocutaneous fistulas, with 68% response rate (50% reduction in fistula drainage) and a 50% complete remission rate. Reinfusion, typically every 8 weeks, is necessary to continue therapeutic benefits in many patients.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Best treatment of refractory peri-anal fistula in crohn's disease:-, with the following options: A: Fistulectomy, B: Infliximab, C: Olasalizine, D: Mesalamine ### Response: Infliximab is effective in CD patients with refractory perianal and enterocutaneous fistulas, with 68% response rate (50% reduction in fistula drainage) and a 50% complete remission rate. Reinfusion, typically every 8 weeks, is necessary to continue therapeutic benefits in many patients. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Satellite lesions in eye is caused by, with the following options: A: Herpes zoster, B: Herpes simplex, C: Aspergillosis, D: Trachoma ### Response:

C i.e. Aspergillosis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Satellite lesions in eye is caused by, with the following options: A: Herpes zoster, B: Herpes simplex, C: Aspergillosis, D: Trachoma ### Response: C i.e. Aspergillosis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Hemmorhagic fever is not caused by -, with the following options: A: Yellow fever, B: KFD, C: Japanese encephalitis, D: Dengue fever ### Response:

kyasanur foerst disease a hemorrhagic fever found in karnataka. It is arboviral disease. A new arbo virus genetically related to RSSE isolated ANANTHANARYANAN TEXT BOOK OF MICROBIOLOGY 9EDITION PGNO.524

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Hemmorhagic fever is not caused by -, with the following options: A: Yellow fever, B: KFD, C: Japanese encephalitis, D: Dengue fever ### Response: kyasanur foerst disease a hemorrhagic fever found in karnataka. It is arboviral disease. A new arbo virus genetically related to RSSE isolated ANANTHANARYANAN TEXT BOOK OF MICROBIOLOGY 9EDITION PGNO.524 ### 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 given in the treatment cyanotic spells in a patient of TOF?, with the following options: A: Phenylephrine, B: Propranolol, C: Calcium chloride, D: Sodium bicarbonate ### Response:

Calcium chloride is not used . Propanolol,sodium bicarbonate, phenylephrine are given for cyanotic spells Ghai essential of pediatrics, eighth edition ,p.no:412,table 15.13

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 given in the treatment cyanotic spells in a patient of TOF?, with the following options: A: Phenylephrine, B: Propranolol, C: Calcium chloride, D: Sodium bicarbonate ### Response: Calcium chloride is not used . Propanolol,sodium bicarbonate, phenylephrine are given for cyanotic spells Ghai essential of pediatrics, eighth edition ,p.no:412,table 15.13 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Paranoid Psychosis with cocaine is seen due to-, with the following options: A: Tolerance, B: Withdrawl, C: Reverse Tolerance, D: Intoxication ### Response:

Paranoid Psychosis is typically a feature of chronic intoxication with cocaine and is related to the prolonged duration of use, high dose, and the individual user's sensitivity to the substance.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Paranoid Psychosis with cocaine is seen due to-, with the following options: A: Tolerance, B: Withdrawl, C: Reverse Tolerance, D: Intoxication ### Response: Paranoid Psychosis is typically a feature of chronic intoxication with cocaine and is related to the prolonged duration of use, high dose, and the individual user's sensitivity to the substance. ### 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 may be seen as severity of mitral stenosis increases Except, with the following options: A: Pulsatile liver, B: Atrial fibrillation, C: Opening snap delayed from S2, D: Length of murmur is prolonged ### Response:

Answer is C (Opening snap delayed from S2) The interval between opening snap and S2 is shoened (reduced) as severity of mitral stenosis increases. 'The opening snap generally follows the sound of Aoic valve closure (A2, S2) by 0.5 - 0.12 seconds. The time interval between S2 and OS varies inversely with the severity of MS'- Features suggesting severe M.S. Proximity of S2-OS gap Longer Duration of mid -diastolic murmur' Atrial Fibrillation may be seen in severe Mitral stenosis Mitral stenosis and mitral regurgitation are common causes of Left atrial enlargement which predisposes to AF. The probability of AF increases as severily of MS increases. The irregularly irregular pulse of AF usually means severe mitral stenosis except in elderly patients when AF can occur with mild mitral stenosis' - 'Clinical Methods in cardiology' by Raju (Orient Blackswan) 2003/201 Pulsatile liver may be seen in severe Mitral Stenosis Enlarged Pulsatile Liver is essentially a feature of Tricuspid Regurgitation. Patients with severe MS have pulmonary hypeension that may cause Tricuspid Regurgitation and result in a pulsatile liver.

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 may be seen as severity of mitral stenosis increases Except, with the following options: A: Pulsatile liver, B: Atrial fibrillation, C: Opening snap delayed from S2, D: Length of murmur is prolonged ### Response: Answer is C (Opening snap delayed from S2) The interval between opening snap and S2 is shoened (reduced) as severity of mitral stenosis increases. 'The opening snap generally follows the sound of Aoic valve closure (A2, S2) by 0.5 - 0.12 seconds. The time interval between S2 and OS varies inversely with the severity of MS'- Features suggesting severe M.S. Proximity of S2-OS gap Longer Duration of mid -diastolic murmur' Atrial Fibrillation may be seen in severe Mitral stenosis Mitral stenosis and mitral regurgitation are common causes of Left atrial enlargement which predisposes to AF. The probability of AF increases as severily of MS increases. The irregularly irregular pulse of AF usually means severe mitral stenosis except in elderly patients when AF can occur with mild mitral stenosis' - 'Clinical Methods in cardiology' by Raju (Orient Blackswan) 2003/201 Pulsatile liver may be seen in severe Mitral Stenosis Enlarged Pulsatile Liver is essentially a feature of Tricuspid Regurgitation. Patients with severe MS have pulmonary hypeension that may cause Tricuspid Regurgitation and result in a pulsatile liver. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Change seen in mitochondria due to aging is?, with the following options: A: Decrease in size & increase in number, B: Decrease in number & increase in size, C: Decrease in size and number both, D: Increase in size and number both ### Response:

Ans. is 'c' i.e., Decrease in size and number both Morphological changes associated with agingCellular changesDecrease in cell size and numberDecreased in size and number of mitochondria Detachment of ribosomes from ERIncreased number of phagolysosomal vacuolesDefective DNA repairNon-enzymatic glycosylation ofprotienConnective tissue changesThere is loss of elasticity (wrinkling of skin| BP due to decreased elasticity of artery)Ground glass substance changes (cataract)Cartilage and bone changes (osteoarthritis, osteoporosis)Decreased immunityDecreased T cells, B cells, plasma cells and antibodies

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Change seen in mitochondria due to aging is?, with the following options: A: Decrease in size & increase in number, B: Decrease in number & increase in size, C: Decrease in size and number both, D: Increase in size and number both ### Response: Ans. is 'c' i.e., Decrease in size and number both Morphological changes associated with agingCellular changesDecrease in cell size and numberDecreased in size and number of mitochondria Detachment of ribosomes from ERIncreased number of phagolysosomal vacuolesDefective DNA repairNon-enzymatic glycosylation ofprotienConnective tissue changesThere is loss of elasticity (wrinkling of skin| BP due to decreased elasticity of artery)Ground glass substance changes (cataract)Cartilage and bone changes (osteoarthritis, osteoporosis)Decreased immunityDecreased T cells, B cells, plasma cells and antibodies ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Products of uronic acid pathway in human beings are all EXCEPT:, with the following options: A: Vitamin C, B: Pentoses, C: NADH, D: Glucuronic acid ### Response:

Humans cannot synthesize vitamin C due to deficiency of enzyme, L-Gulonolactone Oxidase Uronic acid pathway in humans

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Products of uronic acid pathway in human beings are all EXCEPT:, with the following options: A: Vitamin C, B: Pentoses, C: NADH, D: Glucuronic acid ### Response: Humans cannot synthesize vitamin C due to deficiency of enzyme, L-Gulonolactone Oxidase Uronic acid pathway in humans ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The commonest pre-malignant condition of oral cancer is, with the following options: A: Leukoplakia, B: Aphthous ulcer, C: Lichen planus, D: Erythro-leukoplakia ### Response:

Leukoplakia is the most common (~ 85%) of the premalignant lesions of the oral cavity.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The commonest pre-malignant condition of oral cancer is, with the following options: A: Leukoplakia, B: Aphthous ulcer, C: Lichen planus, D: Erythro-leukoplakia ### Response: Leukoplakia is the most common (~ 85%) of the premalignant lesions of the oral cavity. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A child is brought by mother with HO massive hematemesis with HO drug intake previously with NSAIDS and on Rx. Associated with moderate splenomegaly diagnosis is –, with the following options: A: Oesophageal varices, B: Duodenal ulcer, C: Drug induced gastritis, D: Peptic ulcer ### Response:

Clues in this question are - 1) H/0 massive hematemasis                                    2) Splenomegaly Amongst the given options, splenomegaly will be seen only in esophageal varices due to portal hypertension.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A child is brought by mother with HO massive hematemesis with HO drug intake previously with NSAIDS and on Rx. Associated with moderate splenomegaly diagnosis is –, with the following options: A: Oesophageal varices, B: Duodenal ulcer, C: Drug induced gastritis, D: Peptic ulcer ### Response: Clues in this question are - 1) H/0 massive hematemasis                                    2) Splenomegaly Amongst the given options, splenomegaly will be seen only in esophageal varices due to portal hypertension. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most specific marker for myeloid series is, with the following options: A: CD 34, B: CD 45, C: CD 99, D: CD 117 ### Response:

The markers for myeloid series are CD13, CD33, CD 11b, CD15, CD117 and cMPO. c MPO is the most lineage specific marker amongst these. Regarding other options, CD 34 - Myeloid and lymphoid blasts, stem cells, CD 45 - Leukocyte common antigen (nonerythroid hematopoietic cells), CD 99 - Ewing's sarcoma/primitive neuroectodermal cells.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most specific marker for myeloid series is, with the following options: A: CD 34, B: CD 45, C: CD 99, D: CD 117 ### Response: The markers for myeloid series are CD13, CD33, CD 11b, CD15, CD117 and cMPO. c MPO is the most lineage specific marker amongst these. Regarding other options, CD 34 - Myeloid and lymphoid blasts, stem cells, CD 45 - Leukocyte common antigen (nonerythroid hematopoietic cells), CD 99 - Ewing's sarcoma/primitive neuroectodermal cells. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following blocks replication without getting involved in the DNA strand?, with the following options: A: Cytarabine, B: Nalidixic acid, C: Carbamazepine, D: 5-Fluorouracil ### Response:

Nalidixic acid: It is active against gram-negative bacteria, especially coliforms: E. coli, Proteus, Klebsiella, Enterobacter, Shigella but not Pseudomonas. It acts by inhibiting bacterial DNA gyrase and is bactericidal. Resistance to nalidixic acid develops rather rapidly. Nalidixic acid is absorbed orally, highly plasma protein bound and paly metabolized in liver: one of the metabolites is active. It is excreted in urine with a plasma tllz -8 hrs. Concentration of the free drug in plasma and most tissues attained with the usual doses is nontherapeutic for systemic infections (MIC values for most susceptible bacteria just approach the &;break-point&; concentration). However, high concentration attained in urine (20-50 times that in plasma) is lethal to the common urinary pathogens. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:687

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 blocks replication without getting involved in the DNA strand?, with the following options: A: Cytarabine, B: Nalidixic acid, C: Carbamazepine, D: 5-Fluorouracil ### Response: Nalidixic acid: It is active against gram-negative bacteria, especially coliforms: E. coli, Proteus, Klebsiella, Enterobacter, Shigella but not Pseudomonas. It acts by inhibiting bacterial DNA gyrase and is bactericidal. Resistance to nalidixic acid develops rather rapidly. Nalidixic acid is absorbed orally, highly plasma protein bound and paly metabolized in liver: one of the metabolites is active. It is excreted in urine with a plasma tllz -8 hrs. Concentration of the free drug in plasma and most tissues attained with the usual doses is nontherapeutic for systemic infections (MIC values for most susceptible bacteria just approach the &;break-point&; concentration). However, high concentration attained in urine (20-50 times that in plasma) is lethal to the common urinary pathogens. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:687 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Dalen fuchs nodule is a pathognomic feature of which of the following condition ?, with the following options: A: Sympathetic opthalmitis, B: Sarcoidosis, C: Tuberculosis, D: Retinitis pigmentosa ### Response:

Dalen fuchs nodule refers tocollections of epithelial cells lying between Bruch membrane and the retinal pigment epithelium in sympathetic ophthalmitis.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Dalen fuchs nodule is a pathognomic feature of which of the following condition ?, with the following options: A: Sympathetic opthalmitis, B: Sarcoidosis, C: Tuberculosis, D: Retinitis pigmentosa ### Response: Dalen fuchs nodule refers tocollections of epithelial cells lying between Bruch membrane and the retinal pigment epithelium in sympathetic ophthalmitis. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In a patient of mesothelioma, one often finds ?, with the following options: A: Hypoglycaemia, B: An association with asbestosis, C: Haemorrhagic pleural effusion, D: All of the above ### Response:

Ans. is `d' i.e., All of the above

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In a patient of mesothelioma, one often finds ?, with the following options: A: Hypoglycaemia, B: An association with asbestosis, C: Haemorrhagic pleural effusion, D: All of the above ### Response: Ans. is `d' i.e., All of the above ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Non blanchable erythema of skin is classified as which stage of decubitus ulcer?, with the following options: A: Stage I, B: Stage II, C: Stage III, D: Stage IV ### Response:

The four stages of pressure ulcer formation are as follows: Stage I, nonblanchable erythema of intact skin; Stage II, paial-thickness skin loss involving epidermis or dermis, or both; Stage III, full-thickness skin loss, but not through the fascia; and Stage IV, full-thickness skin loss with extensive involvement of muscle and bone. Ref: Schwaz's principle of surgery 9th edition, chapter 9.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Non blanchable erythema of skin is classified as which stage of decubitus ulcer?, with the following options: A: Stage I, B: Stage II, C: Stage III, D: Stage IV ### Response: The four stages of pressure ulcer formation are as follows: Stage I, nonblanchable erythema of intact skin; Stage II, paial-thickness skin loss involving epidermis or dermis, or both; Stage III, full-thickness skin loss, but not through the fascia; and Stage IV, full-thickness skin loss with extensive involvement of muscle and bone. Ref: Schwaz's principle of surgery 9th edition, chapter 9. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Radiocontrast is contraindicated in all except -, with the following options: A: Renal failure, B: Patient on metformin, C: Dehydration, D: Obesity ### Response:

Impoant risk factors for contrast induced nephropathy (CIN) : Renal failure Diabetes Hypeension Dehydration Patient on metformin Hyperuricemia

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Radiocontrast is contraindicated in all except -, with the following options: A: Renal failure, B: Patient on metformin, C: Dehydration, D: Obesity ### Response: Impoant risk factors for contrast induced nephropathy (CIN) : Renal failure Diabetes Hypeension Dehydration Patient on metformin Hyperuricemia ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Drugs which increase GABA level in brains-, with the following options: A: Diazepam, B: Phenobarbitone, C: Sodium valproate, D: Carbamazepine ### Response:

Ans. is 'c' i.e., Sodium valproate GABA level is increased by Valproate and vigabatrine --> by inhibiting GABA transaminase Gabapentin --> by increasing synaptic vesicle release of GABA.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Drugs which increase GABA level in brains-, with the following options: A: Diazepam, B: Phenobarbitone, C: Sodium valproate, D: Carbamazepine ### Response: Ans. is 'c' i.e., Sodium valproate GABA level is increased by Valproate and vigabatrine --> by inhibiting GABA transaminase Gabapentin --> by increasing synaptic vesicle release of GABA. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Methimazole differ from propylthiouracil in all except-, with the following options: A: Is secreated into milk, B: Has more volume of distribution, C: More protein bound, D: All ### Response:

Ans. is 'c' i.e., More protein bound

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Methimazole differ from propylthiouracil in all except-, with the following options: A: Is secreated into milk, B: Has more volume of distribution, C: More protein bound, D: All ### Response: Ans. is 'c' i.e., More protein bound ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Germ tube test is done for, with the following options: A: Candida albicans, B: Candida tropicalis, C: Candida glabrata, D: Candida kefyr ### Response:

Germ tube test / Reynold braude phenomenon - specific test for Candida albicans Colonies are mixed with human or sheep serum & incubated for 2 hours . Wet mount preparation is examined under microscope. Germ tubes are formed , describe as long tube like projections extending from yeast cells.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Germ tube test is done for, with the following options: A: Candida albicans, B: Candida tropicalis, C: Candida glabrata, D: Candida kefyr ### Response: Germ tube test / Reynold braude phenomenon - specific test for Candida albicans Colonies are mixed with human or sheep serum & incubated for 2 hours . Wet mount preparation is examined under microscope. Germ tubes are formed , describe as long tube like projections extending from yeast cells. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All of the following are the reasons for pain in Sub-Mucosal fibroid, EXCEPT ?, with the following options: A: Torsion, B: Large size, C: Sarcomatous change, D: Degeneration ### Response:

Pain due to torsion is see with pedunculated subserosal fibroid Torsion is not characteristic of a Sub Mucosalfibroid Pain in sub mucosal fibroid is due to: Fibroid degeneration Large size Sarcomatous change

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All of the following are the reasons for pain in Sub-Mucosal fibroid, EXCEPT ?, with the following options: A: Torsion, B: Large size, C: Sarcomatous change, D: Degeneration ### Response: Pain due to torsion is see with pedunculated subserosal fibroid Torsion is not characteristic of a Sub Mucosalfibroid Pain in sub mucosal fibroid is due to: Fibroid degeneration Large size Sarcomatous change ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following statements about imipenem is most accurate?, with the following options: A: The drug has a narrow spectrum of antibacterial action, B: It is used in fixed dose combination with sulbactum, C: In renal dysfunction, dosage reductions are necessary to avoid seizures, D: Imipenem is active against methicillin-resistant staphylococci ### Response:

Carbapenems are synthetic b-lactam antibiotics Imipenem, meropenem, doripenem and eapenem are the drugs of this group currently available. Imipenem : Effective against : Gm +ve, Gm -ve including pseudomonas and anaerobic. Dehydropeptidase by kidney metabolises imipenem rapidly. Cilastatin is a dehydropetidase inhibitor, which must be given along with imipenem for desired action. Side effect : Seizure

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following statements about imipenem is most accurate?, with the following options: A: The drug has a narrow spectrum of antibacterial action, B: It is used in fixed dose combination with sulbactum, C: In renal dysfunction, dosage reductions are necessary to avoid seizures, D: Imipenem is active against methicillin-resistant staphylococci ### Response: Carbapenems are synthetic b-lactam antibiotics Imipenem, meropenem, doripenem and eapenem are the drugs of this group currently available. Imipenem : Effective against : Gm +ve, Gm -ve including pseudomonas and anaerobic. Dehydropeptidase by kidney metabolises imipenem rapidly. Cilastatin is a dehydropetidase inhibitor, which must be given along with imipenem for desired action. Side effect : Seizure ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Skin smear is negative in which leprosy, with the following options: A: Indeterminate, B: Neuritic, C: Lepromatous, D: Borderline ### Response:

B i.e. Neuritic Leprosy Type Slit Smear & Infectivity Neuritic NegativeQ Tuberculoid - AFB may be found from margin - Not infective usually Borderline - AFB may be found - Infective Lepromatous - Teeming with AFB - Infective Indeterminate - Slit smear & lepromin test is +- Country Most common type of leprosy India, Africa TT (Polar tuberculoid)Q Southeast Asia BT (Borderline tuber culoid) Mexico, Caribbea Lepromatous (LL>BL)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Skin smear is negative in which leprosy, with the following options: A: Indeterminate, B: Neuritic, C: Lepromatous, D: Borderline ### Response: B i.e. Neuritic Leprosy Type Slit Smear & Infectivity Neuritic NegativeQ Tuberculoid - AFB may be found from margin - Not infective usually Borderline - AFB may be found - Infective Lepromatous - Teeming with AFB - Infective Indeterminate - Slit smear & lepromin test is +- Country Most common type of leprosy India, Africa TT (Polar tuberculoid)Q Southeast Asia BT (Borderline tuber culoid) Mexico, Caribbea Lepromatous (LL>BL) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 15 year old boy had 10–12 partial complex seizures per day inspite of adequate 4 drugs antiepileptic regime. He had a history of repeated high-grade fever in childhood. MRI for epilepsy protocol revealed normal brain scan. What should be the best noninvasive strategy to make a definite diagnosis so that he can be prepared to undergo epilepsy surgery –, with the following options: A: Interictal scalp EEG, B: Video EEG, C: Interictal 18F–FDg PET., D: Video EEG with Ictal 99m Tc – HMPAO Brain SPECT ### Response:

If localization of epileptic focus is unrevealed on MRI, Ictal SPECT with HMPAO is the most practical and best method. Addition of video EEG further helps in localization of epileptic foci.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 15 year old boy had 10–12 partial complex seizures per day inspite of adequate 4 drugs antiepileptic regime. He had a history of repeated high-grade fever in childhood. MRI for epilepsy protocol revealed normal brain scan. What should be the best noninvasive strategy to make a definite diagnosis so that he can be prepared to undergo epilepsy surgery –, with the following options: A: Interictal scalp EEG, B: Video EEG, C: Interictal 18F–FDg PET., D: Video EEG with Ictal 99m Tc – HMPAO Brain SPECT ### Response: If localization of epileptic focus is unrevealed on MRI, Ictal SPECT with HMPAO is the most practical and best method. Addition of video EEG further helps in localization of epileptic foci. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: T-cell mature in:(1991), with the following options: A: Peyer's patches, B: Lymph node, C: Thymus, D: Bursa of fabricius ### Response:

Ans: c (Thymus)Ref: Ananthanarayan Micro, 7th ed, p. 123 & 6th ed, p. 117, 115; Fig. 15.4

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: T-cell mature in:(1991), with the following options: A: Peyer's patches, B: Lymph node, C: Thymus, D: Bursa of fabricius ### Response: Ans: c (Thymus)Ref: Ananthanarayan Micro, 7th ed, p. 123 & 6th ed, p. 117, 115; Fig. 15.4 ### 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:

Superior thyroid aery is a branch of ECA, inferior thyroid aery is a branch of thyrocervical trunk of subclan aery Ref: Gray's40e/262

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: Superior thyroid aery is a branch of ECA, inferior thyroid aery is a branch of thyrocervical trunk of subclan aery Ref: Gray's40e/262 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Rupture of sclera in ocular contusion is seen most commonly in:, with the following options: A: Superonasal quadrant, B: Superotemporal quadrant, C: Inferonasal quadrant, D: Inferotemporal quadrant ### Response:

Ans. Superonasal quadrant

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Rupture of sclera in ocular contusion is seen most commonly in:, with the following options: A: Superonasal quadrant, B: Superotemporal quadrant, C: Inferonasal quadrant, D: Inferotemporal quadrant ### Response: Ans. Superonasal quadrant ### 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 true about sabin vaccine?, with the following options: A: Three doses are given in primary immunization, B: The doses are given at 4-6 weeks interval, C: Given intramuscularly, D: Contains all the 3 strains ### Response:

<p> The primary course of immunisation consists of 4 inoculations. Reference:Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:206. <\p>

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 true about sabin vaccine?, with the following options: A: Three doses are given in primary immunization, B: The doses are given at 4-6 weeks interval, C: Given intramuscularly, D: Contains all the 3 strains ### Response: <p> The primary course of immunisation consists of 4 inoculations. Reference:Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:206. <\p> ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Neologism is seen in:, with the following options: A: Depression, B: Schizophrenia, C: Mania, D: Dysphasia ### Response:

Neologisms - creates new own words, seen in Schizophrenia. Neologisms may be new words that are constructed by the patient or ordinary words that are used in a new way. Neologisms may be mannerisms or stereotypies - in patients with catatonia Is a result of formal thought disorder, words are fused together in the same way as concepts are blended with one another.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Neologism is seen in:, with the following options: A: Depression, B: Schizophrenia, C: Mania, D: Dysphasia ### Response: Neologisms - creates new own words, seen in Schizophrenia. Neologisms may be new words that are constructed by the patient or ordinary words that are used in a new way. Neologisms may be mannerisms or stereotypies - in patients with catatonia Is a result of formal thought disorder, words are fused together in the same way as concepts are blended with one another. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Effect of environment on genes is called?, with the following options: A: Positive Eugenics, B: Negative Eugenics, C: Euthenics, D: Enthenics ### Response:

Ans. is 'c' i.e., Euthenics Eugenics Science which aims to improve the genetic endoment of human population. o That is improving the quality of the human species or a human population by genetic manipulation. o Eugenis may be : 1. Negative Discouraging reproduction by persons having genetic defect or presumed to have inheritable undesirable traits this includes aboions, sterilization & other methods family planing. 2. Postive Eugenics -> Encouraging reproduction presumed to have inheritable desirable trait. For example, in vitro-feilization, cloning, egg transplantation etc. Euthenick Euthenics deal with human improvement through altering the external environment (environmental manipulation). It includes education, prevention and removal of contagious disease and parasites, education regarding home economics, sanitation and housing.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Effect of environment on genes is called?, with the following options: A: Positive Eugenics, B: Negative Eugenics, C: Euthenics, D: Enthenics ### Response: Ans. is 'c' i.e., Euthenics Eugenics Science which aims to improve the genetic endoment of human population. o That is improving the quality of the human species or a human population by genetic manipulation. o Eugenis may be : 1. Negative Discouraging reproduction by persons having genetic defect or presumed to have inheritable undesirable traits this includes aboions, sterilization & other methods family planing. 2. Postive Eugenics -> Encouraging reproduction presumed to have inheritable desirable trait. For example, in vitro-feilization, cloning, egg transplantation etc. Euthenick Euthenics deal with human improvement through altering the external environment (environmental manipulation). It includes education, prevention and removal of contagious disease and parasites, education regarding home economics, sanitation and housing. ### 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 organs is enlarged?, with the following options: A: Colon, B: Ovary, C: Stomach, D: Spleen ### Response:

Answer C. StomachMassive dilation of the stomach with distal gas is most consistent with gastric outlet obstruction.

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 organs is enlarged?, with the following options: A: Colon, B: Ovary, C: Stomach, D: Spleen ### Response: Answer C. StomachMassive dilation of the stomach with distal gas is most consistent with gastric outlet obstruction. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Blood Tellurite media is used for: March 2013, with the following options: A: Mycobacterium tuberculosis, B: Corynebacterium diphtheriae, C: Mycoplasma pneumoniae, D: Yersinia pestis ### Response:

Ans. B i.e. Corynebacterium diphtheriae Identification of C. diphtheriae A Gram stain is performed to show gram-positive, highly pleomorphic organisms with no paicular arrangement. Special stains like Albes's stain and Ponder's stain are used to demonstrate the metachromatic granules formed in the polar regions. The granules are called as polar granules, Babes Ernst Granules, Volutin, etc. An enrichment medium, such as Loffler's medium, is used to preferentially grow C. diptheriae. After that, use a differential plate known as tellurite agar, which allows all Corynebacteria (including C. diphtheriae) to reduce tellurite to metallic tellurium. The tellurite reduction is colormetrically indicated by brown colonies for most Cornyebacteria species or by a black halo around the C. diphtheriae colonies.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Blood Tellurite media is used for: March 2013, with the following options: A: Mycobacterium tuberculosis, B: Corynebacterium diphtheriae, C: Mycoplasma pneumoniae, D: Yersinia pestis ### Response: Ans. B i.e. Corynebacterium diphtheriae Identification of C. diphtheriae A Gram stain is performed to show gram-positive, highly pleomorphic organisms with no paicular arrangement. Special stains like Albes's stain and Ponder's stain are used to demonstrate the metachromatic granules formed in the polar regions. The granules are called as polar granules, Babes Ernst Granules, Volutin, etc. An enrichment medium, such as Loffler's medium, is used to preferentially grow C. diptheriae. After that, use a differential plate known as tellurite agar, which allows all Corynebacteria (including C. diphtheriae) to reduce tellurite to metallic tellurium. The tellurite reduction is colormetrically indicated by brown colonies for most Cornyebacteria species or by a black halo around the C. diphtheriae colonies. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Minimum time of diagnosis for manic illness: DNB 10; AIIMS 14, with the following options: A: 1 week, B: 1 month, C: 1 year, D: 2 years ### Response:

Ans. 1 week

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Minimum time of diagnosis for manic illness: DNB 10; AIIMS 14, with the following options: A: 1 week, B: 1 month, C: 1 year, D: 2 years ### Response: Ans. 1 week ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Compound microscope was invented by: September 2004, with the following options: A: Louis Pasteur, B: Hippocrates, C: Robe Hooke, D: Leeuwenhoek ### Response:

Ans. C i.e. Robe Hook

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Compound microscope was invented by: September 2004, with the following options: A: Louis Pasteur, B: Hippocrates, C: Robe Hooke, D: Leeuwenhoek ### Response: Ans. C i.e. Robe Hook ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Organs involved in calcium homeostasis are all except, with the following options: A: Lungs, B: Kidneys, C: Skin, D: Intestines ### Response:

Answer: a) Lungs.CALCIUM METABOLISM* Total body calcium-lkilogram of which 99% is in bones.* Normal serum calcium: 5mEq/L or 2.5mmol/L or simply 9-10.5 mg/dl.* Normal dietary requirement: 0.5 to lg.Types of calcium:* Ionized calcium (4.5mg/dl) is responsible for many functions such as muscular contraction, coagulation etc...* Maximum calcium absorption occurs in duodenum & proximal jejunum, facilitated by gastric acidDiffusibie/ultra filterable (5.5mg/dl)Non-diffusible/protein bound (4.5mg/dl)Ionized calcium (4.5mg/dl)Albumin bound(4mg/dl)Complexed with other minerals (0.5mg/dl)Globulin bound(0.5mg/dl)* Absorption 'fed by-Acidic pH, hypocalcaemia, proteins* Absorption >ped by Achlorhydria, phosphates, oxalates, alkalis, hypercalcemia.PARATHYROID HORMONESynthesized by principal/ chief cells of parathyroid gland.* In bone, PTH receptors are located on osteoblasts but not on osteoclasts.* Initially and briefly, PTH causes an increase in bone formation by a direct action on osteoblasts. (This brief action is the basis for the usefulness of intermittent PTH administration in the treatment of osteoporosis)* In a second, long-lasting action on osteoclasts, PTH causes an increase in bone resorption.* This second action on osteoclasts is indirect & mediated by cytokines released from osteoblasts.* Thus, osteoblasts, are required for the bone-resorbing action of PTH on osteoclastsSYNTHESIS OF VITAMIN-D* 1, 25-dihydroxyvitamin D rapidly induces absorption of Ca++ by the duodenum (transcaltachia)CALCITONIN* The Para follicular cells (C cells) of the thyroid gland secrete Calcitonin.* Its secretion is increased by hypercalcemia, hypergastrinemia, and b adrenergic agonists* Salmon Calcitonin: produced by ultimo bronchial bodies, is more effective than Calcitonin.* Receptors for calcitonin are found in bones and the kidneys.* Calcitonin lowers circulating calcium and phosphate levels.* It exerts its calcium-lowering effect by inhibiting bone resorption.* This action is direct, and calcitonin inhibits the activity of Osteoclasts in vitro.* It also increases Ca2+ excretion in the urine.FEATURESPTHVITAMIN-DCALCITONINStimulus for release|sb serum ca2+| serum ca2+| serum P| PTH| serum ca2+Receptor locationOsteoblastOsteoblastOsteoclast Action on: Bone| resorption| resorption| resorptionKidney| P reabsorption| ca2+ reabsorption (in distal tubule)| P reabsorption| ca2+ reabsorption Intestine| ca2+ absorption (by activation of vit-D)| P absorption| ca2+ absorption Overall effect on: Serum calcium|| Serum phosphorus|| Other hormones involved in calcium metabolism:* Gluco corticoid excess: 4/ serum ca2 and leads to osteoporosis.* Growth hormone: ^ urinary ca2+ excretion* Oestrogens & testosterone - Prevent osteoporosis.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Organs involved in calcium homeostasis are all except, with the following options: A: Lungs, B: Kidneys, C: Skin, D: Intestines ### Response: Answer: a) Lungs.CALCIUM METABOLISM* Total body calcium-lkilogram of which 99% is in bones.* Normal serum calcium: 5mEq/L or 2.5mmol/L or simply 9-10.5 mg/dl.* Normal dietary requirement: 0.5 to lg.Types of calcium:* Ionized calcium (4.5mg/dl) is responsible for many functions such as muscular contraction, coagulation etc...* Maximum calcium absorption occurs in duodenum & proximal jejunum, facilitated by gastric acidDiffusibie/ultra filterable (5.5mg/dl)Non-diffusible/protein bound (4.5mg/dl)Ionized calcium (4.5mg/dl)Albumin bound(4mg/dl)Complexed with other minerals (0.5mg/dl)Globulin bound(0.5mg/dl)* Absorption 'fed by-Acidic pH, hypocalcaemia, proteins* Absorption >ped by Achlorhydria, phosphates, oxalates, alkalis, hypercalcemia.PARATHYROID HORMONESynthesized by principal/ chief cells of parathyroid gland.* In bone, PTH receptors are located on osteoblasts but not on osteoclasts.* Initially and briefly, PTH causes an increase in bone formation by a direct action on osteoblasts. (This brief action is the basis for the usefulness of intermittent PTH administration in the treatment of osteoporosis)* In a second, long-lasting action on osteoclasts, PTH causes an increase in bone resorption.* This second action on osteoclasts is indirect & mediated by cytokines released from osteoblasts.* Thus, osteoblasts, are required for the bone-resorbing action of PTH on osteoclastsSYNTHESIS OF VITAMIN-D* 1, 25-dihydroxyvitamin D rapidly induces absorption of Ca++ by the duodenum (transcaltachia)CALCITONIN* The Para follicular cells (C cells) of the thyroid gland secrete Calcitonin.* Its secretion is increased by hypercalcemia, hypergastrinemia, and b adrenergic agonists* Salmon Calcitonin: produced by ultimo bronchial bodies, is more effective than Calcitonin.* Receptors for calcitonin are found in bones and the kidneys.* Calcitonin lowers circulating calcium and phosphate levels.* It exerts its calcium-lowering effect by inhibiting bone resorption.* This action is direct, and calcitonin inhibits the activity of Osteoclasts in vitro.* It also increases Ca2+ excretion in the urine.FEATURESPTHVITAMIN-DCALCITONINStimulus for release|sb serum ca2+| serum ca2+| serum P| PTH| serum ca2+Receptor locationOsteoblastOsteoblastOsteoclast Action on: Bone| resorption| resorption| resorptionKidney| P reabsorption| ca2+ reabsorption (in distal tubule)| P reabsorption| ca2+ reabsorption Intestine| ca2+ absorption (by activation of vit-D)| P absorption| ca2+ absorption Overall effect on: Serum calcium|| Serum phosphorus|| Other hormones involved in calcium metabolism:* Gluco corticoid excess: 4/ serum ca2 and leads to osteoporosis.* Growth hormone: ^ urinary ca2+ excretion* Oestrogens & testosterone - Prevent osteoporosis. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most characteristic feature of acute inflammation:, with the following options: A: Vasoconstriction, B: Vascular stasis, C: Vasodilatation and increased vascular permeability, D: Margination of leucocytes ### Response:

The main vascular reactions of acute inflammation are increased blood flow secondary to vasodilation and increased vascular permeability, both designed to bring blood cells and proteins to sites of infection or injury.Changes in Vascular Caliber and FlowAfter transient vasoconstriction (lasting only for seconds), aeriolar vasodilation occursThe microvasculature becomes more permeable, and protein-rich fluid moves into the extravascular tissuesAs stasis develops, leukocytes (principally neutrophils) begin to accumulate along the vascular endothelial surface--a process called marginationIncreased Vascular PermeabilitySeveral mechanisms may contribute to increased vascular permeability in acute inflammatory reactions areEndothelial cell contraction leading to intercellular gaps in postcapillary venules is the most common cause of increased vascular permeability.Endothelial injury results in vascular leakage by causing endothelial cell necrosis and detachmentIncreased transcytosis of proteins by way of an intracellular vesicular pathway augments venular permeabilityLeakage from new blood vessels.( Robbins Basic Pathology, 9th edition, page 33 )

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most characteristic feature of acute inflammation:, with the following options: A: Vasoconstriction, B: Vascular stasis, C: Vasodilatation and increased vascular permeability, D: Margination of leucocytes ### Response: The main vascular reactions of acute inflammation are increased blood flow secondary to vasodilation and increased vascular permeability, both designed to bring blood cells and proteins to sites of infection or injury.Changes in Vascular Caliber and FlowAfter transient vasoconstriction (lasting only for seconds), aeriolar vasodilation occursThe microvasculature becomes more permeable, and protein-rich fluid moves into the extravascular tissuesAs stasis develops, leukocytes (principally neutrophils) begin to accumulate along the vascular endothelial surface--a process called marginationIncreased Vascular PermeabilitySeveral mechanisms may contribute to increased vascular permeability in acute inflammatory reactions areEndothelial cell contraction leading to intercellular gaps in postcapillary venules is the most common cause of increased vascular permeability.Endothelial injury results in vascular leakage by causing endothelial cell necrosis and detachmentIncreased transcytosis of proteins by way of an intracellular vesicular pathway augments venular permeabilityLeakage from new blood vessels.( Robbins Basic Pathology, 9th edition, page 33 ) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A newborn infant refuses breast milk since the 2nd day of bih, vomits on force-feeding but accepts glucose-water, develops diarrhea on the third day, by 5th day she is jaundiced with liver enlargement and eyes show signs of cataract. Urinary reducing sugar was positive but blood glucose estimated by glucose oxidation method was found low. The most likely cause is deficiency of :, with the following options: A: Galactose-1-phosphate uridyl transferase., B: Beta galactosidase, C: Glucose-6-phosphatase, D: Galactokinase ### Response:

A i.e. Galactose-l-phosphate uridyl transferase

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A newborn infant refuses breast milk since the 2nd day of bih, vomits on force-feeding but accepts glucose-water, develops diarrhea on the third day, by 5th day she is jaundiced with liver enlargement and eyes show signs of cataract. Urinary reducing sugar was positive but blood glucose estimated by glucose oxidation method was found low. The most likely cause is deficiency of :, with the following options: A: Galactose-1-phosphate uridyl transferase., B: Beta galactosidase, C: Glucose-6-phosphatase, D: Galactokinase ### Response: A i.e. Galactose-l-phosphate uridyl transferase ### 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 murmurs increase with Valsalva maneuver?, with the following options: A: MR, B: VSD, C: AS, D: Hyperophic cardiomyopathy ### Response:

Hyperophic cardiomyopathy is defined as left ventricular hyperophy that develops in the absence of causative hemodynamic factors, such as hypeension, aoic valve disease, or systemic infiltrative or storage diseases. Patients may be diagnosed after undergoing evaluations triggered by the abnormal physical findings (murmur) or symptoms of exeional dyspnea, angina, or syncope. Alternatively, diagnosis may follow evaluations prompted by the detection of disease in family members.The systolic ejection murmur of left ventricular outflow tract obstruction is harsh and late peaking and can be enhanced by bedside maneuvers that diminish ventricular volume and transiently worsen obstruction, such as standing from a squatting position or the Valsalva maneuver.Ref: Harrison; 19th edition; Page no: 1569

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 murmurs increase with Valsalva maneuver?, with the following options: A: MR, B: VSD, C: AS, D: Hyperophic cardiomyopathy ### Response: Hyperophic cardiomyopathy is defined as left ventricular hyperophy that develops in the absence of causative hemodynamic factors, such as hypeension, aoic valve disease, or systemic infiltrative or storage diseases. Patients may be diagnosed after undergoing evaluations triggered by the abnormal physical findings (murmur) or symptoms of exeional dyspnea, angina, or syncope. Alternatively, diagnosis may follow evaluations prompted by the detection of disease in family members.The systolic ejection murmur of left ventricular outflow tract obstruction is harsh and late peaking and can be enhanced by bedside maneuvers that diminish ventricular volume and transiently worsen obstruction, such as standing from a squatting position or the Valsalva maneuver.Ref: Harrison; 19th edition; Page no: 1569 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Acetazolamide is administered to a glaucoma patient. Given that this drug inhibits carbonic anhydrase in the renal proximal tubule, which of the following substances will be excreted at a lower rate?, with the following options: A: Na+, B: H2O, C: HCO3-, D: NH4 ### Response:

The primary effect of carbonic anhydrase inhibitors such as acetazolamide is to inhibit both H+ secretion and NaHCO3 reabsorption, making the urine alkaline. NH4+ excretion is reduced as a result of the diminished H+ secretion. Carbonic anhydrase inhibitors restrict H+ secretion by inhibiting the intracellular hydration of CO2, a primary source of intracellular H+. The decline in H+ secretion inhibits the Na+-H+ exchange at the luminal membrane of the proximal tubule, which is the primary site of NaHCO3 diuresis. Carbonic anhydrase inhibitors also block the dehydration of H2CO3 formed in the tubular lumen. Chronic doses of such drugs can lead to hyperchloremic acidosis (metabolic acidosis). Ref: McNamara J.O. (2011). Chapter 21. Pharmacotherapy of the Epilepsies. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Acetazolamide is administered to a glaucoma patient. Given that this drug inhibits carbonic anhydrase in the renal proximal tubule, which of the following substances will be excreted at a lower rate?, with the following options: A: Na+, B: H2O, C: HCO3-, D: NH4 ### Response: The primary effect of carbonic anhydrase inhibitors such as acetazolamide is to inhibit both H+ secretion and NaHCO3 reabsorption, making the urine alkaline. NH4+ excretion is reduced as a result of the diminished H+ secretion. Carbonic anhydrase inhibitors restrict H+ secretion by inhibiting the intracellular hydration of CO2, a primary source of intracellular H+. The decline in H+ secretion inhibits the Na+-H+ exchange at the luminal membrane of the proximal tubule, which is the primary site of NaHCO3 diuresis. Carbonic anhydrase inhibitors also block the dehydration of H2CO3 formed in the tubular lumen. Chronic doses of such drugs can lead to hyperchloremic acidosis (metabolic acidosis). Ref: McNamara J.O. (2011). Chapter 21. Pharmacotherapy of the Epilepsies. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Herpes simplex infection can lead to?, with the following options: A: Frontal lobe infarction, B: Parietal lobe infarction, C: Temporal lobe involvement, D: Occipital neuralgia ### Response:

Ans. is 'c' i.e., Temporal lobe involvement Pathology of Herpex simplex encephalitis:o Herpes simplex infection has a prediliction for the involvement of Temporal lobe.o The lesions in HSV encephalitis are intense hemorrhagic necrosis of the inferior and medial temporal lobe and the mediorbital part of frontal lobes.o The temporal lobe lesions are usually b/L but not symmetrical.o The distribution of the lesion is so characteristic that the diagnosis can be made by gross inspection or by their location and appearance on imaging studies.o In the acute stages of the disease, intranuclear eosinophilic inclusions are found in neurons and glial cells in addition to the usual microscopic abnormalities of acute encephalitis and hemorrhagic necrosis.C.S.F examination# Increased C.S.F pressure# Pleocytosis, cells are mostly lymphocytes# Red cells sometimes numbering in thousands and xantho chromia are found refecting the hemorrhagic nature of the brain lesions.# Protein content is increased in most cases.# Slight reduction of glucose.o Herpes simplex encephalitis is characterized bv "focal neurological symptoms"o Over 90% patients will have one of the following symptoms offocal neurological deficit, plus fever -# Focal cranial nerve deficits# Hemiparesis# Dysphasia# Aphasia# Ataxia# Focal seizure# Altered mentation and level of consciousnesso Most common area involved in herpes simplex encephalitis is "Temporal lobe"# Temporal lobe abnormalities on brain imaging are considered strong evidence for herpes simplex encephalitis.# Temporal lobe lesions are predominantly unilateral.# Most sensitive and specific investigation for HSV-1 encephalitic is MRI# In contrast, cranial CT scans have only 50% sensitivity and that too early in the disease.EEG findings in HSV-jencephalitis# Focal electroencephalogram (EEG) findings occur in >80% of cases typically showing prominent intermittent high amplitude slow waves (delta and theta slowing) and occasionally continuous "periodic lateralized epileptiform discharges ".

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Herpes simplex infection can lead to?, with the following options: A: Frontal lobe infarction, B: Parietal lobe infarction, C: Temporal lobe involvement, D: Occipital neuralgia ### Response: Ans. is 'c' i.e., Temporal lobe involvement Pathology of Herpex simplex encephalitis:o Herpes simplex infection has a prediliction for the involvement of Temporal lobe.o The lesions in HSV encephalitis are intense hemorrhagic necrosis of the inferior and medial temporal lobe and the mediorbital part of frontal lobes.o The temporal lobe lesions are usually b/L but not symmetrical.o The distribution of the lesion is so characteristic that the diagnosis can be made by gross inspection or by their location and appearance on imaging studies.o In the acute stages of the disease, intranuclear eosinophilic inclusions are found in neurons and glial cells in addition to the usual microscopic abnormalities of acute encephalitis and hemorrhagic necrosis.C.S.F examination# Increased C.S.F pressure# Pleocytosis, cells are mostly lymphocytes# Red cells sometimes numbering in thousands and xantho chromia are found refecting the hemorrhagic nature of the brain lesions.# Protein content is increased in most cases.# Slight reduction of glucose.o Herpes simplex encephalitis is characterized bv "focal neurological symptoms"o Over 90% patients will have one of the following symptoms offocal neurological deficit, plus fever -# Focal cranial nerve deficits# Hemiparesis# Dysphasia# Aphasia# Ataxia# Focal seizure# Altered mentation and level of consciousnesso Most common area involved in herpes simplex encephalitis is "Temporal lobe"# Temporal lobe abnormalities on brain imaging are considered strong evidence for herpes simplex encephalitis.# Temporal lobe lesions are predominantly unilateral.# Most sensitive and specific investigation for HSV-1 encephalitic is MRI# In contrast, cranial CT scans have only 50% sensitivity and that too early in the disease.EEG findings in HSV-jencephalitis# Focal electroencephalogram (EEG) findings occur in >80% of cases typically showing prominent intermittent high amplitude slow waves (delta and theta slowing) and occasionally continuous "periodic lateralized epileptiform discharges ". ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Thrombotic event is seen in all of following except:, with the following options: A: Paroxysmal nocturnal hemoglobinuria, B: Disseminated intravascular coagulation, C: Idiopathic thrombocytopenic purpura, D: Heparin induced thrombocytopenia ### Response:

*PNH is seen due to PIGA gene defect - Pancytopenia Altered function of platelets - | risk of thrombosis Especially in cerebral & hepatic veins - | Moality *DIC is thrombo-hemorrhagic disorder *Heparin-induced thrombocytopenia has ab produced against platelet factor 4. Also associated with | risk of thrombosis *In ITP, Immune dysfunction characterized by ab formation against Platelet antigen. - Pt sequestration Coombs +ve, Hemolytic anemia -| platelet count - Bleeding

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Thrombotic event is seen in all of following except:, with the following options: A: Paroxysmal nocturnal hemoglobinuria, B: Disseminated intravascular coagulation, C: Idiopathic thrombocytopenic purpura, D: Heparin induced thrombocytopenia ### Response: *PNH is seen due to PIGA gene defect - Pancytopenia Altered function of platelets - | risk of thrombosis Especially in cerebral & hepatic veins - | Moality *DIC is thrombo-hemorrhagic disorder *Heparin-induced thrombocytopenia has ab produced against platelet factor 4. Also associated with | risk of thrombosis *In ITP, Immune dysfunction characterized by ab formation against Platelet antigen. - Pt sequestration Coombs +ve, Hemolytic anemia -| platelet count - Bleeding ### 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 most active against both dormant & non-dormant bacilli -, with the following options: A: Pyrazinamide, B: Rifampicin, C: Streptomycin, D: INH ### Response:

Ans. is 'b' i.e., Rifampin Isoniazid is bacteriostatic for resting bacilli, but is bactericidal for rapidly dividing microorganisms. o The bactericidal action of rifampicin covers all subpopulations of TB bacilli.

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 most active against both dormant & non-dormant bacilli -, with the following options: A: Pyrazinamide, B: Rifampicin, C: Streptomycin, D: INH ### Response: Ans. is 'b' i.e., Rifampin Isoniazid is bacteriostatic for resting bacilli, but is bactericidal for rapidly dividing microorganisms. o The bactericidal action of rifampicin covers all subpopulations of TB bacilli. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Eugene Bleuler's four 'A' of schizophrenia are all EXCEPT, with the following options: A: Autism, B: Affect, C: Anhedonia, D: Association ### Response:

Ans. c (Anhedonia) (Ref: Psychiatry by Niraj Ahuja 5th/pg. 55)SCHIZOPHRENIA# It commonly begins in late adolescence, has an insidious (and less commonly acute) onset, and, classically, a poor outcome, progressing from social withdrawal and perceptual distortions to a state of chronic delusions and hallucinations.# Patients may present with positive symptoms (such as conceptual disorganization, delusions, or hallucinations) or negative symptoms (loss of function, anhedonia, decreased emotional expression, impaired concentration, and diminished social engagement) and must have at least two of these for a 1-month period and continuous signs for at least 6 months to meet formal diagnostic criteria.# "Negative" symptoms predominate in one-third of the schizophrenic population and are associated with a poor long- term outcome and a poor response to drug treatment.# Eugen Bleuler's fundamental symptoms of schizophrenia (4 A's)deg:- Ambivalence (marked inability to decide for or against)- Autism (Withdrawal into self)- Affect blunting (Disturbance of affect)- Association disturbances (loosening of association, thought disorder)# The four main subtypes of schizophrenia are catatonic, paranoid, disorganized, and residual.Catatonic-type:# Patients whose clinical presentation is dominated by profound changes in motor activity, negativism, and echolalia or echopraxia.- Paranoid-type:# Patients who have a prominent preoccupation with a specific delusional system and who otherwise do not qualify as having disorganized-type disease.- Disorganized-type:# Characterized by disorganized speech and behavior are accompanied by a superficial or silly affect.- Residual-type:# Negative symptomatology exists in the absence of delusions, hallucinations, or motor disturbance.# The term schizophreniform disorder describes patients who meet the symptom requirements but not the duration requirements for schizophrenia, and schizoaffective disorder is used for those who manifest symptoms of schizophrenia and independent periods of mood disturbance.Q

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Eugene Bleuler's four 'A' of schizophrenia are all EXCEPT, with the following options: A: Autism, B: Affect, C: Anhedonia, D: Association ### Response: Ans. c (Anhedonia) (Ref: Psychiatry by Niraj Ahuja 5th/pg. 55)SCHIZOPHRENIA# It commonly begins in late adolescence, has an insidious (and less commonly acute) onset, and, classically, a poor outcome, progressing from social withdrawal and perceptual distortions to a state of chronic delusions and hallucinations.# Patients may present with positive symptoms (such as conceptual disorganization, delusions, or hallucinations) or negative symptoms (loss of function, anhedonia, decreased emotional expression, impaired concentration, and diminished social engagement) and must have at least two of these for a 1-month period and continuous signs for at least 6 months to meet formal diagnostic criteria.# "Negative" symptoms predominate in one-third of the schizophrenic population and are associated with a poor long- term outcome and a poor response to drug treatment.# Eugen Bleuler's fundamental symptoms of schizophrenia (4 A's)deg:- Ambivalence (marked inability to decide for or against)- Autism (Withdrawal into self)- Affect blunting (Disturbance of affect)- Association disturbances (loosening of association, thought disorder)# The four main subtypes of schizophrenia are catatonic, paranoid, disorganized, and residual.Catatonic-type:# Patients whose clinical presentation is dominated by profound changes in motor activity, negativism, and echolalia or echopraxia.- Paranoid-type:# Patients who have a prominent preoccupation with a specific delusional system and who otherwise do not qualify as having disorganized-type disease.- Disorganized-type:# Characterized by disorganized speech and behavior are accompanied by a superficial or silly affect.- Residual-type:# Negative symptomatology exists in the absence of delusions, hallucinations, or motor disturbance.# The term schizophreniform disorder describes patients who meet the symptom requirements but not the duration requirements for schizophrenia, and schizoaffective disorder is used for those who manifest symptoms of schizophrenia and independent periods of mood disturbance.Q ### End