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7,800 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: The test used to diagnose Dubin .lohnson syndrome is-, with the following options: A: Scrum transaminases, B: Bromsulphalein test (BSP), C: Hippuratc test, D: Gamma glutamyl transferase level
### Response:
| A prolonged BSP dye excretion test is diagnostic of Dubin Johnson syndrome BSP is a dye which is removed from circulation by the same mechanism as bilirubin. Reference Harsh mohan page no.593 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: The test used to diagnose Dubin .lohnson syndrome is-, with the following options: A: Scrum transaminases, B: Bromsulphalein test (BSP), C: Hippuratc test, D: Gamma glutamyl transferase level
### Response:
A prolonged BSP dye excretion test is diagnostic of Dubin Johnson syndrome BSP is a dye which is removed from circulation by the same mechanism as bilirubin. Reference Harsh mohan page no.593
### End |
7,801 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Cottage Loaf sign in Chest x-ray is seen in, with the following options: A: TGA, B: TAPVC, C: ASD, D: VSD
### Response:
| Snowman or Figure of 8 or Cottage Loaf sign is seen in TAPVC. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Cottage Loaf sign in Chest x-ray is seen in, with the following options: A: TGA, B: TAPVC, C: ASD, D: VSD
### Response:
Snowman or Figure of 8 or Cottage Loaf sign is seen in TAPVC.
### End |
7,802 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Which of these is FALSE for laparoscopic hysterectomy?, with the following options: A: In case of a previous midline scar, a minilap incision may be taken at the umbilicus for primary canula, B: While placing lateral pos , inferior epigastric vessels are to be avoided, C: After opening retroperitoneal space, ureter is identified over medial leaf of broad ligament, D: In LAVH uterine vessels are ligated laparoscopically after skeletonisation
### Response:
| The umbilical site typically is used in patients without a previous history of surgery or intra-abdominal infection. In cases of previous surgery where there was a midline incision or a history of a pelvic-abdominal incision, an open laparoscopy (mini lap at umbilicus) is recommended or an alternate site can be chosen to introduce the primary cannula. The most impoant step when placing lateral pos is to avoid the inferior epigastric vessels, which are branches of the external iliac aery and vein. The retroperitoneal space is opened after ligation of utero-ovarian ligament and the ureter identified on the medial leaf of the broad ligament. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Which of these is FALSE for laparoscopic hysterectomy?, with the following options: A: In case of a previous midline scar, a minilap incision may be taken at the umbilicus for primary canula, B: While placing lateral pos , inferior epigastric vessels are to be avoided, C: After opening retroperitoneal space, ureter is identified over medial leaf of broad ligament, D: In LAVH uterine vessels are ligated laparoscopically after skeletonisation
### Response:
The umbilical site typically is used in patients without a previous history of surgery or intra-abdominal infection. In cases of previous surgery where there was a midline incision or a history of a pelvic-abdominal incision, an open laparoscopy (mini lap at umbilicus) is recommended or an alternate site can be chosen to introduce the primary cannula. The most impoant step when placing lateral pos is to avoid the inferior epigastric vessels, which are branches of the external iliac aery and vein. The retroperitoneal space is opened after ligation of utero-ovarian ligament and the ureter identified on the medial leaf of the broad ligament.
### End |
7,803 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Oesophagus crosses the diaphragm at the level of:, with the following options: A: T8, B: T10, C: T12, D: T2
### Response:
| T10 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Oesophagus crosses the diaphragm at the level of:, with the following options: A: T8, B: T10, C: T12, D: T2
### Response:
T10
### End |
7,804 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: In Baden Walker Halfway system of classification of prolapse, the reference point is:, with the following options: A: Hymen, B: Introitus, C: Internal OS, D: External os
### Response:
| Baden walker halfway system STAGE DESCRIPTION 0 No descent of pelvis 1 leading edge of the prolapse remains 1cm or more above the hymenal ring II leading edge of the prolapse extends from 1 cm above to 1cm below the hymenal ring III From 1cm beyond the hymenal ring but without complete vaginal eversion IV Essentially complete eversion of vagina D.C.DUTTA&;S TEXTBOOK OF GYNAECOLOGY,Pg no:206,6th edition | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: In Baden Walker Halfway system of classification of prolapse, the reference point is:, with the following options: A: Hymen, B: Introitus, C: Internal OS, D: External os
### Response:
Baden walker halfway system STAGE DESCRIPTION 0 No descent of pelvis 1 leading edge of the prolapse remains 1cm or more above the hymenal ring II leading edge of the prolapse extends from 1 cm above to 1cm below the hymenal ring III From 1cm beyond the hymenal ring but without complete vaginal eversion IV Essentially complete eversion of vagina D.C.DUTTA&;S TEXTBOOK OF GYNAECOLOGY,Pg no:206,6th edition
### End |
7,805 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A 55-year-old female presents with abdominal pain, distension, ascites and dyspnea. Her CA 125 levels are elevated. The most likely diagnosis is:, with the following options: A: Ca ovary, B: Ca cervix, C: Ca lung, D: Symphoma
### Response:
| Ans. is a, i.e. Ca ovaryRef: Jeffcoates 7th/ed, p543; Novaks 15th/ed, p1366* M/c age incidence for primary ovarian neoplasms is 40-60 years, peak age incidence being 55-60 years. Ovarian malignancies generally present with vague symptoms like abdominal pain, dyspepsia, and patient may also experience irregular menses and if pelvic mass compresses the bladder or rectum she may have urinary frequency or constipation.In advanced stages patients have symptoms related to presence of ascites, omental metastasis or bowel metastasis like abdominal distension, dyspnea, bloating, nausea, anorexia or early satiety.In the patient given in the question all these symptoms are present (which could be seen in other cancers as well) plus her Ca 125 levels are raised, which favors the diagnosis of ovarian cancer in her.RememberThe most important sign of epithelial ovarian cancer is the presence of a pelvic mass on physical examination. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A 55-year-old female presents with abdominal pain, distension, ascites and dyspnea. Her CA 125 levels are elevated. The most likely diagnosis is:, with the following options: A: Ca ovary, B: Ca cervix, C: Ca lung, D: Symphoma
### Response:
Ans. is a, i.e. Ca ovaryRef: Jeffcoates 7th/ed, p543; Novaks 15th/ed, p1366* M/c age incidence for primary ovarian neoplasms is 40-60 years, peak age incidence being 55-60 years. Ovarian malignancies generally present with vague symptoms like abdominal pain, dyspepsia, and patient may also experience irregular menses and if pelvic mass compresses the bladder or rectum she may have urinary frequency or constipation.In advanced stages patients have symptoms related to presence of ascites, omental metastasis or bowel metastasis like abdominal distension, dyspnea, bloating, nausea, anorexia or early satiety.In the patient given in the question all these symptoms are present (which could be seen in other cancers as well) plus her Ca 125 levels are raised, which favors the diagnosis of ovarian cancer in her.RememberThe most important sign of epithelial ovarian cancer is the presence of a pelvic mass on physical examination.
### End |
7,806 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Young women suffering from 2-1 & 3rd degree uterovaginal prolapse, choice of operation is :, with the following options: A: Purandare and Mnatre sling operation, B: Virkud's sling operation, C: Mangeshkar's Laparoscopic technique, D: Neeta Way's Laparoscopic modification of shirodkar's operation
### Response:
| Purandare and Mnatre sling operation | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Young women suffering from 2-1 & 3rd degree uterovaginal prolapse, choice of operation is :, with the following options: A: Purandare and Mnatre sling operation, B: Virkud's sling operation, C: Mangeshkar's Laparoscopic technique, D: Neeta Way's Laparoscopic modification of shirodkar's operation
### Response:
Purandare and Mnatre sling operation
### End |
7,807 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Primary action of inferior oblique ?, with the following options: A: Abduction, B: Adduction, C: Extorsion, D: Elevation
### Response:
| Ans. is 'c' i.e., Extorsion | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Primary action of inferior oblique ?, with the following options: A: Abduction, B: Adduction, C: Extorsion, D: Elevation
### Response:
Ans. is 'c' i.e., Extorsion
### End |
7,808 | 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 diagnostic investigation for acute pancreatitis, with the following options: A: Serum amylase, B: Serum lipase, C: Serum P-isoamylase, D: Serum LDH
### Response:
| Diagnosis of Acute pancreatitis Corner Stone of the diagnosis of AP: Clinical findings +elevation of pancreatic enzyme level in the plasma Pancreatic enzymes A threefold or higher elevation of amylase & lipase levels confirms the diagnosis Amylase's serum half - life is shoer as compared with lipase Lipase is also a more specific marker of AP because serum amylase levels can be elevated in a number of conditions, such as peptic ulcer disease, mesentric ischaemia, salpingitis and microamylasemia Patients with AP are typically hyperglycemic; they can also have leukocytosis and abnormal elevation of liver enzyme levels Elevation of ALT levels in the serum in the context of AP has a positive predictive value of 95% in the diagnosis of acute biliary pancreatitis X-Ray abdomen Localized ileus of duodenum and proximal jejunum (sentinel loop) or that of transverse colon up to its mid point (colon cut off sign) IOC for acute pancreatitis : CECT Ref: Sabiston 20th edition Pgno :1524-1528 | 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 diagnostic investigation for acute pancreatitis, with the following options: A: Serum amylase, B: Serum lipase, C: Serum P-isoamylase, D: Serum LDH
### Response:
Diagnosis of Acute pancreatitis Corner Stone of the diagnosis of AP: Clinical findings +elevation of pancreatic enzyme level in the plasma Pancreatic enzymes A threefold or higher elevation of amylase & lipase levels confirms the diagnosis Amylase's serum half - life is shoer as compared with lipase Lipase is also a more specific marker of AP because serum amylase levels can be elevated in a number of conditions, such as peptic ulcer disease, mesentric ischaemia, salpingitis and microamylasemia Patients with AP are typically hyperglycemic; they can also have leukocytosis and abnormal elevation of liver enzyme levels Elevation of ALT levels in the serum in the context of AP has a positive predictive value of 95% in the diagnosis of acute biliary pancreatitis X-Ray abdomen Localized ileus of duodenum and proximal jejunum (sentinel loop) or that of transverse colon up to its mid point (colon cut off sign) IOC for acute pancreatitis : CECT Ref: Sabiston 20th edition Pgno :1524-1528
### End |
7,809 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Gottron's papules Seen in?, with the following options: A: SLE, B: MTCD, C: Dermatomyositis, D: Rheumatoid arthritis
### Response:
| ANSWER: (C) DermatomyositisREF: Harrison's 17th ed ch: 388DERM ATOM YOSITIS:DM is a distinctive entity identified by a characteristic rash accompanying, or more often preceding, muscle weakness.[?] Heliotrope rash: The rash may consist of a blue-purple discoloration on the upper eyelids with edema[?] Gottron's sign: A flat red rash on the face and upper trunk and erythema of the knuckles with a raised violaceous scaly eruption.[?] Gottron's papules: Discrete erythematous papules overlying the metacarpal and interphalangeal joint[?] The erythematous rash can also occur on other body surfaces, including the knees, elbows, malleoli, neck and anterior chest (often in a V sign), or back and shoulders (shawl sign), and may worsen after sun exposure.[?] In some patients, the rash is pruritic, especially on the scalp, chest, and back.[?] Dilated capillary loops at the base of the fingernails are also characteristic. The cuticles may be irregular, thickened, and distorted, and the lateral and palmar areas of the fingers may become rough and cracked, with irregular, "dirty" horizontal lines, resembling mechanics hands. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Gottron's papules Seen in?, with the following options: A: SLE, B: MTCD, C: Dermatomyositis, D: Rheumatoid arthritis
### Response:
ANSWER: (C) DermatomyositisREF: Harrison's 17th ed ch: 388DERM ATOM YOSITIS:DM is a distinctive entity identified by a characteristic rash accompanying, or more often preceding, muscle weakness.[?] Heliotrope rash: The rash may consist of a blue-purple discoloration on the upper eyelids with edema[?] Gottron's sign: A flat red rash on the face and upper trunk and erythema of the knuckles with a raised violaceous scaly eruption.[?] Gottron's papules: Discrete erythematous papules overlying the metacarpal and interphalangeal joint[?] The erythematous rash can also occur on other body surfaces, including the knees, elbows, malleoli, neck and anterior chest (often in a V sign), or back and shoulders (shawl sign), and may worsen after sun exposure.[?] In some patients, the rash is pruritic, especially on the scalp, chest, and back.[?] Dilated capillary loops at the base of the fingernails are also characteristic. The cuticles may be irregular, thickened, and distorted, and the lateral and palmar areas of the fingers may become rough and cracked, with irregular, "dirty" horizontal lines, resembling mechanics hands.
### End |
7,810 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: The mechanism of hearing and memory, include all, EXCEPT:, with the following options: A: Changes in level of neurotransmitter at synapse, B: Increasing protein synthesis, C: Recruitment by multiplication of neurons, D: Spatial Reorganization of synapse
### Response:
| Neurons are 'permanent cells' that do not undergo mitotic division in post natal life. The production of neurons stop sholy after bih. Ref: Neurons and Networks: An Introduction to Behavioral Neuroscience By John E. Dowling; Ganong's Review of Medical Physiology, 22nd Edition, Page 259, 270; Robbins Pathologic Basis of Disease, 7th Edition, Page 91 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: The mechanism of hearing and memory, include all, EXCEPT:, with the following options: A: Changes in level of neurotransmitter at synapse, B: Increasing protein synthesis, C: Recruitment by multiplication of neurons, D: Spatial Reorganization of synapse
### Response:
Neurons are 'permanent cells' that do not undergo mitotic division in post natal life. The production of neurons stop sholy after bih. Ref: Neurons and Networks: An Introduction to Behavioral Neuroscience By John E. Dowling; Ganong's Review of Medical Physiology, 22nd Edition, Page 259, 270; Robbins Pathologic Basis of Disease, 7th Edition, Page 91
### End |
7,811 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Arachidonic acid metabolites are all except:, with the following options: A: Prostaglandin G2, B: Leukotriene C4, C: Thromboxanes, D: Phospholipase
### Response:
| The lipid mediators prostaglandins and leukotrienes are produced from arachidonic acid (AA) present in membrane phospholipids, and stimulate vascular and cellular reactions in acute inflammation. AA derived mediators, also called eicosanoids (because they are derived from 20 carbon fatty acids; Greek eicosa = 20) These are synthesized by two major classes of enzymes: cyclooxygenases (which generate prostaglandins and thromboxanes) lipoxygenases (which produce leukotrienes and lipoxins) Principal actions of Arachidonic acid metabolites in inflammation Action Eicosanoid Vasodilation Prostaglandins PGI2 (prostacyclin), PGE1, PGE2, PGD2 Vasoconstriction Thromboxane A2, leukotrienes C4, D4, E4 Increased vascular permeability Leukotrienes C4, D4, E4 Chemotaxis, leukocyte adhesion Leukotrienes B4, HETE (hydroxyeicosatetraenoic acid.) | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Arachidonic acid metabolites are all except:, with the following options: A: Prostaglandin G2, B: Leukotriene C4, C: Thromboxanes, D: Phospholipase
### Response:
The lipid mediators prostaglandins and leukotrienes are produced from arachidonic acid (AA) present in membrane phospholipids, and stimulate vascular and cellular reactions in acute inflammation. AA derived mediators, also called eicosanoids (because they are derived from 20 carbon fatty acids; Greek eicosa = 20) These are synthesized by two major classes of enzymes: cyclooxygenases (which generate prostaglandins and thromboxanes) lipoxygenases (which produce leukotrienes and lipoxins) Principal actions of Arachidonic acid metabolites in inflammation Action Eicosanoid Vasodilation Prostaglandins PGI2 (prostacyclin), PGE1, PGE2, PGD2 Vasoconstriction Thromboxane A2, leukotrienes C4, D4, E4 Increased vascular permeability Leukotrienes C4, D4, E4 Chemotaxis, leukocyte adhesion Leukotrienes B4, HETE (hydroxyeicosatetraenoic acid.)
### End |
7,812 | 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 changes may be observed in a normal pregnancy, EXCEPT:, with the following options: A: Increase in blood viscosity, B: Fall in serum iron concentration, C: Increase in serum iron binding capacity, D: Increase in blood oxygen carrying capacity
### Response:
| During pregnancy there is a dispropoionate increase in plasma and RBC volume which produces a state of hemodilution during pregnancy. During pregnancy plasma volume increases upto 50%. RBC volume increases to the extend of 20-30%. The advantages of hemodilution are: Diminished blood viscosity ensures optimum gaseous exchange between the maternal and fetal circulation. Protection of mother against the adverse effects of blood loss during delivery. Ref: Textbook of Obstetrics By D.C. Dutta, 6th edition, Pages 51-55 | 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 changes may be observed in a normal pregnancy, EXCEPT:, with the following options: A: Increase in blood viscosity, B: Fall in serum iron concentration, C: Increase in serum iron binding capacity, D: Increase in blood oxygen carrying capacity
### Response:
During pregnancy there is a dispropoionate increase in plasma and RBC volume which produces a state of hemodilution during pregnancy. During pregnancy plasma volume increases upto 50%. RBC volume increases to the extend of 20-30%. The advantages of hemodilution are: Diminished blood viscosity ensures optimum gaseous exchange between the maternal and fetal circulation. Protection of mother against the adverse effects of blood loss during delivery. Ref: Textbook of Obstetrics By D.C. Dutta, 6th edition, Pages 51-55
### End |
7,813 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Megaloblastic anemia should be treated with both folic acid and vitamin B12 because:, with the following options: A: Folic acid alone causes improvement of hematologic symptoms but worsening of neurological symptoms, B: It is a co factor, C: It is enzyme, D: None of the above
### Response:
| Megaloblastic anemia may be caused by a deficiency of vitamin B12 (cobalamine) or deficiency of folate. Unless it is clearly established, which of the two deficiencies (folate or cobalamine) is the cause anemia, treatment should include administration of both folic acid and vitamin B12. If only folic acid is administered in a patient with megaloblastic anemia due to vitamin B12 deficiency, worsening of neurological symptoms (cobalamine neuropathy) is seen despite an improvement in the hematological symptoms (anemia). So "Folic acid alone causes improvement of hematologic symptoms but worsening of neurological symptoms" is the single best answer of choice. Ref: Harrison's Principles of Internal Medicine, 17th Edition, Page 651 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Megaloblastic anemia should be treated with both folic acid and vitamin B12 because:, with the following options: A: Folic acid alone causes improvement of hematologic symptoms but worsening of neurological symptoms, B: It is a co factor, C: It is enzyme, D: None of the above
### Response:
Megaloblastic anemia may be caused by a deficiency of vitamin B12 (cobalamine) or deficiency of folate. Unless it is clearly established, which of the two deficiencies (folate or cobalamine) is the cause anemia, treatment should include administration of both folic acid and vitamin B12. If only folic acid is administered in a patient with megaloblastic anemia due to vitamin B12 deficiency, worsening of neurological symptoms (cobalamine neuropathy) is seen despite an improvement in the hematological symptoms (anemia). So "Folic acid alone causes improvement of hematologic symptoms but worsening of neurological symptoms" is the single best answer of choice. Ref: Harrison's Principles of Internal Medicine, 17th Edition, Page 651
### End |
7,814 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: With the use of DMPA contraceptive, the side effects are all of the following EXCEPT:, with the following options: A: Change in quantity and quality of breast milk, B: Weight gain, C: Irregular bleeding, D: Increased reproductive tract inflection
### Response:
| Ans. is 'a' ie change in quantity and quality of breast milk. Change in quantity and quality of breast milk is seen with the use of estrogen contraceptives not progesterone.Infact is a plus point of DMPA that it does not affect lactation. It can be therefore used in the post-partum period, without affecting the lactation.Side effects of Depot Medroxy Progesterone Acetate (DMPA)Weight gain*Irregular menstrual bleeding*Increased incidence of ectopic pregnancy *Increased risk of ovarian cystsProlonged anovulation and infertility after its use is discontinuedOsteoporosis.I could not get any information on the option 'd' (ie increased reproductive tract infection) despite exhaustive search in Williams, Dutta, Shaw's and Park.The only information which I have is that, the risk of vaginitis or vulvovaginitis (Candida) is increased by use of combined pills. Which component of the pill (estrogen or progesterone) is responsible for this is not known. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: With the use of DMPA contraceptive, the side effects are all of the following EXCEPT:, with the following options: A: Change in quantity and quality of breast milk, B: Weight gain, C: Irregular bleeding, D: Increased reproductive tract inflection
### Response:
Ans. is 'a' ie change in quantity and quality of breast milk. Change in quantity and quality of breast milk is seen with the use of estrogen contraceptives not progesterone.Infact is a plus point of DMPA that it does not affect lactation. It can be therefore used in the post-partum period, without affecting the lactation.Side effects of Depot Medroxy Progesterone Acetate (DMPA)Weight gain*Irregular menstrual bleeding*Increased incidence of ectopic pregnancy *Increased risk of ovarian cystsProlonged anovulation and infertility after its use is discontinuedOsteoporosis.I could not get any information on the option 'd' (ie increased reproductive tract infection) despite exhaustive search in Williams, Dutta, Shaw's and Park.The only information which I have is that, the risk of vaginitis or vulvovaginitis (Candida) is increased by use of combined pills. Which component of the pill (estrogen or progesterone) is responsible for this is not known.
### End |
7,815 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Doc for Listeria Monocytogenes is, with the following options: A: Amoxycillin, B: Ampicillin, C: Amikacin, D: Ceftriaxone
### Response:
| Doc - Ampicillin
Cotrimoxazole in case of penicillin allergy. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Doc for Listeria Monocytogenes is, with the following options: A: Amoxycillin, B: Ampicillin, C: Amikacin, D: Ceftriaxone
### Response:
Doc - Ampicillin
Cotrimoxazole in case of penicillin allergy.
### End |
7,816 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: MC cause of anovulation is?, with the following options: A: PCOS, B: Hyperprolactinemia, C: Premature ovarian failure, D: Low ovarian reserves
### Response:
| Ans. is 'a' i.e.,PCOSAnovulation and ovulatory dysfunction can be caused by a number of factors.The most common cause of ovulatory dysfunction is polycystic ovarian syndrome, or PCOS.Other potential causes of irregular or absent ovulation:Obesity Underweight Extreme exerciseHyperprolactinemia Premature ovarian failure Perimenopause, or low ovarian reservesThyroid dysfunction Extremely high levels of stress | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: MC cause of anovulation is?, with the following options: A: PCOS, B: Hyperprolactinemia, C: Premature ovarian failure, D: Low ovarian reserves
### Response:
Ans. is 'a' i.e.,PCOSAnovulation and ovulatory dysfunction can be caused by a number of factors.The most common cause of ovulatory dysfunction is polycystic ovarian syndrome, or PCOS.Other potential causes of irregular or absent ovulation:Obesity Underweight Extreme exerciseHyperprolactinemia Premature ovarian failure Perimenopause, or low ovarian reservesThyroid dysfunction Extremely high levels of stress
### End |
7,817 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Which bacteria acts by inhibiting protein synthesis?, with the following options: A: Pseudomonas, B: Staphylococcus, C: Streptococcus, D: Klebsiella
### Response:
| Ans. is 'a' i.e., Pseudomonas | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Which bacteria acts by inhibiting protein synthesis?, with the following options: A: Pseudomonas, B: Staphylococcus, C: Streptococcus, D: Klebsiella
### Response:
Ans. is 'a' i.e., Pseudomonas
### End |
7,818 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: The superficial external pudendal aery is a branch of which of the following aery?, with the following options: A: Aoa, B: Femoral aery, C: External iliac aery, D: Internal iliac aery
### Response:
| Superficial external pudendal aery is a branch of femoral aery. It runs medially to supply skin of the scrotum (or labium majus). | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: The superficial external pudendal aery is a branch of which of the following aery?, with the following options: A: Aoa, B: Femoral aery, C: External iliac aery, D: Internal iliac aery
### Response:
Superficial external pudendal aery is a branch of femoral aery. It runs medially to supply skin of the scrotum (or labium majus).
### End |
7,819 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Commonest immediate complication after dilatation and evacuation for MTP is: September 2011, with the following options: A: Haemorrhage, B: Injury, C: Retained products of conception, D: Sepsis
### Response:
| Ans. A: Haemorrhage Immediate complications of D and E operation includes 1) haemorrhage, 2) injury, 3) shock, 4) perforation of vessels/ viscera, 5) sepsis, 6) haematometra and 7) increased morbidity. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Commonest immediate complication after dilatation and evacuation for MTP is: September 2011, with the following options: A: Haemorrhage, B: Injury, C: Retained products of conception, D: Sepsis
### Response:
Ans. A: Haemorrhage Immediate complications of D and E operation includes 1) haemorrhage, 2) injury, 3) shock, 4) perforation of vessels/ viscera, 5) sepsis, 6) haematometra and 7) increased morbidity.
### End |
7,820 | 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 describes humoral hypercalcemia of malignancy (HHM)?, with the following options: A: The rise in calcium levels due to PTH-rP, B: Paraneoplastic Calcitonin Production, C: Vitamin D Hypervitaminosis, D: Parafollicular C-cell proliferation of Thyroid Gland
### Response:
| The rise in calcium levels due to PTH-rP is termed humoral hypercalcemia of malignancy (HHM). A common consequence of some cancers can be increased levels of calcium (hypercalcemia) with secretion of PTH-related peptide (PTH-rP). PTH-rP has significant homology with PTH, but only in the amino-terminal 13 amino acids, which make up the receptor-binding region. Because PTH-rP is not secreted by the parathyroid glands, hypercalcemia produces no feedback regulation of its production. Cancers usually associated with HHM include breast and lung cancers and multiple myeloma. Ref: Kerr J. (2012). Chapter 13. Connective Tissue and Bone. In L.W. Janson, M.E. Tischler (Eds), The Big Picture: Medical Biochemistry. | 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 describes humoral hypercalcemia of malignancy (HHM)?, with the following options: A: The rise in calcium levels due to PTH-rP, B: Paraneoplastic Calcitonin Production, C: Vitamin D Hypervitaminosis, D: Parafollicular C-cell proliferation of Thyroid Gland
### Response:
The rise in calcium levels due to PTH-rP is termed humoral hypercalcemia of malignancy (HHM). A common consequence of some cancers can be increased levels of calcium (hypercalcemia) with secretion of PTH-related peptide (PTH-rP). PTH-rP has significant homology with PTH, but only in the amino-terminal 13 amino acids, which make up the receptor-binding region. Because PTH-rP is not secreted by the parathyroid glands, hypercalcemia produces no feedback regulation of its production. Cancers usually associated with HHM include breast and lung cancers and multiple myeloma. Ref: Kerr J. (2012). Chapter 13. Connective Tissue and Bone. In L.W. Janson, M.E. Tischler (Eds), The Big Picture: Medical Biochemistry.
### End |
7,821 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Moist burn refers to?, with the following options: A: Simple bums, B: Scalds, C: Electric bums, D: Thermal bums
### Response:
| Ans. is 'b' i.e., Moist heat o Dry heat (e.g. flame) - Simple burns (or burns).o Moist heat - Scalds. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Moist burn refers to?, with the following options: A: Simple bums, B: Scalds, C: Electric bums, D: Thermal bums
### Response:
Ans. is 'b' i.e., Moist heat o Dry heat (e.g. flame) - Simple burns (or burns).o Moist heat - Scalds.
### End |
7,822 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: All of the following statements are true for episiotomies except:, with the following options: A: Allows widening of bih canal, B: Can be either mid-line or medio -lateral, C: Involvement of anal sphincter is classified 3rd degree perineal tear., D: Mid-line episiotomies bleed less, are easier to repair and heal more quickly
### Response:
| The bih canal is the path made by the pelvic curve through the planes of inlet mid pelvis and outlet, to be taken by the baby, while the vulva is the opening of the bih canal on which the episiotomy is given. An episiotomy will therefore not increase the size of the bih canal per se, but only widen the perineal outlet to facilitate delivery of the baby in conditions like a tight perineum, shoulder dystocia, breech delivery, and prior to application of forceps etc. Involvement of the anal spincter is seen in third degree tear. Type III and IV constitute the Complete Perineal tear. Mid-line episiotomies bleed lesser and heals better but can extend into anal sphincter easily. There are 2 main types- mid-line and medio-lateral episiotomy | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: All of the following statements are true for episiotomies except:, with the following options: A: Allows widening of bih canal, B: Can be either mid-line or medio -lateral, C: Involvement of anal sphincter is classified 3rd degree perineal tear., D: Mid-line episiotomies bleed less, are easier to repair and heal more quickly
### Response:
The bih canal is the path made by the pelvic curve through the planes of inlet mid pelvis and outlet, to be taken by the baby, while the vulva is the opening of the bih canal on which the episiotomy is given. An episiotomy will therefore not increase the size of the bih canal per se, but only widen the perineal outlet to facilitate delivery of the baby in conditions like a tight perineum, shoulder dystocia, breech delivery, and prior to application of forceps etc. Involvement of the anal spincter is seen in third degree tear. Type III and IV constitute the Complete Perineal tear. Mid-line episiotomies bleed lesser and heals better but can extend into anal sphincter easily. There are 2 main types- mid-line and medio-lateral episiotomy
### End |
7,823 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: BCG is used for:, with the following options: A: Treatment of tuberculosis, B: Treatment of superficial bladder cancer, C: Treatment of anthrax, D: All of the above
### Response:
| (Ref: Goodman & Gliman 11/e p1422) BCG is used for immunization against TB. It is also used for the treatment of superficial bladder cancers. It is directly instilled in the urinary bladder for this purpose. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: BCG is used for:, with the following options: A: Treatment of tuberculosis, B: Treatment of superficial bladder cancer, C: Treatment of anthrax, D: All of the above
### Response:
(Ref: Goodman & Gliman 11/e p1422) BCG is used for immunization against TB. It is also used for the treatment of superficial bladder cancers. It is directly instilled in the urinary bladder for this purpose.
### End |
7,824 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: In a multilayered wound, the deep layer is sutured by chromic gut. This is done because chromic gut sutures have:, with the following options: A: Increased strength, B: Increased ease of use, C: Delayed resorption, D: Less tissue irritation
### Response:
| This is a direct pick from one of the question banks and hence the answer given there must be followed. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: In a multilayered wound, the deep layer is sutured by chromic gut. This is done because chromic gut sutures have:, with the following options: A: Increased strength, B: Increased ease of use, C: Delayed resorption, D: Less tissue irritation
### Response:
This is a direct pick from one of the question banks and hence the answer given there must be followed.
### End |
7,825 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Peripheral level health workers are all except?, with the following options: A: Anganwadi workers, B: DAIS, C: Gram Sevak, D: VHNS
### Response:
| Ans. is 'c' i.e., Gram Sevak | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Peripheral level health workers are all except?, with the following options: A: Anganwadi workers, B: DAIS, C: Gram Sevak, D: VHNS
### Response:
Ans. is 'c' i.e., Gram Sevak
### End |
7,826 | 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 erythropoietin is FALSE ?, with the following options: A: It is used for the treatment of anemia due to chronic renal failure, B: It results in decrease in reticulocyte count, C: It decrease the requirement of blood transfusions, D: It can cause hypeension
### Response:
| Ans. is 'b' i.e., It results in decrease in reticulocyte count The primary use of epoetin (recombinant human erythropoietin) is anemia of chronic renal failure. o Other uses --> anemia in AIDS patients treated with zidovudin, cancer chemotherapy induced anemia, and preoperative increased blood production for autologous transfusion during surgery. "The most common adverse effects of erythropoietin are hypeension and thrombotic complications". o It acts on erythroid marrow and ? Stimulates proliferation of colony forming cells of the erythroid series. Induces hemoglobin formation and erythroblast maturation. Releases reticulocytes in circulation --> increased reticulocyte count. | 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 erythropoietin is FALSE ?, with the following options: A: It is used for the treatment of anemia due to chronic renal failure, B: It results in decrease in reticulocyte count, C: It decrease the requirement of blood transfusions, D: It can cause hypeension
### Response:
Ans. is 'b' i.e., It results in decrease in reticulocyte count The primary use of epoetin (recombinant human erythropoietin) is anemia of chronic renal failure. o Other uses --> anemia in AIDS patients treated with zidovudin, cancer chemotherapy induced anemia, and preoperative increased blood production for autologous transfusion during surgery. "The most common adverse effects of erythropoietin are hypeension and thrombotic complications". o It acts on erythroid marrow and ? Stimulates proliferation of colony forming cells of the erythroid series. Induces hemoglobin formation and erythroblast maturation. Releases reticulocytes in circulation --> increased reticulocyte count.
### End |
7,827 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A patient presents to the emergency room with vomiting, diarrhea, high fever, and delirium. Upon physical examination, you notice large buboes, which are painful on palpation, and purpura and ecchymoses suggestive of disseminated intravascular coagulation. Gram stain on aspirate of a bubo reveals gram-negative rods with bipolar staining. Which of the following antibiotics is the drug of choice for empiric therapy?, with the following options: A: Ceftazidime, B: Chloramphenicol, C: Penicillin, D: Streptomycin
### Response:
| The patient is infected with Yersiniapestis and has bubonic plague. The drug of choice for plague is streptomycin (d). Gentamicin or another aminoglycoside can be substituted. Ceftazidime, chloramphenicol, penicillin, and vancomycin are not used to treat plague. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A patient presents to the emergency room with vomiting, diarrhea, high fever, and delirium. Upon physical examination, you notice large buboes, which are painful on palpation, and purpura and ecchymoses suggestive of disseminated intravascular coagulation. Gram stain on aspirate of a bubo reveals gram-negative rods with bipolar staining. Which of the following antibiotics is the drug of choice for empiric therapy?, with the following options: A: Ceftazidime, B: Chloramphenicol, C: Penicillin, D: Streptomycin
### Response:
The patient is infected with Yersiniapestis and has bubonic plague. The drug of choice for plague is streptomycin (d). Gentamicin or another aminoglycoside can be substituted. Ceftazidime, chloramphenicol, penicillin, and vancomycin are not used to treat plague.
### End |
7,828 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: True about genetic code except: (PGI June 2009), with the following options: A: Degenerate, B: Overlapping, C: Ambiguous, D: Universal
### Response:
| Ans: B (Overlapping) & C (Ambiguous) The genetic code is specific (unambiguous), universal, degenerate, nonoverlapping & commaless.Charactemtlc-of Genetic Codespecificity: The genetic code is specificQ (unambiguous) i,e. a particular codon always codes for the same amino acid.universality: The genetic code is virtually universal i.e. the specificity of the genetic code has been conserved from very early stages of evolution with only slight differences in the manner in which the code is translated.degeneracy: The genetic code is degenerate (sometimes called redundant) Although each codon corresponds to a single amino acid, a given amino acid may have more than one triplet coding for it.Nonoverlapping & commaless: The genetic code is nonoverlapping & commutes, i.e. the code is read from a fixed starting point as a continuous sequence of bases, taken three at a time.Not punctuated | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: True about genetic code except: (PGI June 2009), with the following options: A: Degenerate, B: Overlapping, C: Ambiguous, D: Universal
### Response:
Ans: B (Overlapping) & C (Ambiguous) The genetic code is specific (unambiguous), universal, degenerate, nonoverlapping & commaless.Charactemtlc-of Genetic Codespecificity: The genetic code is specificQ (unambiguous) i,e. a particular codon always codes for the same amino acid.universality: The genetic code is virtually universal i.e. the specificity of the genetic code has been conserved from very early stages of evolution with only slight differences in the manner in which the code is translated.degeneracy: The genetic code is degenerate (sometimes called redundant) Although each codon corresponds to a single amino acid, a given amino acid may have more than one triplet coding for it.Nonoverlapping & commaless: The genetic code is nonoverlapping & commutes, i.e. the code is read from a fixed starting point as a continuous sequence of bases, taken three at a time.Not punctuated
### End |
7,829 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A 30 years old male comes to oho emergency with his 3 years old daughter who is crying. The father gives the history of child being swung by forearm. The most probable diagnosis is:, with the following options: A: Supracondylar humerus fracture, B: Elbow dislocation, C: Stress fracture, D: Pulled elbow
### Response:
| D i.e. Pulled elbow | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A 30 years old male comes to oho emergency with his 3 years old daughter who is crying. The father gives the history of child being swung by forearm. The most probable diagnosis is:, with the following options: A: Supracondylar humerus fracture, B: Elbow dislocation, C: Stress fracture, D: Pulled elbow
### Response:
D i.e. Pulled elbow
### End |
7,830 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: All are a differential diagnosis in hypochromic microcytic anaemia Except, with the following options: A: Thalassemia, B: Iron deficiency, C: Sideroblastic anemia, D: Recent blood loss
### Response:
| Differential diagnosis of a hypochromic microcytic anaemia: iron deficiency, thalassemia, anaemia of chronic disease, sideroblastic anaemia.In recent blood loss, the blood smear shows macrocytosis and polychromasia, which results from an increased reticulocyte count.Harrison 19e pg: 628 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: All are a differential diagnosis in hypochromic microcytic anaemia Except, with the following options: A: Thalassemia, B: Iron deficiency, C: Sideroblastic anemia, D: Recent blood loss
### Response:
Differential diagnosis of a hypochromic microcytic anaemia: iron deficiency, thalassemia, anaemia of chronic disease, sideroblastic anaemia.In recent blood loss, the blood smear shows macrocytosis and polychromasia, which results from an increased reticulocyte count.Harrison 19e pg: 628
### End |
7,831 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Low levels of dopamine produced by the hypothalamus is a pathologic condition associated with which of the blood hormone levels., with the following options: A: High prolactin (PRL), B: High TSH, C: High cortisol, D: Low growth hormone (GH)
### Response:
| Tyrosine, produced by the hydroxylation of the essential amino acid phenylalanine, is further hydroxylated to form dihydroxyphenylalanine (dopa), which is subsequently decarboxylated to form dopamine.Dopamine is an inhibitor of prolactin production and secretion. Thus, if dopamine is low, more prolactin will be produced and secreted by the anterior pituitary. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Low levels of dopamine produced by the hypothalamus is a pathologic condition associated with which of the blood hormone levels., with the following options: A: High prolactin (PRL), B: High TSH, C: High cortisol, D: Low growth hormone (GH)
### Response:
Tyrosine, produced by the hydroxylation of the essential amino acid phenylalanine, is further hydroxylated to form dihydroxyphenylalanine (dopa), which is subsequently decarboxylated to form dopamine.Dopamine is an inhibitor of prolactin production and secretion. Thus, if dopamine is low, more prolactin will be produced and secreted by the anterior pituitary.
### End |
7,832 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Most common cause ofAbdominal aneurysm is -, with the following options: A: Atherosclerosis, B: Trauma, C: Marfan's syndrome, D: Congenital
### Response:
| Ans. is 'a' i.e., AtherosclerosisAbdominal aoic aneurysm o The most common etiology for abdominal aoic aneurysm is atherosclerosis.o Atherosclerosis causes aerial wall thining through medial destruction secondary to plaque that originates in the intima.o Besides abdominal aoa, atherosclerotic aneurysm also occur in common iliac aeries, arch and descending pa of thoracic aoa.o The usual site of abdominal aoic aneurism is below the origin of renal aery and above the bifurcation of the aoa.Remembero Most common cause of aoic aneurysm (overall) = Atherosclerosis.o Most common cause of ascending aoic aneurysm = Cystic medial necrosis.o Most common cause of descending aoic aneurysm = Atherosclerosis.o Most common cause of aneurysm of aoic arch = Atherosclerosis.o Syphilitic aneurysm affect = Ascending aoa.o Aneurysm of Takayasu aeritis affects = Aoic arch.o Most common cause of mycotic abdominal aneurysm = salmonella gastroenteritis. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Most common cause ofAbdominal aneurysm is -, with the following options: A: Atherosclerosis, B: Trauma, C: Marfan's syndrome, D: Congenital
### Response:
Ans. is 'a' i.e., AtherosclerosisAbdominal aoic aneurysm o The most common etiology for abdominal aoic aneurysm is atherosclerosis.o Atherosclerosis causes aerial wall thining through medial destruction secondary to plaque that originates in the intima.o Besides abdominal aoa, atherosclerotic aneurysm also occur in common iliac aeries, arch and descending pa of thoracic aoa.o The usual site of abdominal aoic aneurism is below the origin of renal aery and above the bifurcation of the aoa.Remembero Most common cause of aoic aneurysm (overall) = Atherosclerosis.o Most common cause of ascending aoic aneurysm = Cystic medial necrosis.o Most common cause of descending aoic aneurysm = Atherosclerosis.o Most common cause of aneurysm of aoic arch = Atherosclerosis.o Syphilitic aneurysm affect = Ascending aoa.o Aneurysm of Takayasu aeritis affects = Aoic arch.o Most common cause of mycotic abdominal aneurysm = salmonella gastroenteritis.
### End |
7,833 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Role of 2, 3 DPG in hemoglobin -, with the following options: A: Unloading oxygen to tissues, B: Increased affinity for oxygen, C: Buffering capacity, D: Osmotic fraglity
### Response:
| A i.e. Unloading oxygen to tissues | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Role of 2, 3 DPG in hemoglobin -, with the following options: A: Unloading oxygen to tissues, B: Increased affinity for oxygen, C: Buffering capacity, D: Osmotic fraglity
### Response:
A i.e. Unloading oxygen to tissues
### End |
7,834 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Rupa Devi age 65 year old female with ovarian cancer is being treated with cisplatin based chemotherapy. All of the following are used to limit the toxicity of cisplatin except, with the following options: A: N-acetylcycteine, B: Slow rate of infusion, C: Chloride diuresis, D: Amifostine
### Response:
| Ref-harrison 18/e p697 N-acetylcycteine used for Paracetamol poisoning whereas slow intravenous infusion and chloride diersis with amifostine can limit cisplatin induced nephrotoxicity | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Rupa Devi age 65 year old female with ovarian cancer is being treated with cisplatin based chemotherapy. All of the following are used to limit the toxicity of cisplatin except, with the following options: A: N-acetylcycteine, B: Slow rate of infusion, C: Chloride diuresis, D: Amifostine
### Response:
Ref-harrison 18/e p697 N-acetylcycteine used for Paracetamol poisoning whereas slow intravenous infusion and chloride diersis with amifostine can limit cisplatin induced nephrotoxicity
### End |
7,835 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: In a coho study conducted, out of those exposed to risk factor 10 are diseased and out of those non - exposed to risk factor only 5 are diseased. What is the Relative risk?, with the following options: A: 1.33, B: 2, C: 0.5, D: 50
### Response:
| Relative risk = Incidence among exposed / incidence among non - exposed Incidence among exposed is 10, Incidence among non - exposed is 5 Thus, relative risk is 10/5 = 2 Relative risk 2 implies that association is present; and risk of development of disease among exposed is twice as common as compared to non - exposed. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: In a coho study conducted, out of those exposed to risk factor 10 are diseased and out of those non - exposed to risk factor only 5 are diseased. What is the Relative risk?, with the following options: A: 1.33, B: 2, C: 0.5, D: 50
### Response:
Relative risk = Incidence among exposed / incidence among non - exposed Incidence among exposed is 10, Incidence among non - exposed is 5 Thus, relative risk is 10/5 = 2 Relative risk 2 implies that association is present; and risk of development of disease among exposed is twice as common as compared to non - exposed.
### End |
7,836 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A 38 year old female complaining of decreased hearing in the right ear for the last two years. On testing with a 512 Hz tuning fork, the rinne's test without masking is negative on the right ear and positive on the left ear. With the weber's test, the tone is perceived as louder in the left ear. The most likely problem the patient has is, with the following options: A: Right conductive hearing loss, B: Right sensorineural hearing loss, C: Left sensorineural hearing loss, D: Left conductive hearing loss
### Response:
| Patient is presenting with right sided deafness.Interpretation of Rinne's test in this patientRight side negative means : -i) Right sided conductive deafness.orii) Right sided severe sensorineural hearing loss which gives false negative results.Left side positive test means : -Normal left earLeft sided sensorineural hearing loss (However this is not the case in this patient as the patient is presenting with right sided hearing loss).Interpretation of Weber test in this patientWeber is lateralized to left ear. That means : -Right sided sensorineural hearing loss.Left sided conductive deafness (However, this is not the case as patient is presenting with right sided hearing loss).Thus , this patient is suffering from severe right side sensorineural hearing loss in which the Rinne's test is false negative and weber is lateralized to left ear. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A 38 year old female complaining of decreased hearing in the right ear for the last two years. On testing with a 512 Hz tuning fork, the rinne's test without masking is negative on the right ear and positive on the left ear. With the weber's test, the tone is perceived as louder in the left ear. The most likely problem the patient has is, with the following options: A: Right conductive hearing loss, B: Right sensorineural hearing loss, C: Left sensorineural hearing loss, D: Left conductive hearing loss
### Response:
Patient is presenting with right sided deafness.Interpretation of Rinne's test in this patientRight side negative means : -i) Right sided conductive deafness.orii) Right sided severe sensorineural hearing loss which gives false negative results.Left side positive test means : -Normal left earLeft sided sensorineural hearing loss (However this is not the case in this patient as the patient is presenting with right sided hearing loss).Interpretation of Weber test in this patientWeber is lateralized to left ear. That means : -Right sided sensorineural hearing loss.Left sided conductive deafness (However, this is not the case as patient is presenting with right sided hearing loss).Thus , this patient is suffering from severe right side sensorineural hearing loss in which the Rinne's test is false negative and weber is lateralized to left ear.
### End |
7,837 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Best screening test for pheochromocytoma?, with the following options: A: Urinary VMA estimation, B: Serum catecholamine estimation, C: Clonidine suppression test, D: Urinarymetanephrine
### Response:
| Ans: a (Urinary VMA estimation)Ref: Vasudevan & Sreekumari, 6th edi., Pg. 207Vanillyl mandelic acid (VMA) in urineVMA is the main urinary metabolite of the norepinephrine pathway. Metanephrine is acted upon by mono amine oxidase to form(VMA). Normal level of excretion of VMA is 2-6 mg/24 hr.lt is increased in pheochromocytoma and in neuroblastoma.Patient is asked to refrain from intake of chocolate, coffee, banana, vanilla ice creams, citrus fruits (lime & orange). These items contain vanillin, which produces very high value of VMA in urine. Patient should not take aspirin or drugs containing phenol ring.Homovanillic acid (HVA) in urine: HVA is the main urinary metabolite of dopa and dopamine pathway It is increased in neuroblastoma, malignant pheochromocytoma and ganglioneuroma.It is useful to predict prognosis of neuroblastoma. Drugs increasing the value are -L-dopa, disulfiram and reserpine. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Best screening test for pheochromocytoma?, with the following options: A: Urinary VMA estimation, B: Serum catecholamine estimation, C: Clonidine suppression test, D: Urinarymetanephrine
### Response:
Ans: a (Urinary VMA estimation)Ref: Vasudevan & Sreekumari, 6th edi., Pg. 207Vanillyl mandelic acid (VMA) in urineVMA is the main urinary metabolite of the norepinephrine pathway. Metanephrine is acted upon by mono amine oxidase to form(VMA). Normal level of excretion of VMA is 2-6 mg/24 hr.lt is increased in pheochromocytoma and in neuroblastoma.Patient is asked to refrain from intake of chocolate, coffee, banana, vanilla ice creams, citrus fruits (lime & orange). These items contain vanillin, which produces very high value of VMA in urine. Patient should not take aspirin or drugs containing phenol ring.Homovanillic acid (HVA) in urine: HVA is the main urinary metabolite of dopa and dopamine pathway It is increased in neuroblastoma, malignant pheochromocytoma and ganglioneuroma.It is useful to predict prognosis of neuroblastoma. Drugs increasing the value are -L-dopa, disulfiram and reserpine.
### End |
7,838 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Non-shivering thermogenesis is mediated bya) α1 receptorb) β2 receptorc) β3 receptord) UCP-2e) UCP-1, with the following options: A: a, B: ce, C: ac, D: ae
### Response:
| Brown fat is generally where the non-shivering thermogenesis occur. UCP-1 & β3 receptors are involved in the process. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Non-shivering thermogenesis is mediated bya) α1 receptorb) β2 receptorc) β3 receptord) UCP-2e) UCP-1, with the following options: A: a, B: ce, C: ac, D: ae
### Response:
Brown fat is generally where the non-shivering thermogenesis occur. UCP-1 & β3 receptors are involved in the process.
### End |
7,839 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Chlamydia can cause infertilty due to?, with the following options: A: Slaphingitis, B: Endometritis, C: Oophritis, D: Cervicitis
### Response:
| ANSWER: (A) SlaphingitisREF: Shaw 13th ed p. 209Salphingitis due to chlamydia and gonnorrea are common causes of tubal block resulting in infertility | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Chlamydia can cause infertilty due to?, with the following options: A: Slaphingitis, B: Endometritis, C: Oophritis, D: Cervicitis
### Response:
ANSWER: (A) SlaphingitisREF: Shaw 13th ed p. 209Salphingitis due to chlamydia and gonnorrea are common causes of tubal block resulting in infertility
### End |
7,840 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Essential health care made universally accessible to individuals and acceptable to them is called: September 2009, with the following options: A: Essential health care, B: Primary health care, C: Community health care, D: Social medicine
### Response:
| Ans. B: Primary health care Primary health care/ PHC is essential health care based on practical, scientifically sound and socially acceptable methods and technology that are universally accessible to individuals and families in the community through their full paicipation and at a cost that the community and the country can afford to maintain at every stage of their development in the spirit of self-determination. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Essential health care made universally accessible to individuals and acceptable to them is called: September 2009, with the following options: A: Essential health care, B: Primary health care, C: Community health care, D: Social medicine
### Response:
Ans. B: Primary health care Primary health care/ PHC is essential health care based on practical, scientifically sound and socially acceptable methods and technology that are universally accessible to individuals and families in the community through their full paicipation and at a cost that the community and the country can afford to maintain at every stage of their development in the spirit of self-determination.
### End |
7,841 | 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 adverse effect of omeprazole, with the following options: A: Nausea, B: Constipation, C: Jaundice, D: Black stools
### Response:
| PROTON PUMP INHIBITORS (PPIs) Omeprazole Adverse effects:- Nausea, loose stools, headache, abdominal pain, muscle and joint pain, dizziness, Rashes. Leucopenia and hepatic dysfunction are infrequent. On prolonged treatment atrophic gastritis has been repoed. Ref:- kd tripathi; pg num:- 653 | 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 adverse effect of omeprazole, with the following options: A: Nausea, B: Constipation, C: Jaundice, D: Black stools
### Response:
PROTON PUMP INHIBITORS (PPIs) Omeprazole Adverse effects:- Nausea, loose stools, headache, abdominal pain, muscle and joint pain, dizziness, Rashes. Leucopenia and hepatic dysfunction are infrequent. On prolonged treatment atrophic gastritis has been repoed. Ref:- kd tripathi; pg num:- 653
### End |
7,842 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A 17-year-old boy is diagnosed with schizophrenia. What is the risk that one of his siblings will develop the disease?, with the following options: A: 2%, B: 5%, C: 9%, D: 20%
### Response:
| The risk of developing schizophrenia in first degree relatives of schizophrenic patients is elevated compared to the risk of the general population (0.9%). Parents of schizophrenic patients have a lifetime prevalence of 11%, and siblings have a prevalence of 9%. Identical twins have a 50% chance of suffering from schizophrenia if their sibling has it. Children of schizophrenics have a lifetime prevalence of 12.8%. Reference: Kaplon and sadock, 11 th edition, synopsis of psychiatry, 11 th edition, pg no. 310 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A 17-year-old boy is diagnosed with schizophrenia. What is the risk that one of his siblings will develop the disease?, with the following options: A: 2%, B: 5%, C: 9%, D: 20%
### Response:
The risk of developing schizophrenia in first degree relatives of schizophrenic patients is elevated compared to the risk of the general population (0.9%). Parents of schizophrenic patients have a lifetime prevalence of 11%, and siblings have a prevalence of 9%. Identical twins have a 50% chance of suffering from schizophrenia if their sibling has it. Children of schizophrenics have a lifetime prevalence of 12.8%. Reference: Kaplon and sadock, 11 th edition, synopsis of psychiatry, 11 th edition, pg no. 310
### End |
7,843 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A male infant presented with distension of abdomen sholy after bih with passing of less meconium. Subsequently a full-thickness biopsy of the rectum was performed. The rectal biopsy is likely to show ?, with the following options: A: Fibrosis of submucosa, B: Lack of ganglion cells, C: Thickened muscularis propria, D: Hyalinisation of the muscular coat
### Response:
| Ans. is 'b' i.e., Lack of ganglion cells "Whenever neonate presents with delayed passage of stool, Hirschsprung's disease should be suspected-. Diagnosis of Hirschsprung's disease The diagnosis of Hirschsprung's disease is confirmed by rectal suction biopsies Rectal suction biopsies demonstrate -- i) Hyperophied nerve bundles ii) Absence of ganglion cells Other diagnostic procedures in Hirschsprung's disease Rectal manometry Anorectal manometry measures the pressure of internal anal sphincter while a balloon is distended in the rectum. The results are interpreted as Normal individual --> Reflex decline in internal sphincter pressure. Hirschsprung's disease ---> Pressure fails to drop, Paradoxical rise in pressure with rectal distention. o Radiography (Barium enema) It demonstrates the presence of transition zone between normal dilated proximal colon and a smaller caliber obstructed distal colon caused by non relaxation of aganglionic bowel. Delayed passage of stool (meconium) and abdominal distension suggests low intestinal obstruction. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A male infant presented with distension of abdomen sholy after bih with passing of less meconium. Subsequently a full-thickness biopsy of the rectum was performed. The rectal biopsy is likely to show ?, with the following options: A: Fibrosis of submucosa, B: Lack of ganglion cells, C: Thickened muscularis propria, D: Hyalinisation of the muscular coat
### Response:
Ans. is 'b' i.e., Lack of ganglion cells "Whenever neonate presents with delayed passage of stool, Hirschsprung's disease should be suspected-. Diagnosis of Hirschsprung's disease The diagnosis of Hirschsprung's disease is confirmed by rectal suction biopsies Rectal suction biopsies demonstrate -- i) Hyperophied nerve bundles ii) Absence of ganglion cells Other diagnostic procedures in Hirschsprung's disease Rectal manometry Anorectal manometry measures the pressure of internal anal sphincter while a balloon is distended in the rectum. The results are interpreted as Normal individual --> Reflex decline in internal sphincter pressure. Hirschsprung's disease ---> Pressure fails to drop, Paradoxical rise in pressure with rectal distention. o Radiography (Barium enema) It demonstrates the presence of transition zone between normal dilated proximal colon and a smaller caliber obstructed distal colon caused by non relaxation of aganglionic bowel. Delayed passage of stool (meconium) and abdominal distension suggests low intestinal obstruction.
### End |
7,844 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Thin filament consists of all except, with the following options: A: Actin, B: Troponin, C: Myosin, D: Tropomyosin
### Response:
| The thin filaments are made up of actin, tropomyosin, and troponin. Thick filaments are made up ofmyosin.(REF: GANONG'S REVIEW OF MEDICAL PHYSIOLOGY -23rd EDITION. Page No-95) | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Thin filament consists of all except, with the following options: A: Actin, B: Troponin, C: Myosin, D: Tropomyosin
### Response:
The thin filaments are made up of actin, tropomyosin, and troponin. Thick filaments are made up ofmyosin.(REF: GANONG'S REVIEW OF MEDICAL PHYSIOLOGY -23rd EDITION. Page No-95)
### End |
7,845 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Nikolsky's sign is positive in following conditions except:, with the following options: A: Pemphigus vulgaris, B: Toxic epidermal necrolysis, C: Epidermolysis bullosa, D: Pemphigoid
### Response:
| Nikolsky's Sign is seen in: Pemphigus (vulgaris and foliaceous). Porphyria Sjogren's syndrome SSSS TEN (Lyell's disease) Epidermolysis bullosa congenita It occurs due to separation of epidermis from underlying dermis due to intraepidermal cleaving | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Nikolsky's sign is positive in following conditions except:, with the following options: A: Pemphigus vulgaris, B: Toxic epidermal necrolysis, C: Epidermolysis bullosa, D: Pemphigoid
### Response:
Nikolsky's Sign is seen in: Pemphigus (vulgaris and foliaceous). Porphyria Sjogren's syndrome SSSS TEN (Lyell's disease) Epidermolysis bullosa congenita It occurs due to separation of epidermis from underlying dermis due to intraepidermal cleaving
### End |
7,846 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Antipyschotic drug-induced Parkinsonism is treated by -, with the following options: A: Anticholinergics, B: Levodopa, C: Selegiline, D: Amantadine
### Response:
| Ans. is 'a' i.e., Anticholinergics Parkisonism o Rigidity, tremor, hypokinesia, mask like facies, shuffling gate. o Between 1-4 weeks of therapy. o Treatment --> central anticholinergic (levodopa is ineffective). | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Antipyschotic drug-induced Parkinsonism is treated by -, with the following options: A: Anticholinergics, B: Levodopa, C: Selegiline, D: Amantadine
### Response:
Ans. is 'a' i.e., Anticholinergics Parkisonism o Rigidity, tremor, hypokinesia, mask like facies, shuffling gate. o Between 1-4 weeks of therapy. o Treatment --> central anticholinergic (levodopa is ineffective).
### End |
7,847 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Golden S sign is seen in:, with the following options: A: Bronchogenic carcinoma with collapse of lung, B: Traction Bronchiectasis with apical scarring, C: Emphysema with increased lucency and flattened diagphragm, D: Pulmonary edema
### Response:
| Ans. (a) Bronchogenic carcinoma with collapse of lung* The Golden S sign (reverse S sign of Golden.) is seen in PA chest radiographs with right upper lobe collapse.* It is caused by a central mass obstructing the upper lobe bronchus and should raise suspicion of a primary bronchogenic carcinoma.* The right upper lobe appears dense and shifts medially and upwards with a central mass expanding the hilum. The combination of two changes together form a reverse S shane. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Golden S sign is seen in:, with the following options: A: Bronchogenic carcinoma with collapse of lung, B: Traction Bronchiectasis with apical scarring, C: Emphysema with increased lucency and flattened diagphragm, D: Pulmonary edema
### Response:
Ans. (a) Bronchogenic carcinoma with collapse of lung* The Golden S sign (reverse S sign of Golden.) is seen in PA chest radiographs with right upper lobe collapse.* It is caused by a central mass obstructing the upper lobe bronchus and should raise suspicion of a primary bronchogenic carcinoma.* The right upper lobe appears dense and shifts medially and upwards with a central mass expanding the hilum. The combination of two changes together form a reverse S shane.
### End |
7,848 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Condition required for autoclave is?, with the following options: A: 121°C temperature for 20 min, B: 121°C temperature for 15 min, C: 100°C temperature for 60 min, D: 100°C temperature for 90 min
### Response:
| Autoclave: Recommended condition- 121–124°C temperature for 15 min at 1.1 bar pressure
Alternate: 134–138°C temperature for 3 min at 2.2 bar pressure
Hot air oven: 160°C temperature for 120 min or 180°C temperature for 30 min | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Condition required for autoclave is?, with the following options: A: 121°C temperature for 20 min, B: 121°C temperature for 15 min, C: 100°C temperature for 60 min, D: 100°C temperature for 90 min
### Response:
Autoclave: Recommended condition- 121–124°C temperature for 15 min at 1.1 bar pressure
Alternate: 134–138°C temperature for 3 min at 2.2 bar pressure
Hot air oven: 160°C temperature for 120 min or 180°C temperature for 30 min
### End |
7,849 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: The Meckel&;s diverticulum is situated at a maximum distance of about____ cm from the ileocecal valve -, with the following options: A: 25, B: 60, C: 75, D: 100
### Response:
| Meckel diverticulum, caused by persistence of the vitelline duct and, on the antimesenteric ileal border, 60 to 100 cm from the ileocecal valve in adults. It is the most common and the most clinically significant congenital anomaly of the small intestine. Two thirds of patients are younger than 2 years. The omphalomesenteric duct (omphaloenteric duct, vitelline duct or yolk stalk) normally connects the embryonic midgut to the yolk sac ventrally, providing nutrients to the midgut during embryonic development. The vitelline duct narrows progressively and disappears between the 5th and 8th weeks gestation. In Meckel's diverticulum, the proximal part of vitelline duct fails to regress and involute, which remains as a remnant of variable length and location. The solitary diverticulum lies on the antimesenteric border of the ileum (opposite to the mesenteric attachment) and extends into the umbilical cord of the embryo. The left and right vitelline arteries originate from the primitive dorsal aorta, and travel with the vitelline duct. The right becomes the superior mesenteric artery that supplies a terminal branch to the diverticulum, while the left involutes. Having its own blood supply, Meckel's diverticulum is susceptible to obstruction or infection. Meckel's diverticulum is located in the distal ileum, usually within 2-3 feet (60-100 cm) of the ileocecal valve. This blind segment or small pouch is about 3-6 cm long and may have a greater lumen diameter than that of the ileum. It runs antimesenterically and has its own blood supply. It is a remnant of the connection from the yolk sac to the small intestine present during embryonic development. It is a true diverticulum, consisting of all 3 layers of the bowel wall which are mucosa, submucosa and muscularis propria. As the vitelline duct is made up of pluripotent cell lining, Meckel's diverticulum may harbor abnormal tissues, containing embryonic remnants of other tissue types. Jejunal, duodenal mucosa or Brunner's tissue were each found in 2% of ectopic cases. Heterotopic rests of gastric mucosa and pancreatic tissue are seen in 60% and 6% of cases respectively. Heterotopic means the displacement of an organ from its normal anatomic location. Inflammation of this Meckel's diverticulum may mimic appendicitis. Therefore, during appendectomy, ileum should be checked for the presence of Meckel's diverticulum, if it is found to be present it should be removed along with appendix. A memory aid is the rule of 2s: 2% (of the population) 2 feet (proximal to the ileocecal valve) 2 inches (in length) 2 types of common ectopic tissue (gastric and pancreatic) 2 years is the most common age at clinical presentation 2:1 male:female ratio However, the exact values for the above criteria range from 0.2-5 (for example, prevalence is probably 0.2-4%). It can also be present as an indirect hernia, typically on the right side, where it is known as a "Hernia of Littre". A case report of strangulated umbilical hernia with Meckel's diverticulum has also been published in the literature. Furthermore, it can be attached to the umbilical region by the vitelline ligament, with the possibility of vitelline cysts, or even a patent vitelline canal forming a vitelline fistula when the umbilical cord is cut. Torsions of intestine around the intestinal stalk may also occur, leading to obstruction, ischemia, and necrosis. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: The Meckel&;s diverticulum is situated at a maximum distance of about____ cm from the ileocecal valve -, with the following options: A: 25, B: 60, C: 75, D: 100
### Response:
Meckel diverticulum, caused by persistence of the vitelline duct and, on the antimesenteric ileal border, 60 to 100 cm from the ileocecal valve in adults. It is the most common and the most clinically significant congenital anomaly of the small intestine. Two thirds of patients are younger than 2 years. The omphalomesenteric duct (omphaloenteric duct, vitelline duct or yolk stalk) normally connects the embryonic midgut to the yolk sac ventrally, providing nutrients to the midgut during embryonic development. The vitelline duct narrows progressively and disappears between the 5th and 8th weeks gestation. In Meckel's diverticulum, the proximal part of vitelline duct fails to regress and involute, which remains as a remnant of variable length and location. The solitary diverticulum lies on the antimesenteric border of the ileum (opposite to the mesenteric attachment) and extends into the umbilical cord of the embryo. The left and right vitelline arteries originate from the primitive dorsal aorta, and travel with the vitelline duct. The right becomes the superior mesenteric artery that supplies a terminal branch to the diverticulum, while the left involutes. Having its own blood supply, Meckel's diverticulum is susceptible to obstruction or infection. Meckel's diverticulum is located in the distal ileum, usually within 2-3 feet (60-100 cm) of the ileocecal valve. This blind segment or small pouch is about 3-6 cm long and may have a greater lumen diameter than that of the ileum. It runs antimesenterically and has its own blood supply. It is a remnant of the connection from the yolk sac to the small intestine present during embryonic development. It is a true diverticulum, consisting of all 3 layers of the bowel wall which are mucosa, submucosa and muscularis propria. As the vitelline duct is made up of pluripotent cell lining, Meckel's diverticulum may harbor abnormal tissues, containing embryonic remnants of other tissue types. Jejunal, duodenal mucosa or Brunner's tissue were each found in 2% of ectopic cases. Heterotopic rests of gastric mucosa and pancreatic tissue are seen in 60% and 6% of cases respectively. Heterotopic means the displacement of an organ from its normal anatomic location. Inflammation of this Meckel's diverticulum may mimic appendicitis. Therefore, during appendectomy, ileum should be checked for the presence of Meckel's diverticulum, if it is found to be present it should be removed along with appendix. A memory aid is the rule of 2s: 2% (of the population) 2 feet (proximal to the ileocecal valve) 2 inches (in length) 2 types of common ectopic tissue (gastric and pancreatic) 2 years is the most common age at clinical presentation 2:1 male:female ratio However, the exact values for the above criteria range from 0.2-5 (for example, prevalence is probably 0.2-4%). It can also be present as an indirect hernia, typically on the right side, where it is known as a "Hernia of Littre". A case report of strangulated umbilical hernia with Meckel's diverticulum has also been published in the literature. Furthermore, it can be attached to the umbilical region by the vitelline ligament, with the possibility of vitelline cysts, or even a patent vitelline canal forming a vitelline fistula when the umbilical cord is cut. Torsions of intestine around the intestinal stalk may also occur, leading to obstruction, ischemia, and necrosis.
### End |
7,850 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Vertebrate reservoir of Japanese encephalitis is:, with the following options: A: Rat, B: Pig, C: Horse, D: Monkey
### Response:
| (B) Pig > Pigs are vertebrate reservoirs as well as amplifier hosts for Japanese encephalitis virus. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Vertebrate reservoir of Japanese encephalitis is:, with the following options: A: Rat, B: Pig, C: Horse, D: Monkey
### Response:
(B) Pig > Pigs are vertebrate reservoirs as well as amplifier hosts for Japanese encephalitis virus.
### End |
7,851 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Selenium deficiency causes, with the following options: A: Cardiomyopathy, B: Neuropathy, C: Growth retardation, D: Rhabdomyolysis
### Response:
| (A) Cardiomyopathy DEFICIENCIES OF METALSElementDeficiencyBoronNo biologic function determinedCalciumReduced bone mass, osteoporosisCopperAnemia, growth retardation, defective keratinization and pigmentation of hair, hypothermia, degenerative changes in aortic elastin, osteopenia, mental deteriorationChromiumImpaired glucose toleranceFluorideDental cariesIodineThyroid enlargement, T4, cretinismIronMuscle abnormalities, kilonychia, pica, anemia, work performance, impaired cognitive development, premature labor, perinatal maternal mortalityManganeseImpaired growth and skeletal development, reproduction, lipid and carbohydrate metabolism; upper body rashMolybdenumSevere neurologic abnormalitiesSeleniumCardiomyopathy, heart failure, striated muscle degenerationPhosphorousRickets (osteomalacia), proximal muscle weakness, rhabdomyolysis, paresthesia, ataxia, seizure, confusion, heart failure, hemolysis, acidosisZincGrowth retardation, taste and smell, alopecia, dermatitis, diarrhea, immune dysfunction, failure to thrive, gonadal atrophy, congenital malformations | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Selenium deficiency causes, with the following options: A: Cardiomyopathy, B: Neuropathy, C: Growth retardation, D: Rhabdomyolysis
### Response:
(A) Cardiomyopathy DEFICIENCIES OF METALSElementDeficiencyBoronNo biologic function determinedCalciumReduced bone mass, osteoporosisCopperAnemia, growth retardation, defective keratinization and pigmentation of hair, hypothermia, degenerative changes in aortic elastin, osteopenia, mental deteriorationChromiumImpaired glucose toleranceFluorideDental cariesIodineThyroid enlargement, T4, cretinismIronMuscle abnormalities, kilonychia, pica, anemia, work performance, impaired cognitive development, premature labor, perinatal maternal mortalityManganeseImpaired growth and skeletal development, reproduction, lipid and carbohydrate metabolism; upper body rashMolybdenumSevere neurologic abnormalitiesSeleniumCardiomyopathy, heart failure, striated muscle degenerationPhosphorousRickets (osteomalacia), proximal muscle weakness, rhabdomyolysis, paresthesia, ataxia, seizure, confusion, heart failure, hemolysis, acidosisZincGrowth retardation, taste and smell, alopecia, dermatitis, diarrhea, immune dysfunction, failure to thrive, gonadal atrophy, congenital malformations
### End |
7,852 | 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 drug DOES NOT cause megaloblastic anemia?, with the following options: A: Phenytoin, B: Chloroquine, C: Sulfasalazine, D: Metformin
### Response:
| Agents implicated in drug induced macrocytic anemia are: Phenytoin Azathioprine Metformin Leflunomide Sulfisoxazole Sulfasalazine Mesalamine Zidovudine Trimethoprim Sulfamethoxazole | 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 drug DOES NOT cause megaloblastic anemia?, with the following options: A: Phenytoin, B: Chloroquine, C: Sulfasalazine, D: Metformin
### Response:
Agents implicated in drug induced macrocytic anemia are: Phenytoin Azathioprine Metformin Leflunomide Sulfisoxazole Sulfasalazine Mesalamine Zidovudine Trimethoprim Sulfamethoxazole
### End |
7,853 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Calcium initiates a skeletal muscle contraction by, with the following options: A: Binding to tropomyosin, B: Being released primarily from the sarcolemma during an action potential, C: Binding to troponin, D: Covering action binding sites
### Response:
| During excitation-contraction coupling in a skeletal muscle fiber, calcium is released from the sarcoplasmic reticulum (not the sarcolemma) and binds to troponin (not tropomyosin or myosin). The binding of calcium to the troponin causes the troponin to shift the position of the tropomyosin to which it is attached, thus uncovering the actin binding sites for binding with myosin. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Calcium initiates a skeletal muscle contraction by, with the following options: A: Binding to tropomyosin, B: Being released primarily from the sarcolemma during an action potential, C: Binding to troponin, D: Covering action binding sites
### Response:
During excitation-contraction coupling in a skeletal muscle fiber, calcium is released from the sarcoplasmic reticulum (not the sarcolemma) and binds to troponin (not tropomyosin or myosin). The binding of calcium to the troponin causes the troponin to shift the position of the tropomyosin to which it is attached, thus uncovering the actin binding sites for binding with myosin.
### End |
7,854 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: The best possible intervention for acute myocardial infarction is:, with the following options: A: Streptokinase, B: Streptokinase and aspirin, C: Early primary coronary intervention, D: Streptokinase and heparin
### Response:
| Answer is C (Early Primary coronary intervention) Streptokinose (Thrombolysis) is a form of Reperfusion therapy that is indicated for only ST Elevation MI (STEM). Its use is contraindicated in cases of Non ST Elevation MI (NSTEMI) Early Primary Coronary Intervention (Early PCI) can be used as a form of Reperfusion therapy for both STEM! and NSTEMI. Early Primary Caronary Intervention is therefore the single best answer of choice amongst the options provided. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: The best possible intervention for acute myocardial infarction is:, with the following options: A: Streptokinase, B: Streptokinase and aspirin, C: Early primary coronary intervention, D: Streptokinase and heparin
### Response:
Answer is C (Early Primary coronary intervention) Streptokinose (Thrombolysis) is a form of Reperfusion therapy that is indicated for only ST Elevation MI (STEM). Its use is contraindicated in cases of Non ST Elevation MI (NSTEMI) Early Primary Coronary Intervention (Early PCI) can be used as a form of Reperfusion therapy for both STEM! and NSTEMI. Early Primary Caronary Intervention is therefore the single best answer of choice amongst the options provided.
### End |
7,855 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A 73-year-old man with history of hypertension and osteoarthritis is evaluated for gradually increasing dyspnea over the preceding 6 weeks. He takes metoprolol for hypertension and naproxen for the arthritis. He has occasionally awakened in the night with mild dyspnea relieved by sitting up but has not noticed edema. Physical examination shows BP of 148/94, HR 96, and RR 16. O2 saturation is 92%. Neck veins show the jugular column 7 cm above the sternal angle. Lung examination reveals mild basilar crackles but no wheezing. Cardiac examination shows sustained apex impulse, S4 gallop, and no murmur. There is no peripheral edema. ECG shows stable left ventricular hypertrophy; no Q waves are seen. Chest x-ray shows increased interstitial markings and some cephalization of flow to the upper lobe vessels. The cardiac silhouette is boot-shaped, but there is no definite cardiomegaly. Echocardiogram shows left ventricular hypertrophy and LV ejection fraction of 55% (normal 50%-70%). What is the likely pathogenesis of this patient's dyspnea?, with the following options: A: Increased metabolic demands leading to high-output heart failure (HF), B: Occult coronary artery disease with dyspnea as an angina equivalent, C: Impaired diastolic relaxation and filling, D: Interstitial lung disease (ILD) mimicking pulmonary vascular congestion
### Response:
| The most likely explanation for this patient's presentation is heart failure with preserved ejection fraction (HFPEF), also known as diastolic dysfunction. As many as 50% of patients presenting with definite HF (Heart failure) will have an ejection fraction above 50%. HFPEF is more common in the elderly, in women, and those with conditions (especially hypertension) that lead to LV hypertrophy. Often the echocardiogram will show evidence of impaired relaxation or increased stiffness of the LV (the latter often suggested by decreased flow across the MV during atrial systole, giving the so-called reversed e/a flow ratio). Tachycardia, by decreasing diastolic filling time, will often worsen HF symptoms in diastolic dysfunction. As opposed to systolic HF, beta-blockers and ACE inhibitors have not demonstrated long-term survival benefit. Management focuses on controlling BP, preventing tachycardia, and treating pulmonary and peripheral fluid overload with diuretics; so many of the modalities used in systolic HF are also employed in HFPEF, just without proof of survival benefit.High output HF due to an AV fistula, Paget disease, or hyperthyroidism can mimic diastolic HF, but the patient usually has evidence of a hyperdynamic circulation (tachycardia, wide pulse pressure, hyperdynamic precordium). Occult CAD should be considered in patients with exertional dyspnea (which can be an angina equivalent), but this patient's rest symptoms and pulmonary vascular congestion would be unusual. In HF due to coronary artery disease, there is almost always evidence of prior MI or ischemic change on ECG. Nevertheless, a stress test is often obtained in patients with unexplained HF to rule out this possibility. Interstitial lung disease can cause rales and interstitial changes on CXR but would not explain the cephalization of flow nor the elevated venous pressure. Measuring B-type natriuretic peptide (BNP) will resolve the issue in equivocal cases; BNP will be elevated in HF and normal or minimally elevated in ILD. Anemia can cause fatigue and exertional dyspnea and, rarely, even overt HF, but to cause HF the anemia would have to be very severe (usually Hb 7 g/dL or below) and should be apparent from the physical examination. In addition, severe anemia would usually cause evidence of hyperdynamic circulation as seen in high-output HF. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A 73-year-old man with history of hypertension and osteoarthritis is evaluated for gradually increasing dyspnea over the preceding 6 weeks. He takes metoprolol for hypertension and naproxen for the arthritis. He has occasionally awakened in the night with mild dyspnea relieved by sitting up but has not noticed edema. Physical examination shows BP of 148/94, HR 96, and RR 16. O2 saturation is 92%. Neck veins show the jugular column 7 cm above the sternal angle. Lung examination reveals mild basilar crackles but no wheezing. Cardiac examination shows sustained apex impulse, S4 gallop, and no murmur. There is no peripheral edema. ECG shows stable left ventricular hypertrophy; no Q waves are seen. Chest x-ray shows increased interstitial markings and some cephalization of flow to the upper lobe vessels. The cardiac silhouette is boot-shaped, but there is no definite cardiomegaly. Echocardiogram shows left ventricular hypertrophy and LV ejection fraction of 55% (normal 50%-70%). What is the likely pathogenesis of this patient's dyspnea?, with the following options: A: Increased metabolic demands leading to high-output heart failure (HF), B: Occult coronary artery disease with dyspnea as an angina equivalent, C: Impaired diastolic relaxation and filling, D: Interstitial lung disease (ILD) mimicking pulmonary vascular congestion
### Response:
The most likely explanation for this patient's presentation is heart failure with preserved ejection fraction (HFPEF), also known as diastolic dysfunction. As many as 50% of patients presenting with definite HF (Heart failure) will have an ejection fraction above 50%. HFPEF is more common in the elderly, in women, and those with conditions (especially hypertension) that lead to LV hypertrophy. Often the echocardiogram will show evidence of impaired relaxation or increased stiffness of the LV (the latter often suggested by decreased flow across the MV during atrial systole, giving the so-called reversed e/a flow ratio). Tachycardia, by decreasing diastolic filling time, will often worsen HF symptoms in diastolic dysfunction. As opposed to systolic HF, beta-blockers and ACE inhibitors have not demonstrated long-term survival benefit. Management focuses on controlling BP, preventing tachycardia, and treating pulmonary and peripheral fluid overload with diuretics; so many of the modalities used in systolic HF are also employed in HFPEF, just without proof of survival benefit.High output HF due to an AV fistula, Paget disease, or hyperthyroidism can mimic diastolic HF, but the patient usually has evidence of a hyperdynamic circulation (tachycardia, wide pulse pressure, hyperdynamic precordium). Occult CAD should be considered in patients with exertional dyspnea (which can be an angina equivalent), but this patient's rest symptoms and pulmonary vascular congestion would be unusual. In HF due to coronary artery disease, there is almost always evidence of prior MI or ischemic change on ECG. Nevertheless, a stress test is often obtained in patients with unexplained HF to rule out this possibility. Interstitial lung disease can cause rales and interstitial changes on CXR but would not explain the cephalization of flow nor the elevated venous pressure. Measuring B-type natriuretic peptide (BNP) will resolve the issue in equivocal cases; BNP will be elevated in HF and normal or minimally elevated in ILD. Anemia can cause fatigue and exertional dyspnea and, rarely, even overt HF, but to cause HF the anemia would have to be very severe (usually Hb 7 g/dL or below) and should be apparent from the physical examination. In addition, severe anemia would usually cause evidence of hyperdynamic circulation as seen in high-output HF.
### End |
7,856 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Which is NOT pyrogenic Interleukin, with the following options: A: IL-1, B: TNF-a, C: IL-4, D: IL-6
### Response:
| (C) IL-4 # Pyrogenic cytokines: Known pyrogenic cytokines include IL-1, IL-6, TNF, ciliary neurotropic factor (CNTF), and interferon (INF)a. Others probably exist; although IL-18 - a membrane of the IL-1 family - does not appear to be pyrogenic cytokine. Each cytokine is encoded by a separate gene, and each pyrogenic cytokine has been shown to cause fever in laboratory animals and in humans. When injected into humans, IL-1, IL-6 and TNF produce fever at low doses (10 to 100 ng/kg).> Fever, characterized by an elevation of body temperature, usually by 1deg to 4degC, is one of the most prominent manifestations of the acute-phase response, especially when inflammation is caused by infection. Fever is produced in response to substances called pyrogens that act by stimulating prostaglandin (PG) synthesis in the vascular and perivascular cells of the hypothalamus. Bacterial products, such as lipopolysaccharide (LPS; called exogenous pyrogens), stimulate leukocytes to release cytokines such as IL-1 & TNF (called endogenous pyrogens) that increase the levels of cyclooxygenases that convert AA into prostaglandins. In the hypothalamus the PGs, especially PGE2, stimulate the production of neurotransmitters, which function to reset the temperature set point at a higher level. IL-4 is involved in immediate hypersensitivity reactions. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Which is NOT pyrogenic Interleukin, with the following options: A: IL-1, B: TNF-a, C: IL-4, D: IL-6
### Response:
(C) IL-4 # Pyrogenic cytokines: Known pyrogenic cytokines include IL-1, IL-6, TNF, ciliary neurotropic factor (CNTF), and interferon (INF)a. Others probably exist; although IL-18 - a membrane of the IL-1 family - does not appear to be pyrogenic cytokine. Each cytokine is encoded by a separate gene, and each pyrogenic cytokine has been shown to cause fever in laboratory animals and in humans. When injected into humans, IL-1, IL-6 and TNF produce fever at low doses (10 to 100 ng/kg).> Fever, characterized by an elevation of body temperature, usually by 1deg to 4degC, is one of the most prominent manifestations of the acute-phase response, especially when inflammation is caused by infection. Fever is produced in response to substances called pyrogens that act by stimulating prostaglandin (PG) synthesis in the vascular and perivascular cells of the hypothalamus. Bacterial products, such as lipopolysaccharide (LPS; called exogenous pyrogens), stimulate leukocytes to release cytokines such as IL-1 & TNF (called endogenous pyrogens) that increase the levels of cyclooxygenases that convert AA into prostaglandins. In the hypothalamus the PGs, especially PGE2, stimulate the production of neurotransmitters, which function to reset the temperature set point at a higher level. IL-4 is involved in immediate hypersensitivity reactions.
### End |
7,857 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Most impoant factor which decides the results of a randomized controlled trial is: March 2005, with the following options: A: Inclusion of all age groups, B: 50% treated with placebo and 50% with drugs, C: 100% follow up, D: Effective randomization
### Response:
| Ans. D: Effective randomization It is a procedure by which the paicipants are allocated into groups usually called 'study' and 'control' groups. Randomization is the hea of control trials. It eliminates selection bias | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Most impoant factor which decides the results of a randomized controlled trial is: March 2005, with the following options: A: Inclusion of all age groups, B: 50% treated with placebo and 50% with drugs, C: 100% follow up, D: Effective randomization
### Response:
Ans. D: Effective randomization It is a procedure by which the paicipants are allocated into groups usually called 'study' and 'control' groups. Randomization is the hea of control trials. It eliminates selection bias
### End |
7,858 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Catalase positive, coagulase negative beta hemolytic bacteria, with the following options: A: Strep pyogens, B: Staph aureus, C: CONS, D: Enterococci
### Response:
| All staphylococci are catalase positive. Amongst staphylococci, Staph. aureus and Staph haemolyticus (CONS) are beta hemolytic. Most species of coagulase negative staphylococcus species are non-hemolytic except Staph. haemolyticus. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Catalase positive, coagulase negative beta hemolytic bacteria, with the following options: A: Strep pyogens, B: Staph aureus, C: CONS, D: Enterococci
### Response:
All staphylococci are catalase positive. Amongst staphylococci, Staph. aureus and Staph haemolyticus (CONS) are beta hemolytic. Most species of coagulase negative staphylococcus species are non-hemolytic except Staph. haemolyticus.
### End |
7,859 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Which is not a test for diabetes mellitus -, with the following options: A: Fasting blood sampling, B: Random blood sampling, C: D-xylose, D: Oral glucose tolerance test
### Response:
| D-xylose absorption is a laboratory test to determine how well the intestines absorb a simple sugar (D-xylose). The test helps determine if nutrients are being properly absorbed. It is done in : persistent diarrhea, signs of malnutrition, unexplained weight loss. Rest of the options are the tests done in diabetes mellitus. Ref - Harrisons internal medicine 20e topic diabetes | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Which is not a test for diabetes mellitus -, with the following options: A: Fasting blood sampling, B: Random blood sampling, C: D-xylose, D: Oral glucose tolerance test
### Response:
D-xylose absorption is a laboratory test to determine how well the intestines absorb a simple sugar (D-xylose). The test helps determine if nutrients are being properly absorbed. It is done in : persistent diarrhea, signs of malnutrition, unexplained weight loss. Rest of the options are the tests done in diabetes mellitus. Ref - Harrisons internal medicine 20e topic diabetes
### End |
7,860 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Muscles have which efferent nerve fibers for regulating tone?, with the following options: A: a-neuron, B: Gamma neuron, C: Beta neuron, D: Delta neuron
### Response:
| Ans. is 'b' i.e., Gamma neuron(Ref: Ganong 23'd/e p.158-162; Guyton 12n/e p. 657)Muscle tone is maintained by stretch reflex through muscle spindles (intrafusal fibers). | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Muscles have which efferent nerve fibers for regulating tone?, with the following options: A: a-neuron, B: Gamma neuron, C: Beta neuron, D: Delta neuron
### Response:
Ans. is 'b' i.e., Gamma neuron(Ref: Ganong 23'd/e p.158-162; Guyton 12n/e p. 657)Muscle tone is maintained by stretch reflex through muscle spindles (intrafusal fibers).
### End |
7,861 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A most common mode of treatment of a 1-year-old child with asthma is –, with the following options: A: Inhaled short acting beta 2 agonist, B: Oral short acting theophylline, C: Oral ketotifen, D: Leukotriene agonist
### Response:
| Treatment of asthma
Treatment of asthma can be divided into -
A) Treatment of chronic asthma
B) Treatment of acute exacerbation -
Treatment of mild, moderate or severe exacerbation
Treatment of life-threatening exacerbation (status asthmaticus)
Treatment of chronic asthma
Treatment of chronic asthma is given to control asthma and to prevent acute exacerbation.
Severity of asthma is classified on the basis of -
The frequency of daytime symptoms
The frequency of nighttime symptoms
The degree of airflow obstruction (FEV1)
Peak expiratory flow (PEF) variability
For children less than 5 years of age, severity is classified on the basis of (1) and (2) only because young children cannot perform the manoeuvre required for lung function measurement ((3) & (4)).
I) Mild intermittent
Symptoms for ≤ 2 days/week
Symptoms for 5 ≤ 2 night/month
FEV1 80%
PEF variability < 20%
2) Mild persistent
Symptoms > 2days / week
PEF variability 20-30%
Symptoms >2 night / months
FEV1 80%
3) Moderate persistent
Day symptoms daily
Symptoms > I night/week
FEV1 > 60% - < 80%
PEF variability >30%
A stepwise pharmacological therapy is indicated.
4) Severe persistent
Continuous day symptoms
Frequent night symptoms
FEVi 60%
PEF variability >30% | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A most common mode of treatment of a 1-year-old child with asthma is –, with the following options: A: Inhaled short acting beta 2 agonist, B: Oral short acting theophylline, C: Oral ketotifen, D: Leukotriene agonist
### Response:
Treatment of asthma
Treatment of asthma can be divided into -
A) Treatment of chronic asthma
B) Treatment of acute exacerbation -
Treatment of mild, moderate or severe exacerbation
Treatment of life-threatening exacerbation (status asthmaticus)
Treatment of chronic asthma
Treatment of chronic asthma is given to control asthma and to prevent acute exacerbation.
Severity of asthma is classified on the basis of -
The frequency of daytime symptoms
The frequency of nighttime symptoms
The degree of airflow obstruction (FEV1)
Peak expiratory flow (PEF) variability
For children less than 5 years of age, severity is classified on the basis of (1) and (2) only because young children cannot perform the manoeuvre required for lung function measurement ((3) & (4)).
I) Mild intermittent
Symptoms for ≤ 2 days/week
Symptoms for 5 ≤ 2 night/month
FEV1 80%
PEF variability < 20%
2) Mild persistent
Symptoms > 2days / week
PEF variability 20-30%
Symptoms >2 night / months
FEV1 80%
3) Moderate persistent
Day symptoms daily
Symptoms > I night/week
FEV1 > 60% - < 80%
PEF variability >30%
A stepwise pharmacological therapy is indicated.
4) Severe persistent
Continuous day symptoms
Frequent night symptoms
FEVi 60%
PEF variability >30%
### End |
7,862 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Nucleus intercalatus is seen in, with the following options: A: Frontal lobe, B: Medulla, C: Temporal lobe, D: Midbrain
### Response:
| Nucleus intercalates is present in the medulla at the level of olives between the dorsal nucleus of the vagus nerve (lateral to the intercalated nucleus) and the nucleus of the hypoglossal nerve. Probably involved in the control of the vestibuloocular reflex and may contribute to the veical neural integrator. (Ref: vishram Singh textbook of clinical neuroanatomy second edition pg 77) | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Nucleus intercalatus is seen in, with the following options: A: Frontal lobe, B: Medulla, C: Temporal lobe, D: Midbrain
### Response:
Nucleus intercalates is present in the medulla at the level of olives between the dorsal nucleus of the vagus nerve (lateral to the intercalated nucleus) and the nucleus of the hypoglossal nerve. Probably involved in the control of the vestibuloocular reflex and may contribute to the veical neural integrator. (Ref: vishram Singh textbook of clinical neuroanatomy second edition pg 77)
### End |
7,863 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Metastasis of ca buccal mucosa goes to ?, with the following options: A: Regional lymph node, B: Liver, C: Hea, D: Brain
### Response:
| Ans is 'a' ie Regional lymph nodes "Tumors in this area have a propensity to spread locally and to metastasize to regional lymphatics."- Schwaz Also know Lymphatic metastasis of Buccal ca go to submandibular and later upper jugular nodes. - Dhingra 4/e MC type of Buccal ca Squamous cell ca Commonest site of origin --> angle of mouth or the line of occlusion of upper and lower teeth (Dhingra) | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Metastasis of ca buccal mucosa goes to ?, with the following options: A: Regional lymph node, B: Liver, C: Hea, D: Brain
### Response:
Ans is 'a' ie Regional lymph nodes "Tumors in this area have a propensity to spread locally and to metastasize to regional lymphatics."- Schwaz Also know Lymphatic metastasis of Buccal ca go to submandibular and later upper jugular nodes. - Dhingra 4/e MC type of Buccal ca Squamous cell ca Commonest site of origin --> angle of mouth or the line of occlusion of upper and lower teeth (Dhingra)
### End |
7,864 | 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 true regarding about Arachidonic acid (AA) pathway, except:, with the following options: A: Aspirin inhibits arachidonic acid pathway, B: Cytosolic Ca2+ leads to activation of membrane phospholipase A2, C: Action of phospholipase A2 causes synthesis of arachidonic acid, D: Leukotrienes C4, D4 cause vasodilation
### Response:
| Cellular phospholipases, mainly phospholipase A2, release arachidonic acid (AA) from membrane phospholipids. Activation of phospholipase A2 is triggered by increase in cytosolic Ca2+ and activation of various kinases in response to external stimuli. Cyclo-oxygenase inhibitors such as aspirin, indomethacin inhibit activity of cyclo-oxygenase involved in conversion of AA into prostaglandins. Leukotriene A4, B4 cause chemotaxis. Leukotrienes C4 and D4 cause vasoconstriction and increase vascular permeability. Leukotrienes C4, D4, E4 are SLOW REACTING SUBSTANCE OF ANAPHYLAXIS (SRS-A). Action Examples Vasodilation PGI2, PGE1, PGE2, PGD2 Vasoconstriction Thromboxane A2, leukotriene C4, D4, E4 Increase vascular permeability Leukotriene C4, D4, E4 Chemotaxis, leukocyte adhesion Leukotriene B4 Smooth muscle contraction PGC4, PGD4, PGE4 | 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 true regarding about Arachidonic acid (AA) pathway, except:, with the following options: A: Aspirin inhibits arachidonic acid pathway, B: Cytosolic Ca2+ leads to activation of membrane phospholipase A2, C: Action of phospholipase A2 causes synthesis of arachidonic acid, D: Leukotrienes C4, D4 cause vasodilation
### Response:
Cellular phospholipases, mainly phospholipase A2, release arachidonic acid (AA) from membrane phospholipids. Activation of phospholipase A2 is triggered by increase in cytosolic Ca2+ and activation of various kinases in response to external stimuli. Cyclo-oxygenase inhibitors such as aspirin, indomethacin inhibit activity of cyclo-oxygenase involved in conversion of AA into prostaglandins. Leukotriene A4, B4 cause chemotaxis. Leukotrienes C4 and D4 cause vasoconstriction and increase vascular permeability. Leukotrienes C4, D4, E4 are SLOW REACTING SUBSTANCE OF ANAPHYLAXIS (SRS-A). Action Examples Vasodilation PGI2, PGE1, PGE2, PGD2 Vasoconstriction Thromboxane A2, leukotriene C4, D4, E4 Increase vascular permeability Leukotriene C4, D4, E4 Chemotaxis, leukocyte adhesion Leukotriene B4 Smooth muscle contraction PGC4, PGD4, PGE4
### End |
7,865 | 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 transmit a nerve branch to the meninges?, with the following options: A: Foramen spinosum, B: Mastoid foramen, C: Jugular foramen, D: Foramen magnum
### Response:
| The foramen spinosum transmits the middle meningeal aery, the meningeal branch of the mandibular nerve or nervus spinosus, and the posterior trunk of the middle meningeal vein. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th 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 transmit a nerve branch to the meninges?, with the following options: A: Foramen spinosum, B: Mastoid foramen, C: Jugular foramen, D: Foramen magnum
### Response:
The foramen spinosum transmits the middle meningeal aery, the meningeal branch of the mandibular nerve or nervus spinosus, and the posterior trunk of the middle meningeal vein. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.
### End |
7,866 | 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 antidepressent is used in atypical depression, with the following options: A: imipramine, B: phenelezine, C: paroxetine, D: amitriptilline
### Response:
| MAOI * IMPOANCE First class of antidepressant drugs that were introduced * MECHANISM There are three monoamines namely dopamine, adrenaline and serotonin. These mon amines are degraded by monoamine oxidase. MAOI inhibit this enzyme and acts increasing monoamines * DRUGS Phenelezine Tranylcipromine * USE ATYPICAL DEPRESSION, depression with reverse vegetative symptoms * SIDE EFFECTS Hypeensive crisis Cheese reaction When a patient on MAOI takes tyramine rich food like tyramine there will be increased release of monoamines. These excess monoamines cannot be degraded by MAO as it is blocked by MAOI. Thus, this may result in hypeensive crisis. Paresthesia's due to pyridoxine deficiency LIKE IPRONIAZID WEIGHT gain SEXUAL dysfunction ref. Kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 955 | 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 antidepressent is used in atypical depression, with the following options: A: imipramine, B: phenelezine, C: paroxetine, D: amitriptilline
### Response:
MAOI * IMPOANCE First class of antidepressant drugs that were introduced * MECHANISM There are three monoamines namely dopamine, adrenaline and serotonin. These mon amines are degraded by monoamine oxidase. MAOI inhibit this enzyme and acts increasing monoamines * DRUGS Phenelezine Tranylcipromine * USE ATYPICAL DEPRESSION, depression with reverse vegetative symptoms * SIDE EFFECTS Hypeensive crisis Cheese reaction When a patient on MAOI takes tyramine rich food like tyramine there will be increased release of monoamines. These excess monoamines cannot be degraded by MAO as it is blocked by MAOI. Thus, this may result in hypeensive crisis. Paresthesia's due to pyridoxine deficiency LIKE IPRONIAZID WEIGHT gain SEXUAL dysfunction ref. Kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 955
### End |
7,867 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: The tidal volume is, with the following options: A: The amount of air that normally moves into (or out of) the lung with each respiration., B: The amount of air that enters the lung but does not participate in gas exchange., C: The largest amount of air expired after maximal expiratory effort., D: The largest amount of gas that can be moved into and out of the lungs in 1 min.
### Response:
| The amount of air that moves into the lungs with each inspiration (or the amount that moves out with each expiration) is called the tidal volume. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: The tidal volume is, with the following options: A: The amount of air that normally moves into (or out of) the lung with each respiration., B: The amount of air that enters the lung but does not participate in gas exchange., C: The largest amount of air expired after maximal expiratory effort., D: The largest amount of gas that can be moved into and out of the lungs in 1 min.
### Response:
The amount of air that moves into the lungs with each inspiration (or the amount that moves out with each expiration) is called the tidal volume.
### End |
7,868 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Concentrated alcohol-based antiseptic for skin preparation of the operative site leads to, with the following options: A: >95% reduction in bacterial count, B: >50% reduction in bacterial count, C: <50% reduction in bacterial count, D: Contraindicated for operative site
### Response:
| One application of a more concentrated alcohol-based antiseptic is adequate for skin preparation of the operative site.This leads to a >95% reduction in bacterial countCaution should be taken not to leave a pool of alcohol-based fluid on the skin which could ignite with diathermy and burn the patient.Ref: Bailey and Love 27e pg: 52 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Concentrated alcohol-based antiseptic for skin preparation of the operative site leads to, with the following options: A: >95% reduction in bacterial count, B: >50% reduction in bacterial count, C: <50% reduction in bacterial count, D: Contraindicated for operative site
### Response:
One application of a more concentrated alcohol-based antiseptic is adequate for skin preparation of the operative site.This leads to a >95% reduction in bacterial countCaution should be taken not to leave a pool of alcohol-based fluid on the skin which could ignite with diathermy and burn the patient.Ref: Bailey and Love 27e pg: 52
### End |
7,869 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Woods lamp used in diagnosis of – a) P. versicolorb) Vitiligoc) Porphyriad) Psoriasise) Lichen planus, with the following options: A: abc, B: bc, C: acd, D: bcd
### Response:
| Wood's lamp is used in Tinea capitis, Erythrasma, vitiligo, albinism, Leprosy, Tuberous sclerosis, Pseudomonas infection, Porphyria, Tinea versicolor. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Woods lamp used in diagnosis of – a) P. versicolorb) Vitiligoc) Porphyriad) Psoriasise) Lichen planus, with the following options: A: abc, B: bc, C: acd, D: bcd
### Response:
Wood's lamp is used in Tinea capitis, Erythrasma, vitiligo, albinism, Leprosy, Tuberous sclerosis, Pseudomonas infection, Porphyria, Tinea versicolor.
### End |
7,870 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Diazepam poisoning is treated by:, with the following options: A: Flumazenil, B: Hemofiltration, C: Charcoal, D: Resins
### Response:
| ANSWER: (A) FlumazenilREF: Harrison's 17th ed Table e 35-4See APPENDIX-42 below for list of "Antidotes""Specific antidote for benzodiazepine poisoning is flumazenii" APPENDIX - 42AntidotesAntidotePoison/drug/toxinN-AcetylcysteineAcetaminophenCarbon tetrachlorideOther hepatotoxinsAmyl nitrite, sodium nitrite and sodium thiosulfate (Cyanide antidote kit)NitrilesBromatesChloratesCyanide (e.g., HCN, KCX and NaCN)Mustard agentsNitroprussideSmoke inhalation (combustion of synthetic materials)Antivenin, Crotalidae Polyvalent (Equine Origin)Pit viper envenomation (e.g. rattlesnakes, cottonmouths, timber rattlers and copperheads)Antivenin, Crotalidae Polyvalent Immune Fab - Ovine (CroFab)Pit viper envenomation (e.g.. rattlesnakes, cottonmouths, timber rattlers and copperheads)Atropine sulfateAlpba2 agonists (e.g., clonidine)Alzheimer drugs (e.g., donepezil, galantamine, rivastigmine, tacrine)Antimyesthenk agents (e.g., pyridostigmine)Bradyarrhythmia-producing agents (e.g., beta blockers, calcium channel blockers and digitalis glycosides)Cholinergic agonists (e.g., bethanechol) .Muscarine-containing mushrooms Nerve agents (sarin, soman, tabun and VX)Organophosphate and carbamate insecticidesDigoxin immune FabCardiac glycoside-containing plants (foxglove and oleander)Digitoxin, DigoxinEthanolEthylene glycolMethanolFlumazenilBenzodiazepinesZaleplonZolpidemFolic acid and Folinic acid (Leucovorin)Formaldehyde/Formie AcidMethanolMethotrexate, trimetrexatePyrimethamineTrimethoprimFomepizoleEthylene glycolMethanolGlucagonBeta blockersCalcium channel blockersHypoglycemiaHypoglycemic agentsHydroxocobalaminNitrilesBromatesChloratesCyanide (e.g., HCN, KCN and NaCN)Mustard agents NitroprussideSmoke inhalation (combustion of synthetic materials)Hyperbaric oxygen (HBO)Carbon monoxideCarbon tetrachlorideCyanideHydrogen sulfideMethemoglobinemiaMethylene blueMethemoglobin-inducing agents including;Aniline dyesDapsoneLocal anesthetics (e.g., benzocaine)MetoclopramideNaphthaleneNitrates and nitritesNitrobenzenePhenazopyridineNalmefene and NaloxoneACE inhibitorsAlpha2 agonists (e.g., clonidine)Imidazoline decongestants (e.g., oxymetazoline and tetrahydrozoline) LoperamideOpioids (e.g., codeine, fentanyl, heroin, meperidine, morphine)Physostigmine salicylateAntihistaminesAtropine and other anticholinergic agentsDhatura poisoningIntrathecal baclofenPhytonadione (Vitamin Kl)Long-acting anticoagulant rodenticides (e.g., brodifacoum and bromadiolone) WarfarinPralidoxime chloride (2-PAM)Antimyesthenic agents (e.g., pyridostigmine)Nerve agents (sarin, soman, tabun and VX)Organophosphate insecticidesTacrineProtamine sulfateEnoxaparinHeparinPyridoxine hydrochloride (Vitamin B6)Acrylamide Ethylene glycol Hydrazine Isoniazid (INH)Sodium bicarbonateChlorine gasHyperkalemiaSerum Alkalinization:Agents producing a quinidine-like effect as noted by widened QRS complex on EKG (e.g., amantadine, carbamazepine, chloroquine,cocaine, diphenhydramine, flecainide,tricyclic antidepressants, quinidine)Urine Alkalinization:Weakly acidic agents (chlorpropamide, methotrexate, phenobarbital and salicylates)Deferoxamine and DeferasiroxAcute iron poisoningDimercaprol (BAL in oil)Hydrofluoric acid (HF)Hyperkalemia (not digoxin-induced)HypermagnesemiaCalcium disodium EDTA (Versenate)Acute arsenic poisoning,Acute mercury poisoning,Lead poisoning (in addition to EDTA)Dicobalt EDTACyanide poisoningSucdmer/ Dimercaptosuccinic acid (DMSA)Lead poisoning,Arsenic poisoning,Mercury poisoningDimercapto-propane sulfonate (DMPS)Severe acute arsenic poisoning,Severe acute mercury poisoningD-Penicillamine (Cuprimine)Mainly in: copper toxicityOccasionally adjunctive therapy in: Gold toxicity, Arsenic poisoning, Lead poisoning, Rheumatoid arthritisBotulinum antitoxin * Bivalent (types AB)<< Trivalent (types ABE)Food-borne botulismWound botulismBotulism as a biological weaponNote: Not currently recommended for infant botulismL-CarnitineValproic acidCyproheptadine HCLMedications causing serotonin symdromeDantrolene sodiumMedications causing neuroleptic malignant symdrome (NMS)Medications causing malignant hyperthermiaInsulin and dextroseBeta blockersCalcium channel blockers (diltiazem, nifedipine, verapamil)Octreotide acetateSulfonylurea hypoglycemic agents (e.g., glipizide, glyburide)Sodium thiosulfateBromatesChloratesMustard agentsNitroprussideThiamineEthanolEthylene glycolPrussian blue, ferric hexacyan ofer rateRadioactive cesium (Cs-137), radioactive thallium (Tl-201), and nonradioactive thallium | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Diazepam poisoning is treated by:, with the following options: A: Flumazenil, B: Hemofiltration, C: Charcoal, D: Resins
### Response:
ANSWER: (A) FlumazenilREF: Harrison's 17th ed Table e 35-4See APPENDIX-42 below for list of "Antidotes""Specific antidote for benzodiazepine poisoning is flumazenii" APPENDIX - 42AntidotesAntidotePoison/drug/toxinN-AcetylcysteineAcetaminophenCarbon tetrachlorideOther hepatotoxinsAmyl nitrite, sodium nitrite and sodium thiosulfate (Cyanide antidote kit)NitrilesBromatesChloratesCyanide (e.g., HCN, KCX and NaCN)Mustard agentsNitroprussideSmoke inhalation (combustion of synthetic materials)Antivenin, Crotalidae Polyvalent (Equine Origin)Pit viper envenomation (e.g. rattlesnakes, cottonmouths, timber rattlers and copperheads)Antivenin, Crotalidae Polyvalent Immune Fab - Ovine (CroFab)Pit viper envenomation (e.g.. rattlesnakes, cottonmouths, timber rattlers and copperheads)Atropine sulfateAlpba2 agonists (e.g., clonidine)Alzheimer drugs (e.g., donepezil, galantamine, rivastigmine, tacrine)Antimyesthenk agents (e.g., pyridostigmine)Bradyarrhythmia-producing agents (e.g., beta blockers, calcium channel blockers and digitalis glycosides)Cholinergic agonists (e.g., bethanechol) .Muscarine-containing mushrooms Nerve agents (sarin, soman, tabun and VX)Organophosphate and carbamate insecticidesDigoxin immune FabCardiac glycoside-containing plants (foxglove and oleander)Digitoxin, DigoxinEthanolEthylene glycolMethanolFlumazenilBenzodiazepinesZaleplonZolpidemFolic acid and Folinic acid (Leucovorin)Formaldehyde/Formie AcidMethanolMethotrexate, trimetrexatePyrimethamineTrimethoprimFomepizoleEthylene glycolMethanolGlucagonBeta blockersCalcium channel blockersHypoglycemiaHypoglycemic agentsHydroxocobalaminNitrilesBromatesChloratesCyanide (e.g., HCN, KCN and NaCN)Mustard agents NitroprussideSmoke inhalation (combustion of synthetic materials)Hyperbaric oxygen (HBO)Carbon monoxideCarbon tetrachlorideCyanideHydrogen sulfideMethemoglobinemiaMethylene blueMethemoglobin-inducing agents including;Aniline dyesDapsoneLocal anesthetics (e.g., benzocaine)MetoclopramideNaphthaleneNitrates and nitritesNitrobenzenePhenazopyridineNalmefene and NaloxoneACE inhibitorsAlpha2 agonists (e.g., clonidine)Imidazoline decongestants (e.g., oxymetazoline and tetrahydrozoline) LoperamideOpioids (e.g., codeine, fentanyl, heroin, meperidine, morphine)Physostigmine salicylateAntihistaminesAtropine and other anticholinergic agentsDhatura poisoningIntrathecal baclofenPhytonadione (Vitamin Kl)Long-acting anticoagulant rodenticides (e.g., brodifacoum and bromadiolone) WarfarinPralidoxime chloride (2-PAM)Antimyesthenic agents (e.g., pyridostigmine)Nerve agents (sarin, soman, tabun and VX)Organophosphate insecticidesTacrineProtamine sulfateEnoxaparinHeparinPyridoxine hydrochloride (Vitamin B6)Acrylamide Ethylene glycol Hydrazine Isoniazid (INH)Sodium bicarbonateChlorine gasHyperkalemiaSerum Alkalinization:Agents producing a quinidine-like effect as noted by widened QRS complex on EKG (e.g., amantadine, carbamazepine, chloroquine,cocaine, diphenhydramine, flecainide,tricyclic antidepressants, quinidine)Urine Alkalinization:Weakly acidic agents (chlorpropamide, methotrexate, phenobarbital and salicylates)Deferoxamine and DeferasiroxAcute iron poisoningDimercaprol (BAL in oil)Hydrofluoric acid (HF)Hyperkalemia (not digoxin-induced)HypermagnesemiaCalcium disodium EDTA (Versenate)Acute arsenic poisoning,Acute mercury poisoning,Lead poisoning (in addition to EDTA)Dicobalt EDTACyanide poisoningSucdmer/ Dimercaptosuccinic acid (DMSA)Lead poisoning,Arsenic poisoning,Mercury poisoningDimercapto-propane sulfonate (DMPS)Severe acute arsenic poisoning,Severe acute mercury poisoningD-Penicillamine (Cuprimine)Mainly in: copper toxicityOccasionally adjunctive therapy in: Gold toxicity, Arsenic poisoning, Lead poisoning, Rheumatoid arthritisBotulinum antitoxin * Bivalent (types AB)<< Trivalent (types ABE)Food-borne botulismWound botulismBotulism as a biological weaponNote: Not currently recommended for infant botulismL-CarnitineValproic acidCyproheptadine HCLMedications causing serotonin symdromeDantrolene sodiumMedications causing neuroleptic malignant symdrome (NMS)Medications causing malignant hyperthermiaInsulin and dextroseBeta blockersCalcium channel blockers (diltiazem, nifedipine, verapamil)Octreotide acetateSulfonylurea hypoglycemic agents (e.g., glipizide, glyburide)Sodium thiosulfateBromatesChloratesMustard agentsNitroprussideThiamineEthanolEthylene glycolPrussian blue, ferric hexacyan ofer rateRadioactive cesium (Cs-137), radioactive thallium (Tl-201), and nonradioactive thallium
### End |
7,871 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: In collapsing glomerulopathy which of the following is seen -, with the following options: A: Hyperophy and necrosis of the visceral epithelium, B: Proliferation of the parietal epithelium, C: Tuft necrosis, D: Mesangiolysis
### Response:
| A morphologic variant called collapsing glomerulopathy is characterized by the collapse of the glomerular tuft and epithelial cell hyperplasia. This more severe manifestation of FSGS may be idiopathic or may be associated with HIV infection, drug-induced toxicities, and some microvascular injuries. It carries a paicularly poor prognosis Ref: ROBBINS BASIC PATHOLOGY 10th ed Pg no: 557 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: In collapsing glomerulopathy which of the following is seen -, with the following options: A: Hyperophy and necrosis of the visceral epithelium, B: Proliferation of the parietal epithelium, C: Tuft necrosis, D: Mesangiolysis
### Response:
A morphologic variant called collapsing glomerulopathy is characterized by the collapse of the glomerular tuft and epithelial cell hyperplasia. This more severe manifestation of FSGS may be idiopathic or may be associated with HIV infection, drug-induced toxicities, and some microvascular injuries. It carries a paicularly poor prognosis Ref: ROBBINS BASIC PATHOLOGY 10th ed Pg no: 557
### End |
7,872 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Secondary retrosternal goitre derives its blood supply from :, with the following options: A: Mediastinal vessels, B: Thyroid vessels, C: Arch of aorta, D: Bronchial vessels
### Response:
| Secondary retrrosternal goitre : Is the extension of thyroid tissue to mediastinum from thyroid in the neck. and it derives blood supply from thyroid vessels.
Primary retrrosternal goitre : Is the ectopic thyroid tissue in the mediastinum and it derives blood supply from mediastinal vessels. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Secondary retrosternal goitre derives its blood supply from :, with the following options: A: Mediastinal vessels, B: Thyroid vessels, C: Arch of aorta, D: Bronchial vessels
### Response:
Secondary retrrosternal goitre : Is the extension of thyroid tissue to mediastinum from thyroid in the neck. and it derives blood supply from thyroid vessels.
Primary retrrosternal goitre : Is the ectopic thyroid tissue in the mediastinum and it derives blood supply from mediastinal vessels.
### End |
7,873 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: In the lymph node showing non nercrotizing and non caseating granuloma which of the following is suspected, with the following options: A: Toxoplasmosis, B: Lumphogranuloma venereum, C: Cat scratch disease, D: Kikuchis lymphadenitis
### Response:
| Toxoplasmosis is transmitted by cat ( definitive host) man is the intermediate host It is diagnosed by Sabin Feldman dye test Ref Robbins 9/e chapter : environment and infectious diseases pg no.320 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: In the lymph node showing non nercrotizing and non caseating granuloma which of the following is suspected, with the following options: A: Toxoplasmosis, B: Lumphogranuloma venereum, C: Cat scratch disease, D: Kikuchis lymphadenitis
### Response:
Toxoplasmosis is transmitted by cat ( definitive host) man is the intermediate host It is diagnosed by Sabin Feldman dye test Ref Robbins 9/e chapter : environment and infectious diseases pg no.320
### End |
7,874 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A child with three days history of upper respiratory tract infection presents with stridor, which decreases on lying down postion. What is the most probable diagnosis -, with the following options: A: Acute Epiglottitis, B: Laryngotracheobronchitis, C: Foreign body aspiration, D: Retropharyngeal abscess
### Response:
| Ans. is 'b' i.e., Laryngotracheobronchitis This child has : - i) 3 days history of upper respiratory tract infection. ii) Followed by stridor These features suggest the diagnosis of croup. Clinical manifestations of Croup Most patients have an upper respiratory tract infection with some combination of - Rhinorrhea Pharyngitis Mild cough Low grade fever o After 1-3 days signs and symptoms of upper respiratory tract obstruction become apparent - Barking cough Hoarseness Inspiratory stridor | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A child with three days history of upper respiratory tract infection presents with stridor, which decreases on lying down postion. What is the most probable diagnosis -, with the following options: A: Acute Epiglottitis, B: Laryngotracheobronchitis, C: Foreign body aspiration, D: Retropharyngeal abscess
### Response:
Ans. is 'b' i.e., Laryngotracheobronchitis This child has : - i) 3 days history of upper respiratory tract infection. ii) Followed by stridor These features suggest the diagnosis of croup. Clinical manifestations of Croup Most patients have an upper respiratory tract infection with some combination of - Rhinorrhea Pharyngitis Mild cough Low grade fever o After 1-3 days signs and symptoms of upper respiratory tract obstruction become apparent - Barking cough Hoarseness Inspiratory stridor
### End |
7,875 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Transketolase activity is seen with which vitamin, with the following options: A: Vit B1, B: Vit B2, C: Vit B3, D: Vit B4
### Response:
| Transketolase activity is seen in Vit B1. In thiamine deficiency, blood thiamine is reduced, but pyruvate, alpha-ketoglutarate and lactate are increased. Erythrocyte transketolase activity is reduced; this is the earliest manifestation seen even before clinical disturbances. Ref: DM Vasudevan - Textbook of Biochemistry, 6th edition, page no: 392 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Transketolase activity is seen with which vitamin, with the following options: A: Vit B1, B: Vit B2, C: Vit B3, D: Vit B4
### Response:
Transketolase activity is seen in Vit B1. In thiamine deficiency, blood thiamine is reduced, but pyruvate, alpha-ketoglutarate and lactate are increased. Erythrocyte transketolase activity is reduced; this is the earliest manifestation seen even before clinical disturbances. Ref: DM Vasudevan - Textbook of Biochemistry, 6th edition, page no: 392
### End |
7,876 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Most common feature indicative of Antemortem drowing:, with the following options: A: Washerwomen feet, B: Pugilistic attitude, C: Clenched fist, D: Cyanosis
### Response:
| Ans. (c) Clenched fistRef: The essentials of FSM by KS Narayan Reddy 31st ed. P344* Presence of gravel, grass, etc firmly grasped in hand due to cadaveric spasm strongly suggest that person was alive when drowned as it indicates the struggle of person for life.Postmortem signs of drowningPathognomic Signs: indicates antemortem drowningNon Specific signsExternal* Fine copious white leathery froth from mouth, nose & air passage which increases on chest pressure.* Weeds, grass, mud etc in tightly clenched hand: a very definite sign.Internal* Water in stomach & intestine and middle ear* Diatoms in brain & bone marrow of long bones.* Cutis anserine or goose skin* Washer woman hand & feet* Paltauf (subpleural, pectechial) haemorrhage* Emphysema aqousum | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Most common feature indicative of Antemortem drowing:, with the following options: A: Washerwomen feet, B: Pugilistic attitude, C: Clenched fist, D: Cyanosis
### Response:
Ans. (c) Clenched fistRef: The essentials of FSM by KS Narayan Reddy 31st ed. P344* Presence of gravel, grass, etc firmly grasped in hand due to cadaveric spasm strongly suggest that person was alive when drowned as it indicates the struggle of person for life.Postmortem signs of drowningPathognomic Signs: indicates antemortem drowningNon Specific signsExternal* Fine copious white leathery froth from mouth, nose & air passage which increases on chest pressure.* Weeds, grass, mud etc in tightly clenched hand: a very definite sign.Internal* Water in stomach & intestine and middle ear* Diatoms in brain & bone marrow of long bones.* Cutis anserine or goose skin* Washer woman hand & feet* Paltauf (subpleural, pectechial) haemorrhage* Emphysema aqousum
### End |
7,877 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A 40-year-old HIV positive male, presented with complaints of a characteristic rash over his back and buttocks. The rash was painful and has worsened over the past 3 days. Physical examination is unremarkable. Rest of the skin examination is normal. A smear was prepared from the lesions. All of the following drugs are approved for the above condition except: -, with the following options: A: Acyclovir, B: Valcyclovir, C: Ganciclovir, D: Famciclovir
### Response:
| This is a case of Herpes zoster/ Shingles. The image shows hemorrhagic vesicles and pustules on an erythematous base in a dermatomal distribution. 2nd image shows a Tzanck smear with classical multinucleate giant cells seen in varicella. Drugs approved are: - Valcyclovir Famciclovir Acyclovir Ganciclovir is approved for CMV infection. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A 40-year-old HIV positive male, presented with complaints of a characteristic rash over his back and buttocks. The rash was painful and has worsened over the past 3 days. Physical examination is unremarkable. Rest of the skin examination is normal. A smear was prepared from the lesions. All of the following drugs are approved for the above condition except: -, with the following options: A: Acyclovir, B: Valcyclovir, C: Ganciclovir, D: Famciclovir
### Response:
This is a case of Herpes zoster/ Shingles. The image shows hemorrhagic vesicles and pustules on an erythematous base in a dermatomal distribution. 2nd image shows a Tzanck smear with classical multinucleate giant cells seen in varicella. Drugs approved are: - Valcyclovir Famciclovir Acyclovir Ganciclovir is approved for CMV infection.
### End |
7,878 | 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 wrong association ?, with the following options: A: HPV - CaCx, B: EBV - Burkitt's lymphoma, C: HHV 8 - Kaposi sarcoma, D: CMV - Nasopharyngeal carcinoma
### Response:
| Ans. is 'd' i.e., CMV-Nasopharyngeal carcinoma | 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 wrong association ?, with the following options: A: HPV - CaCx, B: EBV - Burkitt's lymphoma, C: HHV 8 - Kaposi sarcoma, D: CMV - Nasopharyngeal carcinoma
### Response:
Ans. is 'd' i.e., CMV-Nasopharyngeal carcinoma
### End |
7,879 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: The peak level of chorionic gonadotropin in normal pregnancy occurs, with the following options: A: 30-40 days, B: 60-70 days, C: 10-20 days, D: 100-110 days
### Response:
| Peak maternal levels of chorionic gonadotropin in normal pregnancy occurs between 60th and 80th days after menses and is around 100,000 mIU/mL. Before 5 weeks of gestation, hCG is expressed in both cytotrophoblast and syncytiotrophoblast. Later during gestation, when maternal serum levels peak, hCG is produced almost solely in syncytiotrophoblasts. Plasma levels of hCG begin to decline at 10 to 12 weeks and a nadir is reached about 16 weeks. Plasma levels are maintained at this lower level for the remainder of pregnancy. Human Chorionic Gonadotropin is a glycoprotein with biological activity similar to luteinizing hormone. It has a molecular weight of 36,000 to 40,000 Da. It is structurally related to LH, FSH and TSH. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 3. Implantation, Embryogenesis, and Placental Development. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: The peak level of chorionic gonadotropin in normal pregnancy occurs, with the following options: A: 30-40 days, B: 60-70 days, C: 10-20 days, D: 100-110 days
### Response:
Peak maternal levels of chorionic gonadotropin in normal pregnancy occurs between 60th and 80th days after menses and is around 100,000 mIU/mL. Before 5 weeks of gestation, hCG is expressed in both cytotrophoblast and syncytiotrophoblast. Later during gestation, when maternal serum levels peak, hCG is produced almost solely in syncytiotrophoblasts. Plasma levels of hCG begin to decline at 10 to 12 weeks and a nadir is reached about 16 weeks. Plasma levels are maintained at this lower level for the remainder of pregnancy. Human Chorionic Gonadotropin is a glycoprotein with biological activity similar to luteinizing hormone. It has a molecular weight of 36,000 to 40,000 Da. It is structurally related to LH, FSH and TSH. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 3. Implantation, Embryogenesis, and Placental Development. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.
### End |
7,880 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Not True about IMNCI, with the following options: A: Includes early Neonatal care, B: Pink color code refers to urgent referral, C: Includes Home based care, D: Dedication of 75% training staff to Infants
### Response:
| Under IMNCI, the proportion of training time devoted to sick infant and other sick children is almost same. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Not True about IMNCI, with the following options: A: Includes early Neonatal care, B: Pink color code refers to urgent referral, C: Includes Home based care, D: Dedication of 75% training staff to Infants
### Response:
Under IMNCI, the proportion of training time devoted to sick infant and other sick children is almost same.
### End |
7,881 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Which is not a complication of PUVA therapy, with the following options: A: Skin cancers, B: Premature aging of skin, C: Cataracts, D: Exfoliation
### Response:
| Complications of PUVA therapy Sho-term side effects Nausea and vomiting Erythema, pruritus and xerosis Skin pain Pigmentation Central nervous system (CNS) side effects such as headache, dizziness, depression, insomnia and hyperactivity Reactivation of herpes Photo-onycholysis, melanonychia, friction blisters and ankle edema. Long-term side effects Photo aging Eye toxicity: This occurs as psoralens accumulate in the lens with an increased potential for cataract. Cutaneous malignancies: nonmelanoma skin cancer, paicularly squamous cell carcinoma (SCC). Men exposed to PUVA have an increased risk of genital skin cancer. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Which is not a complication of PUVA therapy, with the following options: A: Skin cancers, B: Premature aging of skin, C: Cataracts, D: Exfoliation
### Response:
Complications of PUVA therapy Sho-term side effects Nausea and vomiting Erythema, pruritus and xerosis Skin pain Pigmentation Central nervous system (CNS) side effects such as headache, dizziness, depression, insomnia and hyperactivity Reactivation of herpes Photo-onycholysis, melanonychia, friction blisters and ankle edema. Long-term side effects Photo aging Eye toxicity: This occurs as psoralens accumulate in the lens with an increased potential for cataract. Cutaneous malignancies: nonmelanoma skin cancer, paicularly squamous cell carcinoma (SCC). Men exposed to PUVA have an increased risk of genital skin cancer.
### End |
7,882 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Eiosinophilic meningoencephalitis is caused by -a) Gnathostoma spinigerumb) Naegleriac) Toxocara canisd) Angiostrongylus cantonensis, with the following options: A: b, B: c, C: ad, D: ab
### Response:
| Eosinophilic meningoencephalitis
Meningoencephalitis, in which there is > 20% eosinophilic pleocytosis in C.S.F.
Eosinophilic meningoencephilitis is caused by
Angiostrongylus cantonensis (most common)
Gnathostoma spinigerum
Naegleria causes primary amoebic meningoencephilitis but it is not an eosinophilic meningoencephalitis. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Eiosinophilic meningoencephalitis is caused by -a) Gnathostoma spinigerumb) Naegleriac) Toxocara canisd) Angiostrongylus cantonensis, with the following options: A: b, B: c, C: ad, D: ab
### Response:
Eosinophilic meningoencephalitis
Meningoencephalitis, in which there is > 20% eosinophilic pleocytosis in C.S.F.
Eosinophilic meningoencephilitis is caused by
Angiostrongylus cantonensis (most common)
Gnathostoma spinigerum
Naegleria causes primary amoebic meningoencephilitis but it is not an eosinophilic meningoencephalitis.
### End |
7,883 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Umbilical cord separation takes, with the following options: A: First 1 week, B: First 2 weeks, C: First 3 weeks, D: First 4 weeks
### Response:
| Umbilical cord separation usually takes place within first 2 weeks. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Umbilical cord separation takes, with the following options: A: First 1 week, B: First 2 weeks, C: First 3 weeks, D: First 4 weeks
### Response:
Umbilical cord separation usually takes place within first 2 weeks.
### End |
7,884 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: The Electron Microscopy is viually diagnostic in renal biopsy study of -, with the following options: A: Goodpasture's syndrome, B: Churg-Strauss syndrome, C: Alpo syndrome, D: Wegner's granulomatosis
### Response:
| Ans. is 'c' i.e., Alpo syndromeo Alpo's syndrome presents with characteristic histological features on electron microscopy. Such changes may present in other diseases, but are most pronounced and widespread in Alpo's syndrome.Features of Alpo's syndrome on electron microscopy :o Alpo's patients early in their disease typically have diffuse thinning of the basement membrane which thickens over time into multilamellous surrounding lucent areas that often contain granules of varying density.o The characteristic electron electron microscopic finding of fully developed disease is that glomerular basement membrane shows irregular foci of thickening alternating with attenuation (thinning) with pronounced splitting and lamination of lamina densa often with distinctive basket weave appearance. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: The Electron Microscopy is viually diagnostic in renal biopsy study of -, with the following options: A: Goodpasture's syndrome, B: Churg-Strauss syndrome, C: Alpo syndrome, D: Wegner's granulomatosis
### Response:
Ans. is 'c' i.e., Alpo syndromeo Alpo's syndrome presents with characteristic histological features on electron microscopy. Such changes may present in other diseases, but are most pronounced and widespread in Alpo's syndrome.Features of Alpo's syndrome on electron microscopy :o Alpo's patients early in their disease typically have diffuse thinning of the basement membrane which thickens over time into multilamellous surrounding lucent areas that often contain granules of varying density.o The characteristic electron electron microscopic finding of fully developed disease is that glomerular basement membrane shows irregular foci of thickening alternating with attenuation (thinning) with pronounced splitting and lamination of lamina densa often with distinctive basket weave appearance.
### End |
7,885 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Arsenic compounds are used for the treatment of which of the following cancer?, with the following options: A: APML, B: CLL, C: ALL, D: CML
### Response:
| ARSENIC TRIOXIDE It is used for the treatment of Acute Promyelocytic Leukemia (APML). It may cause hyperglycemia and prolonged QT interval. Like tretinoin, it also acts as a differentiating agent. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Arsenic compounds are used for the treatment of which of the following cancer?, with the following options: A: APML, B: CLL, C: ALL, D: CML
### Response:
ARSENIC TRIOXIDE It is used for the treatment of Acute Promyelocytic Leukemia (APML). It may cause hyperglycemia and prolonged QT interval. Like tretinoin, it also acts as a differentiating agent.
### End |
7,886 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Compared to hepatic bile, gallbladder bile contains a reduced concentration of which of the following?, with the following options: A: Bile acids, B: Chloride Ions, C: Protons, D: Cholesterol
### Response:
| Composition of Bile Substance Liver Bile Gallbladder Bile Water 97.5 g/dl 92 g/dl Bile salts 1.1 g/dl 6 g/dl Bilirubin 0.04 g/dl 0.3 g/dl Cholesterol 0.1 g/dl 0.3 to 0.9 g/dl Fatty acids 0.12 g/dl 0.3 to 1.2 g/dl Lecithin 0.04 g/dl 0.3 g/dl Na+ 5 mEq/L 130 mEq/L K+ 5mEq/L 12 mEq/L Ca++ 5 mEq/L 23 mEq/L Cl- 100 mEq/L 25 mEq/L HCO3 28 mEq/L 10 mEq/L | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Compared to hepatic bile, gallbladder bile contains a reduced concentration of which of the following?, with the following options: A: Bile acids, B: Chloride Ions, C: Protons, D: Cholesterol
### Response:
Composition of Bile Substance Liver Bile Gallbladder Bile Water 97.5 g/dl 92 g/dl Bile salts 1.1 g/dl 6 g/dl Bilirubin 0.04 g/dl 0.3 g/dl Cholesterol 0.1 g/dl 0.3 to 0.9 g/dl Fatty acids 0.12 g/dl 0.3 to 1.2 g/dl Lecithin 0.04 g/dl 0.3 g/dl Na+ 5 mEq/L 130 mEq/L K+ 5mEq/L 12 mEq/L Ca++ 5 mEq/L 23 mEq/L Cl- 100 mEq/L 25 mEq/L HCO3 28 mEq/L 10 mEq/L
### End |
7,887 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Finding the most cost effcetive way doing a project -, with the following options: A: Network analysis, B: System analysis, C: Cost analysis, D: Field analaysis
### Response:
| The purpose of system analysis is to help the decision maker to choose an appropriate course action by investigating his problem,searching out objectives,finding out alternative solution,evaluation of the alternatives in terms of cost effectiveness,re-examination of the objectives if necessary and finding the most cost effective alternative (refer pgno:872 park 23 rd edition) | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Finding the most cost effcetive way doing a project -, with the following options: A: Network analysis, B: System analysis, C: Cost analysis, D: Field analaysis
### Response:
The purpose of system analysis is to help the decision maker to choose an appropriate course action by investigating his problem,searching out objectives,finding out alternative solution,evaluation of the alternatives in terms of cost effectiveness,re-examination of the objectives if necessary and finding the most cost effective alternative (refer pgno:872 park 23 rd edition)
### End |
7,888 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Papain cleaves the immunoglobin molecule into:, with the following options: A: 1 Fc and 1 Fab, B: 1 Fc and 2 Fab, C: 2 Fc and 1 Fab, D: 2 Fc and 2 Fab
### Response:
| Ans. (b) 1 Fc and 2 Fab Antibody Fragmentation The performances of ceain immunoassay procedures are enhanced by using antibody fragments, such as Fab and F(a13'),. Antibody fragmentation is accomplished using reducing agents and proteases that digest or cleave ceain poions of the immunoglobulin protein structure. Antibody fragments of primary interest are: Antigen-binding fragments such as Fab and b. Class-defining fragments such as Fc that do not bind antigen. Technique of antibody fragmentation Papain digestion: A nonspecific, thiol-endopeptidase defragment IgG molecules into three fragments of similar size: two Fab fragment and one Fc fragment. Pepsin digestion: A nonspecific endopeptidase produces one F(ab')2 fragment and numerous small peptides of the Fc poion. The resulting F(ab')2 fragment is composed of two disulfide-connected Fab units. Ficin digestion A thiol protease that can digest mouse monoclonal IgG1 into either F(ab')2 or Fab fragments, depending on the concentration of cysteine included. Types of antibody fragments F(ab')2 fragments: F(ab')2 (110,000 daltons) fragments contain two antigen-binding regions joined at the hinge through disulfides. This fragment is void of most, but not all, of the Fc region. Fab' fragments: Fab' (55,000 daltons) fragments can be formed by the reduction of F(ab')2 fragments. The Fab' fragment contains a free sulfhydryl group that may be alkylated or utilized in conjugation with an enzyme, toxin or other protein of interest. Fab' is derived from F(ab')2. Fab fragments: Fab (50,000 daltons) is a monovalent fragment that is produced from IgG and IgM, consisting of the VH, CH1 and VL, CL regions, linked by an intramolecular disulfide bond. Fv fragments: Fv (25,000 daltons) is the smallest fragment produced from IgG and IgM that contains a complete antigen-binding site. Fv fragments have the same binding propeies and similar three-dimensional binding characteristics as Fab. Fc fragments: Fc (50,000 daltons) fragments contain the CH2 and CH3 region and pa of the hinge region held together by one or more disulfides and noncovalent interactions. Fc and Fc5jt fragments are produced from fragmentation of IgG and IgM, respectively. The term Fc is derived from the ability of these antibody fragments to crystallize. The Fc fragment cannot bind antigen, but it is responsible for the effector functions of antibodies, such as complement fixation. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Papain cleaves the immunoglobin molecule into:, with the following options: A: 1 Fc and 1 Fab, B: 1 Fc and 2 Fab, C: 2 Fc and 1 Fab, D: 2 Fc and 2 Fab
### Response:
Ans. (b) 1 Fc and 2 Fab Antibody Fragmentation The performances of ceain immunoassay procedures are enhanced by using antibody fragments, such as Fab and F(a13'),. Antibody fragmentation is accomplished using reducing agents and proteases that digest or cleave ceain poions of the immunoglobulin protein structure. Antibody fragments of primary interest are: Antigen-binding fragments such as Fab and b. Class-defining fragments such as Fc that do not bind antigen. Technique of antibody fragmentation Papain digestion: A nonspecific, thiol-endopeptidase defragment IgG molecules into three fragments of similar size: two Fab fragment and one Fc fragment. Pepsin digestion: A nonspecific endopeptidase produces one F(ab')2 fragment and numerous small peptides of the Fc poion. The resulting F(ab')2 fragment is composed of two disulfide-connected Fab units. Ficin digestion A thiol protease that can digest mouse monoclonal IgG1 into either F(ab')2 or Fab fragments, depending on the concentration of cysteine included. Types of antibody fragments F(ab')2 fragments: F(ab')2 (110,000 daltons) fragments contain two antigen-binding regions joined at the hinge through disulfides. This fragment is void of most, but not all, of the Fc region. Fab' fragments: Fab' (55,000 daltons) fragments can be formed by the reduction of F(ab')2 fragments. The Fab' fragment contains a free sulfhydryl group that may be alkylated or utilized in conjugation with an enzyme, toxin or other protein of interest. Fab' is derived from F(ab')2. Fab fragments: Fab (50,000 daltons) is a monovalent fragment that is produced from IgG and IgM, consisting of the VH, CH1 and VL, CL regions, linked by an intramolecular disulfide bond. Fv fragments: Fv (25,000 daltons) is the smallest fragment produced from IgG and IgM that contains a complete antigen-binding site. Fv fragments have the same binding propeies and similar three-dimensional binding characteristics as Fab. Fc fragments: Fc (50,000 daltons) fragments contain the CH2 and CH3 region and pa of the hinge region held together by one or more disulfides and noncovalent interactions. Fc and Fc5jt fragments are produced from fragmentation of IgG and IgM, respectively. The term Fc is derived from the ability of these antibody fragments to crystallize. The Fc fragment cannot bind antigen, but it is responsible for the effector functions of antibodies, such as complement fixation.
### End |
7,889 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Excessive eating of non-nutritive substances is known as?, with the following options: A: PICA, B: Anorexia nervosa, C: Bulimia, D: Trichoteliomania
### Response:
| Ans. a (PICA). (Ref. O.P Ghai, 6th/pg.p 58)PICA# PICA is a disorder involving repeated or chronic ingestion of non-nutritive substances including plaster, charcoal, clay, wood, ashes and earth.# PICA after 2nd year of life needs to be investigated.# MR, lack of parental nurturing, autism, and behavior disorders like Kleine-Terin syndrome, family disorganization, low socioecomy.# Geophagia (earth eating) is seen with pregnancy.# Here patient develops craving for substance such as- Starch (amylophagia),- Ice (pagophagia) &- Clay (geophagia) these symptoms are peculiar i.e. Characteristic of iron deficiency.# Some of these materials such as starch & clay bind iron in the gastrointestinal tract, worsening the deficiency.# The basis of this bizarre behavior is unknown.# A particularly invidious consequence of iron deficiency, is increased by intestinal absorption of lead.# Children from impoverished families who often have both iron deficiency & pica are at greatest risk of developing lead poisoning.# The toxicity of lead is at least in part due to a disruption of hemesynthesis in neural tissue, a process abetted by iron deficiency.# Thus, these children are at increased risk of lead poisoning, iron deficiency anemia and parasitic infection. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Excessive eating of non-nutritive substances is known as?, with the following options: A: PICA, B: Anorexia nervosa, C: Bulimia, D: Trichoteliomania
### Response:
Ans. a (PICA). (Ref. O.P Ghai, 6th/pg.p 58)PICA# PICA is a disorder involving repeated or chronic ingestion of non-nutritive substances including plaster, charcoal, clay, wood, ashes and earth.# PICA after 2nd year of life needs to be investigated.# MR, lack of parental nurturing, autism, and behavior disorders like Kleine-Terin syndrome, family disorganization, low socioecomy.# Geophagia (earth eating) is seen with pregnancy.# Here patient develops craving for substance such as- Starch (amylophagia),- Ice (pagophagia) &- Clay (geophagia) these symptoms are peculiar i.e. Characteristic of iron deficiency.# Some of these materials such as starch & clay bind iron in the gastrointestinal tract, worsening the deficiency.# The basis of this bizarre behavior is unknown.# A particularly invidious consequence of iron deficiency, is increased by intestinal absorption of lead.# Children from impoverished families who often have both iron deficiency & pica are at greatest risk of developing lead poisoning.# The toxicity of lead is at least in part due to a disruption of hemesynthesis in neural tissue, a process abetted by iron deficiency.# Thus, these children are at increased risk of lead poisoning, iron deficiency anemia and parasitic infection.
### End |
7,890 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Endothelium derived relaxation factor is supposed to be: (Repeat), with the following options: A: Nitric oxide, B: Angiotensin, C: Serotonin, D: Norepinephrine
### Response:
| Ans: A (Nitric oxide) Ref: Pal GK. Synaptic transmission in CNS: ami Neurotransmitters. In: Textbook of medical physiology. 2nd ed. Ahuja publishing house. 2011; 100: 794.Explanation:Nitric oxide is also called as EDRF (Endothelial derived relaxation factor)Formed from arginine by NO synthase which needs NADPHIt mediates the action of many other vasodilators - Histamine, Ach, hradykinin. VIP, substance P | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Endothelium derived relaxation factor is supposed to be: (Repeat), with the following options: A: Nitric oxide, B: Angiotensin, C: Serotonin, D: Norepinephrine
### Response:
Ans: A (Nitric oxide) Ref: Pal GK. Synaptic transmission in CNS: ami Neurotransmitters. In: Textbook of medical physiology. 2nd ed. Ahuja publishing house. 2011; 100: 794.Explanation:Nitric oxide is also called as EDRF (Endothelial derived relaxation factor)Formed from arginine by NO synthase which needs NADPHIt mediates the action of many other vasodilators - Histamine, Ach, hradykinin. VIP, substance P
### End |
7,891 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: DOC for smoking cessation?, with the following options: A: Acamprosate, B: Varenicline, C: Thalidomide, D: Tryptophan
### Response:
| Ans. B. Varenicline (If Bupropion is not an option)Anti-smoking drugs:Bupropion (along with Varenicline & Nicotine replacement therapy) is a USFDA approved first-line agent for pharmacotherapy in smoking cessation.Varenicline:Effective agent for smoking cessation.Synthetic drug with paial agonist action at a4ss2 nicotinic receptors.Has antagonist propeies persisting due to long half-life & high receptor affinity.Hence, prevents stimulant effect of nicotine at presynaptic a4ss2 receptors a results in dopamine release. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: DOC for smoking cessation?, with the following options: A: Acamprosate, B: Varenicline, C: Thalidomide, D: Tryptophan
### Response:
Ans. B. Varenicline (If Bupropion is not an option)Anti-smoking drugs:Bupropion (along with Varenicline & Nicotine replacement therapy) is a USFDA approved first-line agent for pharmacotherapy in smoking cessation.Varenicline:Effective agent for smoking cessation.Synthetic drug with paial agonist action at a4ss2 nicotinic receptors.Has antagonist propeies persisting due to long half-life & high receptor affinity.Hence, prevents stimulant effect of nicotine at presynaptic a4ss2 receptors a results in dopamine release.
### End |
7,892 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Albe's stain is used for ?, with the following options: A: Staphylococcus, B: Corynebacterium diphtheriae, C: C. perfringens, D: C. tetani
### Response:
| Ans. is 'b' i.e., Corynebacterium diphtheriae Albe's stain is used for metachromatic granules, mostly found in corynebacterium diphtheriae. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Albe's stain is used for ?, with the following options: A: Staphylococcus, B: Corynebacterium diphtheriae, C: C. perfringens, D: C. tetani
### Response:
Ans. is 'b' i.e., Corynebacterium diphtheriae Albe's stain is used for metachromatic granules, mostly found in corynebacterium diphtheriae.
### End |
7,893 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Intestinal biopsy is not diagnostic in, with the following options: A: Abetalipoprotienemina, B: Tropical sprue, C: Intestinal lymphagienctaisis, D: Agammaaglobinemia
### Response:
| Refer Robbins page no 9/e 784 Small bowel biopsy is viually always abnormal when the tTG IgA antibody level is very high (more than five-fold the normal range), and EMA is positive. This is done in a procedure called a biopsy. The physician eases a long, thin tube called an endoscope through the mouth andstomach into the small intestine, and then takes samples of the tissue using small instruments passed through the endoscope.Biopsy remains the most accurate way to diagnose celiac disease | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Intestinal biopsy is not diagnostic in, with the following options: A: Abetalipoprotienemina, B: Tropical sprue, C: Intestinal lymphagienctaisis, D: Agammaaglobinemia
### Response:
Refer Robbins page no 9/e 784 Small bowel biopsy is viually always abnormal when the tTG IgA antibody level is very high (more than five-fold the normal range), and EMA is positive. This is done in a procedure called a biopsy. The physician eases a long, thin tube called an endoscope through the mouth andstomach into the small intestine, and then takes samples of the tissue using small instruments passed through the endoscope.Biopsy remains the most accurate way to diagnose celiac disease
### End |
7,894 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A patient complains of muscle weakness. It was reversed on administration of neostigmine,because ?, with the following options: A: It blocks action of acetylcholine, B: It interferes with the action of amine oxidase, C: It interferes with the action of carbonic anhydrase, D: It interferes with the action of acetylcholine esterase
### Response:
| Ans. is 'd' i.e., It interferes with the action of acetyl cholinesterase o Neostigmine acts by inhibiting the enzyme acetylcholinesterase. This enzyme is involved in degradation of ACh, consequently neostigmine increases the synaptic level of ACh. Muscle weakness can be improved by stimulation of NM receptor at muscle end plate due to increased ACh. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: A patient complains of muscle weakness. It was reversed on administration of neostigmine,because ?, with the following options: A: It blocks action of acetylcholine, B: It interferes with the action of amine oxidase, C: It interferes with the action of carbonic anhydrase, D: It interferes with the action of acetylcholine esterase
### Response:
Ans. is 'd' i.e., It interferes with the action of acetyl cholinesterase o Neostigmine acts by inhibiting the enzyme acetylcholinesterase. This enzyme is involved in degradation of ACh, consequently neostigmine increases the synaptic level of ACh. Muscle weakness can be improved by stimulation of NM receptor at muscle end plate due to increased ACh.
### End |
7,895 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Multiple epidermoid cysts are seen in ?, with the following options: A: Turcot's syndrome, B: Gardner's syndrome, C: Peutz-Jegher syndrome, D: Familial polyposis coli
### Response:
| Ans. is 'b' i.e., Gardener's syndrome | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Multiple epidermoid cysts are seen in ?, with the following options: A: Turcot's syndrome, B: Gardner's syndrome, C: Peutz-Jegher syndrome, D: Familial polyposis coli
### Response:
Ans. is 'b' i.e., Gardener's syndrome
### End |
7,896 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Arrange vascular events in acute inflammation: A. Increased blood viscosity B. Vasodilatation C. Stasis D. Vasoconstriction E. Increased vascular permeability, with the following options: A: D,B,E,A,C, B: B,A,E,C,D, C: B,C,E,A,D, D: E,C,A,D,B
### Response:
| The vascular reactions of acute inflammation consist of changes in the flow of blood and the permeability of vessels, both designed to maximize the movement of plasma proteins and leukocytes out of the circulation and into the site of infection or injury. The sequence of vascular changes in acute inflammation are as follows: Immediate transient vasoconstriction Vasodilation Increased vascular permeability Increased blood viscosity and stasis | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Arrange vascular events in acute inflammation: A. Increased blood viscosity B. Vasodilatation C. Stasis D. Vasoconstriction E. Increased vascular permeability, with the following options: A: D,B,E,A,C, B: B,A,E,C,D, C: B,C,E,A,D, D: E,C,A,D,B
### Response:
The vascular reactions of acute inflammation consist of changes in the flow of blood and the permeability of vessels, both designed to maximize the movement of plasma proteins and leukocytes out of the circulation and into the site of infection or injury. The sequence of vascular changes in acute inflammation are as follows: Immediate transient vasoconstriction Vasodilation Increased vascular permeability Increased blood viscosity and stasis
### End |
7,897 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Burst suppression of EEG is sees in, with the following options: A: Herpes, B: SSPE, C: Prions disease, D: Epilepsy
### Response:
| . * In SSPE ,EEG demonstrates characteristic periodic bursts of triphasic waves. Ref Harrison20th edition pg 2567 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Burst suppression of EEG is sees in, with the following options: A: Herpes, B: SSPE, C: Prions disease, D: Epilepsy
### Response:
. * In SSPE ,EEG demonstrates characteristic periodic bursts of triphasic waves. Ref Harrison20th edition pg 2567
### End |
7,898 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Blood supply of liver-, with the following options: A: 80% hepatic artery, 20% portal vein, B: 20% hepatic artery, 80% portal vein, C: 50% hepatic artery, 50% portal vein, D: 100% hepatic artery
### Response:
| The liver has dual blood supply :-
20% of blood supply is through the hepatic artery.
80% of blood supply is through the portal vein. | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Blood supply of liver-, with the following options: A: 80% hepatic artery, 20% portal vein, B: 20% hepatic artery, 80% portal vein, C: 50% hepatic artery, 50% portal vein, D: 100% hepatic artery
### Response:
The liver has dual blood supply :-
20% of blood supply is through the hepatic artery.
80% of blood supply is through the portal vein.
### End |
7,899 | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Acquired blue blindness is a feature of:, with the following options: A: Increased sclerosis of the crystalline lens, B: Disease of optic nerve, C: Disease of macula, D: All of the above
### Response:
| Ans. Increased sclerosis of the crystalline lens | Below is an instruction that describes a task. Write a response that appropriately completes the request.
### Instruction:
Answer the following medical question: Acquired blue blindness is a feature of:, with the following options: A: Increased sclerosis of the crystalline lens, B: Disease of optic nerve, C: Disease of macula, D: All of the above
### Response:
Ans. Increased sclerosis of the crystalline lens
### End |
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