Datasets:

jesse-tong

/

medqa

like 0

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Direct action of radiation is the dominant process for, with the following options: A: X-rays, B: Neutrons and alpha paicles, C: Electrons, D: Gamma rays ### Response:

Ionizing radiation acts by two methods: Direct and IndirectDirect action is radiation directly causing DNA damage; example: neutrons and alpha paiclesIndirect action is radiation causing free radical production which acts on DNA; example: photons and gamma raysReference: Khan Physics of Radiation therapy; 5th edition

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Direct action of radiation is the dominant process for, with the following options: A: X-rays, B: Neutrons and alpha paicles, C: Electrons, D: Gamma rays ### Response: Ionizing radiation acts by two methods: Direct and IndirectDirect action is radiation directly causing DNA damage; example: neutrons and alpha paiclesIndirect action is radiation causing free radical production which acts on DNA; example: photons and gamma raysReference: Khan Physics of Radiation therapy; 5th edition ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which one of the following factors is labelled as cytokine in the pathogenesis of systemic inflammatory response syndrome (SIRS) ?, with the following options: A: Nitric oxide, B: Complements, C: Leukotrienes, D: Tumor Necrosis factor ### Response:

Ans. is 'd' i.e., Tumor Necrosis factor

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which one of the following factors is labelled as cytokine in the pathogenesis of systemic inflammatory response syndrome (SIRS) ?, with the following options: A: Nitric oxide, B: Complements, C: Leukotrienes, D: Tumor Necrosis factor ### Response: Ans. is 'd' i.e., Tumor Necrosis factor ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Vitamin E deficiency causes all EXCEPT:, with the following options: A: Ataxia, B: Neuropathy, C: Megaloblastic anemia, D: Ophthalmoplegia ### Response:

Deficiency of vitamin E can lead to:- Neurological problems Difficulty coordinating movements (ataxia) Speech (dysahria) Loss of reflexes in the legs (lower limb areflexia) Loss of sensation in the extremities (peripheral neuropathy). Ophthalmoplegia in susceptible persons. Megaloblastic anaemia is caused by deficiency of vitamin B12 and folic acid

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Vitamin E deficiency causes all EXCEPT:, with the following options: A: Ataxia, B: Neuropathy, C: Megaloblastic anemia, D: Ophthalmoplegia ### Response: Deficiency of vitamin E can lead to:- Neurological problems Difficulty coordinating movements (ataxia) Speech (dysahria) Loss of reflexes in the legs (lower limb areflexia) Loss of sensation in the extremities (peripheral neuropathy). Ophthalmoplegia in susceptible persons. Megaloblastic anaemia is caused by deficiency of vitamin B12 and folic acid ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Immediate treatment of hypercalcemia of malignancy is, with the following options: A: IV Fluids, B: Bisphosphonates, C: Calcitonin, D: Glucocorticoids ### Response:

Drug of choice for hypercalcemia of malignancy is Bisphosphanates but immediate treatment involves administration of IV fluids.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Immediate treatment of hypercalcemia of malignancy is, with the following options: A: IV Fluids, B: Bisphosphonates, C: Calcitonin, D: Glucocorticoids ### Response: Drug of choice for hypercalcemia of malignancy is Bisphosphanates but immediate treatment involves administration of IV fluids. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Coho study is a type of, with the following options: A: Clinical trial, B: Analytic study, C: Descriptive study, D: Experimental study ### Response:

Coho or follow up is a type of analytical study with individuals as a unit of the study. (refer pg no: 62, 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: Coho study is a type of, with the following options: A: Clinical trial, B: Analytic study, C: Descriptive study, D: Experimental study ### Response: Coho or follow up is a type of analytical study with individuals as a unit of the study. (refer pg no: 62, park 23 rd edition ) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: As a pa of space-research program , a physiologist was asked to investigate the effect of flight-induced stress on blood pressure. Accordingly, the blood pressure of the cosmonauts were to be measured twice: once before the take-off and once after the spacecraft entered the designated orbit around the eah. For a proper comparison, the preflight blood pressure should be recorded in which position?, with the following options: A: The sitting position, B: The standing position, C: The lying down position, D: Any position, as long as the post-flight recording is made in the same position ### Response:

In the space there is no gravity. In order to compare the blood pressure taken preflight and the one in the space, BP should be taken in a position where gravity is nullified. In lying position the gravitational force is nullified, so preflight BP measurement should be done in the lying down position. In supine position, legs are at the same level as the hea so that the gravitational forces that come into play in the upright position are diminished. When a person is lying on his back, the tricuspid valve is located at almost exactly 60% of the chest thickness in front of the back. This the zero pressure reference level. Ref: High-Yield Physiology, Pa 845, Volume 2008 By Ronald W. Dudek, Page 51; Essentials Of Medical Physiology By Khurana, Page 185.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: As a pa of space-research program , a physiologist was asked to investigate the effect of flight-induced stress on blood pressure. Accordingly, the blood pressure of the cosmonauts were to be measured twice: once before the take-off and once after the spacecraft entered the designated orbit around the eah. For a proper comparison, the preflight blood pressure should be recorded in which position?, with the following options: A: The sitting position, B: The standing position, C: The lying down position, D: Any position, as long as the post-flight recording is made in the same position ### Response: In the space there is no gravity. In order to compare the blood pressure taken preflight and the one in the space, BP should be taken in a position where gravity is nullified. In lying position the gravitational force is nullified, so preflight BP measurement should be done in the lying down position. In supine position, legs are at the same level as the hea so that the gravitational forces that come into play in the upright position are diminished. When a person is lying on his back, the tricuspid valve is located at almost exactly 60% of the chest thickness in front of the back. This the zero pressure reference level. Ref: High-Yield Physiology, Pa 845, Volume 2008 By Ronald W. Dudek, Page 51; Essentials Of Medical Physiology By Khurana, Page 185. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In human genome project, scientist notices that one strand of the DNA molecule contains 20 thymine (T), 25 cytosine (C), 30 guanine (C) and 22 adenine (A) residues. How many of each of the bases are found in the complete double-stranded molecule?, with the following options: A: T-44, C=60, G=50, A=40, B: T-22, C=30, G=25, A=20, C: T-40, C=50, G=60, A=44, D: T-42, C=55, G=55, A=42 ### Response:

Question repeated

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In human genome project, scientist notices that one strand of the DNA molecule contains 20 thymine (T), 25 cytosine (C), 30 guanine (C) and 22 adenine (A) residues. How many of each of the bases are found in the complete double-stranded molecule?, with the following options: A: T-44, C=60, G=50, A=40, B: T-22, C=30, G=25, A=20, C: T-40, C=50, G=60, A=44, D: T-42, C=55, G=55, A=42 ### Response: Question repeated ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: ESI act is under which minstry -, with the following options: A: Ministry of human resources developments, B: Ministry of social welfare, C: Ministry of labour and employment, D: Ministry of health 8c education ### Response:

Ans. is 'c' i.e., Ministry of labour and employment* Employees' state insurance (abbreviated as ESI) is a self-financing social security and health insurance scheme for indian workers. This fund is managed by the employees' state insurance corporation (ESIC) according to rules and regulations stipulated there in the ESI Act 1948. ESIC is an autonomous corporation by a statutory creation under ministry of labour and employment government of India.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: ESI act is under which minstry -, with the following options: A: Ministry of human resources developments, B: Ministry of social welfare, C: Ministry of labour and employment, D: Ministry of health 8c education ### Response: Ans. is 'c' i.e., Ministry of labour and employment* Employees' state insurance (abbreviated as ESI) is a self-financing social security and health insurance scheme for indian workers. This fund is managed by the employees' state insurance corporation (ESIC) according to rules and regulations stipulated there in the ESI Act 1948. ESIC is an autonomous corporation by a statutory creation under ministry of labour and employment government of India. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Use of magnesium sulfate in pregnancy are ssociated with all of the following side-effects except: March 2010, with the following options: A: Muscular paralysis, B: Bradycardia, C: Cardiac arryhthmias, D: Respiratory depression ### Response:

Ans. B: Bradycardia Magnesium sulfate (MgSO4) is commonly used as an anticonvulsant for toxemia and as a tocolytic agent for premature labor during the last half of pregnancy. Toxicity of I/V magnesium sulfate includes cardiac arrhythmias, muscular paralysis, respiratory depression and CNS depression in mother as well as the neonate.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Use of magnesium sulfate in pregnancy are ssociated with all of the following side-effects except: March 2010, with the following options: A: Muscular paralysis, B: Bradycardia, C: Cardiac arryhthmias, D: Respiratory depression ### Response: Ans. B: Bradycardia Magnesium sulfate (MgSO4) is commonly used as an anticonvulsant for toxemia and as a tocolytic agent for premature labor during the last half of pregnancy. Toxicity of I/V magnesium sulfate includes cardiac arrhythmias, muscular paralysis, respiratory depression and CNS depression in mother as well as the neonate. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Aplastic crisis in sickle cell anemia as compared to haemolytic crisis leads to, with the following options: A: Increased blood volume, B: Total leucocyte count decreased, C: Decrease in reticulocytes, D: Same findings ### Response:

Aplastic crisis is an acute event caused by sudden decrease in red cell production. This is usually triggered by infection of erythroblasts by parvovirus B-19. Hemolytic crisis is associated with hyperbilirubinemia and compensatory reticulocytosis.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Aplastic crisis in sickle cell anemia as compared to haemolytic crisis leads to, with the following options: A: Increased blood volume, B: Total leucocyte count decreased, C: Decrease in reticulocytes, D: Same findings ### Response: Aplastic crisis is an acute event caused by sudden decrease in red cell production. This is usually triggered by infection of erythroblasts by parvovirus B-19. Hemolytic crisis is associated with hyperbilirubinemia and compensatory reticulocytosis. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In N-linked glycosylation, a core oligosaccharide is transferred to the polypeptide chain after first being attached to a molecule of, with the following options: A: Serine, B: Phosphatidyl choline, C: Cholesterol, D: Dolichol ### Response:

N-linked glycosylation begins in the endoplasmic reticulum. A core oligosaccharide is synthesized attached to a molecule of the lipid dolichol. The oligosaccharide is transferred from dolichol to an asparagine residue of the polypeptide chain. The oligosaccharide is first trimmed and then modified by the addition of monosaccharide units as the protein molecule is processed through the endoplasmic reticulum and the Golgi apparatus. Ref : Biochemistry by U. Satyanarayana 3rd edition Pgno : 562

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In N-linked glycosylation, a core oligosaccharide is transferred to the polypeptide chain after first being attached to a molecule of, with the following options: A: Serine, B: Phosphatidyl choline, C: Cholesterol, D: Dolichol ### Response: N-linked glycosylation begins in the endoplasmic reticulum. A core oligosaccharide is synthesized attached to a molecule of the lipid dolichol. The oligosaccharide is transferred from dolichol to an asparagine residue of the polypeptide chain. The oligosaccharide is first trimmed and then modified by the addition of monosaccharide units as the protein molecule is processed through the endoplasmic reticulum and the Golgi apparatus. Ref : Biochemistry by U. Satyanarayana 3rd edition Pgno : 562 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Minimum quantity of blood required to be preserved for chemical analysis is -, with the following options: A: 2 ml, B: 10 ml, C: 50 ml, D: 100 ml ### Response:

Blood → 30 ml (minimum 10 ml) Urine →  30 ml

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Minimum quantity of blood required to be preserved for chemical analysis is -, with the following options: A: 2 ml, B: 10 ml, C: 50 ml, D: 100 ml ### Response: Blood → 30 ml (minimum 10 ml) Urine →  30 ml ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Typical coloboma of iris occurs:, with the following options: A: Inferonasally, B: Superonasally, C: Inferotemporally, D: Superotemporally ### Response:

Ans. Inferonasally

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Typical coloboma of iris occurs:, with the following options: A: Inferonasally, B: Superonasally, C: Inferotemporally, D: Superotemporally ### Response: Ans. Inferonasally ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Herpes zoster most commonly involves:, with the following options: A: Facial nerve, B: Ophthalmic division of Trigeminal, C: Mandibular division of Trigeminal, D: Maxillary ivision of Trigeminal nerve ### Response:

Ref: Harrison's l8th editionExplanation:The clinical syndrome caused by the reactivation of VZV from sensory ganglia is herpes zoster.The commonly involved dermatomes are:The thoracic dermatomes, especially T4 to T12. are involved in about 50% of casesThe lumbosacral dermatomes in about 16%The cranial nerves in 14 to 20% ot patientso Opthalmic division of trigeminal in 10 to 15 percent ando Other cranial nerves causing 4 to 5 percentThere are two rather characteristic cranial herpetic syndromes are ophthalmic herpes and geniculate herpes.In ophthalmic herpes, which accounts for 10 to 15 percent of all cases of zoster, the pain and rash are in the distribution of the first division of the trigeminal nerve, and the pathologic changes are centered in the gasserian ganglion. The main hazard in this form of the disease is herpetic involvement of the cornea and conjunctiva, resulting in corneal anesthesia and residual scarring. Palsies of extraocular muscles, ptosis, and mydriasis are frequently associated, indicating that the third, fourth, and sixth crania] nerves are affected in addition to the gasserian ganglion.The less common but also characteristic cranial nerve syndrome called Ramsay Hunt syndrome - consists of a facial palsy in combination with a herpetic eruption of the external auditory meatus, sometimes with tinnitus, vertigo, and deafness. This is due to the reactivation of herpes from the geniculate ganglion.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Herpes zoster most commonly involves:, with the following options: A: Facial nerve, B: Ophthalmic division of Trigeminal, C: Mandibular division of Trigeminal, D: Maxillary ivision of Trigeminal nerve ### Response: Ref: Harrison's l8th editionExplanation:The clinical syndrome caused by the reactivation of VZV from sensory ganglia is herpes zoster.The commonly involved dermatomes are:The thoracic dermatomes, especially T4 to T12. are involved in about 50% of casesThe lumbosacral dermatomes in about 16%The cranial nerves in 14 to 20% ot patientso Opthalmic division of trigeminal in 10 to 15 percent ando Other cranial nerves causing 4 to 5 percentThere are two rather characteristic cranial herpetic syndromes are ophthalmic herpes and geniculate herpes.In ophthalmic herpes, which accounts for 10 to 15 percent of all cases of zoster, the pain and rash are in the distribution of the first division of the trigeminal nerve, and the pathologic changes are centered in the gasserian ganglion. The main hazard in this form of the disease is herpetic involvement of the cornea and conjunctiva, resulting in corneal anesthesia and residual scarring. Palsies of extraocular muscles, ptosis, and mydriasis are frequently associated, indicating that the third, fourth, and sixth crania] nerves are affected in addition to the gasserian ganglion.The less common but also characteristic cranial nerve syndrome called Ramsay Hunt syndrome - consists of a facial palsy in combination with a herpetic eruption of the external auditory meatus, sometimes with tinnitus, vertigo, and deafness. This is due to the reactivation of herpes from the geniculate ganglion. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Exocytosis is by, with the following options: A: Engulfment, B: Cell destruction, C: Multiplication of cell organelles, D: Expulsion ### Response:

Ans: d (Expulsion) Ref: Ganong 22nd ed/p. 28-30Exocvtosis:-Vesicles containing the material for export are targeted to the cell mem-brane, where they bond via the vsnare/ t-snare arrangement.The area of fusion then breaks down, leaving the contents of the vesicle outside and the cell membrane intact.This is a Ca2+ dependant process.Thus, there is a net increase in the surface area of the cell as the cytoplas-mic sides of two membranes fuse.Endocvtosis:-The process by which cells take up large molecules. In endocytosis, two non cytoplasmic sides of membranes fuse. Endocytotic vesicles are generated when segments of the plasma membrane invaginate, enclosing a minute volume of extracellular fluid and is contents. The vesicle then pinches off as the fusion of plasma membranes seal the neck of the vesicle at the original site of invagination.There are two general types of endocytosis:-a) Phagocytosisb) PinocytosisPhagocvtosis:-Involves ingestion of large particles such as viruses, bacteria, cells or debris.Occurs only in specialized cells such as macrophages and granulocytes.Pinocvtosis:-Property of all cellsIt is a cellular uptake of fluid and fluid contents.It is of two types:-Fluid phase pinocytosis is a non selective process in which the uptake of a solute is simply proportionate to its concentration in the surrounding extracellular fluid.Absoipti ve pinocytosis is a receptor mediated selective process primarily responsible for the uptake of mac- romolecules. The vesicles formed dur-ing absorptive pinocytosis are derived from invagination (pits) that are coated on the cytoplasmic side with a Filamentous material.In many systems, Clathrin is the filamentous material. For e.g., LDL is internalised by means of coated pits containing the LDL receptors.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Exocytosis is by, with the following options: A: Engulfment, B: Cell destruction, C: Multiplication of cell organelles, D: Expulsion ### Response: Ans: d (Expulsion) Ref: Ganong 22nd ed/p. 28-30Exocvtosis:-Vesicles containing the material for export are targeted to the cell mem-brane, where they bond via the vsnare/ t-snare arrangement.The area of fusion then breaks down, leaving the contents of the vesicle outside and the cell membrane intact.This is a Ca2+ dependant process.Thus, there is a net increase in the surface area of the cell as the cytoplas-mic sides of two membranes fuse.Endocvtosis:-The process by which cells take up large molecules. In endocytosis, two non cytoplasmic sides of membranes fuse. Endocytotic vesicles are generated when segments of the plasma membrane invaginate, enclosing a minute volume of extracellular fluid and is contents. The vesicle then pinches off as the fusion of plasma membranes seal the neck of the vesicle at the original site of invagination.There are two general types of endocytosis:-a) Phagocytosisb) PinocytosisPhagocvtosis:-Involves ingestion of large particles such as viruses, bacteria, cells or debris.Occurs only in specialized cells such as macrophages and granulocytes.Pinocvtosis:-Property of all cellsIt is a cellular uptake of fluid and fluid contents.It is of two types:-Fluid phase pinocytosis is a non selective process in which the uptake of a solute is simply proportionate to its concentration in the surrounding extracellular fluid.Absoipti ve pinocytosis is a receptor mediated selective process primarily responsible for the uptake of mac- romolecules. The vesicles formed dur-ing absorptive pinocytosis are derived from invagination (pits) that are coated on the cytoplasmic side with a Filamentous material.In many systems, Clathrin is the filamentous material. For e.g., LDL is internalised by means of coated pits containing the LDL receptors. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Primary hyperparathyroidism, phaeochromocytoma may be associated with which type of thyroid cancer?, with the following options: A: Medullary carcinoma of the thyroid, B: Papillary carcinoma of the thyroid, C: Anaplastic carcinoma of the thyroid, D: Follicular carcinoma of the thyroid ### Response:

Ref : Bailey and love surgery text book 27th Ed. It is characterized clinically by medullary thyroid carcinoma (MTC), pheochromocytoma, and hyperparathyroidism. Approximately 70-95% of individuals with MEN 2A develop MTC, 50% develop pheochromocytoma, and 15-30% develop hyperparathyroidism.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Primary hyperparathyroidism, phaeochromocytoma may be associated with which type of thyroid cancer?, with the following options: A: Medullary carcinoma of the thyroid, B: Papillary carcinoma of the thyroid, C: Anaplastic carcinoma of the thyroid, D: Follicular carcinoma of the thyroid ### Response: Ref : Bailey and love surgery text book 27th Ed. It is characterized clinically by medullary thyroid carcinoma (MTC), pheochromocytoma, and hyperparathyroidism. Approximately 70-95% of individuals with MEN 2A develop MTC, 50% develop pheochromocytoma, and 15-30% develop hyperparathyroidism. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Endosalpingitis is best diagnosed by, with the following options: A: laparoscopy, B: X-Ray abdomen, C: Hysterosalpingography, D: Hystero-laparoscopy ### Response:

Clinical Triad for Diagnosis of PID Pelvic organ tenderness, Adnexal tenderness, Cervical motion tenderness (Suggests the presence of peritoneal inflammation, which causes pain when the peritoneum is stretched by moving the cervix and causing traction of the adnexa on the pelvic peritoneum) Direct or rebound abdominal tenderness may be present. Evaluation of both vaginal and endocervical secretions is a crucial pa of the workup of a patient with PID. Increased number of polymorphonuclear leukocytes may be detected in a wet mount of the vaginal secretions or in the mucopurulent discharge. More elaborate tests include Endometrial biopsy to confirm the presence of endometritis, Ultrasound or radiologic tests to characterize a tubo-ovarian abscess laparoscopy to confirm salpingitis visually A laparoscopy, if asked in the Questions, is indeed the best test to diagnose PID. Its not a practical option always since this is a common presentation in the OPD and will be impossible to do on every one . Regular OPD diagnosis is made by the clinical triad If a Laparoscopy is being done for some indication & the surgeon notices inflamed tubes, then it is diagnostic of a PID Also: Please note that for diagnosis of PID , any uterine procedure like hysteroscopy, HSG, sonosalpingography ,will all push in fluids through the Uterus and this can in fact increase the PID.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Endosalpingitis is best diagnosed by, with the following options: A: laparoscopy, B: X-Ray abdomen, C: Hysterosalpingography, D: Hystero-laparoscopy ### Response: Clinical Triad for Diagnosis of PID Pelvic organ tenderness, Adnexal tenderness, Cervical motion tenderness (Suggests the presence of peritoneal inflammation, which causes pain when the peritoneum is stretched by moving the cervix and causing traction of the adnexa on the pelvic peritoneum) Direct or rebound abdominal tenderness may be present. Evaluation of both vaginal and endocervical secretions is a crucial pa of the workup of a patient with PID. Increased number of polymorphonuclear leukocytes may be detected in a wet mount of the vaginal secretions or in the mucopurulent discharge. More elaborate tests include Endometrial biopsy to confirm the presence of endometritis, Ultrasound or radiologic tests to characterize a tubo-ovarian abscess laparoscopy to confirm salpingitis visually A laparoscopy, if asked in the Questions, is indeed the best test to diagnose PID. Its not a practical option always since this is a common presentation in the OPD and will be impossible to do on every one . Regular OPD diagnosis is made by the clinical triad If a Laparoscopy is being done for some indication & the surgeon notices inflamed tubes, then it is diagnostic of a PID Also: Please note that for diagnosis of PID , any uterine procedure like hysteroscopy, HSG, sonosalpingography ,will all push in fluids through the Uterus and this can in fact increase the PID. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The preferred treatment of verrucouse carcinoma of the larynx is, with the following options: A: Endoscopic removal, B: Electron beam therapy, C: Pulmonary surgery, D: Total laryngectomy ### Response:

Verrucous Carcinoma 1) Verrcous carcinoma makes up only 1-2% of laryngeal carcinomas. 2) The larynx is the second most common site of occurence in the head and neck after the oral cavity. 3) Most common site of involvement is vocal cord. 4) Grossly, verrucous carcinoma appears as a fungating, papillomatous, grayish white neoplasm. 5) Microscopically, it is well differentiated squamous cell carcinoma with minimal cytological atypia. 6) It has low metastatic potential . 7) Hoarseness is the most common presented symptom. Pain and dysphagia may occur but are less common. 8) Treatment of most verrucous tumors is primary surgery. Endoscopic laser surgery is appropriate as the tumor is less aggressive than usual squamous cell carcinoma. Ref:- Current otolaryngology; pg num:- 444

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The preferred treatment of verrucouse carcinoma of the larynx is, with the following options: A: Endoscopic removal, B: Electron beam therapy, C: Pulmonary surgery, D: Total laryngectomy ### Response: Verrucous Carcinoma 1) Verrcous carcinoma makes up only 1-2% of laryngeal carcinomas. 2) The larynx is the second most common site of occurence in the head and neck after the oral cavity. 3) Most common site of involvement is vocal cord. 4) Grossly, verrucous carcinoma appears as a fungating, papillomatous, grayish white neoplasm. 5) Microscopically, it is well differentiated squamous cell carcinoma with minimal cytological atypia. 6) It has low metastatic potential . 7) Hoarseness is the most common presented symptom. Pain and dysphagia may occur but are less common. 8) Treatment of most verrucous tumors is primary surgery. Endoscopic laser surgery is appropriate as the tumor is less aggressive than usual squamous cell carcinoma. Ref:- Current otolaryngology; pg num:- 444 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Commonest malignancy in renal transplant recipient is, with the following options: A: Skin cancer, B: Renal cell carcinoma, C: Non hodgkins lymphoma, D: Hodgkins lymphoma ### Response:

Cancers seen in renal transplant recipients in decreasing order are: Skin cancer > Lymphoma > Kaposi's Sarcoma > Ca Cervix > Renal tumors > Ca Vulva & perineum.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Commonest malignancy in renal transplant recipient is, with the following options: A: Skin cancer, B: Renal cell carcinoma, C: Non hodgkins lymphoma, D: Hodgkins lymphoma ### Response: Cancers seen in renal transplant recipients in decreasing order are: Skin cancer > Lymphoma > Kaposi's Sarcoma > Ca Cervix > Renal tumors > Ca Vulva & perineum. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common intraocular foreign body retained is, with the following options: A: Airgun pellets, B: Iron, C: Glass, D: Chisel ### Response:

Common foreign bodies responsible for such injuries include: chips of iron and steel (90%), paicles of glass, stone, lead pellets, copper percussion caps, aluminium, plastic and wood. It is impoant to note that during chopping a stone with an iron chisel, it is commonly a chip of the chisel and not of the stone which enters the eye. Ref khurana 6/e p433

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common intraocular foreign body retained is, with the following options: A: Airgun pellets, B: Iron, C: Glass, D: Chisel ### Response: Common foreign bodies responsible for such injuries include: chips of iron and steel (90%), paicles of glass, stone, lead pellets, copper percussion caps, aluminium, plastic and wood. It is impoant to note that during chopping a stone with an iron chisel, it is commonly a chip of the chisel and not of the stone which enters the eye. Ref khurana 6/e p433 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following hormones are increased due to stress during surgery, especially in DM:, with the following options: A: Epinephrine, B: GH, C: Glucocoicoids, D: All ### Response:

A i.e. Epinephrine; B i.e. GH; C i.e. Glucocoicoid Glucagon, catecholamines (epinephrine & norepinephrine), coisol, ACTH, GH (growth hormone) are increased in stress (infection, surgery, hypoglycemia) whereas, insulin is suppressed (decreased)Q. In maintenance of internal homeostasis (ie avoiding stress) and reproduction processes, multiple hormones cooperate to bring about organized biochemical & physiological responses. Stress Syndrome: CRH - ACTH - Coisol Axis The primitive signal of glucose (substrate) lack is expanded to a broder signal of fright or stress and evokes a coordinated neural and endocrine response. Any stressful event eg. surgery, infection, burn triggers a hypermetabolic state in which a resting energy expenditure is increased alongwith body temperature. CRH-ACTH - coisol axis is central to this integrated response to stress. Features of Stress Syndrome - Coicotropin releasing hormone (CRH) is increased in response to noxious environmental stimuli like pain, trauma, hypoglycemia, infection, surgery, hypovolemia. Various nervous impulses using several neuro transmitters (NTs) like norepinephrine, serotonin, acetylcholine, dopamine, and GABA reach CRH neurosecretory cells and cause release of CRH - In response to CRH, both ACTH and p endorphins (secreted 13-LPH & mature p-endorphin) are released in equimolar quantities 13-endorphin produce central analgesic response. - Glucagon & catecholamines (epinephrine & norepinephrine) are increased, stimulating glycogenolysis (glucose production in liver) for immediate use by critical organs such as the brain. - Coisol production is increased in adrenal coex which induces gluconeogenesis (glucose production from noncarbohydrate source like muscles & other body proteins) - Glucogon, epinephrine, ACTH and growth hormone (GH) stimulate lipolysis and free fatty acids (FFA) & ketones are released into the circulation to be used as an alternative metabolic fuel. - Insulin is suppressedQ that results in decrease in glucose utilization. - One form of stress that is cold, specially in neonate causes increased TRH secretion due to depressed metabolism of neurons in pre- optic area by cooling which release inhibitory discharge, permitting TRH secretion. - ADH (vasopressin), angiotensin & aldosterone synthesis is increased enhancing salt water retention - So increased glucose production (by glycogenolysis & gluconeogenesis) and decreased utilization of glucose results in hyperglycemia. There is marked increase in release of aminoacids from tissue protein, paicularly from skeletal muscle for gluconeogenesis. However, synthesis of specific proteins may increase - These metabolic changes are coordinated with increased sympathetic nervous system activity causing peripheral vasoconstriction and increased blood pressure.

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 hormones are increased due to stress during surgery, especially in DM:, with the following options: A: Epinephrine, B: GH, C: Glucocoicoids, D: All ### Response: A i.e. Epinephrine; B i.e. GH; C i.e. Glucocoicoid Glucagon, catecholamines (epinephrine & norepinephrine), coisol, ACTH, GH (growth hormone) are increased in stress (infection, surgery, hypoglycemia) whereas, insulin is suppressed (decreased)Q. In maintenance of internal homeostasis (ie avoiding stress) and reproduction processes, multiple hormones cooperate to bring about organized biochemical & physiological responses. Stress Syndrome: CRH - ACTH - Coisol Axis The primitive signal of glucose (substrate) lack is expanded to a broder signal of fright or stress and evokes a coordinated neural and endocrine response. Any stressful event eg. surgery, infection, burn triggers a hypermetabolic state in which a resting energy expenditure is increased alongwith body temperature. CRH-ACTH - coisol axis is central to this integrated response to stress. Features of Stress Syndrome - Coicotropin releasing hormone (CRH) is increased in response to noxious environmental stimuli like pain, trauma, hypoglycemia, infection, surgery, hypovolemia. Various nervous impulses using several neuro transmitters (NTs) like norepinephrine, serotonin, acetylcholine, dopamine, and GABA reach CRH neurosecretory cells and cause release of CRH - In response to CRH, both ACTH and p endorphins (secreted 13-LPH & mature p-endorphin) are released in equimolar quantities 13-endorphin produce central analgesic response. - Glucagon & catecholamines (epinephrine & norepinephrine) are increased, stimulating glycogenolysis (glucose production in liver) for immediate use by critical organs such as the brain. - Coisol production is increased in adrenal coex which induces gluconeogenesis (glucose production from noncarbohydrate source like muscles & other body proteins) - Glucogon, epinephrine, ACTH and growth hormone (GH) stimulate lipolysis and free fatty acids (FFA) & ketones are released into the circulation to be used as an alternative metabolic fuel. - Insulin is suppressedQ that results in decrease in glucose utilization. - One form of stress that is cold, specially in neonate causes increased TRH secretion due to depressed metabolism of neurons in pre- optic area by cooling which release inhibitory discharge, permitting TRH secretion. - ADH (vasopressin), angiotensin & aldosterone synthesis is increased enhancing salt water retention - So increased glucose production (by glycogenolysis & gluconeogenesis) and decreased utilization of glucose results in hyperglycemia. There is marked increase in release of aminoacids from tissue protein, paicularly from skeletal muscle for gluconeogenesis. However, synthesis of specific proteins may increase - These metabolic changes are coordinated with increased sympathetic nervous system activity causing peripheral vasoconstriction and increased blood pressure. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Trichophyton infects:, with the following options: A: Skin + nail, B: Skin + hair, C: Hair + nail, D: Skin +hair+ nail ### Response:

Ans: (d) Skin + Hair + NailRef: Roxburg 17th ed. / 39* Trichophyton Infects skin, hair & nail.* Infecting species include:# Trichophyton rubrum, Memtangrophyte, Violaceum, Verrucosum and Schoenleinii.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Trichophyton infects:, with the following options: A: Skin + nail, B: Skin + hair, C: Hair + nail, D: Skin +hair+ nail ### Response: Ans: (d) Skin + Hair + NailRef: Roxburg 17th ed. / 39* Trichophyton Infects skin, hair & nail.* Infecting species include:# Trichophyton rubrum, Memtangrophyte, Violaceum, Verrucosum and Schoenleinii. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The order of sensory blockade of local anesthesia is:, with the following options: A: Temperature - pain - touch - pressure, B: Pain - pressure - touch - temperature, C: Touch - pressure - temperature - pain, D: Touch - pain - pressure - temperature ### Response:

Individual type of nerve differs in their minimal blocking concentration. Not all sensory and motor modalities are blocked equally by local anesthetics. This is termed differential blockade. For different fibers order of blockade b > AS = C > AU > A b > Aa autonomic > sensory> motor is the sequence of block. for sensory blockade the sequence is Temperature - pain - touch - pressure

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The order of sensory blockade of local anesthesia is:, with the following options: A: Temperature - pain - touch - pressure, B: Pain - pressure - touch - temperature, C: Touch - pressure - temperature - pain, D: Touch - pain - pressure - temperature ### Response: Individual type of nerve differs in their minimal blocking concentration. Not all sensory and motor modalities are blocked equally by local anesthetics. This is termed differential blockade. For different fibers order of blockade b > AS = C > AU > A b > Aa autonomic > sensory> motor is the sequence of block. for sensory blockade the sequence is Temperature - pain - touch - pressure ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 4-year-old girl developed clumsiness and difficulty ambulating over 6 months. On physical examination, she showed difficulty with balance while walking, dysarthria, poor hand coordination, absent deep tendon reflexes, and a bilateral Babinski sign. Light touch and vibratory sensation were greatly diminished. There was no muscular weakness. Over the next 5 years, she developed congestive heart failure from hypertrophic cardiomyopathy. She also had hyperglycemia. At autopsy, there was increased perinuclear iron deposition within cardiac myocytes. Which of the following genetic abnormalities with trinucleotide repeat expansions was most likely present in this patient?, with the following options: A: CAG repeats in the huntingtin gene, B: CGG repeats in the FMR1 gene, C: CTG repeats in the dystrophila myotonia-protein kinase gene, D: GAA repeats in the frataxin gene ### Response:

She had Friedreich ataxia, an autosomal recessive progressive illness that most often has an onset in the first decade of life. The frataxin gene encodes for a protein involved in iron regulation in cells, and a GAA trinucleotide repeats expansion results in decreased protein and decreased mitochondrial oxidative phosphorylation. The other options listed have no cardiac involvement. Mutations of the huntingtin gene are seen with Huntington disease marked by choreoathetosis beginning in young to middle-aged adults. Increased tandem repeats in the FMR1 gene account for cases of fragile X syndrome characterized by mental retardation. The dystrophila myotonia-protein kinase gene is abnormal in cases of myotonic dystrophy with muscular weakness and dementia.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 4-year-old girl developed clumsiness and difficulty ambulating over 6 months. On physical examination, she showed difficulty with balance while walking, dysarthria, poor hand coordination, absent deep tendon reflexes, and a bilateral Babinski sign. Light touch and vibratory sensation were greatly diminished. There was no muscular weakness. Over the next 5 years, she developed congestive heart failure from hypertrophic cardiomyopathy. She also had hyperglycemia. At autopsy, there was increased perinuclear iron deposition within cardiac myocytes. Which of the following genetic abnormalities with trinucleotide repeat expansions was most likely present in this patient?, with the following options: A: CAG repeats in the huntingtin gene, B: CGG repeats in the FMR1 gene, C: CTG repeats in the dystrophila myotonia-protein kinase gene, D: GAA repeats in the frataxin gene ### Response: She had Friedreich ataxia, an autosomal recessive progressive illness that most often has an onset in the first decade of life. The frataxin gene encodes for a protein involved in iron regulation in cells, and a GAA trinucleotide repeats expansion results in decreased protein and decreased mitochondrial oxidative phosphorylation. The other options listed have no cardiac involvement. Mutations of the huntingtin gene are seen with Huntington disease marked by choreoathetosis beginning in young to middle-aged adults. Increased tandem repeats in the FMR1 gene account for cases of fragile X syndrome characterized by mental retardation. The dystrophila myotonia-protein kinase gene is abnormal in cases of myotonic dystrophy with muscular weakness and dementia. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is NOT affected in Rh isoimmunization?, with the following options: A: Anti C, B: Anti E, C: Anti-Lewis, D: Anti D ### Response:

Anti-Lewis and anti-I antibodies are not associated with fetal hemolytic disease. It differs from all other antigens in that they are not synthesized in RBC membrane, but absorbed into it. Ref: Obstetrics and Gynecology By Charles R. B. Beckmann, American College of Obstetricians and Gynecologists, 2010, Page 197.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is NOT affected in Rh isoimmunization?, with the following options: A: Anti C, B: Anti E, C: Anti-Lewis, D: Anti D ### Response: Anti-Lewis and anti-I antibodies are not associated with fetal hemolytic disease. It differs from all other antigens in that they are not synthesized in RBC membrane, but absorbed into it. Ref: Obstetrics and Gynecology By Charles R. B. Beckmann, American College of Obstetricians and Gynecologists, 2010, Page 197. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Juxtaglomerular apparatus lies in relation to :, with the following options: A: Proximal convoluted tubule, B: Ascending loop of Henle, C: Descending loop of Henle, D: Glomerulus ### Response:

Glomerulus As the name implies ju.aglomerulus apparatus (JGA) lies at hilum of glomerulus Juxtaglornerulus apparatusThe juxtaglomerular apparatus is a microscopic structure in the kidney, which regulates the function of Lech nephron. The juxtaglomerular apparatus is named for its proximity to the glomerulus: it is found between the vascular pole of the renal corpuscle and the returning distal convoluted tubule of the same nephron. This location is critical to its function in regulating renal blood flow and glomerular.filtration rate.The three microscopic components of the apparatus are the macula densa, extraglomerular mesangial cells (lacis cells), and juxtaglomerular cells.Juxtaglomerular cellJuxtaglomerular cells (JG cells, also known as granular cells) are the site of renin secretion.The JG cells are found in the media of afferent aerioles of the glomerulus and act as an intro-renal pressure sensor Lowered pressure leads to decreased pressure on the JG cells stimulating renin secretion. Renin then acts to increase systemic blood pressure (while maintaining GFR) the resi angiotensin systemMacula densaAt the point where the afferent aeriole enters the glomerulus and the efferent leaves it, the tubule of the nephron touches the aeriole of the glomerulus from which it arose.At this location, which marks the sta of the distal convulation, there is the modified region of tubular epithelium called the macula densaThe macula densa senses sodium chloride concentration in the distal tubule of the kidney and secretes a locally active (paracrine) vasopressor which acts on the adjacent afferent aeriole to decrease glomerular filtration rate (GFR), as pa of the tubuloglomerular feedback loop. Specifically, excessive filtration at the glomerulus or inadequate sodium uptake in the proximal tubule / thick ascending loop of Henle brings fluid to the distal convoluted tubule that has an abnormally high concentration of sodium. Na/K/2C1 cotranspoers move sodium into the cells of the macula densa. The increased Na+ conc. triggers a signal that causes constriction of the afferent aeriole thus reducing the GFRLacis cells or extraglomerular mesangial cellsThe function of the extraglomerular mesangial cells remains somewhat mysterious. They contain actin and myosin, allowing them to contract when stimulated by renal sympathetic nerves, which may provide a way for the sympathetic nervous system to modulate the actions of the juxtaglomerular apparatus. In addition, extraglomerular mesangial cells are strategically positioned between the macula densa and the afferent aeriole, and may mediate signalling between these two structures

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Juxtaglomerular apparatus lies in relation to :, with the following options: A: Proximal convoluted tubule, B: Ascending loop of Henle, C: Descending loop of Henle, D: Glomerulus ### Response: Glomerulus As the name implies ju.aglomerulus apparatus (JGA) lies at hilum of glomerulus Juxtaglornerulus apparatusThe juxtaglomerular apparatus is a microscopic structure in the kidney, which regulates the function of Lech nephron. The juxtaglomerular apparatus is named for its proximity to the glomerulus: it is found between the vascular pole of the renal corpuscle and the returning distal convoluted tubule of the same nephron. This location is critical to its function in regulating renal blood flow and glomerular.filtration rate.The three microscopic components of the apparatus are the macula densa, extraglomerular mesangial cells (lacis cells), and juxtaglomerular cells.Juxtaglomerular cellJuxtaglomerular cells (JG cells, also known as granular cells) are the site of renin secretion.The JG cells are found in the media of afferent aerioles of the glomerulus and act as an intro-renal pressure sensor Lowered pressure leads to decreased pressure on the JG cells stimulating renin secretion. Renin then acts to increase systemic blood pressure (while maintaining GFR) the resi angiotensin systemMacula densaAt the point where the afferent aeriole enters the glomerulus and the efferent leaves it, the tubule of the nephron touches the aeriole of the glomerulus from which it arose.At this location, which marks the sta of the distal convulation, there is the modified region of tubular epithelium called the macula densaThe macula densa senses sodium chloride concentration in the distal tubule of the kidney and secretes a locally active (paracrine) vasopressor which acts on the adjacent afferent aeriole to decrease glomerular filtration rate (GFR), as pa of the tubuloglomerular feedback loop. Specifically, excessive filtration at the glomerulus or inadequate sodium uptake in the proximal tubule / thick ascending loop of Henle brings fluid to the distal convoluted tubule that has an abnormally high concentration of sodium. Na/K/2C1 cotranspoers move sodium into the cells of the macula densa. The increased Na+ conc. triggers a signal that causes constriction of the afferent aeriole thus reducing the GFRLacis cells or extraglomerular mesangial cellsThe function of the extraglomerular mesangial cells remains somewhat mysterious. They contain actin and myosin, allowing them to contract when stimulated by renal sympathetic nerves, which may provide a way for the sympathetic nervous system to modulate the actions of the juxtaglomerular apparatus. In addition, extraglomerular mesangial cells are strategically positioned between the macula densa and the afferent aeriole, and may mediate signalling between these two structures ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Type of collagen seen in dermo-epidermal junctions?, with the following options: A: Type IV, B: Type VII, C: Type XV, D: Type XXII ### Response:

Type VII collagen is seen in dermo-epidermal junctions. Reference: Harper; 30th edition; Page no: 628 Table no: 50-1

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Type of collagen seen in dermo-epidermal junctions?, with the following options: A: Type IV, B: Type VII, C: Type XV, D: Type XXII ### Response: Type VII collagen is seen in dermo-epidermal junctions. Reference: Harper; 30th edition; Page no: 628 Table no: 50-1 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are true regarding Sample Registration System (SRS) EXCEPT:, with the following options: A: Initiated in the 1960, B: Estimates of birth and death rates, C: Dual-record system, D: Survey should be done every year ### Response:

(Survey should be done every year) (743-Park 20th)Sample Registration System (SRS) - civil registration is deficient in India.* SRS was initiated in the mid-1960 to provide reliable estimates of birth and death rates at the National and state levels.* SRS is a dual-record system consisting of continuous enumeration of births and deaths by an enumerator and an independent survey every 6 months by an investigator-supervisor* It is major source of health information.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are true regarding Sample Registration System (SRS) EXCEPT:, with the following options: A: Initiated in the 1960, B: Estimates of birth and death rates, C: Dual-record system, D: Survey should be done every year ### Response: (Survey should be done every year) (743-Park 20th)Sample Registration System (SRS) - civil registration is deficient in India.* SRS was initiated in the mid-1960 to provide reliable estimates of birth and death rates at the National and state levels.* SRS is a dual-record system consisting of continuous enumeration of births and deaths by an enumerator and an independent survey every 6 months by an investigator-supervisor* It is major source of health information. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Low serum haptoglobin in hemolysis is masked by -, with the following options: A: Pregnancy, B: Liver disease, C: Bile duct obstruction, D: Malnutriotion ### Response:

Haptoglobin is an acute phase protein and its level increased in case of any inflammation. In hemolytic anemias there is fall in serum haptoglobin levels. If there is any inflammation along with it there will be rise in haptoglobin levels as it is an a/c phase protein (eg biliary obstruction causes inflammation) Ref:Postgraduate Hematology by Victor Hoffbrand pg 127 Ref Robbins 9/e pg 419

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Low serum haptoglobin in hemolysis is masked by -, with the following options: A: Pregnancy, B: Liver disease, C: Bile duct obstruction, D: Malnutriotion ### Response: Haptoglobin is an acute phase protein and its level increased in case of any inflammation. In hemolytic anemias there is fall in serum haptoglobin levels. If there is any inflammation along with it there will be rise in haptoglobin levels as it is an a/c phase protein (eg biliary obstruction causes inflammation) Ref:Postgraduate Hematology by Victor Hoffbrand pg 127 Ref Robbins 9/e pg 419 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Kuttner Tumour is a lesion of following gland, with the following options: A: Lymph gland, B: Salivary gland, C: Sebaceous gland, D: Thymus gland ### Response:

• Kuttner tumor is also called as Chronic sclerosing sialadenitis • Benign inflammatory lesion (fibro inflammatory) • Associated with submandibular glands in most of the cases. • Is basically a chronic inflammatory disease of salivary glands. • Positive for cytokeratin CK 7, 8, 13, 19.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Kuttner Tumour is a lesion of following gland, with the following options: A: Lymph gland, B: Salivary gland, C: Sebaceous gland, D: Thymus gland ### Response: • Kuttner tumor is also called as Chronic sclerosing sialadenitis • Benign inflammatory lesion (fibro inflammatory) • Associated with submandibular glands in most of the cases. • Is basically a chronic inflammatory disease of salivary glands. • Positive for cytokeratin CK 7, 8, 13, 19. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: 70 year old man has abdominal pain with mass inabdomen. Angiography reveals aneurysm of aoa. Mostlikely cause is:, with the following options: A: Trauma, B: Atherosclerosis, C: Syphilis, D: Congenital ### Response:

. Atherosclerosis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: 70 year old man has abdominal pain with mass inabdomen. Angiography reveals aneurysm of aoa. Mostlikely cause is:, with the following options: A: Trauma, B: Atherosclerosis, C: Syphilis, D: Congenital ### Response: . Atherosclerosis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A children presents with running nose, breathlessness, family history positive, Most likely diagnosis is -, with the following options: A: Bronchiolitis, B: Viral pneumonia, C: Bronchial asthma, D: None ### Response:

Ans. is 'c' i.e., Bronchial asthma o Except for bronchial asthma, no other option will have family history (+) ye.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A children presents with running nose, breathlessness, family history positive, Most likely diagnosis is -, with the following options: A: Bronchiolitis, B: Viral pneumonia, C: Bronchial asthma, D: None ### Response: Ans. is 'c' i.e., Bronchial asthma o Except for bronchial asthma, no other option will have family history (+) ye. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 50 year old male presented with history of hematemesis - 500ml of blood and on examination shows BP- 90/60, PR-110bpm and splenomegaly 5cm below lower costal margin. Most probable diagnosis is, with the following options: A: Malory-weiss tear, B: Duodenal ulcer, C: Gastritis, D: Poal hypeension ### Response:

Splenomegaly and massive bleeding leading to hypotension are in our of poal hypeension. Common causes of upper Gastrointestinal Hemorrhage Non-variceal bleeding (80%) Poal Hypeensive Bleeding (20%) Peptic ulcer disease (MC) 30-40% Gastroesophageal varices >90% Malory-weiss tear 15-20% Hypeensive poal gastropathy <5% Gastritis or duodenitis 10-15% Isolated gastric varices <5% Esophagitis 5-10% Aeriovenous malformations 5% Tumors 2% Others 5% Ref: Sabiston 20th edition Pgno : 1142

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 50 year old male presented with history of hematemesis - 500ml of blood and on examination shows BP- 90/60, PR-110bpm and splenomegaly 5cm below lower costal margin. Most probable diagnosis is, with the following options: A: Malory-weiss tear, B: Duodenal ulcer, C: Gastritis, D: Poal hypeension ### Response: Splenomegaly and massive bleeding leading to hypotension are in our of poal hypeension. Common causes of upper Gastrointestinal Hemorrhage Non-variceal bleeding (80%) Poal Hypeensive Bleeding (20%) Peptic ulcer disease (MC) 30-40% Gastroesophageal varices >90% Malory-weiss tear 15-20% Hypeensive poal gastropathy <5% Gastritis or duodenitis 10-15% Isolated gastric varices <5% Esophagitis 5-10% Aeriovenous malformations 5% Tumors 2% Others 5% Ref: Sabiston 20th edition Pgno : 1142 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Superior oblique muscle is supplied by :, with the following options: A: Occulomotor nerve, B: Trochlear nerve, C: Abducent nerve, D: Trigeminal nerve ### Response:

B i.e. Trochlear

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Superior oblique muscle is supplied by :, with the following options: A: Occulomotor nerve, B: Trochlear nerve, C: Abducent nerve, D: Trigeminal nerve ### Response: B i.e. Trochlear ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is not a renal vasoconstrictor?, with the following options: A: Norepinephrine, B: Acetylcholine, C: Angiotensin II, D: None of the above ### Response:

Norepinephrine (noradrenaline) constricts the renal vessels, with the greatest effect of injected norepinephrine being exeed on the interlobular aeries and the afferent aerioles. Dopamine is made in the kidney and causes renal vasodilation and natriuresis. Angiotensin II exes a constrictor effect on both the afferent and efferent aerioles. Prostaglandins increase blood flow in the renal coex and decrease blood flow in the renal medulla. Acetylcholine also produces renal vasodilation. A high-protein diet raises glomerular capillary pressure and increases renal blood flow. Ref: Ganong's Review of Medical Physiology 23rd edition, Chapter 38.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is not a renal vasoconstrictor?, with the following options: A: Norepinephrine, B: Acetylcholine, C: Angiotensin II, D: None of the above ### Response: Norepinephrine (noradrenaline) constricts the renal vessels, with the greatest effect of injected norepinephrine being exeed on the interlobular aeries and the afferent aerioles. Dopamine is made in the kidney and causes renal vasodilation and natriuresis. Angiotensin II exes a constrictor effect on both the afferent and efferent aerioles. Prostaglandins increase blood flow in the renal coex and decrease blood flow in the renal medulla. Acetylcholine also produces renal vasodilation. A high-protein diet raises glomerular capillary pressure and increases renal blood flow. Ref: Ganong's Review of Medical Physiology 23rd edition, Chapter 38. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Von-Rosen's sign is positive in -, with the following options: A: Perthe'sdisease, B: SCFE, C: DDH, D: CTEV ### Response:

Ans. is 'c' i.e., DDHRadiological features of DDH/CPHo In Von Rosen's view following parameters should be notedPerkin's line : Vertical line drawn at the outer border of acetabulumHilgenreiner's line : Horizontal line drawn at the level of tri-radiate cartilageShenton's line : Smooth curve formed by inferior border of neck of femur with superior margin of obturator foramen.Acetabular index: Normally is < 30degCE angle of Wiberg: Normal value is 15-30dego Normally the head lies in the lower and inner quadrant formed by two lines (Perkin's & Hilgenreiner's). In DDH the head lies in outer & upper quadranto Shenton's line is brokeno Delayed appearance & retarded development of ossification of head of femuro Sloping acetabulumo Superior & lateral displacement of femoral headVon-Rosen's lineo This is a line, which helps in the diagnosis of DDH in infants less than 6 months.o For this AP view of pelvis is taken with both lower limb in 45deg abduction and full internal rotation,o Upward prolongation of long axis of shaft of the femur points towards the lateral margin of the acetabulum and crosses the pelvis in the region of sacroiliac joint.o In CDH, upward prolongation of this line points towards anterior superior iliac spine and crosses the midline in the lower lumber region - Positive Von-Rosen's sign.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Von-Rosen's sign is positive in -, with the following options: A: Perthe'sdisease, B: SCFE, C: DDH, D: CTEV ### Response: Ans. is 'c' i.e., DDHRadiological features of DDH/CPHo In Von Rosen's view following parameters should be notedPerkin's line : Vertical line drawn at the outer border of acetabulumHilgenreiner's line : Horizontal line drawn at the level of tri-radiate cartilageShenton's line : Smooth curve formed by inferior border of neck of femur with superior margin of obturator foramen.Acetabular index: Normally is < 30degCE angle of Wiberg: Normal value is 15-30dego Normally the head lies in the lower and inner quadrant formed by two lines (Perkin's & Hilgenreiner's). In DDH the head lies in outer & upper quadranto Shenton's line is brokeno Delayed appearance & retarded development of ossification of head of femuro Sloping acetabulumo Superior & lateral displacement of femoral headVon-Rosen's lineo This is a line, which helps in the diagnosis of DDH in infants less than 6 months.o For this AP view of pelvis is taken with both lower limb in 45deg abduction and full internal rotation,o Upward prolongation of long axis of shaft of the femur points towards the lateral margin of the acetabulum and crosses the pelvis in the region of sacroiliac joint.o In CDH, upward prolongation of this line points towards anterior superior iliac spine and crosses the midline in the lower lumber region - Positive Von-Rosen's sign. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The most common anomaly of the upper urogenital tract is, with the following options: A: Ureteropelvic junction stenosis, B: Ectopic uretheral opening, C: Ureterocele, D: Ectopic ureter ### Response:

UPJ stenosis is the most common abnormality in childhood and is more frequent in male children, characterized by narrowing usually on the left sideOverall, position & shape of the kidney being most common oneHorseshoe kidney is the most common and most frequently found renal abnormality among men.(Refer: OP Ghai's Textbook of Pediatrics, 8th edition, pg no. 470)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The most common anomaly of the upper urogenital tract is, with the following options: A: Ureteropelvic junction stenosis, B: Ectopic uretheral opening, C: Ureterocele, D: Ectopic ureter ### Response: UPJ stenosis is the most common abnormality in childhood and is more frequent in male children, characterized by narrowing usually on the left sideOverall, position & shape of the kidney being most common oneHorseshoe kidney is the most common and most frequently found renal abnormality among men.(Refer: OP Ghai's Textbook of Pediatrics, 8th edition, pg no. 470) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is NOT a feature of HIV infection in childhood –, with the following options: A: Failure to thrive, B: Hepatomegaly, C: Lymphoid interstitial pneumonitis, D: Kaposi sarcoma ### Response:

"Kaposi sarcoma, commonly seen in men with advanced HIV disease, has been reported only rarely in children". Clinical manifestations of HIV infection in children Failure to thrive is universal                                                                    P. carinii pneumonia → M.C. AIDS-defining illness in children       Recurrent and chronic bacterial infections (first sign).                         Otitis, Sinusitis, Pneumonia                                                                   Hepatosplenomegaly                                                                                Anemia / Thrombocytopenia / Neutropenia     Lymphadenopathy         Dermatological complications    Candidiasis     Hepatitis Lymphoid interstitial pneumonia    Cardiomyopathy

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is NOT a feature of HIV infection in childhood –, with the following options: A: Failure to thrive, B: Hepatomegaly, C: Lymphoid interstitial pneumonitis, D: Kaposi sarcoma ### Response: "Kaposi sarcoma, commonly seen in men with advanced HIV disease, has been reported only rarely in children". Clinical manifestations of HIV infection in children Failure to thrive is universal                                                                    P. carinii pneumonia → M.C. AIDS-defining illness in children       Recurrent and chronic bacterial infections (first sign).                         Otitis, Sinusitis, Pneumonia                                                                   Hepatosplenomegaly                                                                                Anemia / Thrombocytopenia / Neutropenia     Lymphadenopathy         Dermatological complications    Candidiasis     Hepatitis Lymphoid interstitial pneumonia    Cardiomyopathy ### End

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 clozapine is:, with the following options: A: Should be discontinued, if WBC counts < 3500/dl, B: Has no anti suicide propey, C: Should not be used along with carbamazepine, D: The action is more on D4 receptors than D2 receptors ### Response:

Clozapine: It is a DOC for treatment resistant schizophrenia(TRS) TRS is defined as lack of response to 2 antipsychotics (atleast 1 atypical) at adequate dose for atleast 4-6 weeks It has more affinity for D4 receptors , less affinity for D2- [?] minimum EPS. It has anti- suicide propey It is an antipsychotic agent with maximum weight gain propey. Side effects: most common- sedation (due to H1 blocking propey) Sialorrhea Syncope, hypotension, tachycardia, nausea and vomiting Anticholinergic side effects like constipation Three life threatening side effects: Agranulocytosis(Idiosyncratic) Myocarditis Seizures(Dose dependent) Monitoring: TLC and ANC Once a week for first 6 months Once in two weeks for next 6 months Once a month till patient is on clozapine If WBC count falls below 3000/dL or ANC falls below 1500/dL, STOP the clozapine. Contraindications: WBC <3500/dL History of agranulocytosis on clozapine Use of bone marrow suppressants such as carbamazepine.

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 clozapine is:, with the following options: A: Should be discontinued, if WBC counts < 3500/dl, B: Has no anti suicide propey, C: Should not be used along with carbamazepine, D: The action is more on D4 receptors than D2 receptors ### Response: Clozapine: It is a DOC for treatment resistant schizophrenia(TRS) TRS is defined as lack of response to 2 antipsychotics (atleast 1 atypical) at adequate dose for atleast 4-6 weeks It has more affinity for D4 receptors , less affinity for D2- [?] minimum EPS. It has anti- suicide propey It is an antipsychotic agent with maximum weight gain propey. Side effects: most common- sedation (due to H1 blocking propey) Sialorrhea Syncope, hypotension, tachycardia, nausea and vomiting Anticholinergic side effects like constipation Three life threatening side effects: Agranulocytosis(Idiosyncratic) Myocarditis Seizures(Dose dependent) Monitoring: TLC and ANC Once a week for first 6 months Once in two weeks for next 6 months Once a month till patient is on clozapine If WBC count falls below 3000/dL or ANC falls below 1500/dL, STOP the clozapine. Contraindications: WBC <3500/dL History of agranulocytosis on clozapine Use of bone marrow suppressants such as carbamazepine. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The minimum age at which an individual is responsible for his criminal act is: COMEDK 07; Bihar 11; NEET 14, with the following options: A: 7 years, B: 12 years, C: 16 years, D: 21 years ### Response:

Ans. 7 years

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The minimum age at which an individual is responsible for his criminal act is: COMEDK 07; Bihar 11; NEET 14, with the following options: A: 7 years, B: 12 years, C: 16 years, D: 21 years ### Response: Ans. 7 years ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 30 year old lady do sudden onset breathlessness, anxiety, palpitation & feeling of impending doom. Physical examination is normal. What is the diagnosis, with the following options: A: Panic attack, B: Anxiety disorder, C: Conversion disorder, D: Acute psychosis ### Response:

Panic attack DSM-IV Criteria for a Panic Attack A panic attack is a period of intense fear or discomfo, developing abruptly and peaking within 10 minutes, and requiring at least four of the following :-Chest pain or discomfoChills or hot .fushesDerealization (feeling of unreality) or depersonalization (being detached from oneself)Fear of losing controlFeeling of chokingNausea or abdominal distressPalpitations or tachycardiadegParesthesiasSensations of shoness of breathdeg or smotheringSense of impending doomdeg.SweatingTrembling or shaking

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 30 year old lady do sudden onset breathlessness, anxiety, palpitation & feeling of impending doom. Physical examination is normal. What is the diagnosis, with the following options: A: Panic attack, B: Anxiety disorder, C: Conversion disorder, D: Acute psychosis ### Response: Panic attack DSM-IV Criteria for a Panic Attack A panic attack is a period of intense fear or discomfo, developing abruptly and peaking within 10 minutes, and requiring at least four of the following :-Chest pain or discomfoChills or hot .fushesDerealization (feeling of unreality) or depersonalization (being detached from oneself)Fear of losing controlFeeling of chokingNausea or abdominal distressPalpitations or tachycardiadegParesthesiasSensations of shoness of breathdeg or smotheringSense of impending doomdeg.SweatingTrembling or shaking ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which cervical veebra that does not have a body or spinous process?, with the following options: A: C1, B: C2, C: C3, D: C4 ### Response:

First cervical veebra is ring-shaped. It has neither a body nor a spine.Features of typical cervical, thoracic and lumbar veebra are given belowFeaturesCervical veebraThoracic veebraLumbar veebraBodySmall and broad from side to sideMedium size and hea-shapedLarge and kidney-shapedVeebral foramenLarge than the body and triangularSmall and circularTriangularSpinous processSmall and bifidLong and directed downwardsSho, flat and projected backwardInferior aicular facetDirected forward and downwardsDirected forwards, slightly downwards and mediallyDirected laterallyTransverse processHave foramen transversariumHas costal facets Long and slender

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which cervical veebra that does not have a body or spinous process?, with the following options: A: C1, B: C2, C: C3, D: C4 ### Response: First cervical veebra is ring-shaped. It has neither a body nor a spine.Features of typical cervical, thoracic and lumbar veebra are given belowFeaturesCervical veebraThoracic veebraLumbar veebraBodySmall and broad from side to sideMedium size and hea-shapedLarge and kidney-shapedVeebral foramenLarge than the body and triangularSmall and circularTriangularSpinous processSmall and bifidLong and directed downwardsSho, flat and projected backwardInferior aicular facetDirected forward and downwardsDirected forwards, slightly downwards and mediallyDirected laterallyTransverse processHave foramen transversariumHas costal facets Long and slender ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which one of the following is the most common tumor to produce metastasis to cervical lymph nodes?, with the following options: A: Glottic carcinoma, B: Nasopharyngeal carcinoma, C: Carcinoma base of tongue, D: Carcinoma lip ### Response:

Ans. is 'b' i.e. 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 one of the following is the most common tumor to produce metastasis to cervical lymph nodes?, with the following options: A: Glottic carcinoma, B: Nasopharyngeal carcinoma, C: Carcinoma base of tongue, D: Carcinoma lip ### Response: Ans. is 'b' i.e. Nasopharyngeal carcinoma ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: You have diagnosed a patient clinically as having SLE and ordered 6 tests. Out of which 4 tests have come positive and 2 are negative. To determine the probability of SLE at this point, you need to know-, with the following options: A: Prior probability of SLE; sensitivity and specificity of each test, B: Incidence of SLE and predictive value of each test, C: Incidence and prevalence of SLE, D: Relative risk of SLE in this patient ### Response:

Ans. is 'a' i.e. Prior probability of SLE; sensitivity and specificity of each test o Probability allows for an accurate method of calculating how much the likelihood of changes as new information (i.e., a test result) becomes available. o Probability of disease after a given test (post-term probability) can be calculated by (Bayes' theorem) Post test probability = Pretest probability x Likelihood ratio Pre test probability o It is the probability of disease before getting a test. o There is a principal "The interpretation of new information depends on old information". o That means the interpretation of a test result (post-test probability) depends on the probability of disease before test (pre-test probability). o Pre-test probability depends on prevalence, infact prevalence rate is described as pre-test probability of having a disease. Likelihood ratio o The likelihood ratio provides a direct estimate of how much a test result will change the probability of having the disease. o Tests results are often expressed as either positive or negative. o So, there is A likelihood ratio for a positive test result (LR +), and A likelihood ratio for a negative test result (LR-) o The positive likelihood ratio (LR +) tells us how much to increased the probability of a disease if the test is positive. It is calculated by following formula. The likelihood ratio is generally a better descriptor than sensitivity or specificity because it more directly describes the effect of a test result on the probability of disease and it incorporates both the sensitivity and specificity. So, in sho o To know the probability of a disease after a test (post test probability) depends upon : i) Pretest probability --> Prevalence ii) Likelihood ratio --> Specificity & sensitivity

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: You have diagnosed a patient clinically as having SLE and ordered 6 tests. Out of which 4 tests have come positive and 2 are negative. To determine the probability of SLE at this point, you need to know-, with the following options: A: Prior probability of SLE; sensitivity and specificity of each test, B: Incidence of SLE and predictive value of each test, C: Incidence and prevalence of SLE, D: Relative risk of SLE in this patient ### Response: Ans. is 'a' i.e. Prior probability of SLE; sensitivity and specificity of each test o Probability allows for an accurate method of calculating how much the likelihood of changes as new information (i.e., a test result) becomes available. o Probability of disease after a given test (post-term probability) can be calculated by (Bayes' theorem) Post test probability = Pretest probability x Likelihood ratio Pre test probability o It is the probability of disease before getting a test. o There is a principal "The interpretation of new information depends on old information". o That means the interpretation of a test result (post-test probability) depends on the probability of disease before test (pre-test probability). o Pre-test probability depends on prevalence, infact prevalence rate is described as pre-test probability of having a disease. Likelihood ratio o The likelihood ratio provides a direct estimate of how much a test result will change the probability of having the disease. o Tests results are often expressed as either positive or negative. o So, there is A likelihood ratio for a positive test result (LR +), and A likelihood ratio for a negative test result (LR-) o The positive likelihood ratio (LR +) tells us how much to increased the probability of a disease if the test is positive. It is calculated by following formula. The likelihood ratio is generally a better descriptor than sensitivity or specificity because it more directly describes the effect of a test result on the probability of disease and it incorporates both the sensitivity and specificity. So, in sho o To know the probability of a disease after a test (post test probability) depends upon : i) Pretest probability --> Prevalence ii) Likelihood ratio --> Specificity & sensitivity ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: % of children with simple febrile seizures developing epilepsy is-, with the following options: A: 1-2%, B: 2-5%, C: 5-10%, D: 10-20% ### Response:

Ans. is 'a' i.e., 1-2% o Children with febrile seizures have an increased risk of developing epilepsy. o Between 2% to 7% of all children with febrile seizures develop epilepsy if followed upto the age of 25 years. Risk depends on type of febrile seizure :- i) Simple febrile seizures --) 2% of all children with simple febrile seizures. ii) Complex febrile seizures --) 6-8% of all children with complex febrile seizures. o Three major risk factors increase the risk of epilepsy :? i) Complex febrile seizures. ii) Pre-existing neurodevelopmental abnormality. iii) Epilepsy in first degree relatives.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: % of children with simple febrile seizures developing epilepsy is-, with the following options: A: 1-2%, B: 2-5%, C: 5-10%, D: 10-20% ### Response: Ans. is 'a' i.e., 1-2% o Children with febrile seizures have an increased risk of developing epilepsy. o Between 2% to 7% of all children with febrile seizures develop epilepsy if followed upto the age of 25 years. Risk depends on type of febrile seizure :- i) Simple febrile seizures --) 2% of all children with simple febrile seizures. ii) Complex febrile seizures --) 6-8% of all children with complex febrile seizures. o Three major risk factors increase the risk of epilepsy :? i) Complex febrile seizures. ii) Pre-existing neurodevelopmental abnormality. iii) Epilepsy in first degree relatives. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the most common type of fingerprint ?, with the following options: A: Arch, B: Composite, C: Loops, D: Whorls ### Response:

About 60 - 70% people have loop pattern in their fingerprints. The order of Frequency is  Loops (60 - 70%) Whorls Arch Composite

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 most common type of fingerprint ?, with the following options: A: Arch, B: Composite, C: Loops, D: Whorls ### Response: About 60 - 70% people have loop pattern in their fingerprints. The order of Frequency is  Loops (60 - 70%) Whorls Arch Composite ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Claw hand is seen in all except:, with the following options: A: Scleroderma, B: Sarcoidosis, C: Leprosy, D: Hurler’s syndrome ### Response:

Claw hand is seen with: Scleroderma  Leprosy​ Mucopolysaccharidosis or Hurler's syndrome or Gorgolism​.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Claw hand is seen in all except:, with the following options: A: Scleroderma, B: Sarcoidosis, C: Leprosy, D: Hurler’s syndrome ### Response: Claw hand is seen with: Scleroderma  Leprosy​ Mucopolysaccharidosis or Hurler's syndrome or Gorgolism​. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: “Smack” is the “common” name for, with the following options: A: Heroin, B: Cocaine, C: Opium, D: None ### Response:

Heroin or di-acetyl-morphine is about two times more potent than morphine in injectable form. Apart from the parenteral mode of administration, heroin can also be smoked or ‘chased’ ( chasing the dragon), often in an impure form (called ‘ smack’ or ‘ brown sugar’ in India). Heroin is more addicting than morphine and can cause dependence even after a short period of exposure.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: “Smack” is the “common” name for, with the following options: A: Heroin, B: Cocaine, C: Opium, D: None ### Response: Heroin or di-acetyl-morphine is about two times more potent than morphine in injectable form. Apart from the parenteral mode of administration, heroin can also be smoked or ‘chased’ ( chasing the dragon), often in an impure form (called ‘ smack’ or ‘ brown sugar’ in India). Heroin is more addicting than morphine and can cause dependence even after a short period of exposure. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Multiple punched out lesion in skull is characteristically seen in, with the following options: A: Thalassemia, B: Multiple Myeloma, C: Rickets, D: Osteoporosis ### Response:

(Multiple myeloma): (1041 -Davidson 21st edition)MULTIPLE MYELOMA - presents as multifocal destructive bone tumours composed of plasma cells throughout the skeletal system* The bone lesions appears radiographically as punched out defects usually 1-4 cm in diameter and grossly consists of gelatinous soft red tumour masses* Hyperparathyroidism - "pepper pot skull", The mandible a common site for 'brown ' tumours* Moth - eaten appearance - syphilis* Rugor Jersy spine - Osteopetrosis* Beheaded scortish terrior sign - Spondylolisthesis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Multiple punched out lesion in skull is characteristically seen in, with the following options: A: Thalassemia, B: Multiple Myeloma, C: Rickets, D: Osteoporosis ### Response: (Multiple myeloma): (1041 -Davidson 21st edition)MULTIPLE MYELOMA - presents as multifocal destructive bone tumours composed of plasma cells throughout the skeletal system* The bone lesions appears radiographically as punched out defects usually 1-4 cm in diameter and grossly consists of gelatinous soft red tumour masses* Hyperparathyroidism - "pepper pot skull", The mandible a common site for 'brown ' tumours* Moth - eaten appearance - syphilis* Rugor Jersy spine - Osteopetrosis* Beheaded scortish terrior sign - Spondylolisthesis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Following shown condition is least common in:, with the following options: A: Frank breech, B: Transverse lie, C: Footling presentation, D: Brow presentation ### Response:

Abnormal Labour patterns diagnostic criteria and potential it.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Following shown condition is least common in:, with the following options: A: Frank breech, B: Transverse lie, C: Footling presentation, D: Brow presentation ### Response: Abnormal Labour patterns diagnostic criteria and potential it. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pyometra commonly occurs following :, with the following options: A: Carcinoma endometrium, B: Carcinoma cervix, C: Carcinoma urethra, D: Senile endometritis ### Response:

Ans. is a i.e. Carcinoma Endometrium Pyometra is collection of pus or mixture of pus and blood within the uterus Causes : Most common cause 2"d most common cause : Other causes : Congenital atresia of the vagina/cervix. Stenosis of cervix / vagina following : - Operations - Burns Radiotherapy Endometritis : Senile Tuberculous Puerperal Carcinoma : - Ca endometrium (most common)deg Ca cervix - Ca corporis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pyometra commonly occurs following :, with the following options: A: Carcinoma endometrium, B: Carcinoma cervix, C: Carcinoma urethra, D: Senile endometritis ### Response: Ans. is a i.e. Carcinoma Endometrium Pyometra is collection of pus or mixture of pus and blood within the uterus Causes : Most common cause 2"d most common cause : Other causes : Congenital atresia of the vagina/cervix. Stenosis of cervix / vagina following : - Operations - Burns Radiotherapy Endometritis : Senile Tuberculous Puerperal Carcinoma : - Ca endometrium (most common)deg Ca cervix - Ca corporis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Dermatome supplying the middle finger is-, with the following options: A: C6, B: C7, C: C8, D: T1 ### Response:

Ans. is 'b' i.e., C7 * Sensory distribution of upper limb is as followThe cutaneous nervesRegion suppliedNerve(s)Root valueDerived fromUpper part of pectoral region, and skin over upper part of deltoidSupraclavicularC3,C4Cervical plexusArm 1. Upper medial partIntercostobrachialT22nd intercostal2. Lower medial partMedial cutaneous nerve of armT1,T2Medial cord3. Upper lateral part (including skin over lower part of deltoid)Upper lateral cutaneous nerve of armC5, C6Axillary nerve4. Lower lateral partLower lateral cutaneous nerve of armC5, C6Radial nerve5. Posterior aspectPosterior cutaneous nerve of armC5Radial nerveForearm 1. Medial sideMedial cutaneous nerve of forearmC8,T1Medial cord2. Lateral sideLateral cutaneous nerve of forearmC5> C6Musculocutaneous3. Posterior sidePosterior cutaneous nerve of forearmC6, C7, C8Radial nervePalm 1. Lateral two-thirdsPalmar cutaneous branch of medianC6, C7Median2. Medial one-thirdPalmar cutaneous branch of ulnarC8UlnarDorsum of hand 1. Medial half including proximal phalanges of medial 2 1/2 digitsDorsal branch of ulnarC8Ulnar2. Lateral half including proximal phalanges of medial 2 1/2 digitsSuperficial terminal branch of radialC6, C7RadialDigits Palmar aspect, and dorsal aspect of middle and distal phalanges 1. Lateral 3V6 digitsPalmar digital branch of medianC7Median2. Medial 1 Vi digitsPalmar digital branch of ulnarC8Ulnar

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Dermatome supplying the middle finger is-, with the following options: A: C6, B: C7, C: C8, D: T1 ### Response: Ans. is 'b' i.e., C7 * Sensory distribution of upper limb is as followThe cutaneous nervesRegion suppliedNerve(s)Root valueDerived fromUpper part of pectoral region, and skin over upper part of deltoidSupraclavicularC3,C4Cervical plexusArm 1. Upper medial partIntercostobrachialT22nd intercostal2. Lower medial partMedial cutaneous nerve of armT1,T2Medial cord3. Upper lateral part (including skin over lower part of deltoid)Upper lateral cutaneous nerve of armC5, C6Axillary nerve4. Lower lateral partLower lateral cutaneous nerve of armC5, C6Radial nerve5. Posterior aspectPosterior cutaneous nerve of armC5Radial nerveForearm 1. Medial sideMedial cutaneous nerve of forearmC8,T1Medial cord2. Lateral sideLateral cutaneous nerve of forearmC5> C6Musculocutaneous3. Posterior sidePosterior cutaneous nerve of forearmC6, C7, C8Radial nervePalm 1. Lateral two-thirdsPalmar cutaneous branch of medianC6, C7Median2. Medial one-thirdPalmar cutaneous branch of ulnarC8UlnarDorsum of hand 1. Medial half including proximal phalanges of medial 2 1/2 digitsDorsal branch of ulnarC8Ulnar2. Lateral half including proximal phalanges of medial 2 1/2 digitsSuperficial terminal branch of radialC6, C7RadialDigits Palmar aspect, and dorsal aspect of middle and distal phalanges 1. Lateral 3V6 digitsPalmar digital branch of medianC7Median2. Medial 1 Vi digitsPalmar digital branch of ulnarC8Ulnar ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following increases the prevalence of the disease-, with the following options: A: Immigration of healthy people, B: Increase in cure rates, C: Decrease in the number of new cases, D: Increase in duration of disease ### Response:

Ans. is 'd' i.e. Increase in duration of disease Prevalence refers "to all current cases (old + new) existing at a given point in time (point prevalence) or over a period of time (period prevalence) in a given population"It thus includes all the new cases, as well as those old persisting cases.

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 increases the prevalence of the disease-, with the following options: A: Immigration of healthy people, B: Increase in cure rates, C: Decrease in the number of new cases, D: Increase in duration of disease ### Response: Ans. is 'd' i.e. Increase in duration of disease Prevalence refers "to all current cases (old + new) existing at a given point in time (point prevalence) or over a period of time (period prevalence) in a given population"It thus includes all the new cases, as well as those old persisting cases. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following disappear in umbilical cord, with the following options: A: Left aery, B: Left vein, C: Right aery, D: Right aery ### Response:

D. i.e. Right vein

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 disappear in umbilical cord, with the following options: A: Left aery, B: Left vein, C: Right aery, D: Right aery ### Response: D. i.e. Right vein ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 7 year old boy presented with generalized edema.Urine examination revealed marked albuminuria.Serum biochemical examinations showedhypoalbuminaernia with hyperlipidaemia. Kidneybiopsy was undeaken. On light microscopicexamination, the kidney appeared normal. Electronmicroscopic examination is most likely to reveal:, with the following options: A: Fusion of foot processes of the glomerular epithelial cells, B: Rarefaction of glomerular basement membrane, C: Deposition of electron dense material in the basement membrane, D: Thin basement membrane ### Response:

Thin basement membrane

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 7 year old boy presented with generalized edema.Urine examination revealed marked albuminuria.Serum biochemical examinations showedhypoalbuminaernia with hyperlipidaemia. Kidneybiopsy was undeaken. On light microscopicexamination, the kidney appeared normal. Electronmicroscopic examination is most likely to reveal:, with the following options: A: Fusion of foot processes of the glomerular epithelial cells, B: Rarefaction of glomerular basement membrane, C: Deposition of electron dense material in the basement membrane, D: Thin basement membrane ### Response: Thin basement membrane ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All of the following are differential diagnosis for constricted pupils except, with the following options: A: Horner's syndrome, B: Pontine myelinosis, C: Opioid withdrawl, D: Organophosphaste poisoning ### Response:

Opioid poisoning: Pin point pupils. Opioid withdrawl: dilated pupils.

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 differential diagnosis for constricted pupils except, with the following options: A: Horner's syndrome, B: Pontine myelinosis, C: Opioid withdrawl, D: Organophosphaste poisoning ### Response: Opioid poisoning: Pin point pupils. Opioid withdrawl: dilated pupils. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 26yr old female presented with complaints of coloured halos, matted and sticky eyelids since 3 days. On examination, visual acuity was normal. Most common organism causing this condition is, with the following options: A: Gonococcus, B: Pneumococcus, C: Staphylococcus aureus, D: Streptococcus hemolyticus ### Response:

The Clinical scenario gives the diagnosis of Acute mucoopurulent conjunctivitis which is most commonly caused by Staphylococcus aureus.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 26yr old female presented with complaints of coloured halos, matted and sticky eyelids since 3 days. On examination, visual acuity was normal. Most common organism causing this condition is, with the following options: A: Gonococcus, B: Pneumococcus, C: Staphylococcus aureus, D: Streptococcus hemolyticus ### Response: The Clinical scenario gives the diagnosis of Acute mucoopurulent conjunctivitis which is most commonly caused by Staphylococcus aureus. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Normal Poal venous pressure is:, with the following options: A: 5-10 mm Hg, B: 10-15 mm Hg, C: 15-20 mm Hg, D: 20-255 mm Hg ### Response:

Normal poal pressure is 5-10 mm Hg (Schwaz) Normal Poal pressure is 5-8 mm Hg (Kumar and Clark)Poal systemThe poal vein drains blood from the small and large intestines, stomach, spleen, pancreas, and gallbladder.The superior mesenteric vein and the splenic vein unite behind the neck of the pancreas to form the poal vein.The poal trunk divides into 2 lobar veins.The right branch drains the cystic vein, and the left branch receives the umbilical and paraumbilical veins that enlarge to form umbilical varices in poal hypeension.The coronary vein, which runs along the lesser curvature of the stomach, receives distal esophageal veins, which also enlarge in poal hypeension.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Normal Poal venous pressure is:, with the following options: A: 5-10 mm Hg, B: 10-15 mm Hg, C: 15-20 mm Hg, D: 20-255 mm Hg ### Response: Normal poal pressure is 5-10 mm Hg (Schwaz) Normal Poal pressure is 5-8 mm Hg (Kumar and Clark)Poal systemThe poal vein drains blood from the small and large intestines, stomach, spleen, pancreas, and gallbladder.The superior mesenteric vein and the splenic vein unite behind the neck of the pancreas to form the poal vein.The poal trunk divides into 2 lobar veins.The right branch drains the cystic vein, and the left branch receives the umbilical and paraumbilical veins that enlarge to form umbilical varices in poal hypeension.The coronary vein, which runs along the lesser curvature of the stomach, receives distal esophageal veins, which also enlarge in poal hypeension. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Trethowan sign is used in radiological diagnosis of?, with the following options: A: TB Hip, B: Pehes Disease, C: Slipped Capital Femoral Epiphysis, D: Avascular Necrosis of head of femur ### Response:

TRETHOWAN'S SIGN In normal hip a line drawn tangential to superior femoral neck (Klein's line) intersects small poion of lateral capital epiphyseal. In posterior displacement of epiphyses the line doesn't intersect.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Trethowan sign is used in radiological diagnosis of?, with the following options: A: TB Hip, B: Pehes Disease, C: Slipped Capital Femoral Epiphysis, D: Avascular Necrosis of head of femur ### Response: TRETHOWAN'S SIGN In normal hip a line drawn tangential to superior femoral neck (Klein's line) intersects small poion of lateral capital epiphyseal. In posterior displacement of epiphyses the line doesn't intersect. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which one of the following is not a feature of liver histology in Non cirrhotic poal fibrosis (NCPF) ?, with the following options: A: Fibrosis in and around the poal tracts, B: Thrombosis of the medium and small poal vein branches, C: Non specific inflammatory cell infiltrates in the poal tracts, D: Bridging fibrosis ### Response:

Ans. is 'd' i.e., Bridging fibrosisFibrosis bridging one poal tract to another (bridging fibrosis) is not seen.Pathology : o Non cirrhotic poal fibrosis is primarily a vascular disorder of the liver characterized by fibrous intimal thichening of the poal vein or its branches in patients with non cirrhotic protal hypeension.Vascular changesHallmark of the disease is thrombosis/sclerosis of the poal vein branches.The poal vein is dilated with sclerosis of the walls and in autopsy thrombin in medium or small poal vein branches with accompanying areas of ischaemic necrosis have been repoed.Aberrant Intrahepatic vessels may be present in the peripoal area, which correspond to dilated terminal poal vein branches or venules. These are often termed as "megasinusuoids" or peripoal angiomatosis. FibrosisVascular changes are accompanied by poal and peripoal fibrosis of varying extent.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which one of the following is not a feature of liver histology in Non cirrhotic poal fibrosis (NCPF) ?, with the following options: A: Fibrosis in and around the poal tracts, B: Thrombosis of the medium and small poal vein branches, C: Non specific inflammatory cell infiltrates in the poal tracts, D: Bridging fibrosis ### Response: Ans. is 'd' i.e., Bridging fibrosisFibrosis bridging one poal tract to another (bridging fibrosis) is not seen.Pathology : o Non cirrhotic poal fibrosis is primarily a vascular disorder of the liver characterized by fibrous intimal thichening of the poal vein or its branches in patients with non cirrhotic protal hypeension.Vascular changesHallmark of the disease is thrombosis/sclerosis of the poal vein branches.The poal vein is dilated with sclerosis of the walls and in autopsy thrombin in medium or small poal vein branches with accompanying areas of ischaemic necrosis have been repoed.Aberrant Intrahepatic vessels may be present in the peripoal area, which correspond to dilated terminal poal vein branches or venules. These are often termed as "megasinusuoids" or peripoal angiomatosis. FibrosisVascular changes are accompanied by poal and peripoal fibrosis of varying extent. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: What is not associated with DIC, with the following options: A: Thrombocytopenia, B: Increased PT, C: Hyperfibrinogenemia, D: Increased FDP ### Response:

Ans. is 'c' i.e., Hyperfibrinogenemia o DIC is associated with decreased plasma fibrinogen level.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: What is not associated with DIC, with the following options: A: Thrombocytopenia, B: Increased PT, C: Hyperfibrinogenemia, D: Increased FDP ### Response: Ans. is 'c' i.e., Hyperfibrinogenemia o DIC is associated with decreased plasma fibrinogen level. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Not used for intravascular volume maintainence is, with the following options: A: Hydroxy ethyl starch, B: Dextran, C: Erythropoetin, D: Gelatin ### Response:

Answer- C. ErythropoetinErytheropoetin InjectionsErythropoietins available for use as therapeutic agents are produced by recombinant DNA technology in cell culture, They are used in treating anemia resulting from chronic kidney disease, chemotherapy induced anemia in patients with cancer, inflammatory bowel disease (Crohn's disease and ulcerative colitis).

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Not used for intravascular volume maintainence is, with the following options: A: Hydroxy ethyl starch, B: Dextran, C: Erythropoetin, D: Gelatin ### Response: Answer- C. ErythropoetinErytheropoetin InjectionsErythropoietins available for use as therapeutic agents are produced by recombinant DNA technology in cell culture, They are used in treating anemia resulting from chronic kidney disease, chemotherapy induced anemia in patients with cancer, inflammatory bowel disease (Crohn's disease and ulcerative colitis). ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Non depolarizing neuromuscular blocker is, with the following options: A: Non competitive neuromuscular blocker, B: Reversed by neostigmine, C: Persistent stimulator of nicotinic cholinergic receptors, D: Induces fasciculations ### Response:

Non depolarising neuromuscular blocker is competitive antagonist at nicotinic cholinergic receptor. It doesn’t cause fasciculations . it is reversed by neostigmine.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Non depolarizing neuromuscular blocker is, with the following options: A: Non competitive neuromuscular blocker, B: Reversed by neostigmine, C: Persistent stimulator of nicotinic cholinergic receptors, D: Induces fasciculations ### Response: Non depolarising neuromuscular blocker is competitive antagonist at nicotinic cholinergic receptor. It doesn’t cause fasciculations . it is reversed by neostigmine. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Vasopressor of choice in hypotension produced during sub-arachnoidblock, with the following options: A: Ephedrine, B: Mephenteramine, C: Adrenaline, D: Dopamine ### Response:

A i.e. Ephedrine Most common complication of spinal anesthesia is hypotensionQ, which can be prevented by preloading with crystalloid. In spinal anesthesia autonomic preganglionic sympathetic fibresQ are the earliest blocked fibres. Block of sympathetic nerves causes vasodialation of venous capacitance vessels, pooling of blood and HypotensionQ (most common complication of spinal anesthesiaQ). It is prevented by preloading with crystalloid. Following spinal subarachnoid block most common complication is hypotensionQ. During sub-arachnoid block, there is sympathetic blockade producing decreased venous return & hence, cardiac output and BP falls. So the patient can be managed by all the four means but the least effective & most controversial mean is lowering head end. The specific gravity (baricity) of CSF is 1.003 - 1.008Q at 37degC. A hyper baric solution of LA is denser than CSF & hypobaric solution of LA is Lighter than CSF. A LA solution can be made hyperbaric by adding glucose & hypobaric by addition of sterile water. Most impoant factors affecting level of spinal anesthesia are: BaricityQ, Position of patient - during & immediately after injection,Q drug dose & site of injection. Thus with a head down position a hyperbaric solution spreads cephald & hypobaric solution moves caudad and vice versa. And in this Q baricity of LA & time passed after injecting spinal anesthesia is not mentioned, so lowering the head end is weakest option.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Vasopressor of choice in hypotension produced during sub-arachnoidblock, with the following options: A: Ephedrine, B: Mephenteramine, C: Adrenaline, D: Dopamine ### Response: A i.e. Ephedrine Most common complication of spinal anesthesia is hypotensionQ, which can be prevented by preloading with crystalloid. In spinal anesthesia autonomic preganglionic sympathetic fibresQ are the earliest blocked fibres. Block of sympathetic nerves causes vasodialation of venous capacitance vessels, pooling of blood and HypotensionQ (most common complication of spinal anesthesiaQ). It is prevented by preloading with crystalloid. Following spinal subarachnoid block most common complication is hypotensionQ. During sub-arachnoid block, there is sympathetic blockade producing decreased venous return & hence, cardiac output and BP falls. So the patient can be managed by all the four means but the least effective & most controversial mean is lowering head end. The specific gravity (baricity) of CSF is 1.003 - 1.008Q at 37degC. A hyper baric solution of LA is denser than CSF & hypobaric solution of LA is Lighter than CSF. A LA solution can be made hyperbaric by adding glucose & hypobaric by addition of sterile water. Most impoant factors affecting level of spinal anesthesia are: BaricityQ, Position of patient - during & immediately after injection,Q drug dose & site of injection. Thus with a head down position a hyperbaric solution spreads cephald & hypobaric solution moves caudad and vice versa. And in this Q baricity of LA & time passed after injecting spinal anesthesia is not mentioned, so lowering the head end is weakest option. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Meckel's cailage develops from, with the following options: A: I branchial arch, B: II branchial arch, C: III branchial arch, D: IV branchial arch ### Response:

The cailage of the first arch is called Meckel's cailage. the incus and malleus are derived from its dorsal end. the ventral pa of the mandible is surrounded by the developing mandible and is absorbed Ref: Human Embryology, Inderbir Singh, 10th edition, page no: 131

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Meckel's cailage develops from, with the following options: A: I branchial arch, B: II branchial arch, C: III branchial arch, D: IV branchial arch ### Response: The cailage of the first arch is called Meckel's cailage. the incus and malleus are derived from its dorsal end. the ventral pa of the mandible is surrounded by the developing mandible and is absorbed Ref: Human Embryology, Inderbir Singh, 10th edition, page no: 131 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 32 year old female patient wants to get her missing tooth replaced but does not want to get dental implants placed. Intra-oral examination reveals a missing 46. 45 and 47 were prepared to receive a 3 unit fixed dental prosthesis. What type of stress will be experienced on the occlusal surface of this prosthesis?, with the following options: A: Tensile, B: Compressive, C: Shear, D: No stress is expressed ### Response:

Subjecting a structure such as an FDP to three-point loading, whereby the endpoints are fixed and a force is applied between these endpoints, tensile stress develops on the tissue side of the FDP, and compressive stress develops on the occlusal side. Between these two areas is the neutral axis that represents a state with no tensile stress and no compressive stress.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 32 year old female patient wants to get her missing tooth replaced but does not want to get dental implants placed. Intra-oral examination reveals a missing 46. 45 and 47 were prepared to receive a 3 unit fixed dental prosthesis. What type of stress will be experienced on the occlusal surface of this prosthesis?, with the following options: A: Tensile, B: Compressive, C: Shear, D: No stress is expressed ### Response: Subjecting a structure such as an FDP to three-point loading, whereby the endpoints are fixed and a force is applied between these endpoints, tensile stress develops on the tissue side of the FDP, and compressive stress develops on the occlusal side. Between these two areas is the neutral axis that represents a state with no tensile stress and no compressive stress. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: What is trench fever:, with the following options: A: Q-fever, B: 5-days fever, C: Boutonneuse fever, D: Indian tick typhus ### Response:

Ans. is. 'b' i. e., 5-days fever

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: What is trench fever:, with the following options: A: Q-fever, B: 5-days fever, C: Boutonneuse fever, D: Indian tick typhus ### Response: Ans. is. 'b' i. e., 5-days fever ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: PQLI is measured by all except?, with the following options: A: Infant moality, B: Life expectancy at age 1, C: Literacy, D: Per capita income ### Response:

Ans. is 'd' i.e., Per capita income Physical quality of life index consolidates three indicators :- Literacy rate Infant moality rate Life expectancy at age I year (LEI

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: PQLI is measured by all except?, with the following options: A: Infant moality, B: Life expectancy at age 1, C: Literacy, D: Per capita income ### Response: Ans. is 'd' i.e., Per capita income Physical quality of life index consolidates three indicators :- Literacy rate Infant moality rate Life expectancy at age I year (LEI ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The risk of endometrial cancer is highest with the following histological pattern of endometrial hyperplasia :, with the following options: A: Simple hyperplasia without atypia, B: Simple hyperplasia with atypia, C: Complex hyperplasia without atypia, D: Complex hyperplasia with atypia ### Response:

Risk of endometrial cancer Simple hyperplasia without atypia: 1% Complex hyperplasia without atypia: 3% Simple hyperplasia with atypia: 8% Complex hyperplasia with atypia: 29%

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The risk of endometrial cancer is highest with the following histological pattern of endometrial hyperplasia :, with the following options: A: Simple hyperplasia without atypia, B: Simple hyperplasia with atypia, C: Complex hyperplasia without atypia, D: Complex hyperplasia with atypia ### Response: Risk of endometrial cancer Simple hyperplasia without atypia: 1% Complex hyperplasia without atypia: 3% Simple hyperplasia with atypia: 8% Complex hyperplasia with atypia: 29% ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is not done before ABG?, with the following options: A: Allen test, B: Heparin to rinse the syring, C: Flexion of wrist, D: Poking the aery at 45 degrees angle ### Response:

Done Before ABG Allen test: integrity of palmer arch. Heparin: to rinse the syringe Poking the aery at 45-degree angle. Extend wrist joint: Radial Aery tent.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is not done before ABG?, with the following options: A: Allen test, B: Heparin to rinse the syring, C: Flexion of wrist, D: Poking the aery at 45 degrees angle ### Response: Done Before ABG Allen test: integrity of palmer arch. Heparin: to rinse the syringe Poking the aery at 45-degree angle. Extend wrist joint: Radial Aery tent. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Early deceleration pattern on cardiotocography indicates :, with the following options: A: Head compression, B: Fetal distress, C: Cord prolapse, D: Hypoxia ### Response:

Head compression

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Early deceleration pattern on cardiotocography indicates :, with the following options: A: Head compression, B: Fetal distress, C: Cord prolapse, D: Hypoxia ### Response: Head compression ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ovulation is associated most commonly with?, with the following options: A: LH surge, B: Increase in progesterone, C: Increase in FSH, D: Increase in basal body temperature ### Response:

LH surge REF: Ganong WF: Review of Medical Physiology, 22nd ed (chapter 23) Figure 6-10, William's obstetrics 22"d edition Figure 3-1. "The onset of the gonadotropin surge resulting from increasing secretion of estrogen by preovulatory follicles is a relatively precise predictor of the time of ovulation, occurring some 34 to 36 hours before the release of the ovum from the follicle. The peak of LH secretion occurs 10 to 12 hours before ovulation and stimulates the resumption of the meiosis process in the ovum with the release of the first polar body"

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Ovulation is associated most commonly with?, with the following options: A: LH surge, B: Increase in progesterone, C: Increase in FSH, D: Increase in basal body temperature ### Response: LH surge REF: Ganong WF: Review of Medical Physiology, 22nd ed (chapter 23) Figure 6-10, William's obstetrics 22"d edition Figure 3-1. "The onset of the gonadotropin surge resulting from increasing secretion of estrogen by preovulatory follicles is a relatively precise predictor of the time of ovulation, occurring some 34 to 36 hours before the release of the ovum from the follicle. The peak of LH secretion occurs 10 to 12 hours before ovulation and stimulates the resumption of the meiosis process in the ovum with the release of the first polar body" ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following best describes the permeability to sodium and potassium in rod cells in response to the light?, with the following options: A: Decreased sodium permeability, decreased potassium permeability, B: Decreased sodium permeability, increased potassium permeability, C: Decreased sodium permeability, no change in potassium permeability, D: Increased sodium permeability, decreased potassium permeability ### Response:

Activated rhodopsin (metarhodopsin II) closes cGMP-gated sodium channels by lowering levels of cGMP; this action decreases sodium permeability. Potassium permeability is not affected.

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 best describes the permeability to sodium and potassium in rod cells in response to the light?, with the following options: A: Decreased sodium permeability, decreased potassium permeability, B: Decreased sodium permeability, increased potassium permeability, C: Decreased sodium permeability, no change in potassium permeability, D: Increased sodium permeability, decreased potassium permeability ### Response: Activated rhodopsin (metarhodopsin II) closes cGMP-gated sodium channels by lowering levels of cGMP; this action decreases sodium permeability. Potassium permeability is not affected. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Candida is most often implicated in causation -(, with the following options: A: Conjunctivitis, B: Tinea capitis, C: Dese rheumatism, D: Thrush ### Response:

Ans. is 'd' i.e., Thrush

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Candida is most often implicated in causation -(, with the following options: A: Conjunctivitis, B: Tinea capitis, C: Dese rheumatism, D: Thrush ### Response: Ans. is 'd' i.e., Thrush ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which among the following is the origin of the uterine aery?, with the following options: A: External iliac aery, B: Inferior rectal aery, C: Internal iliac aery, D: Ovarian aery ### Response:

The blood supply to the uterine corpus arises from the ascending branch of the uterine aery and from the medial or uterine branch of the ovarian aery. The uterine aery may originate directly from the internal iliac aery as an independent branch or it may have a common origin with the internal pudendal or with the vaginal aery. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 38. Anatomy. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which among the following is the origin of the uterine aery?, with the following options: A: External iliac aery, B: Inferior rectal aery, C: Internal iliac aery, D: Ovarian aery ### Response: The blood supply to the uterine corpus arises from the ascending branch of the uterine aery and from the medial or uterine branch of the ovarian aery. The uterine aery may originate directly from the internal iliac aery as an independent branch or it may have a common origin with the internal pudendal or with the vaginal aery. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 38. Anatomy. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: HIAA is a metabolite of:, with the following options: A: Serotonin, B: Dopamine, C: Epinophrine, D: Histamine ### Response:

Ans is 'a' i.e. SerotoninSerotonin or 5 hydroxytryptamine is catabolized to 5 Hydroxy indole acetic acid (5HIAA).The enzyme which catalyzes this reaction is - Monoamine oxidase.5 HIAA is excreted normally in urine. Normal adult excretes about 7 mg of HIAA per day.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: HIAA is a metabolite of:, with the following options: A: Serotonin, B: Dopamine, C: Epinophrine, D: Histamine ### Response: Ans is 'a' i.e. SerotoninSerotonin or 5 hydroxytryptamine is catabolized to 5 Hydroxy indole acetic acid (5HIAA).The enzyme which catalyzes this reaction is - Monoamine oxidase.5 HIAA is excreted normally in urine. Normal adult excretes about 7 mg of HIAA per day. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Commonest site of Ca breast is:, with the following options: A: Upper outer quadrant, B: Upper inner quadrant, C: Lower outer quadrant, D: Lower inner quadrant ### Response:

Ans: a (Upper outer quadrant) Ref: Bailey & Love, 24th ed, p. 837Note:Breast carcinoma with good prognosis evenwith axillary lymph nodes-Medullary CaBull's eye appearance is seen in- Invasive lobularDesmoplastic reaction is shown by- Ductal invasiveComedo carcinoma is- Ductal carcinoma in situ (DCIS)Most common variant of breast carcinoma- Ductal invasiveLobular carcinoma - Multicentnc and bilateralThe underlying lobular architecture can still be recognized on microscopic examination "Indian file pattern" is seen.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Commonest site of Ca breast is:, with the following options: A: Upper outer quadrant, B: Upper inner quadrant, C: Lower outer quadrant, D: Lower inner quadrant ### Response: Ans: a (Upper outer quadrant) Ref: Bailey & Love, 24th ed, p. 837Note:Breast carcinoma with good prognosis evenwith axillary lymph nodes-Medullary CaBull's eye appearance is seen in- Invasive lobularDesmoplastic reaction is shown by- Ductal invasiveComedo carcinoma is- Ductal carcinoma in situ (DCIS)Most common variant of breast carcinoma- Ductal invasiveLobular carcinoma - Multicentnc and bilateralThe underlying lobular architecture can still be recognized on microscopic examination "Indian file pattern" is seen. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: How is endotoxin shock initiated?, with the following options: A: Endothelial injury, B: Peripheral vasodilation, C: Increased vascular permeability, D: Cytokines action ### Response:

. Endothelial injury

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: How is endotoxin shock initiated?, with the following options: A: Endothelial injury, B: Peripheral vasodilation, C: Increased vascular permeability, D: Cytokines action ### Response: . Endothelial injury ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 24 year old male presents to a STD clinic with a single painless ulcer on external genitalia. The choice of laboratory test to look for the etiological agent would be:, with the following options: A: Scrappings from ulcer for culture on chocolate agar with antibiotic supplement., B: Serology for detection of specific IgM antibodies., C: Scrappings from ulcer for dark field microscopy., D: Scrappings from ulcer for tissue culture. ### Response:

Ans. is 'c' i.e. Scrapings from ulcer for dark field microscopy [Ref.: Harrison 16/e p 981 (15 /e p. 1046, 1047)Single painless ulcer on external genitalia in young male is suggestive of syphilis the patient is in the first stage of syphilis. The single painless ulcer is primary chancre.Diagnosis of syphilisAbsolute diagnosis during the first and second stages can be made by direct examination under dark field microscopy of a specimen from infective lesions which arePrimary chancreMaculopapular rashCondyloma lataDarkfield microscopy reveals tiny helically shaped organisms moving in a corkscrew like fashion.Since direct visualization of spirochetes effective only during the active stages primary and secondary syphilis, serological tests were developed for diagnosis. These serologic tests detect antibodies IgM or IgA type against antigen.Let's seeApproach to diagnosis of Genital ulcers (also see the table from Q. No. 74 of May 2001)Painful ulcers* -Chancroid, HerpesPainless ulcers* -Syphilis, lymphogranulomaVenarum, DonovanosisUlcer with Necrotic base -Hemophilus DucreyiIndurated ulcers* -SyphilisVesicular lesions -HerpesMultiple ulcers -ChancroidHerpes (B/L symmetrical)Donovanosis (can be single or multiple)Single lesions* -Syphilis, LGVLymphadenopathy* -Present in all exceptDonovanosis (pseudobuboes* are seen)Painful lymphadenopathy* -Cancroid's LGVSinuses in lymphadenopathy* - Lymphadenopathy present after theLGVlesion has healed* -LGV

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 24 year old male presents to a STD clinic with a single painless ulcer on external genitalia. The choice of laboratory test to look for the etiological agent would be:, with the following options: A: Scrappings from ulcer for culture on chocolate agar with antibiotic supplement., B: Serology for detection of specific IgM antibodies., C: Scrappings from ulcer for dark field microscopy., D: Scrappings from ulcer for tissue culture. ### Response: Ans. is 'c' i.e. Scrapings from ulcer for dark field microscopy [Ref.: Harrison 16/e p 981 (15 /e p. 1046, 1047)Single painless ulcer on external genitalia in young male is suggestive of syphilis the patient is in the first stage of syphilis. The single painless ulcer is primary chancre.Diagnosis of syphilisAbsolute diagnosis during the first and second stages can be made by direct examination under dark field microscopy of a specimen from infective lesions which arePrimary chancreMaculopapular rashCondyloma lataDarkfield microscopy reveals tiny helically shaped organisms moving in a corkscrew like fashion.Since direct visualization of spirochetes effective only during the active stages primary and secondary syphilis, serological tests were developed for diagnosis. These serologic tests detect antibodies IgM or IgA type against antigen.Let's seeApproach to diagnosis of Genital ulcers (also see the table from Q. No. 74 of May 2001)Painful ulcers* -Chancroid, HerpesPainless ulcers* -Syphilis, lymphogranulomaVenarum, DonovanosisUlcer with Necrotic base -Hemophilus DucreyiIndurated ulcers* -SyphilisVesicular lesions -HerpesMultiple ulcers -ChancroidHerpes (B/L symmetrical)Donovanosis (can be single or multiple)Single lesions* -Syphilis, LGVLymphadenopathy* -Present in all exceptDonovanosis (pseudobuboes* are seen)Painful lymphadenopathy* -Cancroid's LGVSinuses in lymphadenopathy* - Lymphadenopathy present after theLGVlesion has healed* -LGV ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about generator potential:, with the following options: A: Graded, B: Follows all or none law, C: Propagated, D: Does not show summation ### Response:

Generator potentialare graded potentials whose magnitude is propotional to ghe intensity of the stimulus . Graded potentials have different names depending on which type of stimulus causes them and where they occur. For eg, when a graded potential occurs in the dendrites or cell body of a neuron in response to a neurotransmitter, it is called a postsynaptic potential. On the other hand, the graded potentials that occur in sensory receptors are termed receptor or generator potentials. Other examples: end-plate potentials, pacemaker potentials, and slow wave potentials. PROPEIES OF GRADED POTENTIAL

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about generator potential:, with the following options: A: Graded, B: Follows all or none law, C: Propagated, D: Does not show summation ### Response: Generator potentialare graded potentials whose magnitude is propotional to ghe intensity of the stimulus . Graded potentials have different names depending on which type of stimulus causes them and where they occur. For eg, when a graded potential occurs in the dendrites or cell body of a neuron in response to a neurotransmitter, it is called a postsynaptic potential. On the other hand, the graded potentials that occur in sensory receptors are termed receptor or generator potentials. Other examples: end-plate potentials, pacemaker potentials, and slow wave potentials. PROPEIES OF GRADED POTENTIAL ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Sandfly can fly upto -, with the following options: A: 50 yards, B: 100 yards, C: 200 yards, D: 300 yards ### Response:

Sandflies Sansflies are troublesome nocturnal pests. They are incapable of flying over long distances. They merely hop about from one place to another. Sandflies are generally confined to within 50 yards. REFERENCE: PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE, 25TH EDITION, PG NO. 835

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Sandfly can fly upto -, with the following options: A: 50 yards, B: 100 yards, C: 200 yards, D: 300 yards ### Response: Sandflies Sansflies are troublesome nocturnal pests. They are incapable of flying over long distances. They merely hop about from one place to another. Sandflies are generally confined to within 50 yards. REFERENCE: PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE, 25TH EDITION, PG NO. 835 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Wolffian duct give rise to, with the following options: A: Vas deference, B: Appendix testis, C: Testis, D: Prostate ### Response:

(Vas deference) (1403-LB) (1377-B &L 25,h)* The testis develops from the genital fold medial to the mesonephros (Wolffian body)* The Wolffian duct becomes the epididymis and vas deferensDevelopment of genitourinary System:Embryonic structureStructure developing in MALEStructure developing in FEMALEGenital tuberclePenis (C. cavernosa)ClitorisUrethral foldsPenile urethra (C. spongiosa)Labia minoraGenital swellingScrotumLabia majoraGubemaculumGubemaculums testisLigament of ovaryRound ligament of uterus Genital glandsTestisOvary (genital ridge)Germinal cordsSeminiferous tubulesPfluger's tubeMesonephric duct (Wolffian duct)Epididymis, Vas deferens and seminal vesicles Ejaculatory ductsAppendix epididymidisDuct of epoophoron Gartner's duct vesicular appendageUreter, renal pelvis etc Trigonal structure**Ureter, renal pelvis, et^ Trigonal structuresMullerian duct (Paramesonephric duct)Appendix testisProstatic utricleUterine tubes, Uterus, Vagina (upper four- fifths)Muller's tubercleVeromontanumSite of hymenSinovaginal bulb from urogenital sinusPart of prostatic utricleLower one-fifth of vaginaJunction of sinovaginal bulb and urogenital sinusDisappears normally (remnants probably from posterior urethral valves)HymenUrogenital sinusVentral and pelvic partUrinary bladder (except the trigone)Supramontanel part of prostatic urethraUrinary bladder (except the trigone) whole urethraPhallic or urethral portionInframontanal part of prostatic urethra Membranous urethraVaginal vestibules

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Wolffian duct give rise to, with the following options: A: Vas deference, B: Appendix testis, C: Testis, D: Prostate ### Response: (Vas deference) (1403-LB) (1377-B &L 25,h)* The testis develops from the genital fold medial to the mesonephros (Wolffian body)* The Wolffian duct becomes the epididymis and vas deferensDevelopment of genitourinary System:Embryonic structureStructure developing in MALEStructure developing in FEMALEGenital tuberclePenis (C. cavernosa)ClitorisUrethral foldsPenile urethra (C. spongiosa)Labia minoraGenital swellingScrotumLabia majoraGubemaculumGubemaculums testisLigament of ovaryRound ligament of uterus Genital glandsTestisOvary (genital ridge)Germinal cordsSeminiferous tubulesPfluger's tubeMesonephric duct (Wolffian duct)Epididymis, Vas deferens and seminal vesicles Ejaculatory ductsAppendix epididymidisDuct of epoophoron Gartner's duct vesicular appendageUreter, renal pelvis etc Trigonal structure**Ureter, renal pelvis, et^ Trigonal structuresMullerian duct (Paramesonephric duct)Appendix testisProstatic utricleUterine tubes, Uterus, Vagina (upper four- fifths)Muller's tubercleVeromontanumSite of hymenSinovaginal bulb from urogenital sinusPart of prostatic utricleLower one-fifth of vaginaJunction of sinovaginal bulb and urogenital sinusDisappears normally (remnants probably from posterior urethral valves)HymenUrogenital sinusVentral and pelvic partUrinary bladder (except the trigone)Supramontanel part of prostatic urethraUrinary bladder (except the trigone) whole urethraPhallic or urethral portionInframontanal part of prostatic urethra Membranous urethraVaginal vestibules ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Russell’s body is found in:, with the following options: A: Metastatic calcification, B: Plasma cells, C: RBC, D: Mast cells ### Response:

Russell bodies are large homogenous eosinophilic inclusions formed by hugely distended endoplasmic reticulum of plasma cell. Their formation is triggered by synthesis of excessive amount of normal secretory proteins in plasma cells.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Russell’s body is found in:, with the following options: A: Metastatic calcification, B: Plasma cells, C: RBC, D: Mast cells ### Response: Russell bodies are large homogenous eosinophilic inclusions formed by hugely distended endoplasmic reticulum of plasma cell. Their formation is triggered by synthesis of excessive amount of normal secretory proteins in plasma cells. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are true about aspirin sensitive asthma excpet -, with the following options: A: Nasal polyposis, B: Treatment with inhaled corticosteroids, C: Rhinosinusitis, D: Increased prostaglandins ### Response:

Ans. is 'd' i.e., Increased prostaglandins o Aspirin-sensitive asthma is associated with severe rhinosinusitis and recurrent nasal polyposis.o The complex pathogenesis of aspirin-sensitive asthma involves chronic eosinophilic inflammatory changes, with evidence of increased mast cell activation.o Aspirin-sensitive asthma is an underdiagnosed condition affecting up to 20% of the adult asthmatic population.o It is associated with more severe asthma, requires increased use of inhaled and oral corticosteroids, more presentations to hospital and a risk of life - threatening reactions with aspirin,o The cyclo-oxygenase pathways play a major role in the respiratory reactions that develop after aspirin ingestion.Aspirin sensitive respiratory syndrome primarily affects adults and is characterized by:Perennial vasomotor rhinitis|Hyperplastic rhino-sinusitis with Nasal Polyps|Aspirin exposure|Block cycloxygenase without affecting lipoxygenase|Increased leukotriene|Progressive AsthmaOn exposure to even very small quantities of aspirin, affected individuals typically develop ocular and nasal congestion with acute, often severe, episodes of airway obstruction.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are true about aspirin sensitive asthma excpet -, with the following options: A: Nasal polyposis, B: Treatment with inhaled corticosteroids, C: Rhinosinusitis, D: Increased prostaglandins ### Response: Ans. is 'd' i.e., Increased prostaglandins o Aspirin-sensitive asthma is associated with severe rhinosinusitis and recurrent nasal polyposis.o The complex pathogenesis of aspirin-sensitive asthma involves chronic eosinophilic inflammatory changes, with evidence of increased mast cell activation.o Aspirin-sensitive asthma is an underdiagnosed condition affecting up to 20% of the adult asthmatic population.o It is associated with more severe asthma, requires increased use of inhaled and oral corticosteroids, more presentations to hospital and a risk of life - threatening reactions with aspirin,o The cyclo-oxygenase pathways play a major role in the respiratory reactions that develop after aspirin ingestion.Aspirin sensitive respiratory syndrome primarily affects adults and is characterized by:Perennial vasomotor rhinitis|Hyperplastic rhino-sinusitis with Nasal Polyps|Aspirin exposure|Block cycloxygenase without affecting lipoxygenase|Increased leukotriene|Progressive AsthmaOn exposure to even very small quantities of aspirin, affected individuals typically develop ocular and nasal congestion with acute, often severe, episodes of airway obstruction. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cerebral infarction is caused by, with the following options: A: Toxoplasma, B: Mucor, C: Aspergillosis, D: All of the above ### Response:

Refer Robbins page no 1363 Causes of cerebral infarction. Syphilis Tuberculosis Toxoplasmosis Aspergillosis Mucormycosis CMV encephalitis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cerebral infarction is caused by, with the following options: A: Toxoplasma, B: Mucor, C: Aspergillosis, D: All of the above ### Response: Refer Robbins page no 1363 Causes of cerebral infarction. Syphilis Tuberculosis Toxoplasmosis Aspergillosis Mucormycosis CMV encephalitis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Husband having suspicion that his wife is having affair with another man, diagnosis is -, with the following options: A: Illusion, B: Delusion, C: Hallucination, D: Delirium ### Response:

Ans. is 'b' i.e. Delusion o A delusion is false, firm (unshakeable) belief that is not accepted by other members of patient's culture and society.o Above is an example of delusion of infedility (morbid jealousy, othello syndrome) i.e. False belief that one's lover has been unfaithful.o Persecutory delusions (paranoid):- The patient feels that he is being persecuted against. There is false belief that one is being harmed, threatened, cheated, poisoned, harassed or spied on or is a victim of conspiracy to damage his reputation. The supposed persecutor of the patient may be people in the environment (e.g., members of family, neighbours, former friend) or may be political or religious groups. These delusions occur in schizophrenia (especially paranoid), severe affective disorders (sever mania or severe depression)> and organic brain syndrome. This is the most common type of delusion. Delusion of persecution may occur in the context of primary delusional experiences, auditory hallucinations, bodily hallucinations or experiences of passivityo Grandiose delusion (expansive delusions) : - False belief that one is exceptionally powerful, talented or important. These delusions seen most commonly in mania, However, can also occur in schizophrenia and organic stateso Delusions of reference:- False belief that certain objects, people or events have intense personal significance and refer specifically to one self, e.g., believing that a television news reader is talking directly about oneself, or people walking on the road are talking about him. These delusions are seen in schizophrenia, mania and organic states.o Religious delusions:- False belief pertaining to a religious theme, often grandiose in nature, e.g., believing that one is a special messenger from God. These delusions are seen in schizophreniao Delusions of love (erotomania):- False belief that another person is in love with one (commoner in woman). In one form, termed de clerambault sydrome, a woman (usually) believes that a man, frequently older and of higher status, is in love with her.o Delusion of infldility (morbid jealousy, othello syndrome): - False belief that one's lover has been unfaithful. These are seen in schizophrenia, alcohol related psychosis, organic states.o Delusion of misidentification:- a) Capgras syndrome (Delusion of double):- Belief that a familiar person has been replaced by an exact double i.e. an impostor, b) Fregoli syndrome:- Belief that a complete stranger is actually a familiar person already known to one.o Delusion of self accusation or guilt:- False feeling of remorse of guilt. It occur in Depressiono Nihilistic delusions:- False belief that oneself, others or the world is non-existent or about to end. There are pessimistic ideas that the patient's career is finished, he is about to die, world is doomed. These occurs in severe depression. If nihilistic delusions are accompanied by ideas concerning bodily function failure, e.g., putrefaction of intestines, etc., the syndrome is called COTARD's SYNDROMEo Hypochondriacal delusions:- False belief about one's health, patient wrongly believes that he has severe medical illness, contrary to the all medical evidences. It is seen in depression.o Delusion of infestations: - False belief that one is infested with small but visible organisms. As a monosymptomatic delusional disorder this is called EKBOM SYNDROME. It is seen in acute confusional state (due to drugs or alcohol withdrawal), in schizophrenia, in dementing illness, and as delusional elaboration of tactile hallucinatory experiences (secondary to formication).o Delusion of control:- Belief that his actions, impulses or thoughts are controlled by an outside agency and accordingly called as made action, made impulse or made affect. Also called somatic passivity experiences (passivity phenomenon). Commonly seen in schizophrenia.o Delusions concerning possession of thoughts - Patients with delusions about possession of thoughts may lose the conviction that their thoughts are their own. Most commonly seen in schizophrenia.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Husband having suspicion that his wife is having affair with another man, diagnosis is -, with the following options: A: Illusion, B: Delusion, C: Hallucination, D: Delirium ### Response: Ans. is 'b' i.e. Delusion o A delusion is false, firm (unshakeable) belief that is not accepted by other members of patient's culture and society.o Above is an example of delusion of infedility (morbid jealousy, othello syndrome) i.e. False belief that one's lover has been unfaithful.o Persecutory delusions (paranoid):- The patient feels that he is being persecuted against. There is false belief that one is being harmed, threatened, cheated, poisoned, harassed or spied on or is a victim of conspiracy to damage his reputation. The supposed persecutor of the patient may be people in the environment (e.g., members of family, neighbours, former friend) or may be political or religious groups. These delusions occur in schizophrenia (especially paranoid), severe affective disorders (sever mania or severe depression)> and organic brain syndrome. This is the most common type of delusion. Delusion of persecution may occur in the context of primary delusional experiences, auditory hallucinations, bodily hallucinations or experiences of passivityo Grandiose delusion (expansive delusions) : - False belief that one is exceptionally powerful, talented or important. These delusions seen most commonly in mania, However, can also occur in schizophrenia and organic stateso Delusions of reference:- False belief that certain objects, people or events have intense personal significance and refer specifically to one self, e.g., believing that a television news reader is talking directly about oneself, or people walking on the road are talking about him. These delusions are seen in schizophrenia, mania and organic states.o Religious delusions:- False belief pertaining to a religious theme, often grandiose in nature, e.g., believing that one is a special messenger from God. These delusions are seen in schizophreniao Delusions of love (erotomania):- False belief that another person is in love with one (commoner in woman). In one form, termed de clerambault sydrome, a woman (usually) believes that a man, frequently older and of higher status, is in love with her.o Delusion of infldility (morbid jealousy, othello syndrome): - False belief that one's lover has been unfaithful. These are seen in schizophrenia, alcohol related psychosis, organic states.o Delusion of misidentification:- a) Capgras syndrome (Delusion of double):- Belief that a familiar person has been replaced by an exact double i.e. an impostor, b) Fregoli syndrome:- Belief that a complete stranger is actually a familiar person already known to one.o Delusion of self accusation or guilt:- False feeling of remorse of guilt. It occur in Depressiono Nihilistic delusions:- False belief that oneself, others or the world is non-existent or about to end. There are pessimistic ideas that the patient's career is finished, he is about to die, world is doomed. These occurs in severe depression. If nihilistic delusions are accompanied by ideas concerning bodily function failure, e.g., putrefaction of intestines, etc., the syndrome is called COTARD's SYNDROMEo Hypochondriacal delusions:- False belief about one's health, patient wrongly believes that he has severe medical illness, contrary to the all medical evidences. It is seen in depression.o Delusion of infestations: - False belief that one is infested with small but visible organisms. As a monosymptomatic delusional disorder this is called EKBOM SYNDROME. It is seen in acute confusional state (due to drugs or alcohol withdrawal), in schizophrenia, in dementing illness, and as delusional elaboration of tactile hallucinatory experiences (secondary to formication).o Delusion of control:- Belief that his actions, impulses or thoughts are controlled by an outside agency and accordingly called as made action, made impulse or made affect. Also called somatic passivity experiences (passivity phenomenon). Commonly seen in schizophrenia.o Delusions concerning possession of thoughts - Patients with delusions about possession of thoughts may lose the conviction that their thoughts are their own. Most commonly seen in schizophrenia. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Earliest symptoms in acute appendicitis is -, with the following options: A: Pain, B: Fever, C: Vomiting, D: Rise of pulse rate ### Response:

Schwartz writes - In more than 95% of patients with acute appendicitis, anorexia is the first symptom, followed by abdominal pain, which is followed in turn, by vomiting (if vomiting occurs). If vomiting precedes the onset of pain, the diagnosis of appendicitis should be questioned".

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Earliest symptoms in acute appendicitis is -, with the following options: A: Pain, B: Fever, C: Vomiting, D: Rise of pulse rate ### Response: Schwartz writes - In more than 95% of patients with acute appendicitis, anorexia is the first symptom, followed by abdominal pain, which is followed in turn, by vomiting (if vomiting occurs). If vomiting precedes the onset of pain, the diagnosis of appendicitis should be questioned". ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True statements about neostigmine are, with the following options: A: It is a quaternary ammonium compounds, B: It is metabolized by the liver, C: It can cross the blood brain barrier, D: Prominent effect on cardiac muscle ### Response:

(Ref. KDT6/e p101-102; Lee 12/ep217) Neostigmine is a reversible cholinesterase inhibitor.It is a quaernary ammonium compound. (lipid insolube agent), so it does not cross blood-brain-barrie. It is paly hydrolyzed by serum cholinesterase and paly excreted unchanged by the kidneys. It possesses some agonistic action on NM receptors.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True statements about neostigmine are, with the following options: A: It is a quaternary ammonium compounds, B: It is metabolized by the liver, C: It can cross the blood brain barrier, D: Prominent effect on cardiac muscle ### Response: (Ref. KDT6/e p101-102; Lee 12/ep217) Neostigmine is a reversible cholinesterase inhibitor.It is a quaernary ammonium compound. (lipid insolube agent), so it does not cross blood-brain-barrie. It is paly hydrolyzed by serum cholinesterase and paly excreted unchanged by the kidneys. It possesses some agonistic action on NM receptors. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Constricted pupil is seen in all poisoning, except: UPSC 13, with the following options: A: Paracetamol, B: Opium, C: Phenol, D: OPC ### Response:

Ans. Paracetamol

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Constricted pupil is seen in all poisoning, except: UPSC 13, with the following options: A: Paracetamol, B: Opium, C: Phenol, D: OPC ### Response: Ans. Paracetamol ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Muller&;s muscle is found in, with the following options: A: Pharynx, B: Middle ear, C: Eye lid, D: Tongue ### Response:

Mullers muscle or involuntary pa of levator palpebrae superioris is supplied by sympathetic fibres from the superior cervical ganglion. Paralysis of mullers muscle leads to paial ptosis. This is a pa of horners syndrome. Ref BDC volume 3,Sixth edition pg 74

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Muller&;s muscle is found in, with the following options: A: Pharynx, B: Middle ear, C: Eye lid, D: Tongue ### Response: Mullers muscle or involuntary pa of levator palpebrae superioris is supplied by sympathetic fibres from the superior cervical ganglion. Paralysis of mullers muscle leads to paial ptosis. This is a pa of horners syndrome. Ref BDC volume 3,Sixth edition pg 74 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Consider the following 1* Malnutrition deficiency 2. Lithostatin (pancreatic stone protein 3. Cassava tuber Oxidant stress (heightened cytochrome P-450 activity) Which of the above produce tropical calcific pancreatitis (fibrocalculous pancreatic diabetes) ?, with the following options: A: 1, 2 and 3 only, B: 2, 3 and 4 only, C: 1 and 4 only, D: 1, 2, 3 and 4 ### Response:

Calcification, which is another sign of chronic inflammation, can develop throughout the pancreas. These calcifications are like stones that are within the tissue itself, or within the pancreatic duct Ref Davidson 23rd edition pg 765

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Consider the following 1* Malnutrition deficiency 2. Lithostatin (pancreatic stone protein 3. Cassava tuber Oxidant stress (heightened cytochrome P-450 activity) Which of the above produce tropical calcific pancreatitis (fibrocalculous pancreatic diabetes) ?, with the following options: A: 1, 2 and 3 only, B: 2, 3 and 4 only, C: 1 and 4 only, D: 1, 2, 3 and 4 ### Response: Calcification, which is another sign of chronic inflammation, can develop throughout the pancreas. These calcifications are like stones that are within the tissue itself, or within the pancreatic duct Ref Davidson 23rd edition pg 765 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Investigation of choice for SCIWORA is, with the following options: A: CT, B: X-ray, C: MRI, D: All of the above ### Response:

'SCIWORA' is the abbretion of 'spinal cord injury without radiographic abnormality'. MRI is the Investigation of Choice and has normal plain film and CT findings. It tends to occur in the paediatric population and involves upper cervical spinal cord. MRI cervical-dorsal spine Sagitta view of a paediatric patient showing hyper intensity in spinal cord at C7-D1 level s/o spinal cord contusion.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Investigation of choice for SCIWORA is, with the following options: A: CT, B: X-ray, C: MRI, D: All of the above ### Response: 'SCIWORA' is the abbretion of 'spinal cord injury without radiographic abnormality'. MRI is the Investigation of Choice and has normal plain film and CT findings. It tends to occur in the paediatric population and involves upper cervical spinal cord. MRI cervical-dorsal spine Sagitta view of a paediatric patient showing hyper intensity in spinal cord at C7-D1 level s/o spinal cord contusion. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Vitamin K leads to?, with the following options: A: g-carboxylation of aspaic acid residues to clotting factor 2,7,9 and 10, B: b-carboxylation of glutamic acid residues to clotting factor 2,7,9 and 10, C: alpha - carboxylation of asparatic acid residues to clotting factor 2,7,9 and 10, D: g-carboxylation of glutamic acid residues to clotting factor 2,7,9 and 10 ### Response:

Vitamin K leads to g-carboxylation of glutamic acid residues to clotting factor 2,7,9 and 10 Vitamin K is essential for adding carboxyl group to glutamic acid residues on 5 impoant clotting factors 1. Prothrombin (II) 2. Factor VII 3. Factor IX 4. Factor X 5. Protein C

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Vitamin K leads to?, with the following options: A: g-carboxylation of aspaic acid residues to clotting factor 2,7,9 and 10, B: b-carboxylation of glutamic acid residues to clotting factor 2,7,9 and 10, C: alpha - carboxylation of asparatic acid residues to clotting factor 2,7,9 and 10, D: g-carboxylation of glutamic acid residues to clotting factor 2,7,9 and 10 ### Response: Vitamin K leads to g-carboxylation of glutamic acid residues to clotting factor 2,7,9 and 10 Vitamin K is essential for adding carboxyl group to glutamic acid residues on 5 impoant clotting factors 1. Prothrombin (II) 2. Factor VII 3. Factor IX 4. Factor X 5. Protein C ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Mycosis fungoides is best described as, with the following options: A: Cutaneous fungal infection, B: Exematous reaction, C: skin, D: Cutaneous Lymphoma ### Response:

Ans d: (Cutaneous Lymphoma) Ref: Harrison 17th edition pg 697 Mycosis fungoides is a lymphoid neoplasm of mature T cell * Median age of presentation - mid fifties * Males > females * Indolent lymphoma with patient often having several years of eczematous or dermatitic skin lesions before diagnosis is established * Skin lesions progress from patch- plaque & cutaneous tumours * Advanced stage lymphoma spread to lymph node and viscera * Patient with this may develop generalised erythroderma and circulates tumour cells- Sezary syndrome Rx Localised early stage- radiotherapy often total skin electron beam radiation More advanced- Topical gluco- corticoid Topical N2 mustard Phototherapy Psoralen with UV A(PUVA) Interferon, antibodies etc

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Mycosis fungoides is best described as, with the following options: A: Cutaneous fungal infection, B: Exematous reaction, C: skin, D: Cutaneous Lymphoma ### Response: Ans d: (Cutaneous Lymphoma) Ref: Harrison 17th edition pg 697 Mycosis fungoides is a lymphoid neoplasm of mature T cell * Median age of presentation - mid fifties * Males > females * Indolent lymphoma with patient often having several years of eczematous or dermatitic skin lesions before diagnosis is established * Skin lesions progress from patch- plaque & cutaneous tumours * Advanced stage lymphoma spread to lymph node and viscera * Patient with this may develop generalised erythroderma and circulates tumour cells- Sezary syndrome Rx Localised early stage- radiotherapy often total skin electron beam radiation More advanced- Topical gluco- corticoid Topical N2 mustard Phototherapy Psoralen with UV A(PUVA) Interferon, antibodies etc ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: HDI includes all except -, with the following options: A: Income, B: Knowledge, C: Life duration and well being, D: Standard of living ### Response:

Ans. is 'd' i.e., Standard of living o Life expectancy at birth is a dimension of HDI (not life expectancy at one year).HUMAN DEVELOPMENT INDEX (HDDo HDI is a composite index combining indicators representing three dimensions.Components of HDIRecent (23"Ve & 22nAle of Park)Old (Previous editions)1. Longevity: - Life expectancy at birth2. Knowledey Mean years of schoolingy Expected years of schooling3. Income:-GNI per capita1. Longevity: - Life expectancy at birth2. Knowledgey Mean years of schooling (gross enrolment ratio)y Adult literacy rate3. Income: - GDP per capita

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: HDI includes all except -, with the following options: A: Income, B: Knowledge, C: Life duration and well being, D: Standard of living ### Response: Ans. is 'd' i.e., Standard of living o Life expectancy at birth is a dimension of HDI (not life expectancy at one year).HUMAN DEVELOPMENT INDEX (HDDo HDI is a composite index combining indicators representing three dimensions.Components of HDIRecent (23"Ve & 22nAle of Park)Old (Previous editions)1. Longevity: - Life expectancy at birth2. Knowledey Mean years of schoolingy Expected years of schooling3. Income:-GNI per capita1. Longevity: - Life expectancy at birth2. Knowledgey Mean years of schooling (gross enrolment ratio)y Adult literacy rate3. Income: - GDP per capita ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Inracellular concentration of K+ is, with the following options: A: 5.5meq/L, B: 15meq/L, C: 28meq/L, D: 150meq/L ### Response:

Ans. is 'd' i.e., 150 meq/L o Intracellular K+ concentration - 150 meq/Lo Extracellular K+ concentration - 4.5 - 5 meq/LComponentExtracellular fluid (ECF) (meq/1)Intracellular fluid (ICF) (meq/l)Na+K+C1-HCO3-Mg+2Ca+2PO4-21425.5103281[?]22[?]5414150410580 0001 75Protein (organic anion)5 (2g%)40 (16g %)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Inracellular concentration of K+ is, with the following options: A: 5.5meq/L, B: 15meq/L, C: 28meq/L, D: 150meq/L ### Response: Ans. is 'd' i.e., 150 meq/L o Intracellular K+ concentration - 150 meq/Lo Extracellular K+ concentration - 4.5 - 5 meq/LComponentExtracellular fluid (ECF) (meq/1)Intracellular fluid (ICF) (meq/l)Na+K+C1-HCO3-Mg+2Ca+2PO4-21425.5103281[?]22[?]5414150410580 0001 75Protein (organic anion)5 (2g%)40 (16g %) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common cause of arrhythmia is -, with the following options: A: Ischemic injury, B: Automatism, C: Trigered activity, D: heafailure ### Response:

Ischemic injury is the most common cause of rhythm disorders, because of direct damage or due to the dilation of hea chambers with consequent alteration in conduction system firing. Far less common are inherited causes of arrhythmias. These are caused by mutations in genes that regulate various ion channels that regulate depolarization and repolarization of myocardial cells. Such channelopathies are impoant (but founately uncommon) substrates for fatal arrhythmias. They underlie some cases of sudden cardiac death. Ref : Harrisons 20th edition pg 1443

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common cause of arrhythmia is -, with the following options: A: Ischemic injury, B: Automatism, C: Trigered activity, D: heafailure ### Response: Ischemic injury is the most common cause of rhythm disorders, because of direct damage or due to the dilation of hea chambers with consequent alteration in conduction system firing. Far less common are inherited causes of arrhythmias. These are caused by mutations in genes that regulate various ion channels that regulate depolarization and repolarization of myocardial cells. Such channelopathies are impoant (but founately uncommon) substrates for fatal arrhythmias. They underlie some cases of sudden cardiac death. Ref : Harrisons 20th edition pg 1443 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Froment signs is positive in injury of which nerve?, with the following options: A: Median, B: Ulnar, C: Radial, D: None of the above ### Response:

Ans. is 'b' i.e.,Ulnar

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Froment signs is positive in injury of which nerve?, with the following options: A: Median, B: Ulnar, C: Radial, D: None of the above ### Response: Ans. is 'b' i.e.,Ulnar ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 64 year old hypeensive obsese female was undergoing surgery for fracture femur under general anaesthesia. Intra-operatively her end-tidal carbon dioxide decreased to 20 from 40 mm of Hg, followed by hypotension and oxygen saturation of 85%. What could be the most probable cause?, with the following options: A: Fat embolism, B: Hypovolemia, C: Bronchospasm, D: Myocardial infarction ### Response:

A i.e. Fat embolism

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 64 year old hypeensive obsese female was undergoing surgery for fracture femur under general anaesthesia. Intra-operatively her end-tidal carbon dioxide decreased to 20 from 40 mm of Hg, followed by hypotension and oxygen saturation of 85%. What could be the most probable cause?, with the following options: A: Fat embolism, B: Hypovolemia, C: Bronchospasm, D: Myocardial infarction ### Response: A i.e. Fat embolism ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 10 year old child develops hematuria after 2 days of diarhoea. Blood film shows fragmented RBCs & thrombocytopenia. Ultrasound shows marked enlargement of both kidneys. The likely diagnosis is:, with the following options: A: Acute pyelonephritis, B: Disseminated intravascular coagulopathy, C: Haemolytic uremic syndrome, D: Renal vein thrombosis ### Response:

Answer is D (Renal vein thrombosis): Although presentation of patient is similar to that of hemolytic uremic syndrome the presence of marked enlargement of both kidneys takes the whole diagnosis in our of renal vein thrombosis. Note : Patient in question has marked enlargement of both kidneys which takes the whole diagnosis in our of renal vein thrombosis. Patients who have bilateral renal vein thrombosis may be difficult to distinguish from those with the hemolytic uraemic syndrome. - Both disorders may be preceded by gastroenteritis and in both children may present with dehydration, pallor and evidence of microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. - The marked enlargement of kidneys of a child with renal vein thrombosis helps to distinguish the disorder. - Doppler flow study or angiography of IVC may be necessary to confirm the diagnosis.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 10 year old child develops hematuria after 2 days of diarhoea. Blood film shows fragmented RBCs & thrombocytopenia. Ultrasound shows marked enlargement of both kidneys. The likely diagnosis is:, with the following options: A: Acute pyelonephritis, B: Disseminated intravascular coagulopathy, C: Haemolytic uremic syndrome, D: Renal vein thrombosis ### Response: Answer is D (Renal vein thrombosis): Although presentation of patient is similar to that of hemolytic uremic syndrome the presence of marked enlargement of both kidneys takes the whole diagnosis in our of renal vein thrombosis. Note : Patient in question has marked enlargement of both kidneys which takes the whole diagnosis in our of renal vein thrombosis. Patients who have bilateral renal vein thrombosis may be difficult to distinguish from those with the hemolytic uraemic syndrome. - Both disorders may be preceded by gastroenteritis and in both children may present with dehydration, pallor and evidence of microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. - The marked enlargement of kidneys of a child with renal vein thrombosis helps to distinguish the disorder. - Doppler flow study or angiography of IVC may be necessary to confirm the diagnosis. ### End