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Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is associated with suicide risk?, with the following options: A: Noradrenaline, B: Serotonin, C: GABA, D: Dopamine ### Response:

Ans. B SerotoninLow concentrations of 5-hydroxyindoleacetic acid (5-HIAA- metabolite of serotonin) in CSF associated with higher suicide risk

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 associated with suicide risk?, with the following options: A: Noradrenaline, B: Serotonin, C: GABA, D: Dopamine ### Response: Ans. B SerotoninLow concentrations of 5-hydroxyindoleacetic acid (5-HIAA- metabolite of serotonin) in CSF associated with higher suicide risk ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The Failure rate of male condom is:, with the following options: A: 0.50%, B: 2-18%, C: 2-4%, D: 18-28% ### Response:

Condoms are barrier method of contraception. Total condom failure rates (breakage and slippage rate combined) can range from 2 to 18 % Contraceptive efficacy of the male condom is enhanced appreciably by areservoir tip and by the addition of a spermicide. Such agents, as well asthose used for lubrication, should be water-based because oil-based productsdegrade latex condoms and diaphragms.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The Failure rate of male condom is:, with the following options: A: 0.50%, B: 2-18%, C: 2-4%, D: 18-28% ### Response: Condoms are barrier method of contraception. Total condom failure rates (breakage and slippage rate combined) can range from 2 to 18 % Contraceptive efficacy of the male condom is enhanced appreciably by areservoir tip and by the addition of a spermicide. Such agents, as well asthose used for lubrication, should be water-based because oil-based productsdegrade latex condoms and diaphragms. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A forceps rotation of 30deg from left occiput anterior (LOA) to occiput anterior (OA) with extraction of fetus from +2station is described as which type of forceps delivery?, with the following options: A: High forceps, B: Mid forceps, C: Low forceps, D: Outlet forceps ### Response:

Presence of fetal head at +2station indicate low forceps delivery. High forceps -head not engaged Mid cavity forceps-head engaged, presenting pa above +2station Low forceps -head at +2or below it but not at reached pelvic flow Outlet-head at or on perineum. Ref: Datta Obs 9e pg 533, table 37.2

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A forceps rotation of 30deg from left occiput anterior (LOA) to occiput anterior (OA) with extraction of fetus from +2station is described as which type of forceps delivery?, with the following options: A: High forceps, B: Mid forceps, C: Low forceps, D: Outlet forceps ### Response: Presence of fetal head at +2station indicate low forceps delivery. High forceps -head not engaged Mid cavity forceps-head engaged, presenting pa above +2station Low forceps -head at +2or below it but not at reached pelvic flow Outlet-head at or on perineum. Ref: Datta Obs 9e pg 533, table 37.2 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Mechanism of action of vancomycin is, with the following options: A: Inhibit protein synthesis, B: Inhibit cell wall synthesis, C: Inhibiting bacterial DNA replication, D: Inhibit DNA dependent RNA synthesis ### Response:

(Inhibit - Cell wall synthesis) (732-KDT6th)VANCOMYCIN - bactericidal and acts by interfering with cell wall synthesis, inhibits the release of peptido glycah units from their site of assembly on cell membrane phospholipids. Thus these residues are not available for cross linking to form the cell wall* Clindemycin, Spectinomycin - inhibits protein synthesis* Nalidixic acid - acts by inhibiting bacterial DNA replication* Rifampicin - inhibits DNA dependent RNA synthesis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Mechanism of action of vancomycin is, with the following options: A: Inhibit protein synthesis, B: Inhibit cell wall synthesis, C: Inhibiting bacterial DNA replication, D: Inhibit DNA dependent RNA synthesis ### Response: (Inhibit - Cell wall synthesis) (732-KDT6th)VANCOMYCIN - bactericidal and acts by interfering with cell wall synthesis, inhibits the release of peptido glycah units from their site of assembly on cell membrane phospholipids. Thus these residues are not available for cross linking to form the cell wall* Clindemycin, Spectinomycin - inhibits protein synthesis* Nalidixic acid - acts by inhibiting bacterial DNA replication* Rifampicin - inhibits DNA dependent RNA synthesis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Not included in armamentarium of tests for malabsorption syndrome:, with the following options: A: D - Xylose, B: 14 C triolein breath test, C: 13 C trioctanoin breath test, D: 13 C triclosan breath test ### Response:

Test Characterstics D- xylose test Sugar malabsorption and tests jejunal damage or proximal enteropathy 14 C triolein test Fat malabsorption picked up by radiocarbon being tagged to the triglycerides 13 C trioactanoin Fat malabsorption due to pancreatic exocrine insufficiency SeHCAT ( 23-seleno - 25- homo tauro -cholic acid) (selenium homocholic acid taurine) To diagnose bile acid malabsorption Hydrogen breath test For sugar malabsorption as unabsorbed sugar is degraded by bacteria. 13 C acetate breath tests For stomach emptying

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Not included in armamentarium of tests for malabsorption syndrome:, with the following options: A: D - Xylose, B: 14 C triolein breath test, C: 13 C trioctanoin breath test, D: 13 C triclosan breath test ### Response: Test Characterstics D- xylose test Sugar malabsorption and tests jejunal damage or proximal enteropathy 14 C triolein test Fat malabsorption picked up by radiocarbon being tagged to the triglycerides 13 C trioactanoin Fat malabsorption due to pancreatic exocrine insufficiency SeHCAT ( 23-seleno - 25- homo tauro -cholic acid) (selenium homocholic acid taurine) To diagnose bile acid malabsorption Hydrogen breath test For sugar malabsorption as unabsorbed sugar is degraded by bacteria. 13 C acetate breath tests For stomach emptying ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Drug used for atrial fibrillation and atrial flutter is, with the following options: A: Verapamil, B: Digitalis, C: Quinidine, D: Diphenylhydantoin ### Response:

For AF, digoxin can be used- it decreases ventricular rate in AF Verapamil decreases conduction velocity and increases the refractory period of the AV node and so used in PSVT. REF.Essentials of Pharmacology KD Tripathi 8th ed.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Drug used for atrial fibrillation and atrial flutter is, with the following options: A: Verapamil, B: Digitalis, C: Quinidine, D: Diphenylhydantoin ### Response: For AF, digoxin can be used- it decreases ventricular rate in AF Verapamil decreases conduction velocity and increases the refractory period of the AV node and so used in PSVT. REF.Essentials of Pharmacology KD Tripathi 8th ed. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Charcot's triad, with the following options: A: Fever, abdominal pain, jaundice, B: Fever, vomiting, jaundice, C: Fever, jaundice, abdominal distension, D: Fever, diarrhoea, jaundice ### Response:

Charcot's triad is seen in cholangitis It is characterized by Abdominal pain Jaundice Fever Reynold's pentad Charcot's triad Altered mental status. Shock (hypotension) Ref: Sabiston 20th edition Pgno :1507

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Charcot's triad, with the following options: A: Fever, abdominal pain, jaundice, B: Fever, vomiting, jaundice, C: Fever, jaundice, abdominal distension, D: Fever, diarrhoea, jaundice ### Response: Charcot's triad is seen in cholangitis It is characterized by Abdominal pain Jaundice Fever Reynold's pentad Charcot's triad Altered mental status. Shock (hypotension) Ref: Sabiston 20th edition Pgno :1507 ### 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 causes 'Euvolvemic hyponatremia*?, with the following options: A: Nephrotic syndrome, B: SIADH, C: Diarrhea, D: Vomiting ### Response:

Ref: Nelson's Textbook of Pediatrics 18th edition: page no.275 & Harrison's 18th editionExplanation:Refer previous question's explanation.

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 causes 'Euvolvemic hyponatremia*?, with the following options: A: Nephrotic syndrome, B: SIADH, C: Diarrhea, D: Vomiting ### Response: Ref: Nelson's Textbook of Pediatrics 18th edition: page no.275 & Harrison's 18th editionExplanation:Refer previous question's explanation. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cause of Cataract, with the following options: A: Infrared, B: Microwaves, C: UV rays, D: All ### Response:

A, C > B i.e. Infrared, UV rays > Microwaves

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cause of Cataract, with the following options: A: Infrared, B: Microwaves, C: UV rays, D: All ### Response: A, C > B i.e. Infrared, UV rays > Microwaves ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Blood when stored at 4degC can be kept for-, with the following options: A: 7 days, B: 14 days, C: 21 days, D: 28 days ### Response:

Typically, blood storage at 4 degrees C is sho term, which ranges from a few days to a few weeks. However, long-term storage usually involves blood being frozen, with a resultant loss in DNA yield. Refer robbins 9/e

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Blood when stored at 4degC can be kept for-, with the following options: A: 7 days, B: 14 days, C: 21 days, D: 28 days ### Response: Typically, blood storage at 4 degrees C is sho term, which ranges from a few days to a few weeks. However, long-term storage usually involves blood being frozen, with a resultant loss in DNA yield. Refer robbins 9/e ### 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 terms is associated with cocaine, with the following options: A: Reefer, B: Smack, C: Speedball, D: Ecstacy ### Response:

Reefer - CANNABIS Smack - HEROIN Speedball - COCAINE AND HEROIN Ecstacy - MDMA

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 terms is associated with cocaine, with the following options: A: Reefer, B: Smack, C: Speedball, D: Ecstacy ### Response: Reefer - CANNABIS Smack - HEROIN Speedball - COCAINE AND HEROIN Ecstacy - MDMA ### 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 feature of airways can make babies enable breathing while suckling breast milk?, with the following options: A: Sho, wide tongue, B: Small pharynx, C: Higher position of larynx, D: Small soft palate ### Response:

Paediatric larynx: Infant's larynx is positioned high in the neck opposite C3 or C4 (vocal cord level ) at rest and reaches C1 or C2 during swallowing. This high position allows the epiglottis to meet soft palate and make a nasopharyngeal channel for nasal breathing during suckling. The milk feed passes separately over the dorsum of tongue and the side of epiglottis, thus allowing breathing and feeding to go on simultaneously. Ref: Diseases of Ear, Nose and Throat by PL Dhingra, 4th edition, Page 262.

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 feature of airways can make babies enable breathing while suckling breast milk?, with the following options: A: Sho, wide tongue, B: Small pharynx, C: Higher position of larynx, D: Small soft palate ### Response: Paediatric larynx: Infant's larynx is positioned high in the neck opposite C3 or C4 (vocal cord level ) at rest and reaches C1 or C2 during swallowing. This high position allows the epiglottis to meet soft palate and make a nasopharyngeal channel for nasal breathing during suckling. The milk feed passes separately over the dorsum of tongue and the side of epiglottis, thus allowing breathing and feeding to go on simultaneously. Ref: Diseases of Ear, Nose and Throat by PL Dhingra, 4th edition, Page 262. ### 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 has both endocrine and exocrine functions?, with the following options: A: Pancreas, B: Thyroid, C: Spleen, D: Kidney ### Response:

Ans: a (Pancreas)Pancreas has both exocrine and endocrine functions.There are 4 distinct types of pancreatic cells in human.A cells (alpha) - GlucagonB cells (beta) - InsulinD cells (delta) - SomatostatinF cells - Pancreatic polypeptide D1 cells - VIPEndocrine pancreas secretes hormones -glucagon, insulin and somatosta-tin. Exocrine pancreas secretes digestive enzymes like trypsin, chymot-rypsin.Site and mechanism of hormone action:-Mechanism and siteHormoneAt nuclear receptorThyroid ormonesAt cytoplasmic receptorsSteroidal hormones eg:- Glucocorticoids, Mineralocortyicoids, Estrogen, Progestins.At cytoplasmic receptorsa) Direct transmembrane activation of tyrosine protein kinase -InsulinPhosphorylation cascade b) Through IP3/DAG generationVasopressin, oxytocinc) Through alteration of intracellular cAMP concentration - alteration of protein kinase A activityAdrenaline, glucagon, TSH,LH, FSH, PTHACTH, Calcitonin

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 has both endocrine and exocrine functions?, with the following options: A: Pancreas, B: Thyroid, C: Spleen, D: Kidney ### Response: Ans: a (Pancreas)Pancreas has both exocrine and endocrine functions.There are 4 distinct types of pancreatic cells in human.A cells (alpha) - GlucagonB cells (beta) - InsulinD cells (delta) - SomatostatinF cells - Pancreatic polypeptide D1 cells - VIPEndocrine pancreas secretes hormones -glucagon, insulin and somatosta-tin. Exocrine pancreas secretes digestive enzymes like trypsin, chymot-rypsin.Site and mechanism of hormone action:-Mechanism and siteHormoneAt nuclear receptorThyroid ormonesAt cytoplasmic receptorsSteroidal hormones eg:- Glucocorticoids, Mineralocortyicoids, Estrogen, Progestins.At cytoplasmic receptorsa) Direct transmembrane activation of tyrosine protein kinase -InsulinPhosphorylation cascade b) Through IP3/DAG generationVasopressin, oxytocinc) Through alteration of intracellular cAMP concentration - alteration of protein kinase A activityAdrenaline, glucagon, TSH,LH, FSH, PTHACTH, Calcitonin ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are used in heroin poisoning EXCEPT:, with the following options: A: Cloni di ne, B: Buprenorphine, C: Pentazocine, D: Haloperidol ### Response:

D i.e. Haloperidol

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are used in heroin poisoning EXCEPT:, with the following options: A: Cloni di ne, B: Buprenorphine, C: Pentazocine, D: Haloperidol ### Response: D i.e. Haloperidol ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A five year old boy presents with precocious puberty and a blood pressure of 130/80 mmHg. Estimation of which of the following will help in diagnosis -, with the following options: A: | 17 hydroxy-progesterone, B: | Cortisol, C: | Aldosterone, D: Renin ### Response:

Ans- A. Ref- Nelson Textbook Of Pediatrics Vol. 1 20th ed Biochemical diagnostic studies show elevated levels of serum 17-OHP, the substrate for the defective 21-hydroxylase enzyme activity.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A five year old boy presents with precocious puberty and a blood pressure of 130/80 mmHg. Estimation of which of the following will help in diagnosis -, with the following options: A: | 17 hydroxy-progesterone, B: | Cortisol, C: | Aldosterone, D: Renin ### Response: Ans- A. Ref- Nelson Textbook Of Pediatrics Vol. 1 20th ed Biochemical diagnostic studies show elevated levels of serum 17-OHP, the substrate for the defective 21-hydroxylase enzyme activity. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: After radical mastectomy there was injury to the long thoracic nerve. The integrity of the nerve can be tested at the bedside by asking the patient to:-, with the following options: A: Shrug the shoulders, B: Raise the arm above the head on the affected side, C: Touch the opposite shoulder, D: Lift a heavy object from the ground ### Response:

Nerve Muscle Movement long thoracic nerve serratus anterior overhead abduction. spinal accessory nerve trapezius Shrugging of shoulder Lateral and medial pectoral nerves Pectoralis major touching the opposite shoulder.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: After radical mastectomy there was injury to the long thoracic nerve. The integrity of the nerve can be tested at the bedside by asking the patient to:-, with the following options: A: Shrug the shoulders, B: Raise the arm above the head on the affected side, C: Touch the opposite shoulder, D: Lift a heavy object from the ground ### Response: Nerve Muscle Movement long thoracic nerve serratus anterior overhead abduction. spinal accessory nerve trapezius Shrugging of shoulder Lateral and medial pectoral nerves Pectoralis major touching the opposite shoulder. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Thyroid gland is stimulated by which hormone during pregnancy ?, with the following options: A: Prolactin, B: HCG, C: Human placental lactogen, D: ACTH ### Response:

Ans. is 'b' i.e., HCGThe endocrine system undergoes notewohy changes during pregnancy.The pituitary, thyroid and parathyroid glands appear enlarged.The enlargement of thyroid gland occurs under the influence of hCGs pituitary thyrotropin (TSH) and human chorionic thyrotropin from placenta. This results in an increase in thyroxine which stimulates metabolic activity in mother and fetus.Increased parathyroid hormone stimulates liberation of calcium ion from maternal bones for fetal use.Increased output of ACTH from pituitary stimulates secretion of :-Glucocoicoids : It mobilizes amino acids for protein synthesis in fetal tissues.Aldosterone : Promotes fluid retention in pregnancy.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Thyroid gland is stimulated by which hormone during pregnancy ?, with the following options: A: Prolactin, B: HCG, C: Human placental lactogen, D: ACTH ### Response: Ans. is 'b' i.e., HCGThe endocrine system undergoes notewohy changes during pregnancy.The pituitary, thyroid and parathyroid glands appear enlarged.The enlargement of thyroid gland occurs under the influence of hCGs pituitary thyrotropin (TSH) and human chorionic thyrotropin from placenta. This results in an increase in thyroxine which stimulates metabolic activity in mother and fetus.Increased parathyroid hormone stimulates liberation of calcium ion from maternal bones for fetal use.Increased output of ACTH from pituitary stimulates secretion of :-Glucocoicoids : It mobilizes amino acids for protein synthesis in fetal tissues.Aldosterone : Promotes fluid retention in pregnancy. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 58 year old male alcoholic with chronic pancreatitis develops a palpable abdominal mass. Ultrasound reveals a 9 cm cystic lesion adjacent to the pancreas. An impoant complication that might occur if this cyst ruptured would be?, with the following options: A: Anaphylactic shock, B: Carcinomatosis, C: Disseminated infection, D: Intestinal hemorrhage ### Response:

The patient most likely has a pancreatic pseudocyst, which is a complication of pancreatitis. Pancreatic pseudocyst is not a true cyst; it is lined by granulation tissue and collagen. It contains pancreatic juices and lysed blood, so rupture would spill the active digestive enzymes onto the adjacent viscera, paicularly the stomach, small intestine, and transverse colon. Digestive action produces potentially severe gastrointestinal hemorrhage. Anaphylactic shock results from massive activation of the IgE-mediated branch of the immune system. Pancreatic secretions do not elicit an IgE response. The classic abdominal cyst that ruptures, producing anaphylactic shock, is a hydatid cyst. Carcinomatosis is widespread serosal spread of a carcinoma, typically due to tumor spillage into a body cavity. Although this may occur with pancreatic mucinous cystadenocarcinoma, this disease is far less likely to occur than is pancreatic pseudocyst in a patient with chronic pancreatitis. Pancreatic pseudocyst is not an infective disease. Although septic abscesses do occur in the abdomen, and may even complicate a pancreatic pseudocyst, the danger of rupture is more associated with tissue destruction by pancreatic enzymes than with infection. Ref: Fisher W.E., Anderson D.K., Bell R.H., Saluja A.K., Brunicardi F.C. (2010). Chapter 33. Pancreas. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 58 year old male alcoholic with chronic pancreatitis develops a palpable abdominal mass. Ultrasound reveals a 9 cm cystic lesion adjacent to the pancreas. An impoant complication that might occur if this cyst ruptured would be?, with the following options: A: Anaphylactic shock, B: Carcinomatosis, C: Disseminated infection, D: Intestinal hemorrhage ### Response: The patient most likely has a pancreatic pseudocyst, which is a complication of pancreatitis. Pancreatic pseudocyst is not a true cyst; it is lined by granulation tissue and collagen. It contains pancreatic juices and lysed blood, so rupture would spill the active digestive enzymes onto the adjacent viscera, paicularly the stomach, small intestine, and transverse colon. Digestive action produces potentially severe gastrointestinal hemorrhage. Anaphylactic shock results from massive activation of the IgE-mediated branch of the immune system. Pancreatic secretions do not elicit an IgE response. The classic abdominal cyst that ruptures, producing anaphylactic shock, is a hydatid cyst. Carcinomatosis is widespread serosal spread of a carcinoma, typically due to tumor spillage into a body cavity. Although this may occur with pancreatic mucinous cystadenocarcinoma, this disease is far less likely to occur than is pancreatic pseudocyst in a patient with chronic pancreatitis. Pancreatic pseudocyst is not an infective disease. Although septic abscesses do occur in the abdomen, and may even complicate a pancreatic pseudocyst, the danger of rupture is more associated with tissue destruction by pancreatic enzymes than with infection. Ref: Fisher W.E., Anderson D.K., Bell R.H., Saluja A.K., Brunicardi F.C. (2010). Chapter 33. Pancreas. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Disorders of phagocytosis are all, except:, with the following options: A: Job's syndrome, B: Chediak-Higashi syndrome, C: Myeloperoxidase deficiency, D: Wiskott-Aldrich syndrome ### Response:

Ans. (d) Wiskott-Aldrich syndrome Ref. Anantlumarayan 9/e, p 172 Disorders of phagocytosis Chronic granulomatous disease Myeloperoxidase deficiency Chediak-Higashi syndrome Leukocyte G6PD deficiency Job's syndrome Tuftsin deficiency Lazy leukocyte syndrome Hyper-IgE syndrome Actin binding protein deficiency Shwachman's disease

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Disorders of phagocytosis are all, except:, with the following options: A: Job's syndrome, B: Chediak-Higashi syndrome, C: Myeloperoxidase deficiency, D: Wiskott-Aldrich syndrome ### Response: Ans. (d) Wiskott-Aldrich syndrome Ref. Anantlumarayan 9/e, p 172 Disorders of phagocytosis Chronic granulomatous disease Myeloperoxidase deficiency Chediak-Higashi syndrome Leukocyte G6PD deficiency Job's syndrome Tuftsin deficiency Lazy leukocyte syndrome Hyper-IgE syndrome Actin binding protein deficiency Shwachman's disease ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 16 year old athlete boy was diagnosed with an isolated avulsion fracture of the lesser tubercle of the humerus. It is caused by the forceful contraction of which of the following muscles ?, with the following options: A: Teres minor, B: Subscapularis, C: Supraspinatus, D: Infraspinatus ### Response:

The subscapularis muscle is inseed on the lesser tubercle of the humerus. Forceful contraction of subscapularis muscle to resist the abduction and external rotation of the shoulder may cause an isolated avulsion fracture of lesser trochanter. Ref : Gray's Anatomy The Anatomical Basics of Clinical Practice 41e pg 806.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 16 year old athlete boy was diagnosed with an isolated avulsion fracture of the lesser tubercle of the humerus. It is caused by the forceful contraction of which of the following muscles ?, with the following options: A: Teres minor, B: Subscapularis, C: Supraspinatus, D: Infraspinatus ### Response: The subscapularis muscle is inseed on the lesser tubercle of the humerus. Forceful contraction of subscapularis muscle to resist the abduction and external rotation of the shoulder may cause an isolated avulsion fracture of lesser trochanter. Ref : Gray's Anatomy The Anatomical Basics of Clinical Practice 41e pg 806. ### 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 streptococcus except :, with the following options: A: M-protein is responsible for production of mucoid colonies, B: M- protein is responsible for virulence, C: Mucoid colonies are virulent, D: No resistance to penicillin has been reported ### Response:

“Mucoid colonies are due to production of capsule of hyaluronic acid not due to M protein.” Harrison 17/e, p 882 Growth characteristic of Strep. pyogenes : On blood agar virulent stains forms matt or mucoid colonies while avirulent form glossy colonies. M, T, R are proteins found on outer part of cell wall and forms the basis of Griffith classification. – M protein - Acts as virulence factor and antibody against it are protective. – T and R protein - No relation to virulence Streptococci (Except enterococci) are usually susceptible to penicillin so option “d” is not completely wrong. As option “a” is completely wrong, that would be the answer.

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 streptococcus except :, with the following options: A: M-protein is responsible for production of mucoid colonies, B: M- protein is responsible for virulence, C: Mucoid colonies are virulent, D: No resistance to penicillin has been reported ### Response: “Mucoid colonies are due to production of capsule of hyaluronic acid not due to M protein.” Harrison 17/e, p 882 Growth characteristic of Strep. pyogenes : On blood agar virulent stains forms matt or mucoid colonies while avirulent form glossy colonies. M, T, R are proteins found on outer part of cell wall and forms the basis of Griffith classification. – M protein - Acts as virulence factor and antibody against it are protective. – T and R protein - No relation to virulence Streptococci (Except enterococci) are usually susceptible to penicillin so option “d” is not completely wrong. As option “a” is completely wrong, that would be the answer. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All can be seen as Post-Diarrhoea complications except:, with the following options: A: HUS, B: Nephritic syndrome, C: Reactive ahritis, D: Guillain Barre syndrome ### Response:

Complications of Chronic diarrhea * Lactase deficiency * Small-bowel bacterial overgrowth * Malabsorption syndromes (tropical and celiac sprue) * Initial presentation or exacerbation of inflammatory bowel disease * Irritable bowel syndrome * Reactive ahritis (formerly known as Reiter's syndrome) * Hemolytic-uremic syndrome (hemolytic anemia, thrombocytopenia, and renal failure) * Guillain-Barre syndrome

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All can be seen as Post-Diarrhoea complications except:, with the following options: A: HUS, B: Nephritic syndrome, C: Reactive ahritis, D: Guillain Barre syndrome ### Response: Complications of Chronic diarrhea * Lactase deficiency * Small-bowel bacterial overgrowth * Malabsorption syndromes (tropical and celiac sprue) * Initial presentation or exacerbation of inflammatory bowel disease * Irritable bowel syndrome * Reactive ahritis (formerly known as Reiter's syndrome) * Hemolytic-uremic syndrome (hemolytic anemia, thrombocytopenia, and renal failure) * Guillain-Barre syndrome ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is a nonsedative anxiolytic, with the following options: A: Buspirone, B: Hydroxyzine, C: Chlorpromazine, D: Alprazolam ### Response:

Buspirone:- It is the first azapirone, a new class of antianxiety drugs. Buspirone * Does not produce significant sedation or cognitive/functional impairment. * Does not interact with BZD receptor or modify GABAergic transmission. * Does not produce tolerance or physical depen dence. * Does not suppress BZD or barbiturate with- drawal syndrome. * Has no muscle relaxant or anticonvulsant activity. Buspirone relieves mild-to-moderate genera lized anxiety, but is ineffective in severe cases. mechanism of anxiolytic action:- It is dependent on its selective paial agonistic action on 5-HT1A receptors. By stimulating presynaptic 5-HT1A autoreceptors, it reduces the activity of dorsal raphe serotonergic neurones. Ref:-kd tripathi; pg num:-466,467

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following is a nonsedative anxiolytic, with the following options: A: Buspirone, B: Hydroxyzine, C: Chlorpromazine, D: Alprazolam ### Response: Buspirone:- It is the first azapirone, a new class of antianxiety drugs. Buspirone * Does not produce significant sedation or cognitive/functional impairment. * Does not interact with BZD receptor or modify GABAergic transmission. * Does not produce tolerance or physical depen dence. * Does not suppress BZD or barbiturate with- drawal syndrome. * Has no muscle relaxant or anticonvulsant activity. Buspirone relieves mild-to-moderate genera lized anxiety, but is ineffective in severe cases. mechanism of anxiolytic action:- It is dependent on its selective paial agonistic action on 5-HT1A receptors. By stimulating presynaptic 5-HT1A autoreceptors, it reduces the activity of dorsal raphe serotonergic neurones. Ref:-kd tripathi; pg num:-466,467 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All of the following statements are false regarding plague, except, with the following options: A: Live attenuated vaccine are used, B: Septicemic Plague is highly infectious, C: Vaccine is not used to control epidemic of pneumonic plague, D: Most impoant measure to control epidemic is rodent control ### Response:

Vaccine is not effective in pneumonic plague.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All of the following statements are false regarding plague, except, with the following options: A: Live attenuated vaccine are used, B: Septicemic Plague is highly infectious, C: Vaccine is not used to control epidemic of pneumonic plague, D: Most impoant measure to control epidemic is rodent control ### Response: Vaccine is not effective in pneumonic plague. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which antidiabetic drug is used both for type I& II DM -, with the following options: A: Sulphonylureas, B: Metformin, C: Acarbose, D: Pramlinitide ### Response:

Ans. is d i.e., Pramlinitide Pramlinide is the only approved drug, beside insulin, to be used in both type-I and type-2 DM. Pramilinitide This is a synthetic amylin analogue (Amylin is a polypeptide produced by pancreatic (3-cells which reduces glucagon secretion from a-cells and delays gastric emptying). Pramlintide attenuates postprandial hyperglycemia and exes a centrally mediate anorectic action. It is given by subcutaneous route and is used in both Type 1 and Type 2 DM.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which antidiabetic drug is used both for type I& II DM -, with the following options: A: Sulphonylureas, B: Metformin, C: Acarbose, D: Pramlinitide ### Response: Ans. is d i.e., Pramlinitide Pramlinide is the only approved drug, beside insulin, to be used in both type-I and type-2 DM. Pramilinitide This is a synthetic amylin analogue (Amylin is a polypeptide produced by pancreatic (3-cells which reduces glucagon secretion from a-cells and delays gastric emptying). Pramlintide attenuates postprandial hyperglycemia and exes a centrally mediate anorectic action. It is given by subcutaneous route and is used in both Type 1 and Type 2 DM. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The optimum length of screw for fixation of plates in mandible:, with the following options: A: 3 mm, B: 4 mm, C: 5 mm, D: 6 mm ### Response:

Usually the thickness of buccal cortex is around 3.5 mm. A 4 mm length screw is adequate for proper screw-bone contact.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The optimum length of screw for fixation of plates in mandible:, with the following options: A: 3 mm, B: 4 mm, C: 5 mm, D: 6 mm ### Response: Usually the thickness of buccal cortex is around 3.5 mm. A 4 mm length screw is adequate for proper screw-bone contact. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In chronic diabetics the value of TG and VLDL are more because, with the following options: A: Increased in activity of hepatic lipase, B: Increase in peripheral function of LDL receptors, C: Increased activity of lipoprotein lipase and decreased activity of hormone sensitive lipase, D: Increased activity of hormone sensitive lipase and decreased lipoprotein lipase activity ### Response:

Insulin Activates Lipoprotein lipase Inhibits Hormone sensitive lipase (HSL) In diabetic condition opposite will occur, i.e. Increased activity of hormone sensitive lipase and decreased lipoprotein lipase activity. Increased activity of hormone sensitive lipase Catabolic activity of Fatty acid in Blood

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In chronic diabetics the value of TG and VLDL are more because, with the following options: A: Increased in activity of hepatic lipase, B: Increase in peripheral function of LDL receptors, C: Increased activity of lipoprotein lipase and decreased activity of hormone sensitive lipase, D: Increased activity of hormone sensitive lipase and decreased lipoprotein lipase activity ### Response: Insulin Activates Lipoprotein lipase Inhibits Hormone sensitive lipase (HSL) In diabetic condition opposite will occur, i.e. Increased activity of hormone sensitive lipase and decreased lipoprotein lipase activity. Increased activity of hormone sensitive lipase Catabolic activity of Fatty acid in Blood ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Monozygotic twins do not have same?, with the following options: A: Fingerprints, B: Genetic make up, C: Facial appearance, D: Stature ### Response:

Ans. is 'a' i.e., Fingerprints Monozygotic twins are a result of the division of the single feilized egg into two embryos. Thus, they have exactly identical DNA, except for the generally undetectable micromutations that begin as soon as the cell stas dividing. Fingerprints of the identical twins sta their development from the same DNA so they show considerable genetic similarity. However identical twins are situated in different pas of the womb during development, so each fetus encounters slightly different intrauterine forces than their siblings. As a result fingerprints of the identical twins have different microdetails which can be used for identification purposes.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Monozygotic twins do not have same?, with the following options: A: Fingerprints, B: Genetic make up, C: Facial appearance, D: Stature ### Response: Ans. is 'a' i.e., Fingerprints Monozygotic twins are a result of the division of the single feilized egg into two embryos. Thus, they have exactly identical DNA, except for the generally undetectable micromutations that begin as soon as the cell stas dividing. Fingerprints of the identical twins sta their development from the same DNA so they show considerable genetic similarity. However identical twins are situated in different pas of the womb during development, so each fetus encounters slightly different intrauterine forces than their siblings. As a result fingerprints of the identical twins have different microdetails which can be used for identification purposes. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: 'Hand and Foot' syndrome can be caused by :, with the following options: A: Cisplatin, B: Vincristine, C: Capecitabine, D: Mitomycin-C ### Response:

5-FU, capecitabine and liposomal doxorubicin can cause hand and foot syndrome. Generally, this disease affects infants and children. Adults with immunodeficiency can also be affected.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: 'Hand and Foot' syndrome can be caused by :, with the following options: A: Cisplatin, B: Vincristine, C: Capecitabine, D: Mitomycin-C ### Response: 5-FU, capecitabine and liposomal doxorubicin can cause hand and foot syndrome. Generally, this disease affects infants and children. Adults with immunodeficiency can also be affected. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pancreatitis may be produced by which of the following drugs?, with the following options: A: Colchicine, B: L- asparagine, C: Ciprofloxacin, D: Nalidixic acid ### Response:

Exposure to ceain drugs is the third most common frequent cause of pancreatitis after gallstones and alcohol. Drugs associated with pancreatitis: Definitive cause 5- Aminosalicylate 6- Mercaptopurine Azathioprine Cytosine arabinoside Dideoxyinosine Diuretics Estrogens Furosemide Metronidazole Pentamidine Tetracycline Thiazide Trimethoprim - sulphamethoxazole Valproic acid Probable cause Acetaminophen a- Methyl- DOPA Isoniazid L- asparagine Phenformin Procainamide Sulindac Ref: Sabiston 18/e, Page 1595

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pancreatitis may be produced by which of the following drugs?, with the following options: A: Colchicine, B: L- asparagine, C: Ciprofloxacin, D: Nalidixic acid ### Response: Exposure to ceain drugs is the third most common frequent cause of pancreatitis after gallstones and alcohol. Drugs associated with pancreatitis: Definitive cause 5- Aminosalicylate 6- Mercaptopurine Azathioprine Cytosine arabinoside Dideoxyinosine Diuretics Estrogens Furosemide Metronidazole Pentamidine Tetracycline Thiazide Trimethoprim - sulphamethoxazole Valproic acid Probable cause Acetaminophen a- Methyl- DOPA Isoniazid L- asparagine Phenformin Procainamide Sulindac Ref: Sabiston 18/e, Page 1595 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A newborn with respiratory distess was noted to have marked nasal flaring, audible grunting, minimal intercostal chest retarction. The respiratory rate was 30/min. The Silverman score of this child would be?, with the following options: A: 1, B: 2, C: 3, D: 6 ### Response:

.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A newborn with respiratory distess was noted to have marked nasal flaring, audible grunting, minimal intercostal chest retarction. The respiratory rate was 30/min. The Silverman score of this child would be?, with the following options: A: 1, B: 2, C: 3, D: 6 ### Response: . ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Bisphosphonates act by -, with the following options: A: Increasing the osteoid formation, B: Increasing the mineralization of osteoid, C: Decreasing the osteoclast mediated resorption of bone, D: Decreasing the parathyroid hormone secretion ### Response:

Ans. is 'c' Decreasing the osteoclast mediated resorption of bone The clinical utility of biosphosphonates resides in their ability to inhibit bone resorption. The mechanism by which the entire resorptive effects occur is not completely known but it is thought that the biphosphonate becomes incorporated into bone matrix and is imbibed by osteoclasts during resorption. The osteoclast is then incapaciated and resorption decreases. Goodman & Gillman 1666.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Bisphosphonates act by -, with the following options: A: Increasing the osteoid formation, B: Increasing the mineralization of osteoid, C: Decreasing the osteoclast mediated resorption of bone, D: Decreasing the parathyroid hormone secretion ### Response: Ans. is 'c' Decreasing the osteoclast mediated resorption of bone The clinical utility of biosphosphonates resides in their ability to inhibit bone resorption. The mechanism by which the entire resorptive effects occur is not completely known but it is thought that the biphosphonate becomes incorporated into bone matrix and is imbibed by osteoclasts during resorption. The osteoclast is then incapaciated and resorption decreases. Goodman & Gillman 1666. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The school health surveys are quite useful in early detection of mainly:, with the following options: A: Refractive errors, B: Amblyopia, C: Colour vision defects, D: All of the above ### Response:

Ans. All of the above

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The school health surveys are quite useful in early detection of mainly:, with the following options: A: Refractive errors, B: Amblyopia, C: Colour vision defects, D: All of the above ### Response: Ans. All of the above ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Phlycten is due to -, with the following options: A: Exogenous allergy, B: Endogeneous allergy, C: Viral keratitis, D: Fungal keratitis ### Response:

Phlyctenular conjunctivitis - Endogenous allergy It is believed to be a delayed hypersensitivity (Type IV cell mediated) response to endogenous microbial proteins. Causative allergens are :- (i) Staphylococcus proteins (most common); (ii) Tuberculous proteins and (iii) Proteins of Moraxells axenfeld bacillus and ceain parasistes. Vernal keratoconjunctivitis - Exogneous allergy Reference : AK khurana 7th edition

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Phlycten is due to -, with the following options: A: Exogenous allergy, B: Endogeneous allergy, C: Viral keratitis, D: Fungal keratitis ### Response: Phlyctenular conjunctivitis - Endogenous allergy It is believed to be a delayed hypersensitivity (Type IV cell mediated) response to endogenous microbial proteins. Causative allergens are :- (i) Staphylococcus proteins (most common); (ii) Tuberculous proteins and (iii) Proteins of Moraxells axenfeld bacillus and ceain parasistes. Vernal keratoconjunctivitis - Exogneous allergy Reference : AK khurana 7th edition ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Atropine poisoning causes all, except, with the following options: A: Dilated pupil, B: Excitement, C: Excessive salivation, D: Hot skin ### Response:

Ans. (C) Excessive salivation(Ref: KDT 8th/e p132)Atropine is an anticholinergic drug. Its toxicity causes:Dry mouth (and not excessive salivation)Hot skinDilated pupil and photophobiaExcitementFlushing of skinHypotension - cardiovascular collapseConvulsions and coma

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Atropine poisoning causes all, except, with the following options: A: Dilated pupil, B: Excitement, C: Excessive salivation, D: Hot skin ### Response: Ans. (C) Excessive salivation(Ref: KDT 8th/e p132)Atropine is an anticholinergic drug. Its toxicity causes:Dry mouth (and not excessive salivation)Hot skinDilated pupil and photophobiaExcitementFlushing of skinHypotension - cardiovascular collapseConvulsions and coma ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The following Thiazide diuretic is active if the GFR is 30-40 mm Hg, with the following options: A: Metolazone, B: Benzthiazide, C: Chlorothiazide, D: Chlohalidone ### Response:

Although most thiazide diuretics lose their effectiveness in renal failure, metolazone remains active even when the glomerular filtration rate (GFR) is below 30-40 mL/min (moderate renal failure). This gives it a considerable advantage over other thiazide diuretics, since renal and hea failure often coexist and contribute to fluid retention(Refer: K. D. Tripathi&;s Essentials of Medical Pharmacology, 7th edition, pg no: 583)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The following Thiazide diuretic is active if the GFR is 30-40 mm Hg, with the following options: A: Metolazone, B: Benzthiazide, C: Chlorothiazide, D: Chlohalidone ### Response: Although most thiazide diuretics lose their effectiveness in renal failure, metolazone remains active even when the glomerular filtration rate (GFR) is below 30-40 mL/min (moderate renal failure). This gives it a considerable advantage over other thiazide diuretics, since renal and hea failure often coexist and contribute to fluid retention(Refer: K. D. Tripathi&;s Essentials of Medical Pharmacology, 7th edition, pg no: 583) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Adrenal hyperplasia due to 21 hydroxylase deficiency is treated with low dose:, with the following options: A: Androgen, B: Estrogen, C: Cortisone, D: Anti androgen ### Response:

Ans: cRef: Pedia ghai, 6th ed, p. 497, Nelson, 17th ed, p. 1912

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Adrenal hyperplasia due to 21 hydroxylase deficiency is treated with low dose:, with the following options: A: Androgen, B: Estrogen, C: Cortisone, D: Anti androgen ### Response: Ans: cRef: Pedia ghai, 6th ed, p. 497, Nelson, 17th ed, p. 1912 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: MC cause of secondary PPH is:, with the following options: A: Atonic uterus, B: Retained placenta, C: latrogenic injury, D: Medical diseases ### Response:

Retained placenta

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: MC cause of secondary PPH is:, with the following options: A: Atonic uterus, B: Retained placenta, C: latrogenic injury, D: Medical diseases ### Response: Retained placenta ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Montgomery tube used in ENT procedure is a:, with the following options: A: Double barrel tub, B: Lobster tail tube, C: Airway tube, D: Silicone tube ### Response:

Montgomery tracheal tube is designed to give the surgeon a complete program for creating a secondary airway-from initial incision through long-term tracheostomy care. It is a tracheal cannula system used in place of tracheostomy tubes. The system provides long-term access to the tracheal airway in situations that require an aificial airway or where access is needed for pulmonary hygiene. It is so designed that the thin inner flange of the cannula is shaped to fit snugly against the contour of the inner anterior tracheal wall. No tube projects into the tracheal lumen. All tracheal cannulas are made of flexible implant grade silicone to assure patient comfo and safety while reducing complications.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Montgomery tube used in ENT procedure is a:, with the following options: A: Double barrel tub, B: Lobster tail tube, C: Airway tube, D: Silicone tube ### Response: Montgomery tracheal tube is designed to give the surgeon a complete program for creating a secondary airway-from initial incision through long-term tracheostomy care. It is a tracheal cannula system used in place of tracheostomy tubes. The system provides long-term access to the tracheal airway in situations that require an aificial airway or where access is needed for pulmonary hygiene. It is so designed that the thin inner flange of the cannula is shaped to fit snugly against the contour of the inner anterior tracheal wall. No tube projects into the tracheal lumen. All tracheal cannulas are made of flexible implant grade silicone to assure patient comfo and safety while reducing complications. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 20 years old nulliparous women is an oral contraceptives pills. She is currently diagnosed as having pulmonary tuberculosis. Which antituberculous drug decreases the effect of OCPs?, with the following options: A: INH, B: Pyrazinamide, C: Ethambutol, D: Rifampicin ### Response:

Because rifampin potently induces CYPs 1A2, 2C9, 2C19, and 3A4, its administration results in a decreased t1/2 for a number of compounds, including: HIV protease and non-nucleoside reverse transcriptase inhibitors Digitoxin Digoxin Quinidine Disopyramide Mexiletine Tocainide Ketoconazole Propranolol Metoprolol Clofibrate Verapamil Methadone Cyclosporine Coicosteroids Coumarin anticoagulants Theophylline Barbiturates Oral contraceptives Halothane Fluconazole Sulfonylureas It leads to therapeutic failure of these agents, with potentially catastrophic consequences. Ref: Gumbo T. (2011). Chapter 56. Chemotherapy of Tuberculosis, Mycobacterium Avium Complex Disease, and Leprosy. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 20 years old nulliparous women is an oral contraceptives pills. She is currently diagnosed as having pulmonary tuberculosis. Which antituberculous drug decreases the effect of OCPs?, with the following options: A: INH, B: Pyrazinamide, C: Ethambutol, D: Rifampicin ### Response: Because rifampin potently induces CYPs 1A2, 2C9, 2C19, and 3A4, its administration results in a decreased t1/2 for a number of compounds, including: HIV protease and non-nucleoside reverse transcriptase inhibitors Digitoxin Digoxin Quinidine Disopyramide Mexiletine Tocainide Ketoconazole Propranolol Metoprolol Clofibrate Verapamil Methadone Cyclosporine Coicosteroids Coumarin anticoagulants Theophylline Barbiturates Oral contraceptives Halothane Fluconazole Sulfonylureas It leads to therapeutic failure of these agents, with potentially catastrophic consequences. Ref: Gumbo T. (2011). Chapter 56. Chemotherapy of Tuberculosis, Mycobacterium Avium Complex Disease, and Leprosy. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about tail wagging of bullet:, with the following options: A: Bullet rotates end-to-end during its path, B: Minor damage to tissues, C: Seen when the bullet leaves the muzzle at the beginning of its flight, D: Seen when the bullet loses its velocity near the termination of its flight ### Response:

Yawning bullet:- Detion between the long axis of the bullet and axis of the path of the bullet Tumbling bullet:- Bullet rotates end-to-end during its path Tail wobble or Tail wagging:- It occurs for few microseconds after the bullet leaves the muzzle May cause great damage

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about tail wagging of bullet:, with the following options: A: Bullet rotates end-to-end during its path, B: Minor damage to tissues, C: Seen when the bullet leaves the muzzle at the beginning of its flight, D: Seen when the bullet loses its velocity near the termination of its flight ### Response: Yawning bullet:- Detion between the long axis of the bullet and axis of the path of the bullet Tumbling bullet:- Bullet rotates end-to-end during its path Tail wobble or Tail wagging:- It occurs for few microseconds after the bullet leaves the muzzle May cause great damage ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Prokaryote is -, with the following options: A: Bacteria, B: Mycoplasma, C: Blue green algae, D: All ### Response:

Ans. is 'a' i.e., Bacteria; 'b' i.e., Mycoplasma; 'c' i.e., Blue green algae

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Prokaryote is -, with the following options: A: Bacteria, B: Mycoplasma, C: Blue green algae, D: All ### Response: Ans. is 'a' i.e., Bacteria; 'b' i.e., Mycoplasma; 'c' i.e., Blue green algae ### 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 type of shoulder dislocation is: March 2011, with the following options: A: Posterior, B: Anterior, C: Inferior, D: Superior ### Response:

Ans. B: Anterior Shoulder joint is the commonest joint in the body to dislocate Anterior shoulder dislocation is much more common than posterior dislocation Shoulder dislocation: MC joint to dislocate in body: Shoulder MC type of shoulder dislocation: Subcoracoid/ inferior Rarest type of shoulder dislocation: Posterior Posterior type of shoulder dislocation is associated with: Epileptic fits Banka's lesion is related with avulsion of glenoidal labrum Hill Sach's lesion is found on humeral head Test for dislocation of shoulder joint: - Duga's test, - Hamilton ruler test, - Callaways test Kocher's manouevre is done to reduce a dislocated shoulder

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common type of shoulder dislocation is: March 2011, with the following options: A: Posterior, B: Anterior, C: Inferior, D: Superior ### Response: Ans. B: Anterior Shoulder joint is the commonest joint in the body to dislocate Anterior shoulder dislocation is much more common than posterior dislocation Shoulder dislocation: MC joint to dislocate in body: Shoulder MC type of shoulder dislocation: Subcoracoid/ inferior Rarest type of shoulder dislocation: Posterior Posterior type of shoulder dislocation is associated with: Epileptic fits Banka's lesion is related with avulsion of glenoidal labrum Hill Sach's lesion is found on humeral head Test for dislocation of shoulder joint: - Duga's test, - Hamilton ruler test, - Callaways test Kocher's manouevre is done to reduce a dislocated shoulder ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Best prognosis in nerve injury, with the following options: A: Neuropraxia, B: Axonotemesis, C: Neurotemesis, D: Complete transaction ### Response:

Neurapraxia is a disorder of the peripheral nervous system in which there is a temporary loss of motor and sensory function due to blockage of nerve conduction, usually lasting an average of six to eight weeks before full recovery.Ref: Ganong&;s review of medical physiology 23rd edition

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Best prognosis in nerve injury, with the following options: A: Neuropraxia, B: Axonotemesis, C: Neurotemesis, D: Complete transaction ### Response: Neurapraxia is a disorder of the peripheral nervous system in which there is a temporary loss of motor and sensory function due to blockage of nerve conduction, usually lasting an average of six to eight weeks before full recovery.Ref: Ganong&;s review of medical physiology 23rd edition ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: H1N1 influenza prophylaxis, with the following options: A: Oseltamivir, B: Zanamivir, C: Amantadine, D: Rimantadine ### Response:

Ans. a. OseltamivirRef: Goodman Gilman 12th E/P1114Drug of Choice for Treatment of InfluenzaInfluenza A and BOseltamivir resistant influenza A and BOral Oseltamivir 75 mg BD for 5 daysInhalational Zanamivir 75 mg OD for 7 daysDrug of Choice for Prophylaxis of InfluenzaInfluenza A and BOseltamivir resistant influenza A and BOral Oseltamivir 10 mg BD 5 daysInhalational Zanamivir 10 mg OD 7 days

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: H1N1 influenza prophylaxis, with the following options: A: Oseltamivir, B: Zanamivir, C: Amantadine, D: Rimantadine ### Response: Ans. a. OseltamivirRef: Goodman Gilman 12th E/P1114Drug of Choice for Treatment of InfluenzaInfluenza A and BOseltamivir resistant influenza A and BOral Oseltamivir 75 mg BD for 5 daysInhalational Zanamivir 75 mg OD for 7 daysDrug of Choice for Prophylaxis of InfluenzaInfluenza A and BOseltamivir resistant influenza A and BOral Oseltamivir 10 mg BD 5 daysInhalational Zanamivir 10 mg OD 7 days ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pseudo tumour cerebri is caused by all except:, with the following options: A: Hypervitaminosis A, B: Outdated tetracycline, C: Nalidixic acid, D: Digoxin ### Response:

Ans: d (Digoxin) Ref: Nelson, 17th ed, p. 2048 & OP Ghai, 6th ed, p. 530Pseudo tumour cerebri is a clinical syndrome that mimics brain tumours and is characterized by increased intra cranial pressure with a normal cerebrospinal fluid cell count and protein content and normal ventricular size, anatomy and positionCAUSES OF PSEUDOTUMOUR CEREBRIMetabolic disoders * Galactosemia* Hypoparathyroidism* Pseudohypoparathyroidism* Hypophosphatasia* Prolonged corticosteroid therapy or too rapid corticosteroid withdrawal* Growth hormone treatment* Refeeding of a significantly malnourished child* Hypervitaminosis A* Vitamin A deficiency* Addison's disease* Obesity* Menarche* Oral contraceptive pills* PregnancyInfectionsHaemetological disorders* Roseola infantum* Chronic otitis media* Mastoiditis* Guillain Barre syndrome* Polycythaemia* Hemolytic anaemia* Iron deficiency anaemia* Wiskott Aldrich syndromeDrugs * Nalidixic acid* Outdated tetracyclins* Nitrofurantoin* Isotretinoin Obstruction of intracranial drainage by venous thrombosisHead injuryObstruction of superior venacava.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pseudo tumour cerebri is caused by all except:, with the following options: A: Hypervitaminosis A, B: Outdated tetracycline, C: Nalidixic acid, D: Digoxin ### Response: Ans: d (Digoxin) Ref: Nelson, 17th ed, p. 2048 & OP Ghai, 6th ed, p. 530Pseudo tumour cerebri is a clinical syndrome that mimics brain tumours and is characterized by increased intra cranial pressure with a normal cerebrospinal fluid cell count and protein content and normal ventricular size, anatomy and positionCAUSES OF PSEUDOTUMOUR CEREBRIMetabolic disoders * Galactosemia* Hypoparathyroidism* Pseudohypoparathyroidism* Hypophosphatasia* Prolonged corticosteroid therapy or too rapid corticosteroid withdrawal* Growth hormone treatment* Refeeding of a significantly malnourished child* Hypervitaminosis A* Vitamin A deficiency* Addison's disease* Obesity* Menarche* Oral contraceptive pills* PregnancyInfectionsHaemetological disorders* Roseola infantum* Chronic otitis media* Mastoiditis* Guillain Barre syndrome* Polycythaemia* Hemolytic anaemia* Iron deficiency anaemia* Wiskott Aldrich syndromeDrugs * Nalidixic acid* Outdated tetracyclins* Nitrofurantoin* Isotretinoin Obstruction of intracranial drainage by venous thrombosisHead injuryObstruction of superior venacava. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: "Bone within a Bone" appearance is seen in:, with the following options: A: Osteogenesis imperfecta, B: Osteopetrosis, C: Scurvy, D: Rickets ### Response:

Osteopetrosis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: "Bone within a Bone" appearance is seen in:, with the following options: A: Osteogenesis imperfecta, B: Osteopetrosis, C: Scurvy, D: Rickets ### Response: Osteopetrosis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A patient with blunt abdominal trauma presented to casualty with BP 90/60 mm Hg & pulse rate 124. The investigation to be done in this patient Is?, with the following options: A: CT abdomen, B: MR1 abdomen, C: DPL, D: FAST ### Response:

ANSWER: (D) FASTREF: Bailey and love 25th edition page 143-144As the above mentioned patient is in shock with history of blunt abdomen trauma, the first investigation to be done should be FAST."Ultrasound has an evolving role in the assessment of acutely traumatised patients. The main current roles of ultrasound include the assessment of intraperitoneal fluid and haemopericardium (focused assessment with sonography for trauma, FAST), the evaluation of pneumothoraces in supine patients and in guiding intervention"FAST ultrasound is a limited examination directed to look for intraperitoneal fluid or pericardial injury as a marker of underlying injury. This avoids the invasiveness of diagnostic peritoneal lavage. In the presence of free intraperitoneal fluid and an unstable patient, the ultrasound allows the trauma surgeon to explore the abdomen as a cause of blood loss. In the presence of fluid and a haemodynamically stable individual, further assessment by way of CT can be performed. Occasionally, a second ultrasound scan may show free fluid in the presence of an initially negative FAST scan.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A patient with blunt abdominal trauma presented to casualty with BP 90/60 mm Hg & pulse rate 124. The investigation to be done in this patient Is?, with the following options: A: CT abdomen, B: MR1 abdomen, C: DPL, D: FAST ### Response: ANSWER: (D) FASTREF: Bailey and love 25th edition page 143-144As the above mentioned patient is in shock with history of blunt abdomen trauma, the first investigation to be done should be FAST."Ultrasound has an evolving role in the assessment of acutely traumatised patients. The main current roles of ultrasound include the assessment of intraperitoneal fluid and haemopericardium (focused assessment with sonography for trauma, FAST), the evaluation of pneumothoraces in supine patients and in guiding intervention"FAST ultrasound is a limited examination directed to look for intraperitoneal fluid or pericardial injury as a marker of underlying injury. This avoids the invasiveness of diagnostic peritoneal lavage. In the presence of free intraperitoneal fluid and an unstable patient, the ultrasound allows the trauma surgeon to explore the abdomen as a cause of blood loss. In the presence of fluid and a haemodynamically stable individual, further assessment by way of CT can be performed. Occasionally, a second ultrasound scan may show free fluid in the presence of an initially negative FAST scan. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Modern IOL is made up of –a) Acrylic acidb) PMMAc) PMLd) Silicone) Glass, with the following options: A: abc, B: abd, C: bc, D: bde ### Response:

IOL are made of (i) PMIVIA (rigid IOL); (ii) Silicon, acrylic, hydrogel, collamer (foldable IOL).

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Modern IOL is made up of –a) Acrylic acidb) PMMAc) PMLd) Silicone) Glass, with the following options: A: abc, B: abd, C: bc, D: bde ### Response: IOL are made of (i) PMIVIA (rigid IOL); (ii) Silicon, acrylic, hydrogel, collamer (foldable IOL). ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which is not a poxvirus-, with the following options: A: Vaccinia virus, B: Molluscum contagiosum, C: Tanapox virus, D: Coxsackie virus ### Response:

Ans. is 'd' i.e., Coxsackie virus o Poxviruses are the largest viruses with largest genome. o Poxviridae has been classified into two subfamilies -i) Chordopoxvirinae: Poxviruses of vertebrates.ii) Entomopoxvirinae: Poxviruses of insects which do not infect vertebrates, o Chordopoxvirinae are classified into six genera or subgroups -i) Orthopoxvirus: These are mammalian poxviruses that tend to cause generalized infection with rash. Exmples are variola (smallpox virus), vaccinia, cowpox, monnkeypox, rabbitpox, buffalopox, camelpox, mousepox.ii) Parapoxvirus: Viruses of ungulates that may occasionally infact human, eg. Orf (contagious pustular dermatitis) and paravaccinia (milker's node, bovine pupular stomatitis).iii) Copripoxvirus: Viruses of goat and sheeps, eg. sheep-pox, goatpox, lumpy skin disease.iv) Leporipox virus: Viruses of of leporids (rabbits, hares, squirrels), e.g. myxoma and fibromas.v) Avipoxvirus: Virus of birds, eg. fowlpox, turkeypox, pigeonpox, canarypox.vi) Suipoxvirus: Virus of swine, eg. swinepox.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which is not a poxvirus-, with the following options: A: Vaccinia virus, B: Molluscum contagiosum, C: Tanapox virus, D: Coxsackie virus ### Response: Ans. is 'd' i.e., Coxsackie virus o Poxviruses are the largest viruses with largest genome. o Poxviridae has been classified into two subfamilies -i) Chordopoxvirinae: Poxviruses of vertebrates.ii) Entomopoxvirinae: Poxviruses of insects which do not infect vertebrates, o Chordopoxvirinae are classified into six genera or subgroups -i) Orthopoxvirus: These are mammalian poxviruses that tend to cause generalized infection with rash. Exmples are variola (smallpox virus), vaccinia, cowpox, monnkeypox, rabbitpox, buffalopox, camelpox, mousepox.ii) Parapoxvirus: Viruses of ungulates that may occasionally infact human, eg. Orf (contagious pustular dermatitis) and paravaccinia (milker's node, bovine pupular stomatitis).iii) Copripoxvirus: Viruses of goat and sheeps, eg. sheep-pox, goatpox, lumpy skin disease.iv) Leporipox virus: Viruses of of leporids (rabbits, hares, squirrels), e.g. myxoma and fibromas.v) Avipoxvirus: Virus of birds, eg. fowlpox, turkeypox, pigeonpox, canarypox.vi) Suipoxvirus: Virus of swine, eg. swinepox. ### 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 an alkaloid, with the following options: A: Morphine, B: Neostigmine, C: Emetine, D: Atropine ### Response:

Neostigmine, sold under the brand name Prostigmin among others, is a medication used to treat myasthenia gravis, Ogilvie syndrome, and urinary retention without the presence of a blockage. It is also used together with atropine to end the effects of neuromuscular blocking medication of the non-depolarizing type. Refer 7/105

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 an alkaloid, with the following options: A: Morphine, B: Neostigmine, C: Emetine, D: Atropine ### Response: Neostigmine, sold under the brand name Prostigmin among others, is a medication used to treat myasthenia gravis, Ogilvie syndrome, and urinary retention without the presence of a blockage. It is also used together with atropine to end the effects of neuromuscular blocking medication of the non-depolarizing type. Refer 7/105 ### 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 susceptibility to coronary aery disease?, with the following options: A: Nephrotic syndrome, B: Von willebrand disease, C: Type V hyperlipoproteinemia, D: Systemic lupus erythematosus ### Response:

Patients with nephrotic syndrome develop hyperlipidemia and hypercholesterolemia, secondary to increased hepatic synthesis of lipoproteins and decreased clearance of lipoproteins from the circulation. Hyperlipidemia in these patients also cause systemic atherosclerosis. Marked reduction of HDL receptor protein expression also contribute to increased atherosclerosis. All of these, acts as predisposing factors for the development of coronary aery disease. Ref: Heptinstall's Pathology of The Kidney, Volume 1 By J. Charles Jennette, Page 132; Therapy of Renal Diseases and Related Disorders By Wadi N. Suki, 2nd Edition, Chapter 321; Current Medical Diagnosis and Treatment, 2012, Chapter 22.

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 susceptibility to coronary aery disease?, with the following options: A: Nephrotic syndrome, B: Von willebrand disease, C: Type V hyperlipoproteinemia, D: Systemic lupus erythematosus ### Response: Patients with nephrotic syndrome develop hyperlipidemia and hypercholesterolemia, secondary to increased hepatic synthesis of lipoproteins and decreased clearance of lipoproteins from the circulation. Hyperlipidemia in these patients also cause systemic atherosclerosis. Marked reduction of HDL receptor protein expression also contribute to increased atherosclerosis. All of these, acts as predisposing factors for the development of coronary aery disease. Ref: Heptinstall's Pathology of The Kidney, Volume 1 By J. Charles Jennette, Page 132; Therapy of Renal Diseases and Related Disorders By Wadi N. Suki, 2nd Edition, Chapter 321; Current Medical Diagnosis and Treatment, 2012, Chapter 22. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Red velvety appearance of stomach mucosa is seen in the poisoning of:, with the following options: A: Lead, B: Arsenic, C: Copper, D: Mercury ### Response:

Ref: The Essentials of Forensic Medicine and Toxicology by KS Narayan Reddy, 29th edition, 2010, Page 452Explanation:"Arsenic Poisoning: The lesions are mainly found in the stomach. The mucosa is swollen, oedematous and red either generally or in patches; especially in the pyloric region. There may be lines of redness running along the wails or curved lines of submucous haemorrhages. The stomach mucosa resembles red velvet." (Ref: KS Narayan Reddy)ARSENIC POISONINGInterferes with cellular respiration by combining with the sulphvdryl groups of mitochondrial enzymes.Affects pyruvate oxidase and phosphatases. Clinical FeaturesSweet metallic taste.Burning colicky abdominal pain.Purging.Tenesmus.Stools are bloody dark coloured, foul smelling.Stools become colourless and odourless in late stages (Rice watery stool).Garlicky odour of breath and faeces.Other FeaturesFatty liver.Nephritis.Increased vascular permeability.Ventricular tachycardia.Ventricular fibrillation.Peripheral neuropathy - Stocking glove distribution.Fatal dose: 0.1 - 0.2 Arsenic trioxide.Fatal period: 1 - 2 days.TreatmentEmetics are not recommended.Stomach wash with warm water and milk.Freshly prepared hydrated ferric oxide: Converts toxic arsenic to nontoxic ferric oxide.BAL.Penicillamine.DMSA.Castor oil or magnesium sulphate decreases intestinal absorption.Postmortem Appearance:Raindrop type of skin pigmentation.Aldrich Mees lines in nails.Red velvety stomach mucosa.COPPER POISONINGAsa metal is not poisonous.Copper compounds are powerful inhibitors ofenzymes.Poisonous compounds:o Copper sulphate (Blue vitriol) o Copper subacetate (Verdigris).Clinical FeaturesMetallic taste.T Salivation.Blue vomitusDiarrhea.Uremia, hematuria.Acidosis.Hemoglobinuria.Jaundice.Pancreatitis.Altered sensorium.Weakness.Coma.Fatal Dose:Copper sulphate-30 grams.Copper subacetate-15 grams.Fatal Period: 1-3 days.TreatmentStomach wash with 1% potassium ferrocyanide.Hemodialysis useful in early stages.Castor oil removes copper from intestine.Chelation with penicillamine/EDTA/BAL.Postmortem AppearanceGastric mucosa and stomach contents: Bluish or greenish.Other CharacteristicsChronic poisoning: Chalcosis - Presence of copper deposits in tissues.MERCURY POISONINGAcid metallic taste.Hoarse voice.Greyish white coating of tongue.B lood- stai ned stool.Circulatory collapse.Necrosis of jaw.Membranous.Colitis.Proximal renal tubular necrosis.o Acrodyniat Aero-Limbs Odynia-Pain) is seen in mercury poisoning (aka Pink's Disease ). It is characterized by pain, swelling and parasthesia of limbso Mimimata disease--Contamination of fish with mercury, at a place called Minimate Bay in Japan.o Chronic Poisoning (Hydrargyrism): The symptoms are salivation, sore mouth and throat, fine tremors of the tongue, hands, arms, anemia.o Shaking palsy is associated with Hg poisoning. Mercurial tremors are also called hatter's shakes or glass blower's shake or Danbury tremors.o Mercurial erethism is seen in persons working with mercury in mirror manufacturing firms. Erethism is characterized by shyness, timidity, irritability, loss of confidence, mental depression, loss of memory and insomnia (Psychological symptoms).o Mercuria lentis is a peculiar eye change due to brownish deposit of mercury through the cornea on the anterior lens capsule (Brown- Malt Reflex). It is bilateral and has no effect on visual acuity.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Red velvety appearance of stomach mucosa is seen in the poisoning of:, with the following options: A: Lead, B: Arsenic, C: Copper, D: Mercury ### Response: Ref: The Essentials of Forensic Medicine and Toxicology by KS Narayan Reddy, 29th edition, 2010, Page 452Explanation:"Arsenic Poisoning: The lesions are mainly found in the stomach. The mucosa is swollen, oedematous and red either generally or in patches; especially in the pyloric region. There may be lines of redness running along the wails or curved lines of submucous haemorrhages. The stomach mucosa resembles red velvet." (Ref: KS Narayan Reddy)ARSENIC POISONINGInterferes with cellular respiration by combining with the sulphvdryl groups of mitochondrial enzymes.Affects pyruvate oxidase and phosphatases. Clinical FeaturesSweet metallic taste.Burning colicky abdominal pain.Purging.Tenesmus.Stools are bloody dark coloured, foul smelling.Stools become colourless and odourless in late stages (Rice watery stool).Garlicky odour of breath and faeces.Other FeaturesFatty liver.Nephritis.Increased vascular permeability.Ventricular tachycardia.Ventricular fibrillation.Peripheral neuropathy - Stocking glove distribution.Fatal dose: 0.1 - 0.2 Arsenic trioxide.Fatal period: 1 - 2 days.TreatmentEmetics are not recommended.Stomach wash with warm water and milk.Freshly prepared hydrated ferric oxide: Converts toxic arsenic to nontoxic ferric oxide.BAL.Penicillamine.DMSA.Castor oil or magnesium sulphate decreases intestinal absorption.Postmortem Appearance:Raindrop type of skin pigmentation.Aldrich Mees lines in nails.Red velvety stomach mucosa.COPPER POISONINGAsa metal is not poisonous.Copper compounds are powerful inhibitors ofenzymes.Poisonous compounds:o Copper sulphate (Blue vitriol) o Copper subacetate (Verdigris).Clinical FeaturesMetallic taste.T Salivation.Blue vomitusDiarrhea.Uremia, hematuria.Acidosis.Hemoglobinuria.Jaundice.Pancreatitis.Altered sensorium.Weakness.Coma.Fatal Dose:Copper sulphate-30 grams.Copper subacetate-15 grams.Fatal Period: 1-3 days.TreatmentStomach wash with 1% potassium ferrocyanide.Hemodialysis useful in early stages.Castor oil removes copper from intestine.Chelation with penicillamine/EDTA/BAL.Postmortem AppearanceGastric mucosa and stomach contents: Bluish or greenish.Other CharacteristicsChronic poisoning: Chalcosis - Presence of copper deposits in tissues.MERCURY POISONINGAcid metallic taste.Hoarse voice.Greyish white coating of tongue.B lood- stai ned stool.Circulatory collapse.Necrosis of jaw.Membranous.Colitis.Proximal renal tubular necrosis.o Acrodyniat Aero-Limbs Odynia-Pain) is seen in mercury poisoning (aka Pink's Disease ). It is characterized by pain, swelling and parasthesia of limbso Mimimata disease--Contamination of fish with mercury, at a place called Minimate Bay in Japan.o Chronic Poisoning (Hydrargyrism): The symptoms are salivation, sore mouth and throat, fine tremors of the tongue, hands, arms, anemia.o Shaking palsy is associated with Hg poisoning. Mercurial tremors are also called hatter's shakes or glass blower's shake or Danbury tremors.o Mercurial erethism is seen in persons working with mercury in mirror manufacturing firms. Erethism is characterized by shyness, timidity, irritability, loss of confidence, mental depression, loss of memory and insomnia (Psychological symptoms).o Mercuria lentis is a peculiar eye change due to brownish deposit of mercury through the cornea on the anterior lens capsule (Brown- Malt Reflex). It is bilateral and has no effect on visual acuity. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Oliguria causing drug is-, with the following options: A: Acyclovir, B: Diazepam, C: Aspirin, D: Montelukast ### Response:

Ans. is 'a' i.e., Acyclovir Drugs Causing Oliguriao Drugs causing decreased renal perfusion - diuretics.o Drugs causing nephrotoxicity - aminoglycosides and chemotherapeutic agents,o Urine retention - adrenergic and anticholinergic drugs.o Urinary obstruction associated with precipitation of urinary crystals - sulfonamides and acyclovir.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Oliguria causing drug is-, with the following options: A: Acyclovir, B: Diazepam, C: Aspirin, D: Montelukast ### Response: Ans. is 'a' i.e., Acyclovir Drugs Causing Oliguriao Drugs causing decreased renal perfusion - diuretics.o Drugs causing nephrotoxicity - aminoglycosides and chemotherapeutic agents,o Urine retention - adrenergic and anticholinergic drugs.o Urinary obstruction associated with precipitation of urinary crystals - sulfonamides and acyclovir. ### 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 varients of Acne, EXCEPT:, with the following options: A: Acne conglobata, B: Acne agminata, C: Acne fulminans, D: Pomade acne ### Response:

Acne agminata also known as lupus miliaris disseminatus faciei or facial idiopathic granulomatous with regressive evolution is a disorder of unceain etiology. Ref: Rook Textbook of Dermatology, 8th Edition, Page 38.37.

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 varients of Acne, EXCEPT:, with the following options: A: Acne conglobata, B: Acne agminata, C: Acne fulminans, D: Pomade acne ### Response: Acne agminata also known as lupus miliaris disseminatus faciei or facial idiopathic granulomatous with regressive evolution is a disorder of unceain etiology. Ref: Rook Textbook of Dermatology, 8th Edition, Page 38.37. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Surface antigen of E coli acting as virulence factors are:-, with the following options: A: LPS O Antigen, B: Capsular K antigen, C: Fimbriae, D: All of the above ### Response:

Virulence factors of E. coli: Surface antigens Toxins Somatic or O ag- Lipopolysaccharide (LPS), most impoant virulence factor & responsible for endotoxic activities LT (heat labile toxin) - - | cAMP so causes excessive secretion of Na/Cl/H2O from within to outside the cell = secretory diarrhea Flagellar or H Ag- Makes the bacteria motile. ST (heat stable toxin)- - | cGMP so fluid accumulation in gut = Diarrhea Capsular or K Ag- It is a polysaccharide capsular Ag, inhibits the phagocytosis. Verocytotoxin or Shiga like toxin - - It inhibits the protein synthesis by binding to 28S subunit of 60S ribosome = Cell death Fimbrial antigen (Pilus) - helps in attachment & colonization.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Surface antigen of E coli acting as virulence factors are:-, with the following options: A: LPS O Antigen, B: Capsular K antigen, C: Fimbriae, D: All of the above ### Response: Virulence factors of E. coli: Surface antigens Toxins Somatic or O ag- Lipopolysaccharide (LPS), most impoant virulence factor & responsible for endotoxic activities LT (heat labile toxin) - - | cAMP so causes excessive secretion of Na/Cl/H2O from within to outside the cell = secretory diarrhea Flagellar or H Ag- Makes the bacteria motile. ST (heat stable toxin)- - | cGMP so fluid accumulation in gut = Diarrhea Capsular or K Ag- It is a polysaccharide capsular Ag, inhibits the phagocytosis. Verocytotoxin or Shiga like toxin - - It inhibits the protein synthesis by binding to 28S subunit of 60S ribosome = Cell death Fimbrial antigen (Pilus) - helps in attachment & colonization. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A type of teiary waste water treatment process is -, with the following options: A: Reverse osmosis, B: Sedimentation, C: Both, D: Neither ### Response:

Sewage treatment Primary treatment : Physical treatment to remove solids (from the liquid) Secondary treatment : Bilogical treatment brought about by aerobic and anaerobic bacteria Teiary treatment : Improving fuher the quality of effluent (advanced waste treatment process), sludge (stabilisation and dewatering), assist sedimentation and sludge treatment (chemical treatment by the addition of coagulants) Ref: Park 25th edition Pgno : 800

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A type of teiary waste water treatment process is -, with the following options: A: Reverse osmosis, B: Sedimentation, C: Both, D: Neither ### Response: Sewage treatment Primary treatment : Physical treatment to remove solids (from the liquid) Secondary treatment : Bilogical treatment brought about by aerobic and anaerobic bacteria Teiary treatment : Improving fuher the quality of effluent (advanced waste treatment process), sludge (stabilisation and dewatering), assist sedimentation and sludge treatment (chemical treatment by the addition of coagulants) Ref: Park 25th edition Pgno : 800 ### 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 muscle cause hip extension and knee flexion ?, with the following options: A: Semitendinosus, B: Gastrosoleus, C: Psoas major, D: Tensor Fascia lata ### Response:

Ans. is'a' i.e.. SemitendinosusSemitendinosus is hamstring muscle.Causes flexion at knee & extension at hip.

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 muscle cause hip extension and knee flexion ?, with the following options: A: Semitendinosus, B: Gastrosoleus, C: Psoas major, D: Tensor Fascia lata ### Response: Ans. is'a' i.e.. SemitendinosusSemitendinosus is hamstring muscle.Causes flexion at knee & extension at hip. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Capitate bone aiculates with all EXCEPT, with the following options: A: Second metacarpal, B: Lunate, C: Trapezium, D: Scaphoid ### Response:

The capitate bone is the largest of the carpal bones in the human hand, and occupies the center of the wrist. It aiculates with trapezoid (not trapezium) bone.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Capitate bone aiculates with all EXCEPT, with the following options: A: Second metacarpal, B: Lunate, C: Trapezium, D: Scaphoid ### Response: The capitate bone is the largest of the carpal bones in the human hand, and occupies the center of the wrist. It aiculates with trapezoid (not trapezium) bone. ### 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 side effects of phenytoin, EXCEPT, with the following options: A: Ataxia, B: Hypoglycemia, C: Hirsutism, D: Gum hypertrophy ### Response:

(B) Hypoglycemia # Dosage and Adverse Effects of Commonly Used Antiepileptic Drugs# Phenytoin (diphenylhydantoin) Principal Uses -- Tonic-clonic (grand mal); Focal-onset Typical Dose; Dose Interval-- 300-400 mg/d (3-6 mg/kg, adult; 4-8 mg/kg, child); qd-bid Half-Life -- 24 h (wide variation, dose dependent) Therapeutic Range -- 10-20 pg/mL Adverse Effects/Neurologic -- Dizziness Diplopia Ataxia Incoordination Confusion Adverse Effects/Systemic -- Gum hyperplasia Lymphadenopathy Hirsutism Osteomalacia Facial coarsening Skin rash Adverse interactions -- Level increased by isoniazid, sulfonamides, fluoxetine Level decreased by enzyme inducing drugs Altered folate metabolism

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are side effects of phenytoin, EXCEPT, with the following options: A: Ataxia, B: Hypoglycemia, C: Hirsutism, D: Gum hypertrophy ### Response: (B) Hypoglycemia # Dosage and Adverse Effects of Commonly Used Antiepileptic Drugs# Phenytoin (diphenylhydantoin) Principal Uses -- Tonic-clonic (grand mal); Focal-onset Typical Dose; Dose Interval-- 300-400 mg/d (3-6 mg/kg, adult; 4-8 mg/kg, child); qd-bid Half-Life -- 24 h (wide variation, dose dependent) Therapeutic Range -- 10-20 pg/mL Adverse Effects/Neurologic -- Dizziness Diplopia Ataxia Incoordination Confusion Adverse Effects/Systemic -- Gum hyperplasia Lymphadenopathy Hirsutism Osteomalacia Facial coarsening Skin rash Adverse interactions -- Level increased by isoniazid, sulfonamides, fluoxetine Level decreased by enzyme inducing drugs Altered folate metabolism ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Teuton giant cells are seen in:, with the following options: A: Sarcoidosis, B: Tuberculosis, C: Foreign body granuloma, D: Xanthoma ### Response:

Touton giant cells These giant cells are seen in lesions with high lipid content such as fat necrosis, xanthoma, and xanthogranulomas. They are also found in dermatofibroma. They are formed by the fusion of epithelioid cells (macrophages) and contain a ring of nuclei surrounded by a foamy cytoplasm.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Teuton giant cells are seen in:, with the following options: A: Sarcoidosis, B: Tuberculosis, C: Foreign body granuloma, D: Xanthoma ### Response: Touton giant cells These giant cells are seen in lesions with high lipid content such as fat necrosis, xanthoma, and xanthogranulomas. They are also found in dermatofibroma. They are formed by the fusion of epithelioid cells (macrophages) and contain a ring of nuclei surrounded by a foamy cytoplasm. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True negative means -, with the following options: A: Sensitivity, B: Specificity, C: Positive predictive value, D: Negative predictive value ### Response:

.true negative means specificity.it is defined as the ability of a test to identify correctly those who do not have the disease that is true negatives. ref:park&;s textbook,22nd edition,pg no 112

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True negative means -, with the following options: A: Sensitivity, B: Specificity, C: Positive predictive value, D: Negative predictive value ### Response: .true negative means specificity.it is defined as the ability of a test to identify correctly those who do not have the disease that is true negatives. ref:park&;s textbook,22nd edition,pg no 112 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which carpal bone fracture causes median nerve involvement?, with the following options: A: Scaphoid, B: Lunate, C: Trapezium, D: Trapeziod ### Response:

A palmar pole fracture of lunate may cause carpal tunnel syndrome and median nerve compression.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which carpal bone fracture causes median nerve involvement?, with the following options: A: Scaphoid, B: Lunate, C: Trapezium, D: Trapeziod ### Response: A palmar pole fracture of lunate may cause carpal tunnel syndrome and median nerve compression. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Organ of Rosenmuller is a remnant of -, with the following options: A: Endodermal sinus, B: Mullerian duct, C: Mesonephric tubule, D: Paramesonephric duct ### Response:

Remnant of mesonephric tubule is known as an organ of Rosenmuller/ Epophoron.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Organ of Rosenmuller is a remnant of -, with the following options: A: Endodermal sinus, B: Mullerian duct, C: Mesonephric tubule, D: Paramesonephric duct ### Response: Remnant of mesonephric tubule is known as an organ of Rosenmuller/ Epophoron. ### 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 seen in high attitude climbers:, with the following options: A: Hyperventilation, B: Hyperventilation, C: Pulmonary edema, D: All ### Response:

A i.e. Hyperventilation, (B) i.e. Decreased Pa CO2 (C) pulmonary edema

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 seen in high attitude climbers:, with the following options: A: Hyperventilation, B: Hyperventilation, C: Pulmonary edema, D: All ### Response: A i.e. Hyperventilation, (B) i.e. Decreased Pa CO2 (C) pulmonary edema ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: CTL inducing vaccines, recombinant adeno-associated virus vaccine and modified vaccinia Ankara are being developed for:-, with the following options: A: Tuberculosis, B: Leprosy, C: Malaria, D: HIV/AIDS ### Response:

CTL inducing vaccines, recombinant adeno-associated virus vaccine and modified vaccinia Ankara are being developed for HIV/AIDS. Since 1987, more than 30 HIV candidate vaccines have been tested in clinical trials phases I/II: some of them are: AIDS VAX; only vaccine in phase III trials. Cytotoxic T-Lymphocytes inducing vaccine. Recombinant adeno-associated virus vaccine. Modified vaccine Ankara vaccine. Subunit vaccine.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: CTL inducing vaccines, recombinant adeno-associated virus vaccine and modified vaccinia Ankara are being developed for:-, with the following options: A: Tuberculosis, B: Leprosy, C: Malaria, D: HIV/AIDS ### Response: CTL inducing vaccines, recombinant adeno-associated virus vaccine and modified vaccinia Ankara are being developed for HIV/AIDS. Since 1987, more than 30 HIV candidate vaccines have been tested in clinical trials phases I/II: some of them are: AIDS VAX; only vaccine in phase III trials. Cytotoxic T-Lymphocytes inducing vaccine. Recombinant adeno-associated virus vaccine. Modified vaccine Ankara vaccine. Subunit vaccine. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The appropriate term used for describing the condition when the palatal cusps of the maxillary posterior teeth are placed buccal to the buccal cusps of mandibular posterior teeth:, with the following options: A: Buccal non-occlusion, B: Lingual non-occlusion, C: Scissor bite, D: Both 1 and 3 ### Response:

Buccal non-occlusion: Here the maxillary teeth palatal cusp of the occlusion are placed buccal to the buccal cusp of the mandibular posterior teeth. The condition is also known as scissors bite.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The appropriate term used for describing the condition when the palatal cusps of the maxillary posterior teeth are placed buccal to the buccal cusps of mandibular posterior teeth:, with the following options: A: Buccal non-occlusion, B: Lingual non-occlusion, C: Scissor bite, D: Both 1 and 3 ### Response: Buccal non-occlusion: Here the maxillary teeth palatal cusp of the occlusion are placed buccal to the buccal cusp of the mandibular posterior teeth. The condition is also known as scissors bite. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Infectious mononucleosis, a viral disorder that can be debilitating, is characterized by which of the following statements?, with the following options: A: It is most prevalent in children less than 14 years old, B: It is caused by a rhabdovirus, C: The causative pathogen is an Epstein-Barr virus, D: Affected persons respond to treatment with the production of heterophil antibodies ### Response:

All of Koch's postulates have been verified for the relationship between infectious mononucleosis and Epstein-Barr virus, a herpesvirus. However, the relationship between this virus and Burkitt's lymphoma, sarcoid, and systemic lupus erythematosus (SLE) is less clear. Infectious mononucleosis is most common in young adults (14 to 18 years of age) and is very rare in young children. There is no specific treatment. Heterophil antibody titer is helpful in diagnosis, but is not expressed as a function of clinical recovery.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Infectious mononucleosis, a viral disorder that can be debilitating, is characterized by which of the following statements?, with the following options: A: It is most prevalent in children less than 14 years old, B: It is caused by a rhabdovirus, C: The causative pathogen is an Epstein-Barr virus, D: Affected persons respond to treatment with the production of heterophil antibodies ### Response: All of Koch's postulates have been verified for the relationship between infectious mononucleosis and Epstein-Barr virus, a herpesvirus. However, the relationship between this virus and Burkitt's lymphoma, sarcoid, and systemic lupus erythematosus (SLE) is less clear. Infectious mononucleosis is most common in young adults (14 to 18 years of age) and is very rare in young children. There is no specific treatment. Heterophil antibody titer is helpful in diagnosis, but is not expressed as a function of clinical recovery. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A sho statured boy with rhizomelic limbs and brachydactyly is a feature of, with the following options: A: Achondroplasia, B: Laron dwarfism, C: Hypothyroidism, D: Morquio disease ### Response:

Features of Achondroplasia Ref image - Researchgate.net

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A sho statured boy with rhizomelic limbs and brachydactyly is a feature of, with the following options: A: Achondroplasia, B: Laron dwarfism, C: Hypothyroidism, D: Morquio disease ### Response: Features of Achondroplasia Ref image - Researchgate.net ### 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 features of musculocutaneous nerve injury at axilla except, with the following options: A: Loss of flexion of shoulder, B: Weak elbow flexion, C: Weak forearm supination, D: Loss of sensation on radial side of forearm ### Response:

Loss of flexion of shoulder* Flexion at shoulder is done by major muscles like pectoralis major, anterior fibres of deltoid, which are intact here. Musculocutaneous nerve (MCN)originates from the lateral cord of the brachial plexus of nerves. It pierces the coracobrachialis muscle and gives off branches to the muscle, as well as to brachialis and biceps brachii, the chief flexors at elbow joint. Coraco-brachialis is a flexor at shoulder joint Biceps brachii is a powerful supinator, hence supination is weakened. MCN terminates as the lateral cutaneous nerve of the forearm.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All of the following are features of musculocutaneous nerve injury at axilla except, with the following options: A: Loss of flexion of shoulder, B: Weak elbow flexion, C: Weak forearm supination, D: Loss of sensation on radial side of forearm ### Response: Loss of flexion of shoulder* Flexion at shoulder is done by major muscles like pectoralis major, anterior fibres of deltoid, which are intact here. Musculocutaneous nerve (MCN)originates from the lateral cord of the brachial plexus of nerves. It pierces the coracobrachialis muscle and gives off branches to the muscle, as well as to brachialis and biceps brachii, the chief flexors at elbow joint. Coraco-brachialis is a flexor at shoulder joint Biceps brachii is a powerful supinator, hence supination is weakened. MCN terminates as the lateral cutaneous nerve of the forearm. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The zinc oxide-eugenol impression pastes harden by:, with the following options: A: Chemical reaction, B: Cold, C: Heat, D: Pressure ### Response:

Key Concept:  ZnO Eugenol impression paste hardens by chemical reaction.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The zinc oxide-eugenol impression pastes harden by:, with the following options: A: Chemical reaction, B: Cold, C: Heat, D: Pressure ### Response: Key Concept:  ZnO Eugenol impression paste hardens by chemical reaction. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Regarding malignant melanoma all the following are true EXCEPT, with the following options: A: Vertical depth of invasion is a prognostic indicator, B: Occurs in actinic damaged skin, C: Lentigo maligna is a type of malignant melanoma, D: May shows spontaneous regression ### Response:

Ans) d (May shows spontaneous regression) Ref: Sabistons textbook of surgery 18th editionRisk factors1. Solar ultraviolet (UV) radiation - actinic damaged skin2. Severe bums in childhood3. Fair complexion4. Dysplastic nevus (DN) syndrome5. Xeroderma pigmentosum6. History of nonmelanoma skin cancer (NMSC)7. Family history of melanoma.Precursor Lesions and Risk Factors1. Congenital nevi2. DNs3. Spitz neviHistologic types of Cutaneous MelanomaSuperficial spreading melanoma - most commonLentigomalignaAcral lentiginous melanomaNodular melanomaPrognostic factors1. LN involvement (Most important)2. Breslows thickness (Major determinant in the absence of nodal disease)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Regarding malignant melanoma all the following are true EXCEPT, with the following options: A: Vertical depth of invasion is a prognostic indicator, B: Occurs in actinic damaged skin, C: Lentigo maligna is a type of malignant melanoma, D: May shows spontaneous regression ### Response: Ans) d (May shows spontaneous regression) Ref: Sabistons textbook of surgery 18th editionRisk factors1. Solar ultraviolet (UV) radiation - actinic damaged skin2. Severe bums in childhood3. Fair complexion4. Dysplastic nevus (DN) syndrome5. Xeroderma pigmentosum6. History of nonmelanoma skin cancer (NMSC)7. Family history of melanoma.Precursor Lesions and Risk Factors1. Congenital nevi2. DNs3. Spitz neviHistologic types of Cutaneous MelanomaSuperficial spreading melanoma - most commonLentigomalignaAcral lentiginous melanomaNodular melanomaPrognostic factors1. LN involvement (Most important)2. Breslows thickness (Major determinant in the absence of nodal disease) ### 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 has autosomal inheritance?, with the following options: A: Hemophilia, B: Marfan syndrome, C: CHD, D: Gout ### Response:

Ans. is 'b' i.e., Marfan syndrome Marfan syndrome is an autosomal disorder (autosomal dominant). o Hemophilia is X-linked recessive. o CHD and gout have multifactorial inheritence.

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 has autosomal inheritance?, with the following options: A: Hemophilia, B: Marfan syndrome, C: CHD, D: Gout ### Response: Ans. is 'b' i.e., Marfan syndrome Marfan syndrome is an autosomal disorder (autosomal dominant). o Hemophilia is X-linked recessive. o CHD and gout have multifactorial inheritence. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 69-year-old woman is taking large amounts of aspirin for osteoarthritis, and now complains of ringing in her ears and nausea.For the above patient with new symptoms, select the most likely acid base disorder., with the following options: A: metabolic acidosis, B: metabolic alkalosis, C: respiratory acidosis, D: respiratory alkalosis ### Response:

Chronic salicylate use can cause respiratory alkalosis. Severe salicylate toxicity results in an anion gap metabolic acidosis such as during an overdose. During acute hyperventilation, plasma bicarbonate concentrations fall by approximately 3 mEq/L when the arterial pressure of CO2 falls to about 25 mm Hg. Acute respiratory alkalosis can be caused by anxiety, central nervous system (CNS) disorders, drugs, or fever. Chronic respiratory alkalosis occurs in pregnancy and liver disease as well.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 69-year-old woman is taking large amounts of aspirin for osteoarthritis, and now complains of ringing in her ears and nausea.For the above patient with new symptoms, select the most likely acid base disorder., with the following options: A: metabolic acidosis, B: metabolic alkalosis, C: respiratory acidosis, D: respiratory alkalosis ### Response: Chronic salicylate use can cause respiratory alkalosis. Severe salicylate toxicity results in an anion gap metabolic acidosis such as during an overdose. During acute hyperventilation, plasma bicarbonate concentrations fall by approximately 3 mEq/L when the arterial pressure of CO2 falls to about 25 mm Hg. Acute respiratory alkalosis can be caused by anxiety, central nervous system (CNS) disorders, drugs, or fever. Chronic respiratory alkalosis occurs in pregnancy and liver disease as well. ### 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 oncogenic viruses except:, with the following options: A: Hepatitis C, B: Ebstein Barr virus, C: Human Metapneumovirus, D: Papillomavirus ### Response:

Ans: C (Human Metapneumovirus) Ref: Robbins and Cotran 'Pathologic Basis of Disease 8th Edition. Elsevier. 201. Pg 313.Explanation:Oncogenic RNA VirusesHuman T-Cell Leukemia Virus Type 1 - T-cell leukemia/lymphomaHepatitis C Virus - Hepatocellular Carcinoma Oncogenic DNA VirusesHuman Papillomavirus.Types 1. 2. 4 & 7 - Benign Squamous Papillomas ( Warts)Types 16 & 18 - squamous cell Ca of the cervix and anogenital areaHuman herpes virus 8 - Kaposi SarcomaEpstein-Barr VirusThe African form of Burkitt lymphoma;B-cell lymphomas in immunosuppressed individualsA subset of Hodgkin lymphoma;Nasopharyngeal carcinomaGastric carcinomas and rare forms ofT cell lymphomas andNatural killer (NK) cell lymphomas.Hepatitis B Virus - Hepatocellular CarcinomaMerkel cell polyomavirus - Merkel Cell CarcinomaOncogenic BacteriaHelicobacter pylori - gastric adenocarcinomas and gastric lymphomas

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are oncogenic viruses except:, with the following options: A: Hepatitis C, B: Ebstein Barr virus, C: Human Metapneumovirus, D: Papillomavirus ### Response: Ans: C (Human Metapneumovirus) Ref: Robbins and Cotran 'Pathologic Basis of Disease 8th Edition. Elsevier. 201. Pg 313.Explanation:Oncogenic RNA VirusesHuman T-Cell Leukemia Virus Type 1 - T-cell leukemia/lymphomaHepatitis C Virus - Hepatocellular Carcinoma Oncogenic DNA VirusesHuman Papillomavirus.Types 1. 2. 4 & 7 - Benign Squamous Papillomas ( Warts)Types 16 & 18 - squamous cell Ca of the cervix and anogenital areaHuman herpes virus 8 - Kaposi SarcomaEpstein-Barr VirusThe African form of Burkitt lymphoma;B-cell lymphomas in immunosuppressed individualsA subset of Hodgkin lymphoma;Nasopharyngeal carcinomaGastric carcinomas and rare forms ofT cell lymphomas andNatural killer (NK) cell lymphomas.Hepatitis B Virus - Hepatocellular CarcinomaMerkel cell polyomavirus - Merkel Cell CarcinomaOncogenic BacteriaHelicobacter pylori - gastric adenocarcinomas and gastric lymphomas ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Hutchinsons secondaries In skull are due to tumors in, with the following options: A: Lung, B: Breast, C: Adrenal, D: Liver ### Response:

Adrenal neuroblastomas are malig8nant neoplasms arising from sympathetic neuroblsts in Medulla of adrenal gland Neuroblastoma is a cancer that develops from immature nerve cells found in several areas of the body.Neuroblastoma most commonly arises in and around the adrenalglands, which have similar origins to nerve cells and sit atop the kidneys.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Hutchinsons secondaries In skull are due to tumors in, with the following options: A: Lung, B: Breast, C: Adrenal, D: Liver ### Response: Adrenal neuroblastomas are malig8nant neoplasms arising from sympathetic neuroblsts in Medulla of adrenal gland Neuroblastoma is a cancer that develops from immature nerve cells found in several areas of the body.Neuroblastoma most commonly arises in and around the adrenalglands, which have similar origins to nerve cells and sit atop the kidneys. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Association of deafness & nephritis is seen in, with the following options: A: Pickwickian syndrome, B: Alpo's syndrome, C: Fabry's disease, D: Lawrence Moon Biedl syndrome ### Response:

Answer is B (Alpo's syndrome): Alpo's syndrome is an inherited disorder characterized by hereditary nephritis, sensorineural deafness and ocular abnormalities paicularly lenticonus.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Association of deafness & nephritis is seen in, with the following options: A: Pickwickian syndrome, B: Alpo's syndrome, C: Fabry's disease, D: Lawrence Moon Biedl syndrome ### Response: Answer is B (Alpo's syndrome): Alpo's syndrome is an inherited disorder characterized by hereditary nephritis, sensorineural deafness and ocular abnormalities paicularly lenticonus. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Stimulation of horizontal semicircular canal causes nystagmus in which directions -, with the following options: A: Vertical, B: Horizontal, C: Rotary, D: Any of thethree ### Response:

Ans. is 'b' i.e., Horizontalo The cupulae of the semicircular canals are stimulated by movement of endolymphatic fluid and each canal causes the nystagmus in its own planeStimulation of horizontal SCC - Horizontal nystagmus.Stimulation of superior SCC - Rotary nystagmus.Stimulation of vertical SCC - Vertical nystagmus

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Stimulation of horizontal semicircular canal causes nystagmus in which directions -, with the following options: A: Vertical, B: Horizontal, C: Rotary, D: Any of thethree ### Response: Ans. is 'b' i.e., Horizontalo The cupulae of the semicircular canals are stimulated by movement of endolymphatic fluid and each canal causes the nystagmus in its own planeStimulation of horizontal SCC - Horizontal nystagmus.Stimulation of superior SCC - Rotary nystagmus.Stimulation of vertical SCC - Vertical nystagmus ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Dystrophic calcification is seen in ?, with the following options: A: Milk alkali syndrome, B: Atheromatous plaque, C: Hyperparathyroidism, D: Vitamin A intoxication ### Response:

Ans. is 'b' i.e., Atheromatous plaqueDystrophic calcification o When pathological calcification takes place in dead, dying or degenerated tissue, it is called dystrophic calcification. o Calcium metabolism is not altered and serum calcium level is normal.Dystrophic calcification in dead tissues1.In caseous necrosis of tuberculosis(most common which may be in lymph nodes)2.Chronic abscess in liquifactive necrosis3.Fungal granuloma4.Infarct5.Thrombi6.Haematomas7.Dead parasites-Cystecercosis/Toxoplasma Hydatid/Schistosoma8.In fat necrosis of breast & other tissuesDystrophic calcification in degenerated tissuesAtheromatous plagueMonkeberg's sclerosisPsommama bodiesDens old scarsSenile degenrated changes such as in costal cailage, tracheal, bronchial rings, Pineal gland in brain.Hea valves damaged by rheumatic fever.How does calcification occurs in these site with normal serum calcium ?o Calcification of dead and dying cells and tissues is a common finding in human pathologic conditions. o Denatured proteins in dead or irreversible damaged tissues preferentially bind phosphate ions. o Phosphate ions react with calcium ions to form a precipitate or calcium phosphate.o Thus, necrotic tissue serves as a calcium sink.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Dystrophic calcification is seen in ?, with the following options: A: Milk alkali syndrome, B: Atheromatous plaque, C: Hyperparathyroidism, D: Vitamin A intoxication ### Response: Ans. is 'b' i.e., Atheromatous plaqueDystrophic calcification o When pathological calcification takes place in dead, dying or degenerated tissue, it is called dystrophic calcification. o Calcium metabolism is not altered and serum calcium level is normal.Dystrophic calcification in dead tissues1.In caseous necrosis of tuberculosis(most common which may be in lymph nodes)2.Chronic abscess in liquifactive necrosis3.Fungal granuloma4.Infarct5.Thrombi6.Haematomas7.Dead parasites-Cystecercosis/Toxoplasma Hydatid/Schistosoma8.In fat necrosis of breast & other tissuesDystrophic calcification in degenerated tissuesAtheromatous plagueMonkeberg's sclerosisPsommama bodiesDens old scarsSenile degenrated changes such as in costal cailage, tracheal, bronchial rings, Pineal gland in brain.Hea valves damaged by rheumatic fever.How does calcification occurs in these site with normal serum calcium ?o Calcification of dead and dying cells and tissues is a common finding in human pathologic conditions. o Denatured proteins in dead or irreversible damaged tissues preferentially bind phosphate ions. o Phosphate ions react with calcium ions to form a precipitate or calcium phosphate.o Thus, necrotic tissue serves as a calcium sink. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 27-year-old woman occasionally uses calcium carbonate (Turns) for "heartburn" symptoms after a large meal.For the above patient with an acid-peptic disorder, select the mechanism of action of the prescribed medication., with the following options: A: neutralizes gastric acid, B: works by binding to cysteine, C: inhibits gastrin release, D: irreversible H1-receptor blockade ### Response:

Although doctors seldom prescribe antacids because of the availability of superior medications, patients still use them extensively. As well as neutralizing acid, calcium carbonate enhances secretion in the stomach. The release of CO2 from bicarbonate can result in belching, nausea, and abdominal distension. Belching can exacerbate gastroesophageal reflex.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 27-year-old woman occasionally uses calcium carbonate (Turns) for "heartburn" symptoms after a large meal.For the above patient with an acid-peptic disorder, select the mechanism of action of the prescribed medication., with the following options: A: neutralizes gastric acid, B: works by binding to cysteine, C: inhibits gastrin release, D: irreversible H1-receptor blockade ### Response: Although doctors seldom prescribe antacids because of the availability of superior medications, patients still use them extensively. As well as neutralizing acid, calcium carbonate enhances secretion in the stomach. The release of CO2 from bicarbonate can result in belching, nausea, and abdominal distension. Belching can exacerbate gastroesophageal reflex. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Aery piercing the oblique popliteal ligament of knee -, with the following options: A: Superior genicular, B: Inferior genicular, C: Middle genicular, D: Popliteal ### Response:

Middle genicular Oblique popliteal ligament is an expansion from the tendon of semimembranosus attachment to intercondylar line of femur. It is closely related to popliteal aery and is pierced by middle genicular vessels and nerve and the terminal pa of the posterior division of the obturator nerve.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Aery piercing the oblique popliteal ligament of knee -, with the following options: A: Superior genicular, B: Inferior genicular, C: Middle genicular, D: Popliteal ### Response: Middle genicular Oblique popliteal ligament is an expansion from the tendon of semimembranosus attachment to intercondylar line of femur. It is closely related to popliteal aery and is pierced by middle genicular vessels and nerve and the terminal pa of the posterior division of the obturator nerve. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A Protein estimation test is confused with, with the following options: A: Phosphates, B: Nitrates, C: Sulphates, D: Bile salts ### Response:

On heating the urine, turbidity arises if proteins are present. However, turbidity also arises if phosphates or carbonates are present in urine. This can leads to confusion. Addition of few drops of acetic acid dissolves the turbidity due to phosphates or carbonates, whereas turbidity due to proteins remains persistent.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A Protein estimation test is confused with, with the following options: A: Phosphates, B: Nitrates, C: Sulphates, D: Bile salts ### Response: On heating the urine, turbidity arises if proteins are present. However, turbidity also arises if phosphates or carbonates are present in urine. This can leads to confusion. Addition of few drops of acetic acid dissolves the turbidity due to phosphates or carbonates, whereas turbidity due to proteins remains persistent. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A young male presented with abdominal pain for the past 2 years. He also complains of weakness in his hands. His hemoblobin level was 8 gm/dL. The most likely diagnosis:, with the following options: A: Lead poisoning, B: Duodenal ulcer, C: Carcinoma stomach, D: Adenomatous polyposis coli ### Response:

Ans. a. Lead poisoning (Ref: Parikh 6/e p9.22; Reddy 33/e p544, 31st/e p506-508)The most likely diagnosis in a young male who presented with abdominal pain for the past 2 years with complains of weakness in his hands and hemoblobin level of 8 gm/dL is lead poisoning.Lead poisoningMetallic lead and all its salts are poisonous.Principal toxic salts of Lead* Lead acetateQ (Saturn salt or sugar of lead)* Lead carbonateQ (safeda)* Lead chromateQ* Lead tetra oxide (red lead, vermillion, sindur)* Lead mono oxide (litharge)* Lead sulphide (Least toxic)At cellular level lead interacts with sulfhydryl groups and interferes in action of enzymes essential for heme synthesis, thus for hemoglobin and cytochrome production. It causes hemolysisQ.Fatal dose:Lead acetate: 20 gm; Lead carbonate: 40 gmFatal period: 1-2 daysSigns and symptoms of Lead PoisoningAcute PoisoningChronic Lead Poisoning (Plumbism, saturnism)* Astringent or metallic taste* Dry throat and thirst* Abdominal painQ, nausea and vomiting, sometimes diarrhea.* Peripheral circulatory collapseQ* Headache, weakness, insomnia, paresthesia, depression, coma and death.* Cerebellar ataxia is common in children in acute lead poisoningQ* Facial pallor Earliest and most consistent signQ* Weakness* Punctate basophilic or basophilic stipplingQ* Lead line (Burtonian lines in gums)Q* Colic (Dry belly ache)Q and constipation is late symptomQ* Sterility in males and females.* Wrist drop and foot dropQ* Vasoconstriction leads to hypertension and arteriolar degenerationQ* Lead encephalopathyQDiagnosis:Porphyrinuria (mainly due to coproporphyrin III inhibition)Stood testsUrine tests* >200 punctate basophilia stippling cells /mm3 is diagnosticQ* Zinc protoporphyrin and free erythrocyte protoporphyrin > 50mg/100mlQ* Increased lead and aminolaevulinic acid (>25mg/100ml)Q* Increased coproporphyrin (CPU) levels. In nonexposed person it is <150mg /literQ* Aminolaevulinic acid > 5mg* Presence of 0.25mg lead/liter is diagnosticQX-ray: Radiopaque matter in GI tract (ingested < 48 hours): Radio-opaque bands /lines at metaphysis of long bones in childrenQTreatment:Gastric lavage with 1% solution of sodium or magnesium sulphateQChelating agent: BAL, DMSAMost effective antidote: Calcium Disodium VersenateQIntravenous calcium chloride causes deposition of lead in skeleton from bloodQ.Peritoneal or hemodialysis.Symptomatic treatmentChronic Lead Poisoning presents with "New-A B C D E F"New* Neuropathy (leading to weakness, wrist drop) and NephropathyQ (Late feature)A* Anemia with punctate basophilia (i.e. basophilic stippling)Q (Early feature)B* Burtonian or blue stippled lead line on gumsQC* Colic (abdominal pain) and ConstipationQD* Dry belly ache i.e. diarrhea is very rareQ* Dyspepsia. Drop of wrist etc due to neuropathyQE* EncephalopathyQ, EosinophiliaF* Facial pallorQ (earliest sign)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A young male presented with abdominal pain for the past 2 years. He also complains of weakness in his hands. His hemoblobin level was 8 gm/dL. The most likely diagnosis:, with the following options: A: Lead poisoning, B: Duodenal ulcer, C: Carcinoma stomach, D: Adenomatous polyposis coli ### Response: Ans. a. Lead poisoning (Ref: Parikh 6/e p9.22; Reddy 33/e p544, 31st/e p506-508)The most likely diagnosis in a young male who presented with abdominal pain for the past 2 years with complains of weakness in his hands and hemoblobin level of 8 gm/dL is lead poisoning.Lead poisoningMetallic lead and all its salts are poisonous.Principal toxic salts of Lead* Lead acetateQ (Saturn salt or sugar of lead)* Lead carbonateQ (safeda)* Lead chromateQ* Lead tetra oxide (red lead, vermillion, sindur)* Lead mono oxide (litharge)* Lead sulphide (Least toxic)At cellular level lead interacts with sulfhydryl groups and interferes in action of enzymes essential for heme synthesis, thus for hemoglobin and cytochrome production. It causes hemolysisQ.Fatal dose:Lead acetate: 20 gm; Lead carbonate: 40 gmFatal period: 1-2 daysSigns and symptoms of Lead PoisoningAcute PoisoningChronic Lead Poisoning (Plumbism, saturnism)* Astringent or metallic taste* Dry throat and thirst* Abdominal painQ, nausea and vomiting, sometimes diarrhea.* Peripheral circulatory collapseQ* Headache, weakness, insomnia, paresthesia, depression, coma and death.* Cerebellar ataxia is common in children in acute lead poisoningQ* Facial pallor Earliest and most consistent signQ* Weakness* Punctate basophilic or basophilic stipplingQ* Lead line (Burtonian lines in gums)Q* Colic (Dry belly ache)Q and constipation is late symptomQ* Sterility in males and females.* Wrist drop and foot dropQ* Vasoconstriction leads to hypertension and arteriolar degenerationQ* Lead encephalopathyQDiagnosis:Porphyrinuria (mainly due to coproporphyrin III inhibition)Stood testsUrine tests* >200 punctate basophilia stippling cells /mm3 is diagnosticQ* Zinc protoporphyrin and free erythrocyte protoporphyrin > 50mg/100mlQ* Increased lead and aminolaevulinic acid (>25mg/100ml)Q* Increased coproporphyrin (CPU) levels. In nonexposed person it is <150mg /literQ* Aminolaevulinic acid > 5mg* Presence of 0.25mg lead/liter is diagnosticQX-ray: Radiopaque matter in GI tract (ingested < 48 hours): Radio-opaque bands /lines at metaphysis of long bones in childrenQTreatment:Gastric lavage with 1% solution of sodium or magnesium sulphateQChelating agent: BAL, DMSAMost effective antidote: Calcium Disodium VersenateQIntravenous calcium chloride causes deposition of lead in skeleton from bloodQ.Peritoneal or hemodialysis.Symptomatic treatmentChronic Lead Poisoning presents with "New-A B C D E F"New* Neuropathy (leading to weakness, wrist drop) and NephropathyQ (Late feature)A* Anemia with punctate basophilia (i.e. basophilic stippling)Q (Early feature)B* Burtonian or blue stippled lead line on gumsQC* Colic (abdominal pain) and ConstipationQD* Dry belly ache i.e. diarrhea is very rareQ* Dyspepsia. Drop of wrist etc due to neuropathyQE* EncephalopathyQ, EosinophiliaF* Facial pallorQ (earliest sign) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Benzodiazepine acts through which receptor:, with the following options: A: Chloride, B: GABA, C: NMDA, D: b adrenergic ### Response:

Ans: b (GABA) Ref: KDT, 6th ed, p. 395BZDs act by enhancing presynaptic/postsynaptic inhibition through a BZD receptor which is an integral part of the GABAA receptor-Cl- channel complex.They have GABA facilitatory action and no GABA mimetic action i.e. the BZD's increase the frequency of Cl channel opening induced by sub maximal concentrations of GABA and enhance GABA binding to GABAA receptor but they do not themselves increase Cl- conductance.Flumazenil is a competitive antagonist at BZD siteCarboline b - is an inverse agonist at BZD siteBicuculline - Competitive antagonist at GABAA receptorMuscimol - acts as agonist at GABAA site.Drugs active at the benzodiazepine receptor may be divided into four categories based on their elimination half-lives:(1) Ultra short acting: Midazolam(2) Short acting (t]/2 <6 hours): Triazolam, the nonbenzodiazepine zolpidem (t1/2 =2 hours) and zopiclone (t1/2 = 5-6 hours).(3) Intermediate-acting (t1/2 = 6-24 hours): Estazolam and temazepam.(4) long-acting (t1/2 >24 hours):Flurazepam, diazepam, and quazepam.Flurazepam has the longest half life of 50-100 hrs.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Benzodiazepine acts through which receptor:, with the following options: A: Chloride, B: GABA, C: NMDA, D: b adrenergic ### Response: Ans: b (GABA) Ref: KDT, 6th ed, p. 395BZDs act by enhancing presynaptic/postsynaptic inhibition through a BZD receptor which is an integral part of the GABAA receptor-Cl- channel complex.They have GABA facilitatory action and no GABA mimetic action i.e. the BZD's increase the frequency of Cl channel opening induced by sub maximal concentrations of GABA and enhance GABA binding to GABAA receptor but they do not themselves increase Cl- conductance.Flumazenil is a competitive antagonist at BZD siteCarboline b - is an inverse agonist at BZD siteBicuculline - Competitive antagonist at GABAA receptorMuscimol - acts as agonist at GABAA site.Drugs active at the benzodiazepine receptor may be divided into four categories based on their elimination half-lives:(1) Ultra short acting: Midazolam(2) Short acting (t]/2 <6 hours): Triazolam, the nonbenzodiazepine zolpidem (t1/2 =2 hours) and zopiclone (t1/2 = 5-6 hours).(3) Intermediate-acting (t1/2 = 6-24 hours): Estazolam and temazepam.(4) long-acting (t1/2 >24 hours):Flurazepam, diazepam, and quazepam.Flurazepam has the longest half life of 50-100 hrs. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Rituximab is used for treatment of -, with the following options: A: RA, B: Crohn's disease, C: Non-Hodgkinscc lymphoma, D: Colorectal carcinoma ### Response:

Ans. is 'c' i.e., Non-Hodgkins lymphoma

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Rituximab is used for treatment of -, with the following options: A: RA, B: Crohn's disease, C: Non-Hodgkinscc lymphoma, D: Colorectal carcinoma ### Response: Ans. is 'c' i.e., Non-Hodgkins lymphoma ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Metabolic alkalosis is seen in-, with the following options: A: Primary mineralocoicoid excess, B: Deficiency of mineralocoicoid, C: Decreased acid excretion, D: Decreased base excretion ### Response:

Mineralocoicoid excess increases net acid excretion and may result in metabolic alkalosis, which may be worsened by associated K+ deficiency. ECFV expansion from salt retention causes hypeension. The kaliuresis persists because of mineralocoicoid excess and distal Na+ absorption causing enhanced K+ excretion, continued K+ depletion with polydipsia, inability to concentrate the urine, and polyuria.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Metabolic alkalosis is seen in-, with the following options: A: Primary mineralocoicoid excess, B: Deficiency of mineralocoicoid, C: Decreased acid excretion, D: Decreased base excretion ### Response: Mineralocoicoid excess increases net acid excretion and may result in metabolic alkalosis, which may be worsened by associated K+ deficiency. ECFV expansion from salt retention causes hypeension. The kaliuresis persists because of mineralocoicoid excess and distal Na+ absorption causing enhanced K+ excretion, continued K+ depletion with polydipsia, inability to concentrate the urine, and polyuria. ### 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 bell's palsy is/are -a) Most common cause of facial palsyb) Associated with tinnitus & vertigoc) Crocodile tears & synkinesisd) No role of steroids, with the following options: A: a, B: bc, C: ad, D: ac ### Response:

Bell's palsy is the most common cause of facial palsy. Synkinesis and crocodile tear are sequelae of Bell's palsy.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: True about bell's palsy is/are -a) Most common cause of facial palsyb) Associated with tinnitus & vertigoc) Crocodile tears & synkinesisd) No role of steroids, with the following options: A: a, B: bc, C: ad, D: ac ### Response: Bell's palsy is the most common cause of facial palsy. Synkinesis and crocodile tear are sequelae of Bell's palsy. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In the setting of G-proteins which of the following is considered a third messenger :, with the following options: A: cAMP., B: Calcium., C: CO., D: NO. ### Response:

Calcium is considered as a third messenger.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In the setting of G-proteins which of the following is considered a third messenger :, with the following options: A: cAMP., B: Calcium., C: CO., D: NO. ### Response: Calcium is considered as a third messenger. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which is long acting glucocarticoid-, with the following options: A: Hydrocartisone, B: Prednisolone, C: Cortisol, D: Dexamethasone ### Response:

Ans. is 'd' i.e., Dexamethasone o Short acting glucocorticoids (t 1/2 : 8-12 hrs.) : Cortisol, hydrocortisone.o Intermediate acting glucocorticoids (t 1/2 : 12-36 hrs.) : Prednisolone, methylprednisolone, triamcinoloneo Long acting glucocorticoids (t 1/2 : 36-54 hrs.) : Dexamethasone ,betamethasone.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which is long acting glucocarticoid-, with the following options: A: Hydrocartisone, B: Prednisolone, C: Cortisol, D: Dexamethasone ### Response: Ans. is 'd' i.e., Dexamethasone o Short acting glucocorticoids (t 1/2 : 8-12 hrs.) : Cortisol, hydrocortisone.o Intermediate acting glucocorticoids (t 1/2 : 12-36 hrs.) : Prednisolone, methylprednisolone, triamcinoloneo Long acting glucocorticoids (t 1/2 : 36-54 hrs.) : Dexamethasone ,betamethasone. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pyridoxine is involved in, with the following options: A: Carboxylation, B: Trans-sulfuration, C: Oxidation-reduction, D: Transketolation ### Response:

Pyridoxine is involved in trans-sulfuration.Sulfur-Containing Amino Acids PLP plays an impoant role in methionine and cysteine metabolism. a.Homocysteine + Serine - Cystathionine. (Enzyme Cystathionine synthase) b.Cystathionine - Homoserine + Cysteine (Enzyme Cystathionase) Both these reactions require PLP. Here transfer of sulphur group occurs.Ref: DM Vasudevan - Textbook of Biochemistry, 6th edition, page no: 396

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Pyridoxine is involved in, with the following options: A: Carboxylation, B: Trans-sulfuration, C: Oxidation-reduction, D: Transketolation ### Response: Pyridoxine is involved in trans-sulfuration.Sulfur-Containing Amino Acids PLP plays an impoant role in methionine and cysteine metabolism. a.Homocysteine + Serine - Cystathionine. (Enzyme Cystathionine synthase) b.Cystathionine - Homoserine + Cysteine (Enzyme Cystathionase) Both these reactions require PLP. Here transfer of sulphur group occurs.Ref: DM Vasudevan - Textbook of Biochemistry, 6th edition, page no: 396 ### 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 death in criminal abortion is?, with the following options: A: Hemorrhage, B: Sepsis, C: Air embolism, D: Perforation ### Response:

ANSWER: (B) SepsisREF: Forensic Medicine and Toxicology By R.N.Karmakar page 230, Textbook of Forensic Medicine and Toxicology, Krishan Vij 5th ed fig 26.2The most common complication from illegal abortion is retained product of conception; the most frequent cause of death is infection and sepsis.NATURAL VS CRIMINAL ABORTION Natural abortionCriminal abortionCauseSpontaneousInducedPrecipitating factorMaternal or fetal diseaseUnwanted pregnancyEvidence of genital violenceAbsentPresentForeign body from genitalsAbsentMay be presentToxic effect of drugAbsentMay be presentFetal injuryAbsentRarely present

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 death in criminal abortion is?, with the following options: A: Hemorrhage, B: Sepsis, C: Air embolism, D: Perforation ### Response: ANSWER: (B) SepsisREF: Forensic Medicine and Toxicology By R.N.Karmakar page 230, Textbook of Forensic Medicine and Toxicology, Krishan Vij 5th ed fig 26.2The most common complication from illegal abortion is retained product of conception; the most frequent cause of death is infection and sepsis.NATURAL VS CRIMINAL ABORTION Natural abortionCriminal abortionCauseSpontaneousInducedPrecipitating factorMaternal or fetal diseaseUnwanted pregnancyEvidence of genital violenceAbsentPresentForeign body from genitalsAbsentMay be presentToxic effect of drugAbsentMay be presentFetal injuryAbsentRarely present ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Staphylococcus differes from streptococcus by -, with the following options: A: Coagulase test, B: Catalase test, C: Phasphatase, D: Gram negative ### Response:

Ans. is 'b' i.e., Catalase test * Coagulase test is used to differentiate the different species of staphylococci (staph aureus, staph, epidermidis).* Catalase test is used to differentiate staphylococci from streptococci.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Staphylococcus differes from streptococcus by -, with the following options: A: Coagulase test, B: Catalase test, C: Phasphatase, D: Gram negative ### Response: Ans. is 'b' i.e., Catalase test * Coagulase test is used to differentiate the different species of staphylococci (staph aureus, staph, epidermidis).* Catalase test is used to differentiate staphylococci from streptococci. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A middle aged man complains of upper abdominal pain after a heavy meal. There is tenderness in the upper abdomen and on X-ray, widening of the mediastinum is seen with pneumo-mediastinum. What is the diagnosis?, with the following options: A: Spontaneous perforation of the esophagus, B: Perforated peptic ulcer, C: Foreign body in esophagus, D: Rupture of emphysematous bulla ### Response:

Above clinical scenario is suggestive of diagnosis of spontaneous perforation of the esophagus. Aka BOERHAAVE Syndrome - Caused by Forceful vomiting Repeated vomiting - Clinical features - Characterized byMackler's triad Thoracic Pain Vomiting Cervical subcutaneous emphysema Investigation - On CXR - Hydropneumothorax - IOC for Dx - Water soluble contrast esophagogram (Gastrograffin > Hypaque)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A middle aged man complains of upper abdominal pain after a heavy meal. There is tenderness in the upper abdomen and on X-ray, widening of the mediastinum is seen with pneumo-mediastinum. What is the diagnosis?, with the following options: A: Spontaneous perforation of the esophagus, B: Perforated peptic ulcer, C: Foreign body in esophagus, D: Rupture of emphysematous bulla ### Response: Above clinical scenario is suggestive of diagnosis of spontaneous perforation of the esophagus. Aka BOERHAAVE Syndrome - Caused by Forceful vomiting Repeated vomiting - Clinical features - Characterized byMackler's triad Thoracic Pain Vomiting Cervical subcutaneous emphysema Investigation - On CXR - Hydropneumothorax - IOC for Dx - Water soluble contrast esophagogram (Gastrograffin > Hypaque) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 60-year-old retired banker complains of feeling dizzy with palpitations and breathlessness. His BP becomes un-recordable while ECG is being recorded. What should be the first step in the management of this patient?, with the following options: A: IV Amiodarone 150mg, B: IV Lasix 40mg, C: Cardioversion, D: IV lignocaine ### Response:

ECG shows broad complex QRS tachycardia diagnostic of Ventricular tachycardia (MONOMORPHIC). Since the BP of the patient is crashing-Pt unstable - Rx- Cardioversion-DC Shock

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 60-year-old retired banker complains of feeling dizzy with palpitations and breathlessness. His BP becomes un-recordable while ECG is being recorded. What should be the first step in the management of this patient?, with the following options: A: IV Amiodarone 150mg, B: IV Lasix 40mg, C: Cardioversion, D: IV lignocaine ### Response: ECG shows broad complex QRS tachycardia diagnostic of Ventricular tachycardia (MONOMORPHIC). Since the BP of the patient is crashing-Pt unstable - Rx- Cardioversion-DC Shock ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Nephrogenic diabetes insipidus is caused by all of the following except: March 2008, with the following options: A: Toxicity of lithium, B: Amyloidosis, C: Hypocalcemia, D: Hypokalemia ### Response:

Ans. C: Hypocalcemia Nephrogenic diabetes insipidus is characterized by a decrease in the ability to concentrate urine due to a resistance to ADH action in the kidney. The 24 hour urine volume is more than 50 mL/kg body weight and the osmolarity is less than 300 mosmol/ L. Nephrogenic diabetes insipidus can be observed in: Drugs: - Lithium toxicity - Demeclocycline - Methoxyflurane - Amphotericin B Metabolic Hypercalcemia, - Hypokalemia, iii. Infiltration: - Amyloidosis Tubulointerstitial diseas Rarely, diabetes insipidus may be hereditary

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Nephrogenic diabetes insipidus is caused by all of the following except: March 2008, with the following options: A: Toxicity of lithium, B: Amyloidosis, C: Hypocalcemia, D: Hypokalemia ### Response: Ans. C: Hypocalcemia Nephrogenic diabetes insipidus is characterized by a decrease in the ability to concentrate urine due to a resistance to ADH action in the kidney. The 24 hour urine volume is more than 50 mL/kg body weight and the osmolarity is less than 300 mosmol/ L. Nephrogenic diabetes insipidus can be observed in: Drugs: - Lithium toxicity - Demeclocycline - Methoxyflurane - Amphotericin B Metabolic Hypercalcemia, - Hypokalemia, iii. Infiltration: - Amyloidosis Tubulointerstitial diseas Rarely, diabetes insipidus may be hereditary ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Lallo 40 years has recently staed writing books. But the matter in this book could not be understood by anybody since it contained words which were never there in any dictionary and the theme was very disjoint. Now adays he has become very shy and self absorbed. When he addresses people he speaks about metaphilosophical ideas. What is likely diagnosis, with the following options: A: Mania, B: Schizophrenia, C: A genius writer, D: Delusional disorder ### Response:

B i.e. Schizophrenia

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Lallo 40 years has recently staed writing books. But the matter in this book could not be understood by anybody since it contained words which were never there in any dictionary and the theme was very disjoint. Now adays he has become very shy and self absorbed. When he addresses people he speaks about metaphilosophical ideas. What is likely diagnosis, with the following options: A: Mania, B: Schizophrenia, C: A genius writer, D: Delusional disorder ### Response: B i.e. Schizophrenia ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A disease has 3 time more incidence in females as compared to males, with same prevalence in both males and females. TRUE statement is - AIIMS 99, with the following options: A: Increase fatality in women, B: More survival in women, C: Better prognosis in men, D: Less fatality in man ### Response:

ref: Park&;s 23rd edition pg 61 Here, incidence in females is 3times that of males. So, we expect such an increase in prevalence of that same disease in females. But, it is given, prevalence in males and females are the same. This means that the affected females donot survive as much as the affected males. This shows that disease has increased fatality in females. note: Prognosis depends on prevalence. As prevaleance is same, prognosis is also same in both. Incidence reflects the causal factors

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A disease has 3 time more incidence in females as compared to males, with same prevalence in both males and females. TRUE statement is - AIIMS 99, with the following options: A: Increase fatality in women, B: More survival in women, C: Better prognosis in men, D: Less fatality in man ### Response: ref: Park&;s 23rd edition pg 61 Here, incidence in females is 3times that of males. So, we expect such an increase in prevalence of that same disease in females. But, it is given, prevalence in males and females are the same. This means that the affected females donot survive as much as the affected males. This shows that disease has increased fatality in females. note: Prognosis depends on prevalence. As prevaleance is same, prognosis is also same in both. Incidence reflects the causal factors ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Landmark which is immune to surface deposition and resorption:, with the following options: A: Xi point and Eva point, B: Point A and Point B, C: Porion and Basion, D: Pogonion and Gnathion ### Response:

Arcial growth of mandible: Proposed by Ricketts. The advantage was that the arc of growth can be constructed for every individual depending on the length of the core of the mandible. In order to locate the central core, which is immune to surface deposition and resorption, he introduced 2 landmarks - Xi point and Eva point on the mandibular ramus. Xi Point: Represents geometric centre of ramus. Eva point: In dried mandible, the stress lines run on the medial aspect parallel to the external oblique ridge and ascend up the ramus. The stress lines fork into two at a  particular point that was named as Eva point. Ref: Shreedhar Premkumar 1st edition P:199

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Landmark which is immune to surface deposition and resorption:, with the following options: A: Xi point and Eva point, B: Point A and Point B, C: Porion and Basion, D: Pogonion and Gnathion ### Response: Arcial growth of mandible: Proposed by Ricketts. The advantage was that the arc of growth can be constructed for every individual depending on the length of the core of the mandible. In order to locate the central core, which is immune to surface deposition and resorption, he introduced 2 landmarks - Xi point and Eva point on the mandibular ramus. Xi Point: Represents geometric centre of ramus. Eva point: In dried mandible, the stress lines run on the medial aspect parallel to the external oblique ridge and ascend up the ramus. The stress lines fork into two at a  particular point that was named as Eva point. Ref: Shreedhar Premkumar 1st edition P:199 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Blood in urine in a patient in labour, with history of previous LSCS, diagnosis is:aEUR', with the following options: A: Impending scar rupture, B: Urethral injury, C: Obstructed labour, D: Cystitis ### Response:

Obstructed labour /Ref. Dutta 6th/c p 405]

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Blood in urine in a patient in labour, with history of previous LSCS, diagnosis is:aEUR', with the following options: A: Impending scar rupture, B: Urethral injury, C: Obstructed labour, D: Cystitis ### Response: Obstructed labour /Ref. Dutta 6th/c p 405] ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Color of oxygen cylinder is:, with the following options: A: Black with white color, B: Blue with white color, C: Yellow with white color, D: White ### Response:

ANSWER: (A) Black with white colorREF: Fundamentals of Anesthesia, Tim Smith Colin Pinnock Ted Lin, 3rd Ed, p830SubstanceColour codingCylinderShoulderOxygenblackwhiteNitrous oxideblueblueEntonox gasblueWhite/blueAirblackWhite/blackCarbon dioxidegreygrey

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Color of oxygen cylinder is:, with the following options: A: Black with white color, B: Blue with white color, C: Yellow with white color, D: White ### Response: ANSWER: (A) Black with white colorREF: Fundamentals of Anesthesia, Tim Smith Colin Pinnock Ted Lin, 3rd Ed, p830SubstanceColour codingCylinderShoulderOxygenblackwhiteNitrous oxideblueblueEntonox gasblueWhite/blueAirblackWhite/blackCarbon dioxidegreygrey ### End