Datasets:

jesse-tong

/

medqa

like 0

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Indication of caesarean section after previous caesarean section is?, with the following options: A: Hypertension, B: Type 1 placenta previa, C: CPD, D: Multigravida ### Response:

ANSWER: (C) CPDREF: Dutta 6th ed page 589See previous question for explanation

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Indication of caesarean section after previous caesarean section is?, with the following options: A: Hypertension, B: Type 1 placenta previa, C: CPD, D: Multigravida ### Response: ANSWER: (C) CPDREF: Dutta 6th ed page 589See previous question for explanation ### 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 a prosthetic hea valve develops endocarditis eight months after Valve replacement. Most likely organisms responsible is, with the following options: A: Staphylococcus aureus, B: Streptococcus Viridians, C: Salmonella faecalis, D: HACEK Group ### Response:

Ref Harrison 19 th ed pg 816 Prosthetic valve endocarditis (PVE) arising within 2 months of valve surgery is generally nosocomial, the result of intraoperative contami- nation of the prosthesis or a bacteremic postoperative complication. This nosocomial origin is reflected in the primary microbial causes: S. aureus, CoNS, facultative gram-negative bacilli, diphtheroids, and fungi. The poals of entry and organisms causing cases beginning >12 months after surgery are similar to those in community-acquired NVE. PVE due to CoNS that presents 2-12 months after surgery often represents delayed-onset nosocomial infection. Regardless of the time of onset after surgery, at least 68-85% of CoNS strains that cause PVE are resistant to methicillin.

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 a prosthetic hea valve develops endocarditis eight months after Valve replacement. Most likely organisms responsible is, with the following options: A: Staphylococcus aureus, B: Streptococcus Viridians, C: Salmonella faecalis, D: HACEK Group ### Response: Ref Harrison 19 th ed pg 816 Prosthetic valve endocarditis (PVE) arising within 2 months of valve surgery is generally nosocomial, the result of intraoperative contami- nation of the prosthesis or a bacteremic postoperative complication. This nosocomial origin is reflected in the primary microbial causes: S. aureus, CoNS, facultative gram-negative bacilli, diphtheroids, and fungi. The poals of entry and organisms causing cases beginning >12 months after surgery are similar to those in community-acquired NVE. PVE due to CoNS that presents 2-12 months after surgery often represents delayed-onset nosocomial infection. Regardless of the time of onset after surgery, at least 68-85% of CoNS strains that cause PVE are resistant to methicillin. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Serum enzyme used for MI, with the following options: A: CK, B: Alkaline phophatase, C: Acid phosphatase, D: Lipase ### Response:

The enzymes routinely measured in the clinical laboratory for the purpose of diagnosing and monitoring myocardial infarction include creatine kinase (CK), aspaate aminotransferase (sGOT or AST), and lactate dehydrogenase (LDH).

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Serum enzyme used for MI, with the following options: A: CK, B: Alkaline phophatase, C: Acid phosphatase, D: Lipase ### Response: The enzymes routinely measured in the clinical laboratory for the purpose of diagnosing and monitoring myocardial infarction include creatine kinase (CK), aspaate aminotransferase (sGOT or AST), and lactate dehydrogenase (LDH). ### 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 site for extra-pelvic endometriosis, with the following options: A: Rectum, B: Sigmoid colon, C: Duodenum, D: Jejunum ### Response:

Most common site for extra-pelvic endometriosis is gastro-intestinal system i.e., sigmoid colon> Rectum.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common site for extra-pelvic endometriosis, with the following options: A: Rectum, B: Sigmoid colon, C: Duodenum, D: Jejunum ### Response: Most common site for extra-pelvic endometriosis is gastro-intestinal system i.e., sigmoid colon> Rectum. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A lady with abdominal mass was investigated. She was found to have bilateral ovarian masses with smooth surface. On microscopy they revealed cells with signet ring shapes. Diagnosis is-, with the following options: A: Dysgerminoma, B: Krukenberg tumour, C: Primary Adenocarcinoma of the ovaries, D: Epithelial ovarian tumour ### Response:

Ans. is 'b' i.e., Krukenberg tumour Krukenberg Tumor* Accounts for 30-40% of metastatic CAs to the ovary.* Arises in the ovarian stroma and has characteristic mucin-filled signet ring cells.* The primary is most frequently located in the stomach and less commonly in the colon, breast, or biliary tract. Rarely, the cervix and bladder may be the primary site.* They are usually bilateral and discovered when the primary is well advanced and hence survival is very poor.* Treatment of primary carcinoma does not revert to Krukenberg tumor.* The ovaries are enlarged and have a smooth surface.* The shape of the ovary is maintained.* There is no tendency of adhesion and the capsule remains intact.* Cut surface shows waxy consistency with cystic spaces due to degeneration.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A lady with abdominal mass was investigated. She was found to have bilateral ovarian masses with smooth surface. On microscopy they revealed cells with signet ring shapes. Diagnosis is-, with the following options: A: Dysgerminoma, B: Krukenberg tumour, C: Primary Adenocarcinoma of the ovaries, D: Epithelial ovarian tumour ### Response: Ans. is 'b' i.e., Krukenberg tumour Krukenberg Tumor* Accounts for 30-40% of metastatic CAs to the ovary.* Arises in the ovarian stroma and has characteristic mucin-filled signet ring cells.* The primary is most frequently located in the stomach and less commonly in the colon, breast, or biliary tract. Rarely, the cervix and bladder may be the primary site.* They are usually bilateral and discovered when the primary is well advanced and hence survival is very poor.* Treatment of primary carcinoma does not revert to Krukenberg tumor.* The ovaries are enlarged and have a smooth surface.* The shape of the ovary is maintained.* There is no tendency of adhesion and the capsule remains intact.* Cut surface shows waxy consistency with cystic spaces due to degeneration. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which amongst the following antimicrobials exhibits a long post antibiotic effect -, with the following options: A: Quinolones, B: Macrolides, C: Beta-lactams, D: Oxazolidinones ### Response:

Ans. is 'a' i.e., Quinoones o Post-antibiotic effect is seen with quinolones (fluoroquinolones) and aminoglycosides.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which amongst the following antimicrobials exhibits a long post antibiotic effect -, with the following options: A: Quinolones, B: Macrolides, C: Beta-lactams, D: Oxazolidinones ### Response: Ans. is 'a' i.e., Quinoones o Post-antibiotic effect is seen with quinolones (fluoroquinolones) and aminoglycosides. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Alvarado scoring in appendicitis includes all expect:, with the following options: A: Migratory right iliac fossa pain, B: Nausea, C: Elevated temperature, D: Leucopenia ### Response:

Alvarado (MANTRELS) scores Manifestation Score Symptoms Migratory RIF pain Anorexia Nausea and vomiting 1 1 1 Signs Tenderness (RIF) Rebound tenderness Elevated temperature 2 1 1 Laboratory Leuocytosis Shift to left 2 1 Total 10 Scores Prediction 9-10 Appendicitis is ceain 7-8 High likelihood of appendicitis 5-6 Equivocal 1-4 Appendicitis can be ruled out

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Alvarado scoring in appendicitis includes all expect:, with the following options: A: Migratory right iliac fossa pain, B: Nausea, C: Elevated temperature, D: Leucopenia ### Response: Alvarado (MANTRELS) scores Manifestation Score Symptoms Migratory RIF pain Anorexia Nausea and vomiting 1 1 1 Signs Tenderness (RIF) Rebound tenderness Elevated temperature 2 1 1 Laboratory Leuocytosis Shift to left 2 1 Total 10 Scores Prediction 9-10 Appendicitis is ceain 7-8 High likelihood of appendicitis 5-6 Equivocal 1-4 Appendicitis can be ruled out ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Fluid used in hypovolemic shock-, with the following options: A: RL, B: DNS, C: Blood, D: 5%Dextose ### Response:

Initial resuscitation requires rapid reexpansion of the circulating intravascular blood volume along with interventions to control ongoing losses. In accordance with Starling's law, stroke volume and cardiac output rise with the increase in preload. After resuscitation, the compliance of the ventricles.may remain reduced due to increased interstitial fluid in the myocardium. Therefore, elevated filling pressures are frequently required to maintain adequate ventricular performance. Volume resuscitation is initiated with the rapid infusion of either isotonic saline (although care must be taken to avoid hyperchloremic acidosis from loss of bicarbonate buffering capacity and replacement with excess chloride) or a balanced salt solution such as Ringer's lactate (being cognizant of the presence of potassium and potential renal dysfunction) through large-bore intravenous lines. Data, paicularly on severe traumatic brain injury (TBI), regarding benefits of small volumes of hypeonicsaline that more rapidly restore blood pressure are variable, but tend to show improved survival thought to be linked to immunomodulation. No distinct benefit from the use of colloid has been demonstrated, and in trauma patients it is associated with a higher moality, paicularly in patients with TBI. The infusion of 2-3 L of salt solution over 20-30 min should restore normal hemodynamic parameters. ref:harrison's principles of internal medicine,ed 18,pg no 2221

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Fluid used in hypovolemic shock-, with the following options: A: RL, B: DNS, C: Blood, D: 5%Dextose ### Response: Initial resuscitation requires rapid reexpansion of the circulating intravascular blood volume along with interventions to control ongoing losses. In accordance with Starling's law, stroke volume and cardiac output rise with the increase in preload. After resuscitation, the compliance of the ventricles.may remain reduced due to increased interstitial fluid in the myocardium. Therefore, elevated filling pressures are frequently required to maintain adequate ventricular performance. Volume resuscitation is initiated with the rapid infusion of either isotonic saline (although care must be taken to avoid hyperchloremic acidosis from loss of bicarbonate buffering capacity and replacement with excess chloride) or a balanced salt solution such as Ringer's lactate (being cognizant of the presence of potassium and potential renal dysfunction) through large-bore intravenous lines. Data, paicularly on severe traumatic brain injury (TBI), regarding benefits of small volumes of hypeonicsaline that more rapidly restore blood pressure are variable, but tend to show improved survival thought to be linked to immunomodulation. No distinct benefit from the use of colloid has been demonstrated, and in trauma patients it is associated with a higher moality, paicularly in patients with TBI. The infusion of 2-3 L of salt solution over 20-30 min should restore normal hemodynamic parameters. ref:harrison's principles of internal medicine,ed 18,pg no 2221 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Prostaglandin used in the treatment of peptic ulcer is, with the following options: A: Carboprost, B: Misoprostol, C: Dinoprost, D: Latanoprost ### Response:

Ans) b (Misoprosotol) Kef: KDT 6th ed p. 629Misoprostol is the prostaglandin analogue used in the treatment of peptic ulcer.DRUGS USED IN PEPTIC ULCER1) H2 antagonists-ranitidine, cimetidine, famotidine roxatidine and nizatidine.Nizatidine has little first-pass metabolism and a bioavailability of al-most 100%. Famotidine is the most potent among them.2) Proton pump inhibitors (PPIs)- omeprazole, lansoprazole, rabeprazole, pantoprazole, and esomeprazole. They are the most effective drugs in GERD.3) Mucosal protective agents-sucralfate, colloidal bismuth compounds4) Prostaglandin analogs-misoprostol5) Antacids6) Anticholinergics-Pirenzipine, propantheline7) Anti-H.pylori drugs -Amoxicillin, clarothromycin, metronidazole, tinidazole, tetracycline.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Prostaglandin used in the treatment of peptic ulcer is, with the following options: A: Carboprost, B: Misoprostol, C: Dinoprost, D: Latanoprost ### Response: Ans) b (Misoprosotol) Kef: KDT 6th ed p. 629Misoprostol is the prostaglandin analogue used in the treatment of peptic ulcer.DRUGS USED IN PEPTIC ULCER1) H2 antagonists-ranitidine, cimetidine, famotidine roxatidine and nizatidine.Nizatidine has little first-pass metabolism and a bioavailability of al-most 100%. Famotidine is the most potent among them.2) Proton pump inhibitors (PPIs)- omeprazole, lansoprazole, rabeprazole, pantoprazole, and esomeprazole. They are the most effective drugs in GERD.3) Mucosal protective agents-sucralfate, colloidal bismuth compounds4) Prostaglandin analogs-misoprostol5) Antacids6) Anticholinergics-Pirenzipine, propantheline7) Anti-H.pylori drugs -Amoxicillin, clarothromycin, metronidazole, tinidazole, tetracycline. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 17-year-old female presents with a pruritic rash around the wrist. Seen in, with the following options: A: Herpes simplex, B: Shingles, C: Contact dermatitis, D: Seborrheic dermatitis ### Response:

Contact dermatitis causes pruritic plaques or vesicles localized to an area of contact. In this case, a bracelet or wristband would be the inciting agent. Dermatitis may have vesicles with weeping lesions. The process is related to direct irritation of the skin from a chemical or physical irritant. It may also be immune-mediated Zoster would be painful and occur in a dermatomal distribution. Herpes simplex produces grouped vesicles, but they are painful and also unlikely to occur around the wrist. Seborrheic dermatitis presents as red, scaly lesions over a circular area with lesions developing in the nasolabial folds, scalp, and retroauricular areas. Ref Harrison 20th edition pg 1245

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 17-year-old female presents with a pruritic rash around the wrist. Seen in, with the following options: A: Herpes simplex, B: Shingles, C: Contact dermatitis, D: Seborrheic dermatitis ### Response: Contact dermatitis causes pruritic plaques or vesicles localized to an area of contact. In this case, a bracelet or wristband would be the inciting agent. Dermatitis may have vesicles with weeping lesions. The process is related to direct irritation of the skin from a chemical or physical irritant. It may also be immune-mediated Zoster would be painful and occur in a dermatomal distribution. Herpes simplex produces grouped vesicles, but they are painful and also unlikely to occur around the wrist. Seborrheic dermatitis presents as red, scaly lesions over a circular area with lesions developing in the nasolabial folds, scalp, and retroauricular areas. Ref Harrison 20th edition pg 1245 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 53 year old male who is a heavy alcoholic presents with 12 hour history of sharp central abdominal pain and vomiting. He prefers to sit up rather than lying fiat as pain increases on lying down. O/E he has mild jaundice. Temp - 38. 3deg C. Pulse 132/min BP 118/82 mm Hg. There is periumbilical discoloration and maximum tenderness in epigastrium. Diagnosis, with the following options: A: Acute pancreatitis, B: Pyelonephritis, C: Acute viral hepatitis, D: Perforated duodenal ulcer ### Response:

Ans. (a) Acute pancreatitisRef: Sabiston page 1525/20th edition* History of pain reduced on sitting with leaning forward is typical pancreatic pain.* Periumbilical discoloration = Cullen's signAll these favor more of acute pancreatitis

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 53 year old male who is a heavy alcoholic presents with 12 hour history of sharp central abdominal pain and vomiting. He prefers to sit up rather than lying fiat as pain increases on lying down. O/E he has mild jaundice. Temp - 38. 3deg C. Pulse 132/min BP 118/82 mm Hg. There is periumbilical discoloration and maximum tenderness in epigastrium. Diagnosis, with the following options: A: Acute pancreatitis, B: Pyelonephritis, C: Acute viral hepatitis, D: Perforated duodenal ulcer ### Response: Ans. (a) Acute pancreatitisRef: Sabiston page 1525/20th edition* History of pain reduced on sitting with leaning forward is typical pancreatic pain.* Periumbilical discoloration = Cullen's signAll these favor more of acute pancreatitis ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Optimal /effective duration of short course therapy for pulmonary TB is:, with the following options: A: 6 months, B: 9 months, C: 12 months, D: 18 months ### Response:

Ans: a (6 months) Ref: Park, 19th ed, p. 157Short course regimes of 6 months duration are highly effective, of low toxicity and well tolerated.These potent regimes are based on a initial intensive phase with four drugs--INH, rifampicin,Pyrizinamide, supplemented by either streptomycin or ethambutol for a period of 2 months, followed by 2 drugs in continuation phase.The treatment must be fully supervised and monitored mainly by bacteriological examination.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Optimal /effective duration of short course therapy for pulmonary TB is:, with the following options: A: 6 months, B: 9 months, C: 12 months, D: 18 months ### Response: Ans: a (6 months) Ref: Park, 19th ed, p. 157Short course regimes of 6 months duration are highly effective, of low toxicity and well tolerated.These potent regimes are based on a initial intensive phase with four drugs--INH, rifampicin,Pyrizinamide, supplemented by either streptomycin or ethambutol for a period of 2 months, followed by 2 drugs in continuation phase.The treatment must be fully supervised and monitored mainly by bacteriological examination. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A person suffers from B27 associated reactive ahritis, urethritis and conjunctivitis. Which is most likely organism involved in this case?, with the following options: A: Borrelia burgdorferi, B: Ureaplasma urealyticum, C: Beta-hemolytic streptococci, D: Streptococcus bovis ### Response:

Agents responsible for Reiter's syndrome: Salmonella enteritidis S. typhimurium S. heidelberg Yersinia enterocolitica Y. pseudotuberculosis Campylobacter fetus Shigella flexneri Genitourinary pathogens (such as Chlamydia or Ureaplasma urealyticum) Ref: Suurmond D. (2009). Section 14. The Skin in Immune, Autoimmune, and Rheumatic Disorders. In D. Suurmond (Ed), Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology, 6e.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A person suffers from B27 associated reactive ahritis, urethritis and conjunctivitis. Which is most likely organism involved in this case?, with the following options: A: Borrelia burgdorferi, B: Ureaplasma urealyticum, C: Beta-hemolytic streptococci, D: Streptococcus bovis ### Response: Agents responsible for Reiter's syndrome: Salmonella enteritidis S. typhimurium S. heidelberg Yersinia enterocolitica Y. pseudotuberculosis Campylobacter fetus Shigella flexneri Genitourinary pathogens (such as Chlamydia or Ureaplasma urealyticum) Ref: Suurmond D. (2009). Section 14. The Skin in Immune, Autoimmune, and Rheumatic Disorders. In D. Suurmond (Ed), Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology, 6e. ### 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 conditions are associated with molar pregnancy except :, with the following options: A: Pregnancy induced hypeension, B: Thyrotoxicosis, C: Gestational diabetes, D: Hyperemesis gravidarum ### Response:

Gestational diabetes

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The following conditions are associated with molar pregnancy except :, with the following options: A: Pregnancy induced hypeension, B: Thyrotoxicosis, C: Gestational diabetes, D: Hyperemesis gravidarum ### Response: Gestational diabetes ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Following drug is aromatase inhibitor:, with the following options: A: Raloxifine, B: Tamoxifen, C: Leuprolide, D: Letrozole ### Response:

Ans. D. Letrozoleletrozole, anastrozole are aromatase inhibitor which is enzyme responsible for estrogen synthesis, this drug is indicated in estrogen receptor positive breast cancer resistant to tamoxifen. It can also be given precocious puberty.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Following drug is aromatase inhibitor:, with the following options: A: Raloxifine, B: Tamoxifen, C: Leuprolide, D: Letrozole ### Response: Ans. D. Letrozoleletrozole, anastrozole are aromatase inhibitor which is enzyme responsible for estrogen synthesis, this drug is indicated in estrogen receptor positive breast cancer resistant to tamoxifen. It can also be given precocious puberty. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Deep branch of ulnar nerve innervates, with the following options: A: I and II lumbricals, B: Palmaris brevis, C: Dorsal interossei, D: Opponens pollicis ### Response:

There are twenty muscles in hands of which all are supplied by the ulnar nerve Except the following five muscles which are supplied by median nerve: 1 Abductor pollicis brevis 2. Flexor pollicis brevis (also often receives additional supply from the deep branch of ulnar nerve) 3. Opponens pollicis 4. First lumbrical 5. Second lumbrical Note: Palmaris Brevis is supplied by the superficial branch of the ulnar nerve. All interossei are supplied by the deep branch of ulnar nerve.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Deep branch of ulnar nerve innervates, with the following options: A: I and II lumbricals, B: Palmaris brevis, C: Dorsal interossei, D: Opponens pollicis ### Response: There are twenty muscles in hands of which all are supplied by the ulnar nerve Except the following five muscles which are supplied by median nerve: 1 Abductor pollicis brevis 2. Flexor pollicis brevis (also often receives additional supply from the deep branch of ulnar nerve) 3. Opponens pollicis 4. First lumbrical 5. Second lumbrical Note: Palmaris Brevis is supplied by the superficial branch of the ulnar nerve. All interossei are supplied by the deep branch of ulnar nerve. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: An 8 year old male patient complains of food lodgement with a history of previous restoration of the same tooth. Intra-oral examination reveals fractured Class II amalgam restoration with mandibular molar. Which of the following is not responsible for the fracture of restoration?, with the following options: A: Poor cavity design resulting in an insufficient bulk of material across the isthmus can lead to failure of even a high-strength alloy, B: Avoiding moisture contamination of amalgam, C: Non-compliance of the child with instructions to refrain from biting down hard on the freshly placed amalgam, D: Thin edges of restoration ### Response:

Moisture contamination of an amalgam restoration can promote failure. If zinc is present in the alloy, it will react with water, and hydrogen gas will be formed. As this gas builds up within the amalgam, a significant delayed expansion  can  occur  and  may  cause  protrusion  of  the amalgam  from  the  cavity  preparation,  which  enhances the possibility of fracture at the margins. If the restoration is improperly finished by the dentist, a thin ledge of amalgam may be left that extends slightly over the enamel at the margins. These thin edges of such a brittle material cannot support the forces of mastication. In time they fracture, leaving an opening at the margins. Poor cavity design resulting in an insufficient bulk of material across the isthmus can lead to failure of even a high-strength alloy. Unlike a resin matrix composite, amalgam gains strength slowly over the first 24 hours. Premature loading can result in minute fractures that are not apparent for weeks or even months. The use of a rapid-setting amalgam with a high 1-hour compressive  strength  should  be  considered  during  the treatment  of  a  pediatric  patient,  in  whom  compliance with instructions to refrain from biting down hard on the freshly placed amalgam is in question.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: An 8 year old male patient complains of food lodgement with a history of previous restoration of the same tooth. Intra-oral examination reveals fractured Class II amalgam restoration with mandibular molar. Which of the following is not responsible for the fracture of restoration?, with the following options: A: Poor cavity design resulting in an insufficient bulk of material across the isthmus can lead to failure of even a high-strength alloy, B: Avoiding moisture contamination of amalgam, C: Non-compliance of the child with instructions to refrain from biting down hard on the freshly placed amalgam, D: Thin edges of restoration ### Response: Moisture contamination of an amalgam restoration can promote failure. If zinc is present in the alloy, it will react with water, and hydrogen gas will be formed. As this gas builds up within the amalgam, a significant delayed expansion  can  occur  and  may  cause  protrusion  of  the amalgam  from  the  cavity  preparation,  which  enhances the possibility of fracture at the margins. If the restoration is improperly finished by the dentist, a thin ledge of amalgam may be left that extends slightly over the enamel at the margins. These thin edges of such a brittle material cannot support the forces of mastication. In time they fracture, leaving an opening at the margins. Poor cavity design resulting in an insufficient bulk of material across the isthmus can lead to failure of even a high-strength alloy. Unlike a resin matrix composite, amalgam gains strength slowly over the first 24 hours. Premature loading can result in minute fractures that are not apparent for weeks or even months. The use of a rapid-setting amalgam with a high 1-hour compressive  strength  should  be  considered  during  the treatment  of  a  pediatric  patient,  in  whom  compliance with instructions to refrain from biting down hard on the freshly placed amalgam is in question. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Respiratory rhythm nucleus-, with the following options: A: Pneumotaxic centre, B: Dorsal group of nucleus, C: Apneustic centre, D: Pre-Botzinger Complex ### Response:

Ans. is 'd' i.e., Pre-Botzinger Complex Important facts about the regulation of respiration o Medullary respiratory group of neurons are - i) Dorsal respiratory group (DRG) - Concerned with inspiration ii) Ventral respiratory group (VRG) - Mainly concerned with Forceful expiration, but also shows some activity during inspiration. iii) Pre - Botzinger complex: - Responsible for generation of respiratory rhythm. o Pontine respiratory centers are - i) Pneumotaxic center - The primary function is to limit inspiration, i.e., to control the switch off point of inspiratory ramp and control of inspiratory depth. ii) Apneustic center - Excites inspiratory center to prolong inspiration.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Respiratory rhythm nucleus-, with the following options: A: Pneumotaxic centre, B: Dorsal group of nucleus, C: Apneustic centre, D: Pre-Botzinger Complex ### Response: Ans. is 'd' i.e., Pre-Botzinger Complex Important facts about the regulation of respiration o Medullary respiratory group of neurons are - i) Dorsal respiratory group (DRG) - Concerned with inspiration ii) Ventral respiratory group (VRG) - Mainly concerned with Forceful expiration, but also shows some activity during inspiration. iii) Pre - Botzinger complex: - Responsible for generation of respiratory rhythm. o Pontine respiratory centers are - i) Pneumotaxic center - The primary function is to limit inspiration, i.e., to control the switch off point of inspiratory ramp and control of inspiratory depth. ii) Apneustic center - Excites inspiratory center to prolong inspiration. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: IgE receptors are present on, with the following options: A: Mast cells, B: NK cells, C: B cells, D: Histiocytes ### Response:

Ref Robbins 9/e p201 Type 1 hypersensitivity is a rapid immunological reaction occuring in a previously sensitized individual that is triggered by the binding of an antigen to IgE antibody on the surface of mast cells

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: IgE receptors are present on, with the following options: A: Mast cells, B: NK cells, C: B cells, D: Histiocytes ### Response: Ref Robbins 9/e p201 Type 1 hypersensitivity is a rapid immunological reaction occuring in a previously sensitized individual that is triggered by the binding of an antigen to IgE antibody on the surface of mast cells ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Xerostomia is seen in all except ?, with the following options: A: Sjogren syndrome, B: RA, C: Sarcoidosis, D: Midline granuloma ### Response:

Ans. is 'd' i.e., Midline granuloma

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Xerostomia is seen in all except ?, with the following options: A: Sjogren syndrome, B: RA, C: Sarcoidosis, D: Midline granuloma ### Response: Ans. is 'd' i.e., Midline granuloma ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Drug of choice for the treatment of acute gout in patients in whom NSAIDs are contraindicated is?, with the following options: A: Colchicine, B: Allopurinol, C: Xyloric acid, D: Paracetamol ### Response:

Ans. is 'a' i.e., Colchicine Treatment of Gout 1) Acute gout NSAIDs are the drugs of choice Colchicine is the fastest acting drug. However it is reserved for the patients in which NSAIDs are contraindicated, because colchicine can cause gastrointestinal disturbances. If neither NSAIDs nor colchicin are tolerated, oral prednisolone is used. Allopurinol and uricosuric drugs (sulfinpyrazone, probenacid) are not effective in acute gout because they will not relieve symptoms as they don't have anti-inflammatory propey. 2) Chronic gout Allopurinal is the drug of choice. Other drugs are sulfinpyrazone and probenacid.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Drug of choice for the treatment of acute gout in patients in whom NSAIDs are contraindicated is?, with the following options: A: Colchicine, B: Allopurinol, C: Xyloric acid, D: Paracetamol ### Response: Ans. is 'a' i.e., Colchicine Treatment of Gout 1) Acute gout NSAIDs are the drugs of choice Colchicine is the fastest acting drug. However it is reserved for the patients in which NSAIDs are contraindicated, because colchicine can cause gastrointestinal disturbances. If neither NSAIDs nor colchicin are tolerated, oral prednisolone is used. Allopurinol and uricosuric drugs (sulfinpyrazone, probenacid) are not effective in acute gout because they will not relieve symptoms as they don't have anti-inflammatory propey. 2) Chronic gout Allopurinal is the drug of choice. Other drugs are sulfinpyrazone and probenacid. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 30 year old lady presents with features of malabsorption and iron deficiency anaemia. Duodenal biopsy shows complete villous atrophy. Which of the following antibodies is likely to be present :, with the following options: A: Antiendomysial antibodies, B: Anti-goblet cell antibodies, C: Anti-saccharomyces cerevisae antibodies, D: Antineutrophil cytoplasmic antibodies ### Response:

Answer is A (Antiendomysial antibodies): Evidence of Malabsorption together with charachteristic histopathological changes on small intestinal biopsy in the form of complete villous atrophy suggests the diagnosis of celiac spree / disease. Antibody studies are frequently used to identify patients with celiac disease. 'The antiendomysial antibody has 90 to 95% sensitivity and 90 to 95% specificity' in the detection of celiac disease.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 30 year old lady presents with features of malabsorption and iron deficiency anaemia. Duodenal biopsy shows complete villous atrophy. Which of the following antibodies is likely to be present :, with the following options: A: Antiendomysial antibodies, B: Anti-goblet cell antibodies, C: Anti-saccharomyces cerevisae antibodies, D: Antineutrophil cytoplasmic antibodies ### Response: Answer is A (Antiendomysial antibodies): Evidence of Malabsorption together with charachteristic histopathological changes on small intestinal biopsy in the form of complete villous atrophy suggests the diagnosis of celiac spree / disease. Antibody studies are frequently used to identify patients with celiac disease. 'The antiendomysial antibody has 90 to 95% sensitivity and 90 to 95% specificity' in the detection of celiac 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 25 year old university student had a fight with the neighboring boy. On the next day while out, he staed feeling that two men in police uniform were observing this movements. When he reached home in the evening he was frightened. He expressed that police was after him and would arrest him. His symptoms represent:, with the following options: A: Delusion of persecution, B: Ideas of reference, C: Passivity, D: Thought inseion ### Response:

A i.e. Delusion of persecution

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 25 year old university student had a fight with the neighboring boy. On the next day while out, he staed feeling that two men in police uniform were observing this movements. When he reached home in the evening he was frightened. He expressed that police was after him and would arrest him. His symptoms represent:, with the following options: A: Delusion of persecution, B: Ideas of reference, C: Passivity, D: Thought inseion ### Response: A i.e. Delusion of persecution ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The efferent fiber bundle of the substantia nigra transmits dopamine to one of the following areas:, with the following options: A: Thalamus, B: Corpus striatum, C: Tegmentum of pons, D: Tectum of midbrain ### Response:

B i.e. Corpus striatum

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The efferent fiber bundle of the substantia nigra transmits dopamine to one of the following areas:, with the following options: A: Thalamus, B: Corpus striatum, C: Tegmentum of pons, D: Tectum of midbrain ### Response: B i.e. Corpus striatum ### 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 true about vasa pre except:, with the following options: A: Incidence is 1:2000 deliveries, B: Fetal moality rate of 10% with undiagnosed case, C: Associated with low lying placenta, D: Cesarean section is indicated ### Response:

Vasa pre - It is a condition in which the fetal blood vessels unsuppoed by either umblical cord or placental tissue,Overlies the internal os and is vulnerable to rupture when suppoing membrane rupture. Bleeding in case of vasa pre is of fetal origin and not maternal origin. Fetal moality is often more than 50% It is rare condition and occurs in 1 in 2000 - 3000 deliveries Vasa pre can be associated with - Velamentous cord inseion - Bilobed placenta - Succenturiate lobed placenta - Placenta pre /low lying placenta in second trimester (option 'c' is correct) Management- In a diagnosed case of vasa pre elective cesarean section should be done or emergency LSCS should Be done if it is diagnosed intrapaum.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All of the following are true about vasa pre except:, with the following options: A: Incidence is 1:2000 deliveries, B: Fetal moality rate of 10% with undiagnosed case, C: Associated with low lying placenta, D: Cesarean section is indicated ### Response: Vasa pre - It is a condition in which the fetal blood vessels unsuppoed by either umblical cord or placental tissue,Overlies the internal os and is vulnerable to rupture when suppoing membrane rupture. Bleeding in case of vasa pre is of fetal origin and not maternal origin. Fetal moality is often more than 50% It is rare condition and occurs in 1 in 2000 - 3000 deliveries Vasa pre can be associated with - Velamentous cord inseion - Bilobed placenta - Succenturiate lobed placenta - Placenta pre /low lying placenta in second trimester (option 'c' is correct) Management- In a diagnosed case of vasa pre elective cesarean section should be done or emergency LSCS should Be done if it is diagnosed intrapaum. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Fastest acting nondepolarizing neuromuscular blocker-, with the following options: A: Rocuronium, B: Pancuronium, C: Succinylcholine, D: Mivacurium ### Response:

Rocuronium has onset of action at 1mg/kg 90 seconds Rocuroniumis the muscle relaxant of choice for day-care surgery. intermediate-acting muscle relaxant with a rapid onset (90 s). Rapacuronium has onset of action 75 secs but it is not in clinical use. Rest all nondepolarising neuromuscular blocker has onset of action - 3-5 minutes

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Fastest acting nondepolarizing neuromuscular blocker-, with the following options: A: Rocuronium, B: Pancuronium, C: Succinylcholine, D: Mivacurium ### Response: Rocuronium has onset of action at 1mg/kg 90 seconds Rocuroniumis the muscle relaxant of choice for day-care surgery. intermediate-acting muscle relaxant with a rapid onset (90 s). Rapacuronium has onset of action 75 secs but it is not in clinical use. Rest all nondepolarising neuromuscular blocker has onset of action - 3-5 minutes ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: ESPS is due to, with the following options: A: K+ influx, B: Na+ efflux, C: Na+ influx, D: Ca++ influx ### Response:

Ans. (c) Na+ efflux(Ref: Ganong, 25th ed/p.122)Excitatory Post Synaptic Potentials (EPSP)#Produced if the neurotransmitter released at the synapse is excitatory#The excitatory transmitter opens mainly Na+ ion channels producing depolarization

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: ESPS is due to, with the following options: A: K+ influx, B: Na+ efflux, C: Na+ influx, D: Ca++ influx ### Response: Ans. (c) Na+ efflux(Ref: Ganong, 25th ed/p.122)Excitatory Post Synaptic Potentials (EPSP)#Produced if the neurotransmitter released at the synapse is excitatory#The excitatory transmitter opens mainly Na+ ion channels producing depolarization ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: After taking some drug for acute attack of migraine a patient develop nausea and vomiting he also develop tingling and numbness in the tip of the finger that also turn blue. which of the following is most likely drug implicated in the cause the above finding, with the following options: A: Dihydroergotamine, B: Sumatriptan, C: Aspirin, D: Butarphanol ### Response:

This is a classical sign of ergot induced vasoconstriction dihydroergotamine can be used for acute attack of migraine and can result in such symptoms. due to their vasoconstriction potential Ergot alkaloids are contraindicated in a patient with peripheral vascular disease this may lead to development of gangrene. Refer katzung 11/e p289

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: After taking some drug for acute attack of migraine a patient develop nausea and vomiting he also develop tingling and numbness in the tip of the finger that also turn blue. which of the following is most likely drug implicated in the cause the above finding, with the following options: A: Dihydroergotamine, B: Sumatriptan, C: Aspirin, D: Butarphanol ### Response: This is a classical sign of ergot induced vasoconstriction dihydroergotamine can be used for acute attack of migraine and can result in such symptoms. due to their vasoconstriction potential Ergot alkaloids are contraindicated in a patient with peripheral vascular disease this may lead to development of gangrene. Refer katzung 11/e p289 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Infantile propoion in adult is seen in, with the following options: A: Morquio's disease, B: Achondroplasia, C: Hypothyroidism, D: Malnutrition ### Response:

Normal body propoion in adults Height = arm span Upper segment= lower segment Normal body propoion in infants is Height ( length)> arm span Upper segment> Lower segment. Infantile propoion means increased upper to lower segment ratio. Seen in conditions like Achondroplasia and hypothyroidism. Reverse infantile propoion means increased lower segment. Seen in Eunuchoidism, Marfans syndrome, Homocystinuria, Klinefelter's syndrome. Ref: Nelson's 20th edition, Pg- 3371.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Infantile propoion in adult is seen in, with the following options: A: Morquio's disease, B: Achondroplasia, C: Hypothyroidism, D: Malnutrition ### Response: Normal body propoion in adults Height = arm span Upper segment= lower segment Normal body propoion in infants is Height ( length)> arm span Upper segment> Lower segment. Infantile propoion means increased upper to lower segment ratio. Seen in conditions like Achondroplasia and hypothyroidism. Reverse infantile propoion means increased lower segment. Seen in Eunuchoidism, Marfans syndrome, Homocystinuria, Klinefelter's syndrome. Ref: Nelson's 20th edition, Pg- 3371. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Monteggia fracture is: (D. REPEAT 2012), with the following options: A: of proximal 1 /3rd ulna w ith dislocation of radioulnar joint, B: of distal 1 /3rd of ulna with dislocation of radioulnarJoint, C: of atlas, D: of distal l/3rd of radius with dislocation of radioulnar joint ### Response:

Ref: Aples's Svstem of Orthopaedics and Fractures, 9th edition, Pages 770 and 773Explanation:MONTEGGIA FRACTUREThe injury described by Monteggia in the early nineteenth century (without the benefit of X-rays!).Fracture of shaft of the proximal third of ulna associated with dislocation of the proximal radio-ulnar joint.The radio-capitellar joint is dislocated.Recently, the definition has been extended to embrace almost any fracture of the ulna associated with dislocation of the radio- capitellar joint, including trans-olecranon fractures with dislocation of proximal radioulnar joint (Hume fracture).If the ulnar shaft fracture is angulated with the apex anterior (the most common type) then the radial head is displaced anteriorly, if the fracture apex is posterior, the radial dislocation is posterior, and if the fracture apex is lateral then the radial head will he laterally displaced.In children, the ulnar injury may he an incomplete fracture (greenstick or plastic deformation of the shaft).Fractures of the distal third of radius with dislocation of the ulnar head from the distal radio-ulnar joint was described by Galeazzi in 1934 and named after him. It is commoner than Monteggia fracture dislocation.Note* Monteggia fracture - Fracture proximal one- third of ulna with dislocation of radial head* Galleazzi fracture - Fracture distal one-third of radius with disruption of the distal radioulnar joint

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Monteggia fracture is: (D. REPEAT 2012), with the following options: A: of proximal 1 /3rd ulna w ith dislocation of radioulnar joint, B: of distal 1 /3rd of ulna with dislocation of radioulnarJoint, C: of atlas, D: of distal l/3rd of radius with dislocation of radioulnar joint ### Response: Ref: Aples's Svstem of Orthopaedics and Fractures, 9th edition, Pages 770 and 773Explanation:MONTEGGIA FRACTUREThe injury described by Monteggia in the early nineteenth century (without the benefit of X-rays!).Fracture of shaft of the proximal third of ulna associated with dislocation of the proximal radio-ulnar joint.The radio-capitellar joint is dislocated.Recently, the definition has been extended to embrace almost any fracture of the ulna associated with dislocation of the radio- capitellar joint, including trans-olecranon fractures with dislocation of proximal radioulnar joint (Hume fracture).If the ulnar shaft fracture is angulated with the apex anterior (the most common type) then the radial head is displaced anteriorly, if the fracture apex is posterior, the radial dislocation is posterior, and if the fracture apex is lateral then the radial head will he laterally displaced.In children, the ulnar injury may he an incomplete fracture (greenstick or plastic deformation of the shaft).Fractures of the distal third of radius with dislocation of the ulnar head from the distal radio-ulnar joint was described by Galeazzi in 1934 and named after him. It is commoner than Monteggia fracture dislocation.Note* Monteggia fracture - Fracture proximal one- third of ulna with dislocation of radial head* Galleazzi fracture - Fracture distal one-third of radius with disruption of the distal radioulnar joint ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: NK cells express, with the following options: A: CD 15;CD55, B: CD 16; CD 56, C: CD16;CD 57, D: CD21;CD66 ### Response:

Ref Robbins 8/e p188 ;9/e p192 NK cells (belonging to the group of innate lymphoid cells) are defined as large granular lymphocytes (LGL) and constitute the third kind of cells differentiated from the common lymphoid progenitor-generating B and T lymphocytes. NK cells are known to differentiate and mature in the bone marrow, lymph nodes, spleen, tonsils, and thymus, where they then enter into the circulation. NK cells differ from natural killer T cells (NKTs) phenotypically, by origin and by respective effector functions; often, NKT cell activity promotes NK cell activity by secreting interferon gamma. In contrast to NKT cells, NK cells do not express T-cell antigen receptors(TCR) or pan T marker CD3 or surface

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: NK cells express, with the following options: A: CD 15;CD55, B: CD 16; CD 56, C: CD16;CD 57, D: CD21;CD66 ### Response: Ref Robbins 8/e p188 ;9/e p192 NK cells (belonging to the group of innate lymphoid cells) are defined as large granular lymphocytes (LGL) and constitute the third kind of cells differentiated from the common lymphoid progenitor-generating B and T lymphocytes. NK cells are known to differentiate and mature in the bone marrow, lymph nodes, spleen, tonsils, and thymus, where they then enter into the circulation. NK cells differ from natural killer T cells (NKTs) phenotypically, by origin and by respective effector functions; often, NKT cell activity promotes NK cell activity by secreting interferon gamma. In contrast to NKT cells, NK cells do not express T-cell antigen receptors(TCR) or pan T marker CD3 or surface ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Normal diurnal variation of intraocular pressure is:, with the following options: A: 0-2 mm of Hg, B: 2-3 mm of Hg, C: 3-6 mm of Hg, D: 6-8 mm of Hg ### Response:

Ans. 3-6 mm of Hg

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Normal diurnal variation of intraocular pressure is:, with the following options: A: 0-2 mm of Hg, B: 2-3 mm of Hg, C: 3-6 mm of Hg, D: 6-8 mm of Hg ### Response: Ans. 3-6 mm of Hg ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which enzyme level is tested in thiamine deficiency?, with the following options: A: PDH, B: Pyruvate kinase, C: Transketolase, D: Kinase ### Response:

Thiamine (vitamin B1) Deficiency It is assessed by Erythrocyte transketolase activity. Thiamine (Vitamin B1) is the marker for transketolase enzyme -which is involved in HMP pathway (in RBCs) Activity of Transketolase is measured (not the quantity).

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which enzyme level is tested in thiamine deficiency?, with the following options: A: PDH, B: Pyruvate kinase, C: Transketolase, D: Kinase ### Response: Thiamine (vitamin B1) Deficiency It is assessed by Erythrocyte transketolase activity. Thiamine (Vitamin B1) is the marker for transketolase enzyme -which is involved in HMP pathway (in RBCs) Activity of Transketolase is measured (not the quantity). ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Not a component of JVP?, with the following options: A: A wave bigger than V wave, B: C wave is called as Dicrotic notch, C: X wave is seen ventricular systole, D: Y descent in ventricular diastole ### Response:

Ans. B C wave is called as dicrotic notchRef: Ganong, 25th ed. pg. 542A waveAtrial systoleC waveBulge of tricuspid valve into right atrium during isovolumetric contractionX descentAtrial relaxationV waveBeginning of isovolumetric relaxationV descentVentricular relaxationDicrotic Notch is seen in Pulse recording.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Not a component of JVP?, with the following options: A: A wave bigger than V wave, B: C wave is called as Dicrotic notch, C: X wave is seen ventricular systole, D: Y descent in ventricular diastole ### Response: Ans. B C wave is called as dicrotic notchRef: Ganong, 25th ed. pg. 542A waveAtrial systoleC waveBulge of tricuspid valve into right atrium during isovolumetric contractionX descentAtrial relaxationV waveBeginning of isovolumetric relaxationV descentVentricular relaxationDicrotic Notch is seen in Pulse recording. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 42-year-old woman is admitted to the hospital with injury to the upper (superior) trunk of the brachial plexus. The diagnosis is Erb-Duchenne palsy. Which of the following conditions is expected to be present during physical examination?, with the following options: A: Winged scapula, B: Inability to laterally rotate the arm, C: Paralysis of intrinsic muscles of the hand, D: Paresthesia in the medial aspect of the arm ### Response:

Injury to the superior trunk of the brachial plexus can damage nerve fibers going to the suprascapular, axillary, and musculocutaneous nerves. Damage to the suprascapular and axillary nerves causes impaired abduction and lateral rotation of the arm. Damage to the musculocutaneous nerve causes impaired flexion of the forearm. A winged scapula would be caused by damage to the long thoracic nerve. The long thoracic nerve is formed from spinal cord levels C5, C6, and C7, so the serratus anterior muscle would be weakened from the damage to C5 and C6, but the muscle would not be completely paralyzed. The intrinsic muscles of the hand are innervated by the ulnar nerve, which would most likely remain intact. Paraesthesia in the medial aspect of the arm would be caused by damage to the medial brachial cutaneous nerve (C8-T1; inferior trunk). Loss of sensation on the dorsum of the hand would be caused by damage to either the ulnar or radial nerves (C6 to T1).

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 42-year-old woman is admitted to the hospital with injury to the upper (superior) trunk of the brachial plexus. The diagnosis is Erb-Duchenne palsy. Which of the following conditions is expected to be present during physical examination?, with the following options: A: Winged scapula, B: Inability to laterally rotate the arm, C: Paralysis of intrinsic muscles of the hand, D: Paresthesia in the medial aspect of the arm ### Response: Injury to the superior trunk of the brachial plexus can damage nerve fibers going to the suprascapular, axillary, and musculocutaneous nerves. Damage to the suprascapular and axillary nerves causes impaired abduction and lateral rotation of the arm. Damage to the musculocutaneous nerve causes impaired flexion of the forearm. A winged scapula would be caused by damage to the long thoracic nerve. The long thoracic nerve is formed from spinal cord levels C5, C6, and C7, so the serratus anterior muscle would be weakened from the damage to C5 and C6, but the muscle would not be completely paralyzed. The intrinsic muscles of the hand are innervated by the ulnar nerve, which would most likely remain intact. Paraesthesia in the medial aspect of the arm would be caused by damage to the medial brachial cutaneous nerve (C8-T1; inferior trunk). Loss of sensation on the dorsum of the hand would be caused by damage to either the ulnar or radial nerves (C6 to T1). ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Lymphangitis is caused by :, with the following options: A: Staphylococcus, B: Streptococci, C: Pneumococii, D: Neisseria ### Response:

Ans. is 'b' i.e. Streptococci "Lymphangitis & lymphadenitis are common manifestation of a bacterial infection that is usually caused by hemolytic streptococci or staphylococci. " - CMDTBy our conventional rule of "First come first served" streptococci is our best option

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Lymphangitis is caused by :, with the following options: A: Staphylococcus, B: Streptococci, C: Pneumococii, D: Neisseria ### Response: Ans. is 'b' i.e. Streptococci "Lymphangitis & lymphadenitis are common manifestation of a bacterial infection that is usually caused by hemolytic streptococci or staphylococci. " - CMDTBy our conventional rule of "First come first served" streptococci is our best option ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Over a holiday weekend, more than 100 adults at a resort hotel develop a diarrheal illness marked by voluminous, watery stools more than 10 times per day. They also report headaches, abdominal cramping pain, and myalgias. On physical examination, they have manifestations of dehydration and mild fever. Laboratory studies of stool samples show no increase in leukocytes or fat and no RBCs. Their illness lasts just 1 to 3 days and resolves with no sequelae. Which of the following infectious agents is the most likely cause of their illness?, with the following options: A: Cytomegalovirus, B: Clostridium botulinum, C: Norovirus, D: Staphylococcus aureus ### Response:

Norovirus outbreaks result from contamination of food or water, most often in venues where multiple persons congregate. Was it the resort pool? Noroviruses, as well as the Giardia parasite, are resistant to chlorination. Was it the buffet? Salads, shellfish, and meats are often implicated. Voluminous diarrhea suggests small intestinal involvement. The lack of leukocytes makes bacterial infection less likely. Cytomegalovirus infections are more likely in immunocompromised persons. Botulism leads to paralysis from a neurotoxin. Staphylococcal food poisoning tends to be abrupt in onset and of short duration. Strongyloidiasis tends to persist for months to years. Cholera produces a life-threatening fluid loss.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Over a holiday weekend, more than 100 adults at a resort hotel develop a diarrheal illness marked by voluminous, watery stools more than 10 times per day. They also report headaches, abdominal cramping pain, and myalgias. On physical examination, they have manifestations of dehydration and mild fever. Laboratory studies of stool samples show no increase in leukocytes or fat and no RBCs. Their illness lasts just 1 to 3 days and resolves with no sequelae. Which of the following infectious agents is the most likely cause of their illness?, with the following options: A: Cytomegalovirus, B: Clostridium botulinum, C: Norovirus, D: Staphylococcus aureus ### Response: Norovirus outbreaks result from contamination of food or water, most often in venues where multiple persons congregate. Was it the resort pool? Noroviruses, as well as the Giardia parasite, are resistant to chlorination. Was it the buffet? Salads, shellfish, and meats are often implicated. Voluminous diarrhea suggests small intestinal involvement. The lack of leukocytes makes bacterial infection less likely. Cytomegalovirus infections are more likely in immunocompromised persons. Botulism leads to paralysis from a neurotoxin. Staphylococcal food poisoning tends to be abrupt in onset and of short duration. Strongyloidiasis tends to persist for months to years. Cholera produces a life-threatening fluid loss. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Sanitary toilets can decrease incidence of all except, with the following options: A: Diarrhoea, B: Poliomyelitis, C: Malaria, D: Cholera ### Response:

Diarrhea, Poliomyelitis, and cholera are transmitted by faeco-oral route Malaria is a vector-borne disease transmitted by Anopheles mosquito. Hence sanitary toilets and hand washing practices cannot prevent Malaria. Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 831

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Sanitary toilets can decrease incidence of all except, with the following options: A: Diarrhoea, B: Poliomyelitis, C: Malaria, D: Cholera ### Response: Diarrhea, Poliomyelitis, and cholera are transmitted by faeco-oral route Malaria is a vector-borne disease transmitted by Anopheles mosquito. Hence sanitary toilets and hand washing practices cannot prevent Malaria. Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 831 ### 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 culture medium is made by adding Agar:, with the following options: A: Solid medium, B: Liquid medium, C: Selective medium, D: Transport medium ### Response:

Ans. (a) Solid mediumRef: Microbiology by Ananthanarayan and Paniker 8th ed. / 39-40GROWING BACTERIAL CULTURES IN LIQUIDNUTRIENT BROTH* Nutrient broth is a liquid bacterial growth medium made of powdered beef extract and short chains of amino acids that have been dissolved in water.* Liquid medium is convenient to use for growing bacteria in test tubes, and can reveal information about the oxygen requirements of bacteria growing within.* Bacteria that require oxygen will grow close to the water s surface, and bacteria that cannot tolerate the presence of oxygen will grow at the bottom of the test tube.B GROWING BACTERIAL CULTURES ON SOUP MEDIA* Broth media can be made solid by adding agar, a gel like polysaccharide extracted from red algae.* Broth with about 1.5% agar added will be liquid when heated, but solid at room temperature, making it easy to pour into a vessel, such as a Petri dish or test tube when hot.* The solution then becomes solid once cooled.

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 culture medium is made by adding Agar:, with the following options: A: Solid medium, B: Liquid medium, C: Selective medium, D: Transport medium ### Response: Ans. (a) Solid mediumRef: Microbiology by Ananthanarayan and Paniker 8th ed. / 39-40GROWING BACTERIAL CULTURES IN LIQUIDNUTRIENT BROTH* Nutrient broth is a liquid bacterial growth medium made of powdered beef extract and short chains of amino acids that have been dissolved in water.* Liquid medium is convenient to use for growing bacteria in test tubes, and can reveal information about the oxygen requirements of bacteria growing within.* Bacteria that require oxygen will grow close to the water s surface, and bacteria that cannot tolerate the presence of oxygen will grow at the bottom of the test tube.B GROWING BACTERIAL CULTURES ON SOUP MEDIA* Broth media can be made solid by adding agar, a gel like polysaccharide extracted from red algae.* Broth with about 1.5% agar added will be liquid when heated, but solid at room temperature, making it easy to pour into a vessel, such as a Petri dish or test tube when hot.* The solution then becomes solid once cooled. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: cutaneous maculopapulary rash of the head and neck preceded by small ulcers in the buccal mucosa would suggest which of the following?, with the following options: A: Primary herpes simplex infection, B: Rubeola, C: Varicella, D: Primary syphilis ### Response:

The maculopapulary rash of rubeola (measles) is preceded by the herald sign of Koplick’s spots (punctate ulcers of the buccal mucosa)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: cutaneous maculopapulary rash of the head and neck preceded by small ulcers in the buccal mucosa would suggest which of the following?, with the following options: A: Primary herpes simplex infection, B: Rubeola, C: Varicella, D: Primary syphilis ### Response: The maculopapulary rash of rubeola (measles) is preceded by the herald sign of Koplick’s spots (punctate ulcers of the buccal mucosa) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Dental local anesthetics containing 2% lignocaine with adrenaline 1 : 80000: A) In any dosage are contraindicated in patients with heart disease B) May cause tachycardia C) Can produce allergic reactions, in which lignocaine is usually responsible D) Or even prilocaine with felypressin should not be used in the pregnant patient because of the oxytocic effects of adrenaline or felypressin. E) Cause hypertensive reactions in patients on tricyclic antidepressants, with the following options: A: Option B is true and ACDE are false, B: Option A true and BCDE are false, C: Option C is true and ABDE are false, D: Option D is true and ABCE are false ### Response:

Adrenaline may cause tachycardia.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Dental local anesthetics containing 2% lignocaine with adrenaline 1 : 80000: A) In any dosage are contraindicated in patients with heart disease B) May cause tachycardia C) Can produce allergic reactions, in which lignocaine is usually responsible D) Or even prilocaine with felypressin should not be used in the pregnant patient because of the oxytocic effects of adrenaline or felypressin. E) Cause hypertensive reactions in patients on tricyclic antidepressants, with the following options: A: Option B is true and ACDE are false, B: Option A true and BCDE are false, C: Option C is true and ABDE are false, D: Option D is true and ABCE are false ### Response: Adrenaline may cause tachycardia. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Systoiic thrill in left 2nd or 3rd intercostal space is heard in which of the following conditions ?, with the following options: A: Sub pulmonic VSD, B: TOF, C: Ebstein's anomaly, D: Pulmonary stenosis ### Response:

Pulmonary stenosis produces Ejection systolic murmur. It stas after S1, peaks at mid-systole and ends before S2. Best heard in pulmonary area. Ref: Harrison&;s 20th edition pg 1445

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Systoiic thrill in left 2nd or 3rd intercostal space is heard in which of the following conditions ?, with the following options: A: Sub pulmonic VSD, B: TOF, C: Ebstein's anomaly, D: Pulmonary stenosis ### Response: Pulmonary stenosis produces Ejection systolic murmur. It stas after S1, peaks at mid-systole and ends before S2. Best heard in pulmonary area. Ref: Harrison&;s 20th edition pg 1445 ### 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 a bullet shaped virus?, with the following options: A: Rabies virus, B: CoxsackieA, C: Coxsackie B, D: Polio virus ### Response:

Ans. (a) Rabies virus

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which is a bullet shaped virus?, with the following options: A: Rabies virus, B: CoxsackieA, C: Coxsackie B, D: Polio virus ### Response: Ans. (a) Rabies virus ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A lady presented with creamy white vaginal discharge with fishy odour, the drug of choice is:, with the following options: A: Doxycycline, B: Ofloxacine, C: Clindamycin, D: Metronidazole ### Response:

Symptoms are suggestive of trichomoniasis Metronidazole 200mg by mouth 3 times a day for 7 days prescribed for both partners, and adviced to abstain from intercourse or use condomduring therapy. It is best taken after meals otherwise nausea and vomiting can occur

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A lady presented with creamy white vaginal discharge with fishy odour, the drug of choice is:, with the following options: A: Doxycycline, B: Ofloxacine, C: Clindamycin, D: Metronidazole ### Response: Symptoms are suggestive of trichomoniasis Metronidazole 200mg by mouth 3 times a day for 7 days prescribed for both partners, and adviced to abstain from intercourse or use condomduring therapy. It is best taken after meals otherwise nausea and vomiting can occur ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cystic medial necrosis responsible for aoic dilatation and rupture is seen in -, with the following options: A: Syphilitic aneurysm, B: Takayasu aeritis, C: Atherosclerosis, D: Marfan syndrome ### Response:

Ans. is 'd' Marfan syndromeo Cystic medial necrosis is the degenerative disease of media of the aoa.o It characterized by degeneration of collagen and elastic fibers in tunica media of aoa, and also the loss of medial cells that are replaced by multiple cleft of mucoid material.It characteristically affects the proximal aoer, results in circumferential weakness and dilatation which results in the development offusiform aneurysm involving the ascending aoa and sinus of vulsalva.o Cystic medial necrosis is a pathological substrate for aoic dissection.Diseases causing cystic medial necrosis o Marfan syndromeo Ehler-Danlus syndrome (type IV)o Congenital bicuspid aoic valveo Familial thoracic aoic aneurysm syndrome o Pregnancy

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cystic medial necrosis responsible for aoic dilatation and rupture is seen in -, with the following options: A: Syphilitic aneurysm, B: Takayasu aeritis, C: Atherosclerosis, D: Marfan syndrome ### Response: Ans. is 'd' Marfan syndromeo Cystic medial necrosis is the degenerative disease of media of the aoa.o It characterized by degeneration of collagen and elastic fibers in tunica media of aoa, and also the loss of medial cells that are replaced by multiple cleft of mucoid material.It characteristically affects the proximal aoer, results in circumferential weakness and dilatation which results in the development offusiform aneurysm involving the ascending aoa and sinus of vulsalva.o Cystic medial necrosis is a pathological substrate for aoic dissection.Diseases causing cystic medial necrosis o Marfan syndromeo Ehler-Danlus syndrome (type IV)o Congenital bicuspid aoic valveo Familial thoracic aoic aneurysm syndrome o Pregnancy ### 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 seen in Henoch schonlein purpura except -, with the following options: A: Thrombocytopenia, B: Glomerulonephritis, C: Ahralgia, D: Abdominal pain ### Response:

Ans. is 'a' i.e., Thrombocytopenia Clinical manifestations of H.S. Purpura Constitutional symptoms --> Fever, fatigue, malaise, Anorexia, weight loss Skin The hallmark of this disease is rash begining as pinkish maculopapules that initially blanch on pressure and progress to petechiae or purpura which are characterized by clinically as palpable purpura. o Purpura usually occurs on dependent areas of the body such as buttocks. Joints o Ahralgia or ahritis of large joints that involves primarily the joint of lower exterimities, i.e. knee & ankle. Migratory pattern of joint involvement occurs. Gastrointestinal tract o Abdominal pain and GI bleeding Diarrhoea (with or without visible blood) or hematemesis. o Intussusception may occur. Kidney o Almost always appear after the development of skin manifestations. o The characteristic of kidney involvement is microscopic heamaturia due to glomerulonephritis. o Non-nephrotic range proteinura. o There is deposition of IgA in the mesangium. Others --> Rarely CNS and pulmonary involvement may occur.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All are seen in Henoch schonlein purpura except -, with the following options: A: Thrombocytopenia, B: Glomerulonephritis, C: Ahralgia, D: Abdominal pain ### Response: Ans. is 'a' i.e., Thrombocytopenia Clinical manifestations of H.S. Purpura Constitutional symptoms --> Fever, fatigue, malaise, Anorexia, weight loss Skin The hallmark of this disease is rash begining as pinkish maculopapules that initially blanch on pressure and progress to petechiae or purpura which are characterized by clinically as palpable purpura. o Purpura usually occurs on dependent areas of the body such as buttocks. Joints o Ahralgia or ahritis of large joints that involves primarily the joint of lower exterimities, i.e. knee & ankle. Migratory pattern of joint involvement occurs. Gastrointestinal tract o Abdominal pain and GI bleeding Diarrhoea (with or without visible blood) or hematemesis. o Intussusception may occur. Kidney o Almost always appear after the development of skin manifestations. o The characteristic of kidney involvement is microscopic heamaturia due to glomerulonephritis. o Non-nephrotic range proteinura. o There is deposition of IgA in the mesangium. Others --> Rarely CNS and pulmonary involvement may occur. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In Familial hypercholesterolemia there is, with the following options: A: LDL receptor, B: Apo protein A, C: Apo protein C, D: Lipoprotein lipase ### Response:

A i.e. LDL receptor

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: In Familial hypercholesterolemia there is, with the following options: A: LDL receptor, B: Apo protein A, C: Apo protein C, D: Lipoprotein lipase ### Response: A i.e. LDL receptor ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: An antibiotic not acting on tubulin is ?, with the following options: A: Bleomycin, B: Colchicine, C: Paclitaxel, D: Vincristine ### Response:

Ans. is 'a' i.e., Bleomycin Bleomycin (an anticancer antibiotic) does not act on tubulin.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: An antibiotic not acting on tubulin is ?, with the following options: A: Bleomycin, B: Colchicine, C: Paclitaxel, D: Vincristine ### Response: Ans. is 'a' i.e., Bleomycin Bleomycin (an anticancer antibiotic) does not act on tubulin. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Acanthosis nigricans is seen in:, with the following options: A: GIT cancer, B: Hypothyroidism, C: Diabetes, D: All of the above ### Response:

Ans. d. All of the aboveMost common association of acanthosis nigricans is obesity

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Acanthosis nigricans is seen in:, with the following options: A: GIT cancer, B: Hypothyroidism, C: Diabetes, D: All of the above ### Response: Ans. d. All of the aboveMost common association of acanthosis nigricans is obesity ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: What will be the BMI of a male whose weight is 89 kg and height is 172cm -, with the following options: A: 27, B: 30, C: 33, D: 36 ### Response:

BMI = weight in kg/ height in metre square = 89/1.72/1.72 =30.08. Ref-Park&;s textbook of Preventive and Social Medicine 24th edition. .

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: What will be the BMI of a male whose weight is 89 kg and height is 172cm -, with the following options: A: 27, B: 30, C: 33, D: 36 ### Response: BMI = weight in kg/ height in metre square = 89/1.72/1.72 =30.08. Ref-Park&;s textbook of Preventive and Social Medicine 24th edition. . ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which is Eaton agent?, with the following options: A: Mycoplasma, B: H.influenza, C: Klebsiella, D: Chlamydia ### Response:

Ref: Ananthnarayan R. Paniker CKJ. Textbook of Microbiology. 8th Edition. Hyderabad: Universities Press: 2009. Pg. 389.Explanation:Mycoplasma pneumoniae causes primary atypical pneumoniaEaton (1944) was the first to isolate the causative agent of the disease in hamsters and cotton rats.He was able to transmit the infection later to chick embryos by amniotic inoculation.Because it was filterable, it was considered to be a virus (Eaton agent), but was subsequently shown to be a mycoplasma and named M pneumoniae.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which is Eaton agent?, with the following options: A: Mycoplasma, B: H.influenza, C: Klebsiella, D: Chlamydia ### Response: Ref: Ananthnarayan R. Paniker CKJ. Textbook of Microbiology. 8th Edition. Hyderabad: Universities Press: 2009. Pg. 389.Explanation:Mycoplasma pneumoniae causes primary atypical pneumoniaEaton (1944) was the first to isolate the causative agent of the disease in hamsters and cotton rats.He was able to transmit the infection later to chick embryos by amniotic inoculation.Because it was filterable, it was considered to be a virus (Eaton agent), but was subsequently shown to be a mycoplasma and named M pneumoniae. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following hormones are raised in Praderwilli syndrome, with the following options: A: Growth Hormone (GH), B: Leutinizing Hormone (LH), C: Follicile Stimulating Hormone (FSH), D: Ghrelin ### Response:

Prader-Willi syndrome (PWS) is a disorder caused by a deletion or disruption of genes in the proximal arm of chromosome 15 or by maternal disomy in the proximal arm of chromosome 15. Commonly associated characteristics of this disorder include diminished fetal activity, , <a href=" stature</a>, hypogonadotropic hypogonadism, strabismus, and small hands and feet. Reference: GHAI Essential pediatrics, 8th edition

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following hormones are raised in Praderwilli syndrome, with the following options: A: Growth Hormone (GH), B: Leutinizing Hormone (LH), C: Follicile Stimulating Hormone (FSH), D: Ghrelin ### Response: Prader-Willi syndrome (PWS) is a disorder caused by a deletion or disruption of genes in the proximal arm of chromosome 15 or by maternal disomy in the proximal arm of chromosome 15. Commonly associated characteristics of this disorder include diminished fetal activity, , <a href=" stature</a>, hypogonadotropic hypogonadism, strabismus, and small hands and feet. Reference: GHAI Essential pediatrics, 8th edition ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Fogo selvagem is a type of:, with the following options: A: Pemphigus vulgaris, B: Pemghigus vegetans, C: Pemphigus foliaceus, D: Bullous pemphigoid ### Response:

Endemic pemphigus foliaceus common in rural pas of South America, paicularly ceain states of Brazil is known as fogo selvagem (wild fire) caused by bite of black fly. Ref: Rook's textbook of dermatology, 8th edition, Pg 40.13

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Fogo selvagem is a type of:, with the following options: A: Pemphigus vulgaris, B: Pemghigus vegetans, C: Pemphigus foliaceus, D: Bullous pemphigoid ### Response: Endemic pemphigus foliaceus common in rural pas of South America, paicularly ceain states of Brazil is known as fogo selvagem (wild fire) caused by bite of black fly. Ref: Rook's textbook of dermatology, 8th edition, Pg 40.13 ### End

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

Ecological studies, as they donot take into consideration individual data of exposure & diseases, have poorest evidence of determining association. Hence they are considered as weak studies. These are done at point of time & commonly used in nutritional surveys. Order from strong to weak study determining association:Randomized Control Trial > Retrospective Coho Study > Prospective Coho Study > Case control study > Cross sectional study > Ecological study.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: To test the association between risk factors and disease, which of the following is the weakest study design?, with the following options: A: Case control study, B: Ecological study, C: Coho study, D: Cross-sectional study ### Response: Ecological studies, as they donot take into consideration individual data of exposure & diseases, have poorest evidence of determining association. Hence they are considered as weak studies. These are done at point of time & commonly used in nutritional surveys. Order from strong to weak study determining association:Randomized Control Trial > Retrospective Coho Study > Prospective Coho Study > Case control study > Cross sectional study > Ecological study. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Longest extra ocular muscle:, with the following options: A: Superior oblique, B: Inferior oblique, C: Superior rectus, D: Lateral rectus ### Response:

Ans: a (Superior oblique)Ref: Khurana anatomy and physiology. 2nd ed. pg. 287Superior oblique muscle arises from body of sphenoid and moves forward to reach the trochlea which is a cartilagenous pulley attached to the frontal bone. It then turns posterolaterally to get inserted on to the sclera.Superior oblique is the longest and thinnest extra ocular muscle. Length of its direct part is 40 mm and reflected tendon is 19.5mm, total length being 59.5 mm.Actions of extraocular musclesMuscleprimarysecondarytertiaryMRAdduction LRAbduction SRElevationIntorsionAdductionIRDepressionExtorsionAdductionSOIntorsionDepressionAbduction10ExtorsionElevationAbductionAlso remember:The first muscle to be affected in thyroid ophthalmopathy- inferior rectusThe last muscle to be affected in retrobulbar block -superior oblique All superiors are intorters. So inferiors are extorters All recti are adductors. So obliques are abductors

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Longest extra ocular muscle:, with the following options: A: Superior oblique, B: Inferior oblique, C: Superior rectus, D: Lateral rectus ### Response: Ans: a (Superior oblique)Ref: Khurana anatomy and physiology. 2nd ed. pg. 287Superior oblique muscle arises from body of sphenoid and moves forward to reach the trochlea which is a cartilagenous pulley attached to the frontal bone. It then turns posterolaterally to get inserted on to the sclera.Superior oblique is the longest and thinnest extra ocular muscle. Length of its direct part is 40 mm and reflected tendon is 19.5mm, total length being 59.5 mm.Actions of extraocular musclesMuscleprimarysecondarytertiaryMRAdduction LRAbduction SRElevationIntorsionAdductionIRDepressionExtorsionAdductionSOIntorsionDepressionAbduction10ExtorsionElevationAbductionAlso remember:The first muscle to be affected in thyroid ophthalmopathy- inferior rectusThe last muscle to be affected in retrobulbar block -superior oblique All superiors are intorters. So inferiors are extorters All recti are adductors. So obliques are abductors ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Extrinsic system of coagulation is checked by:March 2010, with the following options: A: aPTT, B: PT, C: BT, D: PTT ### Response:

Ans. B: PTBleeding Time (Normal:1-6 min.) is for checking the number of platelets. It is prolonged by lack of platelets. Clotting time (Normal:6-10 min.) varies widely depending upon the method employed, so discarded nowadays. Instead measurements of clotting factors are being done.aPTT/PTT is employed for assessing intrinsic system.Prothrombin time (Normal:12 sec.) gives an good indication of concentration of prothrombin in the blood. Extrinsic pathway is assessed.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Extrinsic system of coagulation is checked by:March 2010, with the following options: A: aPTT, B: PT, C: BT, D: PTT ### Response: Ans. B: PTBleeding Time (Normal:1-6 min.) is for checking the number of platelets. It is prolonged by lack of platelets. Clotting time (Normal:6-10 min.) varies widely depending upon the method employed, so discarded nowadays. Instead measurements of clotting factors are being done.aPTT/PTT is employed for assessing intrinsic system.Prothrombin time (Normal:12 sec.) gives an good indication of concentration of prothrombin in the blood. Extrinsic pathway is assessed. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Contraception with increased risk of actinomycosis -, with the following options: A: OCPs, B: Condom, C: IUCD, D: Vaginal ### Response:

Ans. is 'c' i.e., IUCD o Actinomycosis may occur by use of IUCD.Side effects and complications of lUDs1. Bleeding - Most common2. Pain - Second major side effect3. Pelvic infection - PID4. Uterine perforation5. Pregnancy6. Ectopic pregnancy7. Expulsion8. Mortality' - extremely rare

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Contraception with increased risk of actinomycosis -, with the following options: A: OCPs, B: Condom, C: IUCD, D: Vaginal ### Response: Ans. is 'c' i.e., IUCD o Actinomycosis may occur by use of IUCD.Side effects and complications of lUDs1. Bleeding - Most common2. Pain - Second major side effect3. Pelvic infection - PID4. Uterine perforation5. Pregnancy6. Ectopic pregnancy7. Expulsion8. Mortality' - extremely rare ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 26-year-old nulliparous female with third degree uterine prolapse but no cystocele and no rectocele is best treated by:, with the following options: A: Abdominal sling surgery, B: Le fort colpocleisis, C: Fothergills repair, D: Amputation of cervix ### Response:

Ans. is a, i.e. Abdominal sling surgeryBest surgery for prolapse when a female wants to conceive in future is - Abdominal sling surgery.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 26-year-old nulliparous female with third degree uterine prolapse but no cystocele and no rectocele is best treated by:, with the following options: A: Abdominal sling surgery, B: Le fort colpocleisis, C: Fothergills repair, D: Amputation of cervix ### Response: Ans. is a, i.e. Abdominal sling surgeryBest surgery for prolapse when a female wants to conceive in future is - Abdominal sling surgery. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: C.S.F. is required to be preserved in :, with the following options: A: Alcoholic poisoning, B: Arsenic poisoning, C: Copper poisoning, D: Organophosphorous poisoning ### Response:

A i.e. Alcoholic poisoning

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: C.S.F. is required to be preserved in :, with the following options: A: Alcoholic poisoning, B: Arsenic poisoning, C: Copper poisoning, D: Organophosphorous poisoning ### Response: A i.e. Alcoholic poisoning ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Indicator for the outbreak of Plague epidemic is, with the following options: A: Rat burrow index, B: Total flea, C: Specific flea index, D: Cheopis index ### Response:

Cheopis index: It is an average no of X.cheopis per rat. It is a specific flea index. If this index is more than 1, it is regarded as indicative of potential explosiveness of the situation, should a plague outbreak occur

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Indicator for the outbreak of Plague epidemic is, with the following options: A: Rat burrow index, B: Total flea, C: Specific flea index, D: Cheopis index ### Response: Cheopis index: It is an average no of X.cheopis per rat. It is a specific flea index. If this index is more than 1, it is regarded as indicative of potential explosiveness of the situation, should a plague outbreak occur ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: TSH secreted from the pituitary gland is under control by, with the following options: A: TRH and T3, T4, B: Releasing factors same as those of cortisol, C: Releasing factors bypass neurohypophysis to act on the anterior pituitary, D: TRH only ### Response:

(A) TRH and T3, T4

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: TSH secreted from the pituitary gland is under control by, with the following options: A: TRH and T3, T4, B: Releasing factors same as those of cortisol, C: Releasing factors bypass neurohypophysis to act on the anterior pituitary, D: TRH only ### Response: (A) TRH and T3, T4 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 35yr old female who was an Occasional drinker complained of Severe Pruritis that becomes more bothersome in evening. On examination, patient was noted to have icteric sclera. Lab tests revealed anti-mitochondrial antibodies. What is the possible diagnosis?, with the following options: A: Primary sclerosing cholangitis, B: Xanthogranulomatous cholecystitis, C: Primary biliary cirrhosis, D: Alcoholic cirrhosis ### Response:

PBC- primary biliary cirrhosis Autoimmune disorder M/C in females Pathology Progressive destruction of intrahepatic bile ducts only Diagnostic appearance - florid duct lesion with lymphocytic infiltration and granulomatous inflammation Clinical features Pruritis precedes jaundiceQ Pruritis and fatigue - characteristic symptoms Diagnosis Anti-mitochondrial Ab - Can confirm diagnosis Investigation of choice - Biopsy Treatment Liver transplantation (severe pruritus & fatigue are indications for LT)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: A 35yr old female who was an Occasional drinker complained of Severe Pruritis that becomes more bothersome in evening. On examination, patient was noted to have icteric sclera. Lab tests revealed anti-mitochondrial antibodies. What is the possible diagnosis?, with the following options: A: Primary sclerosing cholangitis, B: Xanthogranulomatous cholecystitis, C: Primary biliary cirrhosis, D: Alcoholic cirrhosis ### Response: PBC- primary biliary cirrhosis Autoimmune disorder M/C in females Pathology Progressive destruction of intrahepatic bile ducts only Diagnostic appearance - florid duct lesion with lymphocytic infiltration and granulomatous inflammation Clinical features Pruritis precedes jaundiceQ Pruritis and fatigue - characteristic symptoms Diagnosis Anti-mitochondrial Ab - Can confirm diagnosis Investigation of choice - Biopsy Treatment Liver transplantation (severe pruritus & fatigue are indications for LT) ### 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 an antero-superior mediastinal mass, with the following options: A: Extra adrenal pheochromocytoma, B: Thymoma, C: Branchial cyst, D: Teratoma ### Response:

Anterosuperior Compament The anterosuperior compament of the mediastinum borders the undersurface of the sternum ventrally, the pericardium dorsally, and the visceral pleura laterally (at the apposition of the pleura and pericardium). Tumors of the anterior mediastinum includethymomas, teratoma or germ cell tumors, a spectrum of lympho- mas including Hodgkin disease, and thyroid goiter. In most cases, tissue (core biopsy) is required for diagnosis; fine-needle aspirate is usually inadequate. Thymomas are usually the most frequently occurring neoplasm of the anterior mediastinum, and lymphomas are second. Germ cell neoplasms include benign and malignant teratomas, choriocarcinoma, seminoma, and embryonal cell neoplasm. Teratomas frequently occur in young adults. The gonads are the most common primary site, followed by the mediastinum. Most germ cell neoplasms are benign, but 20% are malignant. Malignant teratomas may produce high serum levels of a-fetoprotein (AFP) and carcinoembryonic antigen. Endocrine disease of the thyroid and parathyroid may occur in the anterior mediastinum as a result of their anatomic position in adults (substernal goiter) or embryologic development. Carcinoid tumors may be foundwithin the thymus. Primary carcinomas of the mediastinum are often unresectable and respond poorly to treatment. Ref: Sabiston 20th edition Pgno: 1608

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 an antero-superior mediastinal mass, with the following options: A: Extra adrenal pheochromocytoma, B: Thymoma, C: Branchial cyst, D: Teratoma ### Response: Anterosuperior Compament The anterosuperior compament of the mediastinum borders the undersurface of the sternum ventrally, the pericardium dorsally, and the visceral pleura laterally (at the apposition of the pleura and pericardium). Tumors of the anterior mediastinum includethymomas, teratoma or germ cell tumors, a spectrum of lympho- mas including Hodgkin disease, and thyroid goiter. In most cases, tissue (core biopsy) is required for diagnosis; fine-needle aspirate is usually inadequate. Thymomas are usually the most frequently occurring neoplasm of the anterior mediastinum, and lymphomas are second. Germ cell neoplasms include benign and malignant teratomas, choriocarcinoma, seminoma, and embryonal cell neoplasm. Teratomas frequently occur in young adults. The gonads are the most common primary site, followed by the mediastinum. Most germ cell neoplasms are benign, but 20% are malignant. Malignant teratomas may produce high serum levels of a-fetoprotein (AFP) and carcinoembryonic antigen. Endocrine disease of the thyroid and parathyroid may occur in the anterior mediastinum as a result of their anatomic position in adults (substernal goiter) or embryologic development. Carcinoid tumors may be foundwithin the thymus. Primary carcinomas of the mediastinum are often unresectable and respond poorly to treatment. Ref: Sabiston 20th edition Pgno: 1608 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: If 10 women use IUCD for 10 years and assuming the failure rate of IUCD at 2/HWY, the number of expected accidental pregnancies would be-, with the following options: A: 1, B: 2, C: 5, D: 20 ### Response:

- Given PI=2 ; Time =10 x 12 =120 months ; No. of women = 10 - Number of expected accidental pregnancies = Pearl Index X Time X No. of women / 1200 = 2 x 120 x 10 / 1200 = 2

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: If 10 women use IUCD for 10 years and assuming the failure rate of IUCD at 2/HWY, the number of expected accidental pregnancies would be-, with the following options: A: 1, B: 2, C: 5, D: 20 ### Response: - Given PI=2 ; Time =10 x 12 =120 months ; No. of women = 10 - Number of expected accidental pregnancies = Pearl Index X Time X No. of women / 1200 = 2 x 120 x 10 / 1200 = 2 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: False statement regarding the procedure shown below is:, with the following options: A: Used to treat high grade CIN, B: Uses freeze thaw freeze technique, C: Destroys dysplastic epithelium upto a depth of 5mm, D: It is an OPD procedure ### Response:

Ans. A. Used to treat high grade CINa. The figure is showing a cryoprobe on the cervix while cryotherapy is being performed.b. It is an ablative procedure used for persistent CIN1. (cervical intraepithelial neoplasia)c. Useful for lesions involving the ectocervix onlyd. It is an OPD procedure and can be done under usual analgesics.e. It works by crystallization of the intracellular water and destroys the dysplastic epithelium upto a depth of 5mmf. It uses cold gas carbon dioxide or nitrous oxide at -22 degree Celsius.g. It works by freeze - thaw - freeze technique and a successful procedure should lead to a formation of an ice ball of 5 to 10mm as shown in this figure.h. The procedure can cause mild pain. It leads to persistent watery discharge. Cervical stenosis and incompetence following the procedure is rare.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: False statement regarding the procedure shown below is:, with the following options: A: Used to treat high grade CIN, B: Uses freeze thaw freeze technique, C: Destroys dysplastic epithelium upto a depth of 5mm, D: It is an OPD procedure ### Response: Ans. A. Used to treat high grade CINa. The figure is showing a cryoprobe on the cervix while cryotherapy is being performed.b. It is an ablative procedure used for persistent CIN1. (cervical intraepithelial neoplasia)c. Useful for lesions involving the ectocervix onlyd. It is an OPD procedure and can be done under usual analgesics.e. It works by crystallization of the intracellular water and destroys the dysplastic epithelium upto a depth of 5mmf. It uses cold gas carbon dioxide or nitrous oxide at -22 degree Celsius.g. It works by freeze - thaw - freeze technique and a successful procedure should lead to a formation of an ice ball of 5 to 10mm as shown in this figure.h. The procedure can cause mild pain. It leads to persistent watery discharge. Cervical stenosis and incompetence following the procedure is rare. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The normal value of P50 on the oxyhaemoglobin dissociation curve in an adult is, with the following options: A: 1.8 kPa, B: 2.7 kPa, C: 3.6 kPa, D: 4.5 kPa ### Response:

Adult Hb- 50% saturation at PO2 of 26mmHg. 1mmHg= 0.133 KPa 26mmHg= 0.133 X 26 = 3.45

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The normal value of P50 on the oxyhaemoglobin dissociation curve in an adult is, with the following options: A: 1.8 kPa, B: 2.7 kPa, C: 3.6 kPa, D: 4.5 kPa ### Response: Adult Hb- 50% saturation at PO2 of 26mmHg. 1mmHg= 0.133 KPa 26mmHg= 0.133 X 26 = 3.45 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following statements about vasomotor centre (VMC) is true?, with the following options: A: Independent of coiCohypothalamic inputs, B: Influenced by baroceptor signals but not by chemoreceptors, C: Acts along with the cardiovagal centre (CVC) to maintain blood pressure, D: Essentially silent in sleep ### Response:

The vasomotor center (VMC) is a poion of the medulla oblongata that, together with the cardiovascular center and respiratory center, regulates blood pressure and other homeostatic processes Ref: guyton and hall textbook of medical physiology 12 edition page number:201,202,203

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which of the following statements about vasomotor centre (VMC) is true?, with the following options: A: Independent of coiCohypothalamic inputs, B: Influenced by baroceptor signals but not by chemoreceptors, C: Acts along with the cardiovagal centre (CVC) to maintain blood pressure, D: Essentially silent in sleep ### Response: The vasomotor center (VMC) is a poion of the medulla oblongata that, together with the cardiovascular center and respiratory center, regulates blood pressure and other homeostatic processes Ref: guyton and hall textbook of medical physiology 12 edition page number:201,202,203 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Incubation period of plasmodium vivax is:, with the following options: A: 5 - 7 days, B: 7 - 10 days, C: 10 - 14 days, D: 15 - 30 days ### Response:

10 - 14 days

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Incubation period of plasmodium vivax is:, with the following options: A: 5 - 7 days, B: 7 - 10 days, C: 10 - 14 days, D: 15 - 30 days ### Response: 10 - 14 days ### 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 does not involve nerve damage -, with the following options: A: Guillian Barre syndrome, B: Erb's paralysis, C: Volkmann's paralysis, D: Neurotmesis ### Response:

Volkmann's ischemic contracture is also called Volkmann's ischemic paralysis. In Volkmann's ischemic contracture nerves (median & ulnar) are involved. But the contracture is due to necrosis and fibrosis as results of ischemia.

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 does not involve nerve damage -, with the following options: A: Guillian Barre syndrome, B: Erb's paralysis, C: Volkmann's paralysis, D: Neurotmesis ### Response: Volkmann's ischemic contracture is also called Volkmann's ischemic paralysis. In Volkmann's ischemic contracture nerves (median & ulnar) are involved. But the contracture is due to necrosis and fibrosis as results of ischemia. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: "Bernoulli's theorem" explains:, with the following options: A: Nasal polyp, B: Thyroglossal cyst, C: Zenker's diverticulum, D: Laryngomalacia ### Response:

(a) Nasal polyp(Ref. Scott Brown, 6th ed., 4/10/2)Thyroglossal cyst and laryngomalacia are the congenital malformations.Zenker's diverticulum occurs due to neuromuscular incoordination.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: "Bernoulli's theorem" explains:, with the following options: A: Nasal polyp, B: Thyroglossal cyst, C: Zenker's diverticulum, D: Laryngomalacia ### Response: (a) Nasal polyp(Ref. Scott Brown, 6th ed., 4/10/2)Thyroglossal cyst and laryngomalacia are the congenital malformations.Zenker's diverticulum occurs due to neuromuscular incoordination. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All have incubatory carriers, except-, with the following options: A: Tetanus, B: Measles, C: Whooping cough, D: Polio ### Response:

Tetanus is not transmitted from person to person; it has NO period of communicability. Delayed infections(up to several months later) are due to dormant spores in the wound. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 339, 340

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: All have incubatory carriers, except-, with the following options: A: Tetanus, B: Measles, C: Whooping cough, D: Polio ### Response: Tetanus is not transmitted from person to person; it has NO period of communicability. Delayed infections(up to several months later) are due to dormant spores in the wound. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 339, 340 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Marie, a 51-year-old woman, is diagnosed with cholecystitis. Which diet, when selected by the client, indicates that the nurse’s teaching has been successful?, with the following options: A: 4-6 small meals of low-carbohydrate foods daily, B: High-fat, high-carbohydrate meals, C: Low-fat, high-carbohydrate meals, D: High-fat, low protein meals ### Response:

For the client with cholecystitis, fat intake should be reduced. The calories from fat should be substituted with carbohydrates. Reducing carbohydrate intake would be contraindicated. Any diet high in fat may lead to another attack of cholecystitis.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Marie, a 51-year-old woman, is diagnosed with cholecystitis. Which diet, when selected by the client, indicates that the nurse’s teaching has been successful?, with the following options: A: 4-6 small meals of low-carbohydrate foods daily, B: High-fat, high-carbohydrate meals, C: Low-fat, high-carbohydrate meals, D: High-fat, low protein meals ### Response: For the client with cholecystitis, fat intake should be reduced. The calories from fat should be substituted with carbohydrates. Reducing carbohydrate intake would be contraindicated. Any diet high in fat may lead to another attack of cholecystitis. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Acute phase reactants are all except-, with the following options: A: C-reactive protein, B: Haptaglobulin, C: Endothelin, D: Fibrinogen ### Response:

Endothelin is a vasoconstrictive mediator released in response to endothelial dysfunction. Basic Pathology, Robbins. Page no.: 484

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Acute phase reactants are all except-, with the following options: A: C-reactive protein, B: Haptaglobulin, C: Endothelin, D: Fibrinogen ### Response: Endothelin is a vasoconstrictive mediator released in response to endothelial dysfunction. Basic Pathology, Robbins. Page no.: 484 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Blood gas paition coefficient of anaesthetic agent tells about, with the following options: A: Solubility in blood, B: Potency of agent, C: Time lag of induction of anaesthesia, D: All of the above ### Response:

Time lag of induction of anaesthesia Blood gas solubility (blood gas paition coefficient) is the best indicator for induction and recovery. Agent with less blood gas solubility will have fast induction and recovery while agents with less blood gas solubility will have slow induction Ref Katzung 12th ed.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Blood gas paition coefficient of anaesthetic agent tells about, with the following options: A: Solubility in blood, B: Potency of agent, C: Time lag of induction of anaesthesia, D: All of the above ### Response: Time lag of induction of anaesthesia Blood gas solubility (blood gas paition coefficient) is the best indicator for induction and recovery. Agent with less blood gas solubility will have fast induction and recovery while agents with less blood gas solubility will have slow induction Ref Katzung 12th ed. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Metastasis to liver is UNCOMMON with malignancy of: March2013, with the following options: A: Colon, B: Lung, C: Breast, D: Prostate ### Response:

Ans. D i.e. ProstateAlthough the most common primary sources producing hepatic metastases are those of the colon, breast, lung, and pancreas, any cancer in any site of the body may spread to the liver, including leukemias, melanomas, and lymphomas

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Metastasis to liver is UNCOMMON with malignancy of: March2013, with the following options: A: Colon, B: Lung, C: Breast, D: Prostate ### Response: Ans. D i.e. ProstateAlthough the most common primary sources producing hepatic metastases are those of the colon, breast, lung, and pancreas, any cancer in any site of the body may spread to the liver, including leukemias, melanomas, and lymphomas ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Prostaglandins are produced by ?, with the following options: A: Neutrophils, B: Endothelium, C: Macrophages, D: All of the above ### Response:

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

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Prostaglandins are produced by ?, with the following options: A: Neutrophils, B: Endothelium, C: Macrophages, D: All of the above ### Response: Ans. is 'd' i.e., All of the above ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Characteristic pathological finding in carcinoid of hea-, with the following options: A: Fibrous endocordial thickening of right ventricle andtricuspid valve, B: Collagen deposition in wall of right ventricle and tricuspid valve, C: Interstitial fibrous thickening of right ventricle and pulmonic valve, D: Mononuclear inflammatory infiltrate in the wall of right atrium ### Response:

The carcinoid syndrome results from bioactive compounds such as serotonin released by carcinoid tumors (; systemic manifestations include flushing, diarrhea, dermatitis, and bronchoconstriction. Carcinoid hea disease refers to the cardiac manifestation caused by the bioactive systemic syndrome develops. Cardiac lesions typically do not occur until there is a massive hepatic metastatic burden, since the liver normally catabolizes circulating mediators before they can affect the hea. Classically, endocardium and valves of the right hea are primarily affected since they are the first cardiac tissues bathed by the mediators released by gastrointestinal carcinoid tumors. (Robbins basic pathology,9th edition,pg no.395)

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Characteristic pathological finding in carcinoid of hea-, with the following options: A: Fibrous endocordial thickening of right ventricle andtricuspid valve, B: Collagen deposition in wall of right ventricle and tricuspid valve, C: Interstitial fibrous thickening of right ventricle and pulmonic valve, D: Mononuclear inflammatory infiltrate in the wall of right atrium ### Response: The carcinoid syndrome results from bioactive compounds such as serotonin released by carcinoid tumors (; systemic manifestations include flushing, diarrhea, dermatitis, and bronchoconstriction. Carcinoid hea disease refers to the cardiac manifestation caused by the bioactive systemic syndrome develops. Cardiac lesions typically do not occur until there is a massive hepatic metastatic burden, since the liver normally catabolizes circulating mediators before they can affect the hea. Classically, endocardium and valves of the right hea are primarily affected since they are the first cardiac tissues bathed by the mediators released by gastrointestinal carcinoid tumors. (Robbins basic pathology,9th edition,pg no.395) ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Creatinine is synthesized from, with the following options: A: Glycine, Arginine and Methionine, B: Glycine and Methionine, C: Ornithine and Glycine, D: Thymine and Ornithine ### Response:

Creatine & CreatinineCreatinine is formed in muscle from creatine phosphate by irreversible, nonenzymatic dehydration, and loss of phosphate. Since the 24-hour urinary excretion of creatinine is propoionate to muscle mass, it provides a measure of whether a complete 24-hour urine specimen has been collected. Glycine, arginine, and methionine all paicipate in creatine biosynthesis. Synthesis of creatine is completed by methylation of guanidinoacetate by S-adenosylmethionine.Ref: Harper&;s Biochemistry; 30th edition; Chapter 30; Conversion of Amino Acids to Specialized Products

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Creatinine is synthesized from, with the following options: A: Glycine, Arginine and Methionine, B: Glycine and Methionine, C: Ornithine and Glycine, D: Thymine and Ornithine ### Response: Creatine & CreatinineCreatinine is formed in muscle from creatine phosphate by irreversible, nonenzymatic dehydration, and loss of phosphate. Since the 24-hour urinary excretion of creatinine is propoionate to muscle mass, it provides a measure of whether a complete 24-hour urine specimen has been collected. Glycine, arginine, and methionine all paicipate in creatine biosynthesis. Synthesis of creatine is completed by methylation of guanidinoacetate by S-adenosylmethionine.Ref: Harper&;s Biochemistry; 30th edition; Chapter 30; Conversion of Amino Acids to Specialized Products ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: ST elevation and hyperacute T waves in precordeal leads VI to V6 and in lead aVL indicates:, with the following options: A: Anterolateral wall MI, B: Posterior wall MI, C: Inferior MI, D: Lateral wall MI ### Response:

Answer is A (Anterolateral wall MI) Acute transmural Anterolateral wall ischaemia is associated with changes in one or more of the precordial leads (V1 through V6)and in leads I and aVL

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: ST elevation and hyperacute T waves in precordeal leads VI to V6 and in lead aVL indicates:, with the following options: A: Anterolateral wall MI, B: Posterior wall MI, C: Inferior MI, D: Lateral wall MI ### Response: Answer is A (Anterolateral wall MI) Acute transmural Anterolateral wall ischaemia is associated with changes in one or more of the precordial leads (V1 through V6)and in leads I and aVL ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Investigation of choice for diagnosing lung sequestration is: March 2009, with the following options: A: X-ray chest-PA view, B: Plain CT scan-chest, C: Angiography, D: MRI ### Response:

Ans. C: Angiography A pulmonary sequestration, also known as a bronchopulmonary sequestration or a cystic lung lesion, is a medical condition where a piece of tissue that develops into lung tissue is not attached to the pulmonary blood supply and does not communicate with the other lung tissue. Often it gets its blood supply from the thoracic aoa. This condition is normally detected in children and is generally held to be congenital in nature. The treatment for this is a segmentectomy a thoracotomy. More and more, these lesions are diagnosed by prenatal ultrasound. Symptoms can vary greatly, but they include a persistent dry cough. Sequestrations can be identified in-utero an abnormal aery on ultrasound. The gold standard for diagnosis is pulmonary angiography, but it being a very invasive procedure is getting replaced by CT Scan with a contrasting fluid, as the investigation of choice.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Investigation of choice for diagnosing lung sequestration is: March 2009, with the following options: A: X-ray chest-PA view, B: Plain CT scan-chest, C: Angiography, D: MRI ### Response: Ans. C: Angiography A pulmonary sequestration, also known as a bronchopulmonary sequestration or a cystic lung lesion, is a medical condition where a piece of tissue that develops into lung tissue is not attached to the pulmonary blood supply and does not communicate with the other lung tissue. Often it gets its blood supply from the thoracic aoa. This condition is normally detected in children and is generally held to be congenital in nature. The treatment for this is a segmentectomy a thoracotomy. More and more, these lesions are diagnosed by prenatal ultrasound. Symptoms can vary greatly, but they include a persistent dry cough. Sequestrations can be identified in-utero an abnormal aery on ultrasound. The gold standard for diagnosis is pulmonary angiography, but it being a very invasive procedure is getting replaced by CT Scan with a contrasting fluid, as the investigation of choice. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The main source of menstrual blood during menstruation is:, with the following options: A: Aerial, B: Venous, C: Both, D: Cavernous ### Response:

Menstrual bleeding is from both systems, but aerial bleeding is appreciably greater than venous. Endometrial bleeding appears to follow rupture of an aeriole of a coiled aery, with consequent hematoma formation. With a hematoma, the superficial endometrium is distended and ruptures. Hemorrhage stops with aeriolar constriction. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 3. Implantation, Embryogenesis, and Placental Development. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The main source of menstrual blood during menstruation is:, with the following options: A: Aerial, B: Venous, C: Both, D: Cavernous ### Response: Menstrual bleeding is from both systems, but aerial bleeding is appreciably greater than venous. Endometrial bleeding appears to follow rupture of an aeriole of a coiled aery, with consequent hematoma formation. With a hematoma, the superficial endometrium is distended and ruptures. Hemorrhage stops with aeriolar constriction. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 3. Implantation, Embryogenesis, and Placental Development. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Sudden painful diminition of vision in Anterior Uveitis is due to, with the following options: A: Blood in Anterior chamber, B: Cells in Anterior chamber, C: Edema of Cornea, D: Ciliary muscle spasm ### Response:

Due to ciliary muscle spasm, convexity of lens increases leading to blurred vision and pain due to spasm.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Sudden painful diminition of vision in Anterior Uveitis is due to, with the following options: A: Blood in Anterior chamber, B: Cells in Anterior chamber, C: Edema of Cornea, D: Ciliary muscle spasm ### Response: Due to ciliary muscle spasm, convexity of lens increases leading to blurred vision and pain due to spasm. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which ofthe following drugs is used for Irritable Bowel Syndrome of the constipating type-, with the following options: A: Lubiprostone, B: Cholestyramine, C: Alosetron, D: Rifaximin ### Response:

Management of IBS The most impoant steps are to make a positive diagnosis and reassure the patient. Many people are concerned that they have developed cancer. A cycle of anxiety leading to colonic symptoms, which fuher heighten anxiety, can be broken by explaining that symptoms are not due to a serious underlying disease but instead are the result of behavioural, psychosocial, physiological and luminal factors. In individuals who fail to respond to reassurance, treatment is traditionally tailored to the predominant symptoms. Dietary management is effective for many patients. Up to 20% may benefit from a wheat-free diet, some may respond to lactose exclusion, and excess intake of caffeine or aificial sweeteners, such as sorbitol, should be addressed. A more restrictive, 'low-FODMAP' diet, supervised by a dietitian, with gradual re-introduction of different food groups, may help some patients, as may a trial of a gluten-free diet. Probiotics, in capsule form, can be effective if taken for several months, although the optimum combination of bacterial strains and dose have yet to be clarified. Patients with intractable symptoms sometimes benefit from several months of therapy with a tricyclic antidepressant, such as amitriptyline or imipramine (10-25 mg orally at night). Side-effects include dry mouth and drowsiness but these are usually mild and the drug is generally well tolerated, although patients with features of somatisation tolerate the drug poorly and lower doses should be used. It may act by reducing visceral sensation and by altering gastrointestinal motility. Anxiety and affective disorders may also require specific treatment . The 5-HT4 agonist prucalopride, the guanylate cyclase-C receptor agonist linaclotide, and chloride channel activators, such as lubiprostone, can be effective in constipation- predominant IBS. Trials of anti-inflammatory agents, such as ketotifen or mesalazine, and the antibiotic rifaximin may be considered in some patients with difficult symptoms but are best prescribed only after specialist referral. Psychological interventions, such as cognitive behavioural therapy, relaxation and gut-directed hypnotherapy, should be reserved for the most difficult cases. A range of complementary and alternative therapies exist; most lack a good evidence base but are popular and help some patients . Most patients have a relapsing and remitting course. Exac- erbations often follow stressful life events, occupational dissatisfaction and difficulties with interpersonal relationships. Ref Davidson edition23rd pg 826

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which ofthe following drugs is used for Irritable Bowel Syndrome of the constipating type-, with the following options: A: Lubiprostone, B: Cholestyramine, C: Alosetron, D: Rifaximin ### Response: Management of IBS The most impoant steps are to make a positive diagnosis and reassure the patient. Many people are concerned that they have developed cancer. A cycle of anxiety leading to colonic symptoms, which fuher heighten anxiety, can be broken by explaining that symptoms are not due to a serious underlying disease but instead are the result of behavioural, psychosocial, physiological and luminal factors. In individuals who fail to respond to reassurance, treatment is traditionally tailored to the predominant symptoms. Dietary management is effective for many patients. Up to 20% may benefit from a wheat-free diet, some may respond to lactose exclusion, and excess intake of caffeine or aificial sweeteners, such as sorbitol, should be addressed. A more restrictive, 'low-FODMAP' diet, supervised by a dietitian, with gradual re-introduction of different food groups, may help some patients, as may a trial of a gluten-free diet. Probiotics, in capsule form, can be effective if taken for several months, although the optimum combination of bacterial strains and dose have yet to be clarified. Patients with intractable symptoms sometimes benefit from several months of therapy with a tricyclic antidepressant, such as amitriptyline or imipramine (10-25 mg orally at night). Side-effects include dry mouth and drowsiness but these are usually mild and the drug is generally well tolerated, although patients with features of somatisation tolerate the drug poorly and lower doses should be used. It may act by reducing visceral sensation and by altering gastrointestinal motility. Anxiety and affective disorders may also require specific treatment . The 5-HT4 agonist prucalopride, the guanylate cyclase-C receptor agonist linaclotide, and chloride channel activators, such as lubiprostone, can be effective in constipation- predominant IBS. Trials of anti-inflammatory agents, such as ketotifen or mesalazine, and the antibiotic rifaximin may be considered in some patients with difficult symptoms but are best prescribed only after specialist referral. Psychological interventions, such as cognitive behavioural therapy, relaxation and gut-directed hypnotherapy, should be reserved for the most difficult cases. A range of complementary and alternative therapies exist; most lack a good evidence base but are popular and help some patients . Most patients have a relapsing and remitting course. Exac- erbations often follow stressful life events, occupational dissatisfaction and difficulties with interpersonal relationships. Ref Davidson edition23rd pg 826 ### 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 cyst of the spleen are, with the following options: A: Hydatid syst, B: Dermatoid cyst, C: Pseudocyst, D: Lymphangioma ### Response:

Pseudocyst or secondary cyst is the common cause for the development of cyst in the spleen ( constitutes 80% ). true cyst and parasitic cyst constitute 20% Reference: SRB 5th edition page no. 679

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most common cyst of the spleen are, with the following options: A: Hydatid syst, B: Dermatoid cyst, C: Pseudocyst, D: Lymphangioma ### Response: Pseudocyst or secondary cyst is the common cause for the development of cyst in the spleen ( constitutes 80% ). true cyst and parasitic cyst constitute 20% Reference: SRB 5th edition page no. 679 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: With which heart diseases in Pregnancy is prognosis worst:, with the following options: A: Eisenmenger's syndrome, B: Aortic Stenosis, C: Mitral Stenosis, D: MVP ### Response:

Ans. a (Eisenmenger's syndrome). (Ref. Textbook of obstetrics D C Dutta 6th ed. 296)HEART DISEASE IN PREGNANCY# The risk of fetal congenital malformations is increased by 3-10% if either parents have congenital lesions. In mother with AV septal defect, risk of having concordant abnormality in baby is very much high.# Most common heart disease in pregnancy is mitral stenosis.# Most common congenital heart disease during pregnancy is ASD.# Absolute indications for termination of pregnancy are = primary pulmonary hypertension, and Eisenmenger's syndrome as maternal mortality is otherwise found to be highest in them.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: With which heart diseases in Pregnancy is prognosis worst:, with the following options: A: Eisenmenger's syndrome, B: Aortic Stenosis, C: Mitral Stenosis, D: MVP ### Response: Ans. a (Eisenmenger's syndrome). (Ref. Textbook of obstetrics D C Dutta 6th ed. 296)HEART DISEASE IN PREGNANCY# The risk of fetal congenital malformations is increased by 3-10% if either parents have congenital lesions. In mother with AV septal defect, risk of having concordant abnormality in baby is very much high.# Most common heart disease in pregnancy is mitral stenosis.# Most common congenital heart disease during pregnancy is ASD.# Absolute indications for termination of pregnancy are = primary pulmonary hypertension, and Eisenmenger's syndrome as maternal mortality is otherwise found to be highest in them. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Rapidly absorbed in the stomach is: September 2006, with the following options: A: Protein, B: Carbohydrate, C: Fat, D: None ### Response:

Ans. D: NoneOnly alcohol is absorbed from the stomach.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Rapidly absorbed in the stomach is: September 2006, with the following options: A: Protein, B: Carbohydrate, C: Fat, D: None ### Response: Ans. D: NoneOnly alcohol is absorbed from the stomach. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Position of leg in fracture of neck of femur is- DELETE, with the following options: A: External rotation with patella facing inwards, B: External rotation with patella facing outwards, C: Internal rotation with patella facing outwards, D: Internal rotation with patella facing inwards ### Response:

*In fracture neck femur, the limb is in external rotation with patella facing outwards. Ref: Essential of Ohopaedics surgery 3rd/e p. 1012

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Position of leg in fracture of neck of femur is- DELETE, with the following options: A: External rotation with patella facing inwards, B: External rotation with patella facing outwards, C: Internal rotation with patella facing outwards, D: Internal rotation with patella facing inwards ### Response: *In fracture neck femur, the limb is in external rotation with patella facing outwards. Ref: Essential of Ohopaedics surgery 3rd/e p. 1012 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: ESI act was made in -, with the following options: A: 1946, B: 1948, C: 1952, D: 1954 ### Response:

- the ESI act passed in 1948 is an impoant measure of social security and health insurance in the country. - it provides for ceain cash and medical benefits to industrial employees in case of sickness, maternity and employment injury. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no: 815 <\p>

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: ESI act was made in -, with the following options: A: 1946, B: 1948, C: 1952, D: 1954 ### Response: - the ESI act passed in 1948 is an impoant measure of social security and health insurance in the country. - it provides for ceain cash and medical benefits to industrial employees in case of sickness, maternity and employment injury. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no: 815 <\p> ### 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 insulin can be given intravenously?, with the following options: A: Protamine zinc insulin, B: Ultra lente insulin, C: Semi lente insulin, D: Regular insulin ### Response:

Ans. is 'd' i.e., Regular insulin o All preparations are administered by S.C. route except regular insulin which can be given

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: The following insulin can be given intravenously?, with the following options: A: Protamine zinc insulin, B: Ultra lente insulin, C: Semi lente insulin, D: Regular insulin ### Response: Ans. is 'd' i.e., Regular insulin o All preparations are administered by S.C. route except regular insulin which can be given ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cervical was are seen with which HPV ?, with the following options: A: 11,13, B: 6, 11, C: 17,18, D: 5, 8 ### Response:

Ans. is 'b' i.e., 6, 11

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cervical was are seen with which HPV ?, with the following options: A: 11,13, B: 6, 11, C: 17,18, D: 5, 8 ### Response: Ans. is 'b' i.e., 6, 11 ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most impoant pathophysiological cause of GERD is:, with the following options: A: Hiatus hernia, B: Transient LES relaxation, C: Hypotensive LES, D: Intermittent changes in LES pressure tone ### Response:

Ans. b. Transient LES relaxation

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Most impoant pathophysiological cause of GERD is:, with the following options: A: Hiatus hernia, B: Transient LES relaxation, C: Hypotensive LES, D: Intermittent changes in LES pressure tone ### Response: Ans. b. Transient LES relaxation ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Position of the patient should be as described except, with the following options: A: Diagnostic laparoscopy- trendlelnburg with about 30 degree tilt, B: Colposcopy - Lithotomy, C: Transvaginal sonography in Gynecology - Lithotomy with full bladder, D: Hysteroscopy - Lithotomy ### Response:

Bladder should be empty during a transvaginal ultrasound

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Position of the patient should be as described except, with the following options: A: Diagnostic laparoscopy- trendlelnburg with about 30 degree tilt, B: Colposcopy - Lithotomy, C: Transvaginal sonography in Gynecology - Lithotomy with full bladder, D: Hysteroscopy - Lithotomy ### Response: Bladder should be empty during a transvaginal ultrasound ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which part is first involved by mummification?, with the following options: A: Heart, B: Skin, C: Stomach, D: Muscles ### Response:

Ans. is 'b' i.e., Skin Mummification* It is also a modification of putrefaction, which occurs in the absence of moisture. That is when there is excess air and warmth but no moisture (humidity), i.e. hot dry and windy climate, mummification takes place in place of normal putrefaction. Thus mummification occurs in deserts, especially in summer and also in bodies buried in shallow grave in sandy soil.* Mummification is characterized by dessication or drying of the dead body. There is drying, dehydration and shriveling of dead body. It proceeds from exterior to interior. Therefore first to be involved is skin, especially of exposed body parts like lips, nose tip, hands (fingers) and feet (toes). The skin is shrunken, contracted, dry, brittle, leathery, streched across bony prominences and rusty brown to black in color. Internal viscera also dry up, darken in color and blend with each other to form a single mass. Body emits smell like rotten cheese. Facial features and injuries are well preserved, thus identification of body and cause of death can be determined (like adipocere formation).* Time required for mummification varies between 3 months - 2 years. If properly preserved, a mummified body can remain for years. Chronic arsenic or antimony poisoning favor mummification.* Medicolegal importance: (i) Identification of body (facial features are preserved), (ii) cause of death (injury marks are preserved), (iii) time since death can be estimated.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Which part is first involved by mummification?, with the following options: A: Heart, B: Skin, C: Stomach, D: Muscles ### Response: Ans. is 'b' i.e., Skin Mummification* It is also a modification of putrefaction, which occurs in the absence of moisture. That is when there is excess air and warmth but no moisture (humidity), i.e. hot dry and windy climate, mummification takes place in place of normal putrefaction. Thus mummification occurs in deserts, especially in summer and also in bodies buried in shallow grave in sandy soil.* Mummification is characterized by dessication or drying of the dead body. There is drying, dehydration and shriveling of dead body. It proceeds from exterior to interior. Therefore first to be involved is skin, especially of exposed body parts like lips, nose tip, hands (fingers) and feet (toes). The skin is shrunken, contracted, dry, brittle, leathery, streched across bony prominences and rusty brown to black in color. Internal viscera also dry up, darken in color and blend with each other to form a single mass. Body emits smell like rotten cheese. Facial features and injuries are well preserved, thus identification of body and cause of death can be determined (like adipocere formation).* Time required for mummification varies between 3 months - 2 years. If properly preserved, a mummified body can remain for years. Chronic arsenic or antimony poisoning favor mummification.* Medicolegal importance: (i) Identification of body (facial features are preserved), (ii) cause of death (injury marks are preserved), (iii) time since death can be estimated. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Housemaid knee is an inflammation of:, with the following options: A: Lateral bursa, B: Prepatellar bursa, C: Suprapatellar bursa, D: Anserine bursa ### Response:

Prepatellar's bursitis is called "housemaids knee" or miner's kneePrepatellar bursitisIt is a common cause of swelling and pain above the patellaIt is due to inflammation of the prepatellar bursa.This structure is a superficial bursa with a thin synol lining located between the skin and the patella.The bursa develops within the first years of life as a result of mechanical pressure and friction, and it serves the purpose of reducing friction on underlying structures and allowing maximal range of motion in the knee.Aseptic prepatellar bursitis is commonly caused by repetitive work in a kneeling position, hence the name "housemaid's knee".Infrapatellar bursitis/clergyman's kneeIt is the inflammation of the infrapatellar bursa, which is located just below the patella.It is often called "clergyman's knee" due to its historical frequency amongst clergyman, who injured the bursa by kneeling on hard surfaces during prayer.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Housemaid knee is an inflammation of:, with the following options: A: Lateral bursa, B: Prepatellar bursa, C: Suprapatellar bursa, D: Anserine bursa ### Response: Prepatellar's bursitis is called "housemaids knee" or miner's kneePrepatellar bursitisIt is a common cause of swelling and pain above the patellaIt is due to inflammation of the prepatellar bursa.This structure is a superficial bursa with a thin synol lining located between the skin and the patella.The bursa develops within the first years of life as a result of mechanical pressure and friction, and it serves the purpose of reducing friction on underlying structures and allowing maximal range of motion in the knee.Aseptic prepatellar bursitis is commonly caused by repetitive work in a kneeling position, hence the name "housemaid's knee".Infrapatellar bursitis/clergyman's kneeIt is the inflammation of the infrapatellar bursa, which is located just below the patella.It is often called "clergyman's knee" due to its historical frequency amongst clergyman, who injured the bursa by kneeling on hard surfaces during prayer. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Malaria is transmitted by, with the following options: A: Female anopheles mosquito, B: Male anopheles mosquito, C: Culex mosquito, D: Aedes mosquito ### Response:

Ans. a (Female anopheles mosquito). (Ref. Park, PSM, 17th/pg.l94)TRANSMISSION OF MALARIA IS BY THREE MODES:# Vector transmission--by female anopheline mosquito# Direct--IM, IV, blood transfusion, drug addicts# CongenitalEducational point:# Blood transfusion of a person in endemic region and who has had malaria should not be accepted as donor until 3 years later.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Malaria is transmitted by, with the following options: A: Female anopheles mosquito, B: Male anopheles mosquito, C: Culex mosquito, D: Aedes mosquito ### Response: Ans. a (Female anopheles mosquito). (Ref. Park, PSM, 17th/pg.l94)TRANSMISSION OF MALARIA IS BY THREE MODES:# Vector transmission--by female anopheline mosquito# Direct--IM, IV, blood transfusion, drug addicts# CongenitalEducational point:# Blood transfusion of a person in endemic region and who has had malaria should not be accepted as donor until 3 years later. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cushing reflex is:, with the following options: A: | Mean arterial pressure with increased intracranial pressure, B: | Mean arterial pressure with decreased intracranial pressure, C: | Mean arterial pressure with increased intracranial pressure, D: | Mean arterial pressure with decreased intracranial pressure ### Response:

Ans.(a) |Mean arterial pressure with increased intracranial pressureRef: Schwartz 10/e pi580-1583Cushing reflex is caused by increased ICP* C/B- Increase in Systolic BP, Decreased Heart Rate and Irregular respiration* Due to insufficient blood flow and arteriole compression

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Cushing reflex is:, with the following options: A: | Mean arterial pressure with increased intracranial pressure, B: | Mean arterial pressure with decreased intracranial pressure, C: | Mean arterial pressure with increased intracranial pressure, D: | Mean arterial pressure with decreased intracranial pressure ### Response: Ans.(a) |Mean arterial pressure with increased intracranial pressureRef: Schwartz 10/e pi580-1583Cushing reflex is caused by increased ICP* C/B- Increase in Systolic BP, Decreased Heart Rate and Irregular respiration* Due to insufficient blood flow and arteriole compression ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Manifestation of squint in children are all EXCEPT, with the following options: A: Diplopia, B: Confusion, C: Detion of eye, D: Stereopsis ### Response:

D i.e. Stereopsis Stereopsis means binocular depth perception. In squint due to detion of eye the two images formed in two eyes are vastly different and the brain is unable to fuse them resulting in diplopia, confusion, nausea & vomiting. Therefore, in squint there is no stereopsis Q

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Manifestation of squint in children are all EXCEPT, with the following options: A: Diplopia, B: Confusion, C: Detion of eye, D: Stereopsis ### Response: D i.e. Stereopsis Stereopsis means binocular depth perception. In squint due to detion of eye the two images formed in two eyes are vastly different and the brain is unable to fuse them resulting in diplopia, confusion, nausea & vomiting. Therefore, in squint there is no stereopsis Q ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Following anterior dislocation of the shoulder, apt develops weakness of flexion at the elbow and lack of sensation over the lateral aspect forearm; nerve injured is -, with the following options: A: Radial nerve, B: Musculocutanous nerve, C: Axillary nerve, D: Ulnar nerve ### Response:

The most common complication of anterior dislocation of the shoulder is axillary (circumflex) nerve injury. There is consequent paralysis of the deltoid muscle, with a small area of anaesthesia at the lateral aspect of the upper arm. However, in this question, the sensation is lost on the lateral aspect of the forearm (not arm). The lateral side of the forearm has sensory supply from the lateral cutaneous nerve of foreign, a branch of musculocutaneous nerve. The musculocutaneous nerve also supplies the biceps brachii (a flexor of elbow joint). Therefore, musculocutaneous nerve injury will cause sensory loss over the lateral aspect of the forearm with the weakness of flexion at the elbow. As occasionally other branches of brachial plexus (other than axillary nerve) can also be injured, the answer to this question is a musculocutaneous nerve.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Following anterior dislocation of the shoulder, apt develops weakness of flexion at the elbow and lack of sensation over the lateral aspect forearm; nerve injured is -, with the following options: A: Radial nerve, B: Musculocutanous nerve, C: Axillary nerve, D: Ulnar nerve ### Response: The most common complication of anterior dislocation of the shoulder is axillary (circumflex) nerve injury. There is consequent paralysis of the deltoid muscle, with a small area of anaesthesia at the lateral aspect of the upper arm. However, in this question, the sensation is lost on the lateral aspect of the forearm (not arm). The lateral side of the forearm has sensory supply from the lateral cutaneous nerve of foreign, a branch of musculocutaneous nerve. The musculocutaneous nerve also supplies the biceps brachii (a flexor of elbow joint). Therefore, musculocutaneous nerve injury will cause sensory loss over the lateral aspect of the forearm with the weakness of flexion at the elbow. As occasionally other branches of brachial plexus (other than axillary nerve) can also be injured, the answer to this question is a musculocutaneous nerve. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: HLA complex is on chromosome?, with the following options: A: 6, B: 7, C: 8, D: 9 ### Response:

Ans. is 'a' i.e., 6 HLA complex of genes is located on the sho arm of chromosome 6.

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: HLA complex is on chromosome?, with the following options: A: 6, B: 7, C: 8, D: 9 ### Response: Ans. is 'a' i.e., 6 HLA complex of genes is located on the sho arm of chromosome 6. ### End

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Disinfection of water is not required if the source is from-, with the following options: A: Tube well, B: Step well, C: Draw well, D: River ### Response:

Ans. is 'a' i.e., Tube well

Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Answer the following medical question: Disinfection of water is not required if the source is from-, with the following options: A: Tube well, B: Step well, C: Draw well, D: River ### Response: Ans. is 'a' i.e., Tube well ### End