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{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nCalorie requirement per day of a child weighing 15 kg would be -\nA) 1150 kcal\nB) 1250 kcal\nC) 1450 kcal\nD) 1550 kcal", "output": "1, because Ans. is 'b' i.e., 1250 kcal"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nA 24-year-old medical student was bitten at the base of her thumb by her dog. The wound became infected and the infection spread into the radial bursa. The tendon(s) of which muscle will most likely be affected?\nA) Flexor digitorum profundus\nB) Flexor digitorum superficialis\nC) Flexor pollicis longus\nD) Flexor carpi radialis", "output": "2, because Tenosynovitis can be due to an infection of the synovial sheaths of the digits. Tenosynovitis in the thumb may spread through the synovial sheath of the flexor pollicis longus tendon, also known as the radial bursa. The tendons of the flexor digitorum superficialis and profundus muscles are enveloped in the common synovial flexor sheath, or ulnar bursa. Neither the flexor carpi radialis nor flexor pollicis brevis tendons are contained in synovial flexor sheaths."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nA two way process of exchanging or shaping ideas,\nfeeling and information is called as\nA) Education\nB) Communication\nC) Interview\nD) Suggestion", "output": "1, because None"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nAngular vein infection causes thrombosis in:\nA) Cavernous sinus\nB) Suprasaggital sinus\nC) Transverse sinus\nD) Inferior petrosal sinus", "output": "0, because Ans. A Cavernous sinusRef: Gray's Anatomy, 40th ed. Ch; 29* The upper most segment of the facial vein, above its junction with the superior labial vein, is also called the angular vein.* Any infection of the mouth or face can spread via the angular veins to the cavernous sinuses resulting in thrombosis."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nWhich laxative acts by opening of Chloride channels ?\nA) Docusate\nB) Anthraquinone\nC) Lubiprostone\nD) Bisacodyl", "output": "2, because Ans. is 'c' i.e., Lubiprostone o Lubiprostone is used for chronic constipation, it acts by - o Stimulating Cl- channel opening in the intestine. Increasing liquid secretion in gut. Decreasing transit time."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAll the following features favour ventricular tachycardia as the cause of broad-complex tachycardia, except -\nA) Fusion beats\nB) Extreme left axis deviation\nC) Very broad QRS complexes (> 140 ms)\nD) Non response to carotid sinus massage", "output": "2, because None"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nLallu a 22 yrs. old male suffers from decreased sleep, increased sexual activity, excitement and spending excessive money for last 8 days. The diagnosis is-\nA) Confusion\nB) Mania\nC) Hyperactivity\nD) Loss of memory", "output": "1, because Decreased sleep, increased sexual activity, excitement and spending excessive money are symptoms of mania."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nBranches of celiac trunk are all except-\nA) Splenic artery\nB) Left gastric artery\nC) Hepatic artery\nD) Inferior phrenic artery", "output": "3, because Ans. is 'd' i.e.. Inferior phrenic artery Inferior phrenic artery is a branch of abdominal aorta, not of Celiac trunk. Branches of Celiac trunk is a extremely important topic for PG exams. Branches of important arteries are very often asked in PG exams. I am giving a list of important arteries. Learn their branches by heart if you want to get selected Celiac trunk Superior mesentric artery Inferior mesentric artery Abdominal aorta Thoracic aorta Internal iliac artery Subclavian artery Axillary artery Carotid artery Maxillary artery Basilar artery Don't waste time on learning the course or relation of arteries. They are never or very rarely asked."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nThe disease process that best accounts for this problem:\nA) Ethylene glycol poisoning\nB) Chronic obstructive pulmonary disease\nC) Congestive hea failure\nD) Vomiting", "output": "3, because Vomiting"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nLoeffler&;s syndrome occurs in all except\nA) Toxocara\nB) Stongyloides\nC) Ascaris\nD) Giardia", "output": "3, because *Giardia lamblia -intestinal flagellate,causing intestinal infection. *Loeffler syndrome- inflammatory and hypersensitivity reaction in the lungs lead to cough ,fever, dyspnoea and eosinophilia *toxocara causes visceral larva migrans . ref:Baveja textbook of parasitology 3rd edition."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nA 7-day-old premature infant born at 26 weeks of gestation now has a grossly bloody stool, abdominal distention, and increasing oxygen requirements. choose the best initial diagnostic step in the evaluation of the patient's apparent GI hemorrhage.\nA) Abdominal series\nB) Fiberoptic endoscopy\nC) Apt test\nD) Routine stool culture", "output": "0, because Necrotizing enterocolitis (NEC) is a life-threatening condition seen mostly in premature infants. Although the precise etiology is unknown, contributing factors include GI tract ischemia, impaired host immunity, the presence of bacterial or viral pathogens, and the presence of breast milk or formula in the gut. Findings include bloody stools, abdominal distension, hypoxia, acidosis, and emesis. The initial diagnostic test of choice is plain film radiographs. The characteristic finding in NEC is pneumatosis intestinalis; free air in the peritoneum may also be seen. Perforation is a surgical emergency, otherwise observation and antibiotics are indicated."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nLactic acid is produced in mouth by\nA) Saccharolytic bacteria in supragingival region\nB) Saccharolytic bacteria in subgingival region\nC) Non-saccharolytic bacteria in supragingival region\nD) Non-saccharolytic bacteria in subgingival region", "output": "0, because None"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nCommonest site of liquifactive necrosis is\nA) Brain\nB) Kidney\nC) Liver\nD) Spleen", "output": "0, because Ans. a (Brain). (Ref. Robbins, Pathologic Basis of Disease, 8th/pg.7-13)NECROSIS# Enzymatic degradation of a cell resulting from exogenous injury.# Characterized by enzymatic digestion and protein denaturation, with release of intracellular components.# Morphologically occurs as coagulative (heart, liver, kidney), liquefactive (brain), caseous (tuberculosis), fat (pancreas), fibrinoid (blood vessels), or gangrenous (limbs, GI tract).# Kidney infarct exhibiting coagulative necrosis will be seen with loss of nuclei and clumping of cytoplasm but with preservation of basic outlines of glomerular and tubular architecture.# Liquefactive necrosis in the kidney can be caused by fungal infection, which will be seen filled with white cells and cellular debris, creating a renal abscess that obliterates the normal architecture.IRREVERSIBLE INJURY AND CELL DEATHMORPHOLOGIC PATTERNCHARACTERSTICSCOAGULATIVE NECROSISMost common type (e.g. Heart, liver, kidney)LIQUEFACTIVE NECROSISAbscesses, brain infarcts, pancreatic necrosisCellular destruction by hydrolytic enzymesCASEOUS NECROSISSeen in tuberculosisCombination of coagulation and liquefaction necrosis soft, friable, and \"cottage-cheese-like\" appearanceFAT NECROSISCaused by the action of lipases on fatty tissue (e.g. with pancreatic damage)Chalky white appearanceFIBRINOID NECROSISEosinophilic homogenous appearance - resembles fibrinGANGRENOUS NECROSISCommon sites: lower limbs, gallbladder, Gl tract and testesDry gangrene - coagulative necrosisWet gangrene - liquefactive necrosisAPOPTOSISA specialized form of programmed cell death, an active process under genetic control.Executed in mitochondria.Mediated by a cascade of caspases (digest nuclear and cytoskeletal proteins and active endonucleases)."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nIxabepilone is used in:\nA) Melanoma\nB) Breast carcinoma\nC) Oat cell carcinoma\nD) Small cell carcinoma lung", "output": "1, because Chemotherapy regimen in CA BreastMnemonic- CMF- C- cyclophosphamide- M- methotrexate- F -5- FUMnemonic-CAF- C- cyclophosphamide- A- Adriamycin (doxorubicin) (anthracycline derivative)- F - 5 - FU- The preferred form of chemotherapy for CA breast - CAF or Adriamycin or Anthracycline based Chemotherapy.- Usually 6 cycles are given- For Adriamycin resistant breast cancer - Taxanes are given (Docetaxel, Paclitaxel)- Chemotherapy agent given in Adriamycin & Taxane resistant breast cancer - IXABEPILONE- LAPATINIB - 2nd line agent for HER-2-NEU + ve breast cancer- HERCEPTIN /TRASTUZUMAB - 1st line agent for HER-2-neu +ve breast cancer Drug given in metastatic and refractory breast cancer - SUNITINIB 1st line agent for advanced and metastatic RCC - SUNITINIBDrug of choice for Imatinib resistant GIST - SUNITINIB."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nHead of sperm is derived from:\nA) Golgi Body.\nB) Nucleus\nC) Mitochondria.\nD) Centromere", "output": "1, because Ans. B. NucleusThe spermatozoon consists of head, neck, and tail. The tail is further divided into three parts: middle piece, principle piece, and end piece.a. The head mainly consists of a nucleus that contains the condensed chromatin material (mostly DNA).b. Anterior two-third of the nucleus is covered by an acrosomal cap that contains various enzymes including hyaluronidase and acrosin.c. Neck contains a funnel-shaped basal plate and a centriole. The centriole gives rise to axial filament that extends throughout the tail.d. Middle piece contains the axial filament in the center that is surrounded by spirally arranged mitochondrial sheath."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nHepatitis A virus shedding in faeces is\nA) One week before the symptoms appear\nB) Two weeks after the symptoms appear\nC) One week before the symptoms and one week thereafter\nD) Two weeks before the symptoms and two week thereafter", "output": "3, because None"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nSpinal anaesthesia in an adult is given at this level:\nA) T12-L1\nB) L1-L2\nC) L3-L4\nD) L5-S1", "output": "2, because Spinal cord ends at lower border of L1 in adults .Hence spinal anesthesia can be given at levels below L1 . L2-L3 or L4-L5 are considered best in adults"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nDecreased motility of fallopian tube is seen in -\nA) Churg- strauss syndrome\nB) Kartagener s syndrome\nC) Noonan syndrome\nD) Turner syndrome", "output": "1, because Ans-B"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nThe earliest manifestation of increased intracranial pressure following head injury is\nA) Ipsilateral pupillary dilatation\nB) Contralateral pupillary dilation\nC) Altered mental status\nD) Hemiparesis", "output": "2, because \u2022 Early signs of elevated ICP includes drowsiness and a diminished level of consciousness.\n\u2022 Coma and unilateral papillary changes are late signs and require immediate intervention."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nWhat is the most likely diagnosis in this 50-year-old woman?\nA) Metastasis\nB) Onychomycosis\nC) Psoriasis\nD) Thromboangiitis obliterans", "output": "0, because Answer A. MetastasisFollowing radiography that revealed a lytic lesion of the terminal phalynx, the firm 2-cm lesion with a scab in the center was biopsied and found to represent a metastasis from follicular thyroid carcinoma."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nAt what level of b-hCG is it that normal pregnancy can be earliest detected by TVS (transvaginal USG)?\nA) 500 IU/mL\nB) 1000 IU/mL\nC) 1500 IU/mL\nD) 2000 IU/mL", "output": "1, because Ans. is b, i.e. 1000IU/MLRef Dutta Obs. 7/e, p 642Critical titre of hCG:b-hCG level (mIU/ml)Structure visibleTVS/TAS* 1000-1200Gestational sacTVS* 6000Gestational SacTAS"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nIn a patient of cholangitis, surgical intervention was performed. In post-operative period, on 10th day this investigation was performed. What is the name of this investigation?\nA) ERCP\nB) MRCP\nC) T-tube cholangiogram\nD) PTC", "output": "2, because The investigation is T-tube cholangiogram."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nHepatitis B virus is NOT present in\nA) Milk\nB) Sweat\nC) Stool\nD) Lymph", "output": "3, because (ref: Harrison's 18/e p2108)"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nMilroys disease is lymphedema which is-\nA) Familial\nB) Follows filariasis\nC) Follows erysipelas\nD) A sequele to white leg", "output": "0, because None"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nErythropoietin is inhibited by\nA) Estrogen\nB) Progesterone\nC) Thyroxine\nD) Testosterone", "output": "0, because Glycoprotein hormone that controls erythropoiesis, or red blood cell production. Estrogen inhibits the erythropoietin whereas testosterone stimuates production . Ref: Ganong's Review of Medical Physiology; 24th edition; page no: 709"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nOther than nitrogen and oxygen, which one of the following is the most abundant gas in the eah's atmosphere?\nA) Argon\nB) Carbon dioxide\nC) Hydrogen\nD) Methane", "output": "0, because Atmosphere composition Nitrogen 78% O2 21% Argon 0.9% CO2 0.03%"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nBlood spill disinfection by:\nA) Isopropyl alcohol\nB) Hypochlorite\nC) Formalin\nD) Glutaraldehyde", "output": "1, because ANS. B# Spaulding's classification for sterilization1. Critical, e.g. heart lung machine, scalpel (contact with blood)2. Semicritical, e.g. endoscopes3. Noncritical, e.g. stethoscope, BP cuff, plasters.Method of sterilization1. Critical: Autoclave/ethylene oxide2. Semicritical: 2% glutaraldehyde for 20 minutes3. For plastic tubes: Gamma rays"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nMost permissible capillaries are seen in\nA) Kidney\nB) Liver\nC) Brain\nD) Skin", "output": "1, because Capillaries are classified in toContinuous or non fenestrated capillaries - Endothelial cells are arranged without any gap in between them. Eg. Skin, BBB. Allows only very small molecules to pass through. Fenestrated capillaries - Gaps in between endothelial cells ranging from 70-100nm in diameter which are lined by basement membrane. Eg. Capillaries of intestinal villi, renal glomeruli, choroid plexus of the ventricles of the brain, ciliary process of eyes and endocrine glandsDiscontinuous type- Very wide cleft are present in between endothelial cells. The basement membrane is incomplete or absent. Almost all substance in plasma can cross this gap. Seen in liver sinusoids, sinusoids of spleen, anterior pituitary and parathyroid gland Ref: Textbook of medical physiology by N Geetha, 2nd edition, page no. 194"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nA 41-year-old male patient presented with recurrent episodes of bloody diarrhoea for 5 years. Despite regular treatment with adequate doses of sulfasalazine, he has had several exacerbations of his disease and required several weeks of steroids for the control for flares. What should be the next line of treatment for him?\nA) Methotrexate\nB) Azathioprine\nC) Cyclosporine\nD) Cyclophosphamide", "output": "1, because None"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAnaplasia is a hallmark feature of _________.\nA) Benign tumors\nB) Malignant tumors\nC) Both 1 & 2\nD) Normal cell", "output": "1, because Anaplastic cells often display the following morphologic features:\n\nPleomorphism (i.e. variation in size and shape).\nNuclear abnormalities, consisting of extreme hyperchromatism\u00a0(dark-staining),\u00a0variation\u00a0in\u00a0nuclear\u00a0size\u00a0and shape, or unusually prominent single or multiple nucleoli.\u00a0Enlargement of nuclei may result\u00a0in\u00a0an\u00a0increased nuclear-to-cytoplasmic ratio that approaches 1:1 instead of the normal 1:4 or 1:6. Nucleoli may attain astounding sizes,\u00a0sometimes approaching\u00a0the\u00a0diameter\u00a0of normal lymphocytes.\nTumor giant cells may be formed.\u00a0\nAtypical mitoses,\u00a0which\u00a0may\u00a0be\u00a0numerous.\u00a0Anarchic multiple spindles may produce tripolar or quadripolar mitotic figures.\u00a0\nLoss of polarity.\n\n\u200bReference-Robbins BASIC PATHOLOGY 10th edition pg-193"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nActive moiety of CoA is\nA) Acetyl group\nB) Pantothenic acid\nC) Thiol of beta alanine\nD) Thiol of pantothenic acid", "output": "3, because -\u00a0Synthesis of coenzyme A from pantothenate occurs in a series of\u00a0 reactions.\u00a0Pantothenate is\u00a0 first\u00a0phosphorylated to\u00a0 which\u00a0 cysteine is\u00a0 added. Decarboxylation, followed by addition of AMP moiety and a phosphate (each from ATP) results in\u00a0 coenzyme A.\n-Coenzyme A serves as a carrier of activated acetyl or acyl groups (as thiol esters)."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAll the following are radiological features of Chronic Cor pulmonale except-\nA) Kerley B lines\nB) Prominent lower lobe vessels\nC) Pleural effusion\nD) Cardiomegaly", "output": "1, because Answer is B (Prominent lower lobe vessels) : Chronic Cor Palmonale is associated with prominence of upper lobe and not lower lobe veins. Features of Congestive Cardiac Failure(CCF / CHF) include : 1. Enlarged cardiac silhouette / Cardiac shadow on chest X-rayQ 2. Ground glass appearance of pulmonary edema Q 3. 'Kerley B' linesQ 4. Prominence of upper lobe blood vessels Q (not lower lobe veins) 5. Pleural effusion, usually bilateral Q 'Kerley B' lines', also known as 'Septa' lines', represent dilated lymphatics and distended interlobular septa. They occur most commonly in pulmonary edema as a result of chronic pulmonary venous hypeension (in CCF). Kerley 'A' lines stand for Apex, 'B' for Base, and 'C' for Central region. B lines are most commonly seen Q.Infact they have a relation with left atrial pressure Q :They are invariably present if LA pressure goes above 20 mmHg. Q Small bilateral pleural effusions are frequently seen in acute LVF. Large effusion may be present in long standing cases of congestive hea failure."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nNestritide is a -\nA) Brain Natriuretic peptide analogue\nB) Endothelin R antagonist\nC) Gp Ilb/IIIa antagonist\nD) INF-a antagonist", "output": "0, because Ans. is 'a' i.e., Brain natriuretic peptide analogue"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nLeukoplakia appears white due to :\nA) Cornified layer which imbibes water.\nB) Thick epithelium\nC) Underlying connective tissue\nD) All of the above", "output": "0, because None"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nWhich of the following tooth can show any of the eight types of Vertucci\u2019s classi\ufb01cation?\nA) Lower 1st premolar\nB) Upper 1st premolar\nC) Lower 2nd premolar\nD) Upper 2nd premolar", "output": "3, because Maxillary 2nd premolar can show any of the eight types of Vertucci's classi\ufb01cation."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nA 25 yr old lady develops brown macular lesions over the bridge of nose and cheeks following exposure to sunlight. What is the most probable diagnosis?\nA) Chloasma\nB) Photodermatitis\nC) SLE\nD) Acne rosacea", "output": "0, because This lady is showing features of chloasma which is a brownish macular hyperpigmentation of the face mostly over the cheek, forehead, nose, upper lip and chin. In a small percentage of cases it is also seen on the malar or mandibular areas of the face and occasionally the dorsum of the forearms. It is exacerbated by sunlight. This is usually seen in women during pregnancy, in women taking OCPs and living in sunny regions. It is also associated with the ingestion of diphenylhydantoin. Ref: Suurmond D. (2009). Section 13. Pigmentary Disorders. In D. Suurmond (Ed), Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology, 6e."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nWhich of the following is a BNP analogue?\nA) Eplerenone\nB) Nesiritide\nC) Levosimendan\nD) Coenzyme Q", "output": "1, because Ans. B. NesiritideBNP (Brain natriuretic peptide) is peptide which is secreted & formed in right atrium of the heart. This is responsible for vasodilation & hence used in CHF. Nesiritide is BNP analogue"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nIntravascular heamolysis occurs in\nA) Hereditory spherocytosis\nB) Antoimmune haemolytic anemia\nC) Paroxysmal nocturnal hemoglobinuria\nD) Thalassemia", "output": "2, because Paroxysmal noctural hemoglobunuria (PNH) is the only hemolytic anemia caused by an acquired intrinsic defect in the cell membrane. It is associated with intravascular hemolysis. Rest all conditions causes extravascular heamolysis."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nHealing of a wound which simply restores the continuity of the diseased marginal gingiva is known as\nA) Regeneration\nB) new attachment\nC) Repair\nD) reattachment", "output": "2, because None"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nIntra uterine growth retardation can be caused by all except -\nA) Nicotine\nB) Alcohol\nC) Propranolol\nD) Phenothiazine", "output": "3, because Ans. is d i.e., Phenotiazines"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAn alcoholic is brought to the casualty, 3 days after he quit alcohol, with the complaints of irrelevant talking. On examination, he is found to be disoriented to time, place and person. He also has visual illusions and hallucinations. There is no history of head injury. The most probable diagnosis is:\nA) Schizophrenia\nB) Delirium tremens\nC) Dementia praecox\nD) Korsakoff psychosis", "output": "1, because This patient in the question who is a chronic alcoholic is showing features of delirium tremens, which typically appears after 3-4 days of abstinence from alcohol (24 hours to 7 days). Ref: CURRENT Diagnosis and Treatment: Emergency Medicine, 7th Edition, Chapter 37 ; CURRENT Diagnosis and Treatment: Psychiatry, 2nd Edition, Chapter 14"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nRepeat upper GI endoscopy in a patient with a gastric ulcer is performed after how many weeks of PPI therapy to assess the healing of the ulcer and confirm absence of malignancy:\nA) 2 weeks\nB) 4 weeks\nC) 6 weeks\nD) 12 weeks", "output": "2, because Repeat upper endoscopy is done in patients with a gastric ulcer after 6 to 10 weeks of acid suppressive therapy to confirm healing of the ulcer and absence of malignancy. 2% to 4% of repeat upper endoscopies have been repoed to disclose gastric cancer. Ref: Sleisenger and Fordtran's, E-9, P-305"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nHassal's corpuscles are seen in\nA) Thymus\nB) Thyroid\nC) Parathyroid\nD) Spleen", "output": "0, because Corpuscles of hassall present in the medulla of thymus Formed from eosinophilic epithelial reticular cells arranged concentrically INDERBIR SINGH'S TEXTBOOK OF HUMAN HISTOLOGY SEVENT EDITION PAGE NO139"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nTrue regarding amaurosis fugax are all except:\nA) Transient, recurrent episodes of visual loss\nB) Binocular lesion\nC) Embolus from carotid aery is commonest cause\nD) Ocular examination may be normal", "output": "1, because Amaurosis fugax Sudden, temporary and painless monocular visual loss occurring due to a transient failure of retinal circulation. Uniocular lesion Lasts for 2-5 minutes and resolves in the reverse pattern of progression, leaving no residual deficit. Fundus : May be normal or shows retinal ischemia-Retinal oedema and small superficialhaemorrhages Causes : Carotid transient ischaemic attacks (TIA) Embolization of retinal circulation Papilloedema Giant cell aeritis Raynaud's disease Migraine Hypeensive retinopathy Venous stasis retinopathy"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nNot a indication for admission in pneumonia ?\nA) Fever of 390 c\nB) Cyanosis\nC) Chest retracion\nD) Not feeding well", "output": "0, because Ans. is 'a' i.e., Fever of 39degC Indications for urgent referral for hospital in AI Not able to drink Convulsions Severe malnutrition Stridor in calm child Abnormally sleepy or difficult to wake o All these are signs of very severe disease which is an indication for urgent hospital referrel. o Signs of very severe pneumonia i.e., chest retraction, cyanosis are also indications for urgent referrel to a hospital."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nA dental floss is applied to the distal bow of a clamp, its function is:\nA) To facilitate the removal of the clamp\nB) To prevent aspiration of clamp\nC) To anchor the dam as cervically as possible\nD) To stabilize the clamp", "output": "1, because None"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nBest way to prevent infection after cataract surgery is\nA) Antibiotics\nB) Eye brow shaving\nC) Through irrigation\nD) None of the above", "output": "0, because Topical antibiotics such as tobramycin or gentamicin or ciprofloxacin QID for 3 days just before surgery is advisable as prophylaxis against endophthalmitis.Ref: Khurana; 4th edition; Pg- 184"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nWhich of the following antismoking drugs can lead to suicidal ideation?\nA) Baclofen\nB) Rimonobant\nC) Varenicline\nD) Naltrexone", "output": "2, because Vareniciline is a partial agonist at\u00a0\u03b14 \u03b22 substype of nicotine receptor used to treat tobbacco addiction.\nSide effects include suicidal ideation, nausea, headache & insomnia."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nPositive dipstick for RBC with red color urine and red supernatant and clear sediment with positive dipstick -\nA) Porphyria\nB) Hematuria\nC) Hemolysis\nD) Rhabdomyolysis", "output": "3, because Answer- D. RhabdomyolysisIf a urine dipstick of the red supernatant is positive for heme, the patient has either hemoglobinuria or myoglobinuria.If a urine dipstick of the red supernatant is negative for heme, the patient may have one of a variety of unusual conditions"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nComplications of obesity is/are: 1. Venous ulcer 2. Pulmonary embolism 3. Pickwickian syndrome 4. Hernias 5. Pulmonary hypeension\nA) 1,2,3 & 4\nB) 2,3,4 & 5\nC) 1,2,3 & 5\nD) All are true", "output": "3, because Clinical presentation of obesity The morbidly obese patients often presents with chronic weight-related problems such as migraine headaches; back and lower extremity joint pain from degenerative joint disease; venous ulcers; dyspnea on exeion; biliary colic; stress urinary incontinence; dysmenorrhea; infeility; gastroesophageal reflux; and inguinal, umbilical, and incisional hernias. Obesity has a profound effect on overall health and life expectancy. The morbidly obese are predisposed to developing serious weight-related comorbidities, including hypeension, CAD, adult onset DM, sleep apnea and/or obesity hypoventilation syndrome (Pickwickian syndrome), deep venous thrombosis, pulmonary embolism, hypercoagulability, hyperlipidemia, and depression among others. Physiological abnormalities resulting from OSA include hypoxemia, hypercapnia, pulmonary and systemic vasoconstriction, and secondary polycythemia (from recurrent hypoxemia). These result in an increased risk of ischemic hea disease and cerebrovascular disease. Right ventricular failure can occur from hypoxic pulmonary vasoconstriction. Obesity is now considered to be the second leading cause of preventable death behind cigarette smoking. The incidence of comorbidities and moalities is directly related to the degree of obesity. in a study with 12 year follow up, moalities rates for those weighing 50% over average weight were doubled. Moalities and morbidities is largely attributable to the comorbidities of obesity. Ref: Schwaz 9/e, Page 1743."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAll are true about popliteus except -\nA) Flexes the knee\nB) Unlocks the knee .\nC) Inserted on medial meniscus\nD) Intracapsular", "output": "2, because Popliteus has an intracapsular origin that arises from lateral surface of lateral condyle of femur and from outer margin of lateral meniscus of knee. It inserts onto the posterior surface of shaft of tibia above the soleal line. Nerve supply: Tibial nerve.\nAction: Unlocking of knee joint by lateral rotation of femur, prior to flexion. It is also an accessory flexor of the knee joint."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nWhich among the following is it best inotrope drug for use in right hea failure\nA) Dobutamine\nB) Digoxin\nC) Dopamine\nD) Milrinone", "output": "3, because (Ref Goamnan and Gilman, 11/e p575, inotropic drugs are not used for treatment of right sided where the major treatment is diuretics and vasodilators. Milriinone being a phosphodiesterase inhibitor act as an inodilator. Thus, this is the only inotropic drug that should be used in right sided failure due to its ablity to produce vasodilation. It is indicated in right hea failure with pulmonary hypeension."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nWhich of the following is a disadvantage of topically applied sodium fluoride solution?\nA) Need to prepare a fresh solution for each patient\nB) Taste is not well accepted by patients\nC) Patient must make four visits to the dentist within a relatively short period of time\nD) The solution should be allowed to dry for 5 minutes", "output": "2, because Advantages of neutral sodium fluoride solution-\n1. It is relatively stable when kept in a plastic container and there is no need to prepare a fresh solution for each patient.\u00a0\n2. The taste is well accepted by patients.\u00a0\n3. The\u00a0 solution\u00a0 is non-irritating\u00a0 to the gingiva.\u00a0\n4. It does not cause discoloration of tooth structure.\u00a0\n5. Once applied to the teeth, the solution is allowed to dry for 3 minutes. Thus the clinician in public health programs can pursue a multiple-chair procedure.\u00a0\n6. The series of treatments must be repeated only four times in the general age range of 3\u00a0 to\u00a0 13, rather than\u00a0 at annual or\u00a0semiannual intervals, therefore in a public health program, other groups of children can be treated in theJintervening years.\u00a0\nDisadvantage of neutral sodium fluoride solution-\n1. The major disadvantage of the use of sodium\u00a0fluoride is that the patient must make four\u00a0visits to the dentist within a relatively short\u00a0period of time."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nThe antimicrobial agent which inhibits the ergosterol biosynthesis is:\nA) Ketoconazole\nB) Amphotericin B\nC) 5-Flucytosine\nD) Griseofulvin", "output": "0, because IMIDAZOLES AND TRIAZOLES: These are presently the most extensively used antifungal drugs. Four irnidazoles are entirely topical, while ketoconazole is used both orally and topically. Two triazoles fluconazole and itraconazole have largely replaced ketoconazole for systemic mycosis because of greater efficacy, longer tlh, fewer side effects and drug interactions. The imidazoles and triazoles have broadspectrum antifungal activity covering dermatophytes, Candida, other fungi involved in deep mycosis (except mucor), Nocardia, some grampositive and anaerobic bacteria, e.g. Staph. aureus, Strep. faecal is, Bac. fragilis and Leishmania. The mechanism of action of irnidazoles and triazoles is the same. They inhibit the fungal cytochrome P450 enzyme &;lanosterol l4--demethylase&; and thus impair ergosterol synthesis leading to a cascade of membrane abnormalities in the fungus. The lower host toxicity of triazoles compared to irnidazoles has correlated with their lower affinity for mammalian CYP450 enzymes and lesser propensity to inhibit mammalian sterol synthesis. However, because they are active against ceain bacteria as well (which do not have ergosterol), other mechanisms of action also appear to be involved. Ketoconazole (KTZ): It is the first orally effective broad-spectrum antifungal drug, useful in both dermatophytosis and deep myc osis. The oral absorption of KTZ is facilitated by gastric acidity because it is more soluble at lower pH. Hepatic metabolism is extensive; metabolites are excreted in urine and faeces. Elimination of KTZ is dose dependent: tlh varies from llh to 6 hours. Penetration in CSF is poor: not effective in fungal men ingitis. However, therapeutic concentrations are attained in the skin and vaginal fluid. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:761,762"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nIn embalmingr solution is given through ?\nA) Veins\nB) Aeries\nC) Lymphatics\nD) none of above", "output": "1, because Emblamings may be aerial emblaming and cavity emblaming."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nLipids are transferred from intestine to liver by\nA) Chylomicrons\nB) VLDL\nC) HDL\nD) LDL", "output": "0, because ."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nA 7 year old boy presented with generalized edema.Urine examination revealed marked albuminuria.Serum biochemical examinations showed hypoalbuminaemia with hyperlipidemia.Kidney biopsy was undeaken.On light microscopic examination, the kidney appeared normal.Electron microscopic examination is most likely to reveal\nA) Fusion of foot processes of the glomerular epithelial cells\nB) Rarefaction of glomerular basement membrane\nC) Deposition of electron dense material in the basement membrane\nD) Thin basement membrane", "output": "0, because Answer is A (Fusion of foot processes of the glomerular epithelial cells):The presence of generalized edema is a 7 year old boy with proteinuria suggests a diagnosis of Nephrotic syndrome. This child is likely to have. Minimal change disease as this is the most common cause of Nephrotic syndrome in children and is associated with normal findings on Light microscopyGeneralized edema May develop Pleural effusion, pulmonary edema, ascitis Patients with minimal change disease characteristically show fusion of foot processes of the glomerular epethelial cells on electron microscopy.Minimal change Disease: ReviewMost common cause of Nephrotic syndrome in children (80% in children; 20% in adults)Peak Age of onset is between 6-8 years of Age (usually < 10 years)Type of onset : InsiduousClinical featuresPeripheral Edema: Presenting FeatureNephrotic syndrome is the typical presentationPeripheral edema is the hallmark of Nephrotic syndrome occurring when serum albumin levels become less than 3g/dlInitially dependent Edema > Generalized edema May develop Pleural effusion, pulmonary edema, ascitisHematuria : 20-30%Hypeension : V. RareRenal failure : Does not usually progress to renal failureLaboratory (Features of Nephrotic syndrome)ProteinuriaHypoalbuminemiaHyperlipidemia/Hyper cholesterolemia (Increased hepatic prduction of lipids)HypercoagulabilityRenal pathology (Biopsy)InvestigationLight microscopy QElectron microscopy QImmunofluorescence QObservationNo abnormality hence the term minimal changeFusion of foot processesAbsence of immunoglobulin or complementPrognosisPrognosis is GoodResponse to steroids is ExcellentDoes not progress to Renal FailureTreatmentsCoicosteroids form the mainstay for treatment of MCD"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nWhich is not synthesized by the vascular epithelium?\nA) Prostacyclin\nB) Angiotensin 2\nC) Endothelin\nD) Heparin", "output": "1, because Endothelial cells constitute a large and impoant tissue. They secrete many growth factors and vasoactive substances. The vasoactive substances include prostaglandins and thromboxanes, nitric oxide, and endothelins.Lungs activate angiotensin I to angiotensin II; this reaction is paicularly prominent in the lungsRef: Ganong's Review of Medical Physiology;23rd edition; Page No: 606"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAll true about conus syndrome except\nA) Begins at the level of lower 3 sacral and coccygeal segment\nB) Absent knee and ankle jerks\nC) Flexor plantar reflex\nD) Saddle anaesthesia", "output": "1, because Since the spinal segments involved in knee and ankle jerks are at higher level than the level of lesion, they are preserved.and not lost. Root value of knee reflex is L-2,3 and 4 and for the ankle reflex is S-1 Conus medullary syndrome is lower motor neuron lesion and involves the lower 3 sacral and coccygeal segments Plantar reflex remains flexor in this syndrome since its spinal arc is also above the level of lesion and is unaffected Root value of plantar reflex is S-1,2. Conus medullary syndrome produces saddle anaesthesia in the perineal region as per the dermatomal pattern. Ref: Gray's 39e/p-227"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAn infant with respiratory distress was intubated. The fastest and accurate method to confirm intubation\nA) Capnography\nB) Clinically by auscultation\nC) Chest radiography\nD) Airway pressure measurement", "output": "0, because Ans. a. Capnography Capnography is the surest confirmatory sign of correct intubationQ So, the fastest and accurate method to confirm intubation in the above mentioned infant is capnography Capnography Capnography is the continuous measurement of end tidal carbon dioxide (ETCO,) and its waveform. Normal: 32 to 42 mmHe (3 to 4 mmHg less than aerial pCO, which is 35 to 45 mmHg) Principle: Infrared light is absorbed by carbon dioxide Uses of Capnography It is the surest confirmatory sign of correct intubation (esophageal intubation will yield ETCO2=0) Intraoperative displacement of endotracheal tubedeg (ETCO2 will become zero) Diagnosis of malignant hypehermie (ETCO, may rise to more than 100 mm Hg) For detecting obstructions and disconnections of endotracheal tubes (ETCO, will fall) Capnography Uses of Capnography Diagnosing pulmonary embolism by air, fat or thrombus (sudden fall of ETCO2 occurs. It may become zero if embolus is large enough to block total pulmonary circulation) Exhausted sodalime or defective valves of closed circuit will show high ETCO2 values. To control level of hypocapnia during hyperventilation in neurosurgery Indicator of cardiac output. In cardiac arrest ETCO, is zero."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAll are impoant mechanisms in the formation of lithogenic bile:\nA) Increased biliary secretion of cholesterol\nB) Increased activity of HMG CoA reductase\nC) Clofibrate\nD) Low calorie and cholesterol rich diet", "output": "3, because Mechanisms in the formation of lithogenic (stone-forming) bile. The most impoant is increased biliary secretion of cholesterol. This may occur in association with obesity, the metabolic syndrome, high-caloric and cholesterol-rich diets, or drugs (e.g., clofibrate) and may result from increased activity of hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase. Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 2617"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nWhich of the following is not true of caloric test?\nA) Induction of nystagmus by thermal stimulation\nB) Normally, cold water induces nystatmus to opposite side and warm water to same side\nC) In canal paresis, the test is inconclusive\nD) None", "output": "2, because Nystagmus can be induced both by cold as well as thermal stimulationCold stimulation causes nystagmus towards opposite side while thermal stimulation causes Nystagmus towards same side. (COWS)In canal paresis either there is a reduced or absent response (causes of U/L canal paresis are-U/L vestibular Schwannoma or vestibular neuritis).B/L absence of caloric nystagmus is seen in case of amminoglycoside ototoxicity or postmeningitis"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nEnlarged liver with Hepatocellular dysfunction may be seen in all of the following, except:\nA) Wilson's disease\nB) Budd Chirai syndrome\nC) Alcoholic hepatitis\nD) Post necrotic syndrome", "output": "3, because Answer is D (Post necrotic cirrhosis) Liver is typically shrunken in size and not enlarged in post necrotic cirrhosis. Alcoholic hepatitis, NASH, Wilson's disease and Budd chiari syndrome may all present with enlarged liver and hepatocellular dysfunction."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nRight-sided vocal cord palsy seen in -\nA) Larynx carcinoma\nB) Aortic aneurysm\nC) Mediastinal lymphadenopathy\nD) Vocal nodule", "output": "0, because First I would like to exclude other three options : -\n\n\nAortic aneurysm (option b) and mediastinal lymphadenopathy (option c) cause left sided vocal cord paralysis.\nVocal nodules does not cause vocal cord paralysis.\u00a0\n\n\nNow we are left with option 'a' only : -\n\n\"Laryngeal carcinoma especially glottic can cause\u00a0unilateral or bilateral vocal cord paralysis\"\u00a0\u2500 Conn's current therapy\n\nSo, answer of this question is laryngeal carcinoma as it can cause unilateral (right or left) or bilateral vocal cord paralysis."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nThe Efferent fibers bundle of the substantia nigra transmits dopamine to one of the following areas\nA) Thalamus\nB) Corpus striatum\nC) Tegmentum of pons\nD) Tectum of midbrain", "output": "1, because Ans. (b) Corpus striatum(Ref: Ganong, 25th ed/p.243)The Efferent fibers bundle of the substantia nigra transmits dopamine to corpus striatum"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAbout lidocaine, all are true except :\nA) LA effect\nB) Cardiac arrhythmia\nC) Ester\nD) Acts on mucous membranes", "output": "2, because C i.e. Ester"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nAcid fast organisms are -\nA) Spores\nB) Nocardia\nC) Legionella\nD) Rodococcus", "output": "0, because Spores may be seen in unstained preparations as Refractile bodies. The forespore stains intensely but once the spores envelope is laid down the spores does not stain readly. Spores appear as unstained areas in Gram-stained preparations but being more acid fast than the vegetative cells they can be stained by a modification of the Diehl -Nelson technique. Ref: Ananthanarayan & paniker's Textbook of Microbiology 9th edition pg no 21"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nMaternal disomy of chromosome 15 is seen in\nA) Prader - Willi syndrome\nB) Klinefelter's syndrome\nC) Angelman syndrome\nD) Turner's syndrome", "output": "0, because Uniparental disomy occurs when both chromosomes of a pair or areas from 2 chromosome in any individual have been inherited from a single parent. Maternal uniparental disomy is seen in Leader -Willi syndrome. Paternal uniparental disomy is seen in Angelman syndrome . Reference: Nelson TB of pediatrics pg 412 19th edition."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nThe mesentery of small intestine, along its attachment to the posterior abdominal wall, crosses all of the following structures except:\nA) Left gonadal vessels\nB) Third pa of duodenum.\nC) Aoa\nD) Right ureter.", "output": "0, because A i.e. Left gonadal vesselsRoot of mesentery crosses (successively) te ascending (4th) and inferior horizontal (3rd) pas of duodenum, abdominal aoa, IVC, right ureter, right psoas major and right gonadal (testicular/ovarian) vesselQ. It does not cross left ureter, leftgonadal vessels and superior mesenteric vessels."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nDrug used to prolong action of LA in Hypeensive pts?\nA) Clonidine\nB) Felypressin\nC) Dexmeditomidate\nD) Noradrenalin", "output": "1, because Ans. is 'b'.e., Felypressin"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nCongenital syndrome associated with lymphoproliferative malignancy- a) Bloom syndrome b) Fanconi's anemia c) Turner syndrome d) Chediak Higashi syndrome e) Ataxia telangiectasia\nA) ab\nB) bd\nC) ca\nD) de", "output": "3, because None"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nA 28 year old female nearing her date of delivery has been admitted following regular contractions. The resident doctor did an examination documents that the head is at +1 station.Where is the exact position of head?\nA) High up in the FALSE pelvis\nB) Just above ischial spine\nC) Just below ischial spine\nD) At the perineum", "output": "2, because Station is leading point of Head. Station 0 = Head at level of Ischial spines + means below Ischial spines - means above Ischial spines Numbers like 1 , 2 denote distance in cm below or above Ischial spine"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nCapillary refill time in a child with shock is?\nA) >1 second\nB) >2 seconds\nC) >3 seconds\nD) >4 seconds", "output": "2, because Capillary refill is a simple test that assesses how quickly blood returns to the skin after pressure is applied.\nIt is carried out by applying pressure to the pink part of the nail bed of the thumb or big toe in a child and over the sternum or forehead in a young infant for 3 seconds.\nThe capillary refill time is the time from release of pressure to complete return of the pink colour. It should be less than 3 seconds.\nIf it is more than 3 seconds the child may be in shock. Lift the limb slightly above heart level to assess arteriolar capillary refill and not venous stasis.\nThis sign is reliable except when the room temperature is low, as the cold environment can cause a delayed capillary refill.\nIn such a situation check the pulses and decide about shock"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAll the following are congenital cysts except\nA) External angular dermoid cyst\nB) Sebaceous cyst\nC) Branchial cyst\nD) Thyroglossal cyst", "output": "1, because None"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nIn a lady at 32 weeks pregnancy is given an injection of dexamethasone to prevent which of the following in the newborn ?\nA) Respiratory Distress Syndrome\nB) Neonatal convulsion\nC) Neonatal jaundice\nD) Cerebral palsy", "output": "0, because The lung maturity occurs at 34 weeks of gestation and this is ceified by checking the L:S ratio which should be > 2:1 or appearance of Phosphatidyl glycerol in the amniotic fluid. Maternal administration of coicosteroid is advocated where the pregnancy is less than 34 weeks. This helps in fetal lung maturation so that the incidence of RDS, Intra Ventricular Hemorrhage , Necrotising Enterocolitis , and Patent Ductus Aeriosus are minimized. Respiratory distress of newborn often results in multiple debility in the fetus if not prevented."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nMost common site for contact ulcer in larynx is\nA) Arytenoids\nB) Corniculate\nC) Anterior 1/3 rd of vocal cord\nD) Cricoid", "output": "0, because None"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nInitial site of RBC production in fetus-\nA) Gestational sac\nB) Yolk sac\nC) Placeta\nD) Fetal bones", "output": "1, because Ans. is 'b' i.e., Yolk sac* Embryonic and fetal hematopoiesis occurs in three phases: megaloblastic, hepatic, and myeloid. At each phase of RBC development both the sites of production and the cell composition change.* Sites and stages of fetal erythropoiesis: Primitive erythropoiesis begins in the yolk sac at 2 to 3 weeks after conception. By the end of the first trimester, the liver has become the main erythroid organ. The liver is the primary source of red blood cells during the second trimester, and the bone marrow is the primary source of red blood cells during the last trimester"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nBest anaesthetic agent for out patient anasthesia is\nA) Fentanyl\nB) Morphine\nC) Alfentanyl\nD) Penthidine", "output": "2, because C i.e. Alfentanyl"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nA 24 yr-old female has flaccid bullae over the skin and oral erosions. Histopathology shows intraepidermal blister with acantholytic cells. Diagnosis is:\nA) Pemphigoid\nB) Erythema multiforme\nC) Pemphigus vulgaris\nD) Dermatitis herpetiformis", "output": "2, because The features of intaepidermal acantholytic blisters coupled with flacid bullae over skin and oral erosions points towards P. vulgaris. The other 3 diseases do now show intraepidermal blistering. They are devoid of mucosal involement. Erythema Multiforme: Target lesion seen on distal extremeties. If mucosa involved it is called as Epidermal Multiforme Major Dermatitis herpetiformis: Extremely pruritic vesicopapules over extensors Pemphigoid: Tense bullae"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nAfter postmoem body is handed over to :\nA) The authority who has conducted inquest in that paicular case\nB) Police station near by\nC) Coroner\nD) Chief magistrate", "output": "0, because A i.e. The authority who has conducted inquest in that paicular case"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nA 16-year-old female presents with primary amenorrhea and raised FSH. On examination, her height was 58 inches. What would be the histopathological finding in the ovary?\nA) Absence of oocytes in the ovaries (streak ovaries)\nB) Mucinous cystadenoma\nC) Psamomma bodies\nD) Hemorrhagic Corpus Leuteum", "output": "0, because Ans. (a) Absence of oocytes in the ovaries (streak ovaries)(Ref: Robbins 9th/pg 166-167; 8th/pg 165-166)In this question, the patient is presenting with primary amenorrhea and raised FSH, along with short stature(Given Height =58 inches, which is less than 5th percentile of expected at 16 years age). All these features are suggestive of Turner Syndrome.Infertility Q due to rudimentary uterus and streak ovaries is an important feature Q, as ovaries are reduced to atrophic fibrous strands without ova and follicles in Turner syndrome"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nPseudohemoptysis is caused by:\nA) Histoplasma capsulatum\nB) Serratia marcescens\nC) Proteus\nD) Klebsiella", "output": "1, because Serratia grows\u00a0in\u00a0sputum after collection and makes sputum red (pigment production) This condition is pseudohemoptysis."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nInterstitial keratitis is commonly seen in: March 2005\nA) Fungal keratitis\nB) Congenital syphilis\nC) Phlyctenular keratitis\nD) Trachoma", "output": "1, because Ans. B: Congenital syphilis It develop from host immune mechanisms to active infections or antigens within the stromal keratocytes. Diseases known to cause interstitial keratitis include: congenital syphilis, herpes simplex, herpes zoster, Epstein-Barr, tuberculosis and leprosy. Clinical manifestations: superficial stromal scarring, necrotizing stromal keratitis and disciform keratitis. As the inflammation subsides, intracorneal blood vessels will regress and become nonperfused vascular channels, which are known as \"ghost\" vessels. These vessels can be readily visualized using slit lamp biomicroscopy and can become active if inflammation recurs."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nMost common cause of gangrene of foot of 30 years old farmer who is a chronic smoker -\nA) Raynaud's disease\nB) Myocardial infarction\nC) Atherosclerosis\nD) Thromboangitis obliterans", "output": "3, because All four can cause gangrene (Myocardial infarction can cause gangrene by thromboembolism)\nLets see, each option one by one.\n\nRaynauds disease \n\nIs ds of young women* (F:M ratio is 5:1)\ncommonly the upper limbs* are affected specially the fingers (the thumb is generally escaped)\nThe disease is characterized by Raynauds phenomenon* which is a series of attacks of\nLocal syncope \u2192 digits become cold and white*\nLocal asphyxia \u2192 digits turn blue with burning sensation*\nLocal recovery \u2192digits regain normal colour*\n\n\nPulses remain unaffected* as this is the disease which affects arterioles\nWith the help of points (a) and (b) Raynauds ds can be ruled out.\n\nAtherosclerosis (Senile gangrene)\n\nSeen in elderly people over 50 years of age.\nThus because of age factor we can rule out atherosclerosis.\n\nMyocardial infaction\n\nAge factor again helps in ruling it out as MI is generally seen in elderly, though its incidence is increasing in young, but it cannot be a more common cause than Buerger's disease.\n\nBuerger's (Thromboangitis obliterans) \u00a0Usual victims of this ds are young men below 40 yrs of age, who are smokers (ds is not seen in females and nonsmokers).\n\nBuerger ds is the inflammatory reaction in the arterial wall with involvement of the neighbouring vein and nerve, terminating in thrombosis of the artery.\nIt characterstically involves small and medium sized arteries (plantars, tibial and radial artery)\nBoth upper and lower extremities are affected.\nIn lower extremity the ds. occurs beyond the popliteal artery. In upper extremity the ds occurs beyond the brachial art.\nEarly in the course of Buergers ds the superficial veins are involved producing the characterstic migratory, recurrent superficial thrombophlebitis.\nAn imp difference with atheroselerosis is that, atherosclerosis is a disease of large sized arteries, buergers is a ds of small arteries."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nThe most commonly seen primary orbital tumour in children is\nA) Optic nerve sheath meningioma\nB) Retinoblastoma\nC) Rhabdomyosarcoma\nD) Glioma of optic nerve", "output": "2, because Rhabdomyosarcoma It is a highly malignant tumour of the orbit arising from the extraocular muscles. It is the most common primary orbital tumour among children, usually occurring below the age of 15 years (90%). Clinical features: It classically presents as rapidly progressive proptosis of sudden onset in a child of 7-8 years. Massive proptosis due to rhabdomyosarcoma located in the superonasal quadrant (mimmicking acute inflammatory process). The clinical presentation mimics an inflammatory process. The tumour commonly involves the superionasal quadrant; but may invade any pa of the orbit. Ref:- A K KHURANA; pg num:-394"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAll is true regarding case fatality rate except ?\nA) Represents killing power of disease\nB) Closely related to viruleance\nC) Very useful for chronic diseases\nD) May vary in different epidemic for same disease", "output": "2, because Ans. is 'c' i.e., Very useful for chronic disease CFR is typically used in acute infectious disease e.g. food poisoning, cholera, measles. o Its usefulness in chronic disease is limited, because the period from onset to death is long and variable. CFR is closely related to virulence of agent. o Limitation of CFR is that time period is not specified. o The case fatality rate for the same disease may vary in different epidemics because of changes in host, agent and environment factors. o Case fatality rate is the complement of survival rate. CFR =1 - survival rate CRF will be more if survival rate is less more patients are dying due to disease (i.CFR) or in other words less patients are surviving survival rate)."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nLength of naso lacrimal duct is:\nA) 10 mm\nB) 11 mm\nC) 12 mm\nD) 9 mm", "output": "2, because Ans. 12 mm"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nA collection of information in a table has been arranged as satisfied, very satisfied and dissatisfied. Which of the following will be the right term for such information?\nA) Interval data\nB) Ratio data\nC) Nominal data\nD) Ordinal data", "output": "3, because Ordinal data is that data which has a meaningful arrangement of order but no valuable data or information can be obtained from the order arrangement. For example in the above question, though the data is arranged as satisfied, very satisfied and dissatisfied no information is obtainable as to what is the difference between satisfied and very satisfied and the difference between very satisfied and dissatisfied and so on. Thus this data is a ordinal data. Ref: High-Yield Bio statistics By Anthony N. Glaser; 3rd Edition; Page 4; Statistics for Management and Economics By Gerald Keller; Pages 13 - 16"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nSubcapsular orchiectomy is done for\nA) Ca testis\nB) Ca prostate\nC) Ca penis\nD) Ca urethra", "output": "1, because Orchidectomy Orchidectomy is performed in advanced disease. In 1941, prostate cancer was shown to be responsive to such treatment by Charles Huggins, the only urologist to win a Nobel Prize. Bilateral orchidectomy, whether total or subcapsular, will eliminate the major source of testosterone production. Ref: Bailey and love 27th edition Pgno : 1474"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nNeostigmine antagonizes non depolarising blockade by all of the following mechanism except\nA) Decreasing the breakdown of acetyl choline at the motor end plate\nB) Preventing the K+efflux\nC) Increasing the release of acetyl choline at the motor end plate\nD) Depolarization at the motor end plate", "output": "0, because Refer Katzung 10/e p 436 Neostigmine is an anti cholinerasterase. It inhibits the breakdown of ACh at the mother end plate This results in increased activity of ACh that causes depolarization of motor end plate by opening Na+channels . It posseses some direct agonistic activating on NM receptors resulting in depolarization"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nTrue about peripheral nerve injury in upper limb-a) Radial nerve injury cause anaesthesia over anatomical snuff boxb) Median nerve injury cause wrist dropc) Ulnar nerve injury cause claw handd) Index finger anesthesia is caused by median nerve injurye) Thumb anaesthesia is caused by ulnar nerve injury\nA) abc\nB) ad\nC) acd\nD) bde", "output": "2, because Radial nerve injury causes wrist drop. Thumb anaesthesia is due to median nerve injury."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAll of the following are synonymous codon pair EXCEPT\nA) CAU & CAC\nB) AUU & AUC\nC) AUG & AUA\nD) AAU & AAC", "output": "2, because Synonymous codons Codons that specify the same amino acids. E.g- GGA, GGG, GGU, and GGC codes for glycine Methionine is coded by AUG only. So, there is no synonymous codon for methionine."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nWidened anion gap is caused by all EXCEPT :\nA) Lactic acidosis\nB) Diarrhea\nC) Diabetic keto-acidosis\nD) Methanol poisoning", "output": "1, because Ans.(b) Diarrhea* Anion gap :The anion gap is the difference between primary measured cations (sodium Na+ and potassium K+) and the primary measured anions (chloride Cl and bicarbonate HCO3) in serum.* So we take value of sodium and from it subtract the value of chloride and bicarbonate.* Value of Normal anion gap =10 to 12 mmol/LAG calculated as follows: AG = Na+ - (Cl\" + HCO3~)Normal anion gap(Mn: FUSED CAR)Increased anion gap(Mn: MUDPILES)Decreased anion gap(Mn: BPH-M)F- Fistula pancreaticM - MethanolBromide intoxicationU- UreterosigmoidostomyU - UremiaPlasma cell dyscrasiaS- Small bowel fistulaD - DKA/ AKA/ SKA (diabetic/alcoholic/ starvation)HypoalbuminemiaE- Extra chlorideP - Paraldehyde / phenforminMonoclonal proteinD- Diarrhea1 - Iron / INH C- Carbonic anhydraseInhibitor (acetazolamide)L - Lactic acidosis A- Adrenal insufficiencyR- Renal tubular acidosisE - Ethylene glycol S - Salicylates"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAll of the following provisions are included in the Primary health care according to the Alma Ata declaration except:\nA) Adequate supply of safe drinking water\nB) Nutrition\nC) Provision of free medicines\nD) Basic sanitation", "output": "2, because ALMA - ATA CONFERENCE: Called for WHO Goal of \"Health for All\" by 2000 India is a signatory Provisions included under Primary Health Care according to Alma Ata conference: E- Essential drugs ; 33-38 essential drugs are included in PHC. Most essential drug is Paracetamol L - Locally endemic disease prevention & control E - Education M - Maternal & child health E - EPI 1978; UIP- 1985 N- Nutrition T - Treatment of common ailments S - Safe water supply & sanitation"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nGradient in pulmonary artery wedge pressure and left venticular end diastolic pressure is seen in\nA) Aortic regurgitation\nB) Constrictive pericarditis\nC) Left atrial myxoma\nD) Pulmonary thromboembolism", "output": "2, because None"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nA 65yr old male with his of Diabetes and HTN presents Ito OPD with complaints of diplopia and squint on examination secondary detion is seen to be more than primary detion Which of the following is the most probable diagnosis\nA) Paralytic squint\nB) Incomitant squint\nC) Restrictive squint\nD) Pseudo squint", "output": "0, because ref : ak khurana 7th ed"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nNOT included in third stage of labour\nA) Controlled cord traction\nB) lM-oxytocin\nC) IV methergin\nD) Uterine massage", "output": "2, because (C) (IV - Methergin) (142 - Dutta 7th)Methergin 0.2 mg IM (Intramuscular) to the mother within one minute of delivery of the babyOyxtocin may be given with crowning of the head, with delivery of the anterior shoulder of the baby or after the delivery of the placenta.Components of Active Management of Third stage of Labour (WHO)* Administration of uterotonic (oxytocin/Ergometrine) soon after birth of baby* Delayed cord clamping and cutting* Controlled Cord traction for delivery of placenta* Uterine massageCurrent evidence show that delayed cord clamping is beneficial for baby, immediate cord clamping has been shown to increase the incidence of iron deficiency anemia for premature and LBW babies immediate cord clamping can also increase the risk of intraventricular haemorrhage and late onset sepsis"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAll are common causes of childhood blindness except\nA) Malnutrition\nB) Glaucoma\nC) Ophthalmia neonatorum\nD) Congenital dacryocystitis", "output": "3, because Congenital dacryocystitis [Ref: Khurana 4/e,p 369, 447; Parson's 20/e, p 530-531 Repeat from May07 Causes of impaired vision in childhood Anatomical classification Whole globe: microphthalmos, anophthalmos, phthisis bulbi, atrophic bulbi Cornea: scar, anterior staphyloma, dystrophy Lens: cataract, dislocation, aphakia Uvea: aniridia, coloboma, uveitis Retina: retinopathy of prematurity, retinal dystrophy, retinal detachment, vasculitis Glaucoma: buphthalmos Optic nerve optic atrophy, hypoplasia Other: coical blindness, amblyopia Aetiological classification Hereditary: chromosomal disorders, single-gene defects Intrauterine: congenital rubella, foetal alcohol syndrome Perinatal: ophthalmia neonatorum, retinopathy of prematurity, bih trauma Childhood: vitamin A deficiency, measles, trauma Unclassified: impossible to determine the underlying cause Congenital dacryocystitis (also k/a dacryocystitis neonatorum) is an inflammation of the lacrimal sac occurring in newborn infants, and thus also known as dacryocystitis neonatorum it is d/t stasis of secretion in the lacrimal following congenital blockage in the nasolacrimal duct. congenital dacryocystis presents as - epiphora, usually developing after 7 days of bih, followed by copious mucopurulent discharge from the eyes - swelling on the sac area It may be complicated by - recurrent conjunctivitis - acute on chronic dacryocistitis - lacrimal abscess & fistula formation"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nEffective for common gram-negative anaerobes ?\nA) Aztreonam\nB) Doxycycline\nC) Vancomycin\nD) Tobramycin", "output": "0, because Ans. is 'a' i.e., Aztreonam"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nThe recipient twin in monochorionic twin gestation effected by twin-twin transfusion syndrome is characterised by all except\nA) Thrombosis\nB) Hypovolemia\nC) Kernicterus\nD) Heart failure", "output": "1, because In TTTS, recipient twin has circulatory overload, hyper volemia and heart failure."} |