text
stringlengths 221
22.9k
|
|---|
{"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 is not a second messenger\nA) c-AMP\nB) IP3\nC) Guanylyl cyclase\nD) Diacylglycerol (DAG", "output": "2, because Ans. c. Guanylyl cyclase"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nArtery of 2nIi pharyngeal arch is -\nA) Maxillaiy artery\nB) Stapedial artery\nC) Subclavian artery\nD) Commoncarotid artery", "output": "1, because Ans. is 'b' i.e., Stapedial artery Pharyngeal ArchMuscular ContributionSkeletal ContributionsNerveArteryCorresponding Pouch Structures1st (mandibular arch)Muscles of mastication, Anterior belly of the digastric,Mylohyoid,Tensor tympani.Tensor veli palatiniMaxilla, mandible (only as a model for mandible not actual formation of mandible). Incus andMalleus, Meckel's cartilage, Ant. Ligament of malleus,SphenomandibularligamentTrigeminal nerve (V2 and V3)Maxillary artery,External carotid arteryEustachian tube,middleear, mastoid antrum,and inner layer ofthe tympanicmembrane.2nd (hyoid archMuscles of facialexpression,Buccinator,Pfatysma,Stapedius,Stylohoid,Posterior belly of the digastricStapes, Styloid process hyoid (lesser horn and upper part of body),Reichert's cartilage.Stylohyoid ligamentFacial nerve (VII)StapedialArterymiddle ear, palatine tonsils3rdStylopharyngeusHyoid (greater horn and lower part of body), thymusGlossophar- yngeal nerve (IX)Common carotid'Internal carotidInferior parathyroid.Thymus4th Cricothyroid muscle, all intrinsic muscles of soft palate incluidng levator veli palatini Thyroid cartilage, epiglottic cartilage Vagus nerve (X)Superior laryngeal nerve Right 4th aortic arch subclavian artery Left 4th aortic arch: aortic arch Superior parathyroid, uitimobranchial body (which forms the Para follicular C-Cells of thyroid gland).6thAll intrinsic muscles of larynx except the cricothyroid muscleCricoid cartilage, arytenoid cartilages, comiculate cartilageVagus nerve (X)RecurrentlaryngealnerveRight aortic arch: pulmonary artery Left 6th aortic arch:Pulmonary artery and ductus arteriosusRudimentary structure, becomes part of the fourth pouch contributing to thyroidC-cells."} |
{"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 probable diagnosis in a patient with a dilated pupil not responsive to 1% pilocarpine\nA) Diabetic third nerve palsy\nB) Ade's pupil\nC) Uncal Herniation\nD) Pharmacological block", "output": "3, because Refer Goodman and Gilman 12e 1777 Looking at the option one by one diabetic third nerve palsy: third Nerve Palsy due to any reason will result in mydriasis( because oculomotor people milk supplies constrictor pupillae). As only one nerve is destroyed and but the receptors remain intact , so it will respond to 1% pilocarpine anthers miosis will occur adie's tunic pupil: it manifests as the denervation super sensitivity. Normal people respond to 1% pilocarpine but does not contract with highly diluted solution may also result in constriction Uncal herniation : IT results in pressure on 3rd cranial nerve and presents as dilated pupil but it will respond to pilocarpine as the receptors are intact"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAlcohol causes -\nA) Dilated cardiomyopathy\nB) HOCM\nC) Restrictive cardiomyopathy\nD) None", "output": "0, because o Chronic Alcohol consumption\u00a0is the most common cause of Toxic Dilated Cardiomyopathy.\n\u2018Alcohol is the most common toxin implicated in chronic dilated cardiomyopathy.' -\u00a0Harrison 18th/e p. 1961"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nColonic polyp with most malignant potential is -\nA) Juvenile polyp\nB) Hyperplastic polyp\nC) Pedunculated Adenomatous polyp\nD) Sessile Adenomatous polyp", "output": "3, because Ans. is 'd' i .e., Sessile Adenomatous poly p o Adenomatous polyps have special clinical significance because only adenomatous polyps are clearly premalignant, and only a minority of these adenomatous lesions ever develop into a cancero Clinically, the probability of an adenomatous polyp becoming a cancer depends on three factors1. Gross appearance of the lesion - on gross appearance polyps are of two typesa. Pedunculated (stalked)b. Sessile (flat based)Cancer develops more frequently in sessile polyps.2. Histologically - Histologically polyps are of 3 typesa. Tubularb. Villous (papillary)c. Tubulovillouso Out of these histological types villous adenomas which are usually sessile become malignant more than 3 times as often as tubular adenomas.3. Size of the polyp -a. Polyp < 1.5 cm ---- Negligible malignant potentialb. Polyp 1.5-2.5 cm ---- Intermediate malignant potentialc. Polyps > 2.5 cm ---- Substantial malignant potential"} |
{"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 is not true regarding Bernard soulier syndrome?\nA) Ristocetin aggregation is normal\nB) Aggregation with collagen and ADP is normal\nC) Large platelets\nD) Thrombocytopenia", "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 is essential for tumor metastasis?\nA) Angiogenesis\nB) Tumorogenesis\nC) Apoptosis\nD) Inhibition of tyrosine kinase activity", "output": "0, because Metastasis is a complex series of steps in which cancer cells leave the original tumor site and migrate to other pas of the body the bloodstream or the lymphatic system. One of the critical events required for metastasis is the growth of a new network of blood vessels, called tumor angiogenesis."} |
{"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 glomerular disease is associated with Crescent formation?\nA) Minimal change disease\nB) Rapidly progressive glomerulonephritis\nC) Focal and segmental glomerulosclerosis\nD) Rapidly non progressive glomerulonephritis", "output": "1, because The most common histological picture of Rapidly progressive glomerulonephritis is the presence of crescents in most of glomeruli. Crescents are formed by proliferation of parietal cells and by migration of monocytes and macrophages in the Bowman's space. The prognosis can be roughly related to the number of crescents. Ref: Robbins Pathologic Basis of Disease, 6th Edition, Page 951"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nAgglutination test is -\nA) ABO incompatibility\nB) VDRL\nC) Weil-felix test\nD) FTA-ABS", "output": "2, because Weil- Felix reaction for the diagnosis of typhus fever. - The Agglutination reaction is when a paiculate antigen is mixed with its antibody in the presence of electrolytes at a suitable temperature and pH, the paicles are clumped or agglutinated. Reference : Anathanarayan & paniker's 9th edition, pg no: 108,109 <\\p>"} |
{"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 vessels is involved in extradural haematoma?\nA) Middle meningeal artery\nB) Venous sinuses\nC) Bridging veins\nD) Middle cerebral artery", "output": "0, because Ans. a (Middle meningeal artery). (Ref: B & L, Surgery, 25th/ 303).Extradural haematoma (EDH)# It is a neurosurgical emergency. An EDH is nearly always associated with a skull fracture and is more common in young male patients. The skull fracture is asso- ciated with tearing of a meningeal artery and a haematoma accumulates in the space between bone and dura. The most common site is temporal, as the pterion is not only the thinnest part of the skull but also overlies the largest meningeal artery - the middle meningeal.# An EDH may also occur in other regions such as frontal as well as in the posterior fossa. They are not always arte- rial: disruption of a major dural venous sinus can result in an EDH. The force required to sustain a skull fracture can be surprisingly small - a fall from standing or a single blow to the head.# The classical presentation of an EDH, occurring in less than one-third of cases, is initial injury followed by a lucid interval when the patient complains of a headache but is fully alert and orientated with no focal deficit. After minutes or hours a rapid deterioration occurs, with contralateral hemiparesis, reduced conscious level and ipsilateral pupillary dilatation as a result of brain compression and herniation.FEATUREEDH (EXTRADURAL HEMATOMA)SDH (SUBDURAL HEMATOMA)Incidence1-4%10-20%EtiologyLacerated middle meningeal artery/ dural sinus in 70 to 85% cases.Stretching, tearing of bridging cortical veins.AgeAnyOlder peoplefractureSeen in 85-95% cases-LocationBetween skull & dura.95% supratentorialCrosses dural attachments but not sutures.Between dura & arachnoid95% supratentorialCrosses suture but not dural attachmentBilateral5%15%CT- Biconvex (lentiform shape)- 2/3 hyperdense (- 1/3 mixed density)- Displace greywhite interfacea) Acute SDH: Crescentic & hyperdenseb) Subacute SDH: May be nearly isodense with cortex neo-membrane, underlying vessels may enhance.c) Chronic SDH: Hypodense with enhancing membrane. About 1-2% of very old SDH calcify"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nMan is intermediate host for -\nA) Malaria\nB) Tuberculosis\nC) Filariasis\nD) Relapsing fever", "output": "0, because option-1- Life Cycle of Plasmodium: Malaria is caused by Plasmodium species. Definitive host: Female Anopheles mosquitoes Intermediate host: Man. option- 2-Tuberculosis is caused by Mycobacterium tuberculosis and doesn't have secondary host. option-3- In Filariasis (W. bancrofti): man is definitive host. option-4- Borrelia causes Relapsing fever and there is no secondary host."} |
{"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 of choice for bleeding oesophageal varices is?\nA) Ethanolamine oleate\nB) Octreotide\nC) Propanolol\nD) Phytonadione", "output": "1, because Ans. is 'b' i.e., Octreotide Among the given options, only octeride is used (otherwise vasopressine analogue terlipressine is the DOC). Has been explained in previous sessions."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nTwo or more oligoclonal bands in cerebrospinal fluid are most often positive in-\nA) Acute bacterial meningitis\nB) Multiple sclerosis\nC) Subarachnoid harmorrhage\nD) Polyneuropathy", "output": "1, because Oligoclonal bands (OCBs) are bands of immunoglobulins that are seen when a patient's blood serum, or cerebrospinal fluid (CSF) is analyzed. They are used in the diagnosis of various neurological and blood diseases, especially in multiple sclerosis. The blood serum can be gained from a clotted blood sample. Ref Davidson 23rd edtion pg 450"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nIodine deficiency control programme ?\nA) Health education\nB) Water testing\nC) Foification of salt\nD) None", "output": "2, because Ans. is 'c' i.e., Foification of salt Iodized salt (salt foified with iodine) is most economical, convenient and effective means of mass prophylaxis in endemic area."} |
{"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 sexually transmited, Except-\nA) Candida albicans\nB) Echinococcus\nC) Molluscum contagiosum\nD) Group B streptococcus", "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\nAll of the following methods are anti-larval measures, EXCEPT:\nA) Intermittent irrigation\nB) Paris green\nC) Gambusia affinis\nD) Malathion", "output": "3, because Malathion is used primarily for killing adult mosquitoes. It is not recommended as a larvicidal agent Fenthion, Chlorpyrifos and abate are preferred as larvicides. Water management such as intermittent irrigation constitutes a proven method of larval control. Paris green or copper acetoarsenite is a stomach poison and is effective when ingested by the larvae. Gambusia afftnis are small fishes that feed readily an mosquito larvae. Ref: Park's Textbook Of Preventive And Social Medicine By K. Park, 19th Edition, Page 638; Park's Textbook Of Preventive And Social Medicine By K. Park, 18th Edition, Page 570, 579, 590"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nIPC 82 states that: child cannot be punished under what age -\nA) 5yrs\nB) 8yrs\nC) 7yrs\nD) lOyrs", "output": "2, because Ans. is 'c' i.e., 7yrs o Section 82 I.P.C.: Criminal responsibility is any act which is done by a child under seven years of age is not an offence.Section of IPCRelated with82A child under the age of seven is incapable of committing an offence. This is so because action alobe does not amount to guilt unless if is accompanied by a guilty mind. And, a child of that tender age cannot have a guilty mind or criminal intention with which the act is done. This presumption, however, is only confined to offenses under the IPC but not to other Acts, e.g., the Railway Act.83A child above seven and under twelve years of age is presumed to be capable of committing an offence it he has obtained sufficient maturity to understand and judge the nature and consequences of his conduct on that occasion. The law presumes such maturity' in a child of that age unless the contrary is proved by the defence.89A child under 12 years of age cannot give valid consent to suffer any harm which can occur from an act done in good faith and for its benefit, e.g., a consent for an operation. Only, a guardian can give such consent.87A person under 12 years of age cannot give valid consent, whether express or implied, to suffer any harm which may result from an act no intended or not known to cause death or grievous hurt e.g. consent for a wrestling contest.84Nothing is an offence which is done by a person who at the time of doing it, by reason of unsoundness of mind, is uncapable of knowing the nature of act (i.e. it is wrong or contrary to law).85,86Drunkness and criminal responsibilityQ"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nTreatment of choice for generalized anxiety disorder is?\nA) Benzodiazepines\nB) Neuroleptics\nC) Beta blockers\nD) Barbiturates", "output": "0, because Ans is 'a' i.e. Benzodiazepines Treatment of generalized anxiety disorderA Benzodiazepines are the drug of choice. Drugs in this group are diazepam, Lorazepam, Alprazolam, Oxazepam, chlordiazepoxide.B. Other drugs used are buspirone; TCA (amptriptyline, imipramine, clomipramine, desipramine); SSRIs (Fluoxetine, Sertaline, Paroxetine, Citalopram); SNRIs (Venalafaxine), p-blockers.C. Anticonvulsants with GABAergic properties may also be effective against anxiety, e.g., Gabapentin, Oxcarbazepine, Tiagabine, pregabalin, and Valproate (divalporex)."} |
{"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 agents may precipitate bronchospasm in patients with reactive airway disease?\nA) Midazolam\nB) Etomidate\nC) Methohexital\nD) Propofol", "output": "2, because Methohexital is an ultra-sho-acting barbiturate that provides sedation and amnesia for sho, invasive procedures. Barbiturate administration may precipitate bronchospasm in patients with moderate to severe reactive airway disease, thus limiting its use in those patients. There is some evidence that ketamine may have a mild, transient bronchodilatory effect. Midazolam, etomidate, and propofol have no clinically significant effect on bronchial smooth muscle tone. Of the listed agents, only ketamine provides analgesia in addition to sedation."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nVegetations below the AV valves are present in -\nA) Libman-Sacks endocarditis\nB) Chronic rheumatic carditis\nC) Acute rheumatic carditis\nD) Non thrombotic endocarditis", "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\n\"Chemical pregnancy\" means :\nA) Negative beta HCG and absent gestational sac\nB) Positive beta HCG and present gestational sac\nC) Positive beta HCG and absent gestational sac\nD) Negative beta HCG and created sac margin", "output": "2, because Positive beta HCG and absent gestational sac"} |
{"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 Biomedical wastes cannot be disposed off in yellow bags?\nA) Reactive chemical wastes\nB) Radiographic wastes\nC) PVC\nD) Human anatomical wastes", "output": "0, because Yellow color bags are used for disposal of: BMW Cat 1: Human anatomical wastes BMW Cat 2: Animal wastes BMW Cat 3: Microbiological and biotechnology waste BMW Cat 6: Soiled waste Container/bags are not required for disposal of BMW Cat 8: Liquid waste BMW Cat 10: Chemical waste BMW Cat 3: (if disinfected locally): Microbiological and biotechnology waste Ref: Park 25th edition Pgno: 827"} |
{"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 bacteria contains mycolic acid in the cell wall\nA) Escherichia\nB) Mycoplasma\nC) Mycobacteria\nD) Staphylococcus", "output": "2, because Mycobacterium are slender rods that sometimes show branching, filamentous forms resembling fungal mycelium. In liquid cultures, they form a mould like a pellicle. they do not stain readily, but once stained, resist decolourisation with dilute mineral acids, due to the presence of mycolic acid in their cell wall. They are called acid-fast bacilli. Mycobacterium are slow-growing, aerobic, non-motile, non-capsulated and non-sporing. Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th edition; Pg;351"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nChild criteria doesnt include\nA) Encephalopathy\nB) ALT\nC) Ascites\nD) Albumin", "output": "1, because Variables in Child-Turcotte-Pugh scoring system Serum albumin Bilirubin Prothrombin time Ascites Encephalopathy Ref: Sabiston 20th edition Pgno : 1436"} |
{"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 will be detected in flow cytometry?\nA) Polycythemia\nB) Thrombocytosis\nC) Leukocytosis\nD) Neutrophilia", "output": "2, because Flow cytometry is an extremely useful investigational tool that allows simultaneous multiparametric analysis of the physical characteristics defining WBC types using the principles of light scattering, excitation, and fluorochrome emission. As such, it can allow for the rapid identification and quantification of populations of WBC in any given patient sample based on the characteristic immunophenotype of the population subset.Also know:Flow cytometry can be a vital investigational tool for the hospitalist. It can be used in the initial workup of a new leukocytosis to identify a malignant versus a benign reactive cause. Flow cytometry also has direct uses in nonmalignant hematologic conditions, such as in the determination of CD4/CD8 count ratios in HIV-associated lymphocytopenia or in the diagnosis of rarer conditions such as paroxysmal nocturnal hemoglobinuria and Langerhans cell histiocytosis. Ref: Leonard B.J., Leber B. (2012). Chapter 174. Disorders of the White Cell. In G.V. Lawry, S.C. McKean, J. Matloff, J.J. Ross, D.D. Dressler, D.J. Brotman, J.S. Ginsberg (Eds), Principles and Practice of Hospital Medicine."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nBase of the skull fracture presents with involvement of the petrous temporal bone, which of the following important sign:\nA) Subconjunctive haematoma\nB) CSF rhinorrhoea\nC) Raccon eyes\nD) Battle sign", "output": "3, because (Battle sign) (595-Baily & Love 24th) (302-B &L 25th)Base of Skull Fractures* Anterior fossa fracture - May open into the frontal or ethmoid air sinuses or run across the cribriform plate.* Presents with sub conjunctival hematoma, anosmia, epistaxis, nasal tip anaesthesia, CSF-rhinorrhea and occasionally carotico-cavernous fistua.* Periorbital haematoma or \"raccoon eye\" indicate subgaleal haemorrhage.* Middle fossa fracture involving petrous temporal bone presents with CSF otorrhoea, haemotympanum, occicular disruption, Battle sign or VII and VIII cranial nerve palsiesBattle sign - bruising behind the ear appearing 36 hours after a head injury with a petrous temporal base of skull fracture"} |
{"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 pubeal events in girls is not estrogen dependant\nA) Menstruation\nB) Vaginal cornification\nC) Height spu\nD) Hair growth", "output": "3, because Functions of estrogen Estrogen changes the vaginal epithelium from cuboidal to stratified type,which is more resistant to trauma and infection Marked proliferation of endometrial stroma and greatly increases the development of the endometrial glands - Menstruation Development of the stromal tissue of breast, growth of an extensive ductile system and deposition of fat Increase in osteoblastic activity and growth rate becomes rapid for several years Estrogens do not greatly affect hair distribution and growth. However hair develops in the pubic region and axilla after pubey. Androgens produced by the adrenal glands are responsible for this TEXTBOOK OF MEDICAL PHYSIOLOGY,GUYTON,Pg no:905,906,8th edition"} |
{"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 pathologist is observing a slide. He repos seeing perineural invasion. In which one of the following perineural invasion is most commonly seen?\nA) Adenocarcinoma\nB) Adenoid cystic carcinoma\nC) Basal Cell Adenoma\nD) Squamous cell carcinoma", "output": "1, because Adenoid cystic carcinoma"} |
{"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 investigations are used in FIGO staging of carcinoma cervix except ?\nA) CECT\nB) Intravenous pyelography\nC) Cystoscopy\nD) Proctoscopy", "output": "0, because CECT According to the FIGO guidlines for clinical staging of cervical carcinoma, diagnostic studies include :-Intravenous urography (pyelography). - Cystoscopic examination of bladder and urethra Proctosigmoidoscopic study - Barium enema Colposcopic study of the vagina and vaginal formices in early stage disease. Colposcopic findings may be used for assigning a stage to the tumour for instance FIGO stage HA. - Chest radiograph and electrocardiographic studies are used to determine cardiopulmonary disease paicularly in oder patients. Pulmonary function studies can be impoant especially for evaluating patients who are candidates for extensive surgery. Remember CT scan, MRI lymphangiography and PET scan may offer information helpful for treatment planning but these findings do not change the FIGO stage of the disease. Pelvic examinations and clinical staging as defined by FIGO cannot detect metastasis such as paraaoic lymph node metastasis. Consequently there is growing body of literature showing the superiority of cross-sectional imaging computed Tomography (CT) and magnetic resonance imaging (MRI) over clinical staging in delineating the extent of the disease in patient with cervical cancer. The official FIGO guidelines do not incorporate the use of either CT or MRI findings into the staging of cervical cancer. This is due to the FIGO guideline that staging methods should be universally available so that staging can be standardized means of communication between different institutions wordwide."} |
{"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 febrile convulsion \u2013\nA) Carbamazepine is good drug to treat it\nB) Patient with family h/o F.C. have increased incidence of recurrence\nC) Longterm neurological deficits are common\nD) Usually last for short while", "output": "1, because Types of febrile convulsions\n\nFebrile convulsions may be of two types.\n\n\nSimple benign\nAtypical complex\n\n1. Simple benign febrile convulsions\n\nMore common \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0\u00a0\nLast less than 10 minutes\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\nConvulsions are generalized\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\nNo post ictal neurological deficit\u00a0 \u00a0\nUsually single seizure in the same day\u00a0\nEEG is normal after a few days\u00a0 \u00a0\n\n2. Complex, atypical febrile convulsions\u00a0\n\nLess common\u00a0\nMore than one seizure in the same day\nLast more than 15 minutes\nConvulsions are focal\u00a0\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0\u00a0\n\nRisk factors for recurrence\n\nPositive family history\nAtypical complex febrile convulsions\nNeurodevelopmental retardation (e.g. cerebral palsy, mental retardation)\nEarly onset of febrile seizure (before 1 year)\n\nTreatment of febrile seizure\n\nFebrile convulsions are managed by prompt reduction of temperature with \u2192\n\ni)\u00a0Antipyretics \u2192\u00a0\u00a0Paracetamole, Ibuprofen\nii) Hydrotherapy \u2192 Sponging\n\nFor seizures lasting > 5 minutes, anticonvulsants can be given -\n\n\nDiazepam is the DOC\nPhenobarbitone is an alternative"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nUterine-cervix ratio up to 10 years of age:\nA) 3:02\nB) 2:01\nC) 3:01\nD) 1:02", "output": "3, because The relationship of the length of the cervix and that of the body of uterus varies with age."} |
{"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 is produced in the lipoxygenase pathway?\nA) Thromboxane\nB) Leukotrienes\nC) Prostaglandin\nD) Prostacyclin", "output": "1, because Thromboxane A2, prostacyclin, and prostaglandins are formed by the cyclooxygenase pathway whereas leukotrienes are formed by the lipooxygenase pathway.Ref: Textbook of medical physiology by N Geetha, 2nd edition, page no. 103"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nApparent volume of distribution (aVd) is more than total body fluid if drug is:\nA) Poorly soluble\nB) Sequestered in tissues\nC) Slow elimination\nD) Poorly plasma protein bound", "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\nDeleterious effect of ultrasound on small organism is:\nA) Ionisation\nB) Vacoulation\nC) Cavitation\nD) Disintegration", "output": "2, because Ans. Cavitation"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nHemophia A due to deficiency of ?\nA) Factor VIII\nB) Factor IX\nC) Factor X\nD) Factor XI", "output": "0, because Ans. is 'a' i.e., Factor VIII Hemophila A :? Hemophilia A is due to deficiency of factor VIII. Hemophilia A is inherited as an X-linked recessive trait. Factor VIII is an intrinsic pathway component required for activation of factor X. Clinical manifestations are due to defect in coagulation system :- Large post traumatic ecchymoses or hematoma. Prolonged bleeding after a laceration or any form of surgical procedure. Bleeding into weight bearing joints. Petechiae are characteristically absent (in contrast to platelet dysfunction where bleeding occur from small vessels of skin and mucous membrane, e.g., petechiae). Laboratory findings :- T PTT Normal PT Normal BT Normal platelet counts Remember Hemophilia B (christmas disease) is due to deficiency of factor IX. Hemophilia B has clinical features and laboratory findings similar to hemophilia A."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nV/Q ratio at the base of lung-\nA) 1\nB) 3\nC) 0.6\nD) 1.8", "output": "2, because Ans. is 'c' i.e., 0.6 o Overall V/Q ratio of lung-0.8o V/Q ratio at apex-3.0 (maximum)o V/Q ratio at base-0.6 (Least)"} |
{"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 70 year old man develops pneumonia and septicemia. Patient goes into renal failure and has a BP of 70/50 mm of Hg. Drug that should be used to maintain BP is:\nA) Adrenaline\nB) Ephedrine\nC) Phenylephrine\nD) Nor epinephrine", "output": "3, because Answer is D (Norepinephrine) The patient in question is presenting with features of septic shock. Dopamine is the initial recommended vasopressor agent to maintain blood pressure but is not provided amongst the options. Patients who remain hypotensive despite dopamine should he adminstered norepinephrine and hence norepinephrine is the single best answer of choice here. Harrison 14th / 221 Treatment of septic shock Iffluid therapy alone fails to restore adequate aerial pressure and organ perfusion , therapy with vaso pressor agent should be intitiated. For the persistantly hypotensive patient dopamine frequently raises aerial pressure and maintains or enhances blood flow to the renal and splanchnic circulation. Patients who remain hypotensive despite dopamine require nor epinephrine, a more potent vasopressor. Once hypotension, has been corrected to optimize oxygen delivery to tissues, raising a low cardiac index with dobutamine can be useful - Harrisons 16th / 605 : Treatment of septic shock In the presence of sepsis, augmentation of cardiac output may require inotropic suppo with dopamine, nore pinephrine or vaso pressin in the presence of hypotension or with dobutamine if aerial pressure is normal"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nTo be defined as a ganglioside,a lipid substance isolated from nervous tissue must contain\nA) NANA,hexose,fatty acid,glycerol\nB) NANA,hexose,fatty acid,phosphorycholine\nC) NANA,sphingosine,ethanolamine\nD) NANA,hexose,sphingosine,long chain fatty acid,", "output": "3, because Gangliosides are the complex glycosphingolipids derived from glucosylceramide that contain in addition one or more molecules of sialic acid. Neuraminic acid is the principal sialic acid found in human tissues. Gangliosides are present in nervous tissue in high concentration.They help in cell-cell recognition and communication and as receptors for hormones and bacterial toxins. Reference: Harpers illustrated biochemistry 30 th 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 25 years old female complains of recurrent rhinitis, nasal discharge and bilateral nasal blockage since one year. She has the history of asthma and allergy. On examination, multiple ethmoidal polyps are noted with mucosal thickening and impacted secretions in both the nasal cavities. A biopsy is taken and the material is cultured which shown the growth of many non pigmented septate hyphae with dichotomous branching typically at 45degrees. Which of the following is the most likely responsible organism\nA) Aspergillus fumigatus\nB) Rhizopus\nC) Mucor\nD) Candida", "output": "0, because Aspergillus shows typical dichotomous branching at an angle of approximately 45degrees. Candida shows pseudohyphae. Rhizopus and mucor shows nonseptate hyphae. Reference: Textbook of Microbiology; Baveja; 4th edition"} |
{"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 for acid base gas (ABGO analysis in a bottle containing heparin can cause decreased value of -\nA) pCO2\nB) HCO2\nC) pH\nD) pO2", "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\nBoerhaave syndrome is due to:\nA) Burns\nB) Vomiting\nC) Stress\nD) Acid ingestion", "output": "1, because Ans. (b) vomitingRef Bailey and Love 27th edition, Page 1073* Vomiting against closed Glottis leads to Boerhaave syndrome.* Vomiting against closed LES leads to Mallory Weiss tear."} |
{"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 anemia the concentration of 2,3 DPG is\nA) Decreased\nB) Increased\nC) A or B\nD) Not changed", "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\nThe primary reason for replacing teeth destroyed due to\nnursing bottle syndrome is\nA) Speech and esthetics\nB) Form and function\nC) Incising and mastication\nD) Arch perimeter requirements in the transitional dentition", "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\nCharacteristic histopathology finding in Whipples disease is ?\nA) PAS positive macrophages and rod shaped bacilli in lamina propria\nB) Shoened thickened villi with increased crypt depth\nC) Blunting and flattening of mucosal surface and absent villi\nD) Mononuclear infiltration at base of crypts", "output": "0, because Ans. is 'a' i.e., PAS positive macrophages and rod shaped bacilli in lamina propriaThe hallmark of Whipple's disease is a small intestinal mucosa laden with distended macrophages in the lamina propria- the macrophages contain periodic acid-schiff (PAS) positive granules and rod shaped bacilli by electron microscopy.Three forms of Malabsorption Syndromes are often asked and the basic understanding of these is able to exclude a large number of questions."} |
{"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 which of the following conditions uniform dilation of esophagus is seen\nA) Scleroderma\nB) Trypanosoma cruzi infection\nC) Dermatomysitis\nD) BD", "output": "3, because In Trypanosoma cruzi infection& dermatomyositis uniform dilatation of oesophagus is seen Esophageal dilatation is a therapeutic endoscopic procedure that enlarges the lumen of the esophagus. ...Complications of esophageal dilatation include the following: Odynophagia, or painful swallowing. Hematemesis, or bloody vomit. Esophageal perforation. Mediastinitis."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nMechanism of action of vincristine in the treatment of ALL is:\nA) Inhibition of topoisomerase II to cause breaks in DNA strands\nB) Alkylation and cross linking DNA strands\nC) Inhibition of DNA mediated RNA synthesis\nD) Inhibition of polymerization of tubulin to form microtubules", "output": "3, because Vinca alkaloids like vincristine and vinblastine act by inhibiting the formation of mitotic by spindle inhibiting polymerization of tubulin. These drugs are selective for M phase of cell cycle."} |
{"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 ketone bodies except\nA) Acetoacetate is primary ketone body\nB) Synthesized in mitochondria\nC) Synthesized in liver\nD) HMG CoA reductase is the rate-limiting enzyme", "output": "3, because KETOSIS Under ceain metabolic conditions associated with a high rate of fatty acid oxidation, liver produces considerable quantities of compounds like acetoacetate and bbb-OH butyric acid, which pass by diffusion into the blood. Acetoacetate continually undergoes spontaneous decarboxylation to produce acetone. These three substances are collectively known as \"ketone bodies\" (or \"acetone bodies\"). Sometimes also called as \"ketones\", which is rather a misnomer. KETONE BODY FORMATION IN LIVER (KETOGENESIS) Enzymes are mitochondrial: Steps 1. Aceto-acetyl-CoA: Aceto-acetyl-CoA is the staing material for ketogenesis. This can arise in two ways: (a)Directly during the course of b-oxidation of fatty acids, or (b)As a result of condensation of two C-2 units, i.e. 'active acetate' (acetyl-CoA) by reversal of thiolase reaction. 2. Formation of Acetoacetate: Acetoacetate is the first ketone body to be formed. This can occur in two ways: a) By deacylation: Acetoacetate can be formed from aceto-acetyl-CoA by simple deacylation catalysed by the enzyme aceto-acetyl-CoA deacylase. SECTION FOUR when excessive amount of ketone bodies are formed, the The above does not seem to be the major pathway deacylation reaction is not enough to cope up. (b) Second pathway: Formation of acetoacetate intermediate production of \"bbb-OH-bbb-methyl glutaryl CoA\" (HMG-CoA). Present opinion ours the HMG-CoA pathway as the major route of ketone body formation. Steps Involves two steps: * Condensation of aceto-acetyl-CoA with another molecule of acetyl-CoA to form b-OH-b methyl glutaryl-CoA (HMG-CoA) catalysed by the enzyme HMG-CoA synthase (mitochondrial enzyme). *HMG-CoA is then acted upon by an another enzyme, HMG-CoA Lyase, which is also mitochondrial enzyme, to produce one molecule \"acetoacetate\" and one molecule of acetyl-CoA (Fig. 25.10). Note *Both the enzymes HMG-CoA synthase and HMG-CoA Lyase are mitochondrial and must be available in mitocondrion for ketogenesis to occur. *Both the enzymes are present in liver cells mitochon- dria only. *A marked increase in activity of HMG-CoA Lyase has been noted in fasting. *HMG-CoA is a committed step. Cholesterol also can be formed by \"HMG-CoA reductase\". 3. Formation of Acetone: As stated earlier, acetone is formed from acetoacetate by spontaneous decarboxy- lation (Non-enzymatic). 4.Formation of b-OH Butyrate: Acetoacetate once formed is conveed to b-OH-butyric acid; the reaction is catalysed by the enzyme b-OH-butyrate dehydro- genase, which is present in liver and also found in many other tissues. b-OH-butyrate is quantitatively the predominant ketone body present in blood and urine in KetosisRef: Textbook of Medical Biochemistry Dr (Brig) MN Chatterjea Rana Shinde, page no: 425,426"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nPseudoparalysis in an infant is suggestive of ?\nA) Acute Rheumatic fever\nB) Vitamin B6 deficiency\nC) Vitamin E deficiency\nD) Vitamin C deficiency", "output": "3, because Ans. is 'd' i.e., Vit C deficiencyPseudoparalysis o A voluntary restriction of motion because of pain, incordination or other cause, but not due to actual muscular paralysis.Causes of pseudoparalysisScurvy (vitamin C deficiency) o OsteomyelitisSeptic (ahritis) o Congenital syphilis"} |
{"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 coronoid process:\nA) Limits the extension of maxillary posterior teeth setting\nB) Limits the thickness of the distobuccal flange of the upper complete denture\nC) Limits the thickness of the distobuccal flange of the lower complete denture\nD) Determines PPS", "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\nGreater than 30 g of fat is excreted in feces per day. The cause is\nA) Exocrine pancreatic insufficiency\nB) Rapid transient diarrhea\nC) Small intesitnal disease\nD) Normal", "output": "0, because (A) Exocrine pancreatic insufficiency # Steatorrheal causes:> Intraluminal maldigestion (pancreatic exocrine insufficiency, bacterial overgrowth, bariatric surgery, liver disease)> Mucosal malabsorption (celiac sprue, Whipple's disease, infections, abetalipoproteinemia, ischemia)> Postmucosal obstruction (1deg or 2deg lymphatic obstruction)> Quantitatively, steatorrhea is defined as stool fat exceeding the normal 7 g/d; rapid-transit diarrhea may result in fecal fat up to 14 g/d; daily fecal fat averages 15-25 g with small intestinal diseases and is often >32 g with pancreatic exocrine insufficiency. Intraluminal maldigestion, mucosal malabsorption, or lymphatic obstruction may produce steatorrhea.> Steatorrhea is a condition characterized by the loss of lipids in the feces. Steatorrhea may be due to1. A defect in the secretion of bile or pancreatic juice into the intestine;2. Impairment in the lipid absorption by the intestinal cells.> Steatorrhea is commonly seen in disorders associated with pancreas, biliary obstruction, severe liver dysfunction etc."} |
{"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 young girl has had repeated infections with Candida albicans and respiratory viruses since she was 3 months old. As part of the clinical evaluation of her immune status, her responses to routine immunization procedures should be tested. In this evaluation, the use of which of the following vaccines is contraindicated?\nA) Bacillus Calmette-Guerin (BCG)\nB) Bordetella pertussis vaccine\nC) Diphtheria toxoid\nD) Inactivated polio", "output": "0, because Recurrent severe infection is an indication for clinical evaluation of immune status. Live vaccines, including BCG attenuated from M. tuberculosis, should not be used in the evaluation of a patient's immune competence because patients with severe immunodeficiencies may develop an overwhelming infection (disseminated disease) from the vaccine. For the same reason, oral (Sabin) polio vaccine is not advisable for use in such persons. The other vaccines listed are acellular and should be safe to use in this clinical scenario described."} |
{"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 in the superficial perineal space of the male EXCEPT the\nA) Bulb of the penis\nB) Crus of the penis\nC) Bulbourethral gland\nD) Bulbospongiosus muscle", "output": "2, because The bulbourethral (Cowper's) gland is in the deep penineal space within the urogenital diaphragm. The duct from the gland leaves the deep perineal space, enters the superficial penineal space, and then enters the urethra. Because the gland is in the deep perineal space within a tightly confined area, infection of the gland is painful. The homologous gland in the female, the greater vestibular (Baholins) gland, is in the superficial perineal space."} |
{"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 62-year-old man is admitted to the hospital with dull, diffuse abdominal pain. A CT scan reveals a tumor at the head of the pancreas. The abdominal pain is mediated by afferent fibers that travel initially with which of the following nerves?\nA) Greater thoracic splanchnic\nB) Intercostal\nC) Phrenic\nD) Vagus", "output": "0, because The afferent fibers mediating the pain from the head of the pancreas run initially with the greater thoracic splanchnic nerves. The greater splanchnic nerves arise from sympathetic ganglia at the levels of T5 to T9 and innervate structures of the foregut and thus the head of the pancreas. Running within these nerves are visceral afferent fibers that relay pain from foregut structures to the dorsal horn of the spinal cord. Also entering the dorsal horn are the somatic afferents from that vertebral level, which mediate pain from the body wall. Intercostal nerves T1 to T12 provide the terminal part of the pathway to the spinal cord of visceral afferents for pain from the thorax and much of the abdomen. Therefore, pain fibers from the pancreas pass by way of the splanchnic nerves to the sympathetic chains and then, by way of communicating rami, to ventral rami of intercostal nerves, finally entering the spinal cord by way of the dorsal roots. The phrenic nerve innervates the diaphragm and also carries visceral afferents from mediastinal pleura and the pericardium, but it does not carry with it any visceral afferent fibers from the pancreas. The vagus nerve innervates the pancreas with parasympathetic fibers and ascends all the way up to the medulla where it enters the brain. It has no visceral afferent fibers for pain. The subcostal nerve is from the level of T12 and innervates structures below the pancreas and carries no visceral afferents from the pancreas."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nAdvantage of Minimal access surgery\nA) Heat loss\nB) Better Hemostasis control\nC) Improved vision\nD) In wound pain", "output": "2, because The core principles of minimal access surgery (independent of procedure or device) can be summarized by the acronym I-VITROS: * Insufflate/create space - to allow surgery to take place in the minimal access setting * Visualise - the tissues, anatomical landmarks and the environment for the surgery to take place * Identify - the specific structures for surgery * Triangulate - surgical tools (such as po placement) to optimise the efficiency of their action, and ergonomics by minimising overlap and clashing of instruments * Retract - and manipulate local tissues to improve access and gain entry into the correct tissue planes * Operate - incise, suture, anastomose, fuse * Seal/haemostasis. Ref: Bailey and love 27th edition Pgno : 105"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nPinch purpura is diagnostic of \u2013\nA) Systemic primary amyloidosis\nB) Secondary systemic amyloidosis\nC) Idiopathic thrombocytopenic purpura\nD) Drug induced purpura", "output": "0, because In primary systemic amyloidosis amyloid deposition occurs in the wall of the blood vessels, this leads to an increase in skin fragility. As a result, petechiae and purpura develop in clinically normal skin as well as in lesional skin following minor trauma. Therefore the skin lesions in case of primary systemic amyloidosis are called pinch purpura. These lesions are pink in colour and translucent.\nCommon locations are\n\n\nFace (especially the periorbital and perioral regions)\nFlexural areas."} |
{"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 mode of action of Lanatoprost in glaucoma:\nA) Increasing trabecular outflow\nB) Releasing pupillary block\nC) Decreasing aqueous humour formation\nD) Increasing uveoscleral outflow", "output": "3, because Lantanoprost is prastoglandin in nature and decrease the intraocular pressure by increasing uveoscleral outflow of aqueous humour. It is very good adjunctive therapy along with betablockers, dorzolamide and pilocarpine. Ref: A.K KHURANA (2005), Chapter 9, \"Glaucoma\", In the book, \"Opthalmology\", 3rd Edition, Newdelhi, Page 229 ; KDT 5th Edition, Page 88"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nGelle&;s test is done in\nA) Otosclerosis\nB) Serous otitis media\nC) Traumatic deafness\nD) Senile deafness", "output": "0, because Gelle's test: It is also a test of bone conduction and examines the effect of increased air pressure in ear canal on the hearing. Normally, when air pressure is increased in the ear canal by Siegel's speculum, it pushes the tympanic membrane and ossicles inwards, raises the intralabyrinthine pressure and causes immobility of basilar membrane and decreased hearing, but no change in hearing is observed when ossicular chain is fixed or disconnected. Gelle's test is performed by placing a vibrating fork on the mastoid while changes in air pressure in the ear canal are brought about by Siegel's speculum. Gelle's test is positive in nor- mal persons and in those with sensorineural hearing loss. It is negative when ossicular chain is fixed or disconnected. It was a popular test to find out stapes fixation in otosclerosis but has now been superceded by tympanometry. Ref:- Dhingra; pg num:- 22,23"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nFactor responsible for Cardiac Hyperophy is?\nA) ANF\nB) TNF alpha\nC) c-myc\nD) TGF beta", "output": "2, because Ans. is 'c' i.e., c-myc"} |
{"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 a 30 year old farmers who is a chronic smoker\nA) Atherosclerosis\nB) Raynaud's disease\nC) Thromboangiitis obliterans\nD) Myocardial infarction", "output": "2, because All four can cause gangrene (Myocardial infarction can cause gangrene by thromboembolism) Lets see, each option one by one. Raynauds disease Is ds of young women* (F:M ratio is 5:1) commonly the upper limbs* are affected specially the fingers (the thumb is generally escaped) The disease is characterized by Raynauds phenomenon* which is a series of attacks of Local syncope - digits become cold and white* Local asphyxia - digits turn blue with burning sensation* Local recovery -digits regain normal colour* Pulses remain unaffected* as this is the disease which affects aerioles With the help of points (a) and (b) Raynauds ds can be ruled out. Atherosclerosis (Senile gangrene) Seen in elderly people over 50 years of age. Thus because of age factor we can rule out atherosclerosis. Myocardial infaction Age 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. Buerger's (Thromboangitis obliterans) Usual victims of this ds are young men below 40 yrs of age, who are smokers (ds is not seen in females and nonsmokers). Buerger ds is the inflammatory reaction in the aerial wall with involvement of the neighbouring vein and nerve, terminating in thrombosis of the aery. It characterstically involves small and medium sized aeries (plantars, tibial and radial aery) Both upper and lower extremities are affected. In lower extremity the ds. occurs beyond the popliteal aery. In upper extremity the ds occurs beyond the brachial a. Early in the course of Buergers ds the superficial veins are involved producing the characterstic migratory, recurrent superficial thrombophlebitis. An imp difference with atheroselerosis is that, atherosclerosis is a disease of large sized aeries, buergers is a ds of small aeries."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nFollowing features are true about lipid insoluble beta blockers except?\nA) Do not cross blood brain barrier\nB) Have good membrane stabilizing effect\nC) Incompletely absorbed orally\nD) Are long acting", "output": "1, because Ans. is `b' i.e., Have good membrane stabilizing effect Lipid insolubile drugs have following features ? Do not cross Blood Brain Barrier and therefore produce no CNS effects. Have good renal excretion Have no membrane stabilizing activity Are incompletely absorbed orally Are long acting Are effective in narrow dose range Lipid insoluble b-blockers Acebutolol Betoxalol Atenolol Caeolol Bisoprolol Celiprolol Esmolol Nodalol Sotalo Labealol Pindolol"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nSideroblastic anemia is seen in chronic poisoning of\nA) Lead\nB) Arsenic\nC) Copper\nD) Mercury", "output": "0, because Ans. (a) Lead(Ref: Wintrobe's 12th/pg837)Sideroblastic anemia is seen in:*. Alcoholism*. Lead poisoning*. Drugs (isoniazid, pyrazinamide, chloramphenicol)*. Copper deficiency (zinc ingestion, copper chelation, nutritional, malabsorption)*. Hypothermia"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\n\"Lift off' and \"Belly Press\" tests are done to examine which of the following rotator cuff muscle?\nA) Teres Minor\nB) Supraspinatus\nC) Subscapularis\nD) Infraspinatus", "output": "2, because Ans. C. SubscapularisSubscapularis muscle is responsible for extremes of internal rotation, which can be tested with belly press and lift off test."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nSuperior Gluteal Nerve supplies ail except:\nA) Gluteus Minimus\nB) Gluteus Medius\nC) Gluteus Maximus\nD) Tensor Fascia Lata", "output": "2, because Ans. C. Gluteus MaximusThe superior gluteal nerve arises from the sacral plexus in the pelvis and is formed by the dorsal branches of the ventral rami of L4, L5; S1. It enters the gluteal region through the greater sciatic notch above the piriformis in company with superior gluteal artery. Here it curves upward and forward, runs between the gluteus medius and the minimus, and supplies both of them. It then comes out by passing between the anterior borders of these muscles and supplies the tensor fasciae latae from its deep surface. It also provides an articular twig to the hip 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\nPlacental abnormality related to PPH is?\nA) Placenta accreta\nB) Placenta percreta\nC) Retained placental\nD) All the above", "output": "3, because Ans. is 'd' i.e., All the abovePlacenta: morbidly adherent placenta (accrete, percreta), paially or completely separately separated placenta but with retained bits of placental tissue leads to PPH."} |
{"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 amount of time required by erupting premolar to move through 1 mm of bone as measured on a bite-wing radiograph?\nA) 3-4 months\nB) 4-5 months\nC) 5-6 months\nD) 6-7 months", "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\nBest method to show trend of events with passage of time is?\nA) Line diagram\nB) Bar diagram\nC) Histogram\nD) Pie chart", "output": "0, because ANSWER: (A) Line diagramREF: Park 20th edition page 747 &748, style=\"font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0; text-align: left\">\"Line diagrams are used to show the trend of events with passage of time\"PictographA pictograph uses an icon to represent a quantity of data : values in order to decrease the size of the graph. A key must be used to explain the icon.Advantages* Easy to read* Visually appealing* Handles large data sets easily using keyed iconsDisadvantages* Hard to quantify partial icons* Icons must be of consistent size* Best for only 2-6 categories* Very simplisticPie chartA pie chart displays categorical data as a percentage of the whole by using a circle. Each pie section should have a label and percentage. A total data number should be included.Advantages* Visually appealing* Shows percent of total for each categoryDisadvantages* No exact numerical data* Hard to compare 2 data sets*\"Other\" category can be a problem* Total unknown unless specified* Best for 3 to 7 categories* Use only with discrete dataHistogramA histogram displays discrete or continuous data in ordered columns. Each column represents a group defined by a quantitative variable such as time, inches, temperature, etc.Advantages* Visually strong* Can compare to normal curve* Usually vertical axis is a frequency count of items falling into each categoryDisadvantages* Cannot read exact values because data is grouped into categories* More difficult to compare two data sets* Use only with continuous dataBar graphA bar graph displays discrete data in separate columns. A double bar graph can be used to compare two data sets. Each column represents a group defined by a categorical variableAdvantages* Visually strong* Can easily compare two or three data setsDisadvantages* Graph categories can be reordered to emphasize certain effects* Use only with discrete dataLine graphA line graph plots continuous data as points and then joins them with a line. To show the trend of event with passage of timeAdvantages* Can compare multiple continuous data sets easily* Interim data can be inferred from graph lineDisadvantages* Use only with continuous dataFrequency PolygonA frequency polygon can be made from a line graph by shading in the area beneath the graph. It can be made from a histogram by joining midpoints of each column.Advantages* Visually appealingDisadvantages* Anchors at both ends may imply zero as data points* Use only with continuous data"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nMore resistance in expiration is due to:\nA) Increased compression of airway\nB) Due to change from linear to turbulent flow\nC) Saturation with moisture\nD) Increased rate of flow during expiration", "output": "0, because A i.e. Increased compression of airways"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAntihypertensive may act by blocking all of following except:\nA) Alpha\u2013adrenoceptors\nB) ATP dependent K+ channels\nC) Nor adrenaline release\nD) Beta adrenoceptors", "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\nTemporal pallor in optic disc seen in all except\nA) Optic neuritis\nB) Compression of optic nerve\nC) Leber's hereditary optic neuritis\nD) Glaucoma", "output": "3, because Optic atrophy, pallor of the optic nerve head, is a sign found in patients with visual loss due to pathology of the optic nerve or retinal ganglion cells. ... It refers topallor of the optic disc which results from irreversible damage to the retinal ganglion cells and axons. It is commonly seen in Optic neuritis Compress of optic nerve Leber's hereditary optic neuritis Ref AK khurana 6/e p459"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nAnti glaucoma drug that act by increasing uvea scleral outflow is?\nA) Latanoprost\nB) Timolol\nC) pilocarpine\nD) Dorzolamide", "output": "0, because REF : KD TRIPATHI 8TH 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\nThe major vitamin deficiency in Wernicke's encephalopathy is :\nA) B1\nB) B2\nC) B6\nD) B12", "output": "0, because Wernicke's disease is a common and preventable disorder due to a deficiency of thiamine. Alcoholics account for most cases, but patients with malnutrition due to hyperemesis, starvation, renal dialysis, cancer, AIDS, or rarely gastric surgery are also at risk. The characteristic clinical triad is that of ophthalmoplegia, ataxia, and global confusion. However, only one-third of patients with acute Wernicke's disease present with the classic clinical triad. Most patients are profoundly disoriented, indifferent, and inattentive, although rarely they have an agitated delirium related to ethanol withdrawal. Ref: Hemphill, III J.C., Gress D.R. (2012). Chapter 275. Neurologic Critical Care, Including Hypoxic-Ischemic Encephalopathy, and Subarachnoid Hemorrhage. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e."} |
{"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 fungal infection of female genitalia in diabetes?\nA) Cryptococcal\nB) Madurmycosis\nC) Candida\nD) Aspergillosis", "output": "2, because Candida is the commonest infection of female genital tract in diabetes. Candida species are normal commensals of the mouth, GI tract, vaginal mucosa and in the patients with an indwelling catheter. Diabetes is paicularly associated with increased susceptibility to vaginal infections."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nWho among the following has contributed to the development of neuro-otology and is considered as the father of 'nen ro-otology'?\nA) Julius Lampa\nB) John J. Shea Jr\nC) William F. House\nD) Hales Main", "output": "2, because Ans. c. William F. House (Ref www.audiology.org For the pioneering work in the field of neuro-otology, William F. House considered as 'Father of Neuro-otology'. William F. House considered as 'Father of Neuro-otology' because of his pioneering development approaches for the removal of acoustic tumors and the management of patients with disabling veigo."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nDrugs causing macular toxicity when given intravitreally-\nA) Gentamycin\nB) Vancomycin\nC) Dexamethasone\nD) Ceftazidime", "output": "0, because Ans. is 'a' i.e., Gentamycino Intravitreal aminoglycosides (gentamycin, amikacin) are a reported cause of macular toxicity.o Aminoglycosides induced macular toxicity is thought to be partially due to the gravity-induced settling of drugs on the macula in supine position.o This may result in a higher concentration of drug locally at the macula."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nFatty liver is caused by all except\nA) DM\nB) Tetracycline\nC) Starvation\nD) Excess iron intake", "output": "3, because Fatty change in the liver may result from one of the two types of causes: 1.Conditions with excess fat: i) Obesity ii)Diabetes mellitus iii)Congenital hyperlipidaemia 2.Liver cell damage: i) Alcoholic liver disease (most common) ii)Starvation iii)Protein calorie malnutrition iv)Chronic illnesses (e.g. tuberculosis) v) Acute fatty liver in late pregnancy vi)Hypoxia (e.g. anaemia, cardiac failure) vii)Hepatotoxins (e.g. carbon tetrachloride, chloroform, ether, aflatoxins and other poisons) viii)Drug-induced liver cell injury (e.g. administration of methotrexate, steroids, CCl4, halothane anaesthetic, tetracycline etc) ix) Reye's syndrome. TEXTBOOK OF PATHOLOGY HARSH MOHAN 6TH EDITION PAGE NO:38"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nUrination in the human subject is decreased by\nA) Nicotinic agonists\nB) AChase inhibitors\nC) muscarinic agonists\nD) muscarinic antagonists", "output": "3, because ANTICHOLINERGIC DRUGS (Muscarinic receptor antagonists, Atropinic, Parasympatholytic) Smooth muscles:- All visceral smooth muscles that receive parasympathetic motor innervation are relaxed by atropine (M3 blockade). Tone and amplitude of contractions of stomach and intestine are reduced; the passage of chyme is slowed--constipation may occur, spasm may be relieved. Atropine has relaxant action on ureter and Urinary bladder; urinary retention can occur in older males with prostatic hyperophy. However,this relaxant action can be beneficial for increasing bladder capacity and controlling detrusor hyperreflexia in neurogenic bladder/enuresis. Ref:- kd tripathi; pg num:-114,115"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nIntraepidermal lgG deposition is seen in\nA) Pemphigus\nB) Bullous pemphigoid\nC) Herpes genitalis\nD) SLE", "output": "0, because Pemphigus"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nMore resistance in respiration is due to which of the following?\nA) Saturation with moisture\nB) Increased rate of flow during expiration\nC) Increased compression of airway\nD) Due to change from linear to turbulent flow", "output": "2, because More resistance in respiration is seen in bronchial construction Ref: guyton and hall textbook of medical physiology 12 edition page number:333,334,335"} |
{"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 patient presented with fever, cervical lymphadenopathy and night sweats four weeks after unprotected sexual contact. Next investigation\nA) p24\nB) ELISA\nC) CD4\nD) HIV PCR", "output": "0, because Ref: PubMed* This is a possible suspicion of HIV infection.* p24 antigen is a viral protein that makes up most of the viral core.* Serum concentrations of p24 antigen are high in the first few weeks after infection; tests sensitive to p24 antigen are therefore useful for diagnosing very early infection when antibody levels are still low."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nApical root fracture in an anterior tooth is treated by:\nA) Extraction\nB) Splinting for 2-3 months\nC) Endodontic treatment\nD) All of the above", "output": "3, because A tooth with its root fractured in its apical third has an excellent prognosis because the pulp in the apical fragment usually remains vital, and the tooth may remain firm in its socket.\u00a0\nA mobile tooth should be splinted.\u00a0\nIf the pulp in the coronal fragment remains vital and the tooth is stable, with or without ligation, then no additional treatment is indicated.\nIn the event of pulpal death in the coronal fragment, endodontic treatment can be done, which is preferably limited to the coronal fragment.\u00a0\nIf the tooth fails to recover, the apical root fragment can be removed surgically.\n\n\nRef : Grossman\u2019s endodontics,13th edition, pg no:430"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nNeonatal Jaundice first time appears in the 2nd week not a cause is \u2013\nA) Galactossemia\nB) Rh Incompatibility\nC) Hypothyroidism\nD) Breast milk Jaundice", "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\nOptical media are clear in:\nA) Cavernous sinus thrombosis\nB) Orbital cellulitis\nC) Both of the above\nD) None of the above", "output": "2, because Ans. Both of the above"} |
{"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 male was brought unconscious to the hospital with external injuries. CT shows no midline shift, but basal cisterns were full (compressed) with multiple small haemorrhage. The most probable diagnosis is:\nA) Brain contusion\nB) Diffuse axonal injury\nC) Subdural hemorrhage\nD) Multiple infarct", "output": "1, because B i.e. Diffuse axonal injuries Diffuse axonal injuries (DAI) - shearing injuries caused by sudden rotational or accelerating / decelerating forces. Patient typically lose consciousness at the time of impactQ. On CT small petechial hemorrhages are seenQ"} |
{"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 patient is delivered by cesarean section under general anesthesia.The baby and placenta are easily delivered, but the uterus is noted to be boggy and atonic despite intravenous infusion of Pitocin. All of the following are appropriate agents to use next except\nA) Methylergonovine (Methergine) administered intramuscularly\nB) Prostaglandin F2\u03b1 (Hemabate) suppositories\nC) Misoprostil (Cytotec) suppositories\nD) Terbutaline administered intravenously", "output": "3, because Methylergonovine, prostaglandin F2\u03b1, prostaglandin E1 (Misoprostil), and prostaglandin E2 (Hemabate)are all uretotonic agents than can be used in situations where there is a postpartum hemorrhage due to uterine atony.\nTerbutalinewould be contraindicated in this situation because it is a tocolytic that is used to promote uterine relaxation."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nUnwinding Enzyme in DNA synthesis:\nA) Helicase\nB) Primase\nC) DNA Polymerase\nD) Transcriptase", "output": "0, because Ans. A. Helicase(Ref: Harper 31/e page 364)Classes of proteins involved in DNA replicationProteinFunctionDNA polymerasesDeoxynucleotide polymerizationHelicasesProcessive unwinding of DNATopoisomerasesRelieve torsional strain that results from helicase-induced unwindingProteinFunctionDNA primaseInitiates synthesis of RNA primersSingle-strand binding proteinsPrevent premature reannealing of dsDNADNA ligaseSeals the single strand nick between the Nascent chain and Okazaki fragments on lagging strand"} |
{"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 pa of larynx involved in Tuberculosis is\nA) Anterior\nB) Posterior\nC) Middle\nD) Anywhere", "output": "1, because Tubercular laryngitisThe disease affects the posterior third of larynx more commonly than anterior paThe pas affected in descending order of frequency are:- i) Interarytenoid fold, ii) Ventricular band, iii) Vocal cords, iv) EpiglottisRef: PL Dhingra, Diseases of Ear, Nose & Throat, 7th edition, pg no. 329 - 330"} |
{"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 bacteria has Ampitrichous flagella\nA) V cholerae\nB) Spirillum minus\nC) Listeria\nD) Alcaligenes faecalis", "output": "3, because Mono - trichous - V.cholerae\nAmpitrichous\u00a0 - Alcaligenes faecalis\nLophotrichous\u00a0 - Spirillum minus\nPeritricous\u00a0 - E.coli, proteus, Listeria"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nHemolytic uremic syndrome is caused by\nA) EIEC\nB) Shigella\nC) Salmonella\nD) Cholera", "output": "1, because Shigella dysenteriae type 1 causes toxemia due to the production of exotoxin.the complication includes polyneuritis, ahritis, conjunctivitis, parotitis and hemolytic uremic syndrome. Ref: Textbook of microbiology; Ananthanarayan and paniker's;10th edition; Pg:293"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nLiposomal amphotericin B has the following advantage over conventional amphotericin B:\nA) Lesser nephrotoxicity\nB) Lesser cost\nC) Absense of infusional toxicity\nD) Once a week administration", "output": "0, because Amphotericin B (AMB): It is obtained from Streptomyces nodosus. Chemistry and mechanism of action The polyenes possess a macrocyclic ring, one side of which has several conjugated double bonds and is highly lipophilic, while the other side is hydrophilic with many OH groups. A polaraminosugar and a carboxylic acid group are present at one end in some. They are all insoluble in water and unstable in aqueous medium. The polyenes have high affinity for ergosterol present in fungal cell membrane: combine with it, get inseed into the membrane and several polyene molecules together orient themselves in such a way as to form a &;micropore&;. The hydrophilic side forms the interior of the pore through which ions, amino acids and other watersoluble substances move out. The micropore is stabilized by membrane sterols which fill up the spaces between the AMB molecules on the lipophilic side-constituting the outer surface of the pore. Thus, cell permeability is markedly increased. New amphotericin B formulations In an attempt to improve tolerability of i.v. infusion of AMB, reduce its toxicity and achieve targeted delivery, 3 new lipid formulations of AMB have been produced. (a) Amphotericin B lipid complex (ABLC): Contains 35% AMB incorporated in ribbon like paicles of dimyristoyl phospholipids. ( b ) Amphotericin B colloidal dispersion (ABCO). Disc shaped paicles containing 50% each of AMB and cholesteryl sulfate are prepared as aqueous dispersion (c) Lpi osomal amphotericin B (small unilamellar vesicles SUV): Consists of 10% AMB incorporated in uniform sized (60-80 nM) unilamellar liposomes made up of lecithin and other biodegradable phospholipids. The special features of these preparations are: * They, except ABCD, produce milder acute reaction (especially liposomal formulation) on i.v. infusion. * They can be used in patients not tolerating infusion oi conventional AMB formulation. * They have lower nephrotoxicity. * They cause minimal anaemia. * The liposomal preparation delivers AMB paicularh* to reticuloendothelial cells in liver and spleen-----especialh valuable for kala azar and in immunocompromised patients. However, some preparations, especially ABLC and ABCD, produce lower AMB levels and their clinical efficacy relative to conventional formulations appear to be lower. Though none of the above formulations is more effectivein deep mycosis than conventional AMB, the liposomal AMB reduces equivalent blood levels, has similar clinical efficacy with less acute reaction and renal toxicity. It thus apears more satisfactory. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:757,758,759"} |
{"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 false regarding neoplastic compressive myelopathy?\nA) Most neoplasms are subdural in origin\nB) Thoracic spine is most commonly involved\nC) Tumor does not cross the disk space to involve adjacent veebral body\nD) Prognosis is poor when motor deficits are established for > 48 hours", "output": "0, because Any malignant tumour can metastasise to spinal columns, paicularly tumours of breast, lung, prostate, kidney, lymphoma and myeloma. The most common site is the thoracic spinal column. Most neoplasms are epidural in origin, resulting from metastases to adjacent veebral body. Unlike infections of the spinal column, the tumours do not cross the disk space. Reference: Harrison's Principles of Internal Medicine, 21st edition, p2653"} |
{"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 which of the following patients would enalapril be the best first line agent for high blood pressure control ?\nA) A 62 year old man with renal artery stenosis\nB) A 32 year old pregnant female\nC) A 41 year old woman with hyperkalemia\nD) A 56 year old diabetic woman", "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\nAn eight year old child has active white spot lesions on his teeth and gives a history of having sugar containing snacks and beverages more than 3 times in between meals. In which category can we classify this child\nA) High Risk\nB) Moderate Risk\nC) Low Risk\nD) None", "output": "0, because Caries-Risk Assessment Form for Children 6 Years Old or Younger"} |
{"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 generations of amalgam exhibit highest nobility?\nA) 3rd generation amalgam\nB) 4th generation amalgam\nC) 5th generation amalgam\nD) 6th generation amalgam", "output": "3, because The set amalgam exhibits the highest nobility of any previous amalgam and has been the most recent 6th generation of amalgam to be developed.\nReference: Marzouk Operative dentistry, pg-106"} |
{"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 patient of Schizophrenia was staed on neuroleptics, his psychotic symptoms began to improve however he developed sadness, would talks less to others, would mostly remain to bed. This presentation could be caused by all of following except:\nA) Parkinsonism\nB) Major depression\nC) Negative symptoms are still persisting\nD) He is reacting to external stimuli", "output": "3, because This question is basically asking for the differential diagnosis of symptoms of ' sadness of mood, talking less and staying on the bed\" in a patient of schizophrenia who has been staed on antipsychotics. 1. The sadness of mood and decreased interaction can be of course due to depression 2. Negative symptoms of schizophrenia have a similar presentation where avolition can result in 'staying on the bed' and asociality and alogia may result in decrease interaction 3. Fuher, the use of antipsychotics can cause drug-induced parkinsonism which again looks quite similar to negative symptoms. The fouh option 'responding to external stimuli' doesn't explain the symptoms and hence is the answer"} |
{"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 location of schatzki&;s ring is\nA) Lower end of pharynx\nB) Upper end of esophagus\nC) Lower end of esophagus\nD) Antrum of stomach", "output": "2, because SCHATZKI'S RING It occurs at the junction of squamous and columnar epithelium at the lower end of oesophagus and has also been called lower oesophageal ring. Usually seen in patients above 50 years of age. Cause is unknown. Symptomatic patients complain of intermittent dysphagia and some may even present with bolus obstruction. It may be associated with hiatus hernia. Treatment is oesophageal dilatation. Ref:- Dhingra; pg num:-345"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nProlactin:\nA) Has somatotropic activity.\nB) It flow can cause infertility in women.\nC) Can suppress menstrual cycle in lactating women.\nD) Levels are increased by dopamine.", "output": "2, because Prolactin, though structurally related to growth hormone does not share its somatotropic activity. Dopamine binds to the lactotropes and inhibits the synthesis and release of prolactin. Hyperprolactinemia suppresses the hypothalamic-pituitary-gonadal axis, causes infertility in women and suppresses the normal menstrual cycle in lactating women."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nTriplet repeats in Fragile X -syndrome is?\nA) CTG\nB) CGG\nC) CAG\nD) GAA", "output": "1, because DISORDER TRIPLET REPEATS Fragile X syndrome CGG Friedreich ataxia GAA Myotonic dystrophy CTG Huntington disease CAG Ref: Nelson, 18th Edition, Pages 135, 499"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nLeft Kidney is preferred for transplantation because\nA) Longer renal Vein\nB) Higher location\nC) Ease of surgery due to anatomical relations\nD) To prevent damage to liver", "output": "0, because The left kidney is preferred because of implantation advantages associated with a longer renal vein making anastomosis easier Also know, procurement of kidney, In a brainstem dead donor, the organ to be procured should be preserved to maintain its functional integrity. For this purpose the organ should be perfused with organ preservative solution twice before it is transplanted to the recipient. The first perfusion is done just after the abdomen is opened at laporotomy and the second perfusion is done just after the organ has been removed from the donor. Commonly used preservative solutions include UW solution (University of Wisconsin) and Eurocollins solution. After removal from the donor, the organ is placed in two sterile bags and stored at 0-4degC by immersion in ice while they are transpoed to the recipient centre Ref srb's manual of surgery 5e p993 , Internet"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nCesarean section is absolutely indicated in :\nA) Previous H/0 LSCS\nB) Type IV placenta pre\nC) Type II placenta pre\nD) Past H/o hysterotomy", "output": "1, because Type IV placenta pre"} |
{"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 dead body recovered from an open field, the below finding is seen. What could be the time since death:\nA) 24- 36 hrs\nB) 3- 5 days\nC) 5-10 days\nD) More than 2 weeks", "output": "1, because Ans. (B). 3 - 5 daysPeeling of skin is a sign of decomposition.Skin slippage is noted on 2 -3 days,Degloving & destocking type of peeling -3-5 days.This type of change is also seen in drowning.The degloved skin can be preserved in formalin and used for fingerprint analysis."} |