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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 multi question.\n\nWaves present in electroretinogram are all EXCEPT:\nA) a wave\nB) bwave\nC) c wave\nD) d wave", "output": "3, because ANSWER: (D) d waveREF: Khurana 4th ed p. 489Electroretinogram is composed of:a wave : Rods and Conesb wave : Muller cellsc wave: Pigment epithelium"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nRapid diffusion of water across cell membranes depends on the presence of water channels, called aquaporins. Proximal convoluted tubule have:\nA) Aquaporin 1\nB) Aquaporin 2\nC) Aquaporin 5\nD) Aquaporin 9", "output": "0, because Aquaporin-1 is localized to both the basolateral and apical membrane of the proximal tubules and its presence allows water to move rapidly out of the tubule along the osmotic gradients set up by active transpo of solutes, and isotonicity is maintained. Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 37. Renal Function & Micturition. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nE.H. Angle introduced his classification of malocclusion in:\nA) 1876\nB) 1900\nC) 1899\nD) 1903", "output": "2, because ANGLE'S CLASSIFICATION OF MALOCCLUSION\nIn 1899, Edward Angle classi\ufb01ed malocclusion based on the mesial-distal relation of the teeth, dental\u00a0arches and jaws. He considered the maxillary \ufb01rst permanent molar as a \ufb01xed anatomical point in the jaws and the key to occlusion.\nRef: Textbook of orthodontics Gurkeerat Singh 2nd ed page no 163"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nHistiocytes are:\nA) Scavenger cells\nB) Allergic cells\nC) Released in immunologic response\nD) Leukocytes", "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\nHow much is the probable bilirubin level of this neonate?\nA) 6 mg/dl\nB) 9 mg/dl\nC) 12 mg/dl\nD) 18 mg/dl", "output": "3, because Yellow staining of palms & soles indicates a bilirubin level > 15 mg/dl Modified Kramer rule:"}
{"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 with glaucoma is being treated with systemic beta blocker. All of the foll,twing can be given to the patient except\nA) Brimonidine\nB) Dorzolamide\nC) Levobunolol\nD) Prostaglandin", "output": "2, because Ans. c. Levobunolol Brimonidine, dorzolamide and prostaglandin are topical anti-glaucoma drugs. These drugs do not have systemic side effects, while levobunolol (beta-blocker) is systemic anti-glaucoma drug given orally, having systemic side effects. That is why in patients with glaucoma treated with systemic beta blockers, levobunolol may add on the side effects of beta-blockers, hence avoided in the above mentioned patient. Topical Anti-glaucoma Drugs Adrenergic agonist Non-selective: Epinephrine, Dipivefrine Alpha2-selective: Apraclonidine, Brimonidine Adrenergic antagonist Beta--blocker (Non-selective): Timolol, Levobunolol, Caeolol, Metipranolol, Adapralol Betal-blocker: Betaxolol Miotics (direct parasympatomimetics) Pilocarpine, Physostigmine Ecothiophate, Carbachol, Demacarium Prostaglandin analogues Latanoprost Carbonic anhydrase inhibitors Dorzolamide Systemic Antiglaucoma Drugs Carbonic anhydrase inhibitors Acetazolamide Dichlorphenamide Methazolamide Hyperosmotic agents Mannitol Glycerol"}
{"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 mechanism of Action of Insulin\nA) Tyrosine kinase-beta cell stimulation\nB) Incroporation of GLUT-4 into cells\nC) Inhibition of Na+K+ATPase\nD) Hexokinase stimulation", "output": "2, because INSULIN is a protein hormone formed from proinsulin in the beta cells of the pancreatic islets of Langerhans. The major fuel-regulating hormone, it is secreted into the blood in response to a rise in concentration of blood glucose or amino acids. Insulin promotes the storage of glucose and the uptake of amino acids, increases protein and lipid synthesis, and inhibits lipolysis and gluconeogenesis.Tyrosine kinase is any of a group of enzymes that influence signaling between cells, esp. as relates to cell growth and death, cellular adhesion and movement, and cellular differentiation. Abnormalities in tyrosine kinases are found in some human diseases, including chronic myeloid (myelogenous) leukemia.Glucose transpoer type 4, also known as GLUT4, is a protein that in humans is encoded by the GLUT4 gene. GLUT4 is the insulin-regulated glucose transpoer found in adipose tissues and striated muscle (skeletal and cardiac) that is responsible for insulin-regulated glucose transpo into the cell. This protein is expressed primarily in muscle and fat cells, the major tissues in the body that respond to insulin.Na+, K+-ATPase is an enzyme that spans the plasma membrane and hydrolyzes ATP to provide the energy necessary to drive the cellular sodium pump.Hexokinase an enzyme that catalyzes the transfer of a high-energy phosphate group of a donor to d-glucose, producing d-glucose-6-phosphate.Ref: Ganong&;s review of medical physiology;24th edition; page no-436"}
{"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 carcinoma prostate with matastasis which is raised\nA) ESR\nB) Alkaline phosphatase\nC) Acid phosphatase\nD) Bilirubin", "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\nInhibitor of Complex I of ETC-\nA) H2S\nB) 2, 4 DND\nC) Rotenone\nD) BAL", "output": "2, because Ans. is 'c' i.e., Rotenone Inhibitors of Electron transport chain (Respiratory chain)o Complex I:- Barbiturates (amoborbital), piercidin A, rotenone, ehlorpromazine, guanithidine.o Complex II:- Carboxin, TTFA, malonate.o Complex III:- Dimercaprol, BAL, actinomycin A, Naphthyloquinone.o Complex IV (cytochrome c oxidase) Carbon monoxide (CO), cyanide (CN-), H2S, azide (N3 )"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nDiuretics that can be used in renal failure is -\nA) Furosetnide\nB) Chlohiazide\nC) Mannitol\nD) Chlohalidone", "output": "0, because Ans. is 'a' i.e., Furosemide Loop diuretics (furosemide) can be used in renal failure. Among thiazides, only metolazone is used in renal 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\npatient is known case of CAD suddenly presents with chest pain , shoness of breath, and with blood pressure of 90/60mmhg o/e cold clammy skin is observed, with urine output of 25ml/hr .what is the drug of choice ?\nA) droxidopa\nB) adrenaline\nC) dopamine\nD) dobutamine", "output": "2, because Cardiogenic shock is a condition in which your hea suddenly can&;t pump enough blood to meet your body&;s needs. The condition is most often caused by a csevere hea attack. Angina Pectoris, squeezing pain in center of chest. # Dysrhythmias * Diminished hea sounds * Acute drop in blood pressure > 30 mm Hg * Decreased cardiac output # Tachypneas, shoness of breath # Weak, thready pulse # Sweating, cold hand & feet # Urine output < 30 mL/hr PHARMACOLOGIC MANAGEMENT : Inotropic Agents augments the coronary blood flow Dopamine stimulates adrenergic and dopaminergic receptors Action depend upon the dose *(low dose): 1-5 mcg/kg/min IV- increase urine output and renal blood flow *(medium dose): 5-15 mcg/kg/min IV ; increase renal blood flow, cardiac output, hea rate, and cardiac contractitlity *(high dose): 20-50 mcg/kg/min IV ; increase blood pressure and stimulate vasoconstriction; may not have a beneficial effect in blood pressure; may increase risk of tachyarrhythmias . 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\nNeoadjuvant chemotherapy stands for -\nA) Chemotherapy along with surgery\nB) Chemotherapy before surgery\nC) Chemotherapy after surgery\nD) Chemotherapy along with radiation therapy", "output": "1, because Ans. B. Chemotherapy before surgeryNeoadiuvant chemotherapy refers to Combination of Chemotherapy and surgery/radiotherapy in which chemotherapy is given prior to surgery/radiotherapy."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nFlowing wax appearance on anterior and posterior borders of vertebrae with normal intervertebral disc space occurring due to ligament calcification is seen in \u2013\nA) Ankylosing spondylitis\nB) Diffuse idiopathic skeletal hypertrophy\nC) Psoriatic spondyloarthropathy\nD) RA", "output": "1, because Diffuse idiopathic skeletal hyperostosis:\u00a0DISH (hyperostotic spondylosis, Forestier's disease) is a multifocal entity of older people characterized by \"flowing ossifications of the spine\" involving four or more contiguous vertebrae and hyperostosis of some ligamentous attachments. The thick, flowing, florid, exuberant corticated plaques are extensive than that seen in degenerative changes producing so-called 'dripping candle wax or flowing candle wax' appearance."}
{"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 false about hemolytic anemia?\nA) Decreased LDH\nB) Decreased Haptoglobin\nC) Decreased RBC survival\nD) Increased Uncongugated Bilirubin", "output": "0, because Ans. (a) Decreased LDH(Ref: 9th/pg 631-632)In hemolytic anemia, there is decreased haptoglobin, decreased RBC survival, increased unconjugated bilirubin & Increased LDH."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nOligohydramnios is seen in -\nA) Renal agenesis\nB) Oesophageal atresia\nC) Exomphalos\nD) Neural tube defect", "output": "0, because Ans. is 'a' i.e. Renal agenesis Renal agenesis prevents urine formation which leads to oligohydramnios.Oligohydramnios is condition where amniotic fluid is deficient in amount to the extent of 100ml or entirely absentAetiologyRenal agenesis*Amnion nodosum*IUGR*Post maturity*Obst. of urinary tract (post urethral Valve*)"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nDermatome supplying the middle finger is-\nA) C6\nB) C7\nC) C8\nD) T1", "output": "1, because Ans. is 'b' i.e., C7 * Sensory distribution of upper limb is as followThe cutaneous nervesRegion suppliedNerve(s)Root valueDerived fromUpper part of pectoral region, and skin over upper part of deltoidSupraclavicularC3,C4Cervical plexusArm 1. Upper medial partIntercostobrachialT22nd intercostal2. Lower medial partMedial cutaneous nerve of armT1,T2Medial cord3. Upper lateral part (including skin over lower part of deltoid)Upper lateral cutaneous nerve of armC5, C6Axillary nerve4. Lower lateral partLower lateral cutaneous nerve of armC5, C6Radial nerve5. Posterior aspectPosterior cutaneous nerve of armC5Radial nerveForearm 1. Medial sideMedial cutaneous nerve of forearmC8,T1Medial cord2. Lateral sideLateral cutaneous nerve of forearmC5> C6Musculocutaneous3. Posterior sidePosterior cutaneous nerve of forearmC6, C7, C8Radial nervePalm 1. Lateral two-thirdsPalmar cutaneous branch of medianC6, C7Median2. Medial one-thirdPalmar cutaneous branch of ulnarC8UlnarDorsum of hand 1. Medial half including proximal phalanges of medial 2 1/2 digitsDorsal branch of ulnarC8Ulnar2. Lateral half including proximal phalanges of medial 2 1/2 digitsSuperficial terminal branch of radialC6, C7RadialDigits Palmar aspect, and dorsal aspect of middle and distal phalanges 1. Lateral 3V6 digitsPalmar digital branch of medianC7Median2. Medial 1 Vi digitsPalmar digital branch of ulnarC8Ulnar"}
{"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 10 year old boy is having hypeension. There is no other significant history and urine analysis is cause for his hypeension ?\nA) Chronic glomerulonephritis\nB) Polycystic kidney disease\nC) Reflux nephropathy\nD) Renal Parenchymal disease", "output": "1, because All these renal disease leads to hypeension. But except in polycystic kidney disease, all other will show characteristics urine findings. Polycystic kidney disease is usually asymptotic. Hypeension devolops about 10 to 20 years of age. Reference: GHAI Essential pediatrics, 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\nWhat is the mechanism of action of Fulvestrant?\nA) Selective estrogen agonist\nB) Selective esrogen receptor modulator\nC) Selective esrogen receptor upregulator\nD) Selective esrogen receptor downregulator", "output": "3, because Fulvestrant: is an estrogen receptor antagonist that downregulates the estrogen receptor and has no agonist effects. Fulvestrant competitively inhibits binding of oestradiol to the estrogen receptor (ER), with a binding affinity that is 89% that of oestradiol. Reduces the number of estrogen receptor. Good to know: It is approved for the treatment of metastatic breast cancer in postmenopausal women who have failed antiestrogen therapy. Given once in a month as a intramusclar injection. Ref: Goodman & Gillman's Pharmacological Basis of Therapeutics' 12th Edition, Page 1759, 1760."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\n8 year old child with hematuria in 5 days after throat infection?\nA) Post streptococcal nephropathy\nB) Ig A nephropathy\nC) Nephrotic syndrome\nD) can be a or b", "output": "1, because Ans. is 'b'i.e., Ig A Nephnopathy IgA nephropathy Predominant deposition of IgA in glomeruli. RECURRENT episode of gross rematuria that also precipitation by UI in last 2-5 days. PSGN Acute GN following infection by group A - -hemolytic streptococci. Common in school age children. o Streptococcal infection usually of throat (4 or 12 strain) or skin (strain 49) by 1-4 week prior to AGN. Edema, oliguria, hypeension, ARF, hematurea of abrupt onset."}
{"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 is derivative of dental lamina:\nA) Epithelial rests of Malassez\nB) Enamel pearls\nC) Rests of Serrae\nD) All of the above", "output": "2, because Options 'C' Rests of Serres are remnants of dental laminal epithelium entrapped within gingiva. Option 'A & B' are remnants of Hertwig epithelial root sheath."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAscent to high altitude may cause all of the following except: March 2012\nA) Cerebral edema\nB) Pulmonary edema\nC) Cerebral palsy\nD) Venous thrombosis", "output": "2, because Ans: C i.e. Cerebral palsyComplications of ascent to high altitudeHACE/ high altitude cerebral edema is rare, life threatening and usually preceded by AMS/ acute mountain sicknessHAPE/ high altitude pulmonary edema is a life threatening condition which usually occurs in the first 4 days after scent above 2500 m.Venous thrombosis has been repoed at altitudes over 6000 m."}
{"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 are pathological hallmark of Alzheimer&;s disease\nA) Intercellular Lewy Bodies\nB) Intracellular Pick's Bodies\nC) Extracellular Beta Amyloid Plaques\nD) Extracellular Neurofibrillary Tangles", "output": "2, because The two hallmark pathologies required for a diagnosis of Alzheimer&;s disease(AD) are the extracellular plaque deposits of the Beta-amyloid peptide (Ab) and the intracellular flame-shaped neurofibrillary tangles of the Hyper-Phophorylated microtubule binding protein &;tau&;. Histological Hallmarks of Alzheimer&;s disease: b-Amyloid Plaque (Extracellular) Neurofibrillary Tangles (Intracellular) b-Amyloid Neuritic plaques are formed by extracellular accumulation of beta amyloid deposits. &;Neuritic&; or &;Senile&; b-amyloid plaques are an early histopathological sign of Alzheimer&;s disease (that occur rarely in healthy subjects) The amyloid b-protein accumulated in single Neuritic plaques is toxic to surrounding structures and adjacent neurons. Clinico-pathological studies have shown that amyloid burden does not directly correlate with severity or duration of dementia. Neurofibrillary tangles are formed by intracellular accumulation of hyper-phophorylated microtubule binding protein &;tau&; NFT&;s occur in many neurodegenerative diseases and/or a group of diseases called &;taupathies&;. These include Frontotemporal dementia, Pick&;s disease etc., The co-occurence of b-amyloid plaques with NFT&;s suggests a diagnosis of Alzheimer&;s disease (AD) The NFT&;s are toxic to the neurons and neurons with NFT&;s eventually die and degnerate leaving a residual &;ghost tangle&; in the extramedullary space reminding of the pyramidal cell body in which it was initially formed. Clinico-pathological studies have shown that dementia correlates more strongly with NFT&;s than with senile plaques (b-Amyloid) Ref: Bailey and Love 27th 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\nWhich of the following is not a cause for the development of carpal tunnel syndrome?\nA) Alcoholism\nB) Sarcoidosis\nC) Gout\nD) Menorrhagia", "output": "3, because Ans. is 'd' i.e., Menorrhagia * There are many causes of carpal tunnel syndrome: -1) Idiopathic: - This is the most common cause.2) Pregnancy and menopause3) Metabolic: - Gout, Diabetes mellitus4) Endocrine: - Hypothyroidism, Myxedema, Acromegaly, Hyperparathyroidism.5) Deposition disorder:- Amyloidosis, Sarcoidosis, Rheumatid arthritis, Leukemia, CRF, Mucopoly-saccharoidosis.6) Alcoholism7) Local causes: - Malunited colie's fracture, osteo-arthritis of the carpal bones, synovitits of flexor tendon sheath, hematoma."}
{"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 childhood disorder improves with increase in age \u2013\nA) Conduct disorder\nB) Emotional problems\nC) Temper tantrum\nD) Sleep disorder", "output": "2, because Temper tantrum reaches its peak point during second and third year of life and gradually subsides in between 3 to 6 years as the child learng to control his negativism and complies to the requests of others."}
{"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 most likely to be the cause of painful third nerve palsy of sudden onset in a man of 40\nA) Rupture of an infraclinoid aneurysm\nB) Sphenoidal ridge meningioma\nC) Diabetes mellitus neuropathy\nD) Rupture of a supraclinoid aneurysm", "output": "3, because Ans. Rupture of a supraclinoid aneurysm"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nCondition in which lid is adhered to conjunctiva is-\nA) Ankyleblepharon\nB) Symblepharon\nC) Trichiasis\nD) Madarosis", "output": "1, because Ans. is 'b' i.e., Symblepharon * A symblepharon is a partial or complete adhesion of the palpebral conjunctiva of the eyelid to the bulbar conjunctiva of the eyeball. It results either from disease (conjunctival sequelae of trachoma) or trauma."}
{"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 10 year old child due to choked suddenly on consuming food . On the failed attempt of Valsalva's manoeuvre a needle cricothyrotomywas performed . It would open into which of the following regions?\nA) Rima glottidis\nB) Laryngeal vestibule\nC) Laryngeal ventricle\nD) Infraglottic cavity", "output": "3, because Infraglottic cavity extends from rima glottidis to the lower border of the cricoid cailage. The rima glottidis is the space between the vocal folds and arytenoid cailages. Vestibule extends from the laryngeal inlet to the vestibular folds. Ventricle extends between vestibular fold and the vocal fold. Piriform recess is a pear-shaped fossa in wall of the laryngopharynx lateral to the arytenoid cailage."}
{"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 main infectious agent associated with recurrent pulmonary infections in patients with cystic fibrosis is _____________ .\nA) Mycoplasma\nB) Pseudomonas\nC) Pneumocystis\nD) Aspergilus", "output": "1, because Pseudomonas affect small children with malnutrition and poor immunity.it colonise airway of patients with cysticfibrosis and cause recurrent pulmonary exacerbations. pathology:well demarcated areas of consolidation and necrosis occur due to vasculitis Ref : ESSENTIAL PEDIATRICS ,O.P.GHAI, PG NO:355,7 th 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\nPleomorphic adenoma is\nA) More common in males\nB) Endothelial origin\nC) Most common site is parotid\nD) More common in females", "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\nWhich is not a product of the pentose phosphate pathway?\nA) Sedoheptulose-7-phosphate\nB) O2\nC) Glyceraldehyde-3-phosphate\nD) NADPH", "output": "1, because Step 5: Transketolase Reaction - Transketolase is a thiamine pyrophosphate (TPP) dependent enzyme. It transfers two-carbon unit (with keto group) from xylulose-5-phosphate to ribose-5-phosphate to form a 7 carbon sugar, sedoheptulose-7-phosphate and glyceraldehyde-3- phosphate. Transketolase enzyme will transfer the group from a donor ketose to an aldose acceptor. In thiamine deficiency transketolase activity is decreased. The reaction may be summarized as 5C + 5C = 7C + 3C. REF: DM VASUDEVAN TEXTBOOK OF BIOCHEMISTRY, SIXTH EDITION,PG.NO.,114."}
{"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 an extrapyramidal tract -\nA) Reticulospinal tract\nB) Rubrospinal tract\nC) Corticospinal tract\nD) Tectospinal tract", "output": "2, because Ans. is 'c' i.e., Corticospinal tract Descending pathwaysPyramidal tractExtrapvramidal tractso Corticospinal tracto Rubrospinal tracto Tectospinal tracto Vestibulospinal tracto Reticulospinal tracto This question is a direct repeat from NBE based A1 2013-14."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nIn cerebellar lesion NOT seen is\nA) Ataxia\nB) Nystagmus\nC) Resting tremors\nD) Past pointing", "output": "2, because Resting tremor is the manifestation of parkinsonism In cerebellar lesion intentional tremors are seen"}
{"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 2 yrs old boy, is brought with sudden onset of stridor and respiratory difficulty. The chest examination reveals decreased breath sounds and wheeze in the right side. The chest X-Ray showed an opaque right hemithorax. Which of the following is the most likely diagnosis:\nA) Pneumothorax\nB) Acute epiglottitis\nC) Massive pleural effusion\nD) Foreign body aspiration", "output": "3, because Foreign body inhalation is most common cause of acute collapse with peak age incedence in 1-2 years. Ref: Textbook of Pediatrics By K.N Agarwal, 2010, Page 235"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nDental caries is caused by\nA) Streptococcus pyogenes\nB) Streptococcus mutans\nC) Enterococcus\nD) Hemophilus Influenzae", "output": "1, because Streptococcus mutans is an alpha Hemolytic streptococcus which is a pa of the normal flora of the oral cavity. This gram-positive coccus is commonly found in the mouth from where it can spread to cause dental caries or endocarditis in individuals with risk factors(dental extraction in individuals with damaged hea valves). The bacteria has a polysaccharide coat that allows it to stick to teeth and also to the damaged hea valves. It produces acid from sugar in saliva and this promotes erosion of tooth enamel. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 221"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nInjury due to Alkalis causes:\nA) Retinal detachment\nB) Retinitis\nC) Perforation\nD) Symbelapharon", "output": "3, because Symbelapharon"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nMassive transfusion can cause a) Hyperkalemia b) DIC c) Thrombocytopenia d) Hypothermia\nA) a,d\nB) b,c\nC) a,c,d\nD) a,b,c,d", "output": "3, because Complications of Massive transfusion Massive transfusion cam lead to coagulapathy and metabolic complications Most common cause of death after massive transfusion : Dilutional Coagulopathy or DIC Transfusion of 15-20 units of blood components causes Dilutional thrombocytopenia After massive transfusion initially transient hyperglycemia due to glucose in preservatives leading to insulin release and causing hypoglycemia (MC) Galvimetric method of estimation of blood loss : Blood loss during operation is measured by weighing the swabs after use & subtracting the dry weight plus volume of blood collected in suction or drainage Metabolic complications of Massive transfusion General Fluid overload Hypothermia Impaired oxygen delivery capacity of Hb (decreased 2,3-DPG). Electrolyte Hyperkalemia Hypocalcemia Hypomagnesemia Metabolic alkalosis Metabolic acidosis (rare) Ref: Harrison's 19th edition Pgno :138"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nBiconcave shape of RBC is useful for all, EXCEPT:\nA) Allows considerable alteration in cell volume\nB) Increasing surface area for diffusion\nC) Resisting hemolysis\nD) Passing easily through smaller capillaries", "output": "1, because Biconcave shape allows easy folding of RBC on itself when it passes through capillaries. It allows considerable alteration in cell volume. Thus can withstand considerable changes of osmotic pressure and resisit hemolysis. Also Know: In humans, they survive in the circulation for an average of 120 days. The average normal red blood cell count is 5.4 million/L in men and 4.8 million/L in women. The number of red cells is also conveniently expressed as the hematocrit, or the percentage of the blood, by volume, that is occupied by erythrocytes. Each human red blood cell is about 7.5 m in diameter and 2 m thick, and each contains approximately 29 pg of hemoglobin. There are thus about 3 x 10 13 red blood cells and about 900 g of hemoglobin in the circulating blood of an adult man. Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 31. Blood as a Circulatory Fluid & the Dynamics of Blood & Lymph Flow. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nSweating is Not present in\nA) Heat syncope\nB) Heat cramps\nC) Heat stroke\nD) Heat fatigue", "output": "2, because Heat stroke Exposure to high environmental temperatures can lead to following conditions ? I . Heat fatigue - Performance of a person decreases due to high environmental temperatures. The person gets tired early d/t high temp. 2. Heat cramps - these are painful spasms of voluntary muscles following strenous work in hot conditions, These cramps are caused by loss of water and salt from profuse sweating. 3. Heat syncope (heat exhaustion, heat collapse) - It is a condition of collapse without increase in body temperature, following exposure to hot and humid atmosphere. - On examination,. face is pale, .skin cold, the temperature subnormal - The pt. usually recovers when placed at rest. Death is unusual and may occur d/t hea failure. 4. Heat stroke - (heat hyperpyrexia, sub stroke) - It is due to impairment of body's heat regulating mechanism caused by failure of cutaneous circulation & sweating, following prolonged exposure to hot, humid conditions. - The onset is usually sudden with sudden collapse and loss of consciousness. Predominant symptoms may also be seen (i.e. headache, nausea, vomitting, dizziness, mental confusion, muscle cramps, excessive thirst, excessive desire to micturate) - The skin is dry, hot and flushed with complete absence of sweating - Body temperature rises as high as 43degC (hence k/a hyperpyrexia) when body temp. rises above 42degC vasodilation occurs with decrease in blood volume leading to circulatory collapse and cardiac failure. - Delirium and convulsions may precede death. - Moality rate in this condition is relatively high. - Fatal period varies from few minutes to 3 days."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nWhen taking a reline impression for an upper denture,\nwhich is the most common error?\nA) Failure to remove undercuts\nB) Improperly rounded peripheries\nC) Improper establishment of a post dam area\nD) Changed centric occlusion", "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\nMitral and periglomerular cells are seen in\nA) Medulla\nB) Olfactory bulb\nC) Primary visual cortex\nD) Geniculate body", "output": "1, because Ans. (b) Olfactory bulb(Ref: Ganong, 25th ed/p.217)Olfactory bulb has got special synaptic units called olfactory glomeruli where four types of cells are seen namely,#Mitral cells#Tufted cells#Granule cells#Periglomerular cells"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nOsteosarcoma commonly affects: September 2005\nA) Metaphysis\nB) Diaphysis\nC) Epiphysis\nD) None of the above", "output": "0, because Ans. A: Metaphysis Metaphysis-common site for osteosarcoma Diachysis- common site for ewing's tumor Epiphysis- common site for osteoclastoma"}
{"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 oral manifestations of HIV except?\nA) Candidiasis\nB) Aphthous ulcers\nC) Hairy leukoplakia\nD) Lichen planus", "output": "3, because Ans. is 'd' i.e., Lichen planus Oral manifestations of HIV/AIDSFungal infectionsOral candidiasis (erythematous & pseudo membranous type)HistoplasmosisCryptococcosisViral diseasesHerpes simplexHerpes zosterHPV (warts)CMVHairy leukoplakia & HBVBacterial infectionsPeriodontal disease (linear gingival erythema, necrotizing ulcerative gingivitis (NUG) and necrotizing ulcerative periodontitis NUP))MAC infectionNeoplastic lesionsKaposi's sarcomaLymphomaOther lesionsSalivary Gland Disease and xerostomiaRecurrent Aphthous Ulcerations (RAU)Angular cheilitis idiopathic thrombocytopenic purpura (ITP)"}
{"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 responsible for adhesion of platelets to the vessel wall?\nA) Von Willebrand factor\nB) Factor IX\nC) Fibrinogen\nD) Fibronectin", "output": "0, because the Von-Willebrand factor is responsible for adhesion of platelets to the vessel wall.\n\u201cEndothelial injury allows platelets to contact the underlying extracellular matrix;\nsubsequent adhesion occurs through interactions with von Willebrand factor (VWF),\nwhich is a product of normal endothelial cells and an essential cofactor for platelet binding to matrix elements.\"\u2014"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nCoracoid process is a ____________ kind of epiphysis -\nA) Atavistic\nB) Pressure\nC) Traction\nD) Aberrant", "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\nLong term side effect of glucocorticosteroids:\nA) Hepatotoxicity\nB) Osteoporosis\nC) Precocious puberty\nD) Lupus like syndrome", "output": "1, because Ans. B. OsteoporosisGlucocorticosteroid have many side effects like Cushing syndrome hyperglycemia, osteoporosis, delay in wound healing, increase in infection and many other."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nPrussak's space is situated in:\nA) Epitympanum\nB) Mesotympanum\nC) Hypotympanum\nD) Ear canal", "output": "0, because (a) Epitympanum(Ref. Cummings, 6th ed., 1983)The space of the epitympanum, lying in between the Shrapnell's membrane or pars flaccida and the neck of malleus is known as \"PRUSSAK'S SPACE\".When the retraction pocket on Pars flaccida grows medially, it goes into this Prussak's space making this the most common site of primary cholesteatoma."}
{"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 the purpose of adjusting the occlusion in dentures?\nA) To obtain balanced occlusion.\nB) To stabilize dentures.\nC) To obtain even occlusal contacts.\nD) All of the above.", "output": "3, because Occlusal adjustment of dentures should be done with the premise of obtaining even occlusal contacts with balanced occlusion in order to stabilize the dentures during function."}
{"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 enzymes is involved in the degradation of the basement membrane?\nA) Metalloproteinases\nB) Oxidases\nC) Elastases\nD) Hydroxylases", "output": "0, because Matrix metalloproteinases are a family a proteolytic enzymes that degrade components of the extracellular matrix and basement membrane. Ref: Robbin's Basic Pathology 7th Edition, Page 110, 111, 312, 103; Clinical Gynecologic Endocrinology and Infeility By Marc A. Fritz, Leon Speroff, 2010, Page 596."}
{"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 case controlled study. It is found that the disease is more common in the group taking coffee as compared to the control group. The significance of this is -\nA) Cause and effect relationship established\nB) Disease median can be calculated\nC) Caffeine is associated with occurrence of disease\nD) Controls will not get the disease", "output": "2, because Ans. is 'c' i.e., Caffeine is associated with occurrence of disease Case-control study does not establish the cause and effect relationship because it can not distinguish between cause and associated factors. o Case-control study can only tell the association between cause and effect."}
{"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 commonest cyst to arise in pancreas after an attack of acute pancreatitis or pancreatic trauma is:March 2004\nA) Serous cyst\nB) Mucinous cyst\nC) Pseudocyst\nD) Malignant cyst", "output": "2, because Ans. C i.e. Pseudocyst"}
{"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 the common amino acid between urea cycle and TCA?\nA) Asparate\nB) Alanine\nC) Asparagine\nD) Glutamate", "output": "0, because Ans. (a) AsparateRef: Satyanarayan Biochemistry, pg. 339Role of Aspartate in urea cycle:* Aspartate participates in urea cycle for condensation with citrulline to form Argino succinic acid. The reaction is catalyzed by Argino succinic acid synthetase (Asparate provides one out of the two nitrogens of urea, the other nitrogen is contributed by Glutamate).* In the subsequent reaction, Argino succinic acid undergoes a lytic reaction to form Arginine and fumarate. Fumarate forms a link between TCA cycle and urea. Fumarate can be recycled to form oxaloacetate, through intermediate formation of malate that can be transmmated to form aspartate, to get reutilized in the urea cycleLink between TCA and urea cycleRole of Aspartate in TCA cycle* Oxaloacetate, the keto acid obtained from Aspartate by transamination is an intermediate of TCA cycle.* Oxaloacetate can either be utilized in TCA cycle or be channeled to the pathway of gluconeogenesis.* Hence asparatate is a common intermediate of TCA cycle (through oxaloacetate) and urea cycle (directly)"}
{"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 structures is not at immediate risk of erosion by cholesteatoma ?\nA) Long process of incus\nB) Fallopian canal containing facial nerve\nC) Horizontal/ lateral semicircular canal\nD) Base plate of stapes", "output": "3, because Ans. is 'd' i.e., Base plate of stapes Cholesteatoma has the propey to destroy the bone by viue of the enzymes released by it. Structures immediately at the risk of erosion are : - Long process of incus. Fallopian canal containing facial nerve. Horizontal / lateral semicircular canal"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nThird nerve palsy causes all except\nA) Ptosis\nB) Miosis\nC) Outward eye movement\nD) Diplopia", "output": "1, because CN III palsy will cause diplopia not miosis."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nSubsternal pain is a feature of:\nA) Tachycardia\nB) Emphysema\nC) Angina pectoris\nD) Thrombi and emboli", "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\nNormal splanchnic blood supply of the liver includes-\nA) Portal vein\nB) Splenic artery\nC) Superior mesenteric artery\nD) Inferior mesenteric vein", "output": "0, because Ans. is 'a' i.e., Portal vein * Liver has dual blood supply and receives 20% of its blood supply through hepatic artery (systemic) and 80% through portal vein (splanchnic). Portal vein is formed by union of splenic vein and superior mesenteric veins.* Venous drainage is through hepatic veins into IVC."}
{"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 prolonged starvation the main energy source of brain is:\nA) Glucose\nB) Ketone bodies\nC) Fructose\nD) Fatty acids", "output": "1, because STARVE FEED CYCLE\nDivided into 5 stages:\n\nWell-fed state (1\u20134 hours after food)\nEarly fasting (4\u201316 hours after food)\nFasting (16\u201348 hours after food)\nStarvation (2\u20133 days without food)\nProlonged starvation (> 5 days without food)."}
{"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 disorder is x-linked recessive ?\nA) Gaucher disease\nB) Neimann Kick disease\nC) Tay Sachs disease\nD) Fabry's disease", "output": "3, because Fabry's disease is x-linked recessive. Red\u00a0are autosomal recessive."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nZollinger Ellison syndrome is characterized by all of the following except -\nA) Post bulbar ulcer\nB) Recurrent duodenal ulcer\nC) Severe diarrhoea\nD) Massive HCL in response to histamine injection", "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\nNational immunization programme, all are involved, EXCEPT:\nA) TT\nB) Hepatitis B\nC) OPV\nD) Measles", "output": "1, because The vaccines recommended for National immunization programme are BCG, DPT, TT, OPV and measles. Hepatitis B is not recommended in National immunization programme. Ref: O.P. Ghai, 6Th Ed Page 200."}
{"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 45-year-old woman has experienced worsening arthritis of her hands and feet for the past 15 years. On physical examination, there are marked deformities of the hands and feet, with ulnar deviation of the hands and swan-neck deformities of the fingers. Laboratory studies show an elevated level of rheumatoid factor. CBC shows hemoglobin, 11.6 g/dL; hematocrit, 34.8%; MCV, 87 mm3; platelet count, 268,000/ mm3; and WBC count, 6800/ mm3. There is a normal serum haptoglobin level, serum iron concentration of 20 mg/ dL, total iron-binding capacity of 195 mg/dL, percent saturation of 10.2, and serum ferritin concentration of 317 ng/mL. No fibrin split products are detected. The reticulocyte concentration is 1.1%. What is the most likely mechanism underlying this patient's hematologic abnormalities?\nA) Autoantibodies against RBC membranes\nB) Impaired synthesis of b-globin chains\nC) Inadequate usage of stored iron\nD) Sequestration of RBCs in splenic sinusoids", "output": "2, because The iron concentration and iron-binding capacity are low; however, in contrast to the finding in anemia of iron deficiency, the serum ferritin level is increased. This increase is typical of anemia of chronic disease. In this case, the chronic disease is rheumatoid arthritis. Underlying chronic inflammatory or neoplastic diseases increases the secretion of cytokines such as interleukin-1, tumor necrosis factor, and interferon-g. These cytokines promote the sequestration of iron in storage compartments and depress erythropoietin production. Autoantibody hemolytic anemias occur in several autoimmune diseases, such as systemic lupus erythematosus, but not usually in patients with rheumatoid arthritis, as in this case. Normal serum haptoglobin rules out intravascular hemolysis; iron is recycled at a rapid rate. Impaired synthesis of b-globin chains gives rise to b-thalassemia, also characterized by hemolysis. Complement lysis is enhanced in paroxysmal nocturnal hemoglobinuria, which results from mutations in the PIGA gene. Patients with this disorder have a history of infections. Sequestration of RBCs in the spleen occur when RBC membranes are abnormal, as in hereditary spherocytosis or sickle cell anemia, or RBCs are coated by antibodies, as in autoimmune hemolytic anemias. Metastases are space-occupying lesions (myelophthisic process) that can lead to leukoerythroblastosis, with nucleated RBCs and immature WBCs appearing on the peripheral blood smear."}
{"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 femoral hernia is -\nA) Occurs exclusively in females\nB) Pregnancy is common cause\nC) Doesn't strangulate\nD) In males associated with cryptorchidism", "output": "1, because Answer is 'b' i.e. Pregnancy is common cause Femoral hernia In this hernia the abdominal contents pass through the femoral ring, traverse the femoral canal and come out through the saphenous opening. It is more common in females (But remember that most common hernia in the females is not femoral, but it is indirect inguinal) Femoral hernia is rare in men and nulliparous women but more common in multiparous women due to stretching of the pelvic ligaments. In contrast to inguinal hernia, femoral hernia is rare in infancy and childhood. It is rare before pubey. It is more common on right side It is bilateral in 20% of cases. Among all the types of hernia, femoral hernia is most liable to become strangulated, mainly because of the narrowness of the neck of the sac and the rigidity of the femoral ring. Infact strangulation is the initial presentation of 40% of femoral hernias. About option 'd' Cryptorchidism is associated with indirect inguinal hernias due to patent processus vaginalis."}
{"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 association with Acanthosis nigricans ?\nA) Hypeension\nB) DM\nC) Obesity\nD) Hypothyroidism", "output": "2, because Ans. is 'c' i.e., Obesity Acanthosis nigricans is a brown to black, velvety hyperpigmentation of the skin. It is usually found in body folds, such as posterior & lateral folds of neck, axilla, groin, umblicus, forehead. It typically occurs in individuals younger than 40 years of age. Histopathologically papillomatosis is characteristically seen; however, there is no hypermelanosis and there is only mild acanthosis, if present. It is associated with : Obesity (most common) Endocrinopathies --> Hypothyroidism, hypehyroidism, insuline resistance diabetes, Cushing's disease, PCOD, Bloom syndrome. Internal malignancy --> Gastric adenocarcinoma."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nDelirium is seen in which of the following poisonings\nA) Dhatura\nB) Lead\nC) Opioid\nD) All", "output": "3, because A i.e. Dhatura; B i.e. Lead; C i.e. Opioid - The Deliriant poisons are - 'Hy - AB - CD' i.e. Hyoscyamus, Atropa Belladona, Cannabis, DhaturaQ - Opium & chronic Lead poisoningQ also causes delirium"}
{"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 74-year-old woman has noted increasing size and number of darker brown patches on the dorsum of each hand for the past 15 years. They do not change with sun exposure, are nonpruritic, and non-tender. On examination, these 0.5- to 1-cm lightly pigmented lesions are flat. Which of the following is the most likely microscopic finding in these lesions?\nA) Basal melanocytic hyperplasia\nB) Dermal nevus cells\nC) Loss of melanin in surrounding skin\nD) Mast cell proliferation", "output": "0, because Unlike a freckle that darkens upon light exposure, lentigo (pleural:lentigenes) does not. There is a focal increase in melanocytes of the basal layer, along with thinning of epidermis and elongation of rete ridges. Lentigines can occur at any age; those in older persons may be termed senile lentigines or age spots. A nevus typically forms a nodule and likely appears much earlier in life. Loss of melanin is termed vitiligo and is a separate process from melanocyte hyperplasia. A collection of mast cells can produce urticaria pigmentosa, which often has a light brown appearance, but pruritus is common. Some superficial fungal infections (black piedra) may be pigmented, but they typically do not persist for years."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nPericardial space is present between\nA) Parietal and visceral pericardium\nB) Endocardium and pericardium\nC) Epicardium and pericardium\nD) Endocardium and epicardium", "output": "0, because Pericardial space (pericardial cavity) lies between parietal serous pericardium and visceral serous pericardium."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nDanazol is used in all except :\nA) Hirsutism\nB) Endometriosis\nC) Dysfunctional uterine bleeding\nD) Fibroid", "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 is NOT a feature of polymyositis?\nA) Pharyngeal muscle involvement\nB) Gottron's rash\nC) Proximal muscle involvement\nD) Pain in limbs", "output": "1, because Answer is B (Gottron's rash) : Gottron's rash is a feature of dermatomyositis and is characterized by erythema of knuckles witlz raised violaceous scaly eruptions. No rash is seen in patients of polymnyositis Polymyositis is essentially a diagnosis of exclusion Polymyositis is a subacute inflammatory myopathy affecting adults and rarely children who do not have I. Rash) Involvement of extraocular or fascial muscles) Family history of neuromuscular disease History of exposure to myotoxic drugs or toxins Endocrinopathy Neurogenic disease Muscular dystrophy Biochemical muscle disorder. Dermatomyositis : is a distinctive entitiy identified by a characteristic rash, accompanying or more often preceding muscles weakness."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nTransmission of R factor is by -\nA) Conjugation\nB) Transduction\nC) Transformation\nD) Lysogenic conversion", "output": "0, because Conjugation\n\nBacterial conjugation is the transfer of genetic material between bacteria through direct cell to cell contact or through a bridge- like the connection between two cells.\nConjugation is a process whereby a donor (male) bacterium makes physical contact with a recipient (female) bacterium.\nDonor status is determined by the presence of plasmid.\nThis plasmid codes for specialized fimbria (sex pilus) and for self-transfer.\nSex pilus (conjugation tube) helps in the transfer of genetic material from male bacterium to female bacterium.\nThe plasmid is known as transfer factor (sex factor or fertility factor).\nThe plasmid may be R factor, which codes for transferrable multiple drug resistance.\nThe DNA of the plasmid replicates during transfer so that each bacterium receives a copy \u2192 Recipient becomes a donor and the donor retains its donor status."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nBoutonniere deformity involves:\nA) Flexion at PIP and DIP joint\nB) Extention at PIP and DIP joint\nC) Flexion at PIP and extention at DIP joint\nD) Extention at PIP and flexion at DIP joint", "output": "2, because Boutonniere deformity involves: Flexion at PIP and extention at DIP joint seen in RA Other deformities in RA- Swan-neck deformity Z-deformity of thumb Ulnar detion of fingers"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nInfective stage for mosquito in case of Plasmodium vivax is:\nA) Gametocyte\nB) Sporozites\nC) Tropozoites\nD) Merozoites", "output": "0, because Gametocyte"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nRhinitiss sicca involves\nA) Anterior nares\nB) Septum\nC) Posterior wall\nD) Lateral wall", "output": "1, because Rhinitis sicca is a crust-forming disease seen in patients who work in hot, dry and dusty surroundings, e.g. bakers, iron- and goldsmiths.Condition is confined to the anterior third of nose paicularly of the nasal septum. Here, the ciliated columnar epithelium undergoes squamous metaplasia with atrophy of seromucinous glands. Crusts form on the anterior pa of septum and their removal causes ulceration and epistaxis, and may lead to septal perforation.Dhingra 6e pg: 155"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nMost abundant and common complement component for both the pathways is:\nA) C3\nB) C5\nC) Clq\nD) C8", "output": "0, because C3"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nCat is an agent for transmission of the following disease of man -\nA) Isospora hominis\nB) Fasciola hepatica\nC) Toxoplasma gondii\nD) Chilomastrix mensili", "output": "2, because Cat and other felines- definitive host Human - intermediate host (Refer pgno:64 baveja 3 rd 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\nScreening of neonatal thyroid disease is done by\nA) T4\nB) T3\nC) TSH\nD) TPO antibodies", "output": "2, because Since the neonates are asymptomatic at bih all newborns are screened for neonatal hypothyroidism. TSH is estimated either in cord blood at the time of bih (preferred) or blood obtained from heel prick after 2 days of bih.(Refer: Nelson's Textbook of Pediatrics, SAE, 1st edition, pg no. 2669 - 2773)"}
{"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 roof of the olfactory region is formed by ?\nA) Nasal bone\nB) Cribriform plate of ethmoid\nC) Sphenoid\nD) Temporal bone", "output": "1, because Ans. is 'b' i.e., Cribriform plate of ethmoid The olfactory mucosa lines the upper one-third of nasal cavity including the roof formed by cribriform plate and the medial and lateral walls up to the level of superior concha (turbinate)."}
{"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 appropriate circuit for ventilating a spontaneously breathing infant -\nA) Jackson Rees modification of Ayre's T piece\nB) Mapleson A or Magill's circuit\nC) Mapleson C or water's to & fro canister\nD) Bain's circuit", "output": "0, because Ayre&;s T piece is used in infants. The patient inspires fresh gas from the reservoir tube,expires into the reservoir tube. Advantages are they are inexpensive,compact,no valves and low dead space"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nInvestigation of choice in postcoital bleeding in a 60 years old lady is :\nA) Pap smear\nB) Colposcopy and biopsy\nC) Pelvic ultrasound\nD) Cone excision of cervix", "output": "1, because Ans. is b i.e. Colposcopy and biopsy investigation of choice in post-coital bleeding in a 60 years old lady (which suggests carcinoma cervix) is Colposcopy and Biopsy. The aim of Colposcopy is : - to confirm the diagnosis - to identify the extent of lesion - it allows conservative treatment in case of precancerous lesions. Pap smear is not the investigation of choice, as it is a screening procedure. If pap smear is negative in this case (In postmenopausal females, where there are less metaplastic changes at squamo columnar junction) we still have to confirm by Colposcopy. Cone biopsy is a destructive method and is advised only if diagnosis cannot be confirmed by colposcopy or SCJ is not visualised."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nPrimary pleural tumor is ?\nA) Mesothelioma\nB) Myxoma\nC) Lipoma\nD) Fibroma", "output": "0, because Ans. is 'a' i.e., Mesothelioma & 'd' i.e., Fibroma The pleura may be involved by primary or secondary tumors. Primary tumors Benign - Solitary fibrous tumor (benign fibrous mesothelioma or benign mesothelioma or pleural fibroma). Malignant - Malignant mesothelioma. Secondary tumors More common than primary tumors. Most common primary sites are lung and breast. Pleural fibroma (Benign fibrous mesothelioma) This is the primary benign lesion of pleura. The tumor is often attached to the pleural surface by a pedicle. These tumor do not usually produce a pleural effusion and have no relationship to asbestos exposure (in contrast to malignant mesothelioma). They consist of dense fibrous tissue with occasional cysts filled with viscid fluid. Microscopically, the tumors show whorls of reticulin and collegen fibers among which are interspersed spindle cells resembling fibroblasts. The tumor cells are CD 34 (+)ve and keratin negative by immunostaining. This feature can be diagnostically useful in distinguishing these lesions from malignant mesothelomas which is CD34 (-)ve and keratin positive."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nEpalrestat is a\nA) Antihypeensive drug\nB) Antidiabetic drug\nC) Anti tubercular drug\nD) None of the above", "output": "3, because Epalrestat is analdose reductase inhibitor. There by it reduces the formation of sorbitol from glucose. Sorbitol acts like a tissue toxin. \"Long-term treatment with epalrestat is well tolerated and can effectively delay the progression of diabetic neuropathy and ameliorate the associated symptoms of the disease, paicularly in subjects with good glycemic control and limited microangiopathy.\" Epalrestat is a drug that we use in diabetic but it is not a antidiabetic drug (i.e. it does not reduce the blood sugar level)."}
{"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 cholera toxin is\nA) Ganglioside\nB) Adenyl cyclase\nC) Both 1 and 2\nD) Exotoxin", "output": "2, because CHOLERA ENTEROTOXIN Light (L) toxin : Binds with ganglioside in epithelial cell membrane Heavy(H) toxin : Activates Adenyl cyclase in Epithelial cell wall which increase camp, leading to outpouring of isotonic fluid in lumen of intestine Ref: Park 25th edition Pgno : 253"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nTissue elevation of which of the following cause vasoconstriction :\nA) Na+\nB) K+\nC) Mg\nD) Ca2+", "output": "3, because Ans. D. Ca2+Vascular Control by lons and Other Chemical Factors Guyton 12th(SAE)/269An increase in calcium ion concentration causes vasoconstriction.An increase in potassium ion concentration,.within the physiological range, causes vasodilation.An increase in magnesium ion concentration causes powerful vasodilation.An increase in hydrogen ion concentration (decrease in pH) causes dilation of the aerioles.Anions that have significant effects on blood vessels are acetate and citrate.An Increase in carbon dioxide concentration causes moderate vasodilation in most tissues but marked vasodilation in the brain."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nVital statistics in a population include:-\nA) Sex ratio\nB) Age composition\nC) Bih rate\nD) Dependency ratio", "output": "2, because Population statistics Vital statistics Population size Sex ratio Density of population Dependency ratio Bih rate, death rate Natural growth rate Life expectancy at bih Moality rates Feility rates"}
{"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 26yr old pregnant mother who had previous twin delivery visits ANC OPD for routine check up she is sure of her dates with 36 wks pay what is the obstetric score\nA) g3p1\nB) g2p1\nC) G2P2\nD) G3P2", "output": "1, because REF : DUTTA 9TH ED"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nWrong statement is \u2013\nA) Mees line in arsenic poisoning\nB) Pterygium of nails in Lichen planus\nC) Onycholysis in Psoriasis\nD) Koilonychia in Megaloblastic Anemia (B12 def)", "output": "3, because Koilonychia is seen in iron deficiency anemia (not in megaloblastic anemia).\nMees line is seen in Arsenic poisoning.\nPterygium is diagnostic for lichen planus.\nPsoriasis can cause onycholysis"}
{"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 appropriate time for self-examination of breast in relation to menstraution in a pre-menopausal woman is?\nA) A week after menstruation stas\nB) Before ovulation\nC) During menstruation\nD) A day after menstruation ends", "output": "0, because Breast self-examination is to be performed by all women above 18 years throughout their life. It should be performed every month at the same time of menstrual cycle. For pre-menopausal women: The best time is right after the menstrual cycle ends (7-10 day; after menstrual cycle stas) as at this time the breasts are less swollen and less tender a; estrogen levels are low. For post-menopausal women: BSE at any specific date can be selected for each month For women on H: BSE to be done after finishing each cycle of H For women on OCP: BSE should be performed with the sta of new pill pack each month"}
{"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 anatomy of right ventricle\nA) Situated posteriorly\nB) More prominent trabeculation\nC) Crista supraventricularis separate tricuspid valve & pulmonary valve\nD) Ellipsoidal in shape", "output": "1, because Forms the major poion of the anterior surface of the hea Right ventricle is divided into 2 pas: an inflow poion named \"the sinus\" and an outflow poion named \"the conus\" separated by the crista supraventricularis. As opposed to the normal left ventricle, the right ventricle is highly trabeculated the right ventricle is triangular when viewed longitudinally and is crescent shaped when viewed transversally Ref - BDC 6th edition vol 1 pg 256"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nRatio of sulfamethoxazole and trimethoprim in cotrimoxazole tablet is:-\nA) 5:01\nB) 1:05\nC) 1:01\nD) 5:05", "output": "0, because COTRIMOXAZOLE This is a fixed dose combination of sulfamethoxazole and trimethoprim in a ratio of 5:1. Due to different bioavailability (more for sulfamethoxazole), plasma concentration of the two drugs attained is 20:1 (in vivo), which is the best bactericidal concentration required. The bactericidal activity is due to sequential blockade at two steps in the DNA synthesis (sulfamethoxazole inhibits folate synthase and trimethoprim inhibits DHFRase). It is the drug of choice for pneumocystosis, nocardiosis and infections caused by Burkholderia cepacia."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nSubacute bacterial endocarditis is caused by\nA) Streptococcus viridans\nB) Haemolytic streptococci\nC) Staphylococcus aureus\nD) Nisseria", "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 is an example of disability limitation\nA) Resting the affected limb in neutral position\nB) Arranging for schooling of a child suffering from PPRP\nC) Reducing occurrence by polio immunisation\nD) Providing calipers for walking", "output": "0, because Disability: Any restriction or lack of ability to perform an activity in the manner or within the range considered normal for human being. Disability Limitation: It is mode of intervention when patient repos late in the pathogenesis phase. The objective of this intervention is to prevent or halt the transition at' the disease process from impairment to handicap. Sequence of events leading to disability and handicap have been stated as follows Disease -> Impairment -> disability --> handicap In the question: Reducing occurrence of polio by immunization = Specific protection Arranging for schooling of child suffering from PPRP and providing calipers for waIking -> Rehabilitation. Resting affected limbs in neutral position = Disability limitation."}
{"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 function of minor connector is\nA) Connects major connector to all components of the RPD\nB) Prevents gingival displacement of the RPD\nC) Allows a single path of placement of the RPD\nD) It is that unit of RPD to which all other parts are directly or indirectly attached", "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\nType B gastritis is\nA) Body predominant\nB) H. pylori associated\nC) Autoimmune gastritis\nD) Environmental gastritis", "output": "1, because Type B gastritis mainly involves the region of antral mucosa (hence antral predominant not body predominant.) and is more common. It is also called hypersecretory gastritis due to excessive secretion of acid, commonly due to infection with H. pylori. These patients may have associated peptic ulcer. Unlike Type A gastritis, this form of gastritis has no autoimmune basis nor has an association with other autoimmune diseases. Type A is body predominant. Type AB gastritis effects the mucosal region of A as well as B types. This is the most common gastritis in all age groups. It is also called environmental gastritis, mixed gastritis, chronic atrophic gastritis. TEXTBOOK OF PATHOLOGY HARSH MOHAN 6TH EDITION PAGE NO:547"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nAn ABG analysis shows : pH 7.2, raised pCO2, decreased HCO3; diagnosis is :\nA) Respiratory acidosis\nB) Compensated metabolic acidosis\nC) Respiratory and metabolic acidosis\nD) Respiratory alkalosis", "output": "2, because Answer is C (Respiratory and metabolic acidosis) The acid base disorder is therefore both respiratory and metabolic acidosis. There is acidosis (pH < 7.35). Raised PCO2 (acidosis) indicates that change in CO2 is in keeping with change in pH. The respiratory component is therefore primary. Decreased HCO3 (acidosis) indicates that change in HCO3 is also primary. The acid base disorder is therefore both respiratory and metabolic acidosis."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nStorage temperature for vaccine is: A\nA) --4degC to 0degC\nB) 0degC to 4degC\nC) +2degC to 8degC\nD) +4degC to 12degC", "output": "2, because +2degC to 8degC"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nRetinoblastoma gene is located on chromosome -\nA) 6\nB) 9\nC) 13\nD) 21", "output": "2, because Harshmohan textbook of pathology 7th edition RB gene is located on long arm chromosome 13. This is the first ever tumor suppressor gene identified and this has been amply studied.."}
{"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 associated with AIDS EXCEPT:\nA) Increased p 24 Ab\nB) Hypogammaglobulinemia\nC) Abnormal mitogen assay\nD) Anergy", "output": "1, because ANSWER: (B) HypogammaglobulinemiaREF: Harrisons 18th ed chapter 189Even though HIV causes immune suppression, it causes hypergammaglobulinemia rather than hypogammglobulinemiaIncreased p24 antibody: basis for detection in window period.T cell anergy is commonly seen in HIVAbnormal response of T cells to mitogens is a test used in HIV"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nHand deformity presennting as hyper-extension at the metcarpo phalaogeal joint and flexion at inter-phalanngeal joint, occurs due to paralysed\nA) Flexor digitorum profundus\nB) Lumbricals\nC) Lumbricals and interossei\nD) Extensor digitorum", "output": "2, because Interossei and lumbricalsflexes MCP (metacarpophallangeal joint) and extend IP (interphallangeal joint). Injury to interossei and lumbricals leads toclaw hand (extended MCP and flexed IP)"}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nEssential pentosuria is due to defect in\nA) HMP pathway\nB) Glycolysis\nC) Gluconeogenesis\nD) Uronic acid pathway", "output": "3, because It is an inborn error of metabolism.In the pathway, L-xylulose is conveed to D-xylulose by two enzymes, xylitol dehydrogenase, and xylulose reductase.Absence of any of these enzymes leads to pentosuria.Ref: DM Vasudevan, 7th edition, page no: 135"}
{"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 retro viral drug causing urinary stones:\nA) Zidovudine\nB) Lamivudine\nC) Indinavir\nD) Nelfinavir", "output": "2, because Ans: c (Indinavir) Ref: Harrison, 16th ed, p. 1127; 17th ed, p. 1192Indinavir is the antiretroviral drug which causes urinary stones.Classification of antiretro viral drugNucleoside reverse transcriptase inhibitors (NRTI)* Zalcitabine* Didanosine* Lamivudine* Zidovudine* Stavudine* Abacavir* EmtricitabineProtease inhibitors* Indinavir* Saquinavir* Ritonavir* Nelfinavir* LopinavirFusion inhibitorsEnliiviritideNon nucleoside reverse transcriptase inhibitors (NNRTI)* Nevirapine* Efavirenz* DelavirdineNucleotide analogueTenefovirAdefbvirSide effects of antiretroviral drugsNRTIPeripheral neuropathy-Stavudine> Zalcitabine> DidanosinePancreatitis-Didanosine> Zalcitabine> StavudineHepatic steatosisAnaemia / neutropeniaProtease InhibitorsGastro intestinal intoleranceFat redistributionHyperlipidaemiaInsulin resistanceIndinavir-Renal stones, crystalluria, hyperbilirubinaemiaRitonavir-Perioral paraesthesiaMyopathyZalcitabine-mouth ulcersZidovudine-nail pigmentationAbacavir-Hypersensitivity.NNRTIRashSteven Johnson syndromeEfavirenz-vivid dreamsNevirapine-hepatitisFusion inhibitors-hypersensitivity."}
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nPoor prognostic factor of non Hodgkin's lymphoma is -\nA) Age > 60 years\nB) Weight loss > 10%\nC) Night sweats with loss of weight\nD) All of the above", "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\nLutembacher syndrome includes all the following except\nA) Mitral stenosis\nB) ASD\nC) VSD\nD) Left to right shunt", "output": "2, because Lutembacher syndrome is defined as a combination of mitral stenosis and a left-to-right shunt at the atrial levelTypically, the left-to-right shunt is an atrial septal defect (ASD) of the ostium secundum varietyBoth these defects, ASD, and mitral stenosis can be either congenital or acquired.(Refer: OP Ghai's Textbook of Pediatrics, 8th edition, pg no. 401)"}