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{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nWhich of the following diseases of the skin is the most\nlikely to be associated with partial anodontia?\nA) erythema multiformae\nB) hereditary ectodermal dysplasia\nC) keratosis follicularits\nD) lichen Onus", "output": "1, because Ectodermal dysplasia is characterized by congenital dysplasia of ectodermaL structures, manifested as hypohidrosis (partial or complete absence of sweat glands) hypotrichosis and hypodontia or partial anodontia.\nTwo types\n\nHypohidrotic (Christ-Siemens-Touraine syndrome) most common type and includes dental manifestations.\nHidrotic (Clouston syndrome)- no specific dental defects 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\nEarly neonatal sepsis occurs within (hours) -\nA) 8\nB) 12\nC) 36\nD) 72", "output": "3, because Ans. is 'd' i.e., 72 hours"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nCylindrical dilatation of renal tubules is seen in -\nA) Polycystic disease of kidney\nB) Medullary cystic disease\nC) Wilms tumour\nD) Lipoid nephrosis", "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 multi question.\n\nAll the following are features of Tropical pulmonary eosinophilia except\nA) Eosinophilia>3000/mm3\nB) Microfilaria in blood\nC) Paroxysmal cough and wheeze\nD) Bilateral chest mottling and increased bronchivascular markings", "output": "1, because In TPE Microfilaria are rapidly cleared from blood stream by the lungs . Thus, Microfilaria are sequestrated in the lungs . Ref Harrison 19th edition pg 1686-87"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nFeilization occurs in which pa of the fallopian tube\nA) Ampulla\nB) Isthmus\nC) Interstitial\nD) Infundibular", "output": "0, because REF : DUTTA OBG 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\nNaturally occurring LA \u2013\nA) Cocaine\nB) Lidocaine\nC) Bupivacaine\nD) Tetracaine", "output": "0, because Cocaine is the only naturally occuring local anaesthetic, obtained from leaves of Erythroxylon coca."} |
{"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 dangerous paicle size causing pneumoconiosis varies from ?\nA) 100-150 m\nB) 50-100 m\nC) 10-50 m\nD) 1-5 m", "output": "3, because Ans. is 'd' i.e., 1-5 m Pneumoconiosis o Pneumoconiosis is an occupational lung disease caused by the inhalation of dust. o The development of pneumoconiosis depends on - (i) The amount of dust retained in the lungs and airways. (ii) The size, shape of the paicles --> The most dangerous paicle ranges from Ito 5 m in diameter because they may reach the terminal small airway and air sacs and settle in their linings. (iii) Paicle solubility and physiochemical reactivity. (iv) Additional effects of other irritants (e.g. concomitant smoking). Impoant pneumoconiosis o Cool worker's pneumoconiosis (CWP) --> Coal dust o Silicosis (grinder's disease) --> Silica dust o Asbestosis --> Asbestos dust o Beryliosis --> Berylium dust o Siderosis --> Iron dust o Byssinosis --> Cotton dust"} |
{"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 6 cm simple ovarian cyst was identified in late pregnancy, what would be the best management ?:\nA) Emergency laparotomy\nB) Removal after after 6 weeks of puerperium\nC) Removal early in the puerperium\nD) Conservative as most tumors would subside", "output": "2, because Treatment of ovarian tumour in pregnancy depending on time of pregnancy: During pregnancy In an uncomplicated case, the best time of elective operation is b/w 14-18wks as chances of aboion are less and access to the pedicle is easy. But if the tumour is diagnosed beyond 36 weeks, tumour is removed early in puerperium. During labour If the tumour is above the presenting pa watchful expectancy is followed but if its impacted in pelvis, caesarian section should be done followed by removal of tumour in same setting. During puerperium The tumour should be removed as early in puerperium as possible because the longer is the wait for the surgery, there is more chance of having the tumor undergo a torsion"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nPeriodontal pack is least successful in the management of?\nA) Splinting\nB) Antimicrobial Properties\nC) Hemostasis\nD) Pain elimination", "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\nNeovascularisation is seen in\nA) Central vein obstruction\nB) Central retinal aery obstruction\nC) Branch retinal vein obstruction\nD) All of the above.", "output": "0, because A i.e. Central vein obstruction"} |
{"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 person present with cribriform plate fracture with CSF rhinorrhea. What will be immediate treatment?\nA) Frequent blowing of nose\nB) Plugging of nose with paraffin\nC) Craniotomy\nD) Antibiotics with wait for 7 days", "output": "3, because TREATMENT OF CSF RHINORRHEA Early cases of post-traumatic CSF rhinorrhoea can be managed by conservative measures such as bed rest, elevating the head of the bed, stool softeners, and avoidance of nose blowing, sneezing and straining. Prophylactic antibiotics can be used to prevent meningitis. Acetazolamide decreases CSF formation. These measures can be combined with lumbar drain if indicated. Surgical repair can be done by the following: 1. Neurosurgical intracranial approach. 2. Extradural approaches such as external ethmoidectomy for cribriform plate and ethmoid area, trans-septal sphenoidal approach for sphenoid and osteoplastic flap approach for frontal sinus leak. 3. Transnasal endoscopic approach. With the advent of endoscopic surgery for nose and sinuses, most of the leaks from the anterior cranial fossa and sphenoid sinus can be managed endoscopically with a success rate of 90% with first attempt. Principles of repair include: (a) Defining the sites of bony areas . It can be (i) Cribriform plate (ii) Lateral lamina close to anterior ethmoid aery (iii) Roof of ethmoid (iv) Frontal sinus leak (v) Sphenoid sinus (b) Preparation of graft site. (c) Underlay grafting of the fascia extradurally followed by placement of mucosa (as a free graft or pedicled flap) (d) If bony defect is larger than 2 cm, it is repaired with cailage (from nasal septum or auricular concha) followed by placement of mucosa. (e) Placement of surgicel and gelfoam fuher strengthens the area. This is followed by a high antibiotic smeared nasal pack. Sometimes fat from the thigh or abdomen is used to plug the defect in place of fascia graft. (f) Lumbar drain if CSF pressure is high. (g) Antibiotics CSF leak from frontal sinus often requires osteoplastic flap, operation and obliteration of the sinus with fat. Ref : ENT textbook by Dhingra 6th edition Pgno : 163-165"} |
{"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 structures is least likely to be damaged during mandibular 3rd molar extraction\nA) Lingual artery\nB) Lingual nerve\nC) Inferior alveolar nerve\nD) Inferior alveolar artery", "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\nA 60 yr old female with I-1/0 8 blood transfusion in 2 years. Her Hb- 60g/L, TLC-5800, platelet-3.4 lakhs, MCV 60, RBC-2.1 lakhs/mm3. He is having hypochromic microcytic anemia. Which investigation is not needed aEUR'\nA) Evaluation for pulmonary hemosiderosis\nB) Urinary hemosiderin\nC) Bone marrow examination\nD) G I endoscopy", "output": "0, because Evaluation for pulmonary hemosiderosis Anemia with low RBC count, microcytotosis and hypochromia point towards iron deficiency anemia. - \"Bone marrow biopsy\" in iron deficiency anemia demonstrates erythroid hyperplasia and micronormoblasts reaction. - Prussian blue staining of the bone marrow aspirate and smear and biopsy demonstrate absent of iron stores. The patient continue to have iron deficiency anemia despite the blood transfusions. - This suggests chronic blood loss leading to iron deficiency anemia. - Chronic blood loss can result .from GIT (melena hematemesis) pathology. - G.I. Endoscopy is done in these cases to rule out GIT pathway. Chronic blood loss may also result from hemolytic anemias. - \"Hemosiderin in urine\" is found in patients with intravascular hemolysis. - Most of the autoimmune hemolytic anemias cause extravascular hemolysis (urine hemosiderin is absent). - Intravascular hemolysis occurs in paroxysmal nocturnal hemoglobinuria. This leads to chronic iron deficiency anemia. - Hemosiderin is present in urine due to intravascular hemolysis. Urinary hemosiderin can differentiate b/w PNH and other autoimmune hemolytic anemias. Idiopathic pulmonary hemosiderosis - Idiopathic pulmonary hemosiderosis is a rare condition chaeracterized by repeated episodes of intraalveolar bleeding that lead to abnormal accumulation of iron as hemosiderin in alveolar macrophage and subsequent development of pulmonary fibrosis and anemia. - The clinical features are characterized by a triad of - Hemoptysis - Moderate to severe iron deficiency anemia. - Diffuse radiological abnormality Diagnosis in these cases is confirmed by - Iron stains of sputum aspiration of and biopsy. The patient in the question does not give any features that are suggestive of idiopathic pulmonary hemosiderosis. He does not require evaluation for pulmonary hemosiderosis."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nNitrates are not used in -\nA) CCF\nB) Esophageal spasm\nC) Renal colic\nD) Cyanide poisoning", "output": "2, because Ans. is 'c' i.e., Renal colic Uses of nitrates Angina pectoris MI CHF and acute LVF --> nitroglycerine i.v. can be used Act by decreasing preload (LV filling pressure). Biliary colic and esophageal spasm (achalasia cardia) Acute coronary syndrome (unstable angina and non-ST segment elevation Ml). Cyanide poisoning"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nNatural uncoupler is-\nA) Thermogenin\nB) 2, 4-dinitrocresol\nC) 2, 4 Dinitrophenol\nD) Oligomycin", "output": "0, because Ans. is 'a' i.e., Thermogenin o Amongst the given options, a, b and c are uncouplers. o However, only thermogenin, among these three is a natural (physiological) uncoupler. Uncouples o As the name suggests, these compounds block the coupling of oxidation with phosphorylation. These compounds allow the transfer or reducing equivalents in respirators chain but prevent the phosphorylation of ADP to ATPy by uncoupling the linkage between ETC and phosphorylation. Thus the energy instead of being trapped by phosphorylation is dissipated as heat. Uncouplers may be NaturalThermogenin, thyroxine Synthetic 2, 4-dinitrophenol (2, 4-DNP), 2, 4-dinitrocresol (2, 4-DNC), and CCCP (chlorocarbonylcyanidephenyl hydrazone)."} |
{"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 statements about hairy cell leukemia are true except:\nA) Splenomegaly is conspicuous\nB) Results from an expansion of neoplastic T-lymphocytes\nC) Cells are positive for Taarate Resistant Acid phosphatase\nD) The cells express CD25 consistently", "output": "1, because Hairy cell leukemia is a type of B-cell leukemia. Clinical feature: Massive splenomegaly Increase chances of infections DIAGNOSIS 1. BLOOD Pancytopenia Phase contrast microscopy- Hairy projections Staining- TRAP 2. Immunophenotyping CD11 + CD25+ CD103 + Annexin A1 + ( Best marker) 3.BM examination BM aspiration - Dry tap BM biopsy- Honey comb appearance - Fried egg appearance"} |
{"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 decrease in which of the following parameters will shift the O2 dissociation curve to the right?\nA) pH\nB) Paial pressure of CO2\nC) 2,3 DPG concentration\nD) Temperature", "output": "0, because Left shift (high affinity for O2) Right shift (low affinity for O2) Temperature decrease increase 2.3-DPG decrease increase p(CO2) decrease increase p(CO) increase decrease pH (Bohr effect) increase (alkalosis) decrease (acidosis) Type of haemoglobin Fetal haemoglobin Adult haemoglobin"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nKussumauls breathing\nA) Metabolic alkalosis\nB) Respiratory alkalosis\nC) Respiratory acidosis\nD) Metabolic acidosis", "output": "3, because Rapid,deep(Kussmaul) breathing usually implies metabolic acidosis but may also occur with pontomesencephalic lesions. Ref:Harrison's medicine -18th edition,page no:2251."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nDislocation of lens is seen in:\nA) Trachoma\nB) Diabetes mellitus\nC) Homocystinuria\nD) Turner's syndrome", "output": "2, because C i.e. Homocystinuria"} |
{"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 prodrug-\nA) Enalapril\nB) Oxcarbazepine\nC) Chloral hydrate\nD) Diazepam", "output": "3, because Ans. is 'd' i.e., Diazepam Prodrug o Few drugs are inactive as such and need conversion in the body to one or more active metabolites. Such a drug is called a prodrug. Prodrug Levodopa Enalapril - Methyldopa Chloralhydrate Dipivefrine Oxcarbazepine Prednisone Bacampicillin Sulfasalazine Cyclophosphamide Mercaptopurine Fluorouracil Sulindac Azathioprine Coisone Benorilate Proguanil Zidovudin Terfenadine Prontosil"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nCause of \"bloody\" vomitus in a neonate\nA) Meckel's diveiculum\nB) Intussusception\nC) Malrotation\nD) Cholecystitis", "output": "0, because Meckel&;s dieiculum may cause severe hemorrhage due to peptic ulceration. The blood is usually passed per rectum and is maroon in colour. it may cause bloody vomitus. Ref : BAILEY AND LOVE&;S SHO PRACTICE OF SURGERY,24 TH EDITION PG NO:1159"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nLancinating pain around the tonsils during eating is indicative of\nA) Trigeminal neuralgia\nB) Glossopharyngeal neuralgia\nC) Facial neuralgia\nD) None of the above", "output": "1, because (B) Glossopharyngeal neuralgia # Nerve Supply of Tonsils:* Lesser palatine branches of sphenopalatine ganglion (CN V) and glossopharyngeal nerve provide sensory nerve supply."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nBird of Prey\" sign is seen in the radiographic barium examination of:\nA) Gastric volvulus\nB) Intussusception\nC) Sigmoid volvulus\nD) Caeca! volvulus", "output": "2, because Sigmoid volvulus"} |
{"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 30-year-old woman sustained a traumatic blow to her right breast. Initially, there was a 3-cm contusion beneath the skin that resolved within 3 weeks, but she then felt a firm, painless lump that persisted below the site of the bruise 1 month later. What is the most likely diagnosis for this lump?\nA) Abscess\nB) Fat necrosis\nC) Fibroadenoma\nD) Inflammatory carcinoma", "output": "1, because Fat necrosis is typically caused by trauma to the breast. The damaged, necrotic fat is phagocytosed by macrophages, which become lipid-laden. The lesion resolves as a collagenous scar within weeks to months. The firm scar can mammographically and grossly resemble a carcinoma. An abscess may form a palpable but painful mass lesion, and often from Staphylococcus aureus infection when localized. A fibroadenoma is a neoplasm, and tumors are not induced by trauma. Inflammatory carcinoma refers to dermal lymphatic invasion by an underlying breast carcinoma, giving a rough red-to-orange appearance to the skin. Sclerosing adenosis is a feature of fibrocystic changes, a common cause of nontraumatic breast lumps."} |
{"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 basis of Korotkoff sound is\nA) Aoic valve closure\nB) Production of hea sound\nC) Aerial turbulence\nD) Aerial valve expansion", "output": "2, because The sounds of Korotkoff are produced by turbulent flow in the brachial aery. When the aery is narrowed by the cuff, the velocity of flow through the constriction exceeds the critical velocity and turbulent flow results."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nAganglionic segment is encountered in which part of colon in case of Hirchsprung's disease -\nA) Distal to dilated segment\nB) In whole colon\nC) Proximal to dilated segment\nD) In dilated segment", "output": "0, because Ans. is 'a' i.e., Distal to dilated segment \"The major feature of Hirschsprung ds is an absence of ganglion cells in the neural plexus of the intestinal wall, together with hypertrophy of nerve trunks. The absence of ganglion cells gives rise to a contracted non-peristaltic segment with a dilated hypertrophied segment of normal colon above it ___ Bailey 24/e"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nEstimation of the following hormones is useful while investigating a case of gynecomastia except-\nA) Testosterone\nB) Prolactin\nC) Estradiol\nD) Luteinising hormone", "output": "1, because Gynecomastia refers to enlargement of the male breast. It is caused by excess estrogen action and is usually the result of an increased estrogen-to-androgen ratio. True gynecomastia is associated with glandular breast tissue that is >4 cm in diameter and often tender. Evaluation of a case of gynecomastia should include a careful drug history, measurement and examination of the testes, assessment of virilization, evaluation of liver function, and hormonal measurements including testosterone, estradiol, and androstenedione, LH, and hCG. Reference : page 2366 Harrison's Principles of Internal Medicine 19th 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\nLight requirement in watch manufacturing company is -\nA) 2000-3000 Lux\nB) 5000-10000 Lux\nC) 10000-20000 Lux\nD) 50000 Lux", "output": "0, because The recommended illumination (IES Code)in watch manufacturing company is 2000-3000 lux Rule of thumb is that the illumination must be 30 times higher the level at which ask can be just done. Parks textbook of preventive and social medicine.K Park. Edition 23.page no:741.table2."} |
{"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 with membrane stabilizing activity is?\nA) Nadolol\nB) Atenolol\nC) Carvedilol\nD) Oxprenolol", "output": "3, because ANSWER: (D) OxprenololREF: KDT 6 th edition page 140Membrane stabilizing activity (in propanolol, oxprenolol, acebutolol). This activity is claimed to contribute to the antiarrhythmic action, but appears to be significant only at high doses"} |
{"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 statement is/are true of all paramyxoviruses -a) They contain a single standed RNA genome of negative polarityb) Envelope is derived from the host cells plasma membranec) They have a cytoplasmic site of replicationd) They enter the body by the respiratory route\nA) acd\nB) abcd\nC) abc\nD) ab", "output": "1, because Paramyxoviruses are negative sense single stranded Enveloped RNA viruses\nSite of riboncleoprotein synthesis is cytoplasm and envelop is derived from host cell plasma membrane\nThey are important pathogens of infants and children and responsible for major part of acute respiratory infections and\u00a0Infection is acquired by respiratory route"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nVenous congestion of liver affects ?\nA) Midzone\nB) Perihepatic zone\nC) Centrilobular zone\nD) All the above", "output": "2, because Ans. is 'c' i.e., Centrilobular zoneNutmeg liver or chronic passive congestion or Congestive hepatopathy :?Chronic passive congestion is liver dysfunction due to venous congestion, usually right sided cardiac dysfunction (right sided cardiac decompenstion).When there is right sided cardiac decompensation, the blood being dammed back in the IVC and hepatic veins. o This results in increase venous pressure and passive congestion of centrilobular region and hemorrhagic necrosis of centrilobular region.The liver takes on a variegated mottled appearance, reflecting hemorrhage and necrosis in the centrilobular region, known as 'nutmeg liver'."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nIn alcohol withdrawal which is not seen -\nA) Seizure\nB) Blackout\nC) Coarse tremor\nD) Hallucination", "output": "1, because Blackout occurs during acute intoxication (not during withdrawal). All the other options can occur in alcohol withdrawal."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nPitting of nails is seen in \u2013 a) Lichen planusb) Psoriasisc) Pemphigusd) Arsenic poisoning\nA) ab\nB) a\nC) ad\nD) bc", "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\nA triphasic withdrawal syndrome follows an abrupt discontinuation of ______ use.\nA) Alcohol\nB) LSD\nC) Heroin\nD) Cocaine", "output": "3, because Cocaine use produces a mild physical, but a strong psychic dependence. A triphasic withdrawal syndrome follows an abrupt discontinuation of chronic cocaine use. Signs and symptoms : In the early phase (crash phase, 9 h to 4 days), there is anorexia, depression, agitation, excessive craving, hypersomnia, fatigue and exhaustion which is followed by normal mood, anxiety and anhedonia (next 4-7 days). In third phase (extinction phase, after 7-10 days), there are no withdrawal symptoms, but increased vulnerability to relapse. Treatment : Bromocriptine and amantadine are useful in reducing cocaine craving. Gabapentin is being used in adult addicts."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nLamivudine is given when?\nA) HBeAg positive\nB) HBeAg negative\nC) ALT >_ 2 ULN\nD) Viral DNA> 10(square) copies", "output": "2, because Lamivudine belongs to the set of antiviral agents effective against hepatitis B virus infection. Given case repos on liver injuries after ceain antiviral agent treatments, this study examined the effects of lamivudine on alanine aminotransferase (ALT) and total bilirubin (TB) using a medical system database Ref Harrison20th edition pg 2675 Lamivudine has been used for treatment of chronic hepatitis B at a lower dose than for treatment of HIV/AIDS. It improves the seroconversion of e-antigen positive hepatitis B and also improves histology staging of the liver. Long-term use of lamivudine leads to emergence of a resistant hepatitis B virus (YMDD) mutant. Despite this, lamivudine is still used widely as it is well tolerated Lamivudine, commonly called 3TC, is an antiretroviral medication used to prevent and treat HIV/AIDS. It is also used to treat chronic hepatitis B when other options are not possible.It is effective against both HIV-1 and HIV-2.It is typically used in combination with other antiretrovirals such as zidovudine and abacavir. Lamivudine may be included as pa of post-exposure prevention in those who have been potentially exposed to HIV. Lamivudine is taken by mouth as a liquid or tablet HIV, high level resistance is associated with the M184V/I mutation in the reverse transcriptase gene as repoed by Raymond Schinazi's group at Emory University. GlaxoSmithKline claimed that the M184V mutation reduces \"viral fitness\", because of the finding that continued lamivudine treatment causes the HIV viral load to rebound but at a much lower level, and that withdrawal of lamivudine results in a higher viral load rebound with rapid loss of the M184V mutation; GSK therefore argued that there may be benefit in continuing lamivudine treatment even in the presence of high level resistance, because the resistant virus is \"less fit\". The COLATE study has suggested that there is no benefit to continuing lamivudine treatment in patients with lamivudine resistance. A better explanation of the data is that lamivudine continues to have a paial anti-viral effect even in the presence of the M184V mutation. In hepatitis B, lamivudine resistance was first described in the YMDD (tyrosine-methionine-aspaate-aspaate) locus of the HBV reverse transcriptase gene. The HBV reverse transcriptase gene is 344 amino acids long and occupies codons 349 to 692 on the viral genome. The most commonly encountered resistance mutations are M204V/I/S. The change in amino acid sequence from YMDD to YIDD results in a 3.2 fold reduction in the error rate of the reverse transcriptase, which correlates with a significant growth disadvantage of the virus. Other resistance mutations are L80V/I, V173L and L180M Ref Davidson 23rd edition pg 768"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nIn PML, all of the following are seen except :\nA) Retinoic acid is used in treatment\nB) 15/17 translocation\nC) CD 15/34 both seen in same cell\nD) Associated with DIVC", "output": "2, because Answer is C (CD15 / 34 both seen in same cell) Acute promyelocytic Leukaemia (PML : FAB M3) * This is a type of Acute Myeloid Leukaemia (AML) and has been classified as the M3 category according to the FAB morphological classification.9 * It constitutes 5 - 10% of all AML (Robbin's / Ghai) Pathological characteristic of PML * It is characterized by the chromosomal translocation 1(15;17)Q - CMDT * t(1 5;17) translocation produces a fusion gene ( PML-RAR }involving the Retinoic Acid Receptor gene and Promyelocytic Leukemia (PML) gene. This PML - RaR fusion protein tends to suppress gene transcription and blocks differentiation of cells. This block can be overcome with pharmacological doses of retinoic acid (Harrrison). * Most cells are hypergranularQ promyelocytes often with many Auer rods per cell. Presentation characteristic / Specific features of PML * Patients of PML are younger (median age 35 - 40 years) - Robbin's * Incidence of Disseminated Intravascular Coagulation (DIVC) is high in patient with PML. -Robbin's DIC may occur with any subgroup of AML but is especially common in acute PML (M3)-Ghai Treatment specific to PML subject All-Trans Retinoic Acid (ATRA/Tretinoin) * The treatment of patient with PML has been dramatically improved by the use of All - Trans - Retinoic acid. This agent is an analog of vitamin A that leads to terminal differentiation of occult promyelocytic leukemia cells. - CMDT * Remission in PML is induced by All - Trans-Retinoic acid as a single agent -Ghai Arsenic Trioxide Arsenic Trioxide produces meaningful response in upto 85% of patients refractory to tretinoin"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAll the following are true of Paget disease Except\nA) It affects elderly individuals\nB) It may be monostotic or polyostotic\nC) There is an imbalance between osteoblastic and osteoclastic activity\nD) Deformed long bones result from coical bone thinning", "output": "3, because Paget disease is a disorder of unknown origin, which occurs in older people and involves either a single bone or several bones. It is not associated with systemic metabolic disturbances, and some pas of the skeleton are always spared. The bones show marked thickening, owing to excessive osteoblastic and reduced osteoclastic activity. Although only a few persons suffering from Paget disease develop sarcoma of bone, in adults the disease remains an impoant predisposing condition for this tumor in long bones. The skull and veebrae are viually never the sites of secondary osteogenic sarcomas. Ref: Maheshwari 6e pg 317."} |
{"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 keratoconus are all of the following except: September 2005\nA) Can be seen in Down's syndrome\nB) It manifests just after bih\nC) Munson sign is characteristic\nD) Corneal transplantation is needed in severe cases", "output": "1, because Ans. B: It manifests just after bih Keratoconus is frequently due to a congenital weakness of the cornea, though it manifests itself after pubey. However it can occur secondarily following trauma or Down's syndrome. Keratoconus is divided into mild, moderate, and advanced. Mild keratoconus - External and corneal signs are often absent or minimal. - A history of multiple inadequate spectacle corrections of one or both eyes may be noted and may include oblique astigmatism on refraction as well as moderate-to-high myopia. - Irregularly astigmatic keratometry values (egg-shaped), not necessarily on the steep side of normal (approximately 45 diopters (D)), are consistent with diagnosis. Diagnosis can be confirmed with computer-assisted videokeratography, which may reveal corneal inferior steepening (approximately 80% of keratoconus cases), central corneal astigmatic steepening (approximately 15% of keratoconus cases), or even bilateral temporal steepening (extremely rare). Diagnosis may also be aided by applying a diagnostic rigid contact lens with its base curve equal to the flat keratometry value. One observes a typical nipple pattern by use of sodium fluorescein dye in the underlying tear film. Moderate keratoconus One or more corneal signs of keratoconus are often present. Enhanced appearance of the corneal nerves is noted. Approximately 40% of eyes in patients with moderate keratoconus develop Vogt striae (fine-stress lines) in the deep stroma. Approximately 50% develop the deposition of iron in the basal epithelial cells in a (often paial) ring shape at the base of the conical protrusion called the Fleischer ring. Approximately 20% develop corneal scarring. Superficial corneal scarring can be fibular, nebular, or nodular. Deep stromal scarring may occur, perhaps representing resolved mini-hydrops events. Some patients show scarring at the level of the Descemet membrane (posterior limiting lamina), consistent in appearance with posterior polymorphous corneal dystrophy. Paraxial (usually inferior to the pupil) stromal thinning may be appreciated. Keratometry values typically increase to 45-52 D. Distoion of the retinoscopy and direct ophthalmoscope red pupillary reflex may allow observation of \"scissoring\" or an inferior distoion termed the oil drop sign. The Munson sign is noted when, upon downgaze, a \"V\" shape is noted in the cornea's profile against the lower lid margin, an accentuation of the conical shape of the modest to advanced keratoconus cornea. Advanced keratoconus This often results in keratometry values greater than 52 D and enhancement of all corneal signs, symptoms, and visual loss/distoion. Vogt striae are seen in approximately 60% of eyes, and Fleischer ring and/or scarring are seen in approximately 70% of eyes. Acute corneal hydrops can occur. Treatment: In the early stages, vision may be improved with spectacles but contact lens are more beneficial as they eliminate the irregular corneal curvature. If the disease progresses and the cone hydrated, the most satisfactory treatment is corneal transplantation."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nVaccines prepared by embryonated hen's egg are:\nA) Measles\nB) Rabies\nC) Rubella\nD) Varicella", "output": "1, because Ans. (b) Rabies Vaccine that grows in embryonated eggs: Influenza Yellow fever (17 D strain) Rabies (Flury strain) Mumps Varicella vaccine growns in chick embryo fibroblast culture. Rubella - RA 27/3 vaccine produced in human diploid fibroblast. No eggs culture vaccine of measles are produced. All are tissue culture vaccine, either chick embryo or human diploid cell line."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nHow does the distal nephron differ functionally from the proximal tubule?\nA) The distal nephron has a more negative intraluminal potential than the proximal tubule.\nB) The distal nephron is less responsive to aldosterone than the proximal tubule.\nC) The distal nephron is more permeable to hydrogen ion than the proximal tubule.\nD) The distal nephron secretes more hydrogen ion than the proximal tubule does.", "output": "0, because Proximal and distal convoluted tubule The site of action of acetazolamide is the proximal convoluted tubule and the site of action of the thiazides is the distal convoluted tubule. The distal nephron has a negative luminal potential because it is poorly permeable to negatively charged ions. Therefore, when Na+ is reabsorbed, negatively charged ions, primarily Cl-, lag behind, producing a negative intraluminal potential. Although a similar situation occurs in the proximal tubule, the proximal tubule has a higher permeability to Cl- and, therefore, does not develop as large a negative intraluminal potential. The distal nephron is less permeable to hydrogen than the proximal tubule. Aldosterone increases Na+ reabsorption from the distal nephron but has no effect on the proximal tubule. K+ is reabsorbed from the proximal tubule and secreted by the distal nephron. Although the amount of H+ excreted each day is determined by the amount of H+ secreted into the distal nephron, Proximal tubule secretes much more H+ than the distal nephron. However, almost all of the H+ secreted in the proximal tubule is reabsorbed in association with the reabsorption of HCO3-"} |
{"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 commonest abdominal mass in neonate -\nA) Wilm's tumor\nB) Polycystic kidney\nC) Neuroblastoma\nD) Rhabdomyosarcoma", "output": "2, because Ans. is 'c' i.e., Neuroblastoma The commonest intra-abdominal tumor in first two years of life Neuroblastoma The commonest intra-abdominal tumor between 2\"d to 5th year of life - Wihn's tumor The commonest intra-abdominal tumor in children (no age specification) Neuroblastoma (Wilm's tumor is the second most common abdominal tumor in children) Remember: The commonest cause of abdominal mass in Newborn is : Multiple dysplastic kidneys (if neoplasm or tumor has not been mentioned when asking for the commonest intra-abdominal mass, the answer will be multiple dysplastic kidneys)"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nMode Is:\nA) Arthimetic average of the values\nB) Most frequently occurring observations\nC) Middle observation when arranged in ascending or descending order\nD) Adding all values and then dividing by number of values", "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\nA patient gets tingling when his bed light is flashed suddenly. Which type of hallucination is this :\nA) Hypnagogic hallucinations\nB) Hypnopompic hallucinations\nC) Reflex hallucinations\nD) Functional hallucinations", "output": "2, because \"Example of reflex hallucination : when the light flashes the patient gets tingling sensation\"."} |
{"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 amino acids is most responsible for the buffering capacity of hemoglobin and other proteins?\nA) Arginine\nB) Aspaic acid\nC) Glutamic acid\nD) Histidine", "output": "3, because Remember that a buffer is most effective when its pKa is within the pH range of the surrounding medium. Histidine is the only amino acid with good buffering capacity at physiologic pH. The imidazole side chain of histidine has a pKa around 6.0 and can reversibly donate and accept protons at physiologic pH. Arginine and lysine are basic amino acids with pKa's of 12.5 and 10.5, respectively; at physiologic pH both will behave as bases and accept protons. Aspaic acid and glutamic acid are acidic amino acids with pKa's of approximately 4; at physiologic pH they will behave as acids and donate protons. Ref: Rodwell V.W. (2011). Chapter 30. Conversion of Amino Acids to Specialized Products. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e."} |
{"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 associated with elevation Right hemi-diaphragm:\nA) Amebic abscess\nB) Pyogenic abscess\nC) Cholecystitis\nD) Sub diaphragmatic abscess", "output": "2, because Ans. (c) CholecystitisCholecystitis is inflammation of gall bladder wall.Radiological evaluation does not show elevation of right hemidiaphragm in these cases.AMOEBIC LIVER ABSCESS* Chest radiographs are abnormal in the majority of patients with amebic hepatic abscesses. Findings include elevation of the right hemi-diaphragm, right pleural effusion, atelectasis in the region of the base of the right lung, and a right pleural effusion.PYOGENIC LIVER ABSCESS* Chest radiographs are abnormal in half of patients with pyogenic liver abscesses, reflecting an underlying inflammatory process. The most frequent findings include a right pleural effusion, elevation of the right hemi-diaphragm, and atelectasisIn case of subdiaphragmatic abscess also, there is elevation of right hemi-diaphragm."} |
{"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 drugs are useful in the treatment of a patient with acute bronchial asthma except\nA) Ipratropium\nB) Salbutamol\nC) Montelukast\nD) Hydrocortisone", "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\nMydriasis is/are caused by:\nA) Homer syndrome\nB) Neurosyphilis\nC) Organophosphorus poisoning\nD) Atropine", "output": "3, because D i.e. Atropine Pinpoint pupils are seen in - 'Car Chlor Or Mor' i.e. Carbolic acid, Chloral hydrate, Organophosphorus, Morphine (opiate)Q and 'New Horn' i.e. neurosyphilis/tabes dorsalis (spinal miosis or small, irregular Argyll Robeson pupil) and Horner's syndrome. Atropine and cocaine cause mydriasisQ Barbiturate poisoning 1/t constricted & reacting pupils which dilate during terminal asphyxiaQ"} |
{"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 techniques use piezoelectric crystals -\nA) Ultrasonography\nB) X-ray diffraction\nC) NMR imaging\nD) Xeroradiography", "output": "0, because Ans. is 'a' i.e., Ultrasonography o Ultrasonography is based on piezoelectric effect.o MRI is based on gyeromagneticproperty of proton (H+).Ultrasonography (USG) / Ultrasoundo USG is performed with the pulse-echo technique. By the virtue of piezoelectric effect in the ultrasound probe (or transducer), electric energy is converted to sound energy that is transmitted into patient's tissues. The US transducer (probe) then becomes a receiver, detecting echo of sound energy reflected from tissue.o The US transducer (probe) then becomes a receiver, detecting echo of sound energy reflected from tissue.o The ultrasound transducer uses the principle or property of piezoelectricity.o Quartz is a naturally occuring peizoelectric material.o Currently, Lead Zirconate titanate (PZT) is the most widely used material in the ultrasound tranducer/probes"} |
{"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 with hypeension is also having aoic dissection. Anti-hypeensive agent of choice is: September 2008\nA) Sodium nitroprusside\nB) Reserpine\nC) Pindolol\nD) Nifedipine", "output": "0, because Ans. A: Sodium Nitroprusside Antihypeensive therapy in acute aoic dissection aims specifically to lessen pulsatile load or aoic stress, in order to retard the propagation of the dissection and prevent aoic rupture. The goals of treatment are to prevent myocardial ischemia, decrease left ventricular afterload, decrease myocardial oxygen consumption, and prevent rupture and bleeding from suture lines Nitroprusside is a potent direct aerial and venous dilator, acting through release of nitric oxide. It has a rapid onset of action, and a shoer half-life and thus is given in the form of continuous infusion. The hypotensive effects of nitroprusside can be unpredictable because it simultaneously causes potent venodilatation and peripheral aerial vasodilatation. This is especially the case for patients with severe left ventricular hyperophy and preload-dependent diastolic dysfunction. It has been shown to cause coronary steal; it can cause a significant reflex tachycardia, and it can decrease oxygen circulation. It is photosensitive, so it requires special handling. Its most serious adverse effect is in the form of cyanide toxicity, which occurs due to accumulation of its metabolites thiocyanate/ cyanide and its clinical presentation may vary leading to difficulty in diagnosis. Thus, it is recommended that this drug be used only when other intravenous antihypeensive agents are not available"} |
{"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 parietal peritoneum covering the inferior surface of the diaphragm transits its sensory information via the phrenic nerve. In the case of peritonitis in the parietal peritoneum on the inferior surface of the diaphragm, pain may be referred through which of the following nerves?\nA) A\nB) B\nC) C\nD) D", "output": "3, because Ans. D. Supraclavicular nervesThe phrenic nerve consists of contributions from spinal nerve levels C3 to 5.Therefore, when sensory information comes from the parietal peritoneum on the inferior diaphragmatic surface, it may refer through spinal nerves at the same levels.a. Supraclavicular nerve shares levels with the C3 and C4 levels.b. The greater and lesser occipital nerves both originate at the C2 level.c. Great auricular nerve root value is C2, 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\nOperation of choice in GERD is\nA) Highly selective vagotomy\nB) Fundoplication\nC) Hellers myotomy\nD) Gastrectomy", "output": "1, because Operations for GORD are based on the creation of an intra-abdominal segment of oesophagus, crural repair and some form of wrap of the upper stomach (fundoplication) around the intra-abdominal oesophagus.Nissen fundoplication is one of the commoner procedures done.Ref: Bailey and Love 27e pg: 1078"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nNon immunized susceptible diphtheria contacts should receive:\nA) Erythromycin\nB) Penicillin and diphtheria antitoxin\nC) Penicillin, diphtheria antitoxin and DPT vaccine\nD) No treatment is required", "output": "2, because Non immunized contacts should receive prophylactic penicillin or erythromycin. They should also be given 1000 to 2000 units of antitoxin and actively immunized against diphtheria. Ref: Park 21st edition, page 151."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nIn emergency tracheostomy following structures are damaged except:\nA) Isthmus of thyroid\nB) Inferior thyoid vein\nC) Inferior thyroid aery\nD) Thyroid ima", "output": "2, because Structures which lie below the midline viz. isthmus of thyroid and thyroid ima aery can be damaged in emergency tracheostomy. Inferior thyroid veins emerge at the lower border of the isthmus form a plexus in front of the trachea and drains into brachiocephalic vein can be damaged during tracheostomy but inferior thyroid aery, a branch of thyrocervical trunk of subclan aery lies laterally away from midline and can thus escape injury."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nIntrinsic factor is required for absorption of ?\nA) Folic acid\nB) Vitamin B12\nC) Vitamin B\nD) Vitamin B2", "output": "1, because Ans. is 'b' i.e., Vitamin B12"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAfter a normal prenatal period, a lady developed sudden HTN and bleeding from all places. Diagnosis is:\nA) DIC\nB) Aplastic anemia\nC) ITP\nD) APLA", "output": "0, because (A) DIC# Disseminated Intravascular Coagulation (DIC), also known as disseminated intravascular coagulopathy or less commonly as consumptive coagulopathy, is a pathological process characterized by the widespread activation of the clotting cascade that results in the formation of blood clots in the small blood vessels throughout the body. This leads to compromise of tissue blood flow and can ultimately lead to multiple organ damage. In addition, as the coagulation process consumes clotting factors and platelets, normal clotting is disrupted and severe bleeding can occur from various sites.> DIC can occur in the following conditions: Solid tumors and blood cancers (particularly acute promyelocytic leukemia) Obstetric complications: abruptio placentae, pre-eclampsia or eclampsia, amniotic fluid embolism, retained intrauterine fetal demise, septic abortion, post partum haemorrhage Massive tissue injury: severe trauma, burns, hyperthermia, rhabdomyolysis, extensive surgery Sepsis or Severe infection of any kind (infections by nearly all microorganisms can cause DIC, though bacterial infections are the most common): bacterial (Gram-negative and Gram-positive sepsis), viral, fungal, or protozoan infections Transfusion reactions (i.e., ABO incompatibility haemolytic reactions) Severe allergic or toxic reactions (i.e. snake or viper venom) Giant haemangiomas (Kasabach-Merritt syndrome) Large aortic aneurysms> Liver disease, HELLP syndrome, thrombotic thrombocytopenic purpura/Haemolytic uremic syndrome, and malignant hypertension may mimic DIC but do not occur via the same pathways."} |
{"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 the best test to diagnose bleeding in DIC?\nA) Increased PT\nB) Increased aPTT\nC) Decreased fibrinogen\nD) Increased fibrin degradation products", "output": "3, because Fibrin degradation product (FDP) is the best test to diagnose bleeding in DIC. D-Dimer assay is for screening | PT & | aPTT seen in a lot of conditions - so not best."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nChlorhexidine as a root canal irrigant is\nA) Active against gram +ve , gram \u2013ve bacterias and to some extent Virus with lipid envelop.\nB) Normally used at 2% conc\nC) A poly biguinide\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 single question.\n\nInferior border of scapula lies at the level of which rib?\nA) 5th\nB) 6th\nC) 7th\nD) 8th", "output": "2, because ANSWER: (C) 7thREF: Gray's Anatomy 40th Ed Ch: 49Indirect repeat Anatomy 2012 Session II, 2013 Session 1The inferior angle overlies the seventh rib or intercostal space and T7"} |
{"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 complication of acute pancreatitis is -\nA) Pancreatic abscess\nB) Pseudocyst\nC) Phlegmon\nD) Pleural effusion", "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\nMarble bone disease, characterized by increase in bone density is due to mutation in the gene encoding:\nA) Carbonic Anhydrase I\nB) Carbonic Anhydrase II\nC) Carbonic Anhydrase III\nD) Carbonic Anhydrase IV", "output": "1, because Ans. B. Carbonic Anhydrase IIIn osteoporosis, also called as marble bone disease there is increased bone density. It is due to mutation in gene encodingcarbonic anhydrase II enzyme. The deficiency of this enzyme in osteoclasts leads to inability of bone resorption."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nCidex is\nA) Gluteraldehyde\nB) Alcohol\nC) A phenolic compound\nD) A caustic agent", "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 multi question.\n\nHemorrhagic fever is caused by -\nA) West-Mile fever\nB) Sandfly fever\nC) Ebola virus\nD) All of the above", "output": "2, because kyasanur forest disease a hemorrhagic fever found in Karnataka. It is an arboviral disease. a new arbovirus genetically related to RSS isolated REF:ANANTHANARYANAN TEXTBOOK OF MICROBIOLOGY 9EDITION PGNO.524"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nInitial stage of clinical union of bone is equivalent to\nA) Callus formation with woven bone\nB) Woven bone Formation\nC) Haematoma formation\nD) Calcification formation only", "output": "0, because The first signs of union are seen in stage of hard callus formation A. Clinical sign:fracture is no more mobile B. Radilogical sign :callus is seen on X ray *hard callus is immature woven bone* Ref: Maheshwari 9th/e p 12"} |
{"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 two-year-old child presents with persistent diarrhea, acidic stools and presence of one percent of reducing substance in the fresh stools. What is the most probable diagnosis?\nA) Cystic fibrosis\nB) Lactose intolerance\nC) Rotavirus induced diarrhea\nD) Intestinal tuberculosis", "output": "1, because Presence of acidic stools with reducing substance positive, suggests a diagnosis of lactose intolerance."} |
{"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 mycoplasma pneumonia is\nA) Penicillin\nB) Tetracycline\nC) Cefuroxime\nD) Erythromycin", "output": "3, because Treatment options for acute M.pneumoniae infection include macrolides (e.g., oral azithromycin, 500 mg on day 1, then 250 mg/d on days 2-5), tetracyclines (e.g., oral doxycycline, 100 mg twice daily for 10-14 days), and respira-tory fluoroquinolones Ref Davidson edition23rd pg 585"} |
{"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 6 year old female patient complains of pain due to a decayed lower right 2nd molar. During the treatment, patient becomes uncooperative and throws a tantrum. The dentist then asks the mother to step out of the operatory, after which the child begins to cooperate. The example demonstrated by the dentist falls under which type of conditioning, as described by Skinner?\nA) Positive reinforcement\nB) Negative reinforcement\nC) Omission\nD) Punishment", "output": "2, because Omission (also called time-out), involves removal of a pleasant stimulus after a particular response. For example, if a child who throws a temper tantrum has his favorite toy taken away for a short time as a consequence of this behavior, the probability of similar misbehavior is decreased."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nDesks provided with table top to prevent neck problems in an example of\nA) Primordial prevention\nB) Secondary prevention\nC) Specific protection\nD) Disability limitation", "output": "2, because Specific protection comes under Primary prevention. It prevents risk factor from progressing to disease. Ref : Park&;s Textbook of Preventive and Social Medicine; 23rd edition; Page 42"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nGlutamine synthetase is a -\nA) Isomerase\nB) Ligase\nC) Lyase\nD) Transferase", "output": "1, because Ans. is 4b' i.e., Ligase /Ref Essential of biochemsitry p. 186]o All synthases are ligases.o All digestive enzymes are hydrolases.o Lyases are:DecarboxylasesAldolasesHydratasesEnolaseFumaraseArginosucinaseEnzyme classImportant enzymesOxidoreductaseOxidases, Dehydrogenases, Hydroperoxidases, (catalase, peroxidase), oxygenases.TransferaseAmino transferase or transaminase, e.g., SGOT (AST) and SGPT (ALT), kinases (HexokinaseQ glucokinase, pyruvate kinase etc), Transketolases, transaldolases, transcarboxylases.HydrolasesAll digestive enzymes (Pepsin, trypsin, lipases, esterases), lysosomal enzymes, urease, and phosphataseLyasesDecarboxylasesQ, aldolases, hydratases, enolase, fumaraseQ, ArginosuccinaseIsomerasesRacemases, epimerases. cis- trans- isomerases, mutasesLigasesSynthatasesQ, Carboxylases, DMA ligase"} |
{"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 an accepted method of randomization-\nA) Computer drawn randomization\nB) Odd/even day hospital admission\nC) Lottery\nD) Random number table", "output": "1, because Ans. is 'b' i.e., Odd/even day hospital admission Methods of Randomization o Randomization is accomplished in a number of classic ways 1. Lottery method Suppose 10 patients are to be put in a control group or the trial group out of 100 available. The serial numbers of patients are noted on 100 cards and then shuffled well. The cards are drawn one by one and thus patients are allocated into trial and control groups. 2. Table of Random Numbers Published tables of Random numbers are used. This is considered to be the best method of randomization. A computer program is used for randomization o Randomization methods , which may at first seem reasonable (odd-even day randomization or daytime-nighttime convenience randomization), may actually suppo bias, paicularly if the study is open-label or the operator or subject are not blinded as to the nature of the intervention. For example, if the study involves a procedure such as wound irrigation and the patients are randomized to have wounds irrigated with sterile saline on even days and tap water on odd days, a patient may present on an even day and the treating clinical investigator may elect not to enroll the patient in the study or to break the randomization, because they \"just think that this paicular wound needs saline irrigation.\" This is a very common error in otherwise well-designed clinical studies."} |
{"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 23 year old profession footballer sufferd a twisting injury to his right ankle. On examination there is a lot of swelling around the medial malleolus but xray doesn't show any fracture. The structure injured could be -\nA) Deltoid Ligament\nB) Anterior talofibular ligament\nC) Spring ligament\nD) Tendo Achilles", "output": "0, because Answer- A. Deltoid LigamentDeltoid ligament injuries involve the deltoid ligament that forms the medial pa of the anHe joint.It attaches the medial malleolus to multiple tarsal bones.It occurs due to eversion and/orpronation injury, or can be associated with lateral ankle fractures."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nVon Willebrand&;s factor is synthesized in which one of the following -\nA) Vascular endothelium\nB) Macrophages\nC) Liver\nD) Eosinophils", "output": "0, because The Von willebrand factor is synthesized in the endothelial cells ,megakaryocytes and platelets While the principal site of synthesis of factor VIII is the liver Reference :textbook of Pathology ,7th edition ,Author: Harsha Mohan, page number 314."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nPersistence of Moro's reflex is abnormal beyond the age of \u2013\nA) 3rd month\nB) 4th month\nC) 5th month\nD) 6th month", "output": "3, because \"In a normal infant, the Moro's reflex begins to fade at three months of age and gradually disappears at 4-6 months.\nWhen it persists beyond 6 months it indicates a delay in CNS development.\" ----------\u00a0Tachdjian\n\"Moro's reflex disappears by six months in a normal infant.\" ------------\u00a0Ghai"} |
{"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 statements regarding live vaccines is false\nA) Two live vaccines cannot be administered simultaneously\nB) Booster doses are not required when live vaccines are administered\nC) Single dose gives lfe long immunity\nD) Live vaccine contains both major and minor antigens", "output": "0, because When 2 live vaccines are required they should be given either simultaneously at different sites or with an interval of at least 3 weeks.In case of live vaccines,protection is generally achieved with a single dose of vaccine (refer pgno:103 park 23 rd 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\nAll are alkylating agents, except ?\nA) 5-FU\nB) Melphalan\nC) Cyclophosphamide\nD) Chlorambucil", "output": "0, because Ans. is 'a' i.e., 5 Fluorouracil"} |
{"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 VSD are all except -\nA) Left to right shunt\nB) Pansystolic mormor\nC) Reverse spitting of S2\nD) Left atrial hyperophy", "output": "2, because Ans. is 'c' i.e., Reverse spliting of S2 Hemodynamics of VSD o A VSD results in shunting of oxygenated blood from left to right because left ventricle has more pressure than right Left to right shunt. o Blood flow from left to right ventricle due to high pressure gradient --> Pansystolic murmur and systolic thrill. o Because left ventricle stas contracting before Right ventricle, pansystolic murmur stas early --> Masking of SI. o This pressure gradient is maintained throughout the systole pansystolic murmur lasts long --> Masking of S2. o Towards the end of systole, the declining left ventricular pressure becomes lower than aoic Early closure of A2. o Left to right shunt occurs during systole at a time when the right ventricle is also contracting, therefore left to right shunt streams to pulmonary aery more or less directly --> No volume overload --> Right ventricle size remains normal. Increased blood flow through pulmonary valve --> Pulmonary ejection systolic murmur and delay & accentuated P2. o Early closure of A2 and delayed closure of P2 cause --> Widely split S2 (But this is usually masked by pansystolic murmur). o Larger volume reaches the left atrium -3 Left atrial hyperophy o Increased blood flow through mitral valve -3 Accentuated Si (But it is masked by pansystolic murmur) and delayed diastolic murmur. Note : o Ejection systolic murmur of pulmonary valve can not be separated from pansystolic murmur. o The effect of ejection systolic murmur is a selective transmission of pansystolic murmur to the upper left sternal border (pulmonary valve area) In this area ejection characteristic of this murmur can be recognized since it does not mask the aoic component of S2. For the same reason second hea sound (S2) can be heard in the pulmonary area where it is not masked by pansystolic murmur."} |
{"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 common causative organism for external otitis in adults is:\nA) Streptococcus viridans\nB) Staphylococcus epidermidis\nC) Pseudomonas aeruginosa\nD) E. coli", "output": "2, because Otitis externa is an inflammatory and infectious process of the external auditory canal. Pseudomonas aeruginosa and Staphylococcus aureus are the most commonly isolated organisms. Less commonly isolated organisms include Proteus species, Staphylococcus epidermidis, diphtheroids, and Escherichia coli."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nInsulin is secreted along with the following molecule in a 1: 1 ratio:\nA) Pancreatic polypeptide\nB) Glucagon\nC) GLP-1\nD) C- peptide", "output": "3, because D i.e. C - PeptideInsulin has two interchain (A7 - B7, & A20 - B19) and one intrachain (A6 - All) disulfide bridges with in AB hetrodimeric structureQ.Insulin is synthesized as pre-pro-hormone (MW 11, 500), which makes it difficult to synthesize insulin in laboratory even after synthesizing A, B chains. This pre prohormone is directed by hydrophobic 23 aminoacid pre or leader sequence into cisternae of endoplasmic retinaculum, which is then removed to form 9000 MW proinsulin.Staing from amino terminal, the chain sequenc of proinsulin is."} |
{"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 20 year old boy c/o hearing of voices, aggressive behavior since 2 days. He has fever since 2 days. When asked to his family, they says that he has been muttering to self and gesticulating. There is no h/o of psychiatric illness. Likely diagnosis is\nA) Dementia\nB) Acute psychosis\nC) Delirium\nD) Delusional disorder", "output": "1, because Acute psychosis ??? [Ref: Kaplan and Saddock synopsis of Psychiatry 10/e p 516-5171We are unable to reach a conclusive diagnosis with the information provided in the question.Acute onset, presence of fever, no history of psychiatric illness suggests delirium.But, the diagnosis of delirium cannot be made definitively in the absence of disorientation.In the question there is no definite comment on orientation of the patient.May be, that suggests, the patient is not disoriented.Acute onset, presence of perceptual disturbances (hallucination and other symptoms point towards acute psychosis.But acute psychosis seems unlikely because:-- Absence of cognitive dysfunction or thought disorders.- Absence of H/o psychiatric illness or substance abuse disorders.Psychotic disorders cannot be diagnosed only in the presence of perceptual disturbances. Some disorder in cognitive dysfunction or thought disorders is also required.May be this is a case of acute transient psychosis- These disorders do not give the classical manifestations of psychotic disorders.- They are characterized by the predominance of perceptual disturbances, and they do not fulfil the criteria of psychotic disorders.Acute and Transient Psychotic disordersA large number of psychiatrists especially from the developing countries like India, repoed that many patients developed an acute psychotic disorder that neither followed the course of schizophrenia nor resembled mood disorders in the clinical picture and usually had a better prognosis than schizophrenia.Acute and transient psychosis as a descriptive entity was recognized only with the advent of 1CD-10 in 1992. Where it is included under psychotic disorder.- The key features that characterize the disorder are an -- acute within (2 weeks) onset in all the cases presence of typical syndrome which are described as rapidly changing variables, polymorphic states and typical schizophrenic symptoms evidence ,for associated acute stress in a substantial number of cases and complete recovery in most cases within 2-3 months.A pa from these criteria ICD-10 also provides diagnostic guide- lines which include- Not meeting the criteria for manic or depressive episodes although the affective symptoms may be prominent - Absence of organic causation although perplexity confusion and inattention may he present. - Absence of obvious intoxication by drugs or alcohol.It is evident that ICD 10 intends to \"clearly differentiate\" the concept of acute transient psychosis .from those of affective psychosis, organic psychosis and drug induced psychosis.This is the point which is creating doubt in our minds.The ICD wants to clearly differentiate it from organic psychosis.- The boy presents with \"fever\" therefore the organic cause for the psychosis cannot be ruled out. - May be the psychosis is due to fever (some C.N.S. infection)- If fever had not been mentioned the diagnosis would have been clear. But the presence of fever prevents us from diagnosing this as acute transient psychosis.- The correct option would have been \"organic psychosis\" or \"psychosis due to general medical condition\". - Acute psychosis cannot be diagnosed without addressing the organic basis of the disease.Four subtypes of acute transient psychosis are described in ICD 10 -Acute polymorphic psychotic disorder without symptoms of schizo- phrenia - Acute polymorphic psychotic disorders with symptoms (?f schizo- phrenia - Acute schizophrenia like psychotic disorder- Acute predominantly delusional psychotic disorderOverall, duration of total episode should not exceed 3 months and that .for schizophrenic symptoms should not exceed 1 month. There is provision for change of diagnosis to schizophrenia."} |
{"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 impoant prognostic factor in breast carcinoma is\nA) Histological grade of the tumor\nB) Stage of the tumor at the time of diagnosis\nC) Status of estrogen and progesterone receptors\nD) Over expression of p-53 tumour suppressor gene", "output": "1, because Stage I and II has got better prognosis. Spread to axillary nodes is the most impoant prognostic indicator. Age: Younger the age worser the prognosis. Sex: Carcinoma male breast has got worser prognosis compared to female breast. Because of early spread in carcinoma male breast. Atrophic scirrhous has got best prognosis. Medullary carcinoma has got better prognosis than scirrhous carcinoma because of lymphocytic infi ltration. Invasive carcinoma has got worser prognosis. Inflammatory carcinoma breast has worst prognosis. Ref; (page no;559 ) 5th edition of SRB&;S manual of Surgery"} |
{"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 associated with > 20% risk of chromosomal anomalies?\nA) Omphalocele\nB) Gastroschisis\nC) Cleft lip\nD) Spina bifida", "output": "0, because Omphalocele is a midline abdominal wall defect. The abdominal viscera (commonly liver and bowel) are contained within a sac composed of peritoneum and amnion from which the umbilical cord arises at the apex and center. When the defect is less than 4 cm, it is termed a hernia of the umbilical cord; when greater than 10 cm, it is termed a giant omphalocele. Associated abnormalities occur in 30-70% of infants and include, in descending order of frequency, Chromosomal abnormalities (trisomy 13, 18, 21) Congenital hea disease (tetralogy of Fallot, atrial septal defect) Beckwith-Wiedemann syndrome (large-for-gestational-age baby; hyperinsulinism; visceromegaly of kidneys, adrenal glands, and pancreas; macroglossia; hepatorenal tumors; cloacal extrophy) Pentalogy of Cantrell Prune belly syndrome (absent abdominal wall muscles, genitourinary abnormalities, cryptorchidism) Ref: Albanese C.T., Sylvester K.G. (2010). Chapter 43. Pediatric Surgery. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nFeatures of SLE include all of the following except -\nA) Recurent abortion\nB) Sterility\nC) Coomb's positive hemolytic anemia\nD) Psychosis", "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\nMultiple myeloma most common part involved is-\nA) Bone marrow\nB) Cortex of bone\nC) Metaphyses\nD) Epiphyses", "output": "0, because Ans. is 'a' i.e., Bone marrow Multiple mveiomao Multiple myeloma is a plasma cell neoplasm characterized by involvement of the skeleton at multiple sites,o Plasma cells proliferate abnormally and the proliferated plasma cells infiltrate various organs, particularly bone marrow, but can also spread to lymph nodes and extranodal sites like skin,o The proliferation and survival of myeloma cells are dependent on several cytokines, IL-h Is particularly important.o The neoplastic plasma cells secrete abnormally large amounts of immunoglobulin.o The immunoglobulin secreted by neoplastic plasma cells are quiet different form the immunoglobulin normally present in the blood.o The normal immunoglobulin consists of two heavy and two lights chains molecules and the production of both chain is tightly balanced.o The immunoglobulin secreted in this condition may be : -Isolated light chain or heasy chain.May be an intact antibody molecule of any heavy chain subclass.May be an altered antibody or fragment."} |
{"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 the causes of neovascular glaucoma except:\nA) Intraocular tumour\nB) Central retinal vein occlusion\nC) Diabetic retinopathy\nD) Central serous retinopathy", "output": "3, because Ans. Central serous retinopathy"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nFalse about Corona viruses?\nA) Corona viruses are non-enveloped\nB) Spreads by coughing and sneezing\nC) Most of them infect animals and birds\nD) Human infection is rare", "output": "0, because Corona viruses are enveloped."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nCopper sulfate poisoning manifests with\nA) High anion gap acidosis\nB) Rhabdomyolysis\nC) Acute hemolysis\nD) Peripheral neuropathy", "output": "2, because COPPER Poisonous Compounds: (1) Copper sulphate (blue vitriol) occurs in large, blue crystals. (2) Copper subacetate (verdigris), occurs in bluish-green masses or powder. Signs and Symptoms: Increased salivation, burning pain in the stomach with colicky abdominal pain, thirst, nausea, eructations and repeated vomiting. The vomited matter is blue or green. There is diarrhoea with much straining; motions are liquid and brown but not bloody. Oliguria, haematuria, albuminuria, acidosis and uraemia may occur. In severe cases haemolysis,haemoglobinuria, methaemoglobinaemia, jaundice, pancreatitis and cramps of legs or spasms and convulsions occur. The breathing is difficult, cold perspiration and severe headache occur. In some cases, paralysis of limbs is followed by drowsiness, insensibility, coma and death due to shock. Later deaths occur due to hepatic or renal failure or both. Ref:- k s narayan reddy; pg num:-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\nWhich of the following enzyme is associated with the conversion of androgen to oestrogen in a growing ovarian follicle is:\nA) Aromatase\nB) 5 alpha reductase\nC) Desmolase\nD) Isomerase", "output": "0, because Aromatase enzyme: In a normal ovary, LH acts on the theca interstitial stromal cells, whereas FSH acts on granulosa cells. In response to LH the thecal cells secretes androgen, and the produced androsendione is conveed in the granulosa cells to estrogen by the action of aromatase enzyme. Ref: Physiology By James N. Pasley 2nd Edition, Page 145 ; Androgens in health and disease By William J. Bremne Page 84 ; Pade approximation and its applications: Diagnosis and management of PCOS, Issue 765, By Luc Wuytack, Page 107"} |
{"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 may occur in Noonan syndrome except:\nA) Hypertrophic cardiomyopathy\nB) Cryptorchidism\nC) Infertility in females\nD) Autosomal dominant transmission", "output": "2, because c. Infertility in females(Ref: Nelson's 20/e p 2744-2746, Ghai 8/e p 640-641)Turner syndromeNoonan syndromeKaryotype 45, XOKaryotype normalInfertileFertile but delayed pubertySeen only in femalesMay be seen in males or femalesIntelligence normalIntellectual disability present"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nGas gangrene is caused by all except\nA) Cl. Histolyticum\nB) Cl. novyi\nC) Cl. septicum\nD) Cl. Sporogenes", "output": "3, because Gas gangrene is rapidly spreading, edematous myonecrosis occurring characteristically in association with a severe wound of extensive muscle mass contaminated by pathogenic clostridia. Most frequently encountered is clostridium perfringes. Also caused by clostridium novyi, Clostridium septicum and clostridium histolyticum. Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 261"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\n60 yrs old, air in biliary tree, colicky abdominal pain hyper-peristaltic abdominal sounds diagnosis -\nA) Gall stone ileus\nB) Hemobilia\nC) Cholangitis\nD) Pneumobilia", "output": "0, because Answer- A. Gall stone ileusPresence in air in biliary tract along with sign of intestinal obstruction is characteristic of gall stone ileus."} |
{"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 term applied when it is doubtful whether there will be space for all the teeth in mixed dentition analysis is:\nA) Space maintenance\nB) Space regaining\nC) Space supervision\nD) None of the above", "output": "2, because Space supervision\u00a0\n\nIt is a term applied when it is doubtful, according to the mixed dentition analysis, whether there will be room for all the teeth.\nPrognosis for supervision is always questionable, where as prognosis is always good for regaining space and for space maintenance.\nSpace supervision cases are those that will have a better chance of getting through the mixed dentition with clinical guidance than they will without.\n\nHandbook of orthodontics\u00a0 Moyers 4th Ed P-364"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nAbsence seizures are seen in:\nA) Grand mal epilepsy\nB) Myoclonic epilepsy\nC) Petitmal epilepsy\nD) Hyperkinetic child", "output": "2, because Ans. is 'c' Petit mal epilepsy \"Absence seizures or (Petit mal epilepsy is characterized by sudden, brief lapses of unconsciousness without loss of postural control line seizures typically lasts for only seconds, consciousness return as suddenly it was lost, and there is no postictal confusion.Absence seizures are usually accompanied by subtle, bilateral signs such as rapid blinking of eyelids, chewing movements or small amplitude clonic movements of the hand\""} |
{"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 enzymes contain manganese as its cofactor?\nA) LDH\nB) Arginase\nC) Hexokinase\nD) DNA polymerase", "output": "1, because Manganese: Cofactor for enzymes, e.g., arginase, pyruvate carboxylase.\nEnzymes that require a metal ion cofactor are termed metal-activated enzymes to distinguish them from the metalloenzymes for which bound metal ions serve as prosthetic groups.\nReference-Satyanarayana Pg- 405"} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nErgometrine is not used for initiation of labour because -\nA) Show onset of action\nB) Fetal hypoxia\nC) Increases blood pressure\nD) Act on D2 receptors to cause vomiting", "output": "1, because Ans. is 'b' i.e., Fetal hypoxia"} |
{"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 60-year-old man presents to the emergency department with chest pain described as retrosternal chest pressure radiating to the jaw. The symptoms started at rest and coming and going, but never lasting more than 15 minutes. He has a prior history of hypertension and smokes 1 pack/day. He is currently chest-pain free and on physical examination the blood pressure is 156/88 mmHg, pulse 88/min, and O2 saturation 98%. The heart and lung examination is normal.His ECG shows ST-segment depression in leads V1 to V4 that is new, and the first set of cardiac enzymes is negative. He is diagnosed with unstable angina pectoris, admitted to a monitored unit, and started on low molecular weight heparin, aspirin, nitroglycerin, and beta- adrenergic blockers. He continues to have ongoing chest pain symptoms. Which of the following is the most appropriate next step in management?\nA) IV streptokinase\nB) coronary angiography\nC) exercise testing\nD) oral aspirin", "output": "1, because A period of 24-48 hours is usually allowed to attempt medical therapy. Cardiac catheterization and angiography may be followed by bypass surgery or angioplasty. For those who do settle down, some form of subsequent risk stratification (e.g., exercise ECG) is indicated."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nWhich of the following manifestations is not a clinical manifestation of parvovirus infection?\nA) Erythema infectiosum\nB) Polyarthropathy\nC) Pure Red Cell aplasia\nD) Tropical sprue", "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\nWhich one of the following statements about the gap junction is true?\nA) It extends as a zone around the apical perimeter of adjacent cells.\nB) It possesses dense plaques composed in pa of desmoplakins.\nC) It permits the passage of ions from one cell to an adjacent cell.\nD) Its adhesion is dependent upon calcium ions.", "output": "2, because The gap junction channel regulates the passage of ions and small molecules from cell to cell, excluding those having a molecular weight greater than 1200 Da. The tight junction is the zone of adhesion around the apical perimeter of adjacent cells. The other statements are characteristics of desmosomes."} |
{"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 muscle responsible for falsetto voice of puber phonia is\nA) Vocalis\nB) Thyroarytenoid\nC) Posterior cricoarytenoid\nD) Cricothyroid", "output": "3, because Cricothyroid is the main tensor responsible for the falsetto voice in puberphonia. There is hyperkinetic function and spasm of cricothyroid muscle. Ref:- TB of ENT Hazarika; pg num:- 636"} |
{"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 virus, which spreads by both hermatogenous and neural route is -\nA) Rabies virus\nB) Varicella zoster virus\nC) Poliovirus\nD) E.B. Virus", "output": "2, because The virus multiplies initially in the epithelial cells of the alimentary canal and the lymohatic tissues from tonsil to peyer's patches. It then spreads to the rwgiinal lymoh node and enters blood stream. Direct neural transmission ti the CNS may also occur. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:486"} |
{"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 esophagus crosses the diaphragm at the level of:\nA) T8\nB) T9\nC) T10\nD) T11", "output": "2, because The oesophagus is a muscular tube 25 cm (10 in) long, which connects the pharynx to the stomach. It begins in the neck, level with the lower border of the cricoid cailage and the sixth cervical veebra. It descends largely anterior to the veebral column through the superior and posterior mediastina, passes through the diaphragm, level with the tenth thoracic veebra, and ends at the gastric cardiac orifice level with the eleventh thoracic veebra."} |
{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nConstriction of the afferent aeriole to the kidney glomerulus results in:\nA) Reduction of glomerular filtration rate and decreased urinary output\nB) Increased urine output\nC) Increased glomerular filtration rate and no change in urine output.\nD) Decreased urine output", "output": "0, because The kidney is innervated primarily by the sympathetic nervous system, and as such, regulates the contraction of the smooth muscle surrounding the afferent and efferent aerioles of the glomerulus. Sympathetic stimulation to the efferent glomerular aerioles causes their constriction and increases the filtration rate, leading to an increase in urinary output. Similarly, with the loss of sympathetic innervation, such as due to sympathectomy of the kidney, relaxation of tone of the afferent aeriole occurs and the filtration rate increases, which results in an increased urine output. Decreased urine output may result from the constriction of the afferent aerioles, leading to a decrease in glomerular filtration rate. Also Know: Factors affecting the GFR: Changes in renal blood flow Changes in glomerular capillary hydrostatic pressure Changes in systemic blood pressure Afferent or efferent aeriolar constriction Changes in hydrostatic pressure in Bowman's capsule Ureteral obstruction Edema of kidney inside tight renal capsule Changes in concentration of plasma proteins: dehydration, hypoproteinemia, etc (minor factors) Changes in Kf Changes in glomerular capillary permeability Changes in effective filtration surface area 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."} |
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