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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 is freely filtered by kidney across glomerular capillariesa) Albumin (across glomerular capillaries)b) Globulinc) Creatinined) HCO3 e) Glucose\nA) cde\nB) acd\nC) bde\nD) ade", "output": "0, because Freely filterable substances by glomerulus\n-\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Water\n-\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Na+\n-\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Cl-\n-\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 HCO3-\n-\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Inulin\n-\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Glucose\n-\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Creatinine\n\u00a0\n-\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Free Calcium or phosphate"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAntibodies associated with GTCS in SLE :\nA) Anti neuronal ab\nB) Anti-Ro ab\nC) Anti-Sm ab\nD) None", "output": "0, because Ans.A Anti neuronal ab (Ref: Harrison's Internal medicine 18th/Table 319-1; 17th edition, P. 2076). Autoantibodies in Systemic Lupus Erythematosus (SLE) Antibody Prevalence, % Antigen Recognized Clinical Utility Antinuclear antibodies 98 Multiple nuclear Best screening test; repeated negative tests make SLE unlikely Anti-dsDNA 70 DNA (double-stranded) High titers are SLE-specific and in some patients correlate with disease activity, Anti-Sm 25 Protein complexed to 6 species of nuclear U1 RNA Specific for SLE; no definite clinical correlations; most patients also have anti Anti-RNP 40 Protein complexed to U1 RNA Not specific for SLE; high titers associated with syndromes that have overlap blacks than whites Anti-Ro (SS-A) 30 Protein complexed to hY RNA, primarily 60 kDa and 52 kDa Not specific for SLE; associated with sicca syndrome, predisposes to subacute cutaneous with decreased risk for nephritis Anti-La (SS-B) 10 47-kDa protein complexed to hY RNA Usually associated with anti-Ro; associated with decreased risk for nephritis Antihistone 70 Histones associated with DNA (in the nucleosome, chromatin) More frequent in drug-induced lupus than in SLE Antiphospholipid 50 Phospholipids, 2 glycoproteins 1 cofactor, prothrombin Three tests available ELISAs for cardiolipin and 2G1, sensitive prothrombin Antierythrocyte 60 Erythrocyte membrane Measured as direct Coombs' test; a small proportion develops overt hemolysis Antiplatelet 30 Surface and altered cytoplasmic antigens on platelets Associated with thrombocytopenia but sensitivity and specificity are not good; Antineuronal (includes anti-glutamate receptor) 60 Neuronal and lymphocyte surface antigens In some series a positive test in CSF correlates with active CNS lupus. Antiribosomal P 20 Protein in ribosomes In some series a positive test in serum correlates with depression or psychosis Also remember: Antibody Best screening test for Antibody ANA SLE Anti-Histone Drug-induced lupus Antinuclear antibodies SLE, nonspecific Anti-dsDNA; Anti-Sm Specific for SLE Anti-sm (Nelson's Paediatric Textbook) Marker of CNS lupus Anti-DNA Level of which correlates with disease activity Anti-Ro (SS-A) SACL, neonatal lupus Anti-Ro and Anti-La ie risk of nephritis (protective against nephritis) Antiphospholipid Hematological and Fetal Loss Antiribosomal protein Depression and Psychosis Anti-basement membrane Goodpasture syndrome Anticardiolipin, lupus anticoagulant SLE, antiphospholipid syndrome Anticentromere Limited scleroderma (CREST syndrome) Anti--Scl--70 (anti--DNA topoisomerase 1) Scleroderma (diffuse) Anti--SSA, anti--SSB (anti-Ro, anti--La) Sjogren syndrome Anti--Jo--1, anti--SRP, anti--Mi--2 Polymyositis, dermatomyositis Anti--TSH receptor Graves disease Anti--U1RNP (ribonucleoprotein) Mixed connective tissue disease c-ANCA (PR3-ANCA) Granulomatosis with polyangiitis (Wegener) IgA antiendomysial, IgA anti--tissue transglutaminase Celiac disease p-ANCA (MPO--ANCA) Microscopic polyangiitis, Churg--*JStrauss syndrome Anti--ACh receptor Myasthenia gravis Rheumatoid factor (antibody, most commonly IgM, specific to IgG Fc region), anti--CCP Rheumatoid arthritis Anti--glutamate decarboxylase Type 1 diabetes mellitus Anti--desmoglein Pemphigus vulgaris Anti--hemidesmosome Bullous pemphigoid Antimicrosomal, antithyroglobulin Hashimoto thyroiditis Antimitochondria! 1*< biliary cirrhosis Anti--smooth muscle Autoimmune hepatitis ALSO KNOW: LE cells Neutrophils with LE bodies seen in SLE, RA Penicillamine drug induced Hematoxilin bodies SLE endocarditis (Libmann-Sack) 'Wire-loop' lesions SLE type IV nephritis"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nTonsillar fossa is bounded anteriorly by\nA) Pharyngobasilar fascia\nB) Palatopharyngeal fold\nC) Buccopharyngeal fascia\nD) Palatoglossal fold", "output": "3, because Tonsilar fossa is bounded by Anterior - Palatoglossal fold containing palatoglossal muscle Posterior - Palatopharyngeal fold containing palato pharyngeal muscle Apex - Soft palate, where both arches meet Base - Dorsal surface of posterior one-third of tongue. (Ref: Anatomy of head, neck and brain. Vishram Singh. P 227 )"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\n\"Castration anxiety\" is seen in which phase of Sigmond Freud's psychosexual stages of development\nA) Oral\nB) Anal\nC) Phallic\nD) Genital", "output": "2, because Phallic phase (3-5years): Male child develops Oedipus complex (sexual feeling towards mother) and will be afraid that father may castrate him for this termed as \"Castration anxiety\"."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nShock causes:\nA) Stagnant hypoxia\nB) Anemic hypoxia\nC) Hypoxic hypoxia\nD) Histotoxic hypoxia", "output": "0, because Ans: A (Stagnant hypoxia)Ref: Pat GK, Hypoxia and Oxygen Therapy, In: Textbook of Medical Physiology, 2nd ed, Abuja Publishing House 2011: 94: 754-55Explanation:Refer the explanation of previous question"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nTwo or more parallel vertical surfaces of abutment teeth shaped to direct the prosthesis during placement and removal, are known as:\nA) Orientation plane\nB) Parallel block out\nC) Survey lines\nD) Guiding planes", "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\nCalcium silicate based material is:\nA) MTA\nB) Geristore\nC) Dieket\nD) Retroplast", "output": "0, because Mineral trioxide aggregate was developed by Dr Torabinejad in 1993.\u00a0\nIt contains tricalcium silicate, dicalcium silicate, tricalcium aluminate, bismuth oxide, calcium sulfate and tetracalcium aluminoferrite.\npH of MTA is 12.5.\n\nTextbook of Endodontics Nisha Garg 3rd 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\nWhich of the following statements about Total Infra\u2013Venous Anaesthesia (TIVA) is true \u2013\nA) Causes More Renal Toxicity\nB) Reduces Cerebral Metabolic Rate\nC) Risk of Malignant Hyperthermia is high\nD) Inhibits Hypoxic Pulmonary Vasconstriction", "output": "1, because Total intravenous anaesthesia refers to a technique in general anaesthesia using a compination of agents given solely by IV route and in the absence of all inhalation agents.\nTIVA (Total intravenous anaesthesia) is produced by IV propoful. Propofol decreases the cerebral metabolic rate.\nPropofol does not impair renal function, does not trigger malignant hyperthermia and does not inhibit hypoxic pulmonary vasoconstriction."}

{"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 Profound MR, IQ is\nA) 50-69\nB) 35-49\nC) 20-34\nD) < 20", "output": "3, because IQ range for categoriesICD-10DSM-IVMild50-6950-55 to 70Moderate35-4935-40 to 50-55Severe20-3420-25 to 35-40ProfoundBelow 20Below 20-25Reference: Oxford Textbook of Psychiatry; 3rd edition; Chapter 18; Learning Disability"}

{"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 iodinated compound is present in a maximum concentration in the thyroid?\nA) Monoiodotyrosine (MIT)\nB) Diiodotyrosine (DIT)\nC) T3\nD) Reverse T3", "output": "1, because THYROID HORMONE SYNTHESIS AND SECRETIONThyroid hormones are synthesized in the colloid, near the apical cell membrane of the follicular cells. Catalyzed by the enzyme thyroidal peroxidase, iodide in the thyroid cell is oxidized to iodine.The iodine enters the colloid and is rapidly bound at the 3 position to tyrosine molecules attached to thyroglobulin, forming monoiodotyrosine (MIT).MIT is next iodinated at the 5 position, forming diiodotyrosine (DIT).Two DIT molecules then condense in an oxidative process (\"coupling reaction\") to form one thyroxine (T4) molecule.Some T3 is probably formed within the thyroid gland by condensation of MIT with DIT. A small amount of reverse T3 (rT3) is also formed.In the normal thyroid, the average distribution of iodinated compounds is 23% MIT, 33% DIT, 35% T4, 7% T3, and 2% reverse T3."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nSilicosis caused by ?\nA) Gold\nB) Coal\nC) CO\nD) Silica", "output": "3, because Ans. is 'd' i.e., Silica"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nHuman development index includes -\nA) Crude death rate\nB) Life expectancy at one year\nC) Life expectancy at bih\nD) All", "output": "2, because Ans. is 'c' i.e., Life expectancy at bih According to 22nd/e of Park, options 'd & e' are not the components of HDI. o Expected years of schooling (not adult literacy rate) and GNI per capita (not GDP) are the components of HDI."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nOne of the constituents of the commonly used metered dose inhalers in bronchial asthma which is an air pollutant & dangerous to earth's stratosphere is -\nA) Flurocarbons\nB) Salbutamol\nC) Ozone\nD) Oxygen", "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\nH. capsulatum, a dimorphic fungus, is found in soil heavily contaminated with bird droppings. Which of the following statements best describes the presence of the organism in tissue biopsies?\nA) Yeasts with broad-based bud\nB) Single-cell yeasts with pseudohyphae\nC) Arthrospores\nD) Oval budding yeasts inside macrophages", "output": "3, because Histoplasma capsulatum is a dimorphic fungus that forms two types of spores: tuberculate macroconidia and microconidia. Inhalation of the microconidia transmits infection. Inhaled spores (microconidia) are engulfed by macrophages and develop into yeast forms. Most infections remain asymptomatic; small granulomatous foci heal by calcification. However, pneumonia can occur. The heterophile antibody test is useful for early diagnosis of infectious mononucleosis. The figure below illustrates the oval budding yeasts."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nBudding reproduction in tissue is seen in\nA) Cryptococcus, candida\nB) Candida, rhizopus\nC) Rhizopus, mucor\nD) Histoplasma, candida", "output": "0, because Cryptococcus is a yeast, candida is a yeast-like fungus. Both are reproduced by budding Histoplasma is a dimorphic fungus Mucor and Rhizopus are produced by asexual means sporangiospores Reference: Textbook of Microbiology; Baveja; 4th edition"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nTrue about polio:\nA) Paralytic polio is most common\nB) Spastic paralysis seen\nC) IM injections and increased muscular activity lead to increased paralysis\nD) Polio drops in pulse polio immunisation given only in <3 years old children", "output": "2, because False 90-95% of polio infections are asymptomatic False Acute flaccid paralysis is seen in Polio & not spastic paralysis True Risk of paralytic polio is increased by tonsillectomy, strenous physical exercise, tooth extraction,Injection (intramuscular) False OPV drops are given to all children less than 5 yr age in pulse polio immunisation"}

{"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 retention of dowel in a pin retained crown is increased by\nA) Increased length, smooth surface and increased taper.\nB) Increased length, serrated surface and increased taper.\nC) Increased length, smooth surface and parallel sides.\nD) Increased length, serrated surface and parallel sides.", "output": "3, because Post should be at least 2/3 the root length, parallel sided and serrated for increased retention in the canal"}

{"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 drugs can be administered by subcutaneous route?\nA) Albuterol\nB) Metaproterenol\nC) Terbutaline\nD) Pirbuterol", "output": "2, because terbutaline can be given as s.c (0.25mg) in asthma."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nMycosis fungoides which is not true:\nA) It is the most common form of cutaneous lymphoma.\nB) Pautriers microabscess.\nC) Indolent course and easily amenable to treatment.\nD) Erythroderma seen and spreads to peripheral.", "output": "2, because Mycosis Fungoides:\nMycosis fungoides is synonymous with Cutaneous T cell lymphoma."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nBacterial pyogenic parotitis affecting the parotid gland is most common after: March 2008\nA) Uveo-parotid fever\nB) Mumps\nC) Debilitation after major surgery\nD) After administration of iodine", "output": "2, because Ans. C: Debilitation after major surgery Acute bacterial parotitis is now infrequent, but its historical impoance. Mumps and bacterial parotitis were differentiated by 1800, but neither was effectively treated. The moality rate for bacterial parotitis was 80%. Before antibiotics and intravenous administration of fluids were available, bacterial parotitis occurred in postoperative patients or other severely ill patients who became dehydrated and contributed to their demise as an incurable sepsis."}

{"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 diagnosed as squamous cell intraepithelial lesion which of the following has the highest risk for progression to carcinoma;\nA) Low grade squamous intraepithelial neoplasia\nB) High grade squamous intraepithelial neoplasia\nC) Squamous intraepithelial associated with HPV 16\nD) Squamous intraepithelial neoplasia associated with HIV", "output": "1, because High grade squamous intraepithelial lesion have a propensity to progress and become invasive, therefore need investigations and treatment Ref: Shaw Gynecology 17 e pg 410."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAutosomal recessive polycystic kidney disease features include:\nA) Can be diagnosed intrauterine\nB) Proceeds to renal failure till children reaches school going age\nC) Can be palpated abdominally\nD) Hypertension doesn't develop until late stages of the disease", "output": "0, because Ans. A. Can be diagnosed intrauterineExplanationClinical features of ARPKD (Autosomal recessive polycystic kidney disease) are:Classic ARPKD is generally diagnosed in utero or within the neonatal period and characterized by greatly enlarged echogenic kidneys in diseased fetuses. (Option a)Reduced fetal urine production may contribute to oligohydramnios and pulmonary hypoplasia.About 30% of affected neonates die shortly after birth due to respiratory insufficiency. Close to 60% of mortality occurs within the first month of life.In the classic group, most patients are bom with renal insufficiency and ESRD (End stage renal disease). (Option b)However, infants often have a transient improvement in their GFR; death from renal insufficiency at this stage is rare.Some patients are diagnosed after the neonatal stage and form the older group. Morbidity and mortality in this group often involve systemic hypertension, progressive renal insufficiency, and liver manifestations.The hallmarks of ARPKD liver disease are biliary dysgenesis due to a primary ductal plate malformation with associated periportal fibrosis, namely congenital hepatic fibrosis (CHF) and dilatation of intrahepatic bile ducts (Caroli's disease). CHF and Caroli's disease can then lead to portal hypertension exhibiting hepatosplenomegaly, variceal bleeding, and cholangitis.Some patients with the diagnosis of ARPKD at 1 year of age with nephromegaly exhibit slowly declining renal function over 20 years with only minimally enlarged kidneys at ESRD (Option c and e) and markedly atrophic kidneys following renal transplantation.The slow progression of renal disease is likely due to increasing fibrosis rather than the development of cysts.Systemic hypertension is common in all ARPKD patients, even those with normal renal function. (option d)"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nYou are the medical officer in charge of the immunisation programme at a sub-centre and you are informed by the local ASHA worker that one of the children who was immunised has has been dizzy. On fuher investigation it was confirmed that the symptoms were due to anxiety of pain of the injection and not as a result of the vaccine. You would consider the incidence as:\nA) Vaccine reaction\nB) Injection reaction\nC) Programme error\nD) Coincidental", "output": "1, because The following are the adverse effect following immunisation: Vaccine reaction - Here the event is caused by the inherent propeies of the vaccine when given correctly. Programme error - In this case the event is as a result of error in preparation, handling or administration of the vaccine. Coincidental - The event after immunisation is not caused by the vaccine but by a chance association. Injection reaction - The anxiety of the pain an injection itself may cause hyperventilation, dizziness etc. This is not a result of the vaccine and is called injection reaction. Ref: Park, 21st Edition, Page 103, 107."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nBicipital aponeurosis lies over which structure in cubital fossa:-\nA) Median cubital vein\nB) Radial nerve\nC) Brachial aery\nD) Anterior interosseous aery", "output": "2, because Bicipital aponeurosis lies superficial to the brachial aery and median nerve. -lies deep to superficial veins. -provides protection for the deeper structures during venepuncture at cubital fossa. -routinely released to decompress the median nerve"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nPostponing paying attention of conscious impulse or conflict is a mature defence mechanism known as -\nA) Sublimation\nB) Suppression\nC) Humor\nD) Anticipation", "output": "1, because Suppression is pushing of unwanted feelings into unconscious which has reached conscious awareness."}

{"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 site of perforation during colonoscopy is -\nA) Caecum\nB) Hepatic flexure\nC) Splenic flexure\nD) Sigmoid colon", "output": "3, because \u2022 Risks of colonoscopy: Perforation and hemorrhage\n\u2022 MC site of bleeding after colonoscopy: Stalk after polypectomy.\n\u2022 MC site of perforation during colonoscopy: Sigmoid colon\n\u2022 Perforation can be caused by excessive air pressure, tearing of the antimesenteric border of the colon from excessive pressure on colonic loops, and at the sites of electrosurgical applications"}

{"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 74-year-old woman develops occipital headache, vomiting, and dizziness. She looks unwell, her blood pressure is 180/100 mm Hg, pulse is 70/min, and respirations are 30/min. She is unable to sit or walk because of unsteadiness. Over the next few hours, she develops a decline in her level of consciousness.For the above patient with altered level of consciousness, select the most likely diagnosis.\nA) basal ganglia hemorrhage\nB) cerebellar hemorrhage\nC) pontine hemorrhage\nD) lobar intracerebral hemorrhage", "output": "1, because Cerebellar hemorrhage, when mild, may present with only headache, vomiting, and ataxia of gait. Patients may complain of dizziness or vertigo. The eyes may be deviated to the side opposite the hemorrhage. Nystagmus is not common, but an ipsilateral sixth nerve palsy can occur. This is the only type of intracerebral hemorrhage that commonly benefits from surgical intervention."}

{"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 an uricosuric drug-\nA) Allopurinol\nB) Probenecid\nC) Indomethacin\nD) Aspirin", "output": "1, because Ans. is 'b' i.e., Probenecid Uricosuric drugs are probenacid, sulfinpyrazone and benzbromarone."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nAfter an incised wound ,new collagen fibrils are seen along with a thick layer of growing epithelium.The approximate age of the wound is\nA) 4-5days\nB) About 1week\nC) 12-24hrs\nD) 24-48 hrs", "output": "0, because Ref Robbins 9/e p106 Incised wound for the formation of collagen and new tissue, thick layer of epithelial ,and granulation tissue formation along with new blood vessels requires atleast 4_5 days"}

{"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 delivery, a 28 year old pre ecclamptic primigra has a soft uterus with moderate-to-heavy bleeding. There is no laceration and there is PPH diagnosed due to uterine atony. Which of the following is the best management option?\nA) 0.2-mg intramuscular (IM) ergonovine (Methergine)\nB) 20 units of IV oxytocin\nC) 10 units of oral oxytocin\nD) 250 mg prostaglandin F2-alpha orally", "output": "1, because Ergot derivatives should not be given in patients with hypeension since this is classically known to increase blood pressure. A high BP may provoke a post paum ecclampsia Oxytocin is not orally effective . Prostaglandin F2-alpha is given IM."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nTrendlenburg's test done for varicose veins is for detection of:\nA) Perforator in competency\nB) Deep veins patency\nC) Saphenofemoral incompetency\nD) Site of perforators", "output": "2, because Ans: C (Saphenofemoral incompetency) Ref : 74 A Manual on Clinical Surgery S. DasExplanation:Clinical Examination of Varicose VeinsBrodie-Trendelenherg TestDone to determine the incompetency of Saphenofemoral valve.Patient is placed in recumbent position.Limbs are raised to empty the veins. Veins are milked proximally for further emptying.Saphenofemoral junction is compressed either with the thumb of the examiner/toumiquet and the patient is asked to stand up quickly.There are two variants of this test.The first method is to assess saphenofemoral incompetency. The pressure is released and if the column of blood fills up quickly from above downwards it indicates saphenofemoral incompetency.The second method is to assess the perforators. Here, the pressure is maintained for one minute. Gradual filling of the veins during this period indicates incompetent perforators allowing reflux of blood from deep veins to superficial veins.Positive Brodie--Trendelenberg test i~ an indication for surgery.Tests to Assess Saphenofemoral IncompetencyBrodie -Trendelenberg testMorrisey's cough impulse testTests to Assess Deep VeinsPerthe's testModified Perthe's testTests to Assess PerforatorsMultiple tourniquet testPratt's testFegan's testBrodie-Trendelenberg testTest to Assess V alves in Superficial VeinSchwartz testNote:Even though Brodie-Trendelenberg test is used to assess both saphenofemoral incompetency and incompetent perforators its primary purpose is to assess saphenofemoral incompetency."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nArrange the following 4 enzymes of gluconeogenesis in sequence: A. Pyruvate carboxylase B. Glucose - 6 - phosphatase C. Phosphoenol pyruvate carboxy kinase D. Fructose 1,6 Bisphosphatase\nA) D-C-A-B\nB) A-C-D-B\nC) B-A-D-C\nD) C-D-B-A", "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\nSpecific poison for succinate dehydrogenase is ?\nA) Cyanide\nB) Malonate\nC) Arsenite\nD) Fluoride", "output": "1, because B i.e. Malonate"}

{"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 widespread zoonotic disease in the world is -\nA) Rabies\nB) Leptospirosis\nC) Brucella\nD) Anthrax", "output": "1, because <p> Leptospirosis is the most wide zoonotic disease in the world. Reference:Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:291. <\\p>"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nPost operative muscle ache is caused by\nA) d-TC\nB) Suxamethonium\nC) Gallamine\nD) Pancuronium", "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\nBlood stained sputum may be the only symptom in?\nA) Bronchiectasis\nB) Carcinoma bronchus\nC) Adenoma bronchus\nD) Pulmonary T.B.", "output": "2, because Ans. is 'c' i.e., Adenoma bronchus"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nInherited hyperammonemia is a result of deficiency of which enzyme of Krebs-Henseleit urea cycle?\nA) Malate dehydrogenase\nB) Isocitrate dehydrogenase\nC) N-acetyl glutamate synthetase\nD) Succinate dehydrogenase", "output": "2, because Inherited hyperammonemias are a group of six diseases caused by inborn deficiencies of the enzymes of the Krebs-Henseleit urea cycle. The enzymes involved are: 1. N-acetyl glutamate synthetase 2. Arbamyl phosphate synthetase (CPS) 3. Ornithine transcarbamylase (OTC) 4. Argininosuccinic acid synthetase (citrullinemia) 5. Argininosuccinase deficiency 6. Arginase deficiency Most Severe Cases: In the most severe forms of the hyperammonemic disorders, the infants are asymptomatic at bih and during the first day or two of life, after which they refuse their feedings, vomit, and rapidly become inactive and lethargic, soon lapsing into an irreversible coma. Profuse sweating, focal or generalized seizures, rigidity with opisthotonos, hypothermia, and hyperventilation have been observed in the course of the illness. These symptoms constitute a medical emergency, but even with measures to reduce serum ammonia, the disease is usually fatal. Ref: Ropper A.H., Samuels M.A. (2009). Chapter 37. Inherited Metabolic Diseases of the Nervous System. In A.H. Ropper, M.A. Samuels (Eds), Adams and Victor's Principles of Neurology, 9e."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nPunishment for infanticide comes under -\nA) IPC102\nB) IPC324\nC) IPC302\nD) IPC300", "output": "2, because Ref:Textbook of forensic medicine and toxicology (V.V.Pillay) 17th edition, page no.377 Infanticide refers to the deliberate killings of chlid below the age of one year.In England, Germany, UK, there is a clear-cut distinction between homicide and infanticides. In India, no such distinction exists, and accuse is punished under sec.302IPC,the same manner as in murder."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nCarotid artery stenosis screening invivo choice is -\nA) USG\nB) CT\nC) MRI\nD) Doppler", "output": "3, because Ans. is 'd' i.e., Doppler o Color doppler ultrasonography is the screening method of choice (not simple USG : option a is incorrect),o Carotid angiography is the investigation of choice for diagnosis,o MRI is the investigation of choice for demyelinating disorder, e.g. multiple sclerosis.Investigations in nervous systemo Investigation of choice for white matter disease - MRI (CT is second choice),o Investigation of choice of acoustic neuroma - GD enhanced MRIo Best investigation for all brain tumors - Contrast enhanced MRIo Investigation of choice for meningeal carcinomatosis - Contrast (gadolinium) enhanced MRI.o Investigation of choice for posterior fossa tumor - MRIo Investigation of choice for para meningeal rhabdomyosarcoma - MRIo Investigation of choice for nasopharyngeal angiofibroma - Contrast enhanced CT.o Investigation of choice for hydrocephalus in older patients and for low pressure hydrocephalus - MRI.o Investigation of choice for acute (<48hrs) subarachnoid hemorrhage (SAH) - Non-Contrast CT scan,o Investivation of choice to know the etiology of SAH - Four vessels digital substruction angiography.o Hallmark of SAH - Blood in CSF on lumbar puncture,o Investigation of choice for chronic SAH - MRI.o Primary procedure of choice for evaluating intracranial complications of acute head injury - CT scan,o Best modality for assessing fractures of the skull base, calvarium and facial bone - CT scan,o Investigation of choice for demyelinating disorders MRI.o Investigation of choice for AV malformation and aneurysm - Angiography (MRI angiography or CT angiography),o Investigation of choice for Craniospinal infection - MRIo Investigation of choice for all intrinsic spinal cord lesions; all causes of cord compression - MRI.o Procedure of choice for emergent evaluation of acute intracerebral hemorrhage - CT scan,o Investigation of choice for myelopathy - MRI.o Shape of epidural hematomas on imaging - Biconvex, hyperdense or mixed density.o Shape of acute subdural hematoma on imaging - Crescent-shaped, hyperdense or mixed density ,o Chronic subdural hematoma on imaging - Hypodense.o Most sensitive test for ischaemic stroke - Diffusion weighted (DW) MRI."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nProposed guideline value for Radioactivity in drinking water is:\nA) Gross a activity 0.1 Bq/L and Gross b activity 1.0 Bq/L\nB) Gross a activity 1.0 Bq/L adn Gross b activity 0.1 Bq/L\nC) Gross a activity 1.0 Bq/L and Gross b activity 10.0 Bq/L\nD) Gross a activity 10 Bq/L and Gross b activity 1.0 Bq/L", "output": "0, because Key guidelines aspects of WHO recommended drinking water quality: Colour <15 true colour units (TCU) Turbidity <1 nephlometric turbidity units (NTU) pH: 6.5-8.5 Total dissolved solids (TDS) <500 mg/Litre Zero pathogenic microorganisms Zero infectious viruses Absence of pathogenic protozoa and infective stages of helminthes Fluoride <1.0 ppm (0.5-0.8 ppm: Optimum level) Nitrates <45 mg/Litre Nitrites <3 mg/Litre Gross alpha radiological activity <0.5 Bq/Litre (new guidelines -WHO) Gross Beta radiological activity <1.0 Bq/Litre (new guidelines-WHO) Ref: Park 25th edition Pgno: 762"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nLens develops from?\nA) Endoderm\nB) Mesoderm\nC) Surface ectoderm\nD) Neuroectoderm", "output": "2, because Ans. c (Surface ectoderm). (Ref. Human Embryology by IB Singh, 6th/352)LENS# LENS develops from surface ectoderm.# Compared to the cornea, it has a much lower converging power of 17 diopters because of the relatively similar refractive indices of aqueous humor, lens, and vitreous body (cornea 42 D).# However, the lens is the only part of the refractive apparatus that is adjustable.# Adjustment to near vision (accommodation) therefore involves only the lens.# In addition, the lens functions as a UV filter for wavelengths between 300 and 400 nm and thus has a protective function for the macula.# Notching of the lens = \"pseudocoloboma\".# Wilson's disease can induce a yellow-green lens discoloration (chalcosis/ sunflower cataract).# Granular gold deposits located under the lens (chrysiasis lends) can occasionally occur after prolonged treatment with gold preparations (e. g. in primary chronic polyarthritis ).# Other medications, e.g., amiodarone or chlorpromazine, are sometimes deposited in the lens.# In patients with cataract, glittering cholesterol crystals are not infrequently found in the lens (so-called Christmas tree/ decoration cataract)."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nFeatures of neurogenic shock are\nA) \u2191Peripheral resistance \u2193 cardiac output\nB) \u2191 Venous return \u2191 cardiac output\nC) \u2193Peripheral resistence\u2193cardiac output\nD) Venoconstriction \u2193cardiac output", "output": "2, because None"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nPalm of one hand is placed horizontally across the mouth and nostrils in\nA) Manual strangulation\nB) Palmar strangulation\nC) Garrotting\nD) Mugging", "output": "1, because palmar strangulation Here the palm of one hand is placed horizontally across the mouth and nostrils, it's pressure being reinforced by placing the other palm on the top of it at right angles, the heel of the palm above pressing upon the front of the neck. Ref: TEXTBOOK OF FORENSIC MEDICINE AND TOXICOLOGY KRISHNAN VIJ FIFTH EDITION PAGE 134"}

{"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 RDS all of the following statements are true except\nA) Usually occurs in infants born before 34 weeks of gestation\nB) Is more common in babies born to diabetic mothers\nC) Leads to cyanosis\nD) Is treated by administering 100% oxygen", "output": "3, because Administration of 100% oxygen may increase the O2 load on fetal lung tissue. Hence, it is not given . 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 multi question.\n\nNational program for prevention and control of Cancer, Diabetes, Cardiovascular disease and stroke (NPCDCS), true is -\nA) Separate centre for stroke, DM, cancer\nB) Implementation in some 5 states over 10 districts\nC) District hospital has specialised facilities\nD) Subcentre has facility for diagnosis and treatment", "output": "2, because Ans. is 'c' i.e., District hospital has specialised facilities Sational program for prevention and control of cancer, diabetes, cardiovascular diseases and stroke (NPCDCS1 Introduction Single centre fi- cancer, diabetes, cardiovascular disease, stroke. 100 districts in 21 states being covered in 1 1 th live year plan. 20,000 subcentres and 700 community health centres (CHCs) covered. o Activities as sub-centres Health promotion for behaviour and lifestyle change. Oppounistic screening of BP. blood glucose (strip method) in age > 30 years. Referral to CHC of cases of DM, HT. o Activities at CHCs : Diagnosis and management at NCD clinic. Home visits by nurse for bedridden cases. Referral to district hospital for complicated cases. o Activities as District hospital : Health promotion Screening of population > 30 years. Diagnosis and management of cardiovascular disease. Home-based palliative care for chronic, debilitating progressive patients. Specialized facilities. Urban health check-up shceme JOr diabetes and high BP : Screen urban slum population. Screen population > 30 years and pregnant females. Cancer control in NPCDCS : Regional cancer control scheme : Regional cancer centres to act as referral centres for complicated cases. Oncology wing development scheme. Decentralized NGO scheme : IEC activities and early cancer detection. lEC at central level. Research and mining."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAll of the following are ACTH independent Cushing syndrome except :\nA) Pituitary adenoma\nB) Adrenal hyperplasia\nC) Adrenocoical carcinoma\nD) McCune Albright Syndrome", "output": "0, because ACTH dependent Cushing syndrome is caused by : ACTH producing pituitary adenoma Ectopic ACTH Bronchial or pancreatic carcinoid Small cell cancer of lung Medullary carcinoma of thyroids Pheochromocytoma ACTH Independent Cushing syndrome is caused by : Adrenocoical adenoma/ carcinoma Primary pigmented nodular adrenal disease Adrenal hyperplasia McCune Albright Syndrome Petrosal/Peripheral ACTH ratio > 2 indicates the presence of a pituitary adenoma-secreting ACTH. NOTE: Overall the most common cause of Cushing's syndrome is Iatrogenic steroids but if asked regarding ACTH dependent cause then answer should be given as Pituitary adenoma."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nHereditary spherocytosis is characterized by: March 2004\nA) Anemia\nB) Splenomegaly\nC) Jaundice\nD) All of the above", "output": "3, because Ans. D i.e. All of the above"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nKetamine can be given by all of following routes except-\nA) IV\nB) IM\nC) SC\nD) Nasally", "output": "2, because Ketamine has been administered intravenously, orally , rectally, intramuscularly and epidural route and very rare intranasal but not subcutaneous"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAll of the following are features of Devic's syndrome (neuromyelitis optica), except?\nA) Separate attacks of acute optic neuritis and myelitis\nB) Optic neuritis is either unilateral or bilateral\nC) Brain MRI is typically normal\nD) It has a fulminant demyelinating process and progress to death in 1-2 year", "output": "3, because Devic's disease is a variant of multiple sclerosis. Fulminant demyelinating process is seen with another variant called Marburg's variant."}

{"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 true about calcification of teeth?\nA) Calcification of primary teeth is almost complete at time of birth\nB) Calcification of all primary teeth and few permanent teeth complete at birth\nC) Calcification of all permanent teeth complete at birt\nD) Calcification of primary teeth starts around birth", "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 7 years old boy presented with painful boggy swelling of scalp, multiple sinuses with purulent discharge, easily pluckable hairs and lymph nodes enlarged in occipital region. Which one of the following would be most helpful for diagnostic evaluation?\nA) Bacterial culture\nB) Biopsy\nC) KOH mount\nD) Patch test", "output": "2, because Ans. c. KOH mount"}

{"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 seen in Hyperparathyroidism except\nA) Subperiosteal erosion of bone\nB) Loss of lamina dura\nC) Calvarial thickening\nD) Pepper - pot skull", "output": "2, because Calvarial thickening is a feature of Hypoparathyroidism."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nSpore forming anaerobic gram positive bacilli ?\nA) Bacillus Anthracis\nB) Clostridia\nC) Corynebacterium\nD) Peptostreptococcus", "output": "1, because Ans. is 'b' i.e., Clostridia There are two medically impoant spore forming bacteria. Both of them are 'gram positive' `bacilli' :-Aerobic : BacillusAnaerobic (obligate anaerobes) : Clostridia."}

{"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 Falciparum Malaria is:-\nA) Chloroquine\nB) Mefloquine\nC) ACT\nD) Proguanil", "output": "2, because DOC for Falciparum Malaria - ACT.( Aemisinin based Combination therapy ) In Noh Eastern states:- ACT-AL co-formulated tablet of Aemether-20 mg / Lumefantrine - 120 mg. Primaquine 0.75 mg/ kg Body weight on day 2. 2. In Other States:- ACT-SP -Aesunate 50 mg tablet for 3 days and Sulphadoxine (500mg) - Pyremethamine (25mg) tablets for 1 Day. Primaquine tablets should be given on Day 2."}

{"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 causes of white-dot syndrome except:\nA) Fuch's heterochromic uveitis\nB) VKH syndrome\nC) HIV retinopathy\nD) Sympathetic ophthalmitis", "output": "3, because Ans. Sympathetic ophthalmitis"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nMaximum flow of Type1 inlay wax at 45degree\nA) 2%\nB) 3%\nC) 10%\nD) 70%", "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\nPlatypnea is seen with?\nA) Hepato-pulmonary syndrome\nB) Hepato-renal syndrome\nC) Renal aery stenosis\nD) Kyphoscoliosis", "output": "0, because Platypnea: Increase dyspnea on sitting position Seen in 1. Atrial myxoma 2. Hepatopulmonary syndrome"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nNeuro lathyrism results due to\nA) Aflatoxin\nB) Pyruvic acid\nC) BOAA\nD) Sanguinarine", "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\nFactor V Leiden is caused due to a mutation that results in a substitution at position 506 glutamine to which of the following:\nA) Alanine\nB) Arginine\nC) Glycine\nD) Glutamine", "output": "1, because Mutation in factor V (called the Leiden mutation, after the city in the Netherlands where it was discovered) causes recurrent DVTs. The mutation results in a glutamine to arginine substitution at position 506 that renders factor V resistant to cleavage by protein C. As a result, an impoant antithrombotic counter-regulatory pathway is lost Ref: Robbins 8th edition Chapter 4."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nKunkel's test is done to demonstrate presence of ................. in blood.\nA) Lead\nB) CuSO4\nC) CO\nD) Dhatura", "output": "2, because Carbon monoxide (CO)"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nIn which case cystometric study is indicated -\nA) Neurogenic bladder\nB) Stress incontinence\nC) Fistula\nD) Urge incontinence", "output": "0, because Cystometric studies are urodynamic studies in which the pressure changes in the bladder is simultaneously measured with bladder filling and during micturition.\nIt helps in accurate assessment of detrusor and sphincter activity especially if a neurogenic abnormality is suspected.\nThough it is also used in stress incontinence but the aim here is to rule out any neurogenic cause."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nFish tank granuloma is seen in -\nA) Mfortuitum\nB) Mkansasi\nC) Mmarinum\nD) M leprosy", "output": "2, because Ans. is 'c' i.e., M. Marinum o Fish tank granulomaalso called ' swimming pool granuiomaf is caused by M. marinum.Principal types of opportunist mycobacterial disease in man and the usual causative agents.DiseasesUsual causative agentLymphadenopathyM. avium complexM. scrofulaceumSkin lesionPost-trauma abscessSwimming pool granulomaBuruli ulcerM. chelonaeM.fortuitumM. terraeM.marinumM. ulceransPulmonary' diseaseM. avium complexM. kansasiiM.xenopiM.malmoenseDisseminated diseaseAIDS-relatedM, avium complexM.genevenseM.avium complexM. chelonae"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nTYNDALLISATION is a type of\nA) intermittent sterilization\nB) pasteurisation\nC) boiling\nD) autoclaving", "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 49-year-old female taking ibuprofen for increasing joint pain in her hands presents with increasing pain in her midsternal area. Gastroscopy reveals multiple, scattered, punctate hemorrhagic areas in her gastric mucosa. Biopsies from one of these hemorrhagic lesions reveal mucosal erosions with edema and hemorrhage. No mucosal ulceration is seen.\nA) Active chronic gastritis\nB) Acute gastritis\nC) Autoimmune gastritis\nD) Chronic gastritis", "output": "1, because Gastritis is a nonspecific term that describes any inflammation of the gastric mucosa. Acute gastritis refers to the clinical situation of gastric mucosal erosions (not mucosal ulcers). Acute gastritis is also known as hemorrhagic gastritis or acute erosive gastritis. Acute gastritis is associated with the use of nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and coicosteroids, and also with alcohol, chemotherapy, ischemia, shock, and even severe stress. Two types of stress ulcers are Curling's ulcers, seen in patients with severe burns, and Cushing's ulcers, seen in patients with intracranial lesions. Grossly acute gastritis appears as multiple, scattered, punctate (less than 1 cm) hemorrhagic areas in the gastric mucosa. This is helpful in differentiating acute gastritis from peptic ulcers, which tend to be solitary and larger. Microscopically the gastric mucosa from a patient with acute gastritis is likely to reveal mucosal erosions, scattered neutrophils, edema, and possibly hemorrhage. Acute gastritis. Erosion and complete effacement of the epithelium is observed. The residual glands, on the left, display regenerative changes with basophilic epithelium. Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nSedimentation coefficient of Ig E is:\nA) 7S\nB) 8S\nC) 11S\nD) 20 S", "output": "1, because Ans : b 8S Ref: Ananthanarayanan 8th editionSvedberg unit - a sedimentation constant of 1 x 1013sec. Sedimentation unit is studied by ultracentrifugation - for diversity of antibody moleculeIgG -7IgA -7IgM -19Ig D -7IgE -8"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nDNA dependent RNA synthesis is inhibited by:\nA) Rifampicin\nB) Ethambutol\nC) Colchicine\nD) Chloromycetin", "output": "0, because Rifampicin"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nIliac crest involvement is common in which condition: March 2007\nA) Ankylosing spondylitis\nB) Rheumatoid ahritis\nC) Reiter's syndrome\nD) Osteoahritis", "output": "0, because Ans. A: Ankylosing Spondylitis The basic pathologic lesion of ankylosing spondylitis occurs at the entheses, which are sites of attachment to bone of ligaments, tendons, and joint capsules. Enthesopathy results from inflammation, with subsequent calcification and ossification at and around the entheses. Inflammation with cellular infiltration by lymphocytes, plasma cells, and polymorphonuclear leukocytes is associated with erosion and eburnation of the subligamentous bone. The process usually stas at the sacroiliac joints. Other enthesopathic sites include the iliac crest, ischial tuberosity, greater trochanter, patella, and calcaneum. Ankylosing spondylitis/ AS/ Bechterew's disease/ Bechterew syndrome/ Marie Strumpell disease/Spondyloahritis is a chronic, painful, degenerative inflammatory ahritis primarily affecting spine and sacroiliac joints, causing eventual fusion of the spine. AS is a systemic rheumatic disease and one of the seronegative spondyloahropathies. About 90% of the patients express the HLA-B27 genotype. Men are affected more than women by a ratio in excess of 10:1. Typical signs of progressed AS are the visible formation of syndesmophytes on X-rays and abnormal bone outgrowths similar to osteophytes affecting the spine. Complete fusion results in a complete rigidity of the spine, a condition known as bamboo spine. In 40% of cases, ankylosing spondylitis is associated with iridocyclitis causing eye pain and photophobia. 4.1 AS is also associated with ulcerative colitis, Crohn's disease, psoriasis, and Reiter's disease Other complications are aoic regurgitation, Achilles tendinitis, AV node block and amyloidosis & restrictive lung disease. A clinical examination and X-ray studies of the spine, which show characteristic spinal changes and sacroiliitis, are the major diagnostic tools. The Schober's test is a useful clinical measure of flexion of the lumbar spine performed during examination."}

{"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 40-year-old man presents with a 2-week history of recur- rent oral ulcers, genital ulcers, intermittent arthritic pain of the knees, and abdominal pain. Physical examination reveals shallow ulcerations of the mucosa of the glans penis, as well as oral aphthous ulcers and conjunctivitis. Which of the following is the most likely diagnosis?\nA) Behyet disease\nB) Genital herpes\nC) Gonorrhea\nD) Polyarteritis nodosa", "output": "0, because Behget disease is a systemic vasculitis characterized by oral aphthous ulcers, genital ulceration, and ocular inflammation, with occasional involvement of the nervous, gastrointestinal, and cardiovascular systems. The mucocutaneous lesions show a non-specific vasculitis of arterioles, capillaries, and venules. The cause of the necrotizing inflammation of small blood vessels is not known, but an association with specific HLA subtypes suggests an immune basis. Herpes (choice B) does not present with arthritis.Diagnosis: Behqet disease"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAbout biotransformation not true ?\nA) Active metabolite generation\nB) Polar to less polar\nC) Less polar to more polar\nD) Generate active drug from prodrug", "output": "1, because Ans. is 'b' i.e., Polar to less polar"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nIn which phase of cell cycle, proof reading occurs?\nA) G1\nB) S\nC) G2\nD) M", "output": "1, because EVENTS PHASE of cell cycle Proofreading S phase Most repairs G1 phase Mismatch repair G2 phase"}

{"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 number of ATPs generated in krebs cycleare ?\nA) 12\nB) 24\nC) 15\nD) 30", "output": "1, because Ans. is 'b' > b' i.e., 24 One turn of the TCA cycle, staing with acetyl CoA produces 10 ATPs. When the staing molecule is pyruvate, the oxidative decarboxylation of pyruvate, the oxidative decarboxylation of pyruvate yields 2.5 ATPs and therefore, 12.5 ATPs are produced when staing compound is pyruvate. Since, two molecules of pyruvate enter the TCA cycle when glucose is metabolized (glycolysis produces 2 molecules of pyruvate), the number of ATPs is doubled. Therefore, 25 ATP molecules, per glucose molecule, are produced when pyruvate enters the TCA cycle.Note : Previously calculations were made assuming that NADH produces 3 ATPs and FADH generates 2 ATPs. This will amount a net generation of 30 ATP molecules in TCA per molecule glucose and total 38 molecules from staing. Recent experiments show that these values are overestimates and NADH produces 2.5 ATPs and FADH produces 1.5 ATPs. Therefore, net generation during TCA is 25 ATPs and complete oxidation of glucose through glycolysis plus citric acid cycle yield a net 32 ATPs.Energy yield (number of ATP generated) per molecule of glucose when it is completely oxidized through glycolysis plus citric acid cycle, under aerobic conditions, is as follows :- Method ofNo of ATPsNo of ATPsPathwayStepEnzymeSource ATP formationgained perglucose(new calculation)As per oldcalculationGlycolysis1Hexokinase MinusMinus 1Do3Phosphofructokinase MinusMinus 1Do5Glyceraldehyde-3-p DHNADH Respiratory chain2.5 x 2 = 53 x 2 = 6Do61,3-BPGkinase ATPSubstrate level1 x 2 -- 21 x 2 = 2Do9Pyruvate kinaseATP Substrate level1 x 2 = 21 x 2 = 2Pyruvate to?PyruvateNADH Respiratory chain2.5x2= 53x2= 6Acetyl CoA Dehydrogenase TCA cycle3Isocitrate DHNADH Respiratory chain2.5x2= 53 x 2= 6Do4Alpha keto glutarate DHNADH Respiratory chain2.5x2= 53x2= 6Do5Succinate thiokinaseGTP Substrate level1 x 2 = 21 x 2 = 2Do6Succicinate DHFADH2Respiratory chain1.5x2= 32 x 2= 4Do8Malate DHNADH Respiratory chain2.5x2= 53 x 2= 6Net generation in glycolytic pathway 9 minus 2= 7 10 minus 2= 8Generation in pyruvate dehydrogenase reaction 5 * 6Generation in citric acid cycle 20 * 24Net generation of ATP from one glucose mole 32 * 38"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nChild with mild squint. Intrauterine, bih history, developmental history till date all normal. Corneal reflex normal. All other eye parameters normal except exaggerated epicanthal fold. Diagnosis ?\nA) Pseudostrabismus\nB) Accomodative squint\nC) Exophoria\nD) Esophoria", "output": "0, because Ans. is 'a' i.e., Pseudostrabismus Epicantnic fold causes Pseudoesotropia (Pseudostrabismus)."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nPain-sensitive intracranial structure is:\nA) Piamater\nB) Pial vassels\nC) Duramater\nD) Brain matter", "output": "2, because C i.e.Duramater"}

{"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 used for iron poison in: FMGE 09; NEET 13\nA) Magnesium hydroxide\nB) Desferrioxamine\nC) Gastric lavage\nD) Penicillamine", "output": "3, because Ans. Penicillamine"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nPosterior relations of the head of the pancreas include all of the following, except:\nA) First pa of the duodenum\nB) Common bile duct\nC) Inferior vena cava\nD) Aoa", "output": "0, because The posterior relations of the head of the pancreas include the common bile duct, inferior vena cava and the right and left renal veins terminating into it. The first pa of the duodenum is an anterior relation of the head of the pancreas.Ref: Clinical Anatomy, By Richard S. Snell, 6th edition, Page 230; Clinical Anatomy (A Problem Solving Approach), By Neeta V Kulkarni, 2nd edition, Page 689."}

{"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 events is involved in cleavage of the zygote during week 1 of development?\nA) A series of meiotic divisions forming blastomeres\nB) Production of highly differentiated blastomeres\nC) An increased cytoplasmic content of blastomeres\nD) A decrease in size of blastomeres", "output": "3, because Cleavage is a series of mitotic divisions by which the large amount of zygote cytoplasm is successively paitioned among the newly formed blastomeres. Although the number of blastomeres increases during cleavage, the size of individual blastomeres decreases until they resemble adult cells in size."}

{"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 female child with virilization, hypertension with low plasma renin diagnosis is :\nA) 21\u03b1 hydroxylase deficiency\nB) 11 \u03b2 hydroxylase deficiency\nC) 3\u03b2 hydroxylase deficiency\nD) Conn\u2019s syndrome", "output": "1, because 9] Congenital adrenal hyperplasia represents a group of autosomal recessive inherited, metabolic errors,\neach characterized by decency or total lack of a particular enzyme involved in the biosynthesis of cortical steroids,\nSteroidogenesis is then channelled into other pathways leading to increased production of androgens,\nwhich accounts for virilization.\nSimultaneously, the decency of cortisol results in increased secretion of ACTH resulting in adrenal hyperplasia.\nFollowing enzymes are implicated in the congenital adrenal hyperplasia 21 \u03b1 hydroxylase decency (partial or complete) 17 \u03b1 hydroxylase deficiency 11\u03b2 hydroxylase\ndeficiency 21 \u03b1 hydroxylase deficiency\n\u2022 Two forms of this deficiency include -\nA. Salt-wasting adrenogenital ism\nB. Simple Virilizing adrenogenital ism\nA) Salt-wasting syndrome (complete lack) The salt wasting syndrome results from complete lack of 21 hydroxylases.\nThere is no synthesis of mineralocorticoids and glucocorticoids in the adrenal cortex.\nDecreased mineralocorticoids causes marked sodium loss in the urine, resulting in hyponatremia, hyperkalemia, acidosis and hypotension.\nBecause of the enzyme block, there is increased formation of 17 - hydroxyprogesterone, which is then shunted into the production of testosterone.\nThis may cause virilism (pseudo-hermaphroditism) in female infants.\nThat is (XX) Female with 21 hydroxylase deficiency develops ovaries,\nfemale ductal structures and external male genitalia. But in the male child, the effect of increased testosterone will not be manifested at the time of birth.\nThe complete21 hydroxylase deficiency or salt wasting syndrome usually comes to light only after the birth because in utero the electrolytes and uids\ncan be maintained by maternal kidneys. Males with this disorder comes to clinical attention 5 to 15 days later because of salt losing crisis while\nfemales come to attention soon after the birth because of the virilization.\nB) Simple Virilizing adrenogenital syndrome (Partial deficiency) Occurs in individuals\nwith partial deficiency of 21 hydroxylases Less severe deficiency of mineralocorticoid, is sufficient for salt reabsorption, but the lowered glucocorticoid fails to cause\nfeedback inhibition of ACTH secretion.\nThus level of aldosterone is mildly reduced, testosterone is increased and ACTH elevated with resultant adrenal hyperplasia.\n11B hydroxylase deficiency-. Rare Leads to decreased cortisol and increased ACTH.\nThis, in turn, leads to the accumulation of DOC (deoxycorticosterone) and 11 deoxycortisol\nboth of which are strong mineralocorticoids. This results in increased sodium retention by the kidneys and hypertension, hypokalemia.\nPatients also develop virilization due to androgen excess. 17 \u03b1 hydroxylase deficiency - Patients with deficiency of 17 hydroxylases also have impaired cortisol production,\nincreased ACTH and secondary increased DOC.\nThese patients, however, cannot synthesize normal amount of androgens and estrogens.\nThis is because the gene that codes for 17 \u03b1 hydroxylase is the same for the enzyme in the adrenal cortex and the gonads and the decency is same in both organs.\nBecause of decreased sex hormones, genotypic females develop primary amenorrhoea and fail to develop secondary sex characteristics while genotypic\nmales will present as pseudohermaphrodite.\n3 \u03b2 hydroxylase deficiency 3-\u03b2 hydroxylase deficiency is a rare genetic disorder of steroid biosynthesis that results\nin decreased production of all three groups of adrenal steroids which include mineralocorticoid, glucocorticoid and sex steroids.\nDecreased mineralocorticoid secretion\nresults in varying degrees of salt wasting in both males and females.\nDecent androgen production results in ambiguous genitalia in males\nThe usual presentation is a male child with ambiguous genitalia and severe salt wasting. Sometimes it may also occur in females"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\n'Patterned' abrasion is variety of:\nA) Linear abrasion\nB) Pressure abrasion\nC) Sliding abrasion\nD) Superficial bruise", "output": "1, because Ans. is 'b' ie pressure abrasion (Ref: Parikh; 6/e, p4.3).An abrasion is a superficial injury involving only the superficial layers of the skin (epidermis only), caused by friction and / or pressure between the skin and some rough object or surface. It bleeds very slightly, heals rapidly in a few days and leaves no scar.They can be classified into 3 types, depending on the manner they are created.ScratchIs a linear injury produced by a sharp object, such as pin, thorn or finger nail.Graze (Sliding, scraping or grinding abrasion).Is produced when a broad surface of skin slides against a rough surface.It is also known as brush or friction burn because it is caused by the frictional force and resembles a burn after dryingIt is commonly found in road traffic accidents.Imprint, Pressure or contact abrasion.Is produced as a result of direct impact or pressure of or contact with some object at right angles to the skin surface.The cuticle is crushed, and the object marks a reproduction of its shape and pattern on the to the skin, therefore it is known as patterned abrasion.Example are ligature marks in hanging and strangulation, nail and thumbs marks in throttling, teeth marks in biting, radiator, grill or tyre mask in vehicular accidents."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nPimozide belongs to class of:\nA) Thiothixanthene\nB) Phenothiazine\nC) Butyrophenone\nD) Diphenyl butyl piperidine", "output": "3, because Thioxanthenes are flupenthioxol. Butyrophenones are haloperidol, trifluperidol , penfluridol. Phenothiazines are Chlorpromazine, triflupromazine , thioridazine, flufenazine. Promazine belongs to the group of other of other hetero cyclics that is diphenyl butyl piperidine. 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\nWhich of the following drugs is antipseudomonal penicillin?\nA) Cephalexin\nB) Dicloxacillin\nC) Piperacillin\nD) Cloxacillin", "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\nFollowing poisoning retards putrefaction: NEET 13\nA) Aluminium phosphide\nB) Lead\nC) Arsenic\nD) Copper", "output": "2, because Ans. Arsenic"}

{"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 statements about parotid gland\nA) Duct opens oppsite to upper 2nd molar tooth\nB) Duct pierces Masseter\nC) Develops from ectoderm\nD) Secretomotor fibres come from facial nerve", "output": "0, because The duct runs forwards for a sho distance between the buccinator and the oral mucosa. Finally, the duct turns medically and opens into the vestibule of the mouth(gingivobuccal vestibule)opposite the crown of the upper second molar tooth. Notes: Parotid abscess may be caused by spread of infection from the opening of parotid duct in the mouth cavity. <img src=\" /> REF.BDC VOL.3,Sixth edition pg 110"}

{"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 false about hydrocele?\nA) Arises due to patent processus vaginalis\nB) Wait for 5 years for spontaneous closure of congenital hydrocele\nC) Lord's plication of sac for small hydrocele\nD) Jaboulay's eversion of sac for medium hydrocele", "output": "1, because Treatment of Hydrocele Congenital Hydrocele: Usually spontaneous obliteration by 2 years age. If persists then Herniotomy. Treatment of Vaginal Hydrocele 1. Small hydrocele: Lord's procedure (Plication of sac)Q 2. Medium hydrocele: Jaboulay's procedure (Eversion of sac)Q 3. Large hydrocele: Excision of sacQ"}

{"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 difference between dental stone and dental plaster is:\nA) Chemical composition\nB) Self life\nC) Shape and size of particles\nD) Solubility in water", "output": "2, because None"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nA normally developing 10 months old child should be able to do all of the following except \u2013\nA) Stand alone\nB) Play peak to boo\nC) Pick up a pellet with thumb and index finger\nD) Build a tower of 3\u20134 cubes", "output": "3, because A child starts trying to build a tower of cubes (2 cubes) by the age of 1 year.\n\nAbout other options\n\nChild can stand with support by 9 months.\nChild can play peak-a-boo game by 10 months.\nChild can pick up a pellet with thumb and index finger (pincer grasp) by 9 months."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nLines of Blaschko&;s are along\nA) Lymphatics\nB) Nervs\nC) Developmental\nD) Blood vessels", "output": "2, because Blaschko&;s lines, are lines of normal cell development in the skin. These lines are invisible under normal conditions."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nAll the teeth in patient\u2019s mouth are similarly affected as shown in the radiograph. What is the most likely anomaly?\nA) Type 1 dentinal dysplasia\nB) Type 2 dentinal dysplasia\nC) Taurodontism\nD) Amelogenesis imperfecta", "output": "1, because Dentinal dysplasia\nDentinal dysplasia is an inherited condition affecting both dentitions. It is divided into two types: Type I (radicular dentinal dysplasia) and Type II (coronal dentinal dysplasia). It occurs less frequently than dentinogenesis imperfecta.\nClinical features\nType I is the more frequent type. Teeth erupt normally with no obvious abnormality but rapidly develop mobility resulting from limited root support. In type II, the deciduous teeth are similar to those in dentinogenesis imperfecta, whereas the permanent teeth appear normal.\nRadiological signs\nIn Type I, all the teeth, except the canines, have extremely short roots. The roots are conical or blunted. There is pulpal obliteration and the inferior aspects of the crown exhibit linear crescent-shaped radiolucent lines. Periapical radiolucencies are commonly seen associated with non-carious teeth in Type I dentinal dysplasia. In Type II dentinal dysplasia, obliteration of the pulp occurs post eruption in the deciduous dentition. In the permanent dentition, there is alteration in the configuration of the pulp resulting in enlarged pulp chambers extending well down into the root. The pulp contains multiple calcifications.\nRef: Interpreting Dental Radiographs by Keith Horner, Jon Rout and Vivian E Rushton"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nMiddle aged female with mass in sella turcica hormone increased is -\nA) Prolactin\nB) Thyroxine\nC) Extrogen\nD) ADH", "output": "0, because The sella turcica is a saddle shaped depression of the sphenoid bone.\nIt forms the caudal border of the pituitary gland. Sella turcica is an anatomically complex area with a number of different potential pathologies especially neoplastic process.\nPathologies of sella turcica can lead to important clinical presentations such as hormonal imbalances from pathologies affecting the pituitary gland and neurological symptoms from the mass effect.\nSella turcica is critically located as several structures pass close to it due to compression of the adjacent structures.\n\nImportant anatomical structures related to sella\n\nOptic chiasm\nPituiatry gland\nInternal carotids\u200b\nGavernous sinus and cranial nerves\nSphenoid sinuses"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nHyoid bone fracture most common occurs in ?\nA) Manual strangulation\nB) Hanging\nC) Smothering\nD) Traumatic asphyxia", "output": "0, because Ans. is 'a' i.e., Manual strangulation As manual strangulation (throttling) is among the most violent form of asphyxia, hyoid fracture and other injury to neck structures is more common."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\n\"Acute Meningoencephalitis\" is caused by:\nA) E. histolytica\nB) Nageleria\nC) Giardia\nD) E.coli", "output": "1, because Nageleria"}

{"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 process of destroying all microbes including spores is called :\nA) Disinfection\nB) Antisepsis\nC) Asepsis\nD) Sterilization", "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\nAll are major symptoms of sinusitis except\nA) Nasal blockage\nB) Facial congestion\nC) Nasal congestion\nD) Halitosis", "output": "3, because According to Rhinosinusitis task force definition of sinusitis,Major criteria-Facial pain, pressure, congestion, nasal obstruction, nasal/postnasal discharge, hyposmia and feverMinor criteria- Headache, halitosis, and dental painRef: Hazarika; 3rd ed; Pg 328"}

{"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 sensitive nerve fiber to hypoxia\nA) A\nB) B\nC) C\nD) All are equally sensitive", "output": "1, because Question repeated"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a multi question.\n\nNasal septum is formed except by\nA) Perpendicular plate of ethmoid\nB) Vomer\nC) Nasal bone\nD) Lateral cailage", "output": "3, because The bony pa is formed by: 1.Vomer 2.Perpendicular plate of ethmoid 3.Nasal spine of frontal bone 4.Rostrum of sphenoid 5.Nasal crest of nasal, palatine and maxillary bones. NOTES: The cailaginous pa is formed by; 1.Septal cailage 2.Septal process of inferior nasal cailages The cuticular pa is formed by; 1.Fibrofatty tissue Ref.BDC volume3,Sixth edition pg 240"}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nMetoprolol is preferred over Propranolol as it: September 2010\nA) Is more potent in blocking beta-1 receptors\nB) Is more potent in blocking beta-2 receptors\nC) Is more effective in suppressing essential tremors\nD) Impairs exercise capacity", "output": "0, because Ans. A: Is more potent in blocking beta-1 receptors Metoprolol is cardioselective beta blocker, more potent in blocking beta-1 than beta-2 adrenergic receptors."}

{"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 will predispose to atherosclerosis, except\nA) Homocystinemia\nB) Fibrinogen\nC) Calcium\nD) Lipoprotein A", "output": "2, because Elevated plasma levels of\u00a0 homocysteine are\u00a0associated with increased risk of atherosclerosis,\u00a0thrombosis\u00a0and\u00a0hypertension.\nLipoprotein A\u00a0inhibits fibrinolysis, therefore predisposes to atherosclerosis.\nAtherosclerosis (Greek\u00a0 athere-mush)\u00a0 is\u00a0a\u00a0complex disease characterized by thickening or\u00a0hardening\u00a0of\u00a0arteries due\u00a0to\u00a0the accumulation of lipids\u00a0(particularly cholesterol, free,\u00a0and\u00a0esterified), collagen, fibrous tissue, proteoglycans,\u00a0calcium deposits, etc. in the inner arterial wall.\u00a0\nSatyanarayana, Ed 3, Pg No 152"}

{"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 serious complication seen in other eye after traumatic injury to one eye: March 2005, September 2008\nA) Subconjunctival hemorrhage\nB) Corneal edema\nC) Sympathetic ophthalmia\nD) Sudden loss of vision", "output": "2, because Ans. C: Sympathetic ophthalmia Sympathetic ophthalmia (SO) is a condition in which serious inflammation attacks the sound eye after injury (including intraocular surgeries) to the other. It is the most dreaded complication of unilateral severe eye injury, as it can leave the patient completely blind. Symptoms may develop from days to several years after a penetrating eye injury. Sympathetic ophthalmia is thought to be an autoimmune inflammatory response toward ocular antigens, specifically a delayed hypersensitivity to melanin-containing structures from the outer segments of the photoreceptor layer of the retina. It is thought that Louis Braille, who injured his left eye as a child, lost vision in his right eye due to SO Floating spots and loss of accommodation are among the earliest symptoms. The disease may progress to severe iridocyclitis with pain and photophobia. Commonly the eye remains relatively painless while the inflammatory disease spreads through the uvea. The retina, however, usually remains uninvolved. Papilledema, secondary glaucoma, vitiligo and poliosis of the eyelashes may accompany SO. Diagnosis is clinical, seeking a history of eye injury. An impoant differential diagnosis is Vogt-Koyanagi-Harada syndrome (VKH), which is thought to have the same pathogenesis, without a history of surgery or penetrating eye injury. Definitive prevention of SO requires prompt (within the first 7 to 10 days following injury) enucleation of the injured eye. Evisceration--the removal of the contents of the globe while leaving the sclera and extraocular muscles intact--is easier to perform, offers long-term orbital stability, and is more aesthetically pleasing. But evisceration may lead to a higher incidence of SO compared to enucleation. Immunosuppressive therapy is the mainstay of treatment for SO. When initiated promptly following injury, it is effective in controlling the inflammation and improving the prognosis."}

{"instruction": "Analyze the question and answer the multiple-choice question. All questions are related to medical subjects.", "input": "This is a single question.\n\nLeast commonly seen in conduct disorder seen in girls:-\nA) Run away from home\nB) High risk sexual behavior\nC) Physical aggression\nD) Emotional bullying", "output": "2, because Conduct disorder - Persistent pattern of antisocial behavior in which the individual repeatedly breaks social rules and carries out aggressive acts.in conduct disorder they do it deliberately usually characterized by aggression and violation of the rights of others boys with conduct disorder show physical & relationship aggression but In girls relationship aggression is more predominant than physical aggression children with conduct disorder usually have behaviors characterized by aggression to persons or animals, destruction of propey, deceitfulness or theft, and multiple violations of rules, such as truancy from school."}

{"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 aminoglycosides has the highest nephrotoxicity?\nA) Paromomycin\nB) Streptomycin\nC) Amikacin\nD) Neomycin", "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\nLeast conduction velocity is seen in:\nA) AV node\nB) Purkinje fibers\nC) Bundle of His\nD) Ventricular myocardial fibres", "output": "0, because None"}