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You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Most appropriate initial method of investigation for carcinoma head of pancreas: and explain in detail? | -Sensitivity of the USG is max when - Dist. b/w probe and organ is min. PA OF PANCREAS PROBE LOCATION Tail of Pancreas Stomach Head & Uncinate Process Duodenum Investigation for carcinoma head of pancreas: If the tumour size is < 1 cm and localised to small ducts and acini the preferred investigation modality is endoscopic USG, trans gastric biopsy. EUS is preferred because the distance is less between the probe and pancreas endoscopically and field of view is higher. Though trans gastric biopsy is not mandatory. It can be performed for histological confirmation and also avoids spillage of tumour cells. Histological confirmation is desirable but not essential as there is intense desmoplastic reaction in Ca head of pancreas, hence biopsy not mandatory as it cannot rule out the malignancy. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Dolutegravir/rilpivirine and explain in detail? | |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Forensic Identification utilizes and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Psychoanalysis was staed by ? and explain in detail? | Ans. is 'b' i.e., Sigmund freud Name Contribution Sigmund Freud Psychoanalysis, free association, (oedipus & electra complex), cocaine in psychiatry, Repression, ego-defence mechanisms, phsychodynamic theory. Phillippe Pinel Moral and humane treatment of mentally ill Jones Maxwell Propagated therapeutic community concept. Kuble Ross Erik Classified five stages of death. Erikson Divided life cycle in 8 stages |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Le Facies sympathique is characteristic of and explain in detail? | Le facies sympathique is a sign of antemortem hanging. When the knot premes on cervical sympathetique chain, eyelid of the same side remains open and pupil is dilated. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is The ideal crown preparation has a degree of convergence from gingival finish line towards occlusal is and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is All of the following are clinical features of MEN-II EXCEPT: March 2004 and explain in detail? | Ans. A i.e. Pituitary tumour Pituitary tumours are a pa of MEN-I/ Wermer syndrome |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Perineal body muscles include all of the following except? and explain in detail? | Ans. is 'd' i.e., IliacusTen muscles of perineum converge and interlace in the perineal body -A) Two unpaired - (i) External anal sphincter, (ii) Fibres of longitudinal muscle coat of anal canal.B) Four paired:- (i) Bulbospongiosus, (ii) Superficial transverse perenei, (iii) Deep transversus perenei, (iv) Levator ani.In females, sphincter urethrovaginalis is also attached here. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Schistosoma japonicum resides in - and explain in detail? | Habitat
S. hematobium: Vesicle plexus (veins of urinary bladder, pelvis ureter)
S. mansoni: Inferior mesentric plexus
S. japonicum: Superior mesentric plexus and its radicles (splenic vein). |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Upington disease and explain in detail? | |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is FALSE about annular pancreas is and explain in detail? | Duodenoduodenostomy is the treatment of choice Bailey & Love,26th,1125. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is The term 'ragged red fibers' is applied to describe the skeletal muscle fibers in - and explain in detail? | Answer- D. Mitochondrial myopathyThe term 'ragged redfibers' is typically applied to describe the skeletal muscle fibers in mitochondrial myopathy. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Fg, FFg, FFFg used to describe: (PGI June 2007) and explain in detail? | Ans. C (Black gunpowder) FG, FFG, FFFG .... are used to discribe the size of grains of black gunpowderQGunpowder used in FirearmsBlack PowderQ It consists of Potassium nitrate 75%, Charcoal 15% & Sulphur 10% (Pnemonic - PCS in decreasing percentage) It is designated as FG, FFG, FFFG, etc., depending on size of the grains. More the no. of F's, the finer are grains & the faster the burning. The powder grains are black, coarse or fine, without any particular shape. It burn with production of much heat, flame & smoke. The gas consists of CO. CO2 N2, H2S, H2, CH4 etc., all at a very high temperature.Smokeless powderQ It consists of nitrocellulose (guncotton) or nitroglycerine & nitrocellulose (double-base). Triple base powder consists of nitrocellulose, nitroglycerine & nitroguanidine.They produce much less flame & smoke & more completely burnt than black powder.Semismoke less powderQ It is a mixture of 80% black & 20% of smokeless powder. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Long term used taxmoxifen causes : and explain in detail? | Endometrium Ca |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Microfilaments include: and explain in detail? | Microfilments include actin and myosin They play a role in muscle contraction and cell motility Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:8,9,14 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is The biggest advantage of pulp revascularisation in endodontics is and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is True about amoebic colitis is - and explain in detail? | Hepatic involvement is the most common extraintestinal complication of amoebiasis caused by entamoeba histolytica. Though trophozoites reach the liver in most cases of amoebic dysenterys, only in a small propoion do they manage to lodge and multiply there. Several patients with amoebic colitis develop an enlarged tender liver without detectable impairment of liver function or fever ENTAMOEBA COLI It is a nonpathogenic commensal intestinal amoeba. Its medical impoance is that it has to be differentiated from E.histolytica. It is larger, about 20 to 50 mm with sluggish motility and contains ingested bacteria but not red cells. The nucleus is clearly visible in unstained films and has a large eccentric karyosome and thick nuclear membrane lined with coarse granules of chromatin. Cysts are large, 10 to 30 mm in size, with a prominent glycogen mass in the early stage. The chromatoid bodies are splinter like and irregular. The mature cyst has eight nuclei. The life cycle is the same as in E.histolytica except that it remains a luminal commensal without tissue invasion and is nonpathogenic. TEXTBOOK OF MEDICAL PARASITOLOGY,CKJ PANIKER,6TH EDITION,PAGE NO30 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A Child presents with complaints of abdominal colic and hematuria USG showed a renal stone 2.5cm in diameter in renal pelvis the next step in management of this case ? and explain in detail? | Ans is 'b' i.e. PCNL Also know Steinstrasse - literally means 'stone street' - it is condition which follows the use of ESWL. - small pieces of fragmented calculi collect and obstruct in the distal ureter, like sand occluding a straw. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Highest density of cones are present in and explain in detail? | The highest density of cones is present in fovea which helps in clear vision when fixation object image falls there. In the fovea, cone density increases almost 200-fold, reaching, at its center, the highest receptor packing density anywhere in the retina. This high density is achieved by decreasing the diameter of the cone outer segments such that foveal cones resemble rods in their appearance. Reference: Aravind FAQS in Ophthalmology; First Edition; Page no: 15 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is The most common organism causing food poisoning in canned food is and explain in detail? | Clostridium botulinum: strict anaerobic, cause botulism. Source of foodborne botulism is preserved food, meat and meat products, canned foods. Proteolytic varieties can digest food, which appears spoiled. The cans are often inflated and show bubbles on opening. Non-proteolytic varieties have food unchanged. Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 269 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Intercalated disks are found in: and explain in detail? | Ans. B. Cardiac musclesINTERCALATED DISKS provide a strong union between cardiac muscle fibers and maintain cell to cell cohesion so that pull of one contractile unit is transmitted along its axis to the next. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Difference between staphylococcus aureus and staphylococcus saprophyticus - and explain in detail? | Ans. is 'b' i.e., Coagulase positivity * Coagulase test used to differentiate betweeni) Coagulase positive staphylococci - Staph aureusii) Coagulase negative staphylococci - Staph epidermidis, staph hemolyticus, staph saprophyticus.* Novobiocin sensitivity is used to differentiate coagulase negative staphylococci:i) Novobiocin susceptible : Staph epidermidis, staph hemolyticusii) Novobiocin resistant: Staph saprophyticus* Coagulase test is used to differentiate the different species of staphylococci (staph aureus, staph, epidermidis).* Catalase test is used to differentiate staphylococci from streptococci. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Eosinophilic meningitis is seen with all except? and explain in detail? | Ans. is 'b' i.e., Cryptococcal meningitis Causes of eosinophilic meningitis Infectious, parasitic causes Roundworm (nematode) infections - commonly present as eosinophilic meningitis Angiotronglylus cantonensis - migrating larvae inherently neurotropic Gnathostoma spinigerum - migrating larvae in visceral and/or neural tissues Baylisascaris procyonis - migrating larvae inherently neurotropic Tapeworm (cestode) infections - may present as eosinophilic meningitis Cysticercosis -Cysts develop in CNS and/or visceral tissues Fluke (trematode) infections - occasionally cause eosinophilic meningitis Paragonimus westermani - ectopic spinal or cerebral localization. Schistosomiasis - ectopic spinal or cerebral localization. Fascioliasis - ectopic CNS localization. Other roundworm infections which occasionally cause eosinophilic meningitis Toxocariasis - migrating larvae Nonparasitic, infectious causes Coccidioidomycosis Cryptococcosis - CSF eosinophilia rare Myiasis - with CNS penetration Virus and bacteria - are of unceain causality Noninfectious causes Idiopathic hypereosinophilic syndromes Ventriculoperitoneal shunts Leukemia or lymphoma with CNS involvement (Hodgkin's) Nonsteroidal antiinflammatory drugs Antibiotics - ciprofloxacin, trimethoprim - sulfamethoxazole, intraventricular gentamicin or vancomycin Myelography contrast agents |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is At what age does an infant discriminate strangers and explain in detail? | <p>. Developmental milestones:- GROSS MOTOR DEVELOPMENT: 2 months: Holds head in plane of rest of the body when held in ventral suspension. In prone position in bed, the chin lifts momentarily. 3 months:lift head above the plane of the body. Head control stas by 3 months and fully developed by 5 months. 4 months:Remain on forearm suppo if put in prone position, lifting the upper pa of the body off the bed. 5 months: Rolls over. 6 months:sit in tripod fashion. 8 months: sits without suppo., crawling 9 months: Takes a few steps with one hand held. Pulls to standing and cruises holding on to furniture by 10 months. 10 months: creeps 12 months:creeps well, walk but falls, stand without suppo. 15 months: walks well, walks backward/ sideways pulling a toy. May crawl upstairs. 18 months: Runs, walks upstair with one hand held. Explores drawers 2 years: walk up and downstairs, jumps. 3 years : rides tricycle, alternate feet going upstairs. 4 years: hops on one foot, alternate feet going downstairs. 5 years:skips FINE MOTOR DEVELOPMENT:- 2 months- eyes follow objects to 180 deg. 3 months-Grasp reflex disappears and hand is open most of the time. 4 months- Bidextrous approach( reaching out for objects with both hands). 6 months- Unidextrous approach( Reach for an object with one hand). 8 months- radial grasp sta to develop. Turns to sound above the level of ear. 9 months- immature pincer grasp, probes with forefinger. 12 months-Unassisted pincer grasp. Releases object on request.Uses objects predominantly for playing, not for mouthing. Holds block on each hand and bang them together. 15 months- imitate scribbling , tower of two blocks 18 months- scribbles, tower of 3 blocks.turn pages of a book, 2-3 at a time. 2 years- tower of 6 blocks, veical and circular stroke. 3 years-Tower of 9 blocks, dressing and undressing with some help, can do buttoning. 4 years- copies cross, bridge with blocks 5 years- copies triangle, gate with blocks. SOCIAL AND ADAPTIVE MILESTONES: 2 months: social smile(smile after being talked to).watches mother when spoken to and may smile. 3 months:Recognizes mother, anticipates feeds. 4 months: Holds rattle when placed in hand and regards it . Laughs aloud. Excited at the sight of food. 6 months:recognizes strangers, stranger anxiety . Enjoy watching own image in mirror, shows displeasure when toy pulled off. 9 months:waves bye bye 12 months:comes when called, plays simple ball game.kisses the parent on request. Makes postural adjustments for dressing. 15 months:jargon, stas imitating mother. 18 months: copies parents in tasking, dry by day, calls mother when he wants potty, points to three pas of body on request. 2 years: ask for food, drink, toilet, pulls people to show toys. 3 years:shares toys, know fullname and gender, dry by night. 4 years:Plays cooperatively in a group, goes to toilet alone, washes face, brushes teeth. Role play . 5 years:helps in household task , dresses and undresses. LANGUAGE MILESTONES: 1 month: Ales to sound. 2 month:respond to sound by stale or quitening to a smooth voice. 3 months: babbles when spoken to. Makes sounds (ahh,coos, ) laughs. 4 months: laughs aloud. 6 months: monosyllables 9 months: understands spoken words, bisyllables. 12 months: 1-2 words with meaning. 18 months: vocabulary of 10 words. Can name one pa of body. 2 years: 3 word simple sentences 3 years:asks questions, knows full name and gender. 4 years: says songs or poem, tells story, knows three colours. 5 years: ask meaning of words. {Reference: GHAI Essential pediatrics, eighth edition} |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is The long acting classical H1 antihistaminic include which of the following ? and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the follwoing is TRUE about free water clearance? and explain in detail? | "Free water clearance" (CH2O) is the difference between the urine volume and the clearance of osmoles (COsm). The excretion or retention of electrolyte-free water by the kidney is modulated by circulating vasopressin (ADH). ADH acts on renal V2-type receptors in the thick ascending limb of Henle and principal cells of the collecting duct (CD), increasing cyclic adenosine monophosphate (AMP) and activating protein kinase A (PKA)-dependent phosphorylation of multiple transpo proteins. Ref: Mount D.B. (2012). Chapter 45. Fluid and Electrolyte Disturbances. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is For the following causes of sexual dysfunction, select the most likely clinical feature.Rarely indicates organic disease. and explain in detail? | An absent orgasm, when libido and erectile function are normal, invariably indicates that organic disease is absent. Loss of desire can also be caused by psychologic disturbance, but may indicate androgen deficiency or drug effect. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Support of uterus - and explain in detail? | Ans. is 'd', i.e., all of the above ,The uterus is primarily supported by the pelvic diaphragm, perineal body and the urogenital diaphragm. Secondarily, it is supported by ligaments and the peritoneal ligament the broad ligament of uterus o All are Supports of uterus. A Primary Supports: o Muscular or active support of Uterus: Pelvic diaphragm Perineal body Urogenital diaphragm o Ligamentous (Fibromuscular or Mechanical) support o Transverse cervical ligaments of Mackenrodt or Cardinal ligament Uterosacral ligament Round ligament of the uterus Pubocervical ligament Uterine axis B. Secondary supports formed by peritoneal ligaments o Broad ligament o Uterovesical fold of peritoneum o Rectovaginal fold of peritoneum o Pelvic diaphragm consists of levator ani and coccygeus. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following weakest phase of the set amalgam: and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is MRI done in a 28yrs old male suffering from Neurofibromatosis 2 showed ice cream cone appearance. On asking he fuher revealed that it began with ringing sensation in ears which progressed to balance problems and hearing loss. Which of the following is the most likely diagnosis and explain in detail? | NF2 is associated with bilateral vestibular schwannomas and hearing loss benign tumors usually originate from perineural fibroblasts. intracranial schwannomas originate from vestibular branch of eighth cranial nerve. Malignant schwannomas although rare, are treated with radiation therapy, if the curative resection is not possible. C/F :- SNHL (M/C) presentation Tinnitus Veigo/Dizziness MRI shows - ice cream cone appearance - depicting b/l vestibular schwannomas |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Sulfur granules in pus are seen in and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Best femoropopliteal bypass graft- and explain in detail? | Ans. is 'b' i.e., Autologus saphenous vein |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Treatment of advanced proliferative diabetic retinopathy with extensive vitreoretinal fibrosis and tractional retinal detachment involves all of the following except – and explain in detail? | There is no role of Exophotocoagulation in the management of advanced proliferative diabetic retinopathy with complications such as tractional RD and extensive vitreoretinal fibrosis. Endophotocoagulation may be used in conjunction with vitrectomy.
Surgery : - Surgery is indicated in advanced PDR and for complications. Pars plana vitrectomy is the treatment of choice.
Advanced PDR with dense vitreous hemorrhage : - Vitrectomy with removal of opaque vitreous gel and endophotocoagulation.
Advanced PDR with extensive fibrovascular epiretinal membrane : - Vitrectomy with removal of fibrovascular epiretinal membrane and endophotocoagulation.
Advanced PDR with tractional retinal detachment : - Vitrectomy and reattachment of detached retina by endophotocoagulation or by other methods. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Proper lip support for complete denture is provided primarily by: and explain in detail? | Proclination of maxillary anterior teeth and the surrounding denture base simulating the gingiva provided for the bulk for lip support in complete denture. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Koilonychia and explain in detail? | |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Antiviral drug amantadine is approved for: and explain in detail? | (Ref: Katzung, 14th ed. pg. 501)* Amantadine is an antiviral for Influenza A. It has been approved for treatment for Parkinson disease as well.* Best for early stage PD or if patient not responding to L-Dopa* Mechanism of action* Facilitate DA release from presynaptic dopaminergic neuron and also Prevents DA uptake* Side effect: Confusion, Hallucination, Ankle edema, Livido reticularis |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A patient with AIDS had an acute episodes of diarrhea. The stool examination revealed an oval structure (8 to 9u in diameter) that was acid-fast and fluorescent blue under ultraviolet light. The most likely identification of this organism is? and explain in detail? | Acid fast structures that autofluoresce under UV light suggests the coccidian protozoa as the cause of the diarrhea. The size of 8-9 microns helps to arrive at the answer of Cyclospora. =Cyclospora, Cystoisospora and Cryptosporidium are coccidian protozoa that cause oppounistic intestinal infections in HIV patients. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is On medical check up of a Punjabi student following findings were seen Hb of 9.9gm/dl,, RBC count of 5-lmillion, MCV of 62.5 fl and RDW of 13.51%. What is the most probable diagnosis? and explain in detail? | ANSWER: (B) Thalassemia traitREF: Harrison 17th ed chapter 98, Wintrobe's 8th ed ch: 48See APPENDIX-52 below for "TYPES OF ANEMIA"The question tests the knowledge and interpretation of RDW of red cell distribution width. The patient is having anemia ( Hb: 9.9mg/dl)Her MCV is low 62.6 FI (Normal: 80-100F1)Her RDWT is normal 13.51% (Normal: 11.5-14.5%)The patient has normal RDW and low MCV. Therefore the patient is expected to have one of the following conditions as per the table belowAnemia of chronic diseaseHeterozygous thalassemiaHemoglobin E traitRed cell distribution width (RDW) is a parameter that measures variation in red blood cell size or red blood cell volume. RDW is elevated in accordance with variation in red cell size (anisocytosis) t ie , wThen elevated RDW is reported on complete blood count, marked anisocytosis (increased variation in red cell size) is expected on peripheral blood smear review.RDW along with mean corpuscular volume (MCV) is helpful in narrowing the cause ofanemiaNormal RDW and low MCVAnemia of chronic diseaseHeterozygous thalassemiaHemoglobin E traitElevated RDW and low MCVIron deficiencySickle cell-b-thalassemiaNormal RDW and high MCVAplastic anemiaChronic liver diseaseChemotherapy/antivirals/akoholElevated RDW and high MCVFolate or vitamin B12 deficiencyImmune hemolytic anemiaCytoxic chemotherapyChronic liver diseaseMyelodysplastic syndromeNormal RDW and normal MCVAnemia of chronic disease Acute blood loss or hemolysis Anemia of renal diseaseElevated RDW and normal MCVEarly iron, vitamin B12, or folate deficiencyDimorphic anemia (for example, iron and folate deficiency)Sickle cell diseaseChronic liver diseaseMyelodysplastic syndromeOption (D); Hb Punjabi also known as HbD: It is a hemoglobinopathy in which there is a substitution of glutamine with glycine in the beta chain of the hemoglobin. It interacts with HbS in forming deoxy hemoglobin aggregates and causing sickling of RBC'S. Hb D Punjab is now recognized to be identical with Hb D Los Angeles. Hb D has been found in many parts of the world, including Africa, northern Europe, and India. APPENDIX - 52Types of Anemia Iron Deficiency(SideropenicAnemia)ThalassemiaSideroblasticAnemiaAnemia Of Chronic DiseasePeripheral smearMicrocytichypochromicMicrocytichypochromicMicrocytichypochromicNormocytic normochromic (Microcytic hypochromic can be seen)Serum ironLowNormalNormalLowTIBCHighNormalNormalLowSaturation %|N/|N/ ||Ferritin (ug/1)|||N/| |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Not a feature of mania and explain in detail? | B i.e. DisorientationDSM - IV Diagnostic criteria of Mania (episode)Abnormally & persistently elevated, expansive, or irritable mood lasting for at least 1 week (or any duration if need hospitalization).are neededInflated self esteem or grandiosityQDecreased need for sleepQ (3 hours)More talkative or pressure to keep talkingQFlight of ideas or subjective experience that thoughts are racingDistractibilityQ (i.e. attention too easily drawn to unimpoant or irrelevant external stimuli)Increase in goal-directed activity (social, spiritual, religious, sexual)Q or psychomotor agitation Excessive involvement in pleasurable activities (eg unrestrained buying sprees, foolish business investments, donations or sexual indiscretions)Q that have a high potential for painful consequences. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Conversion of norepinephrine to epinephrine occurs by and explain in detail? | Ans. a (N-Methylation) (Ref. KDT 6th/pg. 116 and Harper biochemistry 27th/pg. 272)Cells in the adrenal medulla synthesize and secrete epinephrine and norepinephrine. The ratio of these two catechola- mines in humans is roughly 8:1, with 80% of the catecholamine output being epinephrine. Synthesis of catecholamines begins with the amino acid tyrosine, which is taken up by chromaffin cells in the medulla and converted to norepinephrine and epinephrine through the following steps:SYNTHESIS AND SECRETION OF CATECHOLAMINESSTEPS IN CATECHOLAMINE SYNTHESISCatecholamines are synthesized from the amino acid phenylalanine. Tyrosine hydroxylase is the rate limiting enzyme and its inhibition by alphamethyl-p-tyrosine results in depletion of CAs; this can be used in pheochro- mocytoma before surgery and in inoperable cases. All enzymes of CA synthesis are rather nonspecific and can act on closely related substrates, e.g. dopa decarboxylase can form 5-HT from 5-hydroxytryptophan and a methyl DA from a methyl dopa. Synthesis of NA occurs in all adrenergic neurones, while that of Adr occurs only in the adrenal medullary cells. It probably requires high cone of glucocorticoids reaching through intraadrenal portal circulation for induction of the methylating enzyme.# Secretions of Norepinephrine and epinephrine stored in electron-dense granules are stimulated by acetylcholine release from preganglionic sympathetic fibers innervating the medulla.# Many types of "stresses" stimulate such secretion, including exercise, hypoglycemia and trauma.# STEPS:- Tyrosine is transported into catecholamine-secreting neurons and adrenal medullary cells where catecholamine synthesis takes place.- The first step in the process requires tyrosine hydroxylase, which like phenylalanine hydroxylase requires tetrahydrobiopterin (HJB) as cofactor.- The hydroxylation reaction generates DOPA (3,4-dihydrophenylalanine).- DOPA decarboxylase converts DOPA to dopamine, dopamine P-hydroxylase converts dopamine to norepinephrine, and phenylethanolamine.- N-methyltransferase converts norepinephrine to epinephrine.- Tyrosine=> DOPA (HYDROXYLATION)- DOPA=> Dopamine (DECARBOXYLATION)- Dopamine=> Norepinephrine (HYDROXYLATION)- Norepinephrine=> Epinephrine (METHYLATION)# This latter reaction is one of several in the body that uses SAM (S-adenosylhomocysteine) as a methyl donor.ReceptorEffectively bindsEffect of ligand bindingAlpha-1Epinephrine, NorepinephrineIncreased free calciumAlpha-2Epinephrine, NorepinephrineDecreased cyclic AMPBeta-1Epinephrine, NorepinephrineIncreased cyclic AMPBeta-2EpinephrineIncreased cyclic AMP |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is In conversion of lactic acid to glucose, three reactions of glycolytic pathway are circumvented, which of the following enzymes do not participate? and explain in detail? | Ans. C. Pyruvate kinasePyruvate Kinase is the enzyme used in glycolysis. In the conversion of Lactic Acid to glucose the three steps of glycolysis are made reversible. To convert pyruvate to PEP-----Pyruvate carboxy kinase and PEP carboxy kinase are utilized. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Satellite lesion with locally invasive property is seen in and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Incus and malleus are derived from: and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Investigation of choice to demonstrate vesico-ureteric reflex: and explain in detail? | Ans. Contrast MCU |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is All the following drugs are used in the treatment of metastatic breast cancer except: and explain in detail? | Sunitinib is a novel oral multitargeted tyrosine kinase inhibitor with antitumor and antiangiogenic activities. It was recently approved in first-line treatment for patients with advanced renal cell carcinoma (RCC) and for the treatment of patients with gastrointestinal stromal tumors (GIST). Ixabepilone: Antimicrotubule inhibitor(M Phase) : use for breast cancer Abemaciclib and Ribocilib: CDK-4 and CDK-6 inhibitor use in breast cancer |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A patient can be taught to control his involuntary physiological responses by which of the following therapies - and explain in detail? | Biofeedback is the use of an instrument which provides immediate feedback to the patient regarding his physiological activities normally not available to the conscious mind. The feedback helps the patient, apparently to control these responses. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Pseudohermaphroditism in a female child is most commonly due to and explain in detail? | Excess androgen production is the most common cause of disorder of sexual differentiation (pseudohermaphroditism) mainly 21- hydroxylase deficiency. Others are 11- beta-hydroxylase and 3 beta-hydroxysteroid dehydrogenase deficiency Image : Female pseudohermaphroditism with normal uterus. A, Sonographic view of the external genitalia; note the enlarged clitoris (C) with fused prominent labia (L). B, The corresponding postnatal disposition verifying enlarged clitoris and fused labia. Reference: Ghai essential of paediatrics, eighth edition, p.no:538 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Amyloidosis most commonly affects and explain in detail? | Amyloidosis*A disease due to an accumulation of abnormal proteins which are formed due to abnormal protein misfolding. *Light microscopy: Amorphous, eosinophilic, hyaline, extracellular substance that causes atrophy of adjacent cells*Congored stain: Pink or red color to amyloid deposits*Congored under polarized microscopy: Apple green birefringence*To differentiate primary amyloidosis from secondary amyloidosis: Treat with potassium permanganate and then perform congo red stain. Congo red stain show positive in primary amyloidosis but negative in secondary amyloidosis due to potassium permanganate treatment. (Primary-persists) *Electron microscopy: Continous non-branching fibril with a diameter of 7.5 to 10nm*X-ray crystallography and Infrared spectroscopy- cross beta-pleated sheet conformation*Most common organs involved: Kidney and Hea *Most common test performed to diagnose amyloidosis: Abdominal fat pad aspiration*Most reliable test performed to diagnose amyloidosis: Tissue biopsy*Most rapid test to diagnose amyloidosis: Scintigraphy with radiolabelled serum amyloid O component*Test used in treatment follow up: Scintigraphy with radiolabelled serum amyloid O componentRef: Robbins 8/e p249 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is The following is false of placenta pre : and explain in detail? | Associated with toxemia |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Lipid in the tissue is detected by and explain in detail? | Ref Bancroft histology 6/e p53 Oil Red O is a lysochrome diazo dye used for staining of neutral triglycerides and lipids on frozen sections and some lipoproteins on paraffin sections. It has the appearance of a red powder with maximum absorption at 518 nm |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Strain of Japanese encephalitis vaccine is and explain in detail? | Nakayama strain and beijing strain are strains of JE vaccine. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is In Dacryocystorhinostomy, opening is done into which of the following nasal cavity meatus? and explain in detail? | Dacryocystorhinostomy is performed to assist in the drainage of tears and secretions from the lacrimal sac into the middle meatus of the nose by forming a sho circuit through the lacrimal bone and the nasal mucosa. This procedure is performed when the nasolacrimal duct is obstructed by fibrous tissue or bone and has become impermeable in order to establish a new communication pathway between the lacrimal sac and nose. The nasolacrimal duct is about 18mm long. It passes inferiorly, posteriorly and laterally to open into the inferior nasal meatus. Opening of the duct is covered by a mucosal fold(valve of Hasner). |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Commonest cause of pyogenic liver abscess: and explain in detail? | Biliary tract disease is the commonest cause of bacterial liver abscess They are: Choledocholithiasis, obstructing tumours, strictures, congenital anomalies of the biliary tree Other causes are: Diveiculitis inflammatory bowel disease Perforated hollow viscera appendicitis. endocarditis or pyelonephritis. Ref: Heneghan et al. BMC Research Notes 2011, 4:80. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Cholesteatoma is commonly associated with? and explain in detail? | Cholesteatoma is commonly associated with the attico-antral type of CSOM. Attico-antral type of CSOM involves posterosuperior pa of the cleft and is associated with an attic or marginal perforation. The disease is often associated with the bone-eroding processes such as cholesteatoma, granulations and osteitis. Ref: PL Dhingra 7th edition of Ear, Nose and Throat; Pg no 78 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Regarding PCOS and hyperinsulinaemia true statement is : and explain in detail? | In PCOS Hyperinsulinemia is seen in 50-70% cases of PCOS Insulin induces LH to cause thecal hyperplasia and secrete androgens Hyperandrogenism lowers the level of hepatic sex hormone binding globulin Metformin treats the root causes, rectifies endocrine and metabolic function, improves feility rate, used as insulin sensitiser It reduces insulin level, delays glucose absorption, liver production of glucose and improves peripheral resistance Metformin do not cause hypoglycemia in a normoglycemic women Ref: SHAW'S TEXTBOOK OFGYNECOLOGY;15 TH EDITION; PG NO: 370 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following growth alteration is an example of hyperplasia rather than metaplasia? and explain in detail? | Hyperplasia is an increase in cell number, whereas metaplasia is the replacement of one adult cell type by another adult cell type. Hyperplasia occurs when there is increased trophic stimulation (e.g., hormones, growth factors), increased functional demand, or persistent cell injury. Only labile and stable cells undergo hyperplasia; labile cells have stern cells that frequently divide, and stable cells have resting cells that are stimulated to enter the cell cycle. The presence of increased goblet cells in the mainstem bronchus of a smoker is an example of hyperplasia, because goblet cells are normally present in this area. However, their presence in the terminal bronchiole or gastric mucosa, where they are not normally found, is an example of metaplasia. Squamous epithelium in the bladder of a patient with Schistosoma haernatobium is an example of metaplasia, because the epithelium of a normal bladder is transitional. Irritation from the eggs of the schistosomes induces squamous metaplasia and the potential for dysplasia and squamous carcinoma. A distal esophagus with glandular epithelium intermixed with squamous epithelium is an example of Barrett esophagus. Chronic acid injury to the distal esophagus from gastroesophageal reflux stimulates the formation of mucoussecreting glandular epithelium, which is a type of glandular metaplasia and predisposes the patient to adenocarcinoma. Goblet and Paneth cells in the glands of the gastric mucosa is called intestinal metaplasia and is commonly seen in chronic atrophic gastritis of the body and fundus (type A) or pylorus and antrum (type B). It is a precursor lesion of adenocarcinoma of the stomach. Squamous epithelium in the mains tern bronchus of a smoker is squamous metaplasia, because normal epithelium is pseudostratifiecl, ciliated, and columnar. The squamous epithelium is a reaction to injury induced by cigarette smoke. It predisposes the patient to squamous dysplasia and carcinoma. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is The most common form of peripheral neuropathy associated with HIV infection and explain in detail? | In HIV distal symmetric variety is the most common form of peripheral neuropathy |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Gene involved in medullary carcinoma thyroid is and explain in detail? | The RET proto-oncogene encodes a receptor tyrosine kinase for members of the glial cell line-derived neurotrophic factor (GDNF) family of extracellular signalling molecules.RET loss of function mutations are associated with the development of Hirschsprung's disease, while gain of function mutations are associated with the development of various types of human cancer, including medullary thyroid carcinoma, multiple endocrine neoplasiastype 2A and 2B, pheochromocytoma and parathyroid hyperplasia |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Emperioplosis is seen in which of the following conditions? and explain in detail? | Condition Explanation Image Autoimmune hepatitis Emperipolesis Penetration of one cell, into a bigger cell. Rosai Dorfman disease Penetration of lymphocytes into megakaryocyte. Penetration of lymphocytes or plasma cells into a hepatic cell. Interphase hepatitis Hepatic rosette formation Alcoholic hepatitis Hepatocyte swelling & necrosis Mallory-denk bodies Neutrophilic reaction Acute Hepatitis Chronic Hepatitis Poal inflammation is minimal or absent Poal inflammation is dense & prominent Parenchymal injury is scattered throughout Spotty necrosis Lobular hepatitis Lobular hepatitis, Interface hepatitis is seen Bridging necrosis is seen only in severe acute hepatitis Bridging necrosis & fibrosis is seen |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following is not a goal for 2010 as per national health policy 2002? and explain in detail? | Ans. is `d' i.e., Eradicate polio |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A young lady complains of sudden onset of palpitations, extreme weakness and sweating. On examination, she was found to have B.P. 90/70 with a regular pulse rate of 180/minute. Her symptoms disappeared after vomitting but she complained of polyuria. The most likely diagnosis is and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Sclerotic bodies are seen in and explain in detail? | Chromoblastomycosis - histologically the lesions shows the presence of the fungus as round or irregular dark brown yeast like bodies with septae called sclerotic bodies. Diagnosis can be established by demonstration of these sclerotic bodies in KOH mounts or in sections and by culture on SDA. Ref: Textbook of Microbiology, Ananthanarayan and Paniker; 9th edition |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Fetus in transverse position. Which of the following is true: and explain in detail? | Ans- (A) Polyhydramnios is a causeRef. William's Obstetrics 23rd ed. Ch 20, Abnormal Labor* For this question, most of the students usually go for <D> shoulder dystocia is a threat for this condition. But remember one thing that shoulder dystocia usually results in the longitudinal lie, where the head of the baby is born and rest of the body below the neck is stuck, which can be secondary to the contracted pelvis, macrosomic baby etc.* This is a clear case of a transverse lie.TRANSVERSE LIE* Transverse lie is seen in 0.3% of the cases.* In this position, the long axis of the fetus is approximately perpendicular to that of the mother.* In a transverse lie, the shoulder is usually positioned over the pelvic inlet. The head occupies one iliac fossa, and the breach the other (as seen in question).* This creates a shoulder presentation in which the side of the mother on which the acromion rests determines the designation of the lie as of right or left acromial.Etiology* Women with four or more deliveries have a 10-fold incidence of transverse lie compared with nulliparas.* Common causes of transverse lie include:# Abdominal wall relaxation from high parity# Preterm fetus# Placenta previa (NOT abruption placentae)# Abnormal uterine anatomy# Hydramnios, and# Contracted pelvis.Diagnosis* A transverse lie is usually recognized easily, often by inspection alone.* The abdomen is unusually wide, whereas the uterine fundus extends to only slightly above the umbilicusManagement: Active labor in a woman with a transverse lie is usually an indication for cesarean delivery. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is True about clomiphene citrate : and explain in detail? | Clomiphene Citrate : It is a non-steroidal triphenylethylene derivative Selective estrogen receptor modulator with both estrogen agonist and antagonist propeies Racemic mixture of two stereoisomers Enclomiphene (trans): 62% Zuclomiphene (cis): 38%, responsible for ovulation Mechanism of action: It is structurally similar to estrogen Competes for nuclear estrogen receptors throughout reproductive system At hypothalamic level it prevents accurate interpretation of estrogen levels Reduces negative feedback of estrogen triggering normal hypothalamic pituitary ovarian axis. Hence it allows the release of GnRH into the pitutary poal system and stimulates LH and FSH secetion. It has antiestrogenic action at level of cervix and endometrium Indications: Anovulatory infeility, ovulation induction, male infeility due to defective spermatogenesis due to hypogonadism Chances of multiple pregnancy: Twins: 7-10% Higher order: 0.1-0.3% Pregnancy rate is about 50% compared to placebo Ref: D.C. Dutta's Textbook of Gynaecology, 6th edition, page no: 533 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Fluconazole differs from ketoconazole in all the following except (REPEAT) and explain in detail? | Ketoconazole and fluconazole both are used in candidiasisRef: KDT 6/e p 762 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which enzyme converts Testosterone to dihydroxytestosterone? and explain in detail? | Ans. is 'b' i.e., 5 a reductase* 5 a reductase is the enzyme which converts testosterone to dihydroxytestosterone (DHT).* Testosterone is sufficient to support male secondary sexual characteristics* Dihydroxytestosterone (DHT) is however, essential for male type external genitalia to get established. DHT is found to have higher affinity for the receptors, which are responsible for male external genital development, than testosterone. In addition DHT is found to cause prostrate hyperplasia.* Hence 5 a reductase is necessary for male type external genitalia to get established |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Treatment of choice for T2 carcinoma of nasopharynx is - and explain in detail? | Irradiation is treatment of choice (external radiotherapy). |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A 56 year old female is brought to casualty with acute narrow angle glaucoma. She has severe pain in her eye and it spreads. The radiation of pain in acute narrow angle glaucoma is in the distribution of: and explain in detail? | Acute primary angle glaucoma: It occurs due to a sudden total angle closure leading to severe rise in intraocular pressure (IOP). Typically acute attack is characterized by sudden onset of very severe pain in the eye which radiates along the branches of 5th nerve. Nausea, vomiting and prostrations are frequently associated with pain. Ref: Comprehensive Ophthalmology by A K Khurana, 4th edition, Page 229. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Urinary retention in child is most commonly caused by and explain in detail? | (A) Metal scab with ulceration # Acute urinary retention in a male child may be due to local inflammatory causes like meatal ulcer with scabbing.> Etiology of Urinary Retention in Children: Neurological processes Severe voiding dysfunction UTI Constipation Adverse drug effect Local inflammatory causes Locally invading neoplasms Benign obstructing lesions Idiopathic Combined UTI and Constipation Incarcerated Inguinal Hernia. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Bence Jones proteins are derived from? and explain in detail? | Excretion of light chains in the urine has been referred to as Bence Jones proteinuria. Light chains includes K and l (kappa and lambda) These play a role in the pathogenesis of renal dysfunction in multiple myeloma. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Parasympathetic secretomotor fibers to paranasal sinus and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is For which of the following conditions screening for GDM is not required - and explain in detail? | Ans. is 'd' i.e., Previous preeclampsia Gestational diabetes mellitus It is defined as carbohydrate intolerance of varying severity with onset or first recognition during pregnancy. Pregnancy is a form of stress that can cause latent diabetes to manifest just as do surgical operations or acute infections.In most of these cases the carbohydrate intolerance will revert by the end of puerperium but this manifestation may be the first indication of diabetes yet to come.More than half of the women with gestational diabetes will develop frank diabetes within the next 20 years.Screening and diagnosis for gestational diabetes mellitusHistorical risk factors suggestive of gestational diabetes have been known for a long timeUnexplained still birth, macrosomia. preterm birth Unexplained still birth, macrosomia and preterm birth have been consistently found to be significantly increased in both gestational and progestational diabetic pregnancies.H/O gestational diabetes in previous pregnancyH/O gestational diabetes in previous pregnancy or diabetes in a first degree relative also increase the risk of gestational diabetes mellitus in subsequent pregnancies.Congenital malformationsCongenital malformations are associated with true diabetes. Congenital malformations are increased much more in known diabetics for obvious reasons because true gestational diabetes usually manifests in the second half of pregnancy by which time fetal organogenesis is nearly complete.The incidence of gestational diabetes can be stratified and shows good correlation with risk factors which can be utilized to characterize women into low average and high risk of developing gestational diabetes. Low risk categoryHigh risk category* <25 years of age* Markedly obese* Normal baby weight* H/o diabetes in first degree relative* No family history of diabetes * Previous abnormal glucose tolerance test* No history of abnormal glucose metabolism* Previous large baby >4 kg* No history of poor obstetric outcome* Previous bad obstetric history unexplained still birth or congenital malformed babies* Not members of an ethnic/racial group with a high prevalence of diabetes* Those with persistent glycosuria There has been a debate whether screening for diabetes should be universal or selective based on risk factors, or whether it is required at allAlthough there is ample evidence to demonstrate increased pregnancy and neonatal complications with increasing maternal glycemic levels there is not enough quality data to ascertain the impact of screening on maternal and neonatal health outcomes.In such a scenario the best policy seems to be is to offer selective screening based on race, personal and obstetric risk factors and the background prevalence of type 2 diabetics in the community.Also knowThe screening for gestational diabetes mellitus is routinely done at 24-28 weeks of pregnancy.Best screening test is 50 g glucose challenge test. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following is NOT a risk factor for endometrial carcinoma? and explain in detail? | Endometrial carcinoma:- Type I Type II Age - 55-65 yr - 65-75 yr Finding -Endometrial Hyperplasia - Endometrial Atrophy Risk -E- Estrogen -N-Nulliparity -D-DM/Drugs(Tamoxifen) -O-Obesity - Atrophy - Thin Physique Behavior - Indolent - Spreads lymphatic - Aggressive - Intraperitoneal and lymphatic |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Reduction of size and vascularity prior to thyroidectomy is done by and explain in detail? | Ans. (a) Lugol iodineRef: Bailey and Love 26th edition Page 760* Lugol's Iodine: 10% Potassium Iodine+ 5% Iodide is used on last 10 days before surgery to make the gland firm and stronger and decreases the vascularity of gland |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Unit of ecological study is: and explain in detail? | Ref. Foundations of Community medicine. Page. 107
In ecological studies the unit of observation is the population or community.
Disease rates and exposures are measured in each of a series of populations and their relation is examined.
Often the information about disease and exposure is abstracted from published statistics and therefore does not require expensive or time |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Bonney's test is used to demonstrate : and explain in detail? | Stress incontinence |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Vaccines at PHC are stored in - and explain in detail? | Ans. is 'b' i.e., ILR [Ref: Park 22nd/ep. 102)o At PHC levelDeep freezer (small) - For preparation of ice packsIce-lined refrigerators: ILR (small) - For storage of vaccinesCold Chain Components (equipments) & Levels in IndiaLevelComponentTemperatureStorage durationState/Regional levelWalk-in-cold rooms (WIC)+2degCto+8,:,C3 monthsWalk-in-freezers (WIF)-20deg C to -40" CDistrict levelLarge ILRs (Ice-lined refrigerator)+2degCto +8degC1 monthsLarge DFs (Deep freezers)-20PCto-40degCPHC levelSmall ILRs+2degCto+8degC1 month2Small DFs-2Cf'Cto -40" CSub-centre levelVaccine carriers+29Cto +8degC48 -72 hrs.Day carriersSession levelFully frozen icepack+2nCto+8degC1 - 3 hrs. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Percentage of cold nodules that become malignant are and explain in detail? | About 80% of discrete swellings are cold. The risk of malignancy is higher in "cold" lesions (20%) compared to "hot" or "warm" lesions (<5%) Ref: Bailey and love 27th edition Pgno :804 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which muscle is intoor of eye and explain in detail? | A. i.e. Superior rectus |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Mucormycosis -a) Angio-invasionb) Lymph invasionc) Septate hyphaed) Long term deferoxamine therapy is predisposing factore) It may lead to blindness and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Rigor mois first stas in: and explain in detail? | Eyelids |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is The drug NOT used for analgesia in a head injury patient is: and explain in detail? | Morphine is contraindicated in patients with a head injury because by retaining CO2, it increases intracranial tension which will add to that caused by the head injury itself. Even therapeutic doses can cause marked respiratory depression in these patients. Vomiting, miosis, and altered mentation produced by morphine interfere with the assessment of progress on head injury cases. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is As regard the PCOS and hyperinsulinaemia:a) Hyperinsulinaemia is observed in about 40% to 5O% of women with PCOSb) Hyperinsulinaemia stimulates hepatic synthesis of SHBGc) Metformin causes hypoglycaemia in normo-glycaemic womend) Metformin has many other health benefits and explain in detail? | Insulin resistance and compensatory hyperinsulinaemia is observed in about 40% of women with normal weight and 80% obese women with PCOS. Hyperinsulinaemia results in decreased hepatic synthesis of SHBG and increased ovarian androgen biosynthesis. Metformin reduces weight, BMI fasting insulin levels, blood pressure and LDL cholesterol.
Metformin does not cause hypoglycemia neither in normoglycaemic patients nor with diabetic individuals. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Treatment of choice for annular pancreas is - and explain in detail? | Ans B Reference Sabiston Textbook of Surgery. 20th edition. Annular pancreas results from aberrant migration of the ventral pancreas bud which leads to circumferential or near-circumferential pancreas tissue surrounding the second portion of the duodenum This abnormality may be associated with other congenital defects, including Down syndrome, malrotation, intestinal atresia, and cardiac malformations If symptoms of obstruction occur surgical bypass through duodenojejunostomy is performed Axial image from an abdominal CT scan showing the annulus encircling the duodenum (arrow). Courtesy- |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is In skeletal class III malocclusion will show and explain in detail? | None |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Until the end of the 16th week, the placenta grows. At term, ratio of weight of fetus to weight of placenta is: and explain in detail? | Placenta at term is a circular disc with diameter 15-20 cm and thickness of 2.5 cm. Its weight is 500 gm. The propoion of weight of the fetus to the weight of the placenta is roughly 6:1 at term and occupies about 30% of the uterine wall. At term, about four-fifths of the placenta is of fetal origin. Ref: Textbook of Obstetrics by D C Dutta, 6th edition, Page 29. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A 6-month old boy weighing 3.2 kg presents with recurrent vomiting and polyuria. Investigations show blood area 60 mg/dl creatinine 0.7 mg/dL, calcium 12.8 mg/dL, phosphate 3 mg/dL, pH 7.45, bicarbonate 25 mEq/L and PTH 140 pg ml (normal? and explain in detail? | Ans. is 'b' i.e., Mutation of calcium sensing receptor Laboratory abnormalities Patient Normal in the patient Increased calcium 12.8 mg/dl 9-10.5 mg/d1 Normal phosphate 3.0 mg/di 3-4.5 mg/dl (In lowrange) Increased parathormone 140 pg/ml < 60 pg/ml Normal Bicarbonate 25 mEq/L 21-30 meq/L Increased Blood urea 60 mg / dl 10-20 mg / dl Normal creatinine .7 mg/dl < 1-5 mg/dl It is a close diagnosis between hyperparathyroidism and familial hypercalcemic hypocalciuria. It is a case of mutation of the calcium sensing receptor The clincher here is o Age of the patient o Decrease in urinary calcium excretion Familial hypercalcemic hvpocalciuria o It is an autosomal dominant disorder caused by mutation in the calcium sensing receptor. o Pathophysiology of familial hypercalcemic hypocalciuria. The primary defect is the abnormal sensing of the blood calcium by the parathyroid gland and renal tubule. The calcium sensor responds to ECF calcium concentration by suppressing PTH secretion through negative feed back. The mutations lower the capacity of sensors to bind calcium and the mutant receptors functions as though blood calcium levels are low. As a result of the false perception that calcium level are low in the body, the parathyroid gland stas secreting greater amount of parathyroid hormone and renal tubule stas reabsorbing greater amount of calcium in the tubule. o Comparison of hyper parathyroidism and familial hypercalcemic hypocalciuria These two disorders have almost similar features, they differ only in the following aspect 1) Urinary renal calcium reabsorption o FHH --> > 99% of renal calcium reabsorption in the kidney (This causes decrease in urine calcium) o Hyperparathyroidism ---*< 99% of renal calcium reabsorption in the kidney (This causes increase in urine calcium) 2) Age of patient o FIIH --> Hypercalcemia is detected in affected members in first decade of life o Hyper parathyroidism --> Hypercalcemia rarely detected in patient with primary hyperparathyrcidism or MEN syndrome who are less than 20 year of age. 3) Level ofparathvroid hormone o PTH can be elevated in FHH, but the values are usually normal or lower for the same degree of calcium elevation than in patients with primary hyperparathyroidism. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Nocturnal enuresis is abnormal after: and explain in detail? | Ref: Nelson's Textbook of Pediatrics. 19th Edition, Page: 71Explanation:Enuresis (Bed-Wetting)Enuresis is defined as the repeated voiding of urine into clothes or bed at least twice a week for at least 3 consecutive months in a child who is at least 5 yrof age.Diurnal enuresis - wetting while awake Nocturnal enuresis - voiding during sleep. Primary enuresis - In children who have never been consistently dry through the night Secondary enuresis - Resumption of wetting after at least 6 months of dryness.Normal Voiding and Toilet TrainingUrine storage consists of sympathetic and pudendal nerve-mediated inhibition of detrusor contractile activity accompanied by closure of the bladder neck and proximal urethra with increased activity of the external sphincter.The infant has coordinated reflex voiding as often as 15-20 times per day. Over time, bladder capacity increases.At 2-4 yr. the child is developmentally ready to begin toilet training.To achieve conscious bladder control, several conditions must be present: aw areness of bladder filling, cortical inhibition (suprapontine modulation) of reflex (unstable) bladder contractions, ability to consciously tighten the external sphincter to prevent incontinence, normal bladder growth, and motivation by the child to stay dry.The transitional phase of voiding is the period when children are acquiring bladder control.Girls typically acquire bladder control before boys, and bowel control typically is achieved before bladder control.Organic causes of secondary enuresisUrinary tract infectionsChronic kidney diseaseSpinal cord disordersConstipationDiabetes (thirst, polyuria, and polydipsia)Laboratory evaluation should includeUrinalysis to check for glycosuria or a low specific gravityBladder ultrasonography - to check residual urine in bladder after voidingTreatmentThe treatment of monosymptomatic nocturnal enuresis should be marked by a conservative, gentle, and patient approach.Treatment can begin with parent-child education, charting w ith rewards for dry nights, voiding before bedtime, and night awakening 2-4 hr after bedtime, while at the same time making sure that parents do not punish the child for enuretic episodes.In addition, the child should be encouraged to avoid holding urine and to void frequently during the day (to avoid day wetting).If this approach fails, urine alarm treatment is recommended.Application of an alarm for a period of 8-12 wk can be expected to result in a 75-95% success in the arrest of bedwetting.The underlying conditioning principle likely lies in the alarm's being an annoying awakening stimulus that causes the child to awaken in time to go to the bathroom and/or retain urine in order to avoid the aversive stimulus.Urine alarm treatment has been shown to be of equal or superior effectiveness when compared to all other forms of treatment.Relapse rates are approximately 40%, with the simplest response being a second alarm course as well as considering the addition of intermittent schedules of reinforcement or the use of overlearning (drinking just before bedtime).Pharmacotherapy for nocturnal enuresis is second-line treatment.Desmopressin acetate (DDAVP) is a synthetic analog of the antidiuretic hormone (ADH) vasopressin, which decreases nighttime urine production.The relapse rate is high when DDAVP is discontinued.DDAVP is also associated writh rare side effects of hyponatremia and water intoxication, with resulting seizures.Although imipramine has some usefulness, less than 50%' of children respond, and most relapse when the medication is discontinued.Much less commonly used, oxybutynin and tolterodine are antimuscarinic drugs, which may be effective by reducing bladder spasm and increasing bladder capacity. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Multicystic dysplastic kidney and explain in detail? | Multicystic dysplastic kidney (MCDK) is a condition that results from the malformation of the kidney during fetal development. The kidney consists of irregular cysts of varying sizes. Multicystic dysplastic kidney is a common type of renal cystic disease, and it is a cause of an abdominal mass in infants.
Signs and symptoms
When a diagnosis of multicystic kidney is made in utero by ultrasound, the disease is found to be bilateral in many cases. Those with bilateral disease often have other severe deformities or polysystemic malformation syndromes. In bilateral cases, the newborn has the classic characteristic of Potters syndrome.The bilateral condition is incompatible with survival, as the contralateral system frequently is abnormal as well. Contralateral ureteropelvic junction obstruction is found in 3% to 12% of infants with multicystic kidney and contralateral vesicoureteral reflux is seen even more often, in 18% to 43% of infants. Because the high incidence of reflux, voiding cystourethrography usually has been considered advisable in all newborns with a multicystic kidney.
Cause
The cause of multicystic dysplastic kidney can be attributed to genetics. Renal dysplasia can be a consequence of a genetic syndrome, which in turn may affect the digestive tract, nervous system, or other areas of the urinary tract. If the mother had been taking certain prescription drugs such as those for hypertension, this may be a precipitating factor as well.
Pathophysiology
The mechanism of multicystic dysplastic kidney is a result of an abnormal induction of metanephric mesenchyme. This could be a result of a formation difficulty of the mesonephric duct. Some mutations in genes associated with renal dysplasia (in syndromes) have been determined. The mutations in question occur at EYA1 or SIX1 genes (branchio-oto-renal syndrome). The PAX2 gene is also thought to play a role in MCDK.The contralateral kidney often undergoes hypertrophy. This is believed to be a compensatory mechanism to the non-functional MCDK. About 90% of patients with an MCDK will have contralateral hypertrophy into adulthood. The impact of contralateral hypertrophy on long-term renal outcomes is unknown.
Diagnosis
MCDK is usually diagnosed by ultrasound examination before birth. Mean age at the time of antenatal diagnosis is about 28 weeks A microscopic analysis of urine in individuals with probable multicystic dysplastic kidney should be done. One meta-analysis demonstrated that unilateral MCDK occurs more frequently in males and the greater percentage of MCKD occur on the left side of the body.
Treatment
MCDK is not treatable. However, the patient is observed periodically for the first few years during which ultrasounds are generally taken to ensure the healthy kidney is functioning properly and that the unhealthy kidney is not causing adverse effects. In severe cases MCDK can lead to neonatal fatality (in bilateral cases), however in unilateral cases the prognosis might be better (it would be dependent on associated anomalies).
Epidemiology
In regard to the epidemiology of multicystic dysplasia kidney, the incidence of MCDK is estimated to be 1 in every 4,000 live births, making it rare in terms of the general population.
References
Further reading
Al-Khaldi, N.; Watson, A. R.; Zuccollo, J.; Twining, P.; Rose, D. H. (1994). "Outcome of antenatally detected cystic dysplastic kidney disease". Archives of Disease in Childhood. 70 (6): 520–522. doi:10.1136/adc.70.6.520. PMC 1029874. PMID 8048824.
Van Eijk, L.; Cohen-Overbeek, T. E.; Den Hollander, N |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is A 41 year old woman presented with a history of aches and pains all over the body and generalized weakness for four years. She cannot sleep because of the illness and has lost her appetite as well. She has a lack of interest in work and doesn't like to meet friends and relatives. She denies feelings of sadness. Her most likely diagnosis is - and explain in detail? | This is a case of somatized (masked) depression which is a form of major depression in which the depressed patients may present their distress as somatic symptoms, e.g. chronic pain, anorexia (loss of appetite), insomnia (cannot sleep), paresthesia, atypical facial pain, and generalized weakness. Depressive mood is not easily apparent as it is usually hidden behind the somatic symptoms, (e.g. in this question she denies the feeling of sadness). |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is In cases of examination of victims of sexual offence, spray of toluidine blue is used for and explain in detail? | Significance of toludine blue test: In the genital assessment of sexual assault patients the TBD(Toluidine Blue Dye) can be used to identify abrasions; not seen by the naked eye. TBD was used to identify micro-tears or abrasions, especially in the posterior fourchette, that is a common site of trauma from intercourse. Positive results with TBD does not determine whether the injury occurred from consensual or non-consensual intercourse. Procedure: After the collection of swabs, apply 1% aqueous solution of Toludine blue dye to the posterior fourchette and fossa navicularis. After allowing a minute for the dye uptake, remove the excess. Dye uptake is considered positive and affirms injury when there is residual blue coloring of the laceration or its border after the excess dye has been removed. Indication: To visualize subtle injuriesQ |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is In adults, cervical instability most commonly results from and explain in detail? | Cervical instability, defined as AP subluxation of more than 3.5 mm or sagittal angulation greater than 20deg on flexion-extension radiographs, most commonly results from disc degeneration, with its attendant changes in the facet joints and loss of ligamentous suppo. Ref: internet sources |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is All of the following decrease in Nephrotic syndrome except - and explain in detail? | In nephrotic syndrome, there will be loss of endogenous anticoagulants(antithrombin|||, protein c & s) and antiplasmins in urine which results in the increased liver synthesis of procoagulants factors, and there will be decreased fibrinolysis. Highly selective proteinuria consists mostly of low molecular weight proteins(albumin70kd,transferrin76kd molecular weight), whereas poorly selective proteinuria consists of higher molecular weight globulin in addition to albumin. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Treatment of Neurocysticercosis includes following, except: and explain in detail? | Ivermectin |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following drugs are used in the treatment of Obsessive Compulsive Disorder (OCD)? and explain in detail? | Fluoxetine and Clomipramine are the drugs preferred and Cognitive Behavioural Therapy is the treatment modality of choice. SSRIs help the condition by increasing the seratonin levels. |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Which of the following has a Ketogenic effect on liver? and explain in detail? | Physiological Actions of GlucagonGlucagon is the most potent hyperglycemic hormone. It is anti-insulin in nature. Therefore, the net effect is decided by the insulin-glucagon ratio (Fig.24.8).Glucagon is mainly glycogenolytic. The active form of glycogen phosphorylase has formed under the influence of glucagon. Liver is the primary target for the glycogenolytic effect of glucagon.It depresses glycogen synthesis.Gluconeogenesis is ored by glucagon by inducing enzymes like PEPCK, glucose-6-phosphatase, and fructose-1,6-bisphosphatase.Glucagon increases plasma free fatty acid level. In adipose tissue glucagon ors beta-oxidation, as it activates carnitine acyltransferase. The mitochondrial acetyl CoA level increasesKetogenesis is ored.Ref: DM Vasudevan - Textbook of Biochemistry, 6th edition, page no: 284-285 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Death of a person due to compressing of neck by another person is - and explain in detail? | Asphyxia produced by compressing of the neck by human hands is called throttling. It is a common mode of homicide. It is the method of choice in infants. Sometimes it is preceded by rape or attempted rape. Ref: The synopsis of forensic medicine & Toxicology pg: 185 &187 |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is What should be measured in a newborn who presents with hyperbilirubinemia – and explain in detail? | Bilirubin is a tetrapyrrole and a breakdown product of heme catabolism.
Most bilirubin (70%-90%) is derived from hemoglobin degradation and, to a lesser extent, from other hemoproteins. In the serum, bilirubin is usually measured as both direct bilirubin (DBil) and total-value bilirubin
Direct bilirubin correlates with conjugated bilirubin but tends to overestimate actual conjugated bilirubin, as it includes both the conjugated bilirubin and bilirubin covalently bound to albumin (delta-bilirubin).
Indirect bilirubin correlates with unconjugated bilirubin but tends to underestimate unconjugated bilirubin, as a |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is What is this known as? and explain in detail? | Tache Noire, a change after death |
You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information. | What is Banki syndrome and explain in detail? |
Subsets and Splits