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<s>[INST] context: POPLITEAL ARTERY :-
Continuation of femoral artery.
Begins at adductor hiatus. Runs downwards and laterally to reach lower border of popliteus.
Terminates by dividing into anterior and posterior tibial arteries.
Relations:-
1. Anteriorly- popliteal surface of femur, back of knee joint, fascia covering popliteus.
2. Posterior - tibial nerve.
3. Lateral- biceps femoris, plantaris, lateral head of gastrocnemius and lateral condyle of femur.
4. Medial-semimembranosus, medial condyle of femur.
Branches:-
1. Muscular- adductor Magnus, hamstrings, gastrocnemius, soleus, plantaris.
2. Cutaneous
3. Genicular- superior, middle and inferior.
Middle -pierces oblique popliteal ligament. Supplies cruciate ligament and synovial membrane of knee joint.
BP of lower limb measured from popliteal artery.
In coarctation of aorta, popliteal pressure < brachial pressure.
Popliteal artery is fixed to capsule of knee joint by a fibrous band present just above the femoral condyles. This may be a source of continuous traction or stretching in the artery, causing primary thrombosis of artery.
More prone to aneurysm.
Dorsalis pedis- can be easily at proximal end of first intermetatarsal space. i.e .between the tendons of EHL and first tendon of EDL.
Anterior tibial artery- palpable at midway between two malleolus
Posterior tibial artery- pulsation felt at 2 cm behind and below medial malleolus. [/INST] question: Which lower limb artery is difficult to palpate | options: A: Popliteal artery B: Anterior tibial artery C: Posterior tibial artery D: Dorsalis pedis artery | answer: A </s> |
<s>[INST] context: Statue of Liberty Basics:
Statue of Liberty Phone:212-363-3200
Statue cruise phone:877-LADY-TIX
Nearest subways to Statue of Liberty :4/5 to Bowling Green; N/R to Whitehall Street;1 to South Ferry (you must be in the first 5 cars of the train to exit at South Ferry). Follow the signs to Castle Clinton to buy tickets for the ferry to the Statue of Liberty.
There is plenty of room for running around and relaxing on Liberty Island.
For children 7-12 there is a Junior Ranger Program available. Pick up a free booklet on Liberty Island.
Admission to Liberty State Park is free, but you must buy a ferry ticket to get there.
Statue Cruises Ferry Ticket Prices: Adult:$13; Senior Citizens (62+) $10; children (4-12)$5; Children 3 and under free. You can buy your tickets for the ferry online at http//:www.statuecruises.come/ferry-service/welcome.aspx.
Ferry ticket included with the New York Pass----- present New York Pass in Castle Clinton bookstore for ticket.
Statue of Liberty Tour Hours
Ferries to the island leave from 8:30 am to 4:30 pm. Liberty Island closes at 6 pm and the last ferry returns to Battery Park by 6:30. Schedules are updated and revised frequently, so please check the official ferry schedule.
Statue of Liberty Tour Reservation
Climb the Crown of the Statue of Liberty with a Crown Ticket, which costs an additional $3 and includes access to the Museum and Pedestal as well.
Museum/ Pedestrian Tickets are free (with ferry ticket purchase).
Order your tickets in advance: 877-LADY-TIX or online when you purchase your ferry ticket.
Tour tickets are time specific. [/INST] question: How much is the ferry fee for a family of two adults and two children aged 3 and 6? | options: A: $ 26 B: $ 31 C: $32 D: $36 | answer: B </s> |
<s>[INST] context: If you want to live in Hawaii,you need to think about how to save money,because it is one of the most expensive states in the USA.
Hawaii buys most of its goods from other countries.This makes the prices very high.Eating out can be expensive.Breakfast is at$5 or$8 and lunch ia around$12,while dinner goes from $15 to$30.
What makes living in Hawaii more difficult is that there are few high-paying jobs. For example, it is harder to find engineering jobs than waitressing jobs.
Here is some advice on how to get around and enjoy living in Hawaii.
*Check out online travel websites, magazines and books for information about the islands, from their beaches to their restaurants.
*Find hotels by reading newspapers. You can also find someone to share your room to save money.
*Try to find a job. Craigslist is a good website to start your search. Also, check the newspapers.
*Buy your food and other things at cheap chain stores like Costco and Wal-Mart.
Hawaii is an expensive place to live, but there are ways to save your money if you shop properly. [/INST] question: What's the price of having breakfast in Hawaii? | options: A: $ 15 B: $ 12 C: $ 8 D: $ 30 | answer: C </s> |
<s>[INST] context: Peter, a high school student, was pretty busy with school, and he was on the soccer team. High school was hard, because everyone wanted to have nice clothes, hang out, drive cars, and all these cost money. Peter's father was the sort of guy that believed you had to earn whatever you got, so he wasn't just about to hand over lots of money for Peter to use to have fun. So, he had to get a job.
During his freshman year summer vacation, his classmate got him a job working on a hay farm. He threw hay up into wagons as the tractor drove around fields, and then they stacked it in the hot barn. It was a hot, lowpaying job.
He once worked a few nights a week at a grocery store. He put things on the shelf. It was a lot of lifting and carrying, and his arms were strong from this and the previous job. It was dull and didn't pay much.
He took some time off when soccer got serious, but the following summer he tried working at a lumber yard. It was hot outside, but he got a lot of exercise lifting and carrying things like boards and drywall. He also learned a lot about building supplies. It still didn't pay well.
From there, he spent a year doing some tutoring for a friend of the family, but that was piecemeal. His first real job came the last year at school, when he fixed registers and worked on computers at a big box store. It was his favorite job yet, but it still didn't pay well.
What Peter realized with all of these jobs was that he needed a better paying job! The only way to get that was to get trained or educated. He could go to school and get a 2year degree in an office or technical position. His other choices were going to a 4year college or joining the army. He wasn't sure what he was going to do yet, but he knew he had to do something. Jobs were a lot of work, money was hard to earn, but he liked staying busy and being able to buy things. Peter wanted the most out of life, and that meant education. [/INST] question: How many jobs had Peter taken? | options: A: Three B: Four C: Five D: Six | answer: C </s> |
<s>[INST] context: Malignant mesothelioma of pleura
Malignant mesothelioma in the thorax arise from either the visceral or the parietal pleura.
It is associated with exposure to asbestos.
Simian virus 40 (SV40) viral DNA has also been associated with malignant mesothelioma.
Morphology
Malignant mesothelioma is a diffuse lesion that spreads widely in the pleural surface and is usually associated with extensive pleural effusion and direct invasion of thoracic structures.
Malignant mesothelioma may be of following types, depending on the type of mesothelial cells that is present in the tumor.
1. Epithelioid type
Mesothelial cells develop as epithelium like lining cells.
Consists of cuboidal, columnar or flattened cells forming tubular or papillary structures.
Epithelioid type of mesothelioma resembles adenocarcinoma of lung and can be differentiated from it by following featurs:-
Positive staining for mucopolysaccharide.
Lack of staining for carcinoembryonic antigen (CEA).
Strong staining for keratin.
Positive staining for calretinin, wilms' tumor 1 susceptibility gene product, cytokeratin 5/6, mesothelin and thrombomodulin.
Presence of long microvilli and abundant tonofilaments but absent microvillous rootlets and lamellar bodies.
2. Sarcomatoid (mesenchymal type)
Mesothelial cells develop as mesenchymal stromal cells.
They appear as spindle cell sarcoma, resembling fibrosarcoma.
3. Mixed type (Biphasic type)
Contains both epithelioid and sarcomatoid patterns. [/INST] question: Pleural mesothelioma is associated with- | options: A: Asbestosis B: Berylliosis C: Silicosis D: Bagassosis | answer: A </s> |
<s>[INST] context: Dick often goes traveling when the summer holiday begins. But he was out of luck this summer.
He went to an old temple on a high mountain by himself. On his way there it suddenly began to rain heavily and he hurried to go down the mountain. When he got to the foot of the mountain, he found the wooden bridge was under the water, so he had to spend the rainy night in a broken farmhouse. He was so hungry that he hardly fell asleep.
The next morning the rain stopped and he found the bridge was damaged. He saw the river was not too deep and tried to swim across it. In the middle of the river the water nearly washed him away. Luckily , two farmers saved him, but he lost his bag. They gave him some food and dry clothes. He thanked them and went to the nearest town to call up his parents.
At the end of the street, Dick found a small hotel and went in. He asked the price for a room.
"A room on the first floor is twenty dollars, on the second floor, fifteen dollars and on the third, ten dollars," answered the owner.
The young man had only eight dollars in all his pockets. He said thanks and was leaving. The owner asked, "Don't you like our hotel?"
"Yes, it's good," said Dick, "but it's not tall enough!" [/INST] question: Dick spent the rainy night _ . | options: A: in the old temple B: in a farmhouse C: on the bridge D: in a hotel | answer: B </s> |
<s>[INST] context: Having a child may improve a woman's memory, a new study suggests.
In the study, women who were new mothers scored better on tests of visuospatial memory - the ability to understand and remember information about their surroundings--compared with women who didn't have children.
The findings contradicts the old belief that women develop"baby brain" or a decline in memory and cognitive function, after they have kids, said study researcher Melissa Santiago, a doctoral student at Carlos Albizu University in Miami. "You don't have to feel that because you have kids, your memory isn't the same," Santiago said.
The study was small, and the findings will have to be tested in larger groups of people, Santiago said.
Previous studies on the topic have had mixed results--some showed motherhood hurts cognition, and others showed the opposite. Studies on rats show those with pups have better memory than those without offspring.
Santiago analyzed information from 35 first-time mothers whose children were ages 10 to 24 months, and 35 women who had never been pregnant. Both groups scored similarly on intelligence tests. The average age of mothers was 29 and the average age of never-pregnant women was 27.
To test visuospatial memory, the women were shown a paper containing six symbols for 10 seconds, and then asked to draw what they remembered. This task was repeated several times. The first time women were shown the paper, both groups remembered about the same amount. But on the second and third pass, mothers performed better than those without children, indicating that the mothers collected more information each time than the other women.
Later, the women were shown a variety of different symbols, and asked to remember which ones were presented on the earlier task. Mothers did not make a mistake in this task--they remembered every symbol correctly--but those without children made one or two errors, Santiago said. [/INST] question: How did Santiago lead to the findings? | options: A: By observation B: By comparison C: By analyzing intelligence tests D: By asking women questions | answer: B </s> |
<s>[INST] context: Vancouver's Chinatown--Canada's largest Chinatown
Vancouver's Chinatown is North America's second biggest Chinatown, after San Francisco's. Mandarin and Cantonese are the mother tongues in 30% of Vancouver homes, which makes Chinese the largest "minority" ethnic group .
Vancouver's Chinatown is the place to visit for a taste of Chinese culture.
In Chinatown, there are a lot of traditional products and buildings, such as the stone lions which represent for the prestige(;),many red lanterns which stands for the happiness. What's more interesting, in Chinatown, a typical Suzhou garden can be found. Chinatown not only expresses the culture of China to the other cultures, but also one part shows that Vancouver is the multicultural society. Chinatown which carries many Chinese cultures is built by Chinese in Vancouver. In the beginning, Chinatown was the community only for Chinese people, but nowadays, more and more other people from different countries are willing to know the Chinatown. It is the part of the Vancouver's society, and Chinatown is also changing gradually in order to adjust to Vancouver.
There are lots of interesting markets with many varieties of fresh and dried seafood and mushrooms in the Chinatown. You'll also find cheap and fine house ware and traditional Chinese medicine. During the summer, on weekend evenings, Keefer and Pender Streets become a busy open-air night market. If you have enough time for a meal, try at one of the many small restaurants. It is not an expensive, multi-course culinary adventure. Relax in the peaceful Dr. Sun Yat-Sen Classical Chinese Garden, or just steps on Pender Street. Visit the Chinese Cultural Centre Museum, or participate in one of its many activities. [/INST] question: In Vancouver's Chinatown you can see all the things EXCEPT _ . | options: A: a typical Suzhou garden B: the stone lions C: the Chinese History Museum D: red lanterns | answer: C </s> |
<s>[INST] context: “A significant misconception is that shock occurs only with low B.P. (hypotension).
Through various compensatory mechanisms, hypotension is often a late ending.
Tachycardia, with or without tachy apnea may be the 1 st or only sign of early compensated shock”. Shock is an acute dramatic syndrome characterized by the inadequate
circulatory supply of oxygen so that the metabolic demands of vital organs and tissues are not met. Shock has been categorized into a series of the recognizable stage: -
Compensated Uncompensated Irreversible An initial insult triggers shock, thus disrupting blood flow to end organs leading to inadequate tissue perfusion.
The body9s compensatory mechanism is initiated to maintain perfusion to vital organs. If treatment is not introduced during this period,
decompensated shock develops causing tissue damage that leads to multisystem organ dysfunction and death. Compensatory shock
In the early phases of shock, multiple compensatory physiologic mechanisms act to maintain blood pressure and preserve tissue perfusion.
Blood pressure remains normal, initially, because of peripheral vasoconstriction and increased systemic vascular resistance.
Thus hypotension occurs late and is more a characteristic of the uncompensated stage of shock Patients in compensated shock have relatively normal cardiac output and normal blood
pressures but they have an alteration in microcirculation that increases flow to some organs and reduce flow to other.
In infants, compensatory increases in cardiac output are achieved primarily by “tachycardia” rather than by an increase in stroke volume.
Heart rates of 190-210/min are common in infants with compensated shock. On the other hand in older patients, cardiac contractility (stroke volume) and (heart rate) increase to improve cardiac output [/INST] question: Most sensitive indicator of intravascular volume depletion in infant - | options: A: Stroke volume B: Heart rate C: Cardiac output D: Loud pressure | answer: B </s> |
<s>[INST] context: Selena Gomez won Favorite Female Singer at 2014 Kids' Choice Awards on March 29. It is a very important awards show held every year in America.
Gomez was born on July 22,1992 in Texas. The 22-year-old girl is an all-round star----she not only acts well but also sings a lot of popular songs. At the age of 7, Gomez first played with a purple dinosaur on the TV show Barney and Friends. In 2007, Gomez acted in Wizards of Waverly Place (<<>> ),which was a big success. After that, she played different roles in many films and become more and more popular.
Gomez made her own band at the age of 17. Fans love her songs because of her beautiful voice. By fan, she has released three albums . She also has a good sense of fashion. Gomez wore a beautiful dress at the Kids' Choice Award. It made her lovely and she shone the whole night.
Charity is an important part in Gomez's life. In October 2008, she was named UNICEF's spokes-person for Trick-or-Treat, which encourages children to raise money on Halloween to help poor children around the world. She said that she was excited to encourages other kids to make a difference in the world. [/INST] question: _ was (were) very successful and after that Selena Gomez become more and more popular. | options: A: Barney and Friends B: Wizards of Waverly Place C: Her three albums D: Her charity activities | answer: B </s> |
<s>[INST] context: This patient has polycystic ovarian syndrome (PCOS), diagnosed by the clinical picture, abnormally high LH-to-FSH ratio (which should normally be approximately 1:1), and elevated androgen but normal DHAS. DHAS is a marker of adrenal androgen production; when normal, it essentially excludes adrenal sources of hyperandrogenism. Several medications have been used to treat hirsutism associated with PCOS. For many years contraceptives were the most frequently used agents; they can suppress hair growth in up to two-thirds of treated patients. They act by directly suppressing ovarian steroid production and increasing hepatic binding globulin production, which binds circulating hormone and lowers the concentration of metabolically active (free unbound) androgen. However, clinical improvement can take as long as 6 months to manifest. Other medications that have shown promise include medroxyprogesterone acetate, spironolactone, cimetidine, and GnRH agonists, which suppress ovarian steroid production. However, GnRH analogues are expensive and have been associated with significant bone demineralization after only 6 months of therapy in some patients. Surgical wedge resection is no longer considered an appropriate therapy for PCOS given the success of pharmacologic agents and the ovarian adhesions that were frequently associated with this surgery. [/INST] question: A 22-year-old woman consults you for treatment of hirsutism. She is obese and has facial acne and hirsutism on her face and periareolar regions and a male escutcheon. Serum LH level is 35 mIU/mL and FSH is 9 mIU/mL. Androstenedione and testosterone levels are mildly elevated, but serum DHAS is normal. The patient does not wish to conceive at this time. Which of the following single agents is the most appropriate treatment of her condition? | options: A: Oral contraceptives B: Corticosteroids C: GnRH D: Parlodel | answer: A </s> |
<s>[INST] context: (Co-trimoxazole) (1362-63-CMDT-09)Infection or MalignancyTreatmentPoenumocystis carinii/ JiroveciTrimethoprim-sulfamethoxazole orally or IV for 14-21 daysPentamidine, Trimethoprim, Primaquine, Atovaquone, TrimetrexateMycobacterium avium complex infectionClarithromycin with ethambutolToxoplasmosisPyrimethamine with sulfadiazine and Folinic acidLymphomaCombination chemotherapy (eg. Modified CHOP, M-BA COD, with or withoutG-CSF or GM-CSF)Central nervous system disease: radiation treatment with dexamethasone for edemaCryptococcal meningitisAmphotericin B, with or without flucytosineFluconazoleCytomegalovirus infectionValganciclovir, Ganciclovir, FoscametEsophageal candidiasis or recurrent vaginal candidiasisFluconazoleHerpes simplexAcyclovir, Famciclovir, Valacyclovir, FoscarnetHerpes zosterAcyclovir, Famciclovir, Valacyclovir, FoscarnetKaposis sarcoma Limited cutaneous diseaseObservation, intralesional VinblastineExtensive or aggressive cutaneous diseaseSystemic chemotherapy (eg. Liposomal Doxorubicin) Alpha interferon (For patients with CD4 > 200 cells/m/L and no constitutional symptoms).Radiation (amelioration of edema)Visceral disease(eg. Pulmonary)Combination chemotherapy (e.g. Daunorubicin, Bleomycin, Vinblastin) [/INST] question: Treatment therapy for Pneumocystis carinii infection is | options: A: Co-trimoxazole B: Ceftriaxone C: Ceftazidime D: Amicacin | answer: A </s> |
<s>[INST] context: iD Tech camps
Camp Address: 910 E Hamilton Ave. Suite 300 Campbell, California 95008,USA Phone: (888) 709-8324
This summer, encourage the excellent in your child! At iD Tech Camps>> students age 7-17 can learn to code, design video games, engineer robots, model 3D characters, build websites, and Print 3D Capers meet new friends, learn STEM skills, and gain self-confidence.
Alexa Cafestem Camp
Camp Address:California, Colorado, Georgia, Illinois Phone: (212) 796-8350
This summer, encourage the excellent in your daughter. At Alexa Cafe, girls ages 10-15 d,discover technology in a unique environment that celebrates creativity, and puiamhropy . Girls learn engineering principles, code games, design websites' model and print 3D objects.
A Water Planet Dolphine Therapy Camp
Camp Address: 203 Greenwood Drive, Panama City Beach, Florida 32407, USA Phone: (850) 230-6030
1-week camp in Panama City Florida where children with Special Needs swim with dolphins. Water Planets dolphin therapy programs use the emotional impact of a dolphins meeting in his own environment combined with expressive art, massage, and music as a beneficial experience.
iD Tech Mini
Camp Address: a lot of places>> California and more, USA Phone:(323) 287-5580
This summer, encourage the awesome in your child! We've full every half-day camp session with tons of tech awesomeness. Kids ages 6-9 can discover programming, game design, or robotics. And with an emphasis on creativity and exploration, every camper becomes a maker of fun. [/INST] question: What number had you better dial to make your kid's more confident? | options: A: (888) 709-8324 B: (212) 796-8350 C: (850) 230-6030 D: (323) 287-5580 | answer: A </s> |
<s>[INST] context: I've been living in China for a while -- long enough to observe the long-term deterioration of my own native language abilities, as well as those of my fellow English speakers. This deterioration can take different forms, one of which is the non-standard usage of the words. Its source is, specifically, Chinese culture, and its target is native English speakers. Below I give some of the common ways that the Chinese environment strikes down the native speaker's linguistic competence .
Net bar: In Chinese, they're called "", This is fine. We generally call them "Internet cafe" in English. The Chinese seem to think that "" should be translated as "net bar" in English, and many careless foreigners have even been misled by this idea.
Name card: In the English-speaking world, business people have lots of business meetings to discuss business. On these occasions, business people exchange specially printed pieces of paper known as business cards. In China everyone calls them "name cards", because in Chinese they are called "" and "name card" is a more direct translation .
Bean curd. It's called "tofu," OK! This English word comes from Chinese. I know all dictionaries sold in China will tell you "" is "bean curd" in English and that may represent the two characters nicely, but "bean curd" is more a definition than a comfortable translation. And yet some foreigners start saying "bean curd" rather than tofu. Deplorable !
I think you see the pattern. The normal native way of saying something is replaced by a more unnatural way of saying it using other English words.
If you've been living in China for a while and find yourself using all of these, you might be on dangerous ground. You're going to start making a fool of yourself back home. Look out! Resist Chinglish attempts at destroying your own command of your mother tongue! [/INST] question: Which of the following expressions is more native? | options: A: Bean curd B: Tofu C: Name card D: Net bar | answer: B </s> |
<s>[INST] context: Today almost everyone knows computers and the Internet. If I ask you "What is the most important in your life ?" maybe you will say "Computers and the Internet."
The first computer was made in 1946. It was very big but it worked slowly . Today computers are getting smaller and smaller. But they work faster and faster. What can computers do?
A writer has said, "people can't live without computers today."
The Internet came a little later than computers. It is about twenty-five years later than computers. But now it can be found almost everywhere. We can use it to read books, write letters, do shopping, play games or make friends.
Many students like the Internet very much. They often go into the Internet as soon as they are free. They make friends on the Internet and maybe they have never seen these friends. They don't know their real names, ages, and even sex . They are so interested in making the "unreal friends" that they can't put their hearts into study. Many of them can't catch up with others on many subjects because of that.
We can use computers and the Internet to learn more about the world. But at the same time, we should remember that not all the things can be done by computers and the Internet. [/INST] question: The Internet can not be used for _ . | options: A: studying B: shopping C: thinking D: playing | answer: C </s> |
<s>[INST] context: Blue-eyed people have been living in Europe for at least 7,000 years, scientists have discovered.
A man who lived on the Iberian Peninsula before Europeans became farmers probably had blue eyes but dark hair and skin, according to scientists who have sequenced his DNA. This surprising combination of eye, hair and skin color1ing may not have been unusual during his lifetime, but it is no longer seen among modern Europeans, reported by the journal Nature.
The man, a Neolithic hunter-gatherer known to scientists as La BranaI, is of great interest to scientists because he offers a snapshot of what was in Europeans' DNA before agriculture spread through the continent. Experts have theorized that certain genetic feature spread quickly among humans after they adopted the farming lifestyle. La BranaI shows that at least some of their predictions were correct.
The man's skeleton, along with that of a male companion, was discovered in 2006 in a cave in what is now northeastern Spain. The site, known as La Brana-Arintero, sits about 5,000 feet above sea level, and the cave provided a cold, refrigerator-like environment that preserved his DNA.
In the lab, scientists were able to remove enough DNA from a single tooth to reconstruct La BranaI's entire genome . They compared it to the DNA of other ancient Europeans (including Otzi, the 5, 300-year-old mummy found in an Alpine glacier) and determined that he was a closer match with hunter-gatherers than with farmers.
When it came to genes that would influence La BranaI's appearance, the researchers found that their 7,OOO-year-old subject had versions of two skin pigment genes that are either very rare or nonexistent among Europeans today. Then they looked at other places in the genome that influence pigmentation and found a mix of ancient and modern gene variants . Taken together, La BranaI's DNA "is likely to have resulted in dark skin pigmentation and dark or brown hair," they wrote.
However, his DNA indicates that his eyes were most likely blue, the scientists found.This suggests that gene variants for light-color1ed eyes and skin did not spread together, they wrote, adding that La BranaI's combination "of dark skin and non-brown eyes is unique and no longer present in contemporary European populations. " Today, a blue-eyed person would typically have fair skin.
To get some idea of whether La BranaI's color1ing was unusual for his day, the researchers will try to sequence the DNA of his companion, who has been named La BranaII. [/INST] question: La BranaI remains as it was due to_. | options: A: dry weather B: a cold condition C: proper protection D: a high cave | answer: B </s> |
<s>[INST] context: Thiamine ( vit B, )- It is present in the outer layers of cereals (rice polishing), pulses, nuts, green Vegetables, yeasts, egg and meat. Absorption and fate- Physiological amounts are absorbed by active transpo. When large doses are given orally, passive diffusion also occurs. Limited amounts are Stored in tissues. About 1 mg/day is degraded in the Body excess is rapidly excreted in the urine. Physiological role After conversion in the body to Thiamine pyrophosphate, it acts as a coenzyme in carbohydrate metabolism: decarboxylation of ketoacids and hexose monophosphate shunt. The requirement is dependent upon carbohydrate intake-about 0.3 mg/ 1000 Kcal. It also plays some role in neuromuscular transmission. Deficiency symptoms -The syndrome of thiamine deficiency beriberi is seen in dry and wet forms: Dry beriberi: Neurological symptoms are prominent-polyneuritis with numbness, tingling, hyperesthesia, muscular weakness and atrophy resulting in 'wrist drop', 'foot drop', paralysis of the whole limb, mental changes, sluggishness, poor memory, loss of appetite and constipation. Wet beriberi: Cardiovascular system is primarily affected-palpitation, breathlessness, high out- put cardiac failure and ECG changes. Therapeutic uses 1. Prophylactically (2-10 mg daily) in infants, pregnant women, chronic diarrheas, patients on parenteral alimentation. Glucose infusion unmasks marginal thiamine deficiency. 2. Beriberi-100 mg/day i.m. or i.v. till symptoms regress-then maintenance doses orally. 3. Acute alcoholic intoxication: thiamine 100 mg is added to each vac of glucose solution infused. Most neurological symptoms in chronic alcoholics are due to thiamine deficiency-peripheral neuritis, Wernick's encephalopathy, Korsakoff's psychosis: give 100 mg/ day parenterally. 4. In neurological and cardiovascular disorders, hyperemesis gravidarum, chronic anorexia, and obstinate constipation-thiamine has been used even without definite proof of its deficiency- symptoms improve dramatically if thiamine deficiency has been causative. Adverse effects Thiamine is nontoxic. Sensitivity reactions sometimes occur ESSENTIALS of medical PHARMACOLOGY SEVENTH EDITION KD TRIPATHI Page:912 913 914 [/INST] question: Drug therapy used in treatment of Wernick's encephalopathy: | options: A: Diazepam B: Disulfiram C: Thiamine D: Cynocobalamine | answer: C </s> |
<s>[INST] context: Food or friends? Lip salve or iPod? What is the most important thing in the US teenagers' lives today? Let's take a look.
Some find that they can't do without people.
"My biggest need is my friends. Without them, I wouldn't do much," said Adrian Fernandez, a 14-year-old boy.
With others, food always comes first.
"I do not think that I could live without chili con carne . I eat it every day. And if I didn't have it, it's all I would think about," said Max Wu, an 8th-grade boy.
Sometimes, the things teenagers can't do without are strange.
Take 14-year-old girl Hannah Sacchini for example. "I cannot live without lip salve, especially in winter," said Hannah Sacchini. "I go mad if my lips get dry."
Of course, today everybody uses mobile phones and computers. Some teens can't live without these high-tech things.
Justin Beck, a 15-year-old boy, feels like this: "I would not be able to live without my iPod. I use it for so many different things. I always have it with me," he said.
So, now we know the things US kids really must have. What about you and your classmates? What can't you live without?
,. (10) [/INST] question: To Adrian Fernandez, _ is the most important. | options: A: a friend B: lip salve C: a computer D: chili con carne | answer: A </s> |
<s>[INST] context: More than two decades ago, a 10-year-old schoolgirl threw a bottle into the sea off the coast of Hull as she went on a ship on a family holiday, hoping to get a response from a stranger in a faraway land. Inside the bottle was a scrawled letter from Zoe Lemon, a youngster with a love of "ballet, playing the flute and the piano", who had just boarded a ship heading for a holiday in Germany.
She told her expected recipients of her pet hamster and fish, both called Sparkle, and her parents who were both teachers.
Miss Lemon, of Salford, Greater Manchester, soon forgot about her act of fantastic, eventually marrying and having a child herself.
But this Christmas she was extremely surprised to receive a reply after 23 years.
It turned out to be a reply to her letter from Piet and Jacqueline Lateur from near Rotterdam. Mr Lateur was walking his dog in the Oosterschelde dykes , near where he and his wife live in Serooskerke, when he found the bottle with Zoe's letter inside.
Mrs Averianov, 33, who works in a jewellery shop, said: "It's been a bit crazy really. My parents came to visit on Christmas day and they had this letter from Europe addressed to my
, Lemon.
Since receiving the letter, Mrs Averianov has been in contact with Mr Lateur via email and asked to see photographs of where the bottle was found.
He told her: "I am keeping your little letter on my piano. I know you are no longer a little girl but you asked me to write you so I have."
Mrs Averianov's father, John Lemon, 68, had encouraged his daughter to throw the message into the sea on a family holiday and now she is considering doing the same for her five-year-old son Maksim.
She said: "I'll probably wait until he's a bit older and can understand and write a letter, but maybe we'll do it by attaching it to a balloon."
From
, (Jan,2014) [/INST] question: When did Zoe Lemon write the letter? | options: A: In 1990 B: In 1991 C: In 2013 D: In 2014 | answer: A </s> |
<s>[INST] context: It took courage to stand up at work. Now more and more people like to have a change and stand up when they are on something important. Standing up is popular. Medical researchers have found that people who stand at work tend to be much healthier than those who sit.
In the last few years, many office supply companies have begun to sell the adjustable- height desk. These so- called " sit/ stand" models are equipped with an electric motor that lets them shift from chair height to person height at the push of a button. Unfortunately, they're regarded as specially furniture. Sit/ stand desks tend to be expensive, hard to find and not easy to test it in person.
When you worked standing up, your mind was more excited and new ideas kept coming out. This is because when you're standing, you feel a bit _ from your desk. If you got stuck on a word or sentence as you wrote, you found yourself shaking your arms, bouncing on your feet or stepping away from the desk for a bit------ things you couldn't do in a chair. Often, standing up seemed to relax your mind enough for you to get over creative barriers.
There's one other thing about standing for a long time; you tended to get hungrier than you do when you sit on a chair. That felt like confirmation of the stand-up advocates' belief that you burn more calories when you stand than when you sit. For this reason alone, I'm hoping that sit/ stand desks one day hit the mainstream, with mass- market furniture companies making many low- priced versions. We could all do with a bit more standing up. [/INST] question: We can learn that the adjustable- height desk is _ . | options: A: easy to find B: easy to test C: relatively cheap D: smart in operation | answer: D </s> |
<s>[INST] context: Flu like syndrome is an adverse effect of Rifampicin (R) Rifampicin (R) It is a derivative of rifamycin (other derivatives are rifabutin and rifapentine). It is bactericidal against both dividing and non-dividing mycobacterium and acts by inhibiting DNA dependent RNA polymerase. Its metabolites are coloured and can cause orange discolorationof the urine and secretions. It can also cause orange staining of contact lens. It is eliminated mainly in the feces and can be used safely in renal dysfunction. Food interferes with absorption. It penetrates all membranes including blood brain and placental barrier. It is equally effective against intra- and extra-cellular bacilli. It is the only bactericidal drug active against dormant bacteria in solid caseous lesions. It is the most effective and fastest acting drug in leprosy. It can cause light chain proteinuria and may impair antibody responses. It is also hepatotoxic and may cause skin rash, flu like syndrome (more prominent with intermittent regimen) and anemia. [/INST] question: Which anti-tubercular agent is associated with side effects as respiratory syndrome, cutaneous syndrome, flu like syndrome and abdominal syndrome? | options: A: PAS B: Pyrazinamide C: Rifampicin D: Streptomycin | answer: C </s> |
<s>[INST] context: The circumflex scapular aery, the dorsal scapular aery, and the suprascapular aery create aerial anastomoses around the scapula. This means that the scapula will be supplied with blood even if one of these aeries is ligated. Additionally, if the subclan or axillary aery needs to be ligated, blood can flow from the dorsal scapular aery and suprascapular aery to the circumflex scapular aery. This effectively shunts blood from the first pa of the subclan aery to the third pa of the axillary aery so that the upper limb will still receive blood. The connection between the suprascapular and circumflex scapular aeries is termed an open anastomosis because it is grossly visible, compared to the anastomosis with the dorsal scapular, which typically happens within small vessels. The anterior circumflex humeral aery supplies the deltoid muscle. It originates from the third pa of the axillary aery and anastomoses with the posterior circumflex humeral aery. The thoracodorsal aery is a branch of the subscapular aery that supplies latissimus dorsi. The transverse cervical aery is a branch of the thyrocervical trunk that occasionally gives rise to the dorsal scapular aery. None of these aeries contribute to the scapular anastomosis. [/INST] question: An open aerial anastomosis in the shoulder occurs between the suprascapular aery and which other aery? | options: A: Anterior circumflex humeral B: Circumflex scapular C: Dorsal scapular D: Thoracodorsal | answer: B </s> |
<s>[INST] context: Pheochromocytoma must be operated on first.
These tumors are generally (>50%) bilateral. Total thyroidectomy is the treatment of choice for patients with MTC because of the high incidence of multicentricity, the more aggressive course, and the fact that 131I therapy usually is not effective.
Central compartment nodes frequently are involved early in the disease process, so that a bilateral central neck node dissection should be routinely performed.
In patients with palpable cervical nodes or involved central neck nodes, ipsilateral or bilateral, modified radical neck dissection is recommended.
The role of prophylactic lateral neck dissection is controversial.
However, in patients with tumors >1 cm, ipsilateral prophylactic modified radical neck dissection is recommended because >60% of these patients have nodal metastases.
If ipsilateral nodes are positive, a contralateral node dissection should be performed.
In the case of locally recurrent or metastatic disease, tumor debulking is advised not only to ameliorate symptoms of flushing and diarrhea, but also to decrease risk of death from recurrent central neck or mediastinal disease.
External beam radiotherapy is controversial, but is recommended for patients with unresectable residual or recurrent tumor.
There is no effective chemotherapy regimen.
Radiofrequency ablation done laparoscopically appears promising in the palliative treatment of liver metastases >1.5 cm.
In patients who have hypercalcemia at the time of thyroidectomy, only obviously enlarged parathyroid glands should be removed.
The other parathyroid glands should be preserved and marked in patients with normocalcemia, as only about 20% of patients with MEN2A develop HPT.
When a normal parathyroid cannot be maintained on a vascular pedicle, it should be removed, biopsied to confirm that it is a parathyroid, and then autotransplanted to the forearm of the nondominant arm.
Total thyroidectomy is indicated in RET mutation carriers once the mutation is confirmed.
The procedure should be performed before age of 5 years in MEN2A patients and before age 1 year old in MEN2B patients.
Central neck dissection can be avoided in children who are RET -positive and calcitonin-negative with a normal ultrasound examination.
When the calcitonin is increased or the ultrasound suggests a thyroid cancer, a prophylactic central neck dissection is indicated. [/INST] question: Treatment of Medullary Carcinoma thyroid: | options: A: Surgery and Radiotheryapy B: Radiotherapy and Chemotherapy C: Surgery only D: Radioiodine ablation | answer: C </s> |
<s>[INST] context: Treatment of acute necrotizing ulcerative gingivitis
The treatment of ANUG consists of the following phases:
1. Local: Alleviation of the acute inflammation plus treatment of the chronic disease either underlying the acute involvement or elsewhere in the oral cavity.
2. Systemic:
a. Supportive treatment: Alleviation of generalized toxic symptoms, such as fever and malaise.
b. Etiotropic treatment: The correction of systemic conditions that contribute to the initiation or progress of the gingival changes.
Antibiotics are administered systemically only in patients with toxic systemic complications or local adenopathy. They are not recommended in ANUG patients who do not have these complications. The antibiotic of choice is penicillin. Patients who are allergic to penicillin should be given erythromycin. Metronidazole may also be used.
Supportive systemic treatment
In addition to systemic antibiotics, supportive treatment consists of copious fluid consumption and administration of analgesics for the relief of pain. Bed rest is necessary for patients with toxic systemic complications such as high fever, malaise, anorexia, and general debility. In such cases, nutritional requirements also need to be kept in mind.
Pediatric Dentistry / Shobha Tandon - 2nd Ed P: 661 [/INST] question: In 8 year old child, the drug of choice in the treatment of ANUG (Acute necrotizing ulcerative gingivitis) is: | options: A: Aminoglycosides B: Penicillin C: Tetracyclines D: Ciprofloxacin | answer: B </s> |
<s>[INST] context: British men are abandoning(,) their stiff (, )upper lips but still do not wear their hearts on their sleeves like Americans, a new survey showed. When it comes tostrong emotion, the onceseriousBritish are now happy to shed tears quite openly.
"Thirty percent of all British males have cried in the last month. That is a very high figure," said Peter Marsh, director of the Social Issues Research Center which took the emotional temperature of Britain. "Only two percent said they could not remember when they last cried," the head of the independent research group said.
Long gone is the "No Tears -- We're British" time when emotion was considered distinctly bad form. "In our survey of 2,000 people, very few people in their forties or fifties had seen their father cry. Now it is twice as many," he told reporters. "Seventy-seven percent of men considered crying in public increasingly acceptable." Almost half the British men opened the floodgatesover a sad movie, book or TV program. Self-pity got 17 percent crying. Nine percent cried at weddings.
From the days of Empire, the British have always considered themselves models of reserve , laughing at "excitable foreigners" who show no self-control.
Marsh argued the divide was still there: "We have probably not caught up with the Americans or the Italians when it comes to the actual display of emotions."
"But we are clearly changing. What we take as typical British reserve has significantly faded "
Women's battle for equal rights has certainly had an effect -- both in the workplace and at home. "Men in their twenties or thirties are interacting with women on equal terms much more than a generation ago. They have to relate to the opposite sex. Women become more man-like and men become more female. That transfers into the work place too," Marsh said. [/INST] question: The British used to think crying in public _ . | options: A: natural B: sensible C: unacceptable D: important | answer: C </s> |
<s>[INST] context: School Activities
Our school activities are suitable for all ages and levels including foundation>> primary, secondary and A-IeveL We offer workshops, hands-on activities and a teacher support service to help you get the most out of your visit.All school services are free, but must be booked in advance.Earth Lab Workshops
This activity is designed for KS3 and KS4 students.Packed with fascinating fossils ,minerals and rocks.Earth Lab is where students can dig deep into the exciting and varied world of British geology using specialist microscopes and geologist tools.
Darwin Centre
Find out who you really are and where you come from in our interactive films about evolution, narrated by Sir David Attenborough.
Hands-on Activities
Get up close and personal with the Museum in these hands-on activities, where you can handle real specimens from our collections.Hundreds of real,natural history specimens for students to touch and explore are in our hands-on science centre.
Self-led Activities
Pupils can engage with specimens through role-play in a self-guided explorer challenge through the Museum.
The Great Debate Schools Program
Students are introduced to the history of the debate during a lively tour.They are then divided into groups and use exhibits to prepare presentations representing the views of the debated key characters.
Booking
All school activities must be booked in advance by calling the schools booking line: 44 (O) 20 7942 5555. [/INST] question: If you're interested in British geology, you'd better choose _ * | options: A: Earth Lab Workshops B: Darwin Centre C: Hands-on Activities D: Self-led Activities | answer: A </s> |
<s>[INST] context: Angiogenesis
o Blood vessels formation in adults is known as angiogenesis or neovascularization. It can occur by two ways:-
1. Angiogenesis from pre-existing blood vessels
The major steps in this process are
i. Vasodilatation by NO, and VEGF-induced increased permeability of the pre-existing vessel.
ii. Proteolytic degradation of the basement membrane by metalloproteinases (MMPs) and disruption of cell-to-cell contact between endothelial cells by plasminogen activator.
iii. Migration of endothelial cells towards angiogenic stimulus.
iv. Proliferation of endothelial cells, just behind the leading front of migrating cells.
v. Maturation of endothelial cells.
vi. Recruitment of periendothelial cells (pericytes and vascular smooth muscle cells) to form the mature cells.
2. Angiogenesis from endothelial precursor cells (EPCs)
EPCs can be recruited from the bone marrow into tissues to initiate angiogenesis. Growth factors involved in the process of angiogenesis
o VEGF is the most important growth factor in adult tissues undergoing angiogenesis.
o The most important receptor for VEGF is VEGFR-2, a tyrosine kinase receptor.
o VEGF induces the migration of EPCs in the bone marrow, and enhances the proliferation and differentiation of these cells at sites of angiogenesis.
o FGF 2 can also stimulate endothelial cell proliferation, differentiation and migration.
o Newly formed vessels are fragile and need to become stabilized, which requires the recruitment
of pericytes and smooth muscle cells (peri-endothelial cells). Angiopoietin 1 and 2 (Ang 1 & 2), PDGF and TGF-fl participate in stabilization process.
Remember
o VEGF transcription is regulated by the transcription factor HIF, which is induced by hypoxia. [/INST] question: During angiogenesis recruitment of pericytes and peri-endothelial cells is due to - | options: A: VEGF&PDGF B: TGF, VEFG& PDGF C: VEGF, IL-2, IL-6 D: Angiopoietins, TGF & PDGF | answer: D </s> |
<s>[INST] context: The high five is very popular in today's society. However, there was a time when people didn't give it out to each other. The history of the high five isn't very long. It's even been said that the first high five was given out in a 1977 Los Angeles Dodgers game between Dusty Baker and Glen Burke as a way to celebrate Baker's home run .
After this first sighting of the high five in 1977, Derek Smith, a player on the 1980 Lousiville Cardinals basketball team, invented the actual "high five", which the team used all throughout the season as a way to congratulate one another. After the Cardinals began to use the high five, more and more sports teams began to replace other popular celebratory gestures of the time, such as a pat on the back or the behind, with the high five.
As you can probably guess, it didn't take long for the high five to make its way all across the sports scene and into the daily lives of every American who wanted a new and interesting way to congratulate or say hello to their friends, co-workers and family. The high five is here to stay and can be seen in more places and situations than ever before in history.
People use it in the bar, the gym, the office or sometimes on the street. No matter where you try to give a high five most people will happily give you a raised arm and a smile. But giving it in the right way is not easy. You need to have a basic understanding of the rules of giving the right high five. [/INST] question: The high five had its origin in _ . | options: A: a sports game B: daily life C: an exercise D: a ceremony | answer: A </s> |
<s>[INST] context: Gabby Douglas stood beneath the Rio Olympic Arena, still in her Team USA leotard, trying hard to understand how she had become the most unpatriotic athlete in Rio. Tears filled in her eyes. She tried hard to talk but no words came out. Her pauses were long and uncomfortable.
"I've been trying to stay off the Internet because there's so much negativity," she said. The attacks against her have been everywhere these last few days. The bullies blamed her for not putting her hand over her heart while the US national song played. Besides, some other people attacked her for not jumping up and cheering hard enough for team-mates at the all-around final. All of this prompted her mother, Natalie Hawkins, to tell Reuters this weekend, that Douglas is "heartbroken".
It showed on Sunday, in Douglas's final performance of this Olympics and maybe in the Games ever. Douglas finished sixth in the uneven bars, far from the medal stand she owned four years ago in London, and shook her head, confused. What had she done wrong? Nothing made sense.
"I mean, you do [Olympics] for your country, and you do it for yourself, how have I offended them? What have I done? I was standing in respect for USA. I'm coming out there representing them to the best of my abilities, so how would I be in disrespect? [/INST] question: Why was Douglas heartbroken? | options: A: Because she lost the chance to take part in the Olympic Games B: Because she didn't win any medal C: Because she was criticized by many people for her unintentional behaviors D: Because she made a big mistake | answer: C </s> |
<s>[INST] context: There are some strong-minded people that are able to stop smoking today and be free from the addiction the next day. However, some smokers may have to seek help from medication in order to kick the habit.
What medication actually does is to reduce the wish to smoke. Some of the medication must be taken with a doctor's guidance. The five most common medications to stop smoking are Bupropion SR, nicotine gum, nicotine inhalers, nicotine nasal spray and nicotine patches. People can buy nicotine gum and nicotine patches in chemists. However, the other medications require a prescription.
Zyban tablets have been found to be highly effective in curing people of smoking addiction. The tablet needs to be taken whole, without crushing it, as crushing can lead to side effects. It can be bought on the prescription of a doctor.
Nicotine patches are filled with nicotine and they are applied to the skin. The skin takes in the nicotine and carries it to the blood stream. The amount of nicotine in these patches is quite limited, not enough to lead to addiction. But you shouldn't take them for dinner. In fact, millions of people have benefited from these nicotine patches.
Nicotine gum is supposed to be a safer choice. It is used in such a way that it comes into contact with the blood vessels in the mouth and then releases the nicotine. The nicotine should not go through the stomach; otherwise, it may cause certain side effects.
These different types of medications have to be taken quite carefully. Do ask your doctor before taking any of these. [/INST] question: Which of the following medicines can be bought without a prescription? | options: A: Zyban tablets B: Nicotine patches C: Nicotine inhalers D: Nicotine nasal spray | answer: B </s> |
<s>[INST] context: Ashleigh Fraser and Leah Guskjolen, both 18, wondered why they would not be allowed to wear nail polish or artificial nails during their training to become certified nursing assistants. But when they asked, the only response which they got was that "rules are rules." Not satisfied, the teens decided to explore the issue themselves.
For their new study, Ashleigh and Leah, seniors at Willcox High School in Willcox, Arizona., borrowed materials from the hospital where they had been trained as nursing assistants. Ten nurses there agreed to give them little scrapings off the top side of their nails. Half of the participants had natural nails. The other half wore nail polish or fake nails on top of their natural nails. The teens grew bacteria from the scrapings on plates; these are plastic dishes with a gel that feeds bacterial growth.
Natural nails produced an average of 4.3 bacterial colonies. In contrast, scrapings from nail polish or artificial nails produced an average of 17.5 colonies! Leah and Ashleigh had their answer to the question. Only natural nails are allowed because polished or artificial nails tend to harbor far more bacteria. The germs could be dangerous to sick patients.
Leah notes that they are not the first to look at nails in a medical setting. Still, she says, "It is something that should be taken much more seriously than it is." To emphasize that, she points to the large list of similar studies she and Ashleigh uncovered during their research.
When nurses touch patients, they often wear gloves, but many small tasks are performed bare-handed. The teens hope to raise awareness of how dangerous artificial nails can be in the medical setting. "What shocked me," Leah says, "is how unconcerned some of the nurses were. They did not think their nails were dangerous." Ashleigh agrees and observes that to preserve their manicures , nurses with polish or fake nails tended to scrub less vigorously when washing their hands. Their nails might look nice, but this might contribute to the large numbers of germs that hang onto their nails.
Ashleigh has never really liked nail polish, so she will not have to change much to pursue her dream of being a surgeon. But the results have reminded Leah, who wants to be a nurse, to give up her artificial nails for good. "They are very pretty," she says, "I love them." But now that she knows the risks they can cause, she admits that for a health professional they just are "not worth it." [/INST] question: What did the two teenagers do for their study? | options: A: They visited many top scientists B: They consulted the hospital's nurses C: They collected experimental samples at a school D: They grew germs from the scrapings on dishes | answer: D </s> |
<s>[INST] context: For many kids in Africa, the colorful PlayPump is the first playground thing they have ever seen. When the children give it a push and jump in for their first ride, smiles of wonder appears on their faces.
The fun of going round and round in a circle is just part of the wonder. The wonderful invention doesn't only change the kids' play time, but also makes a big difference to the people's lives.
As the merry-go-round starts, _ pumps clean water up from deep underground and keeps it in a huge tank . People are welcomed to come and help themselves to get the water for free. They are very happy these days.
In the countryside of Africa, very few people could drink clean water. They don't have machines that can get water in their homes. Instead, they often walk a long way to carry water back.
Patricia Molope, a fifteen-year-old girl, explains that before her village in South Africa got a PlayPump, people would pay a taxi driver to take them to a well far from their homes. " Sometimes the taxi drivers were so busy that we would have to stop taking showers in order to save water. It was so far to walk there, but at present we have our own clean water in the village, and the life is better, too."
The hard job of carrying water usually is done by women and girls. Carrying water for miles and hours each day is such a heavy job that it sometimes prevents girls from being able to go to school.
Thanks to the PlayPump, getting water is quicker and easier-----and even boys join in. The pumps have become a new activity. Kids and adults seem to love playing with them while collecting water.
A boy named Khumalo, twelve years old, says, " I have seen many kinds of water pumps, but have never seen one that can keep water. When I grow up, I want to be an inventor so I can also invent clever things like the PlayPump that will help my country."
So far, more than 800 PlayPumps are being operated in schools and neighborhoods in four African countries, providing water for almost two million people. [/INST] question: To get water from a PlayPump, people need to _ . | options: A: walk for a long way B: push it first C: make it in a circle D: use a big tank | answer: B </s> |
<s>[INST] context: After ten years, the world' s largest music festival, Rock in Rio, returned to its hometown Rio de Janeiro for seven days of concerts from Friday, September 23rd, attracting 700,000 people over the whole week.
It is the 10th edition of the Rock in Rio festival, but only the 4th to be held in Rio as the organizers exported the festival to Lisbon and Madrid ten years ago.The first edition of the festival was in 1985 and the most recent edition in Rio was held in January, 2001.A total of 700,000 tickets were sold out for this year' s festival.
The festival consists of four stages with the participation of International stars including Elton John, Katy Perry, and bands Metallica, Evanescence and System of a Down.Several stars which performed in previous editions are also on the list this year..In addition, a number of local singers and bands will also join this year.
The performance site, named as Rock City, is a 150,000-square-meter area.Besides the concert area, the site also has a giant Ferns wheel, a roller coaster, and a small shopping mall.After the festival, the Rock City area will be converted into a leisure area to athletes in the 2016 Olympic and Paralympic Games in Rio de Janeiro
According to Rio' s tourism company Riotur, out of the 700,000 people expected in the festival, some 315,000 will be tourists, who raised the hotels' occupation rate to 98 percent.Riotur estimated that the Rock in Rio festival will bring 419 million U.S.dollars for the city and create 10,000 jobs.
The creator of the festival, Brazilian businessmen Roberto Medina, insisted on opening the Rock City gates himself, in the early afternoon, and greeted the first fans to enter the site."We come to the gate because the Brazilian audience is even more important than the bands.We applaud them.They make the greatest show," he said. [/INST] question: The first edition of the festival may be held in _ . | options: A: Rio de Janeiro B: Lisbon C: Madrid D: a place not mentioned | answer: A </s> |
<s>[INST] context: In today's world of modern science and medicine, a more traditional treatment is once again becoming popular-animal friendship.
It is now well-known that people with problems such as heart disease or cancer live longer and get better more quickly if they have pets. Keeping pets lowers blood pressure and makes people less worried. Animals are increasingly important in treating older people who have memory loss and other brain problems. These people often feel nervous and upset. Activities with animals help them improve their physical condition and also give them joy, entertainment and loving friendship.
Here is a case that shows the benefits of animals. John was a six-year-old _ . He had no physical problems. He just refused to talk. His older cousin, Ned, had a parrot called Sally, and John used to visit it. When he arrived, Net used to say, "Hi, John!" We all know parrots copy what they hear. After a few visits, Sally began saying "Hi, John!" when John came into the room. Then, one day, John turned to the parrot and replied "Hi, Sally!" Staying with the parrot encouraged John to begin talking.
Another use of animal helpers is in schools. In some cases, animals are used to help children with physical or personal problems. In other cases, they are used to teach children to get on and share with others, and even to teach them about animals.
If you want to know more about animal helper programs, you can get in touch with organizations like Riding for the Disabled or do a search under "animal therapy" on the Internet. You don't have to be an animal trainer or a doctor to join in. [/INST] question: Which is NOT mentioned as an illness that animals can help with? | options: A: Heart disease B: Cancer C: Fever D: Blood pressure | answer: C </s> |
<s>[INST] context: POST MASTECTOMY PAIN
The breast, axilla and upper are innervated by a variety of nerves; the lateral cutaneous branch of T2 (intercostobrachial nerve), T3 and T4 provide innervation to the anterior chest wall and upper back, the torso and nipple.
Sympathetic innervation of the cutaneous structures of the breast is provided by the medial and lateral branches of the ventral ramus of 3rd to 6th intercostal nerves.
While both nociceptive pain (due to damage of muscles and ligaments) and neuropathic pain can occur after surgery for breast cancer, neuropathic pain is more likely to persist after wound healing has occurred.
Four pain syndromes have been distinguished
1. Phantom breast pain is a painful (often knife-like or shooting) sensation that the removed breast is still present.
2. Intercostobrachial neuralgia: usually known as post-mastectomy pain syndrome (PMP). Consists of pain in the axilla, medial upper arm and anterior chest wall and is often caused by nerve damage during axillary node dissection
3. Neuroma pain: can occur from scars from either mastectomy or lumpectomy but is more common if surgery is followed by radiotherapy.
4. Other nerve injury pain: can occur even if the intercostobrachial nerve is spared and is more common in breast reconstruction and implants.
In Jung et also review, there were 21 studies with follow-up periods from 1-96 months (one study of 210 months), which revealed the following widely varying ranges of prevalence estimates:
Phantom breast pain 3-44 per cent
Intercostobrachial neuralgia (ICN) 16-39 per cent for all breast cancer surgery;
ICN in breast-conserving surgery 14-61 per cent
Neuroma pain 23-49 per cent. [/INST] question: Pain along the medial aspect of the arm in a post-mastectomy patient is due to? | options: A: Phantom breast pain B: Intercostobrachial neuralgia C: Neuroma pain D: Other nerve injury pain | answer: B </s> |
<s>[INST] context: The Brown Bear
My wife Laura and I were on the beach, with three of our children, taking pictures of shore birds near our home in Alaska when we spotted a bear. The bear was thin and small, moving aimlessly.
Just a few minutes later, I heard my daughter shouting, "Dad! The bear is right behind us!" An agreesive bear will usually rush forward to frighten away its enemy but would suddenly stop at the last minute. This one was silent and its ears pinned back---- the sign of an animal that is going in for the kill. And it was a cold April day. The bear behaved abnormally, probably because of hunger.
I held my camera tripod in both hands to form a barrier as the bear rushed into me. Its huge head was level with my chest and shoulders, and the tripod stuck across its mouth. It bit down and I found myself supporting its weight. I knew I would not be able to hold it for long.
Even so, this was a fight I had to win: I was all that stood between the bear and my family, who would stand little chance of running faster than a brown bear.
The bear hit at the camera, cutting it off the tripod. I raised my left arm to protect my face; the beast held tightly on the tripod and pressed it into my side. My arm could not move, and I sensed that my bones were going to break.
Drawing back my free hand, I struck the bear as hard as I could for five to six times. The bear opened its mouth and I grasped its fur, trying to push it away. I was actually wrestling with the bear at this point. Then, as suddenly as it had begun, the fight ended. The bear moved back toward the forest, before returning for another attack----- The first time I felf panic.
Apparently satisfied that we caused no further threat, the bear moved off, destroying a fence as it went. My arm was injured, but the outcome for us could hardly have been better. I'm proud that my family reminded clear-headed when panic could have led to a very different outcome. [/INST] question: The brown bear approached the family in order to _ . | options: A: catch shore birds B: start an attack C: protect the children D: set up a barrier for itself | answer: B </s> |
<s>[INST] context: If you are like me and you love drawing a lot, then I'm sure you'll love "Drawing With Mark". "Drawing With Mark" is a great show and Mark is really helpful. He gives kids some tips on how to draw and often teaches kids some history about the things they draw. Kids can also learn three or four fun facts about what they are drawing.
"Happy Tails" is about cats and dogs. Mark shows how to draw them and talks about how to look after them, too.
In "A Day With The Dinosaurs", Mark visits the Museum of Boston and speaks to an expert to learn how the dinosaurs lived, what they ate and how long they lived.
In "Reach For The Stars", Mark is also at the Museum of Boston. He speaks to another expert about the stars. I learned how far we are from the stars. I thought that the stars were just about 100 miles from us, but they are millions of miles from us. That's really far!
If you love drawing, you can watch this show. You can have fun with the tips Mark gives you. The tips will help you to become an artist. [/INST] question: What's "Drawing with Mark"? | options: A: A movie B: A book C: A show D: A magazine | answer: C </s> |
<s>[INST] context: Duodenal atresia (DA) is thought to occur as a result of the failure of vacuolization of the duodenum from its solid cord stage.
The range of anatomic variants includes duodenal stenosis causing constipation, mucosal web with the intact muscular wall (so-called windsock deformity); two ends separated by a fibrous cord, or complete separation with a gap within the duodenum.
Associated Anomalies: DA is associated with several conditions, including prematurity, Down syndrome, maternal polyhydramnios, malrotation, annular pancreas, and biliary atresia.
Other anomalies, such as cardiac, renal, esophageal, and anorectal anomalies, are also common.
In most cases, the duodenal obstruction is distal to the ampulla of Vater, and infants present with bilious emesis in the neonatal period.
In patients with a mucosal web, the symptoms of postprandial emesis may occur later in life. Diagnosis:
The classic plain abdominal radiograph of DA is termed the double-bubble sign (air-filled stomach and duodenal bulb, In cases in which there is no distal air, the diagnosis is secured, and no further studies are necessary. On the other hand, if the distal air is present, an upper gastrointestinal contrast study is performed fairly rapidly.
This study is important not only to confirm the diagnosis of duodenal stenosis or atresia but also to exclude midgut volvulus, which would constitute a surgical emergency.
Treatment: The management of DA is by surgical bypass of the duodenal obstruction as either a side-to-side or proximal transverse-to-distal longitudinal (diamond-shaped) duodenoduodenostomy. [/INST] question: Anomaly associated with duodenal atresia is | options: A: Down syndrome B: Duodenal adenomas C: Limb defects D: Autoimmune disorders | answer: A </s> |
<s>[INST] context: Cessation of placental blood flow and the beginning of respiration leads to changes in the vascular system at bihStructure/Vessel Remnant (In Adults) Timing of Closure Ductus aeriosus Ligamentum aeriosumQ Almost immediately after bih, by bradykirdn (released during inital inflation of lung) mediated contraction of muscular wall. Actual obliteration takes 1-3monthsUmbilical aeries - Distal pa form medial umbilical ligaments - Proximal poion remains open as superior vesical aeriesFew minutes after bih (d/t thermal, mechanical & 02 tension change), athough actual fibrous obliteration may take 2-3 monthsUmbilical vein (left) Ductus venosus Ligamentum teres hepatis Ligament venosum Occurs sholy after that of umbilical aeriesSeptum prinum Septum secundum (lower free edge)Fossa ovalis Annulus ova us The first breath causes increased left atrial pressure pressing the septum primum against septum secundum Vt closure of ovalforamen. During 1st day its reversible and complete fusion takes about 1 year [/INST] question: Patent formen ovale is due to failure of fusion of- | options: A: Ostium primum with Endocardial cushion B: Ostium primum with Ostium Secundum C: Ostium primum with Septum pnmum D: Septum primum with septum secundum | answer: D </s> |
<s>[INST] context: Midline posterior fossa cyst seen in dandy walker syndrome
• With agenesis of cerebellar vermis.
• May be associated with hydrocephalus.
Arnold-Chiari malformations are congenital herniations of hindbrain structures into the spinal canal.
• In type I Arnold-Chiari malformation, the cerebellar tonsils herniate into the foramen magnum;
• In type II Arnold-Chiari malformation, parts of the hindbrain, cerebellar vermis, and fourth ventricle herniate into the foramen. This second type is commonly associated with meningomyeloceles. (Other neonatal presentations associated with Arnold-Chiari malformation include hydrocephalus (because of cerebrospinal fluid obstruction) and brainstem dysfunction (causing stridor and poor swallowing). Milder cases may present later in life with spinal cord or cerebellar symptoms. “Dandy Walker malformation” is associated with hypoplasia of the cerebellum associated with an enlarged fourth ventricle.
“Holoprosencephaly” is a complex malformation of the brain such that only a single large monoventricular cerebral hemisphere exists.
“Porencephaly” is a severe cleft in the brain that allows the ventricles to communicate with the subarachnoid space. [/INST] question: Midline intra-cranial cyst is: | options: A: Choroid plexus cyst B: Dandy-Walker cyst C: Unilateral hydrocephalus D: Porencephalic cyst | answer: B </s> |
<s>[INST] context: Years ago there was a group of kids who would hang around at some local ponds in the woods near their houses in Warwick, Rhode Island. In summer they caught frogs and fish. When winter arrived they couldn't wait to go skating. Time passed, and the ponds became the only open space for the kids to enjoy themselves in that neighborhood.
One day a thirteen-year-old boy from this group of kids read in the local newspaper that a developer wanted to fill in the ponds and build over a hundred small houses called apartments. So the boy went door to door and gathered more than two hundred signatures to stop the development. A group of citizens met and decided to support him.
At the meeting of the town planning organization,the boy was quite nervous at first and spoke very softly. But when he saw the faces of his friends and neighbors in the crowd and thought about what was happening to their favorite ponds,his voice grew louder. He told the town officials that they should speak for the citizens. He also insisted that they should leave enough space for children. A few days later,the developer stopped his plan.
Nine years later, when that teen was a senior in college, he was informed that the developer was back with his proposal to build apartments. Now twenty-two years old, he was studying wetlands ecology. He again appeared before the town planning organization. This time as an expert, he used environmental protection laws to explain _ on development in and around wetlands and the knowledge of wetlands ecology to help to improve the development. Finally some apartments were built, but less than half the number the developer wanted. The ponds where those kids used to hang around were protected by a piece of natural land, and are still there today. [/INST] question: The kids liked to _ at the local ponds in winter. | options: A: make a snowman B: throw snowballs C: go skating D: go skiing | answer: C </s> |
<s>[INST] context: Alcohol is an enormous contributor to otherwise preventable birth defects. Sequelae include retardation of intrauterine growth, craniofacial abnormalities, and mental retardation. The occasional drink in pregnancy has not been proved to be deleterious. Isotretinoin (Accutane) is a powerful drug for acne that has enormous potential for producing congenital anomalies when ingested in early pregnancy; it should never be used in pregnancy. Tetracyclines interfere with development of bone and can lead to stained teeth in children. Progesterone have been implicated in multiple birth defects, but controlled studies have failed to demonstrate a significant association with increased risk. Patients who have inadvertently become pregnant while on birth control pills should be reassured that the incidence of birth defects is no higher for them than for the general population. Phenytoin (Dilantin) is used for epilepsy and can be associated with a spectrum of abnormalities, including digital hypoplasia and facial abnormalities. [/INST] question: In terms of birth defect potential, the safest of the following drugs is | options: A: Alcohol B: Isotretinoin (Accutane) C: Tetracyclines D: Progesterone | answer: D </s> |
<s>[INST] context: CNS involvement in AIDS
Involvement of C.N.S. is a common and important manifestation of AIDS.
In addition to the lymphoid system, the nervous system is a major target of HIV infection.
Macrophages and microglial cells in the central nervous system that belongs to the monocyte and macrophages lineages are the predominant types in the brain that are infected with HIV.
It is widely believed that HIV is carried into the brain by infected monocytes.
Ninety percent of patients demonstrate some form of neurological involvement at autopsy.
C.N.S. involvement in AIDS usually produces AIDS dementia complex.
The pathology associated with AIDS-related cognitive-motor complex sometimes called subacute encephalitis is located mainly in subcortical areas with relative sparing of the cerebral cortex.
Microscopic changes include :
Diffuse white matter pallor
Perivascular infiltrates of lymphocytes and macrophages.
Foci of necrosis, gliosis and/or demyelination
Microglial nodules, macrophages and multinucleated cells.
Remember,
Vasculitis is characteristically absent in CNS involvement in AIDS
Spinal cord involvement in AIDS
The spinal cord involvement in AIDS leads to vacuolar myelopathy. This change consists of white matter vacuolation in the posterior and lateral column and is mainly due to swelling within myelin sheaths.
Involvement of the posterior column gives symptoms similar to subacute combined degeneration of the cord (Vit B12 deficiency). [/INST] question: Which of the following is not seen in HIV involvement of CNS - | options: A: Perivascular giant cell B: Vacuolar degeneration of posterior column C: Microglial nodule formation D: Inclusion bodies | answer: D </s> |
<s>[INST] context: THE human face doesn't lie. We show sadness and happiness through our expressions. But exactly how many emotions can our face make?Scientists used to believe we had six basic facial expressions that tell others how we feel: sad, happy, surprised, fearful, angry and disgusted .
But a new study shows that our faces can do more than we think. Scientists from Ohio State University found out that humans can actually make 21 different facial expressions after studying how people move their facial muscles.
The scientists took pictures of 230 volunteers making faces in response to different cues .These cues included phrases like "you just got some great unexpected news", which produced a "happily surprised" reaction from volunteers. Other cues included "you smell a bad odor ", which caused "disgusted" faces.
In total, around 5,000 pictures were taken of the volunteers. The scientists then studied similarities of these pictures using a computer expression database. _ helped them to define a facial expression. "That tells us that these 21 emotions are expressed in the same way by nearly everyone," said DrAleix Martinez to The Daily Telegraph. For example, to express surprise, 92 percent of volunteers widened their eyes and opened their mouth. And 99 percent raised their cheeks and smiled to show being happy.
We are not always aware of our facial expressions, which can hold clues to how we really feel. So these results may have a big impact on medical treatment. If doctors were able to recognize more complex emotions, it would help doctors treat patients suffering from certain diseases. [/INST] question: Scientists used to believe how many basic facial expressions that tell others how we feel? | options: A: 21 B: 230 C: 92 D: 6 | answer: D </s> |
<s>[INST] context: Suppose a key man in your firm had just met with a terrible accident. The doctor tell you that this man upon whom you depend for directing sales, checking your books or for performing some other important roles, will be laid up for months, You'd have to replace him, wouldn't you? And probably at a pay about equal to his ?
Then you'd be faced with double paying for one job because stopping the pay of an injured man would simply be out of the question.
You can prevent this kind of unproductive outgo on your payroll by providing your key man with the protection of Travelers Business Accident Insurance!
This insurance provides total medical expense and a weekly income in case a key man is disabled for some time. Should the disability prove everlasting, an income for life is certainty. Why not make out a list of your key men now? Then get together with Travelers Insurance Company, and let us tell you how little it costs to apply this much needed protection to your business.
Write and we'll serve you! [/INST] question: The above is most probably _ . | options: A: a report B: a letter C: an announcement D: an advertisement | answer: D </s> |
<s>[INST] context: Likert Scale: Refer to Theory.
Visual analog scale (VAS):
– VAS is a measurement instrument that tries to measure a characteristic that range across a continuum of values and cannot easily be directly measured (For example, the amount of pain that a patient feels ranges across a continuum from none to an extreme amount of pain. From the patient’s perspective this spectrum appears continuous as their pain does not take discrete jumps, as a categorization of none, mild, moderate and severe would suggest)
– Operationally a VAS is usually a horizontal line, 100 mm (10 cms) in length, anchored by word descriptors at each end: patient marks on the line the point that they feel represents their perception of their current state
– VAS score: is determined by measuring in millimetres from the left hand end of the line to the point that the patient marks
– Continuous (or ‘analogue’) aspect of the scale differentiates it from discrete scales such Likert scale
– Is quite used in Anaesthesia.
Guttman Scale:
– Is also known as ‘Cumulative scale’
– Contains a ‘series of statements that expresses increasing intensity’ of a characteristic AND respondent is asked to agree or disagree to with each statement (For example: Asbestos can cause lung cancer – Asbestos is an important cause of lung cancer – Asbestos is a very important cause of lung cancer and death – Asbestos is the most important cause of lung cancer an death in India)
– Perfect Guttman scale: consists of a uni-dimensional set of items that are ranked in order of difficulty from least extreme to most extreme position
Adjectival scale:
– Is a linguistic scale is a set of words, of the same grammatical category, which can be ordered by their semantic strength or degree of information (For example, lukewarm, warm, and hot fall along a single adjectival scale since they indicate a variation in the intensity of temperature of the modified noun). [/INST] question: The response which is graded by an observer on an agree or disagree continuum is based on | options: A: Visual analog scale B: Guttman Scale C: Adjective scale D: Likert Scale | answer: D </s> |
<s>[INST] context: Kim's classification of microsurgical cases
Class A: Represents a tooth with no periradicular lesion, no mobility, and normal pocket depth. The clinical symptoms have not resolved, though non-surgical options have been exhausted. Clinical symptoms are the only reason for the surgery.
Class B: Represents a tooth with presence of a small periradicular lesion with clinical symptoms. The tooth has normal periodontal probing depth and no mobility. The teeth in this class are ideal candidates for microsurgery.
Class C: Represents a tooth that has a large periradicular lesion, progressing coronally; without periodontal pocket and mobility.
Class D: Represents a tooth that is clinically similar to that in Class C, but has deep periodontal pockets.
Class E: Represents a tooth that has a large periradicular lesion with an endodontic-periodontal communication to the apex, but no obvious fracture.
Class F: Represents a tooth with an apical lesion and complete denudation of the buccal plate, but no mobility.
Textbook of Endodontics Nisha GARG 3rd ED [/INST] question: According to Kim's classification of microsurgical cases, which class represents a tooth with an apical lesion and complete denudation of the buccal plate but no mobility: | options: A: Class C B: Class D C: Class E D: Class F | answer: D </s> |
<s>[INST] context: Mike Maietta was eating lunch when he got a text message from his mom.
"Notre Dame," it said. " _ !"
Mike, a senior at a Californian high school, shouted with joy. The big envelope meant that the excellent university in Indiana had offered him a place in its Class of 2013. But the $51,300 annual fee is a big trouble. So Mike and his parents are considering offers from several other colleges and are figuring out the costs of tuition, housing and holiday trips home.
This year, money is the driving factor for a growing number of high school seniors, who have to decide what colleges to attend this fall. Less jobs and house prices have changed family spending.
"We're excited that Mike got into eight great schools," said Mike's father, an engineer at Microsoft. "But if you consider going to school out of state, you've got to think about all of the other costs: moving, flying back and forth for the holidays. You're looking at about $3,000 a year, just for travel."
As families weigh their choices, some are going back to financial aid offices hoping help packages can be increased.
Rachel Brown was happy to get a thick envelope from New York University (NYU). Although she has always wanted to live in Manhattan, she is seriously considering the University of California San Diego (UCSD), because of the high cost in New York.
"The tuition for NYU is twice as much as UCSD," said Rachel, 17. "My mom doesn't want me to have a big debt when I graduate, and I don't want that either. I'd have to take out a loan of $15,000. I'll check and see if there's any way that NYU can offer me any financial aid."
More than 7.6 million American students have filled out the Free Application for Students Aid, 19.9 percent increase over last year.
This month the Federal Department of Education urged college financial aid officers to give more help to certain families. A record 30,428 students applied for 2,300 places at Stanford, partly because the university increased financial aid for families earning below $10,000. [/INST] question: Mike may give up Notre Dame because of _ . | options: A: travel fees B: financial concerns C: poor exam results D: worries about living far away from home | answer: B </s> |
<s>[INST] context: Spending two or three hours playing outdoors each day can reduce a child's chance of becoming short-sighted, a research shows. It challenges the belief that short-sightedness is caused by computer use, watching TV or reading in weak light.
The Australian government researchers believe that sunlight is good for people's eyes. They compared the vision and habits of 100 seven-year-old children in Singapore and Australia. In all, 30% of the Singaporean children were short-sighted--this rate was ten times higher than Australian children.
Both groups spent a similar amount of time reading, watching television and playing computer games. However, the Australian children spent an average of two hours a day outdoors--90 minutes more than the Singaporean children.
Professor Ian Morgan, from the Australian Research Council's Vision Centre, said, "Humans are naturally long-sighted, but when people begin to go to school and spend little or no time outdoors, the number of short-sighted people gets larger. We're also seeing more and more short-sighted children in cities all around the world--and the main reason may be that city children spend less time outdoors."
Daylight can be hundreds of times brighter than indoor light. But why does playing outside prevent us from becoming short-sighted? Scientists believe that natural light has a special chemical which stops the eyeball from growing out of shape and prevents people becoming short-sighted.
So be outdoors. It doesn't matter if that time is spent having a picnic or playing sports. [/INST] question: How much time did the Singaporean children spend outdoors on average every day in the research? | options: A: 2 hours B: 90 minutes C: 1 hour D: 30 minutes | answer: D </s> |
<s>[INST] context: What's your favorite English letter ? Many of you may say Q. Why ? Because so many of you chat with your friends on QQ .
What do you like about QQ? What do you talk about ? The CCTV reporter ,Miss Wang interviews three kids . Let's listen to what they say .
When do you chat on QQ ? What do you talk about ?
Lin Yuhan , Xi'an : On weekends . We talk about homework and chat with each other .
Tang Yuting ,Shanghai : On weekends and when I don't have much homework .We exchange test answers and chat .
Yang Yuhang , Dalian : Our class goes online together at 4--6pm on weekends , We complain about homework ,chat and talk about computer games .
What do you put on your QQ blog ( )?
Lin : I put good articles. I have found online on my blog . I also write articles myself . They are about funny things that have happened in my class .
Tang : I put pictures on my blog . Not my own photos , but pictures from my favorite Japanese cartoons likeTennis Prince and Conan .
Yang: I put DV films on my blog . I shoot ( )them during sports meetings and school parties .The most popular one is about a dancing teacher .It is so funny that everyone watches it .
How do you like QQ?
Lin : It's a good place for us to make a record of our lives of both good times and sad times .
Tang : My friends and I may not have time to chat at school .But we can do it on QQ. It's very helpful to our friendships .
Yang : If you chat with your friends on the telephone ,your parents sometimes listen in on your convercation . There is no such problem with QQ . You can relax and talk freely . [/INST] question: How many kids are interviewed about QQ? | options: A: Nine B: Six C: Three D: Two | answer: C </s> |
<s>[INST] context: American researchers have developed a technique that may become an important tool in fighting AIDS virus from attacking its target-cells in the body's defense system.When AIDS virus enters the blood,it searches for blood cells called T4 lymphocytes .The virus connects to the outside of T4 lymphocytes.Then it forces its way inside.There it directs the cells' genetic material to produce copies of the AIDS virus.This is how AIDS spreads.
Researchers think they may be able to stop AIDS from connecting to T4 ceils.When AIDS virus finds a T4 cell,it actually connects to a part of the cell called CD4 protein.
Researchers want to fool the virus by putting copies or clones of the CD4 protein into the blood.This way the AIDS virus will connect to cloned protein instead of the real ones.Scientists use genetic engineering methods to make the clones.Normally a CD4 protein remains on the T4 cell at all times;the AIDS virus must go to it.
In a new technique,however,the cloned CD4 protein is not connected to a cell.It floats freely,so a lot more can be put into the blood to keep the AIDS virus away from real CD4 protein on T4 cells.One report says the.AIDS virus connects to cloned protein just as effectively as it connects to real protein.That report was based on tests with blood cells grown in labs.The technique is just now beginning to be tested in animals.If successful,it may be tested in humans within a year. [/INST] question: The new technique can _ . | options: A: cure AIDS B: kill the AIDS virus C: prevent the AIDS virus from spreading D: produce new anti-AIDS cells | answer: C </s> |
<s>[INST] context: The patient's young age, occurrence of pain at night, negativity of rheumatoid factor, and especially, bilateral involvement of sacroiliac joints are consistent with ankylosing spondylitis. This is one of the seronegative spondyloarthropathies, characterized by onset before 40 years of age, absence of circulating autoantibodies, frequent association with HLA-B27 histocompatibility antigen, and common involvement of the spinal column. Ankylosing spondylitis should be suspected in any young person complaining of chronic lower back pain and confirmed by radiographs or CT scans of sacroiliac joints. The disease usually progresses to involve the whole vertebral column, producing ankylosis and respiratory failure secondary to restrictive lung disease. Uveitis and aortic insufficiency are additional manifestations.
Degenerative joint disease would be exceptional at such a young age, unless predisposing conditions were present. Degenerative joint disease is not associated with systemic signs and symptoms. Radiographs of affected joints show narrowed interarticular spaces, osteophytes, and increased density of subchondral bone. Sacroiliac joints are not involved. [/INST] question: A 17-year-old boy presents with chronic low back pain and stiffness for the past 8 months. He denies any GIT or genital infections. His temp is 98.6 F. Lab investigation shows normal ESR and negative RA factor. X-ray films of the vertebral column show flattening of the lumbar curve and subchondral bone erosion involving the sacroiliac joints. Most likely diagnosis? | options: A: Ankylosing spondylitis B: Degenerative join disease C: Reiter syndrome D: Seronegative rheumatoid arthritis | answer: A </s> |
<s>[INST] context: TYPES Of MICROSCOPY:
i) In optical or light microscope, examination of wet films or hanging drops indicates the shape, arrangement, motility and approximate size of cells.
ii) In phase contrast microscopy the structures within the bacterial cell and the surrounding medium, which differ in thickness or refractive index are clearly visible. In this microscope, the "phase differences" are converted into differences in intensity of light, producing light and dark contrast in the image.
iii) In Dark field microscope, reflected light is used instead of the transmitted light used in ordinary microscope. With visible light, the limit of resolution is about 300nm.
iv)The interference microscope not only reveals cells organells but also quantitative measurements of the chemical constituents of cells such as lipids, proteins and nucleic acids.
v) The polarization microscope enables the study of intracellular structures using differences in birefringence.
vi) In electronic microscope, a beam of electrons is employed instead of beam of light. The resolving power is 0.1nm. [/INST] question: Which of the following type of microscope not only reveals cell organelles but also quantitative measurement of chemical constituents of cell: | options: A: Light microscope B: Phase contrast microscope C: Dark field microscope D: Interference microscope | answer: D </s> |
<s>[INST] context: When he was driving home one evening on a country road, he saw an old lady, strained on the side of the road. He stopped in front of her car and got out. Even with the smile on his face, she was worried. He looked poor and hungry. He knew how she felt. He said, "I am here to help you, madam. Why don't you wait in the car where it's warm? By the way, my name is Joe."
She had a flat tire . Joe crawled under the car, changed the tire. But he got dirty and his hands hurt. She could not thank him enough and asked him how much she owed him. He told her that if she really wanted to pay him back, the next time she saw someone who needed help, she could give that person the assistance they needed, and Joe added," And think of me."
She drove off. A few miles down the road the lady saw a small restaurant. She went in. The waitress had a sweet smile, and was nearly eight months pregnant. The old lady wondered how someone like her who seemed poor could be so kind to a stranger. Then she remembered Joe. After the lady finished her meal, the waitress went to get her change from a hundred-dollar bill. But she stepped right out the door.
When the waitress came back, she noticed something written on a napkin, "I am helping you because someone once helped me. If you really want to pay me back, here's what you do ---Do not let the chain of love end with you."
That night when she got home, she was thinking about the money and what the lady had written. She and her husband needed money with the baby due next month. She knew how worried her husband was, and as he lay sleeping next to her, she whispered, "Everything's going to be all right. I love you, Joe" [/INST] question: When Joe stopped to help the lady, she_. | options: A: became excited B: was afraid to be hurt C: refused his offer D: met another poor guest | answer: B </s> |
<s>[INST] context: VLDL is synthesized in the liver, particularly after a high carbohydrate meal. It is formed from triacylglycerols that are packaged with cholesterol, apolipoproteins (particularly, apoB-100), and phospholipids, and it is released into the blood, where it acquires apoC-II and apo E.Chylomicrons contain triacylglycerols synthesized from dietary lipid in intestinal epithelial cells. LDL is the cholesterol-rich particle in the blood. Cells take up LDL by LDL binding to the LDL receptor, and the LDL-LDL receptor complex enters the cell via endocytosis. Once inside the cell, the cholesterol is released from cholesterol esters by a lysosomal enzyme and enters the cytoplasm of the cell for further processing. VLDL contains newly synthesized triglyceride and cholesterol produced by the liver. HDL is involved in reverse cholesterol transport, which requires the LCAT reaction. Fatty acids, because they are so hydrophobic, cannot travel freely in the blood and need to be bound to albumin for transport through the circulatory system. [/INST] question: Composed mainly of triacylglycerols synthesized in intestinal epithelial cells is | options: A: Chylomicrons B: VLDL C: LDL D: HDL | answer: A </s> |
<s>[INST] context: Insiduous /gradual onset of fever over a duration of two weeks, with features of raised intracranial tension in the form of vomiting and altered sensorium with characteristic basal exudates and hydrocephalus on cranial CT scan are almost characteristic of tuberculous meningitis.
TUBERCULOUS MENINGITIS
Tuberculous meningitis usually arises from the formation of metastatic caseous lesions in the cerebral cortex or meningitis that develops during the lymphohaematogenous spread of primary infection. This initial lesion increases in size and discharges tubercle bacilli in the subarachnoid space.
This results in gelatinous basal exudate which interferes in the normal flow of CSF, in and out of the ventricular system at the level of basal cisterns leading to a communicating hydrocephalus.
Clinical manifestations of tuberculous meriins
The clinical course of TB meningitis has three stages -
Prodromal stage or stage of invasion
Insidious onset o Headache and vomiting
Low grade fever, loss of appetite o Photophobia
Disturbed sleep o Constipation
2. Stage of meningitis
Signs of meningeal irritation develops - Neck rigidity, Kernig's sign
3. Stage of coma
o Loss of consiousness o Bradycardia
Pupils are dilated & fixed ❑ Chyne-strokes or Biot type of respiration
Episodic decerebration
CT findings in TBM :
Basal cisterns are obliterated by isodense / hyperdense exudate
Post contrast there is a avid enhancement of the basal meninges extending into the ambient, sylvian, pontine and chiasmatic cisterns.
Meningeal enhancement may continue over the cerebral and cerebellar hemispheres.
3. Hydrocephalus is present in 45-87% of patients at time of diagnosis. [/INST] question: A 10 month old child presents with two weeks history off fever, vomiting and alteration of sensorium Cranial CT scan reveals basal exudates and hydrocephalus, the most likely etiological agent is – | options: A: Mycobacterium tuberculosis B: Cryptococcus neoformans C: Listera monocytogenes D: Streptococcus pneumoniae | answer: A </s> |
<s>[INST] context: Let's see each option one by one
Adynamic ileus or Paralytic ileus
is seen commonly after abdominal operations, or post inflammatory conditions of abdomen eg Appendicitis, peritonitis, pancreatitis. Metabolic abnormalities are also a cause.
Abdominal distention, usually without the colicky abdominal pain, is the typical & most notable finding.
Vomiting may occur but may also be absent.
Absent or hypoactive bowel sounds.
Multiple air-fluid levels on x-ray.
Points b & e help in ruling out dynamic ileus.
Pseudo-obstruction
This condition describes an obstruction, usually of the colon in the absence of any mechanical cause
This may occur in acute or chronic form (Acute form is k/a Ogilvie syndrome*) Acute form usually involves only the colon.
Vomiting appears late or even absent.
Abd. cramps appear late.
Abd. distention is the chief symptom.
Since it usually involves the colon air-fluid level are not seen if the ileocecal valve is intact.
Points c, d, e help in ruling out Pseudo obstruction in this pt.
Ca Rectum :
Usually ads. of old age
Obstruction is not a common presentation Even if obstruction occurs, it is insidious in onset with pain & vomiting a late feature. There will be abdominal distention.
These point help in ruling Ca Rectum out.
Duodenal obstruction
Features of this pt. match perfectly with duodenal obstruction as
Pain and vomiting are early features.
No distention of the bowel
No air-fluid level. (There is no distention of bowel and no air fluid level as the whole of the intestinal tract distal to the obstruction is patent allowing free passage to gas and the fluids out of the body. Obstruction to duodenum prevent further entry of gas or fluids into the intestines). [/INST] question: A Pseudo-obstruction of 35-year-old comes to the emergency department with symptoms of pain in abdomen and bilious vomiting but no distension of bowel. Abdominal x-ray showed no air fluid level. Diagnosis is | options: A: CA rectum B: Duodenal obstruction C: Adynamic ileus D: Pseudoobstruction | answer: B </s> |
<s>[INST] context: Immune recognition of viral antigens on the cell surface. Viral cytotoxicity is either direct or indirect (immunologically mediated). Viruses may injure cells directly by subverting cellular enzymes and depleting the cell's nutrients, thereby disrupting the normal homeostatic mechanisms. Some viruses also encode proteins that induce apoptosis once daughter virions are mature. Viruses may also injure cells indirectly through activation of the immune system. Both humoral and cellular arms of the immune system protect against the harmful effects of viral infections by eliminating infected cells. In brief, the presentation of viral proteins to the immune system in the context of a self major histocompatibility complex on the cell surface immunizes the body against the invader and elicits both killer cells and antiviral antibodies. These arms of the immune system eliminate virus-infected cells by inducing apoptosis or by lysing the virally infected target cell with complement. None of the other choices describe mechanisms of indirect viral cytotoxicity.Diagnosis: Hepatitis, viral [/INST] question: A 45-year-old woman presents with a 2-month history of fatigue and recurrent fever. She also complains of tenderness below the right costal margin and dark urine. Physical examination reveals jaundice and mild hepatomegaly. The serum is positive for hepatitis B virus antigen. Which of the following best describes the mechanism of indirect virus-mediated hepatocyte cell death in this patient? | options: A: Accumulation of abnormal cytoplasmic proteins B: Immune recognition of viral antigens on the cell surface C: Generation of cytoplasmic free radicals D: Impaired plasma membrane Na+/K+ ATPase activity | answer: B </s> |
<s>[INST] context: The clinical manifestations (fever, headache, nuchal rigidity, and low Glasgow coma score), along with the CSF findings (increased neutrophils, elevated protein, and reduced glucose), strongly indicate acute pyogenic (bacterial) meningitis as the underlying condition. Of the microorganisms either Neisseria meningitidis or Streptococcus pneumoniae can cause this form of meningitis; however, Streptococcus pneumoniae is by far the most frequent organism causing acute meningitis in elderly patients. Arboviruses and herpesviruses can cause an encephalitis characterized by lymphocytic infiltration of the brain parenchyma and leptomeninges. In this case, CSF findings would include an increased number of lymphocytes and a normal glucose concentration. Mycobacterium tuberculosis may cause a chronic meningoencephalitis, with a prolonged clinical course. It is characterized pathologically by a dense granulomatous infiltrate of the base of the brain. Associated CSF findings include increased lymphocytes and normal or slightly decreased glucose. [/INST] question: A 65-year-old man presents with fever, severe headache, and nuchal rigidity. Physical examination in the emergency depament shows a Glasgow coma score of 7. Lumbar puncture reveals cloudy cerebrospinal fluid (CSF) with 1200 neutrophils/mm3, elevated protein, and decreased glucose. Which of the following is the most probable etiologic agent of this condition? | options: A: Arbovirus B: Herpesvirus C: Mycobacterium tuberculosis D: Streptococcus pneumoniae | answer: D </s> |
<s>[INST] context: Resistance to aminoglycosides is acquired by one of the following mechanisms: (a) Acquisition of cell membrane bound inactivating enzymes which phosphorylate/ adenylate or acetylate the antibiotic. The conjugated aminoglycosides do not bind to the target ribosomes and are incapable of enhancing active transpo like the unaltered drug. These enzymes are acquired mainly by conjugation and transfer of plasmids. Nosocomial microbes have become rich in such plasmids, some of which encode for multidrug resistance. This is the most impoant mechanism of development of resistance to aminoglycosides. Susceptibility of different aminoglycosides to these enzymes differs. Thus, cross resistance among different members is paial or absent. (b) Mutation decreasing the affinity of ribosomal proteins that normally bind the aminoglycoside: this mechanism can confer high degree resistance, but operates to a limited extent, e.g. E. coli that develop streptomycin resistance by single step mutation do not bind the antibiotic on the polyribosome. Only a few other instances are known. This type of resistance is specific for a paicular amino glycoside. (c) Decreased efficiency of the aminoglycoside transpoing mechanism: either the pores in the outer coat become less permeable or the actiYe transpo is interfered. This again is not frequently encountered in the clinical setting. In some Pseudomonas which develop resistance, the antibiotic induced 2nd phase active transpo has been found to be deficient. ESSENTIALS OF MEDICAL PHARMACOLOGY Page no.744 [/INST] question: Enzyme inactivation is the main mode of resistance to: | options: A: Aminoglycosides B: Quinolones C: Rifamycins D: Glycopeptides | answer: A </s> |
<s>[INST] context: When your dream is to become a footballer, nothing should get in your way--even if you have no feet.
Gabriel Muniz, an 11-year-old Brazil kid, was born without feet. Although his family thought he would have serious difficulties living a normal life, he started walking before he was one year old. His mother would go after him, expecting him to keep falling, but he never fell. It took him a while to make the jump from walking to playing football, but he did make it. And, in fact, there's nothing he loves more than playing football. In his school, the skillful youngster is not only the best player in his school team but also the captain of his gym team.
He knows that his disability means he'll never be able to play for a professional football team. So Gabriel is hoping that football will one day become a Paralympics sport. He proved to everyone there he could go head to head with any other boy. Watching him play is unbelievable. He's fast and he's got a big bag of tricks--he's very skilled and he does everything he can to copy his hero, Messi so much that he is invited to go to Spain to meet his hero Messi and show his talent in the Barcelona Football Club.
His coach says he is proving the disability only exists inside our heads and he is challenging the social
. [/INST] question: What's wrong with Gabriel Muniz? | options: A: He can't see and hear anything B: He always gives trouble to his family C: He was born without feet D: He often argues with his partners | answer: C </s> |
<s>[INST] context: In 1933 an unknown American called Clarence Nash went to see the filmmaker Walt Disney. He had an unusual voice and he wanted to work in Disney's cartoon film for children. When Walt Disney heard Nash's voice, he said "Stop! That's our duck!"
The duck was the now-famous Donald Duck, who first appeared in 1934 in the film The Wise Little Hen. Donald lived in an old houseboat and wore his sailor jacket and hat. Later that year he became a star after an eight-minute Mickey Mouse film. The cinema audience liked him because he was lazy and greedy, and because he lost his temper very quickly. And they loved his voice when he became angry with Mickey's eight nephews. Soon Donald was more popular than Mickey Mouse himself, probably because he wasn't a _ like Mickey.
In the 1930s, 40s and 50s Donald and his friends Mickey, Goofy and Pluto made hundreds of Disney cartoons. He also made educational films about the place of the USA in the world, and safety in the home. Then in 1966 Donald Duck and his voice disappeared---there were no more new cartoons.
Clarence Nash died in February, 1985. But today's children can still see the old cartoons on television and hear that famous voice. [/INST] question: Who made Donald Duck film? | options: A: Mickey Mouse B: Clarence Nash C: Walt Disney D: Pluto | answer: C </s> |
<s>[INST] context: Hello, I'm Severn Suzuki speaking for E.C.O. -- The Environmental Children's Organization.
Coming here today, I am fighting for my future. I am here to speak for all generations to come. I am here to speak on behalf of the starving children around the world whose cries go unheard. I am here to speak for the countless animals dying across this planet because they have nowhere left to go. I am afraid to go out in the sun now because of the holes in the ozone . I am afraid to breathe the air because I don't know what chemicals are in it.
You don't know how to fix the holes in our ozone layer. You don't know how to bring back an animal now extinct. And you can't bring back forests that once grew where there is now desert. If you don't know how to fix it, please stop breaking it!
Here, you may be delegates of your governments, business people, organizers, reporters or politicians-- but really you are mothers and fathers, brothers and sister, aunts and uncles-- and all of you are somebody's child.
At school, even in kindergarten, you teach us to behave in the world. You teach us: not to fight with others, to respect others, to clean up our mess, not to hurt other creatures, to share-- not be greedy. Then why do you go out and do the things you tell us not to do?
Do not forget why you're attending these conferences, who you're doing this for-- we are your own children. You are deciding what kind of world we will grow up in. But are we even on your list of priorities? My father always says "You are what you do, not what you say."
Well, what you do makes me cry at night. You grown-ups say you love us. I challenge you, please make your actions reflect your words. Thank you for listening. [/INST] question: What did the speaker mainly talk about? | options: A: politics B: environment C: economy D: war | answer: B </s> |
<s>[INST] context: A new Canada Prize for the Arts and Creativity could be in place by 2010, with large cash prizes for emerging artists in dance, music, theatre and visual arts.
The prize is the idea of Tony Gagliano and David Pecaut, founders of the Luminato festival,who were able to convince the federal government to back it. The federal budget has allocated $25 million to support the awards open to emerging artists. The aim is to create a prize that has the prestige of a Nobel Prize.
"When you think about the major prizes of the world ---- the Nobel Prize in Sweden,the Kyoto prizes in Japan or the Booker Prize in the U.K . --- they bring great honor and opportunity to the countries that award them," Pecaut said."The idea here is that every year,the Canada prizes will be awarded to the very best promising emerging artists around the world in those four fields. "
A jury of international experts would judge the 12 finalists,who would come to Canada and perform or show their work in public to win the Canada prizes.The performances would be televised, allowing Canadians across the country to see it.
The federal government liked the idea of such an international prize that would advance Canada's brand,draw tourists and arts professionals from around the world.For the Canadian arts community, one of the greatest challenges is connecting to that international arts world to come up with co-productions and foreign investment and touring chances.
A group is working toward establishing the prize by 2010,with potential for semi-final rounds to take place about the same time as the Vancouver Olympic Games."Thirty or forty years from now,the future outstanding dancers and performers will look back and say, 'I broke out on the world scene in Toronto -- that's where I was discovered.' " [/INST] question: Why did David Pecaut have the idea of founding a new Ganada Prize? | options: A: To enlarge the content of the Luminato festival B: To advance Canada's honor and opportunities C: To consider his own benefits from the prize D: To make more Canadians get world prizes | answer: B </s> |
<s>[INST] context: "An apple a day keeps the doctor away." Similarly, if we drink a little more water ever day, we may find that we need to go to the doctor a lot less often. A healthy diet is made up of water and a great many different kinds of foods. We know that healthy foods like fruits, vegetables and fish, are important as they provide us with energy and fibre, without giving us too much fat and sugar. But why is water important?
The human body needs water to survive. Water is important as it carries poisons and waste out of our bodies. However, doctors advise us to drink plenty of water, much more than the small amount we need to stay alive.
Some doctors believe that water is important for our health in all kinds of ways. They believe that a great many illnesses and health problems stars as a result of dehydration--a lack of water in the body. Most people are dehydrated at least some of time, although they probably don't know it. It is surprising to learn that if we feel thirsty, we are already in the first stages of dehydration. In fact, we are advised to drink water before we feel thirsty.
These doctors think that health problems such as headaches, high blood pressure and asthma could be helped if people drink more water. They also believe that drinking more water can help people who are overweight. Water contains no calories so it will not make us put on weight. If we drink water, we will probably drink less sugary soft drinks such as Coca-cola. Doctors also believe that drinking more water may stop people from overeating. They say that many people think that they are hungry when they are, in fact, thirsty. Doctors suggest, therefore, that we eat less food and drink more water.
There are still many health problems that cannot be solved by drinking water, so we should not stop going to seeing the doctor completely. However, if we make a decision to drink water every day, we may find that we need to go to the doctor a lot less often. [/INST] question: We need _ for a healthy diet. | options: A: fibre B: food C: water D: Water and different foods | answer: D </s> |
<s>[INST] context: A traveler lost his way and got off the highway to see where he was. As he drove by, he saw rows and rows of pigpens and pigs running in fields. Suddenly, his eyes caught something really strange. It looked like a pig with a wooden leg.
He drove up into the arm, where he met the farmer. " Excuse me, " the traveler said. " I was just driving by and looking at all your pigs, and I just had to stop and ask about it. Tell me, is there really a pig out there with a wooden leg?" The farmer smiled. " Oh, that would be old Caesar you saw. He's the finest pig I've ever had ---and smart! Well, let me tell you a little about that pig."
" One night a couple of years ago I got to drinking and I guess I had more than I should have. I fell down and knocked over a lamp. That started a fire in the house and old Caesar smelled the smoke. He came in the back door, got the wife and kid out, roused me up and got me out. There is no question about it ---- that night old Caesar saved all our lives. You know that I'm not going to forget it too easily."
" Why," the traveler said, " this is amazing! I have never heard of a pig like this before! This is fantastic! But tell me, how did he get that wooden leg?"
The farmer laughed and said, " Well, when you have a pig so smart, you don't want to eat him all at one time!" [/INST] question: The farmer thought the pig _ . | options: A: very fat B: very clever C: very kind D: very strange | answer: B </s> |
<s>[INST] context: WASHINGTON---At least four more U.S. air-traffic controllers are caught nodding off on the job at three separate airports across the nation, the government said Wednesday.
The controller working alone in the tower fell asleep and was out of communication for 16 minutes while a medical flight carrying a patient was trying to land at about 2 A.M. Wednesday at Reno-Tahoe International Airport in Nevada, the Federal Aviation Administration (FAA) said in a statement.
The FAA announced that it is also investigating a controller who fell asleep Monday at Boeing King County International Airport in Seattle and two controllers who were unresponsive at Preston Smith International Airport in Lubbock, Texas, on March 29.The agency had earlier revealed that an air-traffic supervisor fell asleep March 23 at Ronald Reagan Washington National Airport and a controller slept for five hours at McGhee Tyson Airport in Knoxville, Tennessee on Feb.19.
"I am sick of this," Senate Commerce, Science and Transportation Chairman Jay Rockefeller, a West Virginia Democrat, said in a statement. "We can't have an aviation system where some of the people responsible for safety are asleep at the switch."
As the incidents pile up, sleep experts say it demonstrates that the agency faces a systemic issue with the thousands of people expected to work through the night in safety-critical jobs. Scientific research shows that workers on midnight shifts make more errors because it is so difficult for the body to adapt to sleeping during the day, they say. ks5u
The agency will add an extra controller at the 27 towers staffed with one worker on the midnight shift, the FAA statement said. Agency chief Randy Babbitt and the controllers' union president, Paul Rinaldi, will visit facilities around the country next week to reinforce the need for "the highest professional standards," according to the FAA.
Doug Church, a spokesman for Rinaldi of the National Air Traffic Controllers Association, didn't immediately return a telephone call for comment.
Representative John Mica, the Florida Republican who chairs the House transportation committee, criticized the decision to add controllers. "Only in the federal government would you _ , averaging $161,000 per year in salary and benefits, that aren't doing their job," Mica said in a statement. Mica has pushed legislation that would allow as many as 90 smaller airports to switch from federal to private controllers.
"People have known these problems with fatigue have existed for years," said John Goglia, a Boston-based aviation safety consultant. "They're now showing up. The FAA is admitting they exist. Now the FAA needs to work on it."
Babbitt said April 6 a controller was in the process of being fired for deliberately sleeping on the job at the McGhee Tyson Airport in Knoxville, Tennessee, on February 19.
The four controllers in Nevada, Seattle and Texas have been suspended pending investigations, the FAA said. [/INST] question: _ controllers since February have been caught sleeping on duty at night or early morning. | options: A: 4 B: 5 C: 6 D: 7 | answer: C </s> |
<s>[INST] context: Developmental milestones:-
GROSS MOTOR DEVELOPMENT:
2 months: Holds head in the plane of rest of the body when held in ventral suspension. In the prone position in bed, the chin lifts momentarily.
3 months: lift head above the plane of the body. Head control starts by 3 months and fully developed by 5 months.
4 months: Remain on forearm support if put in prone position, lifting the upper part of the body off the bed.
5 months: Rolls over.
6 months: sit in a tripod fashion.
8 months: sits without support., 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 support.
15 months: walks well, walks backward/ sideways pulling a toy. May crawl upstairs.
18 months: Runs, walks upstairs 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 start to develop. Turns to sound above the level of ear.
9 months- immature pincer grasp, probes with the 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, vertical 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 the mirror, shows displeasure when toy pulled off.
9 months: waves bye bye.
12 months: comes when called, plays a simple ball game. kisses the parent on request. Makes postural adjustments for dressing.
15 months: jargon, starts imitating mother.
18 months: copies parents in tasking, dry by day, calls mother when he wants potty, points to three parts of the body on request.
2 years: ask for food, drink, toilet, pulls people to show toys.
3 years: shares toys, know full name and gender, dry by night.
4 years: Plays cooperatively in a group, goes to the toilet alone, washes face, brushes teeth. Role play.
5 years helps in the household task, dresses and undresses.
LANGUAGE MILESTONES:
1 month: alerts to sound.
2 month: respond to sound by startle or quietening 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: a vocabulary of 10 words. Can name one part of the body.
2 years: 3-word simple sentences.
3 years: asks questions, knows full name and gender.
4 years: says songs or poem, tells a story, knows three colors.
5 years: ask the meaning of words. [/INST] question: Developmental milestone attained at 9 months of age is | options: A: Knows full name and gender B: Monosyllables C: Builds tower of 2 blocks D: Stands with support | answer: D </s> |
<s>[INST] context: The brain receives information from the outside world through the sensory system.This information is collected through the eyes,the nose,the ears,the mouth and the surface of the body.It is then kept in the memory.In fact,scientists do not completely understand how the memory works but they are not sure how much information that the human brain can store.Also, it appears that the information is never lost.Very old people often remember things that happened in their childhood which have not come to their minds for sixty to seventy years.If we have kept something in our memory, it is here.But can we get it out again and use it? That is the difficulty.
Some of the information we receive only goes into the Short Term Memory.We only keep this information for a minute or two,then we lose it.This temporary memory is very important in our thinking and understanding.It is used,for example,when you try to remember a name that someone told you a moment ago or a telephone number that you are going to dial .School children in class often seem to use the Short Term Memory if they are not interested in the subject.When school teachers describe this,they say that things go"in one ear and out in the other".But if a child is interested,he puts the information in his Long Term Memory, and he never loses it.Long Term Memory depends heavily on our understanding of the meaning of the information we receive. [/INST] question: Information is collected through the _ of sight,hearing,smell,taste and touch. | options: A: sense B: experience C: practice D: brightness | answer: A </s> |
<s>[INST] context: A Bite of China, made by CCTV's Documentary Channel, sparked discussion not only on Chinese food, but also on locally made documentary programs.
When you think of documentaries, you may think of them as long, boring programs. But documentaries can be wonderful and bring stories from the real world into our homes. With fascinating footage and stories, documentaries encourage us to think about interesting issues we wouldn't necessarily know about.
So, what makes a good documentary, and what should we pay attention to when we watch one? Here, we offer a few easy strategies to help you get the most out of watching documentaries.
Pay attention to the themes
While watching a documentary, keep your eyes and ears peeled for the themes people talk about and what ideas they focus on. Is it meant to be informative or raise a certain emotional response?
Think critically
Listen to what the people in the documentary are saying and ask yourself the following questions: If you were debating with someone or introducing a new concept, would you say the things the people in the documentary are saying? Do the arguments make sense?
Check the sources
If you're sitting at the computer and can't think of anything to do, why not look up the points the documentary made and see if they are accurate? You could even read more about what is presented in the documentary.
Who are the creators?
The creators or financial backers of a film will usually be involved with how the subject matter is presented. For instance, as the documentary 2016: Obama's America was directed in large part by a conservative writer, it's not surprising that it's critical of President Obama from the beginning. [/INST] question: Which of the following is the most proper to describe documentaries? | options: A: non-fictional B: controversial C: subjective D: thoughtful | answer: A </s> |
<s>[INST] context: DUCHENNE MUSCULAR DYSTROPHY (PSEUDO HYPERTROPHIC MUSCULAR DYSTROPHY)
Duchenne muscular dystrophy is the most common hereditary neuromuscular disease affecting all races and ethnic groups.
Inheritance: X linked recessive
Presentation occurs between ages 3 and 5
Pathogenesis
Duchenne muscular dystrophy is caused by a mutation in the gene responsible for producing dystrophin.
Dystrophin is `subsarcolemmal protein' localized to the inner surface of the sarcolemma of the muscle fibre.
Dystrophin is part of Dystrophin - Glycoprotein sarcolenzmal complex and this protein deficiency leads to secondary loss of sarcoglycans and dystroglycans resulting in weakness of sarcolemma, causing membrane tears and muscle fibre necrosis.
Clinical manifestations:
Gower's sign is positive
Pseudohypertrophy of the calf is seen (muscle is replaced by fat & connective tissue)
Loss of muscle strength is progressive.
Proximal muscles and neck flexors are involved more
Leg involvement is more severe than arm involvement.
Contractures of heel cords and iliotibial band occurs (by age of 6 years)
progressive scoliosis develops.
Complications:
Chest deformity (scoliosis): Impairs pulmonary function By age of 16 and 18 years patients are predisposed to serious pulmonary fatal infections.
Cardiac: Cardiomyopathy and CHF may be seen Cardiac cause of death is uncommon
Intellectual impairment: is common (IQ is one SD below the mean) [/INST] question: Duchenne Muscular Dystrophy is a disease of – | options: A: Neuromuscular junction B: Sarcolemmal proteins C: Muscle contractile proteins D: Disuse atrophy due to muscle weakness | answer: B </s> |
<s>[INST] context: Biceps femoris - hybrid muscle - have two nerves supply - Present in posterior compament (lateral) of thigh It has two heads Long head: 1. Originates from inferomedial pa of upper area of ischial tuberosity. 2. Innervated by sciatic nerve - common fibular division. Sho head: 1. Arise from lateral lip of Linea aspera on shaft of femur. 2. innervated by sciatic nerve - common fibular division. It flexes & laterally rotates leg at knee joint; Extends & laterally rotates thigh at hip joint Long head is a pa of hamstrings while sho head is not - gracilis, adductor longus, adductor magnus - belong to medial compament of thigh Muscle Origin Inseion Innervation Function * Gracilis A line on external surface of body of pubis, the inferior pubic ramus & ramus of ischium Medial surface of proximal shaft of tibia. Obturator nerve (L2, L3) Adducts thigh at hip joint & flexes leg at knee joint. * Adductor longus External surface of body of pubis (triangular depression inferior to pubic crest & lateral to pubic symphysis) Linea aspera on middle 1/3rd of shaft of femur Obturator nerve (anterior division L2, L3, L4) Adducts & medially rotates thigh at hip joint * Adductor magnus Ischiopubic ramus Ischial tuberosity Adductor pa - Posterior surface of proximal femur, Linea aspera, medial supracondylar line Hamstring pa - Adductor tubercle, medial supracondylar line Obturator N (L2, L3, L4) Sciatic N (tibial division) (L2, L3, L4) Adducts & medially rotates thigh at hip joint Extends thigh at hip joint. [/INST] question: Tibial and common peroneal nerve supplies the muscle (FMGE Dec 2018) | options: A: Gracilis B: Biceps femoris C: Adductor longus D: Adductor magnus | answer: B </s> |
<s>[INST] context: MIT ( Massachusetts Institute of Technology) is a world-class university mainly in math, science and technology, but you may be surprised to learn that MIT sets arts courses.
MIT believe in the passion of learning, the value of working and teaching methods. MIT's teaching power is quite strong. There are eight Nobel winners and many other national and international winners in the teacher group of MIT. MIT is proud of these top scholars and thinkers.
The ratio of teachers and students in MIT is about 1 to 7.5. About 63 percent of the classes have fewer than 20 students each. Only 4 percent of the classes have more than 100 students each. Most MIT students can learn courses that they like.
The students in MIT have many activities when they finish their lessons, for example:
Student Life And Culture
Student Organizations
Music & The Arts @ MIT
Athletics
Most students in famous universities feel serious pressure both in life and study. In MIT the students have the same pressure which encourages them to have to study hard. But MIT usually gives one year for the new students to adjust to the transition (;). In their first term all the new students are graded by a test. In this test if he or she receives a C or the level better than C, his or her result will be kept forever. If she or he receives a D or an F, no record will be kept. [/INST] question: Which courses are well-known in MIT? | options: A: math B: science C: technology D: all above | answer: D </s> |
<s>[INST] context: While children are dogs---loyal and affectionate --teenagers are cats. It's so easy to be a dog owner. You feed it, train it, and boss it around. It puts its head on your knee and gazes at you as if you were a Rembrandt painting. It bounds indoors with enthusiasm when you call it.
Then around age 13, your adoring little puppy turns into a big old cat. When you tell it to come inside, it looks amazed, as if wondering who died and made you emperor. Instead of dogging your doorsteps, it disappears. You won't see it again until it gets hungry--then it pauses on its sprint through the kitchen long enough to turn its nose up at whatever you're serving. when you reach out to ruffle its head, in that old affectionate gesture, it twists away from you, then gives you a blank stare, as if trying to remember where it has seen you before.
You, not realizing that the dog is now a cat, think something must be desperately wrong with it. It seems so antisocial, so distant, sort of depressed. It won't go on family outings.
Since you are the one who raised it, taught it to fetch and stay and sit on command, you assume that you did something wrong. Flooded with guilt and fear, you redouble your efforts to make your pet behave.
Only now you're dealing with a cat, so everything that worked before now produces the opposite of the desired result. Call it, and it runs away. Tell it to sit, and it jumps on the counter. The more you go toward it, wringing your hands, the more it moves away.
Put a dish of food near the door, and let it come to you. But remember that a cat needs your help and your affection too. Sit still, and it will come, seeking that warm, comforting lap it has not entirely forgotten. Be there to open the door for it.
One day your grown-up child will walk into the kitchen, give you a big kiss and say, "You've been on your feet all day. Let me get those dishes for you. "
Then you'll realize your cat is a dog again. [/INST] question: When you call a dog, how will it probably react to you? | options: A: excitedly B: indifferently C: angrily D: calmly | answer: A </s> |
<s>[INST] context: The patient is giving symptoms of the acute viral syndrome.
The clinically acute viral syndrome is associated with nonspecific symptoms including a sore throat, myalgia, fever, rash, weight loss and fatigue
Patient with primary HIV infection develops the acute viral syndrome 3-6 weeks after infection, which resolves spontaneously in 2-4 weeks.
During this phase, the immune response to HIV infection has not yet developed. There are no HIV specific antibody ie., no seroconversion.
Since these phases are characterized by high level of viremia, the infection in these stages can be diagnosed by direct detection of virus or virus particles.
A variety of laboratory tests are available for the direct detection of HIV or its components.
p24 Ag Assay
The simplest of the direct detection test is p24 antigen capture assay.
During the first few weeks of infection before an immune response develops, there is a brisk rise in p 24 antigen. After the development of the p24 antibody, these levels decline. Thus p24 Ag assay has its greatest use as a screening test for HIV infection in patients suspected of having the acute HIV syndrome as high levels of p24 Ag are present prior to the development of antibody.
Detection of HIV RNA
Measurement of HIV RNA in the plasma of patients with HIV infection is also useful in conditions where measurement of anti-HIV antibodies is not possible e.g. in acute infections and in neonatal infections.
Currently, three assays are available for the diagnosis of HIV RNA.
HIV RNA by PCR
HIV RNA by bDNA
HIV RNA by NASBA
Note: In neonates, there is the passive transmission of antibodies from the mother. Thus the antibodies cannot be used for the diagnosis in this condition as it would be impossible to tell whether the antibodies detected are acquired from the mother or they have developed as a result of infection.
With the use of direct detection techniques, there is a decrease in the interval between infection and detection of (window period).
Window period for
Antibody testing → 22 days approximately
p24 Ag Assay → 16 days
HIV RNA → 12 days. [/INST] question: A patient comes to the hospital with a history of a sore throat, diarrhoea and sexual contact 2 weeks before. The best investigation to rule out HIV is - | options: A: P24 antigen assay B: ELISA C: Western blot D: Lymph node biopsy | answer: A </s> |
<s>[INST] context: A board game is a game played on a pre-marked surface or "board" according to a set of rules. Board games have been played in most cultures and societies throughout history. Do you think of yourself as a bit of an expert at board games like chess or Go?
Maybe you're not quite as good as you think. New research from the University of Manchester and Oxford suggests complex games like these are impossible to learn fully. They may even be too complex for the human mind to understand.
Researchers studied two-player games, to try and understand the strategies which people use to make decisions during the game. Some games with two players are simple, with only a small number of possible moves. Players can quickly work out the best strategy but that means the game soon becomes boring.
It gets more interesting when there are many possible moves. That's why people are so fascinated by complex board games like chess or Go, or some card games. But what the researchers found was that with difficult games, players find it hard to work out the best strategy and their actions become less reasonable.
This research is part of the field called game theory: the study of human strategic decision-making. Much thinking on how people play complex games is based on something called "the balance point", which is when players have a perfect knowledge of what they are going to do and of what their rivals are going to do.
When you add more than two players then of course the game becomes even harder to understand. Trading on the stock market is an example of a complex multi-player game. [/INST] question: Which of the following games belongs to board games? | options: A: football B: badminton C: swimming D: Mahjong | answer: D </s> |
<s>[INST] context: Most tissue adhesives or glue are cyanoacrylate polymers, such as n-butyl-2-cyanoacrylate (eg, Histoacryl®, PeriAcryl®) or 2-octyl cyanoacrylate (eg, Dermabond®, Surgiseal).
Cyanoacrylate tissue adhesives are liquid monomers that undergo an exothermic reaction on exposure to moisture (eg, on the skin surface), changing to polymers that form a strong tissue bond. When applied to a laceration, the polymer binds the wound edges together to allow normal healing of the underlying tissue.
Compared with wounds closed with sutures, the tensile strength of wounds closed by tissue adhesives is less at the time of initial application, but equalizes by one week post-repair.
Advantages:
Less painful application, and sometimes no need for local anesthetic injection
More rapid application and repair time
Cosmetically similar results at 12 months post-repair
Waterproof barrier
Antimicrobial properties
Better acceptance by patients
No need for suture removal or follow-up
Indications and contraindications:
For use of tissue adhesives the wound needs to be clean, dry with near perfect hemostasis and under no tension.
Complex stellate lesions or crush injuries should not be closed with tissue adhesives since good wound approximation is difficult to achieve.
Tissue adhesives are not recommended for lacerations of the hands, feet, or joints, since repetitive movements could cause the adhesive bond to break before sufficient tensile strength is achieved.
Tissue adhesives are not recommended for the oral mucosa or other mucosal surfaces or areas of high moisture such as the axillae and perineum.
Lacerations involving the hairline or vermilion border require more precision, and should be repaired with traditional sutures. [/INST] question: Tissue suturing glue contains: | options: A: Cyanoacrylate B: Ethanolamine oleate C: Methacrylate D: Polychloroprene | answer: A </s> |
<s>[INST] context: I shall never forget the night, a few years ago, when Marion J. Douglas was a student in one of my calsses. (I have not used his real name for personal reasons. As he requested.) But here is his real story as he told it before one of our adult - education classes. He told us how tragedy had struck at his home, not once, but twice. The first time he had lost his five-old daughter, a child he adored. He and his wife thought they couldn't bear that first loss; but, as he said:"Ten months later, God gave us another little girl and she died in five days."
This double
was almost too much to bear. "I couldn't take it," this father told us. "I couldn't sleep, I couldn't eat, I couldn't rest or relax. My nerves were entirely shaken and my confidence gone." At last he went to doctors; one recommended sleeping pills and another recommended a trip. He tried both, but neither helped. He said:"My body felt as if it was surrounded in a vice , and the jaws of the vice were being drawn tighter and tighter." The tension of grief ----if you have ever been paralyzed by sorrow, you know what he meant.
But thank God, I had one child left ----a four --year-- old son. He gave me the solution to my problem. One afternoon as I sat around feeling sorry for myself, he asked; 'Daddy, will you build a boat for me?' I was in no mood to build a boat; in fact, I was in no mood to do anything. But my son is a persistent little fellow! I had to give in.
Building that toy boat took me about three hours. By the time it was finished, I realized that those three hours spent building that boat were first hours of mental relaxation and peace that I had had in months! I realized that it is difficult to worry while you are busy doing something that requires planning and thinking. In my case, building the boat had knocked worry out of the ring. So I determined to keep busy.
The following night, I went from room to room in the house, making a list of jobs that ought to be done. Scores of items needed to be repaired: bookcase, stair steps, storm windows, window-shades, locks, leaky taps. Amazing as it seems, in the course of two weeks I had made a list of 242 items that needed attention.
"During the last two years I have completed most of them. I am busy now that I have no time for worry."
No time for worry! That is exactly what Winston Churchill said when he was working eighteen hours a day at the height of the war. When he was asked if he worried about his huge responsibilities, he said :"I am too busy. I have no time for worry." [/INST] question: Marion felt his body as if it was caught in a vice because _ . | options: A: he couldn't earn enough money to support his family B: he was suffering from sleeplessness disease C: he couldn't get out of mental pressure D: he felt tired of adult-education classes | answer: C </s> |
<s>[INST] context: Below is a discussion on http://www.TalkingPoints.com/.
Stuck on a desert island?
Started on 23rd April by Steve Posts 1 - 7 of 42
Post 1
Steve
USA Hi, everyone. What would you miss most and least if you were stuck on a desert island? For me, it would be the changing seasons in New England. I guess this will sound stupid but I'd probably miss the rain, too. I would not miss getting up at six every day to go to work, though! What about you?
Post 2
Tomas
Germany Good question. Steve, I think I'd miss different types of bread, and shopping at the supermarket. I'd miss the food most. What would I miss least? My mobile phone---I'd like to be completely quiet --- at least for a little while
Post 3
Paola
Italy I would miss the company of people because I know I'd like to have someone to share experiences with. I'd go mad on my own. And I sure would not miss junk mail--- I hate coming home every evening and a pile of junk mail in my post box.
Post 4
Miko
Japan Hi, I would miss Manga cartoon, the internet and Japanese food, like sushi. I'd also miss TV shows and shopping for clothes... In fact, I'd miss everything.
Post 5
Roger
UK I would miss my daily newspaper and listening to the news on TV and radio. I'd feel very cut off if I didn't know what was happening in the world. What I'd miss least would be traffic jams in the city, particularly my journey to work.
Past 6
Jayne Why hasn't anyone mentioned their family? I'd be lost without my husband and two kids. They're the most important for me. And I can't get started in the morning without a cup of black coffee. I wouldn't miss doing the housework!
Post 7
Jaime
Mexico It would have to be music. I couldn't live without my music. I wouldn't miss going to school at all or doing homework! [/INST] question: Who would miss his or her family most? | options: A: Jaime B: Jayne C: Miko D: Paola | answer: B </s> |
<s>[INST] context: The primary treatment of digoxin toxicity is digoxin immune fab, which is an antibody made up of anti-digoxin immunoglobulinfragments. This antidote has been shown to be highly effective in treating life-threatening signs of digoxin toxicity such as hyperkalemia, hemodynamic instability, and arrhythmias. Fab dose can be determined by two different methods. First method is based on the amount of digoxin ingested whereas the second method is based on the serum digoxin concentration and the weight of the person. Other treatment that may be used to treat life-threatening arrhythmias until Fab is acquired are magnesium, phenytoin, and lidocaine. Magnesium suppresses digoxin-induced ventricular arrhythmias while phenytoin and lidocaine suppresses digoxin-induced ventricular automaticity and delay afterdepolarizations without depressing AV conduction. In the case of an abnormally slow hea rate (bradyarrhythmias), Atropine, catecholamines (isoprenaline or salbutamol), and/or temporary cardiac pacing can be used Refer kDT 6/e p499 [/INST] question: Best treatment of severe digitalis toxicity is | options: A: Potassium supplements B: Diphenyl hydantoin C: Quinidine D: Fab fragments of digitalis antibody | answer: D </s> |
<s>[INST] context: The Internet has become part of teenagers' life. A new report shows that 38 percent (......) of 3,375 students use the Internet often.
Most of the students get useful information for their studies, but some are not using it in a good way. Many students are playing online games too much. Some even visit some unhealthy websites. A teacher from Beijing Yinghua Middle School, Hong Ying warns that something bad can happen if young people spend too much time on the Internet. She said that one of her students used to be good at school. But when he started visiting unhealthy websites,he hurt a girl by cheating online. At last the police caught him and sent him into the prison .
In order to help young people use the Internet safely, some schools in Shanghai find a good way. The schools provide a textbook for the students. The book uses real examples to teach students about good ways of using the Internet. Teachers and parents all think the book is good.
Hong said that the book will help students keep away from the bad behaviors of using computer. The book will teach students how to be a good person in the online world. [/INST] question: _ of the 3,375 students use the Internet very often. | options: A: 10 B: 18 C: 38 D: About 1282 | answer: D </s> |
<s>[INST] context: Folic acid deficiency in Pregnancy
In nonpregnant women, the folic acid requirement is 50 to 100 μg/day
During pregnancy, requirements are increased and 400 μg/day is recommended
The earliest biochemical evidence is low plasma folic acid concentrations
Normal serum folate levels
Non Pregnant women: 5.4-18ng/ml
1st trimester: 2.6-15ng/ml
2nd trimester: 0.8-24ng/ml
3rd trimester: 1.4-20.7ng/ml
Early morphological changes usually include neutrophils that are hypersegmented and newly formed erythrocytes that are macrocytic
As the anaemia becomes more intense, peripheral nucleated erythrocytes appear, and bone marrow examination discloses megaloblastic erythropoiesis
The fetus and placenta extract folate from maternal circulation so effectively that the fetus is not anaemic despite severe maternal anaemia
Treatment
As little as 1mg of folic acid administered orally once daily produces a striking haematological response
By 4 to 7 days after beginning folic acid treatment, the reticulocyte count is increased, and leukopenia and thrombocytopenia are corrected
American College of Obstetricians and Gynecologists (2013c) have recommended that all women of childbearing age consume at least 400 μg of folic acid daily
Increased need of Folic acid
Multifetal pregnancy
Hemolytic anaemia
Crohn disease
Alcoholism
Inflammatory skin disorders [/INST] question: The dose of folic acid per day for treating megaloblastic anaemia in pregnancy | options: A: 400 μg B: 1 mg C: 5mg D: 2 mg | answer: B </s> |
<s>[INST] context: At the World Expo Shanghai 2010, you will be able to see the world in just one day.
The World Expo (short for "exposition") is the third largest world event after the Olympics and the FIFA World Cup. Countries build pavilions at the Expo, showing off technologies and cultures with colorful exhibitions and performances.
People can experience the most advanced technologies at the World Expo. Throughout history, many new inventions have made their debuts at the World Expo, including the TV, telephone and even the ice cream cone.
But the Expo is not just a trade fair . It's a platform for cultural exchange, bringing people closer to the rest of the world.
For example, at the Shanghai Expo, couples may be able to marry in French-style weddings at the France Pavilion. Thailand will let visitors walk into its emperor's palace. Visitors to the Austria Pavilion will have the chance to experience the snow-capped mountains of the country.
Many countries have also decided to bring their national treasures to the event.
Since the 1993 Expo in Chicago, the World Expo began to focus on one theme. It changed from a show into a community event. Visitors are invited to help solve global issues, such as environmental problems.
The theme of the Shanghai Expo is "Better city, better life". It will call on the world to solve the problems human beings face as a result of urbanization . In the future, more and more people may care about protecting the places they live in. [/INST] question: Countries build pavilions to show us _ with colorful exhibitions and performances. | options: A: the Olympic games B: the FIFA World Cup C: technologies and cultures D: many cities | answer: C </s> |
<s>[INST] context: Chinese star Yao Ming has retired. Yao made it official Wednesday, telling a news conference that a series of foot and leg injuries forced him to end his playing career at the age of 30.
"I will formally end my career,'' said Yao, who became a household name in China before starting his NBA career with the Houston Rockets in 2002. Yao played eight seasons in the NBA.
"Today is an important day for me and holds a special meaning for both my basketball career and my future,'' Yao said. "I had to leave the court since I suffered a stress fracture in my left foot for the third time at the end of last year. My past six months were a painful wait. I have been thinking about my future over and over. Today I am announcing a personal decision, ending my career as a basketball player and officially retire. But one door is closing and another one is opening.''
Yao said he would return to work with his former Chinese team, the Shanghai Sharks, with the possibility of becoming general manager. He already owns the club and wants to contribute more. "My playing career started with the club. I hope I can do something for it,'' Yao said.
He later appeared with his family on the stage to the applause and cheers of the crowd. He thanked a lot of people -- his family, former coaches, even players like Shaquille O'Neal -- "for making me a better player.''
Rockets general manager Daryl Morey was among those attending the farewell conference Wednesday. Morey made the long trip from Houston. Morey said 20 hours on planes was tiring but "I would be sorry if I wasn't here." "It's a big moment,'' Morey added. "Yao had a sense of humor, a great attitude and sense of responsibility. I hope we can continue his culture in the NBA.'' [/INST] question: Yao Ming has retired from basketball because of _ . | options: A: his age B: his bad conducts on the court C: his foot and leg injuries D: his poor health | answer: C </s> |
<s>[INST] context: When Jackie Robinson walked onto Ebbets Field in Brooklyn, New York, on April 15, 1947, he changed baseball forever. As the first African American to play in the Major League in modern times, many believe he changed the country forever.
Robinson was born in 1919. He lived in a time when rules controlled what African Americans could do. He was a top athlete, playing football, basketball and baseball. But playing for a major League team was off limits to Robinson because of his race.
Branch Rickey, president and manager of the Brooklyn Dodgers, signed (......) Robinson in 1947. He believed that Robinson not only had the skills, but the courage to face the challenge of becoming modern baseball's first black player.
It wasn't easy. Robinson sometimes faced boos from fans. But he became a star, anyway. In 1962, he became the first African-American player chosen to enter the Baseball Hall of Fame. In 2005, he was awarded a Congressional Gold Medal, the highest award Congress can give to an American.
By breaking baseball's color barrier , Robinson opened the door for many to follow his footsteps, not only in baseball, but in other areas of life as well. After he stopped playing the game, Robinson worked as a manager for a coffee company. He wrote a newspaper column . He also started a bank. [/INST] question: Before Jackie Robinson, no African-American players could _ . | options: A: play baseball B: play in the Major League C: play football and basketball D: watch Major League games | answer: B </s> |
<s>[INST] context: Although 19-year-old George Dennehy is armless, he isn't letting that stop him from pursuing his dreams and sharing his passion with the world.
Born without arms, the young boy's birth parents left him. Luckily, a warm-hearted couple _ him and took good care of him. However, his new parents never allowed him to use his disability as an excuse to be lazy. When George turned eight, they asked him to sign up for cello lessons. The instrument is tough even for people who have the use of both their hands, so it was even more challenging for George, who had to learn to play it with his feet.
Thanks to his music teacher, the young boy not only mastered the cello, but also realized that he had a passion and talent for music. During middle school years, he also mastered the piano and guitar.
His music talent caught the eye of an American rock band who invited him to perform alongside them at a ten-day-long music festival.
The experience has inspired this once shy boy to pursue a career in music. He has also become a motivational speaker who encourages both able and disabled people to pursue their dreams, no matter how impossible these dreams may sound.
Geoge Dennehy is armless, he isn't letting that stop him from pursuing his dreams and sharing his passion with the world. [/INST] question: When did George Dennehy begin to learn play the cello? | options: A: at the age of 19 B: at the age of 8 C: when he began to go to school D: We don't know | answer: B </s> |
<s>[INST] context: Can you imagine a classroom without one thing that has long been considered a necessary part? No notebooks, no textbooks, no test papers. Nor are there any pencils or pens, which always seem to run out of ink at the _ moment.
A "Paperless classroom" is what more and more schools are trying to realize. Students don't do any handwriting in this class. Instead, they use hand-sized or specially-designed computers. The teacher downloads texts from Internet libraries and sends them to every student's personal computer.
Having computers also means that students can use the Web. They can look up information on any subject they're studying, from maths to social science.
A high school teacher, Judy Herrel in Florida, US, described how her class used the Web. "Using a book that's three or four years old is impossible," she said.
A paperless classroom is a big step towards reducing the waste of paper.
"Think about the money and trees we could save with the computers," she said.
But, with all this technology, there's always a risk that the machines will break down. So, in case of a power failure or a technical problem, paper textbooks should still be widely available for these students. [/INST] question: You are sure to find _ in a paperless classroom. | options: A: pens B: computers C: test papers D: notebooks | answer: B </s> |
<s>[INST] context: Warwick New York Hotel
This hotel offers you stylish rooms in a quiet neighborhood, just a short walk from some of New York's business streets. It's small. Family-owned hotel with 16 rooms. They provide not only comfortable rooms but also warm smiles and friendly greetings.
The Westpark Inn
The Westpark has 90 rooms and is close to Manhattan tourist centers. The hotel's rooms have been recently painted. On the Internet many travelers say it is below the usual standard and should be avoided. If you want to save money, you may have a try.
The Affinia Hotel
The Affinia is a good choice for experienced business travelers, families and international visitors. The 80 guest rooms are stylish and modern with good furniture. Guests who need more space might like the hotel's rooms. All the rooms have a kitchen.
The 60 Thompson
The 60 Thompson, with 100 beautiful guest rooms, is a stylish hotel in the heart of SoHo. Good use of dark wood and full-wall leather headboards give the hotel warmth. Guests can enjoy fine food in the hotel's Kittichhai restaurant and cocktails at Thom's Bar. [/INST] question: Which of the hotels does NOT have stylish guest room? | options: A: The Affinia Hotel B: The Westpark Inn C: Warwick New York Hotel D: She complained her father | answer: B </s> |
<s>[INST] context: Dear Liz,
My stay in Thailand has certainly been the experience of my life.
Life is busy and exciting.Bangkok is just like any other big city with a population of 10 million and heavy traffic.I'm very lucky because my host family is in a nice quiet area outside the city.There are Mr. and Mrs. Phairat, their son Sanan, who is 18, the daughter Chinda, who is 16, and Grandpa and Grandma.
I go to an international school with Sanan and Chinda.The school teaches about 70 percent in English,and 30 percent in Thai. I've learned some spoken language,but Thai writing is very difficult.The cooking lesson is my favourite.I'm learning all about Thai food and culture People don't use chopsticks here,but spoons and forks.When I come back,I'm going to cook you a real Thai meal.
Last weekend we visited some temples.We also drove to Pattaya beach near Bangkok.I thought it was great,but Sanan and Chinda say that next month they're taking me to Phuket Island,where the beaches are even more beautiful.The month after next,we're going to travel to Mr.Phairat,s hometown in the north of Thailand.The Phairats own land there,and they have two elephants.I'm going to ride those elephants -- and even wash them.Sanan and Chinda say it's really fun.
I'm amazed by everything in this country,especially by the elephants.Elephants are an important pan of Thai culture and way of life.They have been a traditional symbol of Thailand for many years in times of war and peace.In the seventh century,a Thai king trained 20,000 elephants for battle.
I'll tell you all about my Thai boxing lessons next time I write.
Love,
Mandy [/INST] question: How many family members are there in Mandy's host family? | options: A: 4 B: 5 C: 6 D: 7 | answer: C </s> |
<s>[INST] context: Animals can move from place to place, but plants cannot. When an animal is under attack, it can run away or fight back. Plants certainly cannot run away, and they lack teeth and claws. But plants can defend themselves by using both physical and chemical means.
Some plants have their own ways to keep animals away. For example, the leaves of the holly plant have sharp spines that discourage grass-eating animals. Holly leaves on lower branches have more spines than leaves on upper branches. This is because the lower leaves are easier for most animals to reach.
Some plants, such as the oak tree, have thick and hard leaves that are difficult for animals to eat. Some grasses may contain a sandy material; eating such grasses wears down the animal's teeth.
Many plants also have chemical defenses. Some plants produce chemicals that taste bitter or cause an unpleasant reaction. Some plants may fight against an attack by increasing the production of these chemicals. When a caterpillar bites a tobacco leaf, the leaf produces a chemical messenger. This messenger sends to the roots the information to produce more nicotine. The higher levels of nicotine discourage the caterpillar.
Many plants depend on both physical and chemical defenses. A certain plant in China, for instance, has prickly leaves, and each prickle contains poisonous venom A single experience with this kind of plant will teach an animal to stay away from it in the future. [/INST] question: To defend themselves, oak trees use _ . | options: A: chemical means B: physical means C: bitter chemicals D: sandy materials | answer: B </s> |
<s>[INST] context: Steroid-dependent patients, frequent relapses, and steroid-resistant patients may be candidates for alternative agents, paicularly if the child suffers severe coicosteroid toxicity (cushingoid appearance, hypeension, cataracts, and/or growth failure). Cyclophosphamide prolongs the duration of remission and reduces the number of relapses in children with frequently relapsing and steroid-dependent nephrotic syndrome. The potential side effects of the drug (neutropenia, disseminated varicella, hemorrhagic cystitis, alopecia, sterility, increased risk of future malignancy) should be carefully reviewed with the family before initiating treatment. The dose of cyclophosphamide is 2-3 mg/kg/24 hr given as a single oral dose, for a total duration of 8-12 wk. Alternate-day prednisone therapy is often continued during the course of cyclophosphamide administration. During cyclophosphamide therapy, the white blood cell count must be monitored weekly and the drug should be withheld if the count falls below 5,000/mm3 [/INST] question: A 7-year-old child has steroid dependent Nephrotic syndrome. His weight is 30 kg and height is106 cm. He is having truncal obesity with sub-capsular bilateral cataracts.Which is the best drug for this patient? | options: A: Mycophenolate B: Levamisole C: Cyclophosphamide D: Azathioprine | answer: C </s> |
<s>[INST] context: "Iodinated contrast Materials Water-soluble iodinated contrast media can be used to visualize the upper gastrointestinal tract. These contrast material are considered safer than barium sulfate in patients with esophageal perforation or communication between esophagus and airways and when there is a risk of aspiration onto the bronchi. They are also used for the examination of the esophagus in the early postoperative period following esophageal surgery or correction of hiatal hernia. The demonstration of leak is a contraindication for the withdrawal of the postoperative gastric tube. Water-soluble- Water-soluble iodinated contrast media can be classified by osmolality. High osmolality contrast media- High osmolality contrast media (HOCM) are approximately five to eight times the osmolality of serum. diatrizoate sodium/meglumine (Gastrografin, MD-Gastroview, Cystografin) iothalamate sodium/meglumine (Conray, Cysto-Conray) Low osmolality contrast media-Low osmolality contrast media (LOCM) are less than three times the osmolality of human serum and preferred for intravascular and intrathecal administration iopamidol (Isovue) iohexol (Omnipaque) - most safest used iopromide (Ultravist) ioversol (Optiray) ioxilan (Oxilan) [/INST] question: Safest contrast in esophageal perforation: | options: A: Iohexol B: Barium sulphate C: Gadolinium D: Hypaque | answer: A </s> |
<s>[INST] context: Typing Success in 20 Minutes a Day
-- Teaching Your K-12 Students to Type in 20 Minutes a Day
Typing is fast becoming an important skill in our world. Making this skill available to your students is very important. Just 20 minutes of the following activities per day will give your students the finger strength and keyboard knowledge they need to be ready to include typing in their learning programs.
Step 1 Knitting : You can try various styles until you find the one that best suits your students' abilities. Finger knitting is a great way to start! It helps students focus on finger strength. Knitting with needles is a little more challenging but will suit some older students. The more practice the fingers get the stronger they will become.
Step 2 Key board games: It helps your students become familiar with the keyboard. Students as young as four years old can practice finger placement, letter sounds and names using the keyboard of computers.
Step 3 Clay modeling: Many children develop the ability to be quick and skilful with their hands through creating clay models. The creative nature of this activity keeps children engaged for long periods of time. It helps keep fingers strong and supple.
Step 4 Lego building: Little fingers become strong when children pull apart little Lego time and time again. Because of the fun nature of this activity it helps build and does a lot to reinforce the ability to arrange things into an order -- another important aspect in typing.
Choose an age-appropriate, interactive and engaging typing program. All students are different and with firm finger skills typing can be easily learned in 20 minutes a day with the use of a mixture of these different approaches. [/INST] question: All the following steps can make one's fingers stronger EXCEPT _ . | options: A: Step4 B: Step3 C: Step2 D: Step1 | answer: C </s> |
<s>[INST] context: Amyloid deposits appear similar by light and electron microscopy, but actually represent a heterogeneous population of proteins that have a common teiary structure forming a beta-pleated sheet. Questions about the type of amyloid seen in different disease states are orites on examinations. Here are two tables to help you out: Systemic amyloidosis: Chronic active diseaseAA amyloid from serum amyloid- associated (SAA) protein from liver (choice A)Myelomas and related diseasesAL amyloid from immunoglobulin light chain (choice B)Chronic hemodialysisBeta2 microglobulin (related to high plasma levels) (choice C)Nephropathic hereditary forms (familial Mediterranean fever)AA amyloid from SAA (choice A)Cardiomyopathic hereditary forms (senile systemic amyloidosis)Prealbumin/transthyretin Neuropathic hereditary syndromesPrealbumin/transthyretin Localized amyloidosis: Senile cardiac amyloidosisAtrial natriuretic peptide-related fibrilsCerebral amyloid in Alzheimer disease, Down syndromeCerebral amyloid in Alzheimer disease, Down syndromeMedullary carcinoma of thyroidCalcitonin precursors (choice D)Isolated, massive, nodular deposits (skin, lung, urogenital tract)AL from light chains (choice B) [/INST] question: A 55-year-old diabetic man has a long history of renal failure. He is currently waiting for an organ for transplant and has been on hemodialysis in the interim. If this man develops amyloid deposits around his joints, they are likely to be composed of which of the following substances? | options: A: Amyloid-associated protein B: Amyloid light chains C: Beta2 microglobulin D: Calcitonin precursors | answer: C </s> |
<s>[INST] context: We bought a pair of geese one spring when they were both two weeks old. One was a female Chinese goose I named Su and her mate was a white goose I named Goose. They would follow us all around the yard talking to us whenever we came outside. At night, they stayed in a box in our kitchen until they were too big and then they stayed at night outside. They loved the river and soon began staying out all night on the river. Whenever I wanted to know where they were, I would make a honking noise , and they would answer me and come into the yard for their corn.
One night, I was woken up by loud noise. We ran out to see what was wrong. A raccoon had decided that some goose eggs would taste good and had come too close to the setting.When we found Su, the raccoon had caught her by her neck and was biting it.We drove it away and took Su to the garage, washed her wound and wrapped it up in a bandage.Goose knew she was there and wanted to be with her, so we opened the small garage door and he hurried in.After two days and nights, I released them back outside.
For the first three nights at dusk, we would get her and carry her into the garage for the night and Goose would come running behind us to join her there.We were touched by his devotion to her.We took off her bandage and she was fine so that next night, we had not planned to take her to the garage any longer.We were amazed, however, that when dusk fell that night, she climbed the back steps to our garage door waiting for us to come and get her in! They do not speak our language, but they know when people care about them and love them and they respond in kind. [/INST] question: The raccoon attacked Su one night because _ . | options: A: it thought goose eggs were delicious B: Su's nest was too close to the raccoon's C: it wanted to hunt the goose for food D: Su's appearance in the area annoyed it | answer: A </s> |
<s>[INST] context: The Kyoto Protocol is a plan created by the United Nations for the United Nations Framework Convention on Climate Change.The plan aims to reduce the amount of industrial gases released into the environment.Some scientists say carbon dioxide and other industrial gases are to blame for climate change around the world.The scientists say such gases build up in the atmosphere and trap heat below.They say this results in increasing temperatures and rising sea levels.
The plan is called the Kyoto Protocol because it was negotiated in Kyoto,Japan in December,1997.The goal of the agreement is to reduce the amount of emissions --industrial gases released to below the levels of 1990.
Nations responsible for at least 55%of the world's industrial carbon dioxide emissions had to approve the agreement before it could go into effect.The European Union and many other industrial nations quickly approved the Kyoto Protocol.They receive credit for their own emissions if they invest in cleaned technologies in developing nations.Developing nations do not have to meet the emissions requirements of the agreement.
The United States produced 36%of the world's carbon dioxide emissions in 1999.But the United States refused to approve the Kyoto Protocol.Before the Protocol was negotiated,the United States Senate voted that any treaty harmful to the economy of the United States could not be signed.President Bush has said that he supports the general idea of the treaty but will not send the treaty to the Senate for approval.Mr. Bush said that the agreement sets unfair differences between industrial and developing nations.He also said that the treaty could cause some Americans to lose their jobs.
After the United States rejected the Kyoto Protocol,approval by Russia was necessary for the agreement to come into effect.Russia approved the Protocol in November,2004 and the Kyoto Protocol went into effect on February 16th,2005.157 countries have approved the agreement. [/INST] question: How many years was the Kyoto Protocol negotiated before its coming into effect? | options: A: Nearly 1 year B: Nearly 6 years C: Nearly 8 years D: Nearly 15 years | answer: C </s> |
<s>[INST] context: Anatomical snuff box: The given picture shows anatomical snuff box which is a depression formed at the posterolateral side of the wrist and metacarpal by the extensor tendons passing into the thumb. Base of the triangle is at the wrist and apex is directed into thumb. It is most apparent when thumb is extended. Boundaries: Lateral: Abductor pollicis longus and extensor pollicis brevis tendons. Medial :Extensor pollicis longus tendon Floor: Scaphoid and trapezium the distal ends of the tendons of the extensor carpi radialis longus and extensor carpi radialis brevis Scaphoid Fracture: The commonest carpal injury is a fracture across the waist of the scaphoid bone . It is uncommon to see other injuries. In approximately 10% of individuals, the scaphoid bone has a sole blood supply from the radial aery, which enters through the distal poion of the bone to supply the proximal poion. When a fracture occurs across the waist of the scaphoid, the proximal poion therefore undergoes avascular necrosis. [/INST] question: An injury to the shown area can lead to fracture of which bone (FMGE June 2019) | options: A: Lunate B: Scaphoid C: Hamate D: Trapezium | answer: B </s> |
<s>[INST] context: The Chinese word"Shanzhai" means a small mountain village, but now it becomes an accepted name for fakes after" Shanzhai cell phones " produced by small workshops in southern China ,became popular in the mainland market over the past few years.
Besides" Shanzhai" electronic products, there are "Shanzhai" movies, "Shanzhai" stars and even a "Shanzhai" Spring Festival Gala, a copy of the 25-year-old traditional show presented by CCTV on Chinese Lunar New Year's Eve.
" Shanzhai" has become a culture of its own,symbolizing anything that _ something famous.
The phenomenon has caused a public debate over whether it is healthy or sick being a copycat.
In southwestern China's Chongqing Municipality,a "Shanzhai" -version"Bird's Nest" woven by farmers with bamboo attracts wide attention and the"Shanzhai"-version "Water Cube"is popular with tourists too. Both are copies of the famous Olympics buildings in Beijing.
Xie Xizhang,a literature critic,said that taking the "Shanzhai" Gala as an example, when the traditional CCTV program becomes less and less attractive to the audience, the "Shanzhai" version appears naturally to attract people.
"In spite of its poor techniques and operation, 'Shanzhai' culture meets the psychological demands of common people and could be a comfort to their minds," Xie said.
Tian Huiqun,a professor at Beijing Normal University,said that "Shanzhai" culture never copies classic things,only trendy products. In that sense,it's like a computer virus, multiplying without meaning.
Though controversial,"Shanzhai" culture is becoming a widely accepted phenomenon.
"To the mainstream culture, the rise of 'Shanzhai' culture is a challenge as well as a motivation," said Xie.
Tian said different kinds of cultures developing together is an ideal situation and it is for the public to choose. [/INST] question: The Chinese word "Shanzhai" may have its origin in _ . | options: A: fake cell phones B: electronic products C: Spring Festival Gala D: Olympics buildings | answer: A </s> |
<s>[INST] context: The median
A median is described as the value separating the higher half of a data set from the lower half.
It does not depend on the total, and number of items.
To obtain the median, the data is first arranged in an ascending or descending order of magnitude, and then the value of the middle observation is located, which is called median.
For example, diastolic BP of 9 individuals was as follows -
83, 75, 81, 79, 71, 95, 75, 77, 84
Now data is arranged in ascending order -
71, 75, 75, 77, 79, 81, 83, 84, 95
Here, 79 is the middle observation that is separating the upper four values from lower four values, so it is the median.
If there are two values in the middle instead of one, the median is worked out by taking the average of the two middle values.
For example, If diastolic BP of 10 individuals is as follows :-
83, 75, 81, 79, 71, 95, 75, 77, 84, 90
Data is arranged in ascending order -
71, 75, 75, 77, 79, 81, 83, 84, 90, 95
Here two values are separating the upper half of values from lower half. So the median here is -
Median = (79 + 81) / 2 = 80
Advantage of median
The value of median is not affected by abnormal very high or very low value.
Taking the example as was taken in mean -
The income of 7 people per day in rupees is as follows
5, 5, 5, 7,10, 20, 300 = (Total 352)
Here mean = 50.3
median = 7
The value of mean has affected seriously, whereas median is not affected, and median is more nearer to the truth.
So, median is used when the distribution of values is skewed (deviated) with some small number of very high values → median is used for skewed distribution. [/INST] question: Determination of which statistical parameter requires quantities to be arranged in an ascending or descending order's - | options: A: Mean B: Median C: Mode D: S.D | answer: B </s> |
<s>[INST] context: News 1 : Have you ever thought of being able to fly around the world in a few hours though it is about 40,000 kilometers? One day,maybe you can. Last Saturday,the American X-43A airplane made its first flight. It reached a speed of 8,000 kilometres an hour. This makes it the fastest plane in the world. The X-43A is only three to four metres long,but it's very heavy:it weighs 1,270 kilogrames.
News 2 : Have you ever got angry at books that are full of mistakes? Don't worry,things will get better soon. Last week,China started checking textbooks,dictionaries and children's books all over the country. The government said the results of the checking would come out at the end of June.
News 3 : There will be a new "star" in the sky soon. China plans to send a satellite into space by December 2006. It will stay in space for one year. It will go around the moon and take pictures. It must be very expensive,right? That's for sure-1. 4 billion yuan!
News 4 : Floods across the northern Mexican state of Coahuila killed at least 32 people and left100 more missing. It was reported on Monday. The heavy rain hit the state all night last Friday,so some banks of the river were broken. Along the river about 3,000 families were seriously affected . [/INST] question: If the X-43A goes around the earth,it will take about _ hours to finish the trip. | options: A: 3 B: 5 C: 8 D: 12 | answer: B </s> |
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